scholarly journals Ultrasound-guided non-invasive retraction for strangulated obturator hernia allows elective radical surgery: analysis of 12 cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuto Maeda ◽  
Osamu Nakahara ◽  
Seiya Saito ◽  
Jiro Nasu ◽  
Hideo Baba
Keyword(s):  
Radical Surgery ◽  
Elective Surgery ◽  
Underlying Disease ◽  
Obturator Hernia ◽  
Case Presentation ◽  
Non Invasive ◽  
Threatening Condition ◽  
Life Threatening ◽  
Perioperative Safety ◽  
Physical Findings

Abstract Background Obturator hernia is a life-threatening condition, requiring emergency intervention due to strangulation, if non-invasive repair for strangulation cannot be complete. Change from emergency surgery to elective surgery using minimal non-invasive options can greatly contribute to perioperative safety and curability of the underlying disease. Case presentation 12 cases of strangulated obturator hernia from April 2013 to February 2020 with male:female patient ratio of 0:12. Reduction under ultrasound guidance was possible amongst 10 out of 12 cases. The average age was 85.3 years (74–97) and average BMI was 17.4 (15.0–20.1). Based on physical findings and CT examination, diagnosis of obturator hernia was made using echo guided non-invasive reduction. Prevention in the intestinal ischemia and perforation was observed in the treated cases. Upon request, elective radical surgery was performed in 7 of these patients after their condition improved and monitored other organs for any signs. Conclusion Attempt to improve the strangulation of obturator hernia under an echo-guided approach could enable elective and safe surgery and is believed to be a diagnostic treatment worth attempting.

scholarly journals Successful treatment of pulmonary mucormycosis caused by Rhizopus microsporus with posaconazole

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
F. Yuan ◽  
J. Chen ◽  
F. Liu ◽  
Y. C. Dang ◽  
Q. T. Kong ◽  
...  
Keyword(s):  
Fungal Culture ◽  
Rhizopus Microsporus ◽  
Pulmonary Tissue ◽  
Case Presentation ◽  
Common Cause ◽  
Pulmonary Mucormycosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
One Year

Abstract Background Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation We report a case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up. Conclusions Pulmonary mucormycosis is a life-threatening condition and posaconazole is an effective treatment for pulmonary mucormycosis caused by Rhizopus microspores.

Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? – case report and literature review

2020 ◽  
Vol 33 (2) ◽  
pp. 319-322
Author(s):  
Krzysztof Jeziorny ◽  
Arleta Waszczykowska ◽  
Dobromiła Barańska ◽  
Agnieszka Szadkowska ◽  
Wojciech Młynarski ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cerebral Edema ◽  
Diagnostic Methods ◽  
Newly Diagnosed ◽  
Cns Disorders ◽  
Case Presentation ◽  
Non Invasive ◽  
Appropriate Treatment ◽  
Life Threatening

AbstractBackgroundCerebral edema (CE) is one of the most serious complications of diabetic ketoacidosis (DKA) and can result in central nervous system (CNS) disorders and even lead to death of the patient.Case presentationWe present the case of a 11-year-old boy with severe DKA in the course of newly diagnosed type 1 diabetes (T1D). The delay in the diagnosis of DKA and some therapeutic problems contributed to the development of CE and direct life-threatening conditions. Early diagnosis of CE development in the course of DKA using non-invasive methods such as pachymetry or transorbital ultrasound seems to be a very important prognostic factor.ConclusionsThis case highlights the importance of appropriate treatment according to the newest recommendations and presents the usefulness of new diagnostic methods to assess the risk of CE in children with newly diagnosed T1D.

scholarly journals Ultrasonographic Evaluation of the Optic Nerve Sheath in the Diagnosis of Idiopathic Intracranial Hypertension

2016 ◽  
Vol 38 (01) ◽  
pp. 073-076
Author(s):  
Marx Araújo ◽  
Benjamim Vale ◽  
Irapua Ricarte ◽  
Lívio de Macêdo ◽  
Anderson Rodrigues ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Clinical Results ◽  
Optic Nerve Sheath ◽  
Non Invasive ◽  
Nerve Sheath ◽  
Threatening Condition ◽  
Life Threatening ◽  
Invasive Techniques

AbstractIntracranial hypertension (ICH) is a life-threatening condition that can be observed in several diseases. Its clinical presentation is variable, with headache, nausea, vomiting, visual disturbances, papilledema, and alterations in the level of consciousness. The gold standard for the diagnosis of ICH is still the intracranial implantation of invasive devices. Non-invasive techniques, such as ultrasonography of the optic nerve sheath (USONS), have emerged in recent years with promising clinical results. The authors report the case of a patient with progressive headache associated with visual impairment and papilledema, and the eventual diagnosis of idiopathic intracranial hypertension using USONS.

