scholarly journals Orbital Lymphoma Masquerading as Orbital Cellulitis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
B. D. Chaurasiya ◽  
Ganesh Agrawal ◽  
Santosh Chaudhary ◽  
Sangeeta Shah ◽  
Anju Pradhan ◽  
...  
Keyword(s):  
Sudden Onset ◽  
Orbital Cellulitis ◽  
Radiological Investigation ◽  
Diagnostic Dilemma ◽  
Non Hodgkin Lymphoma ◽  
Oral Steroids ◽  
Orbital Lymphoma ◽  
Atypical Presentations ◽  
The Right ◽  
Enhanced Computed Tomography

Background. Orbital lymphomas are primarily non-Hodgkin type and can originate from the eyelids, extraocular muscles, soft tissue orbital adnexa, conjunctiva, or lacrimal glands. Orbital malignancies often represent a diagnostic dilemma for clinicians given their varying and atypical presentations. Objective. To report a case of orbital lymphoma mimicking orbital cellulitis. Case. A 66-year-old male patient presented with sudden onset of painful proptosis with visual impairment in the left eye for 15 days. On ocular examination, best-corrected visual acuity was 6/12 in the right eye and 2/60 in the left eye, abaxial proptosis with hypertropia, swollen and erythematous eyelids, restricted extraocular movement in all cardinal position of gaze, conjunctival congestion with chemosis and tortuous vessels, sluggish pupillary reaction, and chorioretinal folds in the inferior quadrants. The case was diagnosed as left eye orbital cellulitis, and the patient was treated with broad-spectrum intravenous antibiotics and oral steroids. No clinically discernible response was noted despite 7 days of antibiotics and steroids. Contrast-enhanced computed tomography (CECT) orbit showed features suggestive of orbital lymphoma involving the ipsilateral maxillary and ethmoid sinuses. ENT consultation with diagnostic nasal endoscopy and biopsy was done. Histopathological reports showed features of non-Hodgkin lymphoma. Conclusion. Orbital malignancies masquerading as orbital cellulitis can pose a diagnostic dilemma. A multidisciplinary approach involving ENT consultation, radiological investigation, and pathological sampling can help achieve a timely diagnosis and appropriate management.

scholarly journals Orbital Cellulitis Following Uncomplicated Glaucoma Drainage Device Surgery: Case Report and Review of Literature

2020 ◽  
Author(s):  
Cindy X. Zheng ◽  
Joshua H. Uhr ◽  
Jordan D. Deaner ◽  
Michael M. Lin ◽  
Stephen J. Moster ◽  
...  
Keyword(s):  
Case Report ◽  
Postoperative Complication ◽  
Fluid Collection ◽  
Orbital Cellulitis ◽  
Glaucoma Drainage Device ◽  
Source Control ◽  
Drainage Device ◽  
Minimal Improvement ◽  
The Right ◽  
Enhanced Computed Tomography

Purpose: Orbital cellulitis (OC) is a rare postoperative complication of glaucoma drainage device (GDD) implantation. To date, there have only been 10 reported cases of OC following GDD implantation. Case Report: Here, we report a case of OC in a 57-year-old man who developed pain, proptosis, and limited extraocular motility two days after uneventful Ahmed FP7 implantation in the right eye. Contrast-enhanced computed tomography of the orbits demonstrated fat stranding and a small fluid collection, consistent with OC. He had minimal improvement with intravenous antibiotics and ultimately underwent GDD explantation. A systematic review of the literature showed that the development of OC following GDD implantation can occur in the early or late postoperative period. Immediate hospitalization with intravenous administration of broad-spectrum antibiotics is recommended. Explantation of the infected GDD is often required for source control. Conclusion: OC is a rare postoperative complication of GDD implantation. Prompt evaluation and treatment are required, often combined with GDD explantation.

