scholarly journals Red herring unmasked: the trail leading to retinoblastoma

2021 ◽  
Vol 3 (2) ◽  
pp. 101-106
Author(s):  
Variant Nee Vern Chee ◽  
Li Yen Chan ◽  
Zayani Binti Zohari ◽  
Fazliana Binti Ismail ◽  
Jamalia Binti Rahmat
Keyword(s):  
Anterior Chamber ◽  
Blunt Trauma ◽  
Poor Prognosis ◽  
Foreign Bodies ◽  
Histopathological Examination ◽  
Case Series ◽  
Accurate Diagnosis ◽  
Vitreous Haemorrhage ◽  
History Of ◽  
High Index Of Suspicion

This case series highlights the possibility of retinoblastoma in children with a history of trauma. Retinoblastoma commonly presents with leukocoria. In our series, the history of blunt trauma led to a misdiagnosis. The delay in correctly diagnosing retinoblastoma was made more difficult with hyphaema and vitreous haemorrhage obscuring the fundus view. Hyperdensities in imaging tests were mistaken for intraocular foreign bodies and post-trauma insult rather than calcification of an intraocular tumour. Both patients underwent anterior chamber washout. The patients were referred to our centre when their condition worsened. Retinoblastoma was highly suspected and confirmed from histopathological examination after enucleation. An accurate diagnosis can only be achieved by exercising a high index of suspicion. Misdiagnosis and mismanagement will lead to poor prognosis.

Foreign Body Nose: An Unusual Presentation

2021 ◽  
Vol 28 (3) ◽  
pp. 282-284
Author(s):  
Ankit Gulati ◽  
Surinder K Singhal ◽  
Shashikant A Pol ◽  
Nitin Gupta
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Interesting Case ◽  
Alar Cartilage ◽  
Open Approach ◽  
Medial Canthus ◽  
History Of ◽  
Foreign Body Impaction ◽  
Nasal Bleed ◽  
High Index Of Suspicion

Introduction This is a very interesting case of retained homicidal foreign body in the nose in contrast to most of the foreign bodies which are accidental. Case Report A 27 year old male presented to ENT emergency with alleged history of assault over face with sharp object following which patient developed nasal bleed. On examination vertical laceration of approximately 8 cm in length was present along left naso-orbital groove extending superiorly from medial canthus of left eye and inferiorly to nasal alar cartilage. On anterior rhinoscopy a metallic foreign body was seen in both nasal cavities, which appeared to be crossing from left to right side piercing the nasal septum. Foreign body was removed via open approach. Discussion Penetrating maxillofacial injury with foreign body impaction are less common. High index of suspicion is required in diagnosing these cases. Radiological intervention should be done to get idea of exact location and extent of foreign body. Lateral rhinotomy is a useful approach in removing these foreign bodies.

scholarly journals Vaping in today’s pandemic: E-cigarette, or vaping, product use–associated lung injury mimicking COVID-19 in teenagers presenting with respiratory distress

2020 ◽  
Vol 8 ◽  
pp. 2050313X2096959
Author(s):  
Daphne O Darmawan ◽  
Kriti Gwal ◽  
Brian D Goudy ◽  
Sanjay Jhawar ◽  
Kiran Nandalike
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Lung Injury ◽  
Respiratory Distress ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Product Use ◽  
Abdominal Symptoms ◽  
History Of ◽  
High Index Of Suspicion

The clinical presentation of children and adolescents infected with severe acute respiratory syndrome coronavirus 2 can range from asymptomatic to mild or moderate manifestations. We present a case series of three adolescents who presented during the coronavirus disease 2019 (COVID-19) pandemic with symptoms concerning for COVID-19, including fever, abdominal symptoms, cough, respiratory distress, and hypoxemia. Their laboratory results showed elevated inflammatory markers that are also commonly seen in COVID-19. The chest imaging studies mimicked COVID-19 with non-specific ground glass opacities and interstitial prominence patterns. However, severe acute respiratory syndrome coronavirus 2 testing was negative and further questioning of these adolescents and their parents revealed a history of vaping marijuana-related products leading to the eventual diagnosis of e-cigarette, or vaping, product use–associated lung injury. Our patients were successfully treated with corticosteroids. The providers caring for pediatric patients, especially adolescents, should continue to have a high index of suspicion for e-cigarette, or vaping, product use–associated lung injury in patients presenting with unexplained respiratory failure, while ruling out COVID-19.

