The spontaneous resolution of a vortex vein varix: case report

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

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Real-World Experience with Type I Endoleaks after Endovascular Repair of the Thoracic Aorta

The American Surgeon ◽

10.1177/000313481007600623 ◽

2010 ◽

Vol 76 (6) ◽

pp. 599-605 ◽

Cited By ~ 4

Author(s):

Joshua D. Adams ◽

Margaret C. Tracci ◽

Sahir Sabri ◽

Kenneth J. Cherry ◽

John F. Angle ◽

...

Keyword(s):

Natural History ◽

Thoracic Endovascular Aortic Repair ◽

Spontaneous Resolution ◽

Type I ◽

Single Center ◽

Type I Endoleak ◽

History Of ◽

Aortic Pathologies ◽

Initial Results

Endoleaks are a frequent complication of thoracic endovascular aortic repair (TEVAR) and will likely increase in incidence with application of the technique to more complicated aortic anatomy and a wider range of thoracic aortic pathologies. Management generally consists of aggressive repair of Type I endoleaks; however, the natural history of Type I endoleaks after TEVAR remains largely unknown. The purpose of this study was to examine the incidence and characteristics of Type I endoleaks and to evaluate clinical outcomes of patients with Type I endoleaks after TEVAR. A single-center retrospective review was performed on all patients who underwent TEVAR over a 4-year period. Type I endoleaks were detected in 21 per cent (27 of 129) of patients on post-deployment aortography or CT angiography. During a mean follow-up of 750.63 ± 483 days, 59 per cent (16 of 27) closed spontaneously; 30 per cent (eight of 27) required secondary endovascular intervention; and 11 per cent (three of 27) have persisted with no increase in maximum aortic diameter. No patients have died or required open surgical conversion as a result of their Type I endoleak. Although accurate predictors of spontaneous resolution of Type I endoleaks have yet to be definitively characterized, our initial results suggest that it may be safe to observe small Type I endoleaks given that a large percentage resolve spontaneously and no endoleak-related deaths have occurred.

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Chilaiditi Syndrome: A Case Report Highlighting the Intermittent Nature of the Disease

Case Reports in Medicine ◽

10.1155/2018/3515370 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Esha M. Kapania ◽

Christina Link ◽

Joshua M. Eberhardt

Keyword(s):

Case Report ◽

Complete Resolution ◽

Clinical Symptoms ◽

Case Reports ◽

Delayed Diagnosis ◽

Spontaneous Resolution ◽

Radiographic Evidence ◽

Case Presentation ◽

Chilaiditi Syndrome

Background. Chilaiditi syndrome is a phenomenon where there is an interposition of the colon between the liver and the abdominal wall leading to clinical symptoms. This is distinct from Chilaiditi sign for which there is radiographic evidence of the interposition, but is asymptomatic. Case Presentation. Here, we present the case of a patient who, despite having clinical symptoms for a decade, had a delayed diagnosis presumably due to the interposition being intermittent and episodic. Conclusions. This case highlights the fact that Chilaiditi syndrome may be intermittent and episodic in nature. This raises an interesting question of whether previous case reports, which describe complete resolution of the syndrome after nonsurgical intervention, are perhaps just capturing periods of resolution that may have occurred spontaneously. Because the syndrome may be intermittent with spontaneous resolution and then recurrence, patients should have episodic follow-up after nonsurgical intervention.

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Uterovaginal prolapse following suspected sexual abuse to a child: a case report

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00105-8 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Odion-Obomhense Kesiena Helen ◽

Ntaji Maureen Iru ◽

Ekpebe Patrick Akpofure ◽

Afeyodion Akhator

Keyword(s):

Sexual Abuse ◽

Case Report ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Uterovaginal Prolapse ◽

Traumatic Rupture ◽

Connective Tissues ◽

Case Presentation ◽

History Of

Abstract Background Uterovaginal prolapse occurs when damaged connective tissues allow the uterus to drop into the vagina. Rare in children, uterovaginal prolapse can occur as a result of violent sexual assault. This case is being reported because there has been no previous report of acquired pelvic organ prolapse following trauma suspected to be sexual abuse in a child in our setting. Case presentation Two-year-old female presented to our hospital with a 3-day history of abnormal protrusion from the vagina and a 2-day history of bleeding per vagina. Traumatic rupture of the hymen was observed. The urethra was not edematous or hyperemic. The reduction was done successfully under sedation and maintained using a crepe bandage. There was no recurrence after 3-month follow-up. Conclusions Uterovaginal prolapse presenting among children below 5 years is rare. If bleeding per vagina is reported in a child, the clinician should be aware of the possibility of uterovaginal prolapse.