Successful Treatment of Pulmonary Mucormycosis Caused by Rhizopus Microsporus With Posaconazole

2021 ◽  
Author(s):  
Fan Yuan ◽  
Jun Chen ◽  
Fang Liu ◽  
Yongchao Dang ◽  
Qingtao Kong ◽  
...  
Keyword(s):  
Fungal Culture ◽  
Rhizopus Microsporus ◽  
Pulmonary Tissue ◽  
Case Presentation ◽  
Common Cause ◽  
Pulmonary Mucormycosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
One Year

Abstract Background: Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation: We report the case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis has mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up.Conclusions: Pulmonary mucormycosis is a life-threatening condition and based on direct microscopy, histopathology, and culture for the diagnosis.

Thyroid storm after choking

2018 ◽  
Vol 31 (8) ◽  
pp. 933-936 ◽  
Author(s):  
Ana L. Creo ◽  
Bryan C. Cannon ◽  
Siobhan T. Pittock
Keyword(s):  
Adolescent Girl ◽  
Pediatric Patients ◽  
Medical Attention ◽  
Thyroid Storm ◽  
Neck Swelling ◽  
Case Presentation ◽  
Cat Scan ◽  
Threatening Condition ◽  
Life Threatening ◽  
Hyperthyroid Patients

Abstract Background: A thyroid storm (TS) is a rare, but life-threatening condition in hyperthyroid patients. Mortality in adult TS patients may be as high as 10%. Typically, a trigger precipitates the storm in hyperthyroid patients. Case presentation: We report the case of an adolescent girl with untreated hyperthyroidism who developed fulminant TS after a significant choking episode. Initially, she was found to have neck swelling and tachycardia leading providers to suspect infection. She deteriorated after a CAT Scan (CT) was performed with iodine contrast, potentially worsening storm symptoms. Here, we describe the case, the treatment strategy and propose a treatment modification for pediatric patients. Conclusions: While many children are found to have minor abnormalities in thyroid studies, this case highlights the critical importance of prompt medical attention for any child with significantly elevated free thyroxine (FT4) levels as morbidity can occur when left untreated.

scholarly journals Anemia That Presented with Desaturation: A Focus on Core Concepts

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Lakshmi Shobhavat ◽  
Antonio D’Costa ◽  
Karthik Shroff
Keyword(s):  
Blood Smear ◽  
Intensive Care Admission ◽  
Case Presentation ◽  
Threatening Condition ◽  
Core Concepts ◽  
Life Threatening ◽  
History Of ◽  
The Common ◽  
Treatable Condition ◽  
Prompt Diagnosis

Background. Methemoglobinemia is a potentially life-threatening condition which presents with cyanosis and characteristic “chocolate-coloured blood.” Although a co-oximetry would give a prompt diagnosis, there have been multiple reports of misdiagnosing this treatable condition—from being diagnosed as sepsis to asthma and even being operated for “ruptured ectopic pregnancy.” Here, we report a case which presented without the classical signs of poisoning and methemoglobinemia—without vomiting, cyanosis, or chocolate-coloured blood. We also discuss the common misconceptions regarding anemia physiology and the pitfalls in diagnosing this condition and warn the reader regarding the reflexive use of antidotes like methylene blue. Case Presentation. A well-grown 3-year old boy presented with an acute history of irritability, cola-coloured urine, and desaturation on examination. The child was pale, with tachypnoea and in failure. Blood smear was suggestive of severe hemolytic anemia. Methemoglobinemia was diagnosed on co-oximetry. By focussing on physiologic principles of management rather than a specific antidote, the child was discharged home, well and active within 3 days of intensive care admission.

A NEW APPROACH FOR CLASSIFICATION OF ATHEROSCLEROSIS OF COMMON CAROTID ARTERY FROM ULTRASOUND IMAGES

2019 ◽  
Vol 19 (01) ◽  
pp. 1940001 ◽  
Author(s):  
B. SMITHA ◽  
K. PAUL JOSEPH
Keyword(s):  
Myocardial Infarction ◽  
Human Life ◽  
Treatment Protocol ◽  
Support Vector ◽  
Ultrasound Images ◽  
Artery Wall ◽  
Non Invasive ◽  
Threatening Condition ◽  
Life Threatening ◽  
Occurrence Matrix