scholarly journals Blunt Trauma Associated With Bilateral Diaphragmatic Rupture: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Marco Pace ◽  
Damiano Vallati ◽  
Elena Belloni ◽  
Marco Cavallini ◽  
Mohsen Ibrahim ◽  
...  
Keyword(s):  
Ct Scan ◽  
Rare Event ◽  
Sudden Onset ◽  
Diaphragmatic Rupture ◽  
Left Hemidiaphragm ◽  
Preoperative Ct ◽  
General Surgeons ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Car Accident

Background: A bilateral diaphragmatic rupture is a rare event that occurs in cases of blunt thoracic-abdominal trauma.Case Presentation: We report the case of a 56-year-old female patient with pelvic fracture and second-stage bilateral rupture of the diaphragm due to a car accident. After a chest and abdominal contrast-enhanced computed tomography (CT) scan, the patient underwent emergency suturing of the left hemidiaphragm. On postoperative day (POD) 4, a CT scan performed due to the sudden onset of dyspnea revealed rupture of the right hemidiaphragm, which was not detected on the preoperative CT scan. On POD 9, the right hemidiaphragm was repaired with mesh during a right thoracotomy. The patient recovered 14 days after surgery. However, the postoperative course was complicated by an asymptomatic COVID-19 infection that significantly delayed her discharge from the hospital.Conclusions: Difficulties in preoperative diagnosis and treatment, together with the lack of data in the literature, make this type of trauma a challenge for all acute care and general surgeons.

scholarly journals Orbital pseudotumor masquerading orbital cellulitis

2021 ◽  
Vol 7 (2) ◽  
pp. 213-216
Author(s):  
Hannah Ranjee Prasanth ◽  
Suriya Djeamourthy ◽  
S. Veni Priya ◽  
Justin Prashanth JP ◽  
Renuka Srinivasan
Keyword(s):  
Rectus Muscle ◽  
Orbital Cellulitis ◽  
High Dose ◽  
Ocular Movements ◽  
Lateral Rectus Muscle ◽  
Oral Steroids ◽  
Dose Oral ◽  
Ocular Pressure ◽  
The Right ◽  
Fat Stranding

Here with presenting a case of pseudotumor orbit initially diagnosed as orbital cellulitis which responded to steroids. A 44 year old male presented with complaints of swelling, redness, watering and inability to open the right eye for 1 day. He had no h/o trauma or insect bite. On examination, visual acuity in both eyes was 6/6. The right eye was proptosed with gross restriction of the extra ocular movements, conjunctival congestion and chemosis. The intra ocular pressure was 52 mm Hg. The left eye was normal. CT orbit showed enlargement of right lateral rectus muscle and lacrimal gland, with fat stranding and soft tissue thickening of periorbital, pre septal and perinasal regions diagnostic of pseudotumor tumour. He was started on high dose oral steroids with which he improved dramatically.

scholarly journals Giant hepatic capillary hemangioma, a diagnostic dilemma: case report

2021 ◽  
Vol 8 (5) ◽  
pp. 704
Author(s):  
Arkadeep Dhali ◽  
Anirban Hazra ◽  
B. Rathna Roger ◽  
Gopal Krishna Dhali ◽  
Avik Sarkar
Keyword(s):  
Histopathological Examination ◽  
Capillary Hemangioma ◽  
Vascular Lesions ◽  
Benign Tumors ◽  
Diagnostic Dilemma ◽  
Contrast Enhanced ◽  
One Year ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Upper Abdomen

Hepatic Hemangiomas (HH) are benign tumors of the liver consisting of a blood-filled cavity supplied by the hepatic artery. Most of the HH are asymptomatic and are discovered incidentally during radiological imaging of various unrelated pathology. Typical capillary hemangiomas range from a few millimeters to three centimeters and are unlikely to generate any future symptomatology. However, giant liver hemangiomas (more than 10 cm) are a very rare entity and might become symptomatic, hence requiring prompt intervention. We are reporting this case to make the readers aware of the pitfalls and radiological uncertainties while interpreting vascular lesions of the liver. We reported a case of a 21-year-old female with complaint of awareness of a mass over the right upper abdomen since a period of one year which has been gradually increasing in size. On pre-operative Contrast-Enhanced Computed Tomography, features suggestive of Fibrolamellar variant of Hepatocellular Carcinoma was found which was substantiated by biochemical investigations. However, post-operative histopathological examination revealed a capillary hemangioma.

