Diabetic striatopathy: a rare condition and diagnostic dilemma

Primary umbilical endometriosis is a rare condition with an overall incidence of around 0.5% to 1% among all the endometriosis cases, but at times it poses a diagnostic dilemma. In our institution we encountered a case of primary umbilical endometriosis presented to multiple surgical speciality departments. A prompt clinical examination with surgical biopsy was the key tool which lead to the diagnosis and providing a complete cure for the patient. Pelvic endometriosis affects 5-10% of women in the child bearing age group. The most pronounced symptoms are dyspareunia, pelvic pain, and infertility. Clinical presentations of umbilical endometriosis are as a nodule with or without associated umbilical pain and bleeding. This patient was given primary hormonal therapy and later underwent a biopsy which paved way for an accurate diagnosis of primary umbilical endometriosis. In this case of umbilical swelling, conditions like a benign nevus, lipoma, abscess, cyst, hernia, as well as metastatic deposit from a systemic malignancy were considered in the clinical differential diagnosis. However surgical excision helped us arrive at a definitive diagnosis and cure for the patient.

Download Full-text

Rare presentation of isolated hydatid disease of the breast

BMJ Case Reports ◽

10.1136/bcr-2021-243052 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243052

Author(s):

Ronal Kori ◽

Sudhir Kumar Jain ◽

Rehan Nabi Khan

Keyword(s):

Hydatid Cyst ◽

Echinococcus Granulosus ◽

Hydatid Disease ◽

Similar Case ◽

Rare Condition ◽

Rare Presentation ◽

Diagnostic Dilemma ◽

Endemic Areas ◽

Accidental Host ◽

Cattle And Sheep

Isolated hydatid disease of the breast is a rare condition, possessing a diagnostic dilemma for the clinicians. Hydatid disease is common in endemic areas affecting most commonly the liver and lungs. Other organs rarely involved are the kidney, bone and brain. It is caused by the parasite Echinococcus granulosus, widely spread by cattle and sheep. Humans are the accidental host for this organism. We present a similar case of isolated hydatid cyst of the breast, which was diagnosed preoperatively and managed successfully.

Download Full-text

Bilateral Facial Nerve Palsy: A Diagnostic Dilemma

Case Reports in Emergency Medicine ◽

10.1155/2012/458371 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Sohil Pothiawala ◽

Fatimah Lateef

Keyword(s):

Differential Diagnosis ◽

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Rare Condition ◽

Facial Nerve Paralysis ◽

Diagnostic Challenge ◽

Radiological Investigation ◽

Diagnostic Dilemma ◽

Nerve Paralysis

Introduction. Bilateral facial nerve palsy (FNP) is a rare condition, representing less than 2% of all cases of FNP. Majority of these patients have underlying medical conditions, ranging from neurologic, infectious, neoplastic, traumatic, or metabolic disorders.Objective. The differential diagnosis of its causes is extensive and hence can present as a diagnostic challenge. Emergency physicians should be aware of these various diagnostic possibilities, some of which are potentially fatal.Case Report. We report a case of a 43-year-old female who presented to the emergency department with sequential bilateral facial nerve paralysis which could not be attributed to any particular etiology and, hence, presented a diagnostic dilemma.Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant.

Download Full-text

Multiple Symmetric Lipomatosis: A Diagnostic Dilemma

Case Reports in Medicine ◽

10.1155/2013/836903 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Mladen Mimica ◽

Danijel Pravdic ◽

Emina Nakas-Icindic ◽

Maja Karin ◽

Emil Babic ◽

...

Keyword(s):

Rare Condition ◽

Fat Distribution ◽

Diagnostic Dilemma ◽

Disease Etiology ◽

Neck Masses ◽

Multiple Symmetric Lipomatosis ◽

Madelung's Disease ◽

Madelung’S Disease ◽

High Incidence ◽

History Of

Introduction. Multiple symmetric lipomatosis, or Madelung's disease, is a rare condition which is characterized with large symmetrical accumulation of noncapsulated fat tissue in upper arms, neck, and shoulder areas. The disease etiology is unknown, with the highest incidence in the Mediterranean region.Case Presentation. Here, we present the case of Madelung's disease with symmetric fat distribution throughout the neck and history of alcoholism. The patient was treated from several diseases associated with alcoholism and hospitalized several times, but the diagnosis of Madelung's disease was omitted. The thyroid gland disease was excluded, while enlargement of the neck adipose tissue was attributed to obesity.Conclusions. This study points out possible diagnostic mistakes when a physician is not aware of a differentiation diagnosis of symmetrically enlarged neck masses, especially in geographic regions with high incidence of this disease.

