Clinical and ultrasound characteristics of pediatric lateral neck masses

Lateral neck masses (LNM) often present a diagnostic challenge in the practice of pediatric plastic surgeon. The aim of this study is to investigate the clinical and ultrasound (US) characteristics of pediatric LNM in order to make mutual comparison between their entities and enable the most accurate preoperative diagnosis. A cross-sectional study was conducted among 250 pediatric patients treated by surgical excision or sclerotherapy in our institution in the period from July 2009 to June 2019. Lymphatic malformation was the most frequent congenital LNM (60.9%), while reactive or granulomatous lymphadenitis was the most frequent acquired LNM (47%). Congenital anomalies were significantly more often localized in the upper half of the sternocleidomastoid (SCM) muscle region, and had more often soft consistency than acquired ones. Congenital LNM had a 32.37 (3.44–304.63) times higher likelihood of incorrect (p = 0.002) and 5.86 (1.35–25.48) times higher likelihood of undetermined (p = 0.018) than correct US findings, respectively. Acquired LNM were significantly more often localized in the region behind the SCM muscle and more often had solid US appearance in comparison to the congenital ones. Association of the clinical and US findings is very important in determining the most accurate preoperative diagnosis without exposing the children to unnecessary utilizing ionizing radiation or anesthesia. Although they are mostly benign, extreme caution is necessary due to malignancies which were found in 16.4% of all our patients.

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Bilateral Cervical Pilomatricoma: A Diagnostic Dilemma for the Pediatric Otolaryngologist

Ear Nose & Throat Journal ◽

10.1177/0145561320958978 ◽

2020 ◽

pp. 014556132095897

Author(s):

Nicholas A. Rossi ◽

Rachelle Gietzen ◽

Cecilia G. Clement ◽

Jason F. Ohlstein ◽

Harold S. Pine ◽

...

Keyword(s):

Pediatric Patient ◽

Surgical Management ◽

Preoperative Diagnosis ◽

Surgical Excision ◽

Skin Tumors ◽

Diagnostic Challenge ◽

Diagnostic Dilemma ◽

Accurate Preoperative Diagnosis

Pilomatricomas are benign skin tumors often encountered by otolaryngologists but frequently misdiagnosed. Although they can occur at any age, they commonly present in children as a discolored superficial lesion adhered to the overlying skin. Accurate preoperative diagnosis is crucial for appropriate management, which is surgical in most cases. Here, we present bilateral pilomatricomas mimicking features of several other diagnoses in a pediatric patient. The patient was successfully treated with surgical excision. This case presented a unique diagnostic challenge, as the lesions exhibited features of several common diagnoses. In general, surgical management of pilomatricoma is curative, and recurrence is rare.

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Surgical Excision of a Contained Rupture of an Inferior Mesenteric Aneurysm

Vascular and Endovascular Surgery ◽

10.1177/15385744211069746 ◽

2022 ◽

pp. 153857442110697

Author(s):

Andre S. Dubois ◽

Joyce M. Mathew ◽

Sotirios A. Makris ◽

Bryce Renwick

Keyword(s):

Vascular Surgery ◽

Mesenteric Artery ◽

Preoperative Diagnosis ◽

Inferior Mesenteric Artery ◽

Surgical Excision ◽

Correct Position ◽

True Aneurysm ◽

Visceral Aneurysm ◽

Accurate Preoperative Diagnosis ◽

Open Excision

Inferior mesenteric artery (IMA) aneurysms represent the minority of visceral aneurysm presentations. A 57-year-old female was admitted with a symptomatic IMA aneurysm secondary to atherosclerotic disease. She was treated with open excision which revealed a contained ruptured of a true aneurysm. This case highlights the challenges of an accurate preoperative diagnosis of IMA aneurysm and the correct position of the recent guidelines on visceral aneurysms issued by the Society of Vascular Surgery (SVS).

