scholarly journals Respiratory distress due to platypnea-orthodeoxia syndrome: A diagnostic challenge in emergency setting

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Sandro Di Domenico ◽  
Paolo Aseni ◽  
Luca Bonacchini ◽  
Maurizio Bottiroli ◽  
Rossella Guerrieri ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Correct Diagnosis ◽  
Emergency Setting ◽  
Shortness Of Breath ◽  
Computed Tomography Scan ◽  
Diagnostic Challenge ◽  
Air Bubble ◽  
Postural Changes ◽  
Enormous Variation ◽  
Tomography Scan

Platypnea-orthodeoxia syndrome (POS) is an unusual cause of hypoxia characterized by enormous variation in oxygen saturation during postural changes. We describe here the clinical presentation, the diagnostic challenge of POS and discuss the main pathophysiological etiologies of the disease in a 75-year-old woman who was admitted because shortness of breath. After ruling out the most important causes of dyspnea we observed that the symptoms improved when the patient was lying flat. The diagnostic workup with computed tomography scan and air bubble saline echocardiography lead us to a correct diagnosis.

Non-malignant gall bladder perforation: Our experience from an institution-based retrospective analysis of 25 cases

2021 ◽  
pp. 004947552110365
Author(s):  
Abhijeet Kumar ◽  
Nirmal Prasad Shah ◽  
Narendra Pandit ◽  
Suresh Prasad Sah ◽  
Rakesh Kumar Gupta ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gall Bladder ◽  
Clinical Presentation ◽  
Gallbladder Perforation ◽  
Type I ◽  
Computed Tomography Scan ◽  
Duration Of Hospital Stay ◽  
Symptoms And Signs ◽  
Tomography Scan ◽  
Better Than

Gallbladder perforation still continues to perplex surgeons; 25 such patients diagnosed either pre- or intra-operatively and managed at our institute over the last 10 years period were analysed. Only eight were diagnosed pre-operatively, while a large majority (17) had a wrong initial working diagnosis. Symptoms and signs were variable. No blood investigation was specific. A computed tomography scan was generally better than ultrasound in detecting the perforation. All our cases were managed operatively with no mortality and a mean duration of hospital stay of 6.8 days. Most perforations were extra-hepatic (84%) and those of Niemeier’s type I (52.2%). Because of its varied clinical presentation, gallbladder perforation is often an intra-operative diagnosis, but early intervention carries a good outcome.

Epidemiology, diagnosis, and assessment on non-traumatic subarachnoid haemorrhage

2016 ◽  
Author(s):  
Chethan P. Venkatasubba Rao ◽  
Jose Ignacio Suarez
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Clinical Presentation ◽  
Severe Headache ◽  
Cranial Computed Tomography ◽  
Computed Tomography Scan ◽  
Neurological Signs ◽  
Grading Systems ◽  
Traumatic Subarachnoid Haemorrhage ◽  
Males And Females ◽  
Tomography Scan

Non-traumatic subarachnoid haemorrhage (ntSAH) is a neurological emergency. Clinical presentation is usually with severe headache, with or without abnormal neurological signs on clinical examination. NtSAH affects both males and females from 30 to 70 years, and the incidence increases with age. The incidence varies widely around the world. The gender distribution also varies in different countries, although overall the incidence is higher in women than in men. The commonest cause is rupture of an intracranial aneurysm, accounting for around 80% of cases. Diagnosis is usually by finding blood in the classical subarachnoid distribution on a cranial computed tomography scan. A number of grading systems are used to classify ntSAH.

scholarly journals Dacryocele in an adult presenting as facial cellulitis

2019 ◽  
Vol 1 (1) ◽  
pp. 48-51
Author(s):  
Prerana Kansakar ◽  
Gangadhara Sundar
Keyword(s):  
Clinical Presentation ◽  
Computed Tomography Scan ◽  
Effective Treatment Option ◽  
Silicone Tube ◽  
Inferior Meatus ◽  
Tender Mass ◽  
Silicone Tube Intubation ◽  
Painful Mass ◽  
Tomography Scan ◽  
Medial Canthal Tendon

A 47-year-old male presented with left sided facial cellulitis of one-week duration associated with a painful mass over the left medial canthal area. On examination, there was a firm, tender mass below the medial canthal tendon. Computed tomography scan revealed a bulky, cystic lesion at the left inferomedial orbit and medial maxilla with bony remodeling suggestive of a chronic dacryocele. The patient underwent marsupialization of the dacryocele at the inferior meatus with silicone tube intubation. His symptoms of epiphora resolved after surgery. We describe a rare clinical presentation of dacryocele in an adult and its simple, yet effective treatment option.