Download Full-text

Concordant Ventriculoarterial Connections With Parallel Arterial Trunks, Divided Left Atrium, and Juxtaposed Atrial Appendages

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135111429472 ◽

2012 ◽

Vol 3 (2) ◽

pp. 260-263

Author(s):

Sachin Talwar ◽

Vinitha Vishambaran Nair ◽

Shiv Kumar Choudhary ◽

Gurpreet Singh Gulati ◽

Robert H. Anderson ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Left Atrium ◽

Septal Defect ◽

Rare Condition ◽

Morphological Features ◽

Cor Triatriatum ◽

Diagnostic Dilemma ◽

Cor Triatriatum Sinister

We describe a patient with concordant ventriculoarterial connections with parallel arterial trunks, divided left atrium (cor triatriatum sinister), ventricular septal defect, bilateral superior caval veins, and juxtaposed atrial appendages. The aorta was anterior and left sided. We discuss the morphological features of this rare condition, and the diagnostic dilemma it produced.

Download Full-text

Rare case of a 3-year-old with Candida skull base osteomyelitis: lessons to be learnt

BMJ Case Reports ◽

10.1136/bcr-2018-228026 ◽

2019 ◽

Vol 12 (4) ◽

pp. e228026 ◽

Cited By ~ 2

Author(s):

Johan Bastianpillai ◽

Sidrah Chaudhry ◽

Ananth Vijendren

Keyword(s):

Skull Base ◽

Rare Case ◽

Rare Condition ◽

Good Effect ◽

Microbiological Analysis ◽

Diagnostic Dilemma ◽

Skull Base Osteomyelitis ◽

Cortical Mastoidectomy ◽

Ct Head ◽

Initial Improvement

Skull base osteomyelitis (SBO) is a serious and rare condition most commonly seen in elderly diabetic or immunocompromised patients as a complication of otitis externa. We present the case of a previously healthy 3-year-old girl who presented to the paediatric emergency department with vomiting, fever, lethargy, headache and left-sided facial nerve palsy. The initial CT head revealed left-sided otitis media with otomastoiditis and she was managed with intravenous antibiotics and myringotomy with grommet insertion with initial improvement. Two weeks later she re-presented having deteriorated and a dedicated mastoid CT and temporal bone MRI showed SBO. She underwent urgent cortical mastoidectomy where microbiological analysis of the cultures and specimen grew Candida albicans. She was subsequently treated with long-term antifungals and antibiotics, and eventually recovered with good effect. The diagnostic dilemma and the empirical treatment of such a rare case are discussed.

Download Full-text

ADULT BOCHDALEK HERNIA: AN UNUSUAL PRESENTATION AND DIAGNOSTIC DILEMMA.

International Journal of Advances in Scientific Research ◽

10.7439/ijasr.v1i2.1802 ◽

2015 ◽

Vol 1 (2) ◽

pp. 111

Author(s):

Nikhil S Shetty ◽

Vijay P Agrawal ◽

Ashwin Narasimhaprasad

Keyword(s):

Pleural Effusion ◽

Physical Examination ◽

Rare Condition ◽

Chest Ct ◽

Delayed Presentation ◽

Bochdalek Hernia ◽

Diagnostic Dilemma ◽

X Ray ◽

Chest X Ray ◽

Chest Ct Scan

Bochdalek hernia is a rare condition in adult and usually diagnosis is missed. It is usually mistakenly diagnosed as TB, pleural effusion, empyema, lung cyst and pneumothorax. Delayed presentation is not uncommon. We present a case of 18 year old male patient who was misdiagnosed as having left sided pleural effusion with TB and associated gastritis for three days and later referred to our institution. Diagnosis was established by physical examination, chest x-ray and chest CT- scan. Per operatively a gangrenous ileal segment was seen of about 10 cms which was later resected. The Hernia was later closed with Prolene sutures.