Delayed presentation of a congenital duodenal web managed successfully with incision of web

2020 ◽  
Vol 13 (12) ◽  
pp. e237307
Author(s):  
Mahendra Kumar Jangid ◽  
Reyaz Ahmad ◽  
Sujeet Pandre
Keyword(s):  
Abdominal Pain ◽  
Duodenal Obstruction ◽  
Accurate Diagnosis ◽  
Unusual Presentation ◽  
Contrast Study ◽  
Delayed Presentation ◽  
History Of ◽  
Duodenal Web ◽  
High Index Of Suspicion ◽  
The Web

One of the causes of congenital incomplete duodenal obstruction is the presence of congenital duodenal web with fenestration. This condition requires a high index of suspicion for an early and accurate diagnosis. We present an unusual presentation of duodenal web in a 6-year-old girl who presented with a 3-year history of cyclical and seasonal vomiting and abdominal pain. The diagnosis of congenital duodenal web with fenestration was made on contrast study and endoscopy and was treated surgically by incision of the web.

scholarly journals The “Fountain of Death”: A Case Series on Tracheo-innominate Artery Fistula

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Jason Lo ◽  
Marina Mat Baki ◽  
Yeoh Xing Yi ◽  
Nik Hisyam Amirul ◽  
Zahirrudin Zakaria
Keyword(s):  
Potential Role ◽  
Rare Complication ◽  
Case Series ◽  
Innominate Artery ◽  
Survival Outcomes ◽  
Permissive Hypotension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion

Tracheo-innominate artery fistula (TIF) is a very rare complication related to tracheostomy and has been reported in 0.7% of patients, but certainly is one of the most life-threatening conditions. It is of paramount importance to maintain a high index of suspicion in evaluating patients with TIF and to anticipate occurrence of massive haemorrhage even during simple procedures related to tracheostomy such as tube change. We report 3 cases of TIF, each with a unique and unsuspecting history of the condition and review the emergency protocol in arresting the bleeding. We’ve also highlighted the potential role of permissive hypotension with sedation in improving survival outcomes of patients with TIF.

scholarly journals Rectal perforation caused by a self-inserted foreign body: a case report

2021 ◽  
Vol 8 (9) ◽  
pp. 2803
Author(s):  
R. Sanjay ◽  
Rajendra Bargee ◽  
Pradeep Panwar ◽  
Prashant Kumar
Keyword(s):  
Severe Pain ◽  
Foreign Bodies ◽  
Cell Phones ◽  
Lower Abdomen ◽  
Rectal Perforation ◽  
Rectal Foreign Bodies ◽  
Seeking Behavior ◽  
History Of ◽  
Sex Toys ◽  
High Index Of Suspicion

Rectal foreign bodies have a storied history as a part of anorectal trauma. Objects encountered are most commonly household objects consisting of bottles and glasses. Other objects include tooth brushes, deodorant bottles, food articles, knives, sports equipment, cell phones, flash lights, wooden rods, broom sticks, sex toys including dildos and vibrators, light bulbs, nails, or other construction tools, christmas ornaments, aerosol canisters, cocaine packets, and many more. The reasons for insertion in decreasing order of frequency are autoeroticism, concealment, attention-seeking behavior, accidental, assault and to alleviate constipation. Here we presented a case of 32 years old presented to the ER with complaints of pain in lower abdomen and anal region for 12 hours. He complained of severe pain when he tried to defecate. He gave history of self-insertion of an empty drug vial into his rectum. Rectal foreign bodies represent a challenging and unique field of colorectal trauma. The important factors in dealing with these patients are careful history and physical examination. Patients are often embarrassed about this condition and may conceal the truth. So, a high index of suspicion is required to accurately diagnose.

