C’è dolore e dolore: l’osteoma osteoide

Sebastiano Rizza

doi:10.53126/meb403794a

C'è dolore e dolore: l'osteoma osteoide

Medico e Bambino ◽

10.53126/meb40394a ◽

2021 ◽

Vol 40 (6) ◽

pp. 394-394

Author(s):

Sebastiano Rizza

Keyword(s):

Ct Scan ◽

Osteoid Osteoma ◽

Severe Pain ◽

Pain Attack ◽

History Of

A 5-year-old boy with one-month history of atraumatic pain in his left leg was taken to the ED for a severe pain attack. A femoral osteoid osteoma was eventually diagnosed after the performance of a CT scan.

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Osteoid Osteoma of Distal Phalanx of Toe: A Rare Cause of Foot Pain

Case Reports in Orthopedics ◽

10.1155/2014/560892 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Hakan Başar ◽

Osman Mert Topkar ◽

Bülent Erol

Keyword(s):

Osteoid Osteoma ◽

Chronic Infection ◽

Severe Pain ◽

Benign Tumor ◽

Surgical Excision ◽

Distal Phalanx ◽

Foot Pain ◽

Recurrent Tumour ◽

Percutaneous Procedures ◽

History Of

Osteoid osteoma is an uncommon benign tumor and causes severe pain, being worse at night, that responds dramatically to nonsteroidal anti-inflammatory medications. An osteoid osteoma of the toe is very rare and arising in a pedal phalanx may be difficult to diagnose. A 34-year-old male has local swelling and tenderness but there were no hyperemia, temperature increase, or clubbing. There was a 2-month history of antibiotic treatment with suspicion of soft tissue infection in another clinic. The osteoid osteoma was completely excised by curettage and nidus removal with open surgical technique. The patient was followed up for 63 months with annual clinical and radiographic evaluations. There was no relapse of the pain and no residual recurrent tumour. Osteoid osteoma may be difficult to distinguish from chronic infection or myxedema. The patients may be taken for unnecessary treatment. The aim of the treatment for osteoid osteoma is to remove entire nidus by open surgical excision or by percutaneous procedures such as percutaneous radiofrequency and laser ablation. Osteoid osteomas having radiologic and clinical features other than classical presentation of osteoid osteoma are called atypical osteoid osteomas. Atypical localized osteoid osteomas can be easily misdiagnosed and treatment is often complicated.

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A case of sigmoid volvulus in an unexpected demographic

Surgical Case Reports ◽

10.1186/s40792-020-01105-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Mohammad Saba ◽

Joshua Rosenberg ◽

Gregory Wu ◽

Gudata Hinika

Keyword(s):

Abdominal Pain ◽

Severe Pain ◽

Rare Case ◽

Young Female ◽

Sigmoid Volvulus ◽

Case Presentation ◽

Operative Complications ◽

History Of ◽

Male Sex ◽

Emergent Laparotomy

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.

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Additive value of positron emission tomography/computed tomography scan for detection of aortic tube graft infection: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa512 ◽

2020 ◽

Author(s):

Farnoosh Larti ◽

Mohammad Amin Khadembashiri ◽

Mehrshad Abbasi ◽

Alborz Sherafati

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Diagnostic Accuracy ◽

Ct Scan ◽

Graft Infection ◽

Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

History Of ◽

Pet Ct Scan

Abstract Background Diagnosis of aortic graft infection is challenging, and delayed diagnosis is associated with poor prognosis. Positron emission tomography/computed tomography (PET/CT) has improved diagnostic accuracy. Case summary A patient with a history of congenital heart disease was admitted due to fever. He had a history of four cardiac surgeries, including the Bentall procedure for endocarditis. Blood cultures were negative. A semi-mobile mass was detected in the distal portion of the aortic tube graft in echocardiography. PET/CT scan was used to confirm tube graft infection and to support proceeding to cardiac surgery. Discussion Using multimodality imaging, including PET/CT scan in combination with echocardiography, can improve diagnostic accuracy for the detection of aortic tube graft infection, infection of prosthetic valves, or intra-cardiac devices, especially in high-risk surgical cases.

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Pancreatic enzymatic mediastinitis followed by total gastrectomy with splenectomy: report of two cases

Surgical Case Reports ◽

10.1186/s40792-021-01240-5 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yoko Zaitsu ◽

Takashi Nishizaki ◽

Takuma Izumi ◽

Daisuke Taniguchi ◽

Yuichiro Kajiwara ◽

...

Keyword(s):

Gastric Cancer ◽

Abdominal Surgery ◽

Ct Scan ◽

Pancreatic Fistula ◽

Medical History ◽

Advanced Gastric Cancer ◽

Total Gastrectomy ◽

Upper Body ◽

History Of ◽

Acute Mediastinitis

Abstract Background Acute mediastinitis is a rare disease that rapidly progresses with a high mortality rate. Its most common cause is direct injury of the mediastinum, including iatrogenic causes such as cardiac surgery or upper endoscopy. Enzymatic mediastinitis is a rare complication of a pancreatic fistula caused by the inflammatory digestion of the parietal peritoneum spreading to the mediastinum. Here, we present two cases of enzymatic mediastinitis caused by total gastrectomy with splenectomy. One of them was successfully treated and cured after early diagnosis and transabdominal drainage. Case presentation Case 1 was that of a 60-year-old man (body mass index [BMI] 27) with a medical history of diabetes and hypertension who was diagnosed with advanced gastric cancer in the upper body of the stomach. A total gastrectomy with splenectomy was performed. The patient experienced acute respiratory failure 24 h after surgery. Pulmonary embolism was suspected, so a computed tomography (CT) scan was performed; however, no relevant causes were found. Although he was immediately intubated and treated with catecholamine, he died in the intensive care unit (ICU) 40 h after surgery. Post-mortem findings revealed retroperitonitis caused by a pancreatic fistula spreading towards the mediastinum, causing severe mediastinitis; a review of the CT scan revealed pneumomediastinum. We concluded that the cause of death was enzymatic mediastinitis due to post-gastrectomy pancreatic fistula. Case 2 involved a 61-year-old man (BMI 25) with a medical history of appendicitis who was diagnosed with advanced gastric cancer at the gastric angle between the lesser curvature and the pylorus, spreading to the upper body of the stomach. A total gastrectomy with splenectomy was also performed. The patient had a high fever 3 days after the surgery, and a CT scan revealed pneumomediastinum, indicating mediastinitis. As the inflammation was below the bronchial bifurcation, we chose a transabdominal approach for drainage. The patient was successfully treated and discharged. Conclusion Acute mediastinitis caused by gastrectomy is rare. The acknowledgment of abdominal surgery