Primary Sternal Cleft Repair in First Week of Life

2021 ◽  
pp. 215013512097576
Author(s):  
Raina Sinha ◽  
Jennifer Knod ◽  
Katerina Dukleska ◽  
Dennis Mello
Keyword(s):  
Primary Repair ◽  
Ductus Arteriosus ◽  
Computed Tomography Scan ◽  
Midline Incision ◽  
Postnatal Diagnosis ◽  
Sternal Cleft ◽  
Inferior Portion ◽  
Cardiac Evaluation ◽  
Tomography Scan

We present a full-term neonate with a postnatal diagnosis of a sternal cleft. Cardiac evaluation was otherwise remarkable for a patent ductus arteriosus and patent foramen ovale. Computed tomography scan confirmed the absence of a sternum except for a small inferior portion, including the xyphoid process. The patient underwent primary repair at five days of age through a midline incision where an absence of pericardium anteriorly was noted. She was extubated successfully the next day and discharged home on postoperative day 3. On follow-up examination, her sternum has been healing well without any clinical concerns. We advocate early repair of such defects in order to allow primary closure in a tension-free manner.

Limitation of computed tomography scan in ocular trauma in diagnosing posterior globe rupture and retinal detachment

Trauma ◽  
2016 ◽  
Vol 20 (1) ◽  
pp. 72-76
Author(s):  
AR Munirah ◽  
MK Safinaz ◽  
ZMZ Aida ◽  
A Malisa ◽  
MI Hazlita
Keyword(s):  
Computed Tomography ◽  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Primary Repair ◽  
Computed Tomography Scan ◽  
Penetrating Eye Injury ◽  
Globe Rupture ◽  
Open Globe ◽  
Tomography Scan

Ocular trauma with penetrating eye injury or globe rupture is an ophthalmic emergency. Immediate but gentle ocular assessment is mandatory to diagnose the extent of the injury. Imaging modalities are valuable in aiding diagnosis and management in open globe injury due to the difficulty of full eye assessment in the presence of multiple head and facial injuries. This report presents a case of an elderly man with ocular trauma of the left only seeing eye where computed tomography scan showed anterior globe rupture and the possibility of posterior globe rupture due to discontinuity of the posterior sclera. Primary repair and exploration of the left eye revealed no posterior globe rupture. Post-operative B-scan revealed a total retinal detachment with intact posterior globe. Vision of the left eye after pars planar vitrectomy and tamponade of the retina detachment with heavy silicone oil improved to 1/60. Computed tomography scan in ocular trauma has limitations especially in diagnosing retinal detachment and posterior globe rupture.

Adaptive Dosing of Nivolumab + Ipilimumab Immunotherapy Based Upon Early, Interim Radiographic Assessment in Advanced Melanoma (The ADAPT-IT Study)

2021 ◽  
Author(s):  
Michael A. Postow ◽  
Debra A. Goldman ◽  
Alexander N. Shoushtari ◽  
Allison Betof Warner ◽  
Margaret K. Callahan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Progression Free Survival ◽  
Advanced Melanoma ◽  
Computed Tomography Scan ◽  
Free Survival ◽  
Immunotherapy Trial ◽  
Grade 3 ◽  
Almost All ◽  
Tomography Scan

PURPOSE Nivolumab + ipilimumab (nivo + ipi) is highly efficacious but has high toxicity. Standard treatment in advanced melanoma is four doses of nivo + ipi followed by nivo alone. Whether four doses of nivo + ipi are needed is unclear. METHODS The Adaptively Dosed ImmunoTherapy Trial (ADAPT-IT) study ( NCT03122522 ) is a multicenter, single-arm phase II clinical trial. Patients received two doses of nivo (1 mg/kg) + ipi (3 mg/kg) followed by a computed tomography scan at week 6. Patients without new lesions or index lesion tumor growth of > 4% had protocol-defined early favorable antitumor effect (FATE) and ceased nivo + ipi, transitioning to nivo monotherapy. Patients without FATE at week 6 received the standard third and fourth doses of nivo + ipi followed by nivo monotherapy. The primary end point was response rate by RECIST 1.1 at week 12. Secondary end points included additional efficacy assessments and safety. RESULTS Sixty patients were enrolled; 41 patients (68%) had FATE at week 6 and met criteria for stopping nivo + ipi. Best overall response rates by RECIST at week 12 or any time afterward were 48% (95% CI, 35 to 62) and 58% (95% CI, 45 to 71), respectively. With a median follow-up of 25 months, the estimated 18-month progression-free survival and overall survival are 52% and 80%, respectively. Fifty seven percent of patients had grade 3-5 treatment-related toxicity. CONCLUSION The efficacy and toxicity of standard four dose nivo + ipi induction therapy in melanoma is likely driven by the first two doses. An interim computed tomography scan after two doses guided cessation of combination dosing and identified almost all responders. Longer follow-up and further study are needed to fully understand the implications of a shortened induction course of nivo + ipi.