scholarly journals Urachal Sinus Presenting with Abscess Formation

ISRN Urology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Jalal Eddine El Ammari ◽  
Youness Ahallal ◽  
Oussama El Yazami Adli ◽  
Mohammed Jamal El Fassi ◽  
My Hassan Farih
Keyword(s):  
Incidental Findings ◽  
Computed Tomography Scan ◽  
Broad Spectrum Antibiotic ◽  
Diagnostic Challenge ◽  
Rare Type ◽  
Complete Excision ◽  
Male Adult ◽  
Postoperative Course ◽  
Urachal Sinus ◽  
Tomography Scan

Urachal affections are rare. Their variable ways of presentation may represent a diagnostic challenge. Urachal sinuses are a rare type of these abnormalities. They are usually incidental findings and remain asymptomatic unless a complication (most commonly the infection) occurs. Infection of the urachal sinus would clinically present as purulent umbilical discharge, abdominal pain, and periumbilical mass. We report herein a case of infected urachal sinus in male adult. The diagnosis was suspected clinically and confirmed with ultrasonography and computed tomography scan. A preoperative cysto-fibroscopy showed normal aspect of the bladder and excluded sinus communication. An initial broad spectrum antibiotic therapy followed by complete excision of the sinus and fibrous tract without cuff of bladder has been therefore performed. The postoperative course was uneventful. No recurrence was observed after 18 months of followup. Histological examination did not reveal any sign of malignancy.

External auditory canal paraganglioma: an atypical presentation

2012 ◽  
Vol 126 (12) ◽  
pp. 1278-1280 ◽  
Author(s):  
N Grover ◽  
F Amen ◽  
A Gallimore ◽  
G Brookes
Keyword(s):  
Clinical Diagnosis ◽  
External Auditory Canal ◽  
Otitis Externa ◽  
Clinical Presentation ◽  
External Ear ◽  
Computed Tomography Scan ◽  
Low Threshold ◽  
Atypical Presentations ◽  
Superior Portion ◽  
Tomography Scan

AbstractObjective:We present the first published description of a painful paraganglioma of the external auditory canal. Atypical histopathology made the diagnosis difficult. We discuss the potential pitfalls of clinical diagnosis and treatment of such a case.Clinical presentation:A 49-year-old woman presented with left-sided otalgia, hearing loss and tinnitus. Physical examination revealed a firm swelling arising from the superior portion of the left external auditory canal. A clinical diagnosis of otitis externa was made.Intervention:There was minimal response to medical treatment. The swelling was aspirated, leading to brisk bleeding. A tumour was suspected from the computed tomography scan, and confirmed by a biopsy. The patient underwent excision of the paraganglioma. The histopathology was atypical, making diagnosis difficult.Conclusion:Such unusual masses of the external ear should always be borne in mind, especially when dealing with atypical presentations of commonly encountered diseases. Clinicians should have a low threshold for early intervention with imaging and biopsy.

scholarly journals Clinical and biological characterization of macroprolactinemia with and without prolactin-IgG complexes

2003 ◽  
pp. 201-207 ◽  
Author(s):  
J De Schepper ◽  
J Schiettecatte ◽  
B Velkeniers ◽  
Z Blumenfeld ◽  
M Shteinberg ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Biological Characterization ◽  
Resonance Imaging ◽  
Computed Tomography Scan ◽  
Heterogeneous Condition ◽  
Pituitary Lesion ◽  
Tomography Scan ◽  
Precipitation Test

OBJECTIVE: Macroprolactinemia, which can be detected by a polyethylene glycol (PEG) precipitation test, is a clinically and biologically heterogeneous condition. In this study, we analyzed whether the clinical presentation, the hormonal findings and the in vitro lactogenic activity differed between macroprolactinemic patients with and without circulating prolactin (PRL)-IgG complexes. DESIGN: Clinical data were reviewed and additional hormonal studies were performed in 50 hyperprolactinemic patients with macroprolactinemia. METHODS: Macroprolactinemia was identified by a PRL recovery after PEG precipitation of <50%, as measured by an automated commercial immunoassay system and circulating PRL-IgG complexes by an abnormal PRL binding to anti-IgG agarose. RESULTS: PRL-IgG complexes were found in 46 patients. The origin of hyperprolactinemia in these 46 patients was idiopathic in 33 patients, while a pituitary lesion or stalk magnetic resonance imaging or computed tomography scan was detected in 13 patients found compression. Galactorrhea was found in 11 of these 46 patients, while this condition was present in three of the four patients without circulating PRL-IgG complexes. The median free PRL concentration was significantly lower in patients with PRL-IgG complexes than in the group without complexes (243 vs 969 mIU/l; P<0.005), whereas median total PRL immunoreactivity and median PRL bioactivity in the Nb2 assay were not significantly different. In patients with circulating PRL-IgG complexes, Nb2 bioassay results correlated significantly with total PRL immunoreactivity (r=0.64; P<0.0001), but not with free PRL results (r=0.24; P<0.17). CONCLUSIONS: These results indicate that PRL-IgG complexes (i) account for most cases of macroprolactinemia--as identified by PEG precipitation--in hyperprolactinemic patients presenting with a variety of diagnoses, (ii) are not associated with a specific clinical presentation, (iii) can be found in patients with diverse pituitary pathologies, and (iv) possess an in vitro lactogenic activity in the Nb2 bioassay in relation to their immunoreactivity.