Background and objectives: The diagnosis of carotid atherosclerosis is of vital importance, as this cardiovascular disease may cause myocardial infarction. One-third of deaths in the world occur due to myocardial infarction, commonly known as heart attack. Atherosclerosis is deposition of plaque in artery wall. It could be detected from the features of intima-media complex of the artery wall. This study proposes a new classification approach to distinguish between symptomatic and asymptomatic plaques using non-invasive carotid B-mode ultrasound images. These two types of plaques have diverse impacts on human life. In the first condition, slowly plaque formation reaches life-threatening condition and the second condition is acute in nature. Hence treatment protocol is to be decided based on the type of plaque. Methods: To locate the intima-media-complex region, the images are segmented using snake-based segmentation algorithm. Several features are extracted using fixed size blocks selected from the segmented region using gray-level co-occurrence matrix. Finally classification is performed using support vector machine. Results: The performance shows improvement in accuracy using lesser number of features than previous works. The reduction in feature size is achieved by incorporating segmentation in the pre-processing stage. In the classifier, 10-fold cross-validation protocol is used for training and testing and an accuracy of 100% is obtained. Conclusion: This proposed technique could work as an adjunct tool in quick decision-making for cardiologists and radiologists.

scholarly journals Hyperglycaemic hyperosmolar state in an obese prepubertal girl with type 2 diabetes: case report and critical approach to diagnosis and therapy

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Angelika Mohn ◽  
Nella Polidori ◽  
Valeria Castorani ◽  
Laura Comegna ◽  
Cosimo Giannini ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Elevated Serum ◽  
Serum Glucose ◽  
Critical Approach ◽  
Obese Adults ◽  
Case Presentation ◽  
Threatening Condition ◽  
Life Threatening

Abstract Introduction Isolated Hyperosmolar Hyperglycaemic Syndrome (HHS) is a life-threatening condition characterized by elevated serum glucose concentrations and hyperosmolality without significant ketosis. It is often described in obese adults with unknown Type 2 Diabetes (T2D), rarely in youth. In childhood the most common cause of metabolic glucose related derangement is Diabetic Ketoacidosis (DKA) in Type 1 Diabetes (T1D). Interestingly, both components can be combined with each other, thus the prevalent condition needs to be recognised implying a different therapeutic approach. Case presentation In this case, we report a prepubertal Caucasian obese girl admitted for two episodes of combined HHS/DKA in order to elucidate her clinical course taking into account the current pediatric recommendations based on adult guidelines for HHS. Conclusions The treatment of HHS and even more of HHS/DKA in youth is still controversial as no specific guidelines for children are available especially during the prepubertal age. The description of our case might be helpful and offer relevant points for future consensus.

scholarly journals Tracheal Diverticulum in SARS-CoV-2 Patients on Non-Invasive Ventilation A not so “Spontaneous” Cause of Pneumomediastinum? An imaging Pictorial Presentation of Two Cases with Review of Literature

2021 ◽  
Vol 28 (2) ◽  
pp. 19
Author(s):  
Veena Mariam Joseph ◽  
Donboklang Lynser ◽  
Iadarilang Tiewsoh ◽  
Kaustuv Dutta ◽  
Pranjal Phukan ◽  
...  
Keyword(s):  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Non Invasive ◽  
Pictorial Presentation ◽  
Tracheal Diverticulum ◽  
Free Air ◽  
Non Invasive Ventilation ◽  
Threatening Condition ◽  
Life Threatening

Spontaneous pneumomediastinum is a rare but potentially life-threatening condition, the incidence of which has showed an increase in patients with SARS-CoV-2 pneumonia, especially when they are on positive pressure ventilation. None of the reported cases of covid related pneumomediastinum had an associated tracheal diverticulum. Also, to the best of our knowledge, tracheal diverticulum has not been reported in patients on NIV. We report 2 cases of COVID-19 pneumonia on NIV with pneumomediastinum, which also had associated tracheal diverticulum, one of which developed after NIV. Though the establishment of causality needs further research, early detection of a tracheal diverticulum, which might be a harbinger of pneumomediastinum, can be a timely alarm to prompt titration of the pressure settings and judicious use of NIV. The role of inverted grey scale CT images in mediastinal window is a simple, yet hardly utilised radiological tool to increase detection of ‘mediastinal air’, let it be free air or air within a diverticulum. Through this case report, we would like to highlight the role of conventional and inverted CT imaging of pneumomediastinum and tracheal diverticulum in general and in SARS-CoV-2 pneumonia in particular, and to call for more objective research to throw light on the plausible relationship between pneumomediastinum and tracheal diverticulum.

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