scholarly journals Papillary Tumor of the Pineal Region: Case Report and Literature Review

2018 ◽  
Vol 37 (03) ◽  
pp. 252-257
Author(s):  
Vitor Yamaki ◽  
Felipe Vera ◽  
Renan Ribeiro ◽  
Raphael Medeiros ◽  
Manoel Teixeira ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Literature Review ◽  
Histopathological Examination ◽  
Subcommissural Organ ◽  
Tumor Resection ◽  
Case Series ◽  
Pineal Region ◽  
Papillary Tumor ◽  
Clinical Onset ◽  
History Of

AbstractPapillary tumor of the pineal region (PTPR) is a neuroectodermal tumor thought to originate from cells of the subcommissural organ. Its oncologic properties are still under investigation, as well as the most suitable therapeutic measures for this type of neoplasm. We report the case of a 36-year-old woman with a 1-year history of headache and intermittent diplopia. The magnetic resonance imaging (MRI) scan showed a heterogeneously enhancing mass in the pineal region that caused an acute hydrocephalus, and an emergency shunt derivation was necessary. One week later, the patient was submitted to subtotal tumor resection, and remained asymptomatic in the post-operative period. In the follow-up, the patient remained asymptomatic; in the imaging control 3.5 years after the surgical resection, local recurrence was identified, and the patient was submitted to a local radiation protocol. Our literature review showed an early clinical onset due to intracranial hypertension signs. Definitive clinical onset might be reached only through a histopathological examination. Gross total resection followed by radiotherapy is the current standard of care. Local recurrence is often observed, with rare dissemination to the cerebral spinal fluid. The natural history of the PTPR remains unknown, as well as the best treatment strategy. Large case series with longer follow-ups are necessary for further conclusions.

scholarly journals Intraocular foreign body in the anterior chamber angle of the eye—a 30-year-old ‘emergency’

2021 ◽  
Vol 2021 (6) ◽  
Author(s):  
Nadir A M Ali ◽  
Charlotte P Buscombe ◽  
David H Jones
Keyword(s):  
Foreign Body ◽  
Anterior Chamber ◽  
High Velocity ◽  
Best Practice ◽  
Unusual Case ◽  
Foreign Bodies ◽  
Intraocular Foreign Body ◽  
Anterior Chamber Angle ◽  
Ocular Penetration ◽  
High Index Of Suspicion

ABSTRACT We report an unusual case of a missed intraocular foreign body, which was incidentally discovered in the anterior chamber drainage angle of the left eye of a retired masonry worker, some 30 years after the inciting injury. The ocular penetration and intraocular foreign body were missed during initial emergency management, despite the high-velocity mechanism of chiselling granite, which was reported. This case effectively highlights the need for a careful history and examination in high-velocity injuries to the eye (such as those caused by hammering and grinding), a high index of suspicion for intraocular foreign bodies, and considers best practice in managing such presentations.

scholarly journals Spruelike Enteropathy Associated with Olmesartan: An Unusual Case of Severe Diarrhea

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Stephanie E. Dreifuss ◽  
Yutaka Tomizawa ◽  
Nicholas J. Farber ◽  
Jon M. Davison ◽  
Adam E. Sohnen
Keyword(s):  
Clinical Response ◽  
Unusual Case ◽  
Chronic Diarrhea ◽  
Villous Atrophy ◽  
Case Series ◽  
Screening Colonoscopy ◽  
Drug Induced ◽  
Severe Diarrhea ◽  
History Of ◽  
High Index Of Suspicion

