scholarly journals Rectal perforation, a rare presentation of a swollen limb

2021 ◽  
Vol 8 (9) ◽  
pp. 2842
Author(s):  
Sreenidhi G. M. ◽  
Jyothi S. ◽  
Vikyath Satish
Keyword(s):  
Gastrointestinal Tract ◽  
Lower Limb ◽  
Subcutaneous Tissue ◽  
Rare Presentation ◽  
Incision And Drainage ◽  
True Incidence ◽  
Definitive Therapy ◽  
Feasible Option ◽  
Fatal Course ◽  
Probable Origin

Soft tissue infection of right lower limb secondary to perforation of the gastrointestinal tract is very rare and the true incidence is probably higher, as some cases will be misdiagnosed as gas gangrene unless careful clinical examinations are performed. Only rapid recognition of the probable origin of the gas, coupled with aggressive, definitive therapy, can prevent the usually fatal course of this condition. In the absence of trauma or infection in a previously normal leg, subcutaneous emphysema of a limb should alert the clinician to the possibility of a gastrointestinal perforation as a source of the gas. Perforations of the gastrointestinal tract into the subcutaneous tissue can occur anywhere from the neck to the lower extremities. The mechanisms and anatomical pathways are discussed in this case report. Diversion colostomy with incision and drainage of the lower limb of the same is a safe and feasible option.

Sonography of subcutaneous tissue cannot determine causes of lower limb edema

VASA ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Mandy Becker ◽  
Tom Schilling ◽  
Olga von Beckerath ◽  
Knut Kröger
Keyword(s):  
Clinical Diagnosis ◽  
Lower Limb ◽  
Subcutaneous Tissue ◽  
Hepatic Disease ◽  
Clinical Use ◽  
Single Image ◽  
Heart Insufficiency ◽  
Chronic Hepatic Disease ◽  
Limb Edema ◽  
Venous Disorders

Background: To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema. Patients and methods: 38 (70 ± 12 years, 22 (58 %) females) patients with lower limb edema were recruited according the clinical diagnosis: 10 (26 %) lymphedema, 16 (42 %) heart insufficiency, 6 (16 %) venous disorders, 6 (16 %) chronic hepatic disease. Edema was depicted sonographically at the most affected leg in a standardised way at distal and proximal calf. 38 sets of images were anonymised and send to 5 experienced doctors. They were asked whether they can see criteria for lymphedema: 1. anechoic gaps, 2. horizontal gaps and 3. echoic rims. Results: Accepting an edema as lymphedema if only one doctor sees at least one of the three criteria for lymphatic edema on each single image all edema would be classified as lymphatic. Accepting lymphedema only if all doctors see at least one of the three criteria on the distal image of the same patient 80 % of the patients supposed to have lymphedema are classified as such, but also the majority of cardiac, venous and hepatic edema. Accepting lymphedema only if all doctors see all three criteria on the distal image of the same patients no edema would be classified as lymphatic. In addition we separated patients by Stemmers’ sign in those with positive and negative sign. The interpretation of the images was not different between both groups. Conclusions: Our analysis shows that it is not possible to differentiate lymphedema from other lower limb edema sonographically.

Oesophageal malignancy with cutaneous metastasis over lower limb: A rare presentation

2016 ◽  
Vol 5 (1) ◽  
pp. 68
Author(s):  
Swapna Jilla ◽  
Archana Prathipati ◽  
Rashmi Patnayak ◽  
S Sarala ◽  
MS Venkata Rami Reddy
Keyword(s):  
Lower Limb ◽  
Cutaneous Metastasis ◽  
Rare Presentation

scholarly journals Challenging Presentations of Seven Cases of Gastrointestinal Basidiobolomycosis in Sudan: Clinical Features, Histology, Imaging, and Recommendations

2020 ◽  
Vol 12 (04) ◽  
pp. 281-284
Author(s):  
Sawsan A. Mohammed ◽  
Azza A. Abdelsatir ◽  
Mohamed Abdellatif ◽  
Suliman Hussein Suliman ◽  
Omer Mohammed Ibrahim Elbasheer ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Fungal Infection ◽  
Clinical Features ◽  
Subcutaneous Tissue ◽  
Case Series ◽  
First Case

AbstractsBasidiobolomycosis is a fungal infection caused by Basidiobolus ranarum which affects the skin and subcutaneous tissue and rarely the gastrointestinal tract. We report seven cases of gastrointestinal basidiobolomycosis with interesting clinical, radiological, and histological presentations. To our knowledge, this is the first case series of abdominal basidiobolomycosis to be reported from Sudan.