scholarly journals Voluminous Intrapericardial Lipoma Mimicking Pericardial Effusion

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Fabíola Prado de Morais ◽  
Noah Romero Nakajima ◽  
Olívia Félix Marconi Andalécio ◽  
Pedro de Santana Prudente ◽  
Guilherme Emílio Ferreira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pericardial Effusion ◽  
Signs And Symptoms ◽  
Tumor Location ◽  
Pathological Examination ◽  
Computed Tomography Scan ◽  
Radiologic Imaging ◽  
Heart Tumors ◽  
Tomography Scan

Lipomas are rare primary heart tumors and may involve the endocardium, myocardium, or pericardium. Signs and symptoms depend on the tumor location and size. The intrapericardial lipoma we report has massive dimensions and mimics a pericardial effusion. A 38-year-old male complained of dyspnea and precordial pain. On physical examination, heart sounds were diminished. The patient had received extensive medication for a clinically suspected pericardial effusion due to heart failure. A voluminous mass resembling fat within the pericardial sac was revealed by transesophageal echocardiography and a computed tomography scan. The tumor was removed successfully by a subxiphoid surgical approach. The diagnosis of a 635 gram intrapericardial lipoma was confirmed by pathological examination. After surgery, the patient recovered well and was completely asymptomatic at a follow-up at 90 days. No medications were being taken since. The diagnosis of a pericardial effusion should be secured by imaging exams to avoid unnecessary medications. Cardiac lipomas can be readily recognized by their typical features on radiologic imaging. The surgical pathology examination confirms the diagnosis and rules out malignancy criteria.

Grisel syndrome: a delayed presentation in an asymptomatic patient

2007 ◽  
Vol 121 (8) ◽  
pp. 800-802 ◽  
Author(s):  
J Doshi ◽  
S Anari ◽  
I Zammit-Maempel ◽  
V Paleri
Keyword(s):  
Skull Base ◽  
Asymptomatic Patient ◽  
Neck Region ◽  
Rare Condition ◽  
Delayed Presentation ◽  
Computed Tomography Scan ◽  
Head And Neck Region ◽  
Grisel Syndrome ◽  
Tomography Scan

AbstractGrisel syndrome is a rare condition characterised by atlanto-axial subluxation following an inflammatory process in the head and neck region. It occurs more commonly in children and usually presents with cervical pain and torticollis, in addition to symptoms of the primary infection. We present the case of an asymptomatic 78-year-old man who was incidentally found to have atlanto-axial subluxation on a routine follow-up computed tomography scan, three months following successful treatment of a skull base infection. This case emphasises the importance of appropriate follow-up imaging for patients with skull base infections, even if they respond clinically to medical treatment.

scholarly journals Intussusception in a pregnant woman

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Ana Cristina Silva ◽  
Pedro Soares Moreira ◽  
Vitor Costa Simões ◽  
Mónica Sampaio ◽  
Marisa Domingues Santos
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Pregnant Woman ◽  
Pregnant Patient ◽  
Computed Tomography Scan ◽  
Intestinal Necrosis ◽  
History Of ◽  
Emergent Laparotomy ◽  
Tomography Scan

Abstract Abdominal pain in a pregnant woman with a history of laparoscopic Roux-en-Y gastric bypass (LRYGB) in the emergency department is challenging. Intussusception is a rare cause of small bowel obstruction after LRYGB and can lead to intestinal necrosis, perforation, sepsis and death. The authors report a case of a 34-week pregnant patient, previously submitted to LRYGB, presenting to the emergency department with abdominal pain and vomiting. A computed tomography scan suggested the presence of ileoileal intussusception. So, an emergent laparotomy was performed with invagination reduction. The postoperative period was uneventful, as well as pregnancy and caesarian performed 4 weeks after surgery. At the 45-month follow-up, there was no recurrence of intussusception.