A 64-year-old male with a history of hypertension presented with worsening diarrhea and 25-pound weight loss over the preceding three months. Prior screening colonoscopy was unremarkable, and the patient failed conservative management. On presentation, the patient had orthostatic hypotension associated with prerenal azotemia for which olmesartan (40 mg/day) was held. Initial workup for chronic diarrhea was essentially unremarkable. Then, EGD was performed with small bowel biopsy, which showed a moderate villous blunting and an intraepithelial lymphocyte infiltration. Celiac disease was excluded by negative conventional serology tests and the absence of clinical response to a gluten-free diet. In the interim, diarrhea became resolving without any other interventions, and clinical response was achieved even with gluten-containing diet. Two months later, he achieved a complete resolution of diarrhea and regained 20-pound weight. Spruelike enteropathy is a clinical entity manifested by chronic diarrhea and intestinal villous atrophy. Spruelike enteropathy associated with olmesartan as a cause of drug-induced diarrhea is rare, and it has been reported only in a case series to date. This case highlighted the importance for clinicians to maintain a high index of suspicion for olmesartan as a precipitant of spruelike enteropathy.

scholarly journals Acute retropharyngeal abscess in adults: a case series

2016 ◽  
Vol 3 (1) ◽  
pp. 151 ◽  
Author(s):  
Inderdeep Singh ◽  
Vikas Gupta ◽  
Sunil Goyal ◽  
Manoj Kumar ◽  
Lakshmi Ranjit ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Case Series ◽  
Retropharyngeal Abscess ◽  
Retropharyngeal Space ◽  
Surgical Drainage ◽  
Deep Neck Space Infections ◽  
Primary Focus ◽  
High Index Of Suspicion ◽  
Dental Infections ◽  
Primary Modality

<p>Retropharyngeal abscesses are uncommon but potentially lethal infections. In the adult group they are usually secondary to trauma, foreign bodies, or as a complication of dental infections. Early diagnosis and the wide spread use of antibiotics have made these infections less common today. High index of suspicion and clinical acumen is required to provisionally diagnose these cases. In the current era where empirical use of high end and advanced antibiotics is prevalent it is not surprising to find patients with highly resistant microbes, such cases present further difficulty to treat. For large retropharyngeal abscesses, surgical drainage remains the primary modality followed by aggressive targeted antibiotic therapy. We present three cases of deep neck space infections with primary focus in retropharyngeal space. All required surgical drainage and aggressive postoperative care. Extensive review of literature of retropharyngeal abscess in adults was done to derive characterizations about this disease. </p>

scholarly journals Preauricular pilomatrixoma in a 3 year-old girl: A case study

2012 ◽  
Vol 18 (1) ◽  
pp. 84-86
Author(s):  
H Hirbod ◽  
F Ameli ◽  
M Swamintanhan ◽  
BS Goh
Keyword(s):  
Foreign Body Reaction ◽  
Histopathological Examination ◽  
Excisional Biopsy ◽  
Pyogenic Granuloma ◽  
Clinical Feature ◽  
Sebaceous Cyst ◽  
Characteristic Clinical Feature ◽  
History Of ◽  
High Index Of Suspicion

Objectives: To report a case of preauricular pilomatrixoma in a 3-year-old girl.Methods: Retrospective review on a case reportResults: A three-year-old girl presented with six month history of painless right pre-auricular swelling that was gradually increasing in size. The mass was small, soft, non tender with normal overlying skin. She underwent excisional biopsy of lesion and histopathological examination showed pilomatrixoma. She was well post operatively and no recurrence after 2 years of follow up.Conclusion: Pilomatrixoma is often misdiagnosed clinically as epidermoid cyst, sebaceous cyst, dermoid cyst, foreign body reaction, calcification in lymph node, fat necrosis, pyogenic granuloma, chalazion and keratoacanthoma, but a high index of suspicion and careful histological examination of its characteristic clinical feature can help clinicians to differentiate it from other tumors.   DOI: http://dx.doi.org/10.3329/bjo.v18i1.10426  Bangladesh J Otorhinolaryngol 2012; 18(1): 84-86

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