scholarly journals A Mammary Nodule Mimicking Breast Cancer

2014 ◽  
Vol 99 (3) ◽  
pp. 200-202 ◽  
Author(s):  
Leonardo Solaini ◽  
Anna Bianchi ◽  
Luigi Filippini ◽  
Laura Lucini ◽  
Edda Simoncini ◽  
...  
Keyword(s):  
Renal Mass ◽  
Clinical Presentation ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Lymph Node Biopsy ◽  
Computed Tomography Scan ◽  
Breast Metastasis ◽  
Primary Tumors ◽  
Node Biopsy ◽  
Tomography Scan

Abstract Metastases to the breast from extramammary tumors are rare. Several clinical, radiologic, and histologic signs can help to distinguish metastases from breast primary tumors. In the present study, we present a case of a left-sided breast metastasis from renal cancer in a 44-year-old woman whose clinical presentation was a mammary nodule in the upper internal quadrant. The patient underwent quadrantectomy with sentinel lymph node biopsy. The histology revealed a clear cell carcinoma. On computed tomography scan a 5×8-cm left renal mass with pulmonary, liver, and intrapericardial nodules was found. The patient underwent palliative care and died after 4 months. Metastasis to the breast is rare, but all of those clinical, radiologic, and histologic signs more typical of extramammary malignancies should always be considered in order to choose the best treatment strategy.

scholarly journals Nasal Septal Angiofibroma

2021 ◽  
pp. 014556132110265
Author(s):  
Oratile Thobejane ◽  
Shivesh Maharaj
Keyword(s):  
Computed Tomography ◽  
Clinical Presentation ◽  
Vascular Tumor ◽  
Adolescent Males ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Computed Tomography Scan ◽  
Excessive Bleeding ◽  
Nasopharyngeal Angiofibroma ◽  
Extranasopharyngeal Angiofibroma ◽  
Tomography Scan

Juvenile nasopharyngeal angiofibroma is a benign vascular tumor seen predominantly in adolescent males in the second decade of life. Extranasopharyngeal angiofibroma includes vascular fibrous masses that occur outside the nasopharynx. The diagnosis of an angiofibroma is based on the clinical presentation and imaging, with biopsies being avoided to avoid excessive bleeding. Computed tomography scan is considered sufficient for the diagnosis of extranasopharyngeal angiofibroma as it clearly delineates and identifies the tumor.

scholarly journals "Stray" achalasia: From gastroenterologist to pulmonologist and back

2016 ◽  
Vol 144 (1-2) ◽  
pp. 85-89
Author(s):  
Dusanka Obradovic ◽  
Biljana Joves-Sevic ◽  
Milos Stojanovic ◽  
Miroslav Ilic ◽  
Igor Ivanov
Keyword(s):  
Correct Diagnosis ◽  
Gastrointestinal Symptoms ◽  
Computed Tomography Scan ◽  
X Ray ◽  
Chest X Ray ◽  
Pulmonary Infiltration ◽  
Fluid Levels ◽  
Tomography Scan ◽  
Frequent Presence

Introduction. Achalasia is a rare esophageal disorder which, due to frequent presence of both respiratory and gastrointestinal symptoms, can initially be referred either to pulmonologist or gastroenterologist. Case Outline. A 50-year-old patient was initially referred to gastroenterologist with the following symptoms: nausea, vomiting, occasional hiccups, weight loss, chest pain, dysphonia, and dry cough. After chest X-ray, the patient was referred to pulmonologist with differential diagnosis for pulmonary infiltration and thoracic aortic aneurysm. Pulmonologist interpreted chest X-ray as showing paratracheal mediastinal enlargement with air-fluid levels, thus suspecting achalasia. Computed tomography scan of the thorax with per os contrast showed extremely dilated esophagus with food stasis. The patient was then referred to thoracic surgeon, who ordered additional diagnostics (esophageal passage with contrast, esophagomanometry, esophagogastroduodenoscopy), and finally performed Heller myotomy. Postoperatively there were no complications, and the patient was symptom free during the follow-up. Conclusion. Although achalasia can also result in respiratory symptoms, fastidious anamnesis and accurate radiological interpretation are essential for the correct diagnosis.

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