scholarly journals Intraoperative Ultrasound-assisted Treatment of Idiopathic Spontaneous Intramedullary Hemorrhage: A Case Report and Literature Review

2020 ◽  
Author(s):  
Chunyang Liu ◽  
Huiqin Zhu ◽  
Mingxin Yu ◽  
Bo Yang ◽  
Xianfeng Zhang ◽  
...  

Abstract Background: Idiopathic spontaneous intramedullary hemorrhage is a rare clinical disease. No cases of intraoperative ultrasound-assisted treatment of the disease have been reported in the literature. To present a case of idiopathic spontaneous intramedullary hemorrhage treated with intraoperative ultrasound and review the diagnosis and treatment of the disease.Case presentation: An 11-year-old child was admitted to our department because of a sudden severe pain on the left side of her back. Magnetic resonance images of the thoracic vertebrae showed abnormal signals in T2-T3 and spontaneous intramedullary hemorrhage was suspected. Intraoperative ultrasound-assisted evacuation of the intramedullary hematoma was performed and no abnormal blood vessels or malformations were found during intraoperative exploration.Conclusion: We report a rare case of idiopathic spontaneous intramedullary hemorrhage with intraoperative ultrasound-assisted hematoma clearance and a good prognosis.

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.


1998 ◽  
Vol 88 (2) ◽  
pp. 87-91 ◽  
Author(s):  
GW Chalmers ◽  
WR Brown ◽  
JJ Stienstra

Tumoral calcinosis-like lesions of the foot are a pedal manifestation of end-stage renal disease. Although they are benign, they have the potential to cause significant morbidity because of their invasive nature. Following a brief description of tumoral calcinosis-like lesions, the authors provide an illustrative case presentation including radiographs, magnetic resonance images, surgical photographs, and histopathology.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mohammad Saba ◽  
Joshua Rosenberg ◽  
Gregory Wu ◽  
Gudata Hinika

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Ting Zhu ◽  
Jin Wu ◽  
Li Yuan Wang ◽  
Xiao Mei Sun

Abstract Background Phenylketonuria (PKU) is a genetic metabolic disorder in which patients have no ability to convert phenylalanine to tyrosine. Several autoimmune diseases have been reported to combine with PKU, co-existent of PKU and Juvenile Idiopathic Arthritis (JIA) has not been presented. Case presentation The girl was diagnosed with PKU at the age of 1 month confirmed by molecular data. At the age of 3.5 years, she presented with pain and swelling of her right ankle, right knee, and right hip joint. After a serial of examinations, she was diagnosed with JIA and treated with a nonsteroidal anti-inflammatory drug. Conclusions We report a rare case of a 4-year-old girl with PKU and JIA, which supports a possible interaction between PKU and JIA. Long-term metabolic disturbance may increase the susceptibility to JIA. Further chronic inflammation could alter the metabolism of tryptophan and tyrosine to increase blood Phe concentration. In addition, corticosteroid and methotrexate therapy for JIA may increase blood Phe concentration.


2018 ◽  
Vol 19 (4) ◽  
pp. 351-353
Author(s):  
E Forbat ◽  
MJ Rouhani ◽  
C Pavitt ◽  
S Patel ◽  
R Handslip ◽  
...  

Background Leptospirosis is a rare infectious illness caused by the Spirochaete Leptospira. It has a wide-varying spectrum of presentation. We present a rare case of severe cardiogenic shock secondary to leptospirosis, in the absence of its common clinical features. Case presentation A 36-year-old woman presented to our unit with severe cardiogenic shock and subsequent multi-organ failure. Her clinical course was characterised by ongoing pyrexia of unknown origin with concurrent cardiac failure. She was initially managed with broad-spectrum antibiotics and inotropes. Percutaneous cardiac biopsy excluded major causes of myocarditis. On day 21 after presentation, she was found to be IgM-positive for leptospirosis. Conclusions This is a rare case of severe cardiogenic shock secondary to leptospirosis infection. The case also highlights the importance of obtaining a thorough social history when assessing a patient with an unusual presentation, as clues can often be missed.


2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Ozcan Kaya ◽  
Okan Ozkunt ◽  
Irem Kurt