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Mirizzi syndrome grades III and IV: surgical treatment

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912016004005 ◽

2016 ◽

Vol 43 (4) ◽

pp. 243-247 ◽

Cited By ~ 1

Author(s):

RONALD REVERDITO ◽

ANDRÉ DE MORICZ ◽

TÉRCIO DE CAMPOS ◽

ADHEMAR MONTEIRO PACHECO JÚNIOR ◽

RODRIGO ALTENFELDER SILVA

Keyword(s):

Surgical Treatment ◽

Preoperative Diagnosis ◽

Anastomotic Stricture ◽

Cross Sectional Study ◽

Biliary Fistula ◽

Mirizzi Syndrome ◽

Cross Sectional ◽

Biliodigestive Anastomosis ◽

Type Iv

ABSTRACT Objective : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. Methods : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. Results : the incidence of MS was 0.6% (23 cases) and grades III and IV amounted to 0.35% of this number. There was a predominance of type IV (12 cases). The preoperative diagnosis was possible in 53.8% of cases. The preferred approach was biliary-digestive derivation (10 cases), and "T" tube drainage with suture of the bile duct was the choice in three special occasions. Three patients had biliary fistula resolved with clinical management, and one coliperitoneum case required reoperation. In the outpatient follow-up of patients who underwent biliodigestive anastomosis (eight), 50% are asymptomatic, 25% had anastomotic stricture and 25% lost follow-up. The mean follow-up was 41.8 months. Conclusion : MS in advanced degrees has low incidence, preoperative diagnosis in only half of cases, and has the biliodigestive anastomosis as the best conduct, but not without morbidity.

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Are Ultrasound Findings Similar in Patients with Axial Spondyloarthritis and in Athlete Entheses?

The Journal of Rheumatology ◽

10.3899/jrheum.160715 ◽

2017 ◽

Vol 44 (5) ◽

pp. 609-612 ◽

Cited By ~ 7

Author(s):

Marie-Alix Lanfranchi ◽

Olivier Leluc ◽

Alice Tavano ◽

Cécile Wormser ◽

Sophie Morange ◽

...

Keyword(s):

Physical Activity ◽

Healthy Subjects ◽

Axial Spondyloarthritis ◽

Cross Sectional Study ◽

Healthy Controls ◽

Sectional Study ◽

Control Groups ◽

Cross Sectional ◽

Ultrasound Findings ◽

Us Findings

Objective.Enthesitis is the spondyloarthritis (SpA) landmark, but can also be seen after entheses overuse, such as during intensive sport.Methods.We aimed to compare entheses ultrasound (US) findings in a prospective cross-sectional study of 30 axial SpA cases, 30 athletes, and 29 controls.Results.Mean (SD) MAdrid Sonographic Enthesis Index (MASEI) score was 26.3 (13), 12.2 (7), and 10.4 (6) in patients with SpA, athletes, and non-athlete control groups, respectively (p < 0.0001).Conclusion.The MASEI score was significantly higher in patients with SpA compared with healthy controls, athletes, and non-athletes, and can be of value to distinguish SpA from healthy subjects, whatever their physical activity.

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Incidence of Malignant Neck Masses (MNMs) in Fallujah District , Iraq; Descriptive Cross Sectional Study 2017-2018

Indian Journal of Public Health Research & Development ◽

10.37506/ijphrd.v11i7.10281 ◽

2020 ◽

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Neck Masses

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Hadfield’s procedure for Duct Ectasia; The histopathological spectrum.

The Professional Medical Journal ◽

10.29309/tpmj/2019.27.01.3062 ◽

2020 ◽

Vol 27 (01) ◽

pp. 29-34

Author(s):

Fareya Usmani ◽

Imran Munir ◽

Ghazanfar Saleem Jadoon ◽

Nadia Shams

Keyword(s):

Clinical Assessment ◽

Past History ◽

Nipple Discharge ◽

Cross Sectional Study ◽

Pathology Report ◽

Diagnostic Challenge ◽

High Grade Fever ◽

Cross Sectional ◽

Duration Of Symptoms ◽

Benign Condition

Objectives: Mammary duct ectasia, a benign condition of breast is a diagnostic challenge both for surgeon and histo-pathologist. Duct ectasia is commonly encountered in clinical practice and its histo-pathological spectrum needs to be studied in detail in our patients. Study Design: Descriptive cross sectional study. Setting: Sir Syed College of Medical Sciences Karachi after ethical approval. Period: 24 months from June 2016-June 2018. Material & Methods: Total 104 female patients (>18 years) were included after informed consent. Patients presenting with lump in breast, breast pain, tenderness or nipple discharge were screened by ultrasound breasts or mammography. Pregnant women, patients having high grade fever, hematological abnormalities, coagulopathy, axillary lymphadenopathy, papilloma of nipple, galactocele, lactating mothers and those with past history of malignancy were excluded. Only those cases were included that had diagnosis of duct ectasia on ultrasound breast. Cone excision (Hadfield’s operation) was performed after pre-requisites and histo-pathological findings were documented. Patients were kept admitted under observation for minimum 24 hours and then followed up with histo-pathology report. Results: Amongst 104 cases, mean age was 41+6.35(range=30-50) years. The mean duration of symptoms was11.6+5.76 (range=1-24) months. 72(69%) women were married and 32(30.8%) were unmarried. As per histo-pathology report duct ectasia was found in 102(98%), hyperplasia in 61(58.7%), metaplasia in 41(39.4%) and atypical cells in 2(1.9%) samples. Conclusions: Current study demonstrated final outcome of metaplasia in thirty nine percent cases with initial clinical and sonographic diagnosis of duct ectasia. This suggests the triple technique evaluation (i.e. clinical assessment, ultrasound breast/mammography along with histo-pathological assessment) to identify cases with metaplasia. The high risk cases should be frequently followed with clinical assessment and imaging along with BRCA 1 & 2 gene for timely detection and intervention of breast malignancy.

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Epidemiology of Enuresis among Children in Diyala Governorate

Diyala Journal of Medicine ◽

10.26505/djm.20025791115 ◽

2021 ◽

Vol 20 (2) ◽

pp. 31-42

Author(s):

Enas S Salahaldeen ◽

◽

Nadhim Gh Noaman ◽

Mehdi SH Al-Zuheiry

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Educational Attainment ◽

Nocturnal Enuresis ◽

Cross Sectional Study ◽

Cross Sectional ◽

History Of ◽

Us Findings ◽

Primary Type ◽

Diurnal Enuresis

Background: Nocturnal enuresis, is intermittent involuntary voiding in a child aged five years or more. One time a month for three months is required for the diagnosis. It is a common problem in children. It is the cause of stress for them and for their families. Enuresis can be classified into two types to understand its causes and treatment. These types are primary and secondary enuresis, monosymptomatic and polysymptomatic. Primary enuresis always associated with a familial history of delayed control of the urinary bladder. Secondary enuresis may cause by urinary tract or neurogenic causes like the spinal cord and urinary tract infection. Most of the cases were of the primary type. Objective: To evaluate the associated factor of nocturnal enuresis, study the various types of nocturnal enuresis, and evaluate the associated factors that affect the types of nocturnal enuresis. Patients and Methods: A cross-sectional study conducted in outpatient clinic of Albatool hospital in Diyala province, Iraq, 150 children was eligible in the study, which started from 1st Febreuary to 30th June 2020. Collection of the data was done by interview parents’ or the children's caregiver by a questionnaire that was used before for study enuresis. Analysis was carried out using statistical package for social sciences SPSS version 24. Results: The present study included 150 patients with enuresis, their mean age was 7.51±1.34 years (range:= 5-10 years), there were (59.3%) males and (40.7%) females. Most of the patients (61.3%) had 2-3 sibling, second in their birth order (52%), reside in the urban area (56%), a majority of the mothers 38% had primary school as their highest educational attainment, a majority of the fathers (32.7%) had secondary school as their highest educational attainment, most of the mothers 62.7% were housewives and 57.3% of fathers were employees. Regarding clinical features of the patients, 32% had a family history of enuresis, 52% had a history of fluid consumption other than water, 7.3% had a history of punishment, 8% had history of constipation, 27.3% had a history of emotional stress, 5.3% had a history of DM, 30.7% had a history of drug intake, 61.3% reveal UTI in their urinalysis, 78% reveal abnormal US findings. Secondary enuresis was found in 65.3% of the patients, while primary enuresis found in 34.7% of the patients, 7.3% of the patients complaining of diurnal enuresis. All studied factors not significantly associated with types of enuresis except constipation was found more in patients with secondary enuresis 91.7%. Conclusion: According to the previous study many risk factors were associated with nocturnal enuresis, in the current study these risk factors, except constipation which was associated with secondary enuresis, were not associated with nocturnal enuresis.

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A clinicopathological study of rhinosporidiosis in a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182599 ◽

2018 ◽

Vol 4 (4) ◽

pp. 981

Author(s):

Mudassar A. Shariff

Keyword(s):

Nasal Cavity ◽

Blood Group ◽

Tertiary Care ◽

Young Male ◽

Surgical Excision ◽

Cross Sectional Study ◽

High Risk Group ◽

Study Group ◽

Care Hospital ◽

Cross Sectional

Background: Rhinosporidiosis is a chronic granulomatous infective disorder that is caused by Rhinosporidium seeberi. It usually presents as a soft polypoidal, pedunculated or sessile mass arising from the nasal mucosa. Common sites of occurrence of rhinosporidiosis are nasal cavity and nasopharynx, it can also be found in conjunctiva, larynx and maxillary sinuses.Methods: A cross-sectional study was conducted in the outpatient department of ENT, at Vinayaka Mission’s Medical College and Hospital for a period of 1 year 7 months from October 2011 to April 2013. During the study period, all cases that were diagnosed as rhinosporidiosis by histopathology were included in the study group. The aim of this study is to determine the epidemiology, risk factors, clinical features and evaluation of blood group in patients with rhinosporidiosis in a study group. Results: Majority of patients in our study were young male adults from low socio-economic strata and from rural area. The common sites involved were the nasal cavity and nasopharynx. It showed an association with blood group O type.Conclusions: Rhinosporidiosis is an infective disease which is seen in individuals using surface water sources for daily needs. It requires careful clinical evaluation and diagnosis. Patients in high risk group with suspicion should undergo surgical excision with electrocautery. Careful follow up is essential for early diagnosis of recurrence.

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Hidradenitis Suppurativa From a Patient Perspective Including Symptoms and Self-Treatment

Journal of Cutaneous Medicine and Surgery ◽

10.1177/12034754211024157 ◽

2021 ◽

pp. 120347542110241

Author(s):

Christina M. Huang ◽

Mark G. Kirchhof

Keyword(s):

Hidradenitis Suppurativa ◽

Patient Perspective ◽

Life Quality ◽

Surgical Excision ◽

Cross Sectional Study ◽

Cross Sectional ◽

Dermatology Clinic ◽

Disease Characteristics ◽

Female Predominance

Introduction Hidradenitis Suppurativa (HS) is a chronic inflammatory disordercommonly affecting body folds. It can significantly impair quality of life due to the physical, psychological, and socialturmoil experienced by patients. Treatment remains a challenge.Limited data on the HS patient experience, such as self-treatment exists. Methods This was a single-center cross-sectional study, utilizing a paper-based survey. Surveys were mailed out to all HS patients from the dermatology clinic and completed on a voluntary basis. Demographics, disease characteristics, medical and family history, treatments tried, and life quality were documented. Results The response rate was 49.4% (41/83), with a female predominance (26/41). Eighty-five percent (35/41) were Caucasian with an average age and BMI of 39.0 ± 16.78 and 30.71 ± 7.02, respectively. In total, 24.4% (10/41), 56.0% (23/41), and 19.5% (8/41) had Hurley I, II, and III, respectively. Lesions affected the genital region (75.6%), thigh/groin (68.2%), and axilla (46.3). Almost half (49%) of patients experienced an average of 1-2 flares per month. The most bothersome symptoms were pain (92.7%), discharge (68.3%), malodor (63.4%), and itch (61%). Depression (53.7%), severe facial acne (14.6%), and hypertension (14.6%) were the most common co-morbidities. Treatments used included antibiotics (82.9%) and surgical excision (34.2%) were. Over 90% of patients reportedself-treatment of lesions by squeezing (80.5%), soaking (53.7%), and lancing (41.4%). Conclusions This study provides insight into the patient perspective of HS. We identify itch as a symptom that is not frequently associated with HS and reveal how commonly patients utilize various types of self-treatment in their experience of disease.

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