scholarly journals Extranasopharyngeal Angiofibroma: A Diagnostic Dilemma

2018 ◽  
Vol 33 (1) ◽  
pp. 39-42
Author(s):  
Nitin Gupta ◽  
Arjun Dass ◽  
Vaibhav Saini ◽  
Shashikant Anil Pol ◽  
Lovekesh Mittal
Keyword(s):  
Diagnostic Dilemma ◽  
X Ray ◽  
Contrast Enhanced ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Design Case ◽  
Atypical Presentations ◽  
Extranasopharyngeal Angiofibroma ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Objective: To report two cases of extranasopharyngeal angiofibroma, highlighting the diagnostic challenges involved. Methods:             Design:           Case Report             Setting:           Tertiary Teaching Hospital and Medical School             Patients:         Two (2) Results: A 13-year-old boy who presented with epistaxis and a vascular mass on the posterior nasal septum that enhanced on contrast-enhanced computed tomography (CECT), and a 3-year-old boy who presented with dysphagia and mild respiratory difficulty, with a large naso-oropharyngeal mass arising from the soft palate on physical and x-ray examination that could not be corroborated because stridor developed during sedation for CECT, both underwent endoscopic tumor excision. Conclusion: As illustrated in these cases, atypical presentations of extranasopharyngeal angiofibromas can pose a considerable diagnostic and surgical challenge for clinicians.    Key words: angiofibroma: classification; diagnosis; diagnostic imaging; extranasopharyngeal

Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

2014 ◽  
Vol 17 (4) ◽  
pp. 196
Author(s):  
Erhan Kaya ◽  
Halit Yerebakan ◽  
Daniel Spielman ◽  
Omer Isik ◽  
Cevat Yakut
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Right Coronary Artery ◽  
Type A ◽  
Sudden Onset ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Syndrome ◽  
Bentall Procedure ◽  
The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

Renal Infarction and Pulmonary Embolism in Patient with Myelodysplastic

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mounia Bendari ◽  
Nouama Bouanani ◽  
Mohamed Amine Khalfaoui ◽  
Maryam Ahnach ◽  
Aziza Laaraj ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Myeloproliferative Neoplasms ◽  
Bone Biopsy ◽  
Bone Marrow Aspiration ◽  
Myeloproliferative Disorders ◽  
Acute Onset ◽  
International Prognostic Scoring System ◽  
Renal Infarction ◽  
The Right ◽  
Enhanced Computed Tomography

The myelodysplastic syndrome-myeloproliferative neoplasms (MDS/MPNs) are defined by a group of heterogeneous hematological malignancies resulting from stem cell−driven clonal growth of pathological hematopoietic progenitors and ineffective hematopoiesis, they are characterized concomitant myelodysplastic and myeloproliferative signs. Myelodysplastic/myeloproliferative disorders have been considered to have a higher risk of thrombus formation.We report a rare case about a 64 years old Moroccan woman, experienced renal infarction (RI) associated with pulmonary embolism as a complication of a myelodysplastic/myeloproliferative disorder.The patient complained of acute-onset severe left flank pain, a contrast-enhanced computed tomography (CT) of the chest and abdomen revealed RI by a large wedge-shaped defect in the right kidney with pulmonary embolism.Biological exam showed deep anemia, the bone marrow aspiration found myelodysplasia.the bone biopsy showed signs of myeloproliferatif disease. The karyotype was normal, BCR-ABL, JAK2, CALR mutations were absents, and MPL mutation was positive. The International Prognostic Scoring System (IPSS-R) was 0, and the patient was included to the low risk group.Anticoagulation therapy was initiated with heparin to treat RI and pulmonary embolism. Three months later, pulmonary embolism had resolved without the appearance of additional peripheral infarction.This case emphasizes the need to consider myelodysplastic/myeloproliferative disorders as a cause of infraction renal and pulmonary embolism.

