scholarly journals Pott’s Puffy Tumour: a rare but sinister cause of facial swelling

2021 ◽  
Vol 20 (2) ◽  
pp. 144-147
Author(s):  
S Birks ◽  
◽  
L Peart ◽  
Keyword(s):  
Emergency Department ◽  
Mr Imaging ◽  
Allergic Reaction ◽  
Epidural Space ◽  
Frontal Sinus ◽  
Surgical Intervention ◽  
Medical Team ◽  
Intravenous Antibiotics ◽  
Facial Swelling ◽  
Uncommon Condition

A 27 year old female presented to the emergency department with intermittent central forehead swelling over several months associated with a headache. She was admitted under the medical team as having had a suspected allergic reaction but the diagnosis of a Pott’s Puffy Tumour was quickly made and confirmed through CT and MR imaging. This uncommon condition is related to sinusitis leading to localised abscess formation with osteomyelitis and a subsequent swollen appearance over the affected facial sinus. This patient’s sinus abscess extended into the epidural space and caused destruction of the anterior and posterior walls of the frontal sinus. The patient was managed with intravenous antibiotics, analgesia and referral to the local ENT team for surgical intervention.

scholarly journals Morbidity and Mortality following Traditional Uvulectomy among Children Presenting to the Muhimbili National Hospital Emergency Department in Dar es Salaam, Tanzania

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
H. R. Sawe ◽  
J. A. Mfinanga ◽  
F. H. Ringo ◽  
V. Mwafongo ◽  
T. A. Reynolds ◽  
...  
Keyword(s):  
Emergency Department ◽  
Surgical Intervention ◽  
Dar Es Salaam ◽  
Clinical Findings ◽  
Morbidity And Mortality ◽  
Care Providers ◽  
Hospital Emergency ◽  
National Hospital ◽  
Intravenous Antibiotics ◽  
Clinical Presentations

Background. Traditional uvulectomy is performed as a cultural ritual or purported medical remedy. We describe the associated emergency department (ED) presentations and outcomes.Methods.This was a subgroup analysis of a retrospective review of all pediatric visits to our ED in 2012. Trained abstracters recorded demographics, clinical presentations, and outcomes.Results. Complete data were available for 5540/5774 (96%) visits and 56 (1.0%, 95% CI: 0.7–1.3%) were related to recent uvulectomy, median age 1.3 years (interquartile range: 7 months–2 years) and 30 (54%) were male. Presenting complaints included cough (82%), fever (46%), and hematemesis (38%). Clinical findings included fever (54%), tachypnea (30%), and tachycardia (25%). 35 patients (63%, 95% CI: 49–75%) received intravenous antibiotics, 11 (20%, 95% CI: 10–32%) required blood transfusion, and 3 (5%, 95% CI: 1–15%) had surgical intervention. All were admitted to the hospital and 12 (21%, 95% CI: 12–34%) died. By comparison, 498 (9.1%, 95% CI: 8–10%) of the 5484 children presenting for reasons unrelated to uvulectomy died (p=0.003).Conclusion. In our cohort, traditional uvulectomy was associated with significant morbidity and mortality. Emergency care providers should advocate for legal and public health interventions to eliminate this dangerous practice.

scholarly journals Clinicopathological Conference: 54-year-old with Facial Swelling for One Month

2020 ◽  
Vol 4 (4) ◽  
pp. 638-641
Author(s):  
Justin Pile ◽  
Adam Dawson ◽  
Lynn Maxa
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Allergic Reaction ◽  
Early Treatment ◽  
Multidisciplinary Approach ◽  
Correct Diagnosis ◽  
Critical Importance ◽  
Correct Conclusion ◽  
Facial Swelling ◽  
Ed Visits

A 54-year-old female with facial swelling for one month who had repeatedly been treated for allergic reaction during multiple emergency department (ED) visits, presented to the ED for the same complaint of facial swelling. Maintaining a broad differential diagnosis was of critical importance to appropriately evaluating the patient and arriving at the correct conclusion for the etiology of the patient’s symptoms. Upon establishing the correct diagnosis, a multidisciplinary approach was used to intervene to provide early treatment without delay.

scholarly journals Facial Swelling in the Presence of a COVID-19 Diagnosis: Case Report

Oral ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 102-107
Author(s):  
Jenelle Fleagle ◽  
Margarita Lorch
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Significant Influence ◽  
Dental Care ◽  
Healthy Male ◽  
Dental Services ◽  
Daily Lives ◽  
Moderate Sedation ◽  
Intravenous Antibiotics ◽  
Facial Swelling

