scholarly journals Temporary Kerato-Prosthesis to Resolve Traumatic Loss of a Healed Corneal Button

2021 ◽  
Vol 12 (1) ◽  
pp. 254-258
Author(s):  
Alessandra Balestrazzi ◽  
Alessandro Di Maggio ◽  
Paolo Michieletto ◽  
Gianluca Martone ◽  
Angelo Balestrazzi
Keyword(s):  
Rare Case ◽  
Complete Loss ◽  
Donor Cornea ◽  
Slit Lamp ◽  
Traumatic Loss ◽  
Surgical Units ◽  
Open Globe ◽  
Operating Theatres ◽  
History Of ◽  
Corneal Button

The aim of this study is to report a rare case of traumatic complete loss of a donor corneal button successfully resolved by a 24-h implantation of a temporary kerato-prosthesis. A healthy 30-year-old man with a history of prior penetrating keratoplasty (PKP) presented with an open globe following accidental contusive trauma with a ball, while he was playing football. At slit-lamp evaluation, complete dehiscence of the wound at the graft-host junction and complete corneal button loss was evident. The patient was immediately taken to the operating room, but a donor cornea was not available; therefore, a vitreo-retinal temporary kerato-prosthesis was implanted to close the eyeball until a new donor cornea was available. In case of complete dehiscence of the donor-host junction after PKP with corneal button loss, it is possible to use a temporary kerato-prosthesis to stabilize the eye and contain the intraocular structures. We recommend the availability of temporary vitreo-retinal kerato-prosthesis in the operating theatres of Corneal Surgical Units.

scholarly journals Corneal erforation casused by eyelid margin trichilemmal carcinoma: A case report

2019 ◽  
Author(s):  
Liying Zhang ◽  
Zhirong Lin ◽  
Huping Wu
Keyword(s):  
Rare Case ◽  
The Elderly ◽  
Corneal Perforation ◽  
Slit Lamp ◽  
Blurred Vision ◽  
Eyelid Margin ◽  
Case Presentation ◽  
Adnexal Tumor ◽  
History Of

Abstract Background: Trichilemmal carcinoma (TLC) is a rare malignant adnexal tumor predominantly affecting the scalp, eyelids, neck and face of the elderly. Here, we firstly report a rare case of corneal perforation caused by TLC grown in eyelid margin. Case presentation: A 68-year-old female presented with two months history of unprovoked redness, pain and blurred vision in the left eye. On slit-lamp examination, a 1×2mm aseptic corneal perforation embedded by iris prolapsed was noted. After excluding other causes through examinations and case history inquiry, we speculated that the severe MGD and subsequent BKC might be the cause. In order to prevent the ulcer enlargement and intraocular infection, the patient was treated with penetrating keratoplasty immediately. However, a terrible phenomenon has aroused our concern that several small nodules gradually developed on the eyelid margin, accompanied with bleeding, burst and madarosis postoperatiely. The biopsy revealed the eyelid was involved by TLC and then the lesionectomy was performed immediately. There was no evidence of local recurrence and metastasis during 1 year follow-up. Conclusions: The involvement of eyelid margin by TLC, and subsequent BKC and corneal perforation were very rare and it has not been reported yet. The concomitant BKC can be gradually healed after rectifying eyelid margin by total excision of TLC. It is very important to offer careful follow-up to all patients.

scholarly journals The case of missing punctum

2020 ◽  
Vol 2 (3) ◽  
pp. 242-244
Author(s):  
Anubhav Chauhan ◽  
◽  
Anchit Wapa ◽  
Deepak Sharma ◽  
Pankaj Thakur ◽  
...  
Keyword(s):  
Rare Case ◽  
Slit Lamp ◽  
History Of

We report a case of a 25-year-old male with a long history of watering from both the eyes. Complete ocular examination of the patient was carried out under slit lamp. Out of four, three punctums were found absent in our patient. Our case highlights a rare case of epiphora from both the eyes.

A rare case of duodenal cancer with achalasia cardia

2019 ◽  
Vol 22 (2) ◽  
pp. 32-34
Author(s):  
Kartikesh Mishra
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Similar Case ◽  
Barium Meal ◽  
Duodenal Adenocarcinoma ◽  
Gastrointestinal Malignancies ◽  
Achalasia Cardia ◽  
Proliferative Growth ◽  
History Of ◽  
Duodenal Carcinoma

Duodenal adenocarcinoma constitutes 0.4% of gastrointestinal malignancies. Achalasia incidence rate is 0.5-1.2 per 100000. The combination is rare. This is a report of a 68-year-old male from Nepal with history of five years abdominal pain, dysphasia and weight loss. Duodenoscopy could confirm ulcero-proliferative growth at D1-D2. Barium meal depicted features of achalasia cardia. No similar case report suggests that occurrence of duodenal carcinoma and achalasia cardia is merely co- incidental. Discussion: No similar case report suggests that occurrence of duodenal carcinoma and achalasia cardia is merely co- incidental. Consent: Informed consent was obtained from the patient for publication of this case report .

