scholarly journals Subcutaneous Facial Emphysema Following Open-Flap Air-Powder Abrasive Debridement for Peri-Implantitis: A Case Report and an Overview

Author(s):  
Gerardo La Monaca ◽  
Nicola Pranno ◽  
Susanna Annibali ◽  
Iole Vozza ◽  
Maria Paola Cristalli

Subcutaneous facial emphysema related to dental treatments is a well-known clinical complication due to incidental or iatrogenic air or gas penetration into the subcutaneous tissues and fascial planes, leading to distension of the overlying skin. To the best of our knowledge, from 1960 to the current date, only six cases have been reported arising from peri-implant cleaning or non-surgical peri-implantitis treatment. Therefore, the present case of subcutaneous facial emphysema following open-flap air-powder abrasive debridement was the first report during surgical peri-implantitis therapy. Swelling on the left cheek and periorbital space suddenly arose in a 65-year-old woman during open-flap debridement with sodium bicarbonate air-powder abrasion (PROPHYflex™ 3 with periotip, KaVo, Biberach, Germany) of the infected implant surface. The etiology, clinical manifestations, diagnosis, potential complications, and management of subcutaneous emphysema are also briefly reviewed. The present case report draws the attention of dental practitioners, periodontists, oral surgeons, and dental hygienists to the potential iatrogenic risk of subcutaneous emphysema in using air-powder devices in implant surface debridement.

2021 ◽  
Vol 2 ◽  
pp. 53-55
Author(s):  
Surajudeen Oyeleke Bello ◽  
Sandra Umejiaku ◽  
Taofik Oluwaseun Ogunkunle ◽  
Oyetundun Fausat Afolabi ◽  
Ahmed Ashuku Yakubu

Background: Spontaneous subcutaneous emphysema (SSE) is a clinical condition in which air escapes into the subcutaneous tissues. It is a rare complication of childhood pneumonia and often occurs with pneumothorax and/or pneumomediastinum. Although the sight of a child with SSE could be frightening, it is mostly benign requiring in most cases supportive care. We report a case of SSE complicating pneumonia in an 18-month-old toddler that was managed conservatively. Case Report: An 18-months-old toddler was admitted with a 5-day history of progressive swelling of the face, scalp, upper limbs, and trunk. He was referred from a peripheral hospital where he was admitted for 5 days with pneumonia and had received antibiotics, intravenous fluid, and oxygen therapy. Clinical evaluation revealed extensive subcutaneous emphysema and right-sided pneumothorax. Antibiotics were optimized and the patient was provided supportive care and monitored for 7 days with complete resolution of the emphysema. Conclusion: SSE could complicate childhood pneumonia but it has a benign course. Effective treatment of underlying pneumonia alongside supportive care will achieve complete resolution.


Homeopathy ◽  
2021 ◽  
Vol 110 (02) ◽  
pp. 132-136
Author(s):  
Silvia Waisse

AbstractThromboinflammation is a still not well-understood phenomenon, which has recently come to the foreground as a function of its relevance in the pathophysiology of coronavirus disease 2019 (COVID-19). The patient described in the present case report exhibited acute fever, giant urticaria, elevated acute phase reactants, and very high d-dimer levels, thus characterizing thromboinflammation. She was diagnosed as a COVID-19 suspect case, which was not confirmed; urticarial vasculitis was ruled out. Homeopathic treatment was started with the earliest clinical manifestations, resulting in rapid and drastic reduction of inflammation and hypercoagulability within the first 12 hours, and full recovery on 10-day follow-up assessment. This case demonstrates the effectiveness of homeopathy in a severe acute disorder, and points to the need to include laboratory testing in homeopathic clinical assessment to achieve an accurate picture of disease, and to avoid the risk of passing over life-threatening disorders.


2019 ◽  
Vol 7 ◽  
pp. 2050313X1987097
Author(s):  
Christine Helene Opedal Ringvold ◽  
Ulla Møller Weinreich

Subcutaneous emphysema, the presence of air under the subcutaneous tissues, often arises in relation to pneumothorax, including iatrogenic pneumothorax. It can arise as a consequence of chest drain insertion and removal. This case report describes worsening of subcutaneous emphysema subsequent to chest drain removal, leading to tardive and life-threatening subcutaneous emphysema. There are few international guidelines describing chest drain removal and there are few reports describing tardive subcutaneous emphysema. These areas need further exploration using evidence-based research in order to develop a consensus on treatment options.