Download Full-text

Abdominal Wall Endometrioma: A Diagnostic Enigma—A Case Report and Review of the Literature

Case Reports in Obstetrics and Gynecology ◽

10.1155/2019/6831545 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Ketan Vagholkar ◽

Suvarna Vagholkar

Keyword(s):

Case Report ◽

Abdominal Wall ◽

Clinical Evaluation ◽

Wide Local Excision ◽

Rare Condition ◽

Review Of The Literature ◽

Diagnostic Dilemma ◽

Adequate Treatment ◽

Extrapelvic Endometriosis ◽

Prompt Diagnosis

Background. Abdominal wall endometriomas are quite uncommon. They are usually misdiagnosed by both the surgeon and the gynaecologist. Awareness of the details of this rare condition is therefore essential for prompt diagnosis and adequate treatment. Introduction. Endometriosis though a condition commonly seen in the pelvic region can also occur at extrapelvic sites giving rise to a diagnostic dilemma. Abdominal wall endometrioma is one such complex variant of extrapelvic endometriosis with an incidence of less than 2% following gynaecologic operations. Case Report. A case of abdominal wall endometrioma diagnosed clinically and treated by wide surgical resection is presented to highlight the importance of clinical evaluation in the diagnosis of this condition. Discussion. The etiopathogenesis, presentation, investigations, and management are discussed briefly. Conclusion. Clinical evaluation confirmed by supportive imaging is diagnostic. Wide local excision is the mainstay of treatment.

Download Full-text

Spontaneous Haemoperitoneum in Pregnancy- A Diagnostic Challenge

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45142.14184 ◽

2020 ◽

Author(s):

Niranjan Mayadeo ◽

Anusha Devalla

Keyword(s):

Caesarean Section ◽

Acute Pain ◽

Rare Condition ◽

Fetal Outcome ◽

Emergency Caesarean Section ◽

Posterior Surface ◽

Diagnostic Challenge ◽

Diagnostic Dilemma ◽

Emergency Caesarean ◽

In Pregnancy

Spontaneous haemoperitoneum in pregnancy is an extremely rare condition that poses a diagnostic dilemma for the obstetrician. The authors here present a case of 23-year-old primigravida presenting at 34-weeks with acute pain in abdomen masquerading as clinical chorioamnionitis secondary to prolonged rupture of membranes. Abdomen palpation revealed uterine tenderness and pathological cardiotocography tracings suggesting the need for immediate delivery of the foetus by emergency caesarean section. Intraoperatively, there was haemoperitoneum (800 mL) and bleeding superficial uterine serosal veins on the posterior surface of uterus seen on exploration. The patient was successfully managed with favourable maternal and fetal outcome.

Download Full-text

M5 segment aneurysm presenting as “pure acute SDH”

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.140002 ◽

2014 ◽

Vol 05 (04) ◽

pp. 402-404 ◽

Cited By ~ 5

Author(s):

Navneet Singla ◽

Manjul Tripathi ◽

Rajesh Chhabra

Keyword(s):

Subarachnoid Hemorrhage ◽

Head Injury ◽

Subdural Hematoma ◽

Artery Aneurysm ◽

Rare Condition ◽

Acute Subdural Hematoma ◽

Middle Cerebral Artery Aneurysm ◽

Diagnostic Dilemma ◽

Outpatient Departments ◽

Cerebral Artery Aneurysm

ABSTRACTSpontaneous "pure acute subdural hematoma (SDH)" is arguably a rare condition. We report on a pregnant female patient presenting as spontaneous acute SDH without subarachnoid hemorrhage (SAH) due to rupture of distal (M5 segment) middle cerebral artery aneurysm. We hereby discuss the diagnostic dilemma of this rare condition, along with the need for watchful evaluation of acute SDH without preceding head injury presenting in emergency outpatient departments, especially when it is first encountered by a trainee resident.

Download Full-text