Unusual case of soft palate and uvula haematoma in a patient on anticoagulant drugs

2020 ◽  
Vol 13 (12) ◽  
pp. e236513
Author(s):  
Stephanie Farrugia ◽  
Karl Sapiano ◽  
Robert Sciberras
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Soft Palate ◽  
Unusual Case ◽  
Sudden Onset ◽  
Anticoagulant Drugs ◽  
International Normalised Ratio ◽  
Oral Steroids

A 91-year-old Caucasian man on warfarin for atrial fibrillation presented in view of sudden-onset haemoptysis with fresh bleeding with clots immediately after having eaten a piping-hot traditional cheesecake (pastizz) and burning the soft-palate of his mouth. The haemoptysis had resolved by the time that the patient had arrived to hospital. On examination, a 2 cm by 2 cm dark red, solitary mass could be seen just anterior to the uvula. This was not causing any pain or discomfort to the patient. Blood results were mostly unremarkable except for a raised international normalised ratio (INR) of 3.53. The patient was administered 5 mg vitamin K orally in attempt to lower the INR level and warfarin was subsequently omitted for 7 days. He was also prescribed oral steroids on discharge. The lesion resolved in 7 days and warfarin was restarted then with no further consequences.

scholarly journals Recurrence hernia in the broad ligament of the uterus: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yoshifumi Hashimoto ◽  
Tatsuo Kanda ◽  
Tadasu Chida ◽  
Kazuyoshi Suda
Keyword(s):  
Small Bowel ◽  
Rare Disease ◽  
Broad Ligament ◽  
Significant Risk ◽  
Disease Recurrence ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Bowel Segments ◽  
Hernia Orifice ◽  
Bowel Herniation

Abstract Background Bowel herniation through a defect in the broad ligament of the uterus is a rare disease and few cases of recurrence have been reported. We report herein a recurrence case of a patient with broad ligament hernia (BLH), along with a review of the literature. Case presentation A 53-year-old woman complaining of abdominal pain was transported to our hospital. She had a history of laparotomy for small-bowel obstruction associated with hernia in the broad ligament of the uterus 10 years ago at a local hospital. Abdominal pelvic contrast-enhanced computed tomography revealed that the mesentery of the dilated bowels converged at a thick band in the pelvis, suggesting closed loop obstruction of the small bowel. The patient underwent urgent laparotomy and was diagnosed with bowel herniation through an opening in the broad ligament of the uterus on the right side, which was ipsilateral with the previous surgery. The hernia orifice was widened by incision and incarcerated bowel segments were released and preserved because ischemia was reversible. The membranous defect of BLH was closed by suture with braded silk strings. Conclusions Although BLH is a rare disease, patients face a significant risk of disease recurrence. Nonabsorbable suture may be advisable for closure of the hernia orifice in BLH.

scholarly journals Unilateral mydriasis in a child with a ventriculoperitoneal shunt for obstructive hydrocephalus: a diagnostic dilemma

2020 ◽  
Vol 13 (12) ◽  
pp. e237257
Author(s):  
Monidipa Banerjee ◽  
Eiman Haj Ahmed ◽  
Kathryn Foster ◽  
Arundoss Gangadharan
Keyword(s):  
Ipratropium Bromide ◽  
Obstructive Hydrocephalus ◽  
Sudden Onset ◽  
Unique Case ◽  
Diagnostic Dilemma ◽  
Vp Shunt ◽  
Life Threatening ◽  
Unilateral Mydriasis ◽  
The Brain ◽  
Rule Out

There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.

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