COVID-19 became a pandemic with a worldwide impact leading to stay-at-home orders, death, economic difficulties, and a significant influence on daily lives. Dental services became limited at this time, causing increased concerns for patients requiring urgent dental care. We report the case of a 5-year-old previously healthy male who presented to our hospital’s emergency department (ED) with facial swelling secondary to infected maxillary left molars. Extractions were performed in the ED with moderate sedation. He was later found to be COVID-19 positive before admission for intravenous antibiotics. The use of universal precautions during the pandemic in treating patients with possible COVID-19 symptoms and in aerosol-generating procedures is recommended. Evaluating and providing treatment to our patients with urgent dental care should not be delayed to prevent further complications and decrease the burden placed on the ED, which may be limited in its ability to provide definitive care.

scholarly journals Swimming with the Pigs: A Case of Severe Soft Tissue Infection during a Caribbean Vacation

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Alexandra W. Dretler ◽  
Jesse T. Jacob ◽  
Nadine G. Rouphael
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Activities Of Daily Living ◽  
Soft Tissue Infection ◽  
Daily Living ◽  
Complete Resolution ◽  
Surgical Intervention ◽  
Blood Cultures ◽  
The Bahamas ◽  
Severe Soft Tissue

A 74-year-old man presented to the emergency department with severe right leg cellulitis following a trip to the Bahamas where he swam in both chlorinated pools and the ocean. His blood cultures grew Shewanella species, a marine pathogen known to cause disease in humans, following exposure to seawater. He was treated with cefepime for a total of two weeks without needing any surgical intervention. The patient had complete resolution of infection and was able to return to his activities of daily living.

Epidural abscess treated with a medial supraorbital craniotomy through an incision in the eyebrow

2008 ◽  
Vol 1 (2) ◽  
pp. 145-147 ◽  
Author(s):  
David S. Rosen ◽  
Stephen Shafizadeh ◽  
Fuad M. Baroody ◽  
Bakhtiar Yamini
Keyword(s):  
Frontal Sinus ◽  
Epidural Abscess ◽  
Fluid Collection ◽  
Skin Incision ◽  
Frontalis Muscle ◽  
Supraorbital Nerve ◽  
Facial Swelling ◽  
Anterior Fossa ◽  
Supraorbital Craniotomy

✓The authors describe a medial supraorbital craniotomy performed through a medial eyebrow skin incision to approach an epidural abscess located in the medial anterior fossa of the skull. An 8-year-old boy presented with fevers and facial swelling. Imaging demonstrated pansinusitis and an epidural fluid collection adjacent to the frontal sinus. A medial supraorbital craniotomy was performed to access and drain the epidural abscess. The supraorbital nerve laterally and the supratrochlear nerve medially were preserved by incising the frontalis muscle vertically, parallel to the course of the nerves, and dissecting the subperiosteal plane to mobilize the nerves. This approach may be a useful access corridor for other lesions located near the medial anterior fossa.

Does Hydrogen Peroxide Mouthwash Improve the Outcome of Secondary Post-Tonsillectomy Bleed? A 10-year Review

2005 ◽  
Vol 133 (2) ◽  
pp. 202-205 ◽  
Author(s):  
Irumee Pai ◽  
Stephen Lo ◽  
Satsuki Brown ◽  
Abbad G. Toma
Keyword(s):  
Hydrogen Peroxide ◽  
Retrospective Study ◽  
Study Design ◽  
Broad Spectrum ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Control Group ◽  
Intravenous Antibiotics ◽  
The Common

Objective: To determine whether hydrogen peroxide (H2O2) mouthwash influences the outcome of secondary post-tonsillectomy hemorrhage in children. Study Design: Ten-year retrospective study of all children with secondary post-tonsillectomy hemorrhage. Setting: Tertiary otolaryngology center. Results: Of the 156 patients, 59 received H2O2 and 97 did not. All patients received broad-spectrum intravenous antibiotics. The average rehospitalization duration due to hemorrhage was 1.7 days (H2O2 group) and 1.6 days (control group). In the H2O2 group, 8.5% required surgery, compared with 10.3% in the control group. Further hemorrhage episodes requiring readmission occurred in 3.4% of the H2O2 group and 3.1% of controls. There was no difference between the 2 groups in rehospitalization duration ( P = 0.49), rate of surgical intervention ( P = 0.85), and rate of readmission with further hemorrhage ( P = 0.92). Conclusion: Hydrogen peroxide mouthwash does not improve the outcome of secondary post-tonsillectomy hemorrhage in pediatric patients. Significance: This study does not support the common practice of treating post-tonsillectomy hemorrhage with H2O2.