2016 ◽  
Vol 19 (3) ◽  
pp. 106
Author(s):  
Marcelo Bighetti Toniollo ◽  
Andrea Sayuri Silveira Dias Terada ◽  
Marco Aurelio Kenichi Yamaji

<p>Subcutaneous emphysema is an event often generated by iatrogenic reason, caused by improper dissection of air into soft tissues and/or anatomical structures, causing edema and visually noticeable volumetric change in the area of the incident. The main etiological factor for this is the use of equipment such as syringe air or high-speed handpieces in surgical procedures of greater magnitude; however, subcutaneous emphysema may also occur in simple procedures, such as occurred in the present case report, using the air-abrasive device usually proper for prophylaxis execution. The aim of this article is to report the case and to describe the care to avoid such an event, describing proper procedures for the correct resolution of the case, as well as alert the professional of the risks and necessary precautions.</p>


2020 ◽  
Vol 27 (3) ◽  
pp. 241-244
Author(s):  
Mihai MEHEDINTU ◽  
Razvan DANCIU ◽  
Alexandra CHELARIU ◽  
Andrei S. COMAN ◽  
Cristian R. JECAN

Cutaneous leiomyomas are uncommon benign smooth muscle tumors that comprise of three distinct types such as piloleiomyoma, angioleiomyoma, and genital leiomyoma. The discovery in 2001 of the association between cutaneous leiomyomas, uterine leiomyomas in women, and an aggressive form of renal cell cancer (RCC) underscores the importance of accurate dermatologic diagnosis of CL so that appropriate cancer screening and counseling of patients and at-risk relatives can be instituted. The present case report will discuss the pathogenesis, clinical manifestations, diagnosis, and management of a piloleiomyoma.


1970 ◽  
Vol 5 (4) ◽  
pp. 51-60
Author(s):  
José Henrique Pereira Pinto ◽  
Renan Lemos de Toledo ◽  
William do Prado Franquelo

RESUMOIntrodução: Alergia à Proteína do Leite de Vaca (APLV) é uma doença inflamatória secundária à reação imunológica contra uma ou mais proteínas do leite de vaca (LV) que afeta principalmente a faixa pediátrica. A real prevalência é discutida em muitos estudos. As manifestações clínicas dependem do tipo da resposta imunológica, ser IgE mediada ou não. Os sintomas se iniciam por volta dos 06 meses de vida e na maioria dos casos, esse processo alérgico regride, com o paciente desenvolvendo tolerância até a adolescência. Casuística: Relata-se um caso de um paciente do sexo masculino, apresentando desde os 6 meses de idade de anafilaxia e broncoespasmo. Nesta época foi levado em hospitais e ambulatórios sendo diagnosticado e tratado como asma apenas, porém sem sucesso. Aos 18 anos, em consulta com especialista foi diagnosticado com APLV, apesar da dieta de exclusão, apresentou diversas reações anafiláticas, devido a ingestão acidental do alérgeno. Discussão: O paciente iniciou os primeiros sintomas quando houve contato com LV e apresentou teste laboratorial com valores compatíveis a patologia. Segundo a literatura a prevalência de APLV cai para menos de 1% aos 6 anos de vida e está persistência pode estar associada a múltiplos fatores, no caso relatado, o paciente não apresentou tolerância até o presente momento. Conclusão: APLV é uma doença usualmente de criança em que, se estas não adquirirem tolerância, complicações podem perdurar indefinidamente. O Diagnóstico precoce e o manejo adequado desta condição, revela grande importância na qualidade de vida e na prevenção de anafilaxia.Palavras chave: Alergia, Proteína do leite de vaca, Anafilaxia. ABSTRACT Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease secondary to immune response against one or more cow's milk proteins (LV) which primarily affects pediatric patients. The current prevalence is discussed in many studies. The clinical manifestations depend on the type of immune response, being IgE mediated or not. Symptoms start at about 06 months of life and in most cases, the allergic process subsides, and the patient develops tolerance through adolescence. Case Report: We report the case of a male patient, who was presenting, since his 06 months of age, anaphylaxis and bronchospasm. At that time he was taken into hospitals and clinics being diagnosed and treated as asthma, but without success. At 18, in consultation with expert was diagnosed with CMPA, and despite the exclusion diet, presented several anaphylactic reactions due to accidental ingestion of the allergen. Discussion: The patient began the first symptoms when there was contact with LV and presented laboratory test values compatible with the pathology. According to the literature the prevalence of CMPA drops to less than 1% to 6 years of life and this persistence can be associated with multiple factors, in our case, the patient did not develop tolerance to date. Conclusion: CMPA is usually a child disease but ,if they do not acquire tolerance, complications can last indefinitely. Early diagnosis and appropriate management of this condition, reveals a great deal on quality of life and prevention of anaphylaxis. Keywords: Allergy, Cow’s milk protein, Anaphylaxis. 