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Large choroidal excavation in myopic macular degeneration: A case report

European Journal of Ophthalmology ◽

10.1177/1120672120942748 ◽

2020 ◽

pp. 112067212094274 ◽

Cited By ~ 1

Author(s):

Federico Borghesan ◽

Alessandro Arrigo ◽

Francesco Bandello ◽

Maurizio Battaglia Parodi

Keyword(s):

Optical Coherence Tomography ◽

Case Report ◽

Natural History ◽

Macular Degeneration ◽

Fluorescein Angiography ◽

Clinical Features ◽

Multimodal Imaging ◽

Focal Choroidal Excavation ◽

History Of

Purpose: To report the morphological and clinical features of a case of myopic macular degeneration with large choroidal excavation. Methods: A myopic patient underwent multimodal imaging, including optical coherence tomography and fluorescein angiography, over a 8-year follow-up. Results: A choroidal excavation was found in left eye, superior to the fovea. The excavation started as a focal choroidal excavation (FCE) and got deeper and larger during the 8-years-long follow-up, thus resulting in a large choroidal excavation (LCE). Conclusions: LCE may be the evolution of FCE in highly myopic eyes, further studies are needed to describe the natural history of choroidal excavations in degenerative myopia.

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Natural History of Disseminated Coccidioidomycosis: Examination of the Veterans Affairs–Armed Forces Database

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1154 ◽

2020 ◽

Cited By ~ 1

Author(s):

Derek J Bays ◽

George R Thompson ◽

Susan Reef ◽

Linda Snyder ◽

Alana J Freifeld ◽

...

Keyword(s):

Natural History ◽

Pulmonary Nodules ◽

Armed Forces ◽

Veterans Affairs ◽

Initial Infection ◽

All Cause Mortality ◽

History Of ◽

Insight Into

Abstract Background The natural history of non–central nervous system (non-CNS) disseminated coccidioidomycosis (DCM) has not been previously characterized. The historical Veterans Affairs (VA)–Armed Forces coccidioidomycosis patient group provides a unique cohort of patients not treated with standard antifungal therapy, allowing for characterization of the natural history of coccidioidomycosis. Methods We conducted a retrospective study of 531 VA–Armed Forces coccidioidomycosis patients diagnosed between 1955–1958 and followed to 1966. Groups were identified as non-DCM (462 patients), DCM (44 patients), and CNS (25 patients). The duration of the initial infection, fate of the primary infection, all-cause mortality, and mortality secondary to coccidioidomycosis were assessed and compared between groups. Results Mortality due to coccidioidomycosis at the last known follow-up was significantly different across the groups: 0.65% in the non-DCM group, 25% in the DCM group, and 88% in the CNS group (P < .001). The primary fate of pulmonary infection demonstrated key differences, with pulmonary nodules observed in 39.61% of the non-DCM group, 13.64% of the DCM group, and 20% of the CNS group (P < .001). There were differences in cavity formation, with 34.20% in the non-DCM group, 9.09% in the DCM group, and 8% in the CNS group (P < .001). Dissemination was the presenting manifestation or was concurrent with the initial infection in 41% and 56% of patients in the non-CNS DCM and CNS groups, respectively. Conclusions This large, retrospective cohort study helps characterize the natural history of DCM, provides insight into the host immunologic response, and has direct clinical implications for the management and follow-up of patients.

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Histiocytoid Giant Cellulitis-Like Sweet Syndrome At The Site of Sternal Aspiration: A Case Report

10.21203/rs.3.rs-966833/v1 ◽

2021 ◽

Author(s):

Dewan Zhao ◽

Jing Ni ◽

Xiuli Sun

Keyword(s):

Case Report ◽

Cutaneous Lesion ◽

Blood Cultures ◽

Puncture Site ◽

Angioneurotic Edema ◽

Sweet Syndrome ◽

Case Presentation ◽

Floor Of The Mouth ◽

History Of

Abstract Background: Sweet syndrome with both histiocytoid pathology and giant cellulitis-like lesion feature is extremely rare and has only been reported once. Our case is different from the previous report because the cutaneous lesion was caused by local invasive irritation, which made it much more difficult to distinguish from cellulitis.Case presentation: A 52-year-old male was diagnosed with myelodysplastic syndrome with multilineage dysplasia (MDS-MLD) associated with myelofibrosis (MDS-F) as well as angioneurotic edema of the tongue and floor of the mouth. Seven days after sternal aspiration, a cellulitis-like lesion was formed at the puncture site. Since he had neutropenia, history of glucocorticoid use and didn't keep the site dry and clean after aspiration, cellulitis was diagnosed, followed by broad-spectrum antibiotics and debridement. However, the lesion continued to expand, associated with blisters formation, accompanied by chills and fever. Blood cultures and blister smears didn't detect any pathogens. Biopsy of the lesion was performed and histiocytoid Sweet syndrome was diagnosed. He received prednisone treatment, and the fever relieved within 24 hours and the cutaneous lesion resolved within one week. He has had no recurrence during two-month follow-up.Conclusions: This case can provide help for timely diagnosis and treatment and a reference for further summarizing the characteristics of this rare variant.