scholarly journals Metachronous Bilateral Isolated Adrenal Metastasis from Rectal Adenocarcinoma: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
H. Jabir ◽  
N. Tawfiq ◽  
M. Moukhlissi ◽  
M. Akssim ◽  
A. Guensi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Rectal Cancer ◽  
Histopathological Examination ◽  
Rectal Adenocarcinoma ◽  
Adrenal Metastasis ◽  
Computed Tomography Scan ◽  
Serum Carcinoembryonic Antigen ◽  
Tomography Scan

We report a case of adrenal metastasis from colorectal cancer in a 54-year-old woman. Nine months after resection for advanced rectal carcinoma, a computed tomography scan revealed bilateral adrenal metastasis. The level of serum carcinoembryonic antigen was normal. A bilateral adrenalectomy was performed after chemotherapy. Histopathological examination showed adenocarcinoma, compatible with metastasis from the rectal cancer. Adrenal metastasis should be considered in the patients’ follow-up for colorectal cancer.

Role of routine computed tomography scan in the oncological follow up of patients treated by radical cystectomy for bladder cancer

2016 ◽  
Vol 23 (10) ◽  
pp. 840-846 ◽  
Author(s):  
Quentin Alimi ◽  
Grégory Verhoest ◽  
Solene-Florence Kammerer-Jacquet ◽  
Romain Mathieu ◽  
Nathalie Rioux-Leclercq ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Computed Tomography Scan ◽  
Tomography Scan

Is surveillance without immediate treatment an option for newly diagnosed testicular germ-cell cancer patients with borderline size retroperitoneal lymph nodes on computed tomography scan?

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 560-560
Author(s):  
Nadav Milk ◽  
Ilan Leibovitch ◽  
Daniel Keizman ◽  
Hadas Dresler ◽  
Itay Sternberg
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Clinical Laboratory ◽  
Cell Cancer ◽  
Tumor Board ◽  
Tumor Type ◽  
Computed Tomography Scan ◽  
Tomography Scan ◽  
Undetermined Significance

560 Background: The AJCC TNM Staging System for Testicular Cancer (TC) does not set a minimal diameter to define positive lymph nodes (LN) on computed tomography scan. It is common to refer to LN ≥ 1 cm in diameter as positive, even though benign LN in the borderline size of 1-1.5cm are common. Our goal is to describe the outcome of TC patients with borderline size retroperitoneal LN of undetermined significance managed initially with surveillance. Methods: We retrospectively reviewed the medical records of all TC patients treated at our institution during 2006-2016. Demographic, clinical, laboratory, imaging, pathological, treatment and surveillance data were obtained. Results: Of a total of 109 TC patients, 25 patients (22.7%) with borderline size LN were assigned to an active surveillance protocol by our tumor board. Median age at the time of orchiectomy was 37.2 years (IQR, 23.9-40.3). With a median follow-up of 3.9 years (IQR 1.7-6.5), overall survival rate in the group was 100%. Nine of 25 patients (36%) relapsed and were treated within a median of 4.9 months (IQR 2.2-5.5). Median follow-up for 16 patients who did not relapse was 3.4 years (IQR 1.5-5.4). Relapse-free survival was 71% (95% CI 48-85), and 61% (95% CI 38-77) at one and two years, respectively. Orchiectomy pathology included pure seminoma in 18/25 (72%), and a nonseminomatous tumor in 7/25 (28%). Tumor type was not associated with likelihood of relapse (p = 0.66). The median LN diameter at the time of diagnosis was 11 mm (IQR 9-12, mean 10.4). LN diameter was not associated with likelihood of relapse (p = 0.34). Patients who relapsed during follow-up were significantly younger at the time of TC diagnosis than patients who did not relapse (Median age 23.9 years [IQR 19.6-35.2] and 39.2 years [IQR 34.3-47.9] respectively, p = 0.0056). Conclusions: Surveillance alone for TC patients with borderline size LN of undetermined significance at diagnosis is a possible option and may help avoid overtreatment in 60% of these patients.

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