scholarly journals Rectosigmoid prolapse - a case report

2015 ◽  
Vol 72 (12) ◽  
pp. 1118-1121
Author(s):  
Vasilije Jeremic ◽  
Srdjan Mijatovic ◽  
Slobodan Krstic ◽  
Sanja Dragasevic ◽  
Tamara Alempijevic
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Sigmoid Colon ◽  
Severe Pain ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Preoperative Management ◽  
Perianal Region ◽  
Rectosigmoid Colon ◽  
Possible Cause

Introduction. Many factors have been indentified as a possible cause of rectal prolaps. Despite the fact that it is not a lifethreating condition, its clinical presentation varies, and sometimes it can present as an emergency. We presented a patient with prolapse of an unusually large segment of the rectosigmoid colon caused by chronic constipation, as an incarcerated segment repaired surgically. Case report. A 62-year-old female patient was referred to the Emergency Department in bad condition with severe pain in the perianal region. On examination a complete rectal prolaps as well as a part of sigmoid colon were found. Macroscopically, the prolapsed segment appeared edematous, livid, with ulcerations. An attempt to manually reduce prolapse failed, therefore resection of 50 cm of sigmoid colon with rectopexy had to be performed. No complications occurred and the patient was without symptoms six months later. Colonoscopy did not reveal any abnormality. Conclusion. Although the preoperative management and preparation of the patient was limited, emergancy surgical intervention for such a case was the strategy of choice due to magnitude of the prolapsing segment. It provided a successful and permenant solution.

Tension pneumocephalus with cerebrospinal fluid rhinorrhoea in a post craniotomy patient

2010 ◽  
Vol 9 (1) ◽  
pp. 13-14
Author(s):  
Nicholas H Smallwood ◽  
◽  
Sreenivasan Shiva ◽  
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Features ◽  
Frontal Sinus ◽  
Surgical Intervention ◽  
Csf Leak ◽  
Dural Tear ◽  
Tension Pneumocephalus ◽  
Neurological Signs ◽  
Important Complication ◽  
Csf Rhinorrhoea

Tension pneumocephalus is an uncommon but important complication of neurosurgery, often requiring urgent surgical intervention. It should be considered in any patient presenting with neurological symptoms after recent craniotomy, particularly if they also have clinical features consistent with cerebrospinal fluid (CSF) leak. We describe a patient who presented four weeks post-craniotomy with fluctuating neurological signs and CSF rhinorrhoea, who made a full recovery following repair of a frontal sinus defect and dural tear.

Trends and outcomes of ruptured ovarian cysts

2021 ◽  
pp. postgradmedj-2020-138833
Author(s):  
Wei How Lim ◽  
Nikki Woods ◽  
Vincent P Lamaro
Keyword(s):  
Emergency Department ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Ovarian Cysts ◽  
Free Fluid ◽  
Vaginal Intercourse ◽  
Imaging Diagnosis ◽  
Retrospective Audit ◽  
Common Clinical Presentation ◽  
Health Institutions

BackgroundRuptured ovarian cysts are common gynaecological presentation to health institutions with abdominal pain. While this phenomenon is generally self-limiting, surgery may be necessary in cases of haemodynamic compromise or association with torsion. The aim of this audit is to identify the trend of hospital presentations, as well as the review the management of modern gynaecology practice.MethodsA retrospective audit of all women who presented to the emergency department with an imaging diagnosis of ruptured ovarian cysts was conducted over a 5-year period at St Vincent’s Hospital, Sydney.ResultsDuring the study period, 408 women were identified. There was a trend towards conservative management, as observed in 84.7% of women, while the remaining 15.4% underwent surgery. Haemorrhagic or ruptured corpus luteum was the most common diagnoses. As expected, women who had surgical intervention were more likely to have larger cysts (20 vs 50%; p<0.05), and larger free fluid findings on imaging (1.4 vs 23.8%; p<0.05) compared with those managed conservatively. There were no statistically significant differences in location of ovarian cysts (right or left) or antecedent to hospital presentation (vaginal intercourse or trauma).ConclusionRuptured ovarian cysts of both functional and non-functional types remained a common clinical presentation of acute pain for women to the emergency department. Majority of women were managed conservatively in our cohort, and indications for surgery were large ovarian cysts and large free fluid seen on imaging findings. Surgery was largely feasible with minimal complications.

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