scholarly journals A Rare Presentation of ConcurrentScedosporium apiospermumandMadurella griseaEumycetoma in an Immunocompetent Host

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Vivek Gulati ◽  
Seun Bakare ◽  
Saket Tibrewal ◽  
Nizar Ismail ◽  
Junaid Sayani ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Sensu Stricto ◽  
Scedosporium Apiospermum ◽  
Immunocompetent Host ◽  
Rare Presentation ◽  
Atypical Case ◽  
Granulomatous Infection

Mycetoma is a disfiguring, chronic granulomatous infection which affects the skin and the underlying subcutaneous tissue. We present an atypical case of recurrent mycetoma without ulceration, in a 35-year-old immunocompetent male caused byScedosporium apiospermumsensu stricto andMadurella grisea, occurring at two separate anatomical sites.

scholarly journals A case of acute limb ischemia

2021 ◽  
Vol 8 (10) ◽  
pp. 1608
Author(s):  
Kshiti Rai ◽  
K. G. Sajeeth Kumar ◽  
Danish Ekkalayil ◽  
Anoop Chanthu K. K.
Keyword(s):  
Acute Myeloid Leukemia ◽  
Early Diagnosis ◽  
Lower Limb ◽  
Myeloid Leukemia ◽  
Hematological Malignancy ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Rare Presentation ◽  
Hematological Evaluation ◽  
Acute Myeloid

Thromboembolism is a well-recognized complication of hematological malignancy. The incidence of symptomatic thrombosis at diagnosis is relatively low in AML (acute myeloid leukemia) patients, though its incidence increases on treatment with anthracyclines. We reported a case of 69 year old female with T2DM who presented with DVT and later on acute limb ischemia of the same lower limb. On hematological evaluation, she had leukocytosis and thrombocytopenia. Further evaluation revealed AML. Thromboembolism as a rare presentation of AML in adults with leukemic hyperleukocytosis has seldom been reported. In the absence of clear guidelines, early diagnosis and management are desirable.

scholarly journals Spinal Dural Arteriovenous Fistula and Cecal Arteriovenous Malformation in a Boy

2017 ◽  
Vol 8 (1) ◽  
pp. 3
Author(s):  
Vimlesh Soni ◽  
Pankaj C Vaidya ◽  
Jitendra Kumar SSahu ◽  
Mukesh Yadav ◽  
Pratibha Singhi
Keyword(s):  
Gastrointestinal Tract ◽  
Arteriovenous Malformation ◽  
Arteriovenous Fistula ◽  
Lower Limb ◽  
Dural Arteriovenous Fistula ◽  
Severe Anemia ◽  
Spinal Dural Arteriovenous Fistula ◽  
Glue Embolization ◽  
Spinal Dural Avf ◽  
Work Up

Concurrent spinal dural arteriovenous fistula (AVF) and cecal arteriovenous malformation (AVM) are very rare. A 6-year old boy presented with lower limb paresis after trauma. On imaging work-up spinal dural AVF was found. It was managed with endovascular glue embolization. After two years, the boy presented with severe anemia and occult gastrointestinal tract (GIT) bleed. Cecal AVM was diagnosed and managed with embolization.

scholarly journals Empyema Necessitans in the Setting of Methicillin-Susceptible Staphylococcus aureus Causing Pneumonia and Bacteremia

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Sindhura Bandaru ◽  
Sukesh Manthri ◽  
Vidya Sundareshan ◽  
Vidhya Prakash
Keyword(s):  
Staphylococcus Aureus ◽  
Chest Wall ◽  
Subcutaneous Tissue ◽  
Parietal Pleura ◽  
Intravenous Drug Use ◽  
Rare Occurrence ◽  
Left Forearm ◽  
Gram Stain ◽  
Incision And Drainage ◽  
Prompt Diagnosis

Empyema necessitans (EN) is a rare phenomenon that refers to an insidious extension of the empyema through parietal pleura and subsequent dissection into subcutaneous tissue of the chest wall. A 29-year-old man presented to the hospital with fever and chills a few days after an inadvertent needle stick while injecting heroin. His left forearm was warm with an area of fluctuance. He underwent incision and drainage of the left forearm abscess with fluid submitted for Gram stain and culture. His condition rapidly deteriorated due to sepsis, and he required transfer to the intensive care unit. A new 4 × 3 cm area over the left pectoralis muscle had become increasingly indurated, fluctuant, and erythematous. CT of the chest demonstrated extensive cavitary lung lesions and a large loculated left-sided pleural effusion with extension through the chest wall. TEE revealed a 3 cm complex lesion on the superior septal leaflet of the tricuspid valve. The patient underwent incision and drainage of the pectoralis major EN with placement of a drain. Blood and sputum cultures grew methicillin-susceptible Staphylococcus aureus (MSSA) at which time antibiotic therapy was tailored to oxacillin. Our case highlights a rare occurrence of EN due to MSSA in a patient with intravenous drug use (IDU) and underscores the importance of prompt diagnosis and treatment.