A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Femoral Hernia ◽  
Rare Case ◽  
Hernia Recurrence ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

scholarly journals A case of sigmoid volvulus in an unexpected demographic

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mohammad Saba ◽  
Joshua Rosenberg ◽  
Gregory Wu ◽  
Gudata Hinika
Keyword(s):  
Abdominal Pain ◽  
Severe Pain ◽  
Rare Case ◽  
Young Female ◽  
Sigmoid Volvulus ◽  
Case Presentation ◽  
Operative Complications ◽  
History Of ◽  
Male Sex ◽  
Emergent Laparotomy

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.

scholarly journals Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

2021 ◽  
Vol 07 (03) ◽  
pp. e124-e126
Author(s):  
Mark Portelli ◽  
Mark Bugeja ◽  
Charles Cini
Keyword(s):  
Computed Tomography ◽  
Young Adult ◽  
Rare Case ◽  
Surgical Repair ◽  
Bochdalek Hernia ◽  
Case Presentation ◽  
Atypical Case ◽  
Accident And Emergency ◽  
History Of ◽  
Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

scholarly journals Recurrent noncirrhotic hyperammonemia causing acute metabolic encephalopathy in a patient with a continent ileocecal pouch: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
T. M. Skipina ◽  
S. Macbeth ◽  
E. L. Cummer ◽  
O. L. Wells ◽  
S. Kalathoor
Keyword(s):  
Emergency Department ◽  
Metabolic Acidosis ◽  
Mental Status ◽  
Rare Case ◽  
Liver Function Tests ◽  
Altered Mental Status ◽  
Potassium Citrate ◽  
Metabolic Encephalopathy ◽  
History Of ◽  
Normal Urine

Abstract Introduction Acute encephalopathy, while a common presentation in the emergency department, is typically caused by a variety of metabolic, vascular, infectious, structural, or psychiatric etiologies. Among metabolic causes, hyperammonemia is relatively common and typically occurs in the setting of cirrhosis or liver dysfunction. However, noncirrhotic hyperammonemia is a rare occurrence and poses unique challenges for clinicians. Case presentation Here we report a rare case of a 50-year-old Caucasian female with history of bladder cancer status post chemotherapy, radical cystectomy, and ileocecal diversion who presented to the emergency department with severe altered mental status, combativeness, and a 3-day history of decreased urine output. Her laboratory tests were notable for hyperammonemia up to 289 μmol/L, hypokalemia, and hyperchloremic nonanion gap metabolic acidosis; her liver function tests were normal. Urine cultures were positive for Enterococcus faecium. Computed tomography imaging showed an intact ileoceal urinary diversion with chronic ileolithiasis. Upon administration of appropriate antibiotics, lactulose, and potassium citrate, she experienced rapid resolution of her encephalopathy and a significant reduction in hyperammonemia. Her hyperchloremic metabolic acidosis persisted, but her hypokalemia had resolved. Conclusion This case is an example of one of the unique consequences of urinary diversions. Urothelial tissue is typically impermeable to urinary solutes. However, when bowel segments are used, abnormal absorption of solutes occurs, including exchange of urinary chloride for serum bicarbonate, leading to a persistent hyperchloremic nonanion gap metabolic acidosis. In addition, overproduction of ammonia from urea-producing organisms can lead to abnormal absorption into the blood and subsequent oversaturation of hepatic metabolic capacity with consequent hyperammonemic encephalopathy. Although this is a rare case, prompt identification and treatment of these metabolic abnormalities is critical to prevent severe central nervous system complications such as altered mental status, coma, and even death in patients with urinary diversions.

scholarly journals Identification of a Novel Missense KRT12 Mutation in a Vietnamese Family with Meesmann Corneal Dystrophy

2020 ◽  
Vol 11 (1) ◽  
pp. 120-126
Author(s):  
Pham Ngoc Dong ◽  
Le Xuan Cung ◽  
Tran Khanh Sam ◽  
Do Thi Thuy Hang ◽  
Doug D. Chung ◽  
...  
Keyword(s):  
Sanger Sequencing ◽  
Novel Mutation ◽  
Family Members ◽  
Corneal Dystrophy ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Corneal Epithelial ◽  
Epithelial Phenotype ◽  
History Of ◽  
Characteristic Features

Meesmann epithelial corneal dystrophy (MECD) is a rare dominantly inherited disorder that is characterized by corneal epithelial microcysts and is associated with mutations in the keratin 3 (KRT3) and keratin 12 (KRT12) genes. In this study, we report a novel mutation in the KRT12 gene in a Vietnamese pedigree with MECD. Slit-lamp examination was performed on each of the 7 recruited members of a Vietnamese family to identify characteristic features of MECD. After informed consent was obtained from each individual, genomic DNA was isolated from saliva samples and screening of KRT3and KRT12 genes was performed by Sanger sequencing. The proband, a 31-year-old man, complained of a 1-year history of eye irritation and photophobia. Slit-lamp examination revealed intraepithelial microcysts involving only the corneal periphery in each eye with clear central corneas and no stromal or endothelial involvement. Three family members demonstrated similar intraepithelial microcysts, but with diffuse involvement, extended from limbus to limbus. Sanger sequencing of KRT3 (exon 7) and KRT12 (exons 1 and 6) in the proband revealed a novel heterozygous KRT12 variant (c.1273G>A [p.Glu425Lys]) that was present in the three affected family members but was absent in the three family members with clear corneas. This study is the first report of a Vietnamese family affected with MECD, associated with an atypical peripheral corneal epithelial phenotype in the proband and a novel mutation in KRT12.

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