Introduction: Ulnar volar dislocation (UVD) is a very rare entity. Due to rarity of condition, usually, it’s misdiagnosed at emergency departments and management of this clinical entity is not well studied. Here, we report a case of UVD impressing diagnostic challenge, indication of treatment, and follow-up. Case Report: A 29-year-old man presented to orthopedic outpatient service with complaining of the right wrist pain. He had an assault history 3 days before. In the emergency department, he had been diagnosed as wrist sprain. Splint and pain killers were prescribed. Due to increase of pain, he admitted to orthopedics. He was diagnosed UVD. Under general anesthesia, joint was reduced with forced pronation maneuver. After 3 weeks immobilization period, magnetic resonance images revealed partial injury of triangular fibrocartilage complex then splint removed and rehabilitation initiated. Over than 24 months, he is doing well without movement limitation and wrist strength impairment. Conclusion: For prevention misdiagnosis of UVD, physical examination is very important. Forearm rotation limitation with pain in the wrist should be indicative for distal radioulnar joint injury. Physical examination should be supported with proper evaluation of suitable radiographs. After reduction of joint, magnetic resonance images give clues about ligamentous injury. Our case supports the importance of rigorous physical examination and evaluation of radiographs for wrist injury. In the presence of partial injury of ligaments, the condition can be treated with shorter periods of immobilization and early rehabilitation. Keywords: Wrist pain, ulnar volar dislocation, distal radioulnar joint, forearm rotation.


Author(s):  
Sharanya Suseela ◽  
Anandaraman Puthanmadom Venkatraramana Sharma ◽  
Kesavan Parameswaran Namboothiri ◽  
Prathibha Changuli Krishna Bhat

Abstract Objectives Vipadika (Palmo plantar Psoriasis) is a Kshudra Kushta (minor skin disorder) of Vatakapha origin (body humors like vata and kapha) characterized by Sphutana (cracks) and Teevra Vedana (severe pain) in Pani (palm) and Pada (sole). Based on the symptoms it can be correlated to Palmo Plantar Psoriasis which is a variant of psoriasis which affects the skin of the palms and soles with the features of hyperkeratotic, pustular, or mixed morphologies. The treatment methods for Palmo plantor psoriasis causes severe side effects due to which an evident shift from modern treatments to ayurvedic treatment line. Case presentation A 15 year old, female, with complaint of cracks and dryness over sole of both feet with pain for the last 12 and half years. The case was managed with Padanimajjana (immersion of foot). Padanimajjana is a modified form of Avagaha Sweda (switz bath) where the affected part of the foot is dipped in medicated liquid. Here Mahisha Gritha (Buffaloe ghee) is used for Padanimajjana. Conclusions Mahisha Gritha Padanimajjana shows significant improvement in number of cracks, dryness and pain within short period of time. This is a very simple, economical, and effective treatment for Vipadika.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wen Wang ◽  
Xu Lu ◽  
Chengbo Li ◽  
Myong Jun Ri ◽  
Wei Cui

Abstract Background We report a rare case of chronic brucellosis accompanied with myelodysplastic syndrome and neutrophilic dermatosis, which to the best of our knowledge, has never been reported. Case presentation A young man was admitted to our hospital complaining of recurrent fever, arthritis, rashes and anemia. He had been diagnosed with brucellosis 6 years prior and treated with multiple courses of antibiotics. He was diagnosed with myelodysplastic syndrome and neutrophilic dermatosis following bone marrow puncture and skin biopsy. After anti-brucellosis treatment and glucocorticoid therapy, the symptoms improved. Conclusions Clinicians should consider noninfectious diseases when a patient who has been diagnosed with an infectious disease exhibits changing symptoms.


2000 ◽  
Vol 21 (5) ◽  
pp. 408-412 ◽  
Author(s):  
J.A. Harty ◽  
P. Kelly ◽  
D. Niall ◽  
J.C. O'Keane ◽  
M.M. Stephens

We report the a case of Nora's lesion (Bizarre Parosteal Osteochondromatous Proliferation) of the sesamoid. A 32-year-old woman presented with a painless, enlarging mass of two years duration on the plantar aspect of the first metatarsophalangeal joint of the left foot. Radiographs, Computerized Tomographs and Magnetic Resonance images, initially suggested a parosteal osteosarcoma arising from the tibial sesamoid. The mass was excised, and a histological diagnosis of Bizarre Parosteal Osteochondromatous Proliferation of bone (Nora's lesion) was made. The aggressive growth of this lesion may suggest a neoplasm clinically. Histological features, however, are those of a reactive lesion.


2004 ◽  
Vol 101 (2) ◽  
pp. 343-346 ◽  
Author(s):  
Takatoshi Sorimachi ◽  
Yukihiko Fujii ◽  
Naoto Tsuchiya ◽  
Masatsune Saito

✓ The authors report on two patients in whom an increased signal on T1-weighted magnetic resonance images and a high-density signal on computerized tomography scans of the striatum were demonstrated, both of which were associated with nonketotic hyperglycemia. Involuntary movements, which have been present in all previously reported cases, were not observed in either patient at any time during the entire course of illness. One patient displayed hemiparesis, whereas the other had dementia, gait disturbance, and urinary incontinence. Clinical and radiological abnormalities improved on control of blood glucose levels. Invasive studies, including biopsy procedures, should be avoided on encountering this disease given the good prognosis that results from simple medical treatment.


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