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The natural history of type 2 endoleaks after endovascular aneurysm repair justifies conservative management

Vascular ◽

10.1177/1708538118766103 ◽

2018 ◽

Vol 26 (5) ◽

pp. 524-530 ◽

Cited By ~ 5

Author(s):

Mark Ajalat ◽

Russell Williams ◽

Samuel E Wilson

Keyword(s):

Natural History ◽

Conservative Management ◽

Endovascular Aneurysm Repair ◽

Spontaneous Resolution ◽

Type 2 Endoleak ◽

History Of ◽

Tomographic Angiography ◽

Aneurysm Repair

Objective Management of type 2 endoleaks after endovascular aneurysm repair has been controversial. Some advocate for conservative management, while others believe that intervention is indicated. This study investigated the natural history of type 2 endoleaks in order to derive direction in management. Methods Patients who had endovascular aneurysm repair at the Veterans Affairs Long Beach were retrospectively identified and computerized tomographic angiography was independently reviewed by a radiologist and a vascular surgeon. Type 2 endoleaks were analyzed for the following outcomes: rupture, duration of endoleak, spontaneous resolution, changes in the size of the aneurysm sac, and reintervention rates. Results Of the 160 patients who had completed required follow-up to date (mean 3 years) after endovascular aneurysm repair, 39 (24.4%) patients were identified as having a type 2 endoleak on computerized tomographic angiography imaging. 6 (15.4%) of these 39 patients required repair due to aneurysm sac growth >1 cm. 2 (5.13%) were repaired with an open procedure and 4 (10.3%) with an endovascular approach. Of these 6 aneurysm leaks requiring repair, 4 (66.7%) had a simultaneous endoleak (types 1 or 3) in addition to the identified type 2 endoleak. Spontaneous resolution of type 2 endoleaks occurred in 16 (41.0%) patients. 4 patients (10.3%) had delayed type 2 endoleaks that presented 4, 9, 12, and 23 months after their 30 day post op computed tomography was normal. None of the 4 patients with delayed type 2 endoleaks required reintervention and none had aneurysm sac growth greater than 5 mm. Conclusions Overall, we found that 85% of patients who had type 2 endoleaks did not require intervention after a mean follow-up time of 3 years. The association of a type 1 or 3 endoleak with a type 2 endoleak was more likely to require correction due to aneurysm expansion >1 cm, thus type 2 endoleaks associated with another type of endoleak require more aggressive management.

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Xia–Gibbs syndrome in adulthood: a case report with insight into the natural history of the condition

Molecular Case Studies ◽

10.1101/mcs.a003608 ◽

2019 ◽

Vol 5 (3) ◽

pp. a003608 ◽

Cited By ~ 2

Author(s):

David R. Murdock ◽

Yunyun Jiang ◽

Michael Wangler ◽

Michael M. Khayat ◽

Aniko Sabo ◽

...

Keyword(s):

Case Report ◽

Natural History ◽

History Of ◽

Insight Into

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I Kneed help!

Pediatric Traumatic Emergencies ◽

10.1093/med/9780190946623.003.0011 ◽

2020 ◽

pp. 89-94

Author(s):

Kristol Das

Keyword(s):

Emergency Department ◽

Natural History ◽

Sensitivity And Specificity ◽

Knee Pain ◽

Physical Exam ◽

Imaging Modalities ◽

X Rays ◽

Case Presentation ◽

History Of

This chapter reviews a case of an adolescent presenting to the emergency department with unilateral knee pain after a traumatic fall. This chapter reviews key history questions, physical exam maneuvers including special tests to examine the knee, the workup and management of this case presentation based on pediatric literature. Specifically, the chapter reviews indications to obtain x-rays versus other imaging modalities and the sensitivity and specificity of special tests based on recent data. Follow-up and subspecialty referral indications for knee pain are also reviewed. Lastly, the epidemiology, pathophysiology, management and natural history of this patient’s unique diagnosis are briefly discussed.

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