1970 ◽  
Vol 5 (3) ◽  
pp. 53-67
Author(s):  
Aline Dos Santos ◽  
Ana Caroline Balducci Scafi ◽  
Luciene Azevedo Morais ◽  
Pablo Girardelli Mendonça Mesquita

RESUMOIntrodução: A Granulomatose de Wegener (GW) é uma vasculite rara e idiopática associada à presença do anticorpo Anticitoplasma de Neutrófilo (ANCA) que acomete, preferencialmente, os pequenos vasos. As manifestações clínicas são diversas, ocorrendo em mais de 90% dos casos, sintomas do trato respiratório. O comprometimento renal é tardio e preditor de mau prognóstico.  Sua morbidade a médio e longo prazo inclui insuficiência renal crônica. A probabilidade de sucesso de manutenção da função renal depende da concentração sérica de creatinina ao início do tratamento, o que indica a importância do diagnóstico e terapêutica adequada precoces. Casuística: Relata-se o caso de uma paciente do sexo feminino, 61 anos, portadora de GW com comprometimento renal avançado à apresentação não precedido por sintomas pulmonares esperados. O tratamento imunossupressor associado a plasmaferese permitiu a melhora da função renal da paciente poupando-a de tornar-se dialítica- dependente. Discussão: A paciente iniciou a doença através de insuficiência renal assintomática, com valores de função renal compatíveis com o estágio mais avançado de doença renal crônica, ultrassonografia dos rins sem alterações compatíveis e sem os sintomas respiratórios esperados. Segundo a literatura, a combinação de imunossupressores e plasmaferese associa-se à recuperação renal em três meses com sobrevivência sem necessidade de diálise por 12 meses, no caso relatado, obteve-se tal resultado em 22 dias sem a necessidade de diálise após um ano. Conclusão: Devido ao diagnóstico precoce, o tratamento adequado foi instalado rapidamente proporcionando à paciente um aumento da expectativa e da qualidade de vida, evitando dependência de terapia renal substitutiva.Palavras-Chave: Granulomatose de Wegener, Plasmaferese, Doença renal crônica.  ABSTRACTIntroduction: The Wegener's Granulomatosis (WG) is a rare and idiopathic vasculitis associated with the presence of Antineutrophil Cytoplasmic Antibody (ANCA), that affects, preferentially, the small vessels. The clinical manifestations are diverse, occurring in over 90% of cases, symptoms in the respiratory tract. Kidney damage is a late and bad prognostic predictor. Morbidity in the medium and long term includes chronic renal failure. The probability of renal function maintenance success depends on serum creatinine concentration at the beginning of treatment that indicates the importance of early diagnosis and deployment of an appropriate therapy. Case Report: We present a case of a 61-year-old female patient, carrier of GW with advanced renal impairment presentation, not preceded by expected pulmonary symptoms. The immunosuppressive treatment associated with plasmapheresis allowed the improvement of the patient’s renal function, saving her from becoming dialysis-dependent Discussion: The patient developed the disease through asymptomatic renal failure, renal function with values that are compatible with the most advanced stage of chronic kidney disease, ultrasound of the kidneys without compatible changes and without the expected respiratory symptoms. According to the literature, the combination of immunosuppressive drugs and plasmapheresis is associated with renal recovery in three months with survival without dialysis for 12 months. In this case, a result was obtained in 22 days without the need for dialysis after one year. Conclusion: Due to the early diagnosis, appropriate treatment was quickly installed giving the patient increased life expectancy and quality, preventing dependence on renal replacement therapy.Keywords: Wegener’s granulomatosis, Plasmapheresis, Chronic renal failure.


2015 ◽  
Vol 04 (01) ◽  
pp. 043-045
Author(s):  
Gyata Mehta ◽  
Varsha Mokhasi

AbstractThe median nerve is formed in the axilla by fusion of the two roots from the lateral and medial cords. The present case report describes an anomalous presentation of double formation of median nerve and its relation with axillary and brachial arteries. The median nerve was formed in two stages at different levels, first in the axilla and then in the upper arm by receiving double contribution from the lateral root of the lateral cord, which fuse with the medial root of the medial cord to form the median nerve. The formation took place medial to the axillary artery in the axilla and antero-medial to the brachial artery in the arm. Such anatomical variations and their relation with the arteries are important for the surgeons and anesthesiologists and of great academic interest to the anatomists.


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