Clinical biochemical tissue monitoring during ischaemia and reperfusion in major vascular surgery

2003 ◽  
Vol 40 (3) ◽  
pp. 289-291 ◽  
Author(s):  
S Klaus ◽  
KH Staubach ◽  
W Eichler ◽  
J Gliemroth ◽  
M Heringlake ◽  
...  
Keyword(s):  
Blood Flow ◽  
Vascular Surgery ◽  
Lower Limb ◽  
Subcutaneous Tissue ◽  
Aortic Surgery ◽  
Tissue Blood Flow ◽  
Limb Ischaemia ◽  
Additional Tool ◽  
Acute Changes ◽  
Major Vascular Surgery

Background: Major vascular surgery with aortic cross-clamping is associated with temporary ischaemia of the lower limb due to lack of tissue blood flow. The present study was designed to determine if the short-term changes in cellular metabolism occurring during this situation can be detected by subcutaneous microdialysis. It was also hoped to ascertain if this new technique is useful in the continuous bedside monitoring of metabolism during aortic surgery. Methods: In a controlled clinical study 20 patients undergoing elective aortic surgery were monitored using microdialysis probes that were inserted in the subcutaneous tissue of the left lower limb and a non-ischaemic region (shoulder). Interstitial fluid was obtained and the concentrations of glucose and lactate during lower limb ischaemia and during reperfusion were measured and compared with concentrations observed in fluid obtained from the non-ischaemic control tissue. Results: Circulatory occlusion caused an immediate and significant decrease in the glucose/lactate ratio from 3·1±1·3 to 0·48±0·5 (P<0·05) that returned to preocclusion values within 2 h of commencing reperfusion. Conclusion: We suggest that microdialysis may be used both to assess acute changes in tissue metabolism during ischaemic periods and also to act as an additional tool for the detection of peri-operative acute variations in limb blood flow.

Bloodless removal of varicose veins - a new technique

2004 ◽  
Vol 19 (4) ◽  
pp. 185-188 ◽  
Author(s):  
D Lorenz ◽  
W Kullich ◽  
M Redtenbacher ◽  
W Weissenhofer
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
High Frequency ◽  
Varicose Veins ◽  
Subcutaneous Tissue ◽  
Compression Bandages ◽  
Standard Procedures ◽  
Added Benefit ◽  
Preliminary Study ◽  
A New Technique

Objective: To describe the use of a novel electric vein stripper (EVS) for use in patients with varicosities of the greater saphenous vein and tributaries. Methods: In addition to standard procedures as performed in varicose veins of the lower limb, an EVS, powered by a standard high frequency electrocoagulation generator (HF), is introduced. The application of this new EVS makes it possible to avoid tearing of the structures of the subcutaneous tissue surrounding the greater saphenous vein, leaving the channel of the vein blood dry. Results: A preliminary study including two groups of patients - 20 in the Babcock group and 24 in the EVS group - resulted in significantly reduced pain and discomfort. An added benefit for the patients was the fact that postoperative compression bandages were not needed. Conclusions: Application of EVS can prevent bruising and haematomas in vein stripping can be avoided.

scholarly journals Rare Presentation of Unilateral Weakness, Involuntary Movements and Ataxia with Subcortical T2 Hypointensity in a Diabetic Patient: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Venkatraman Indiran ◽  
Prabakaran Maduraimuthu
Keyword(s):  
Case Report ◽  
Diabetic Patient ◽  
Upper Limb ◽  
Lower Limb ◽  
Early Identification ◽  
Common Finding ◽  
Rare Presentation ◽  
Involuntary Movements ◽  
Left Lower Limb ◽  
Unilateral Weakness

Subcortical T2 hypointensity on MRI is not a common finding. We present a case of subcortical T2 hypointensity in a diabetic patient, who was referred with weakness of left lower limb and involuntary movements and ataxia of the left upper limb. Lab reports confirmed the diagnosis of nonketotic hyperglycemia. It is rather important to identify subcortical T2 hypointensity which has only been recently found to be associated with nonketotic hyperglycemia. Early identification and prompt correction of blood sugar would help in alleviating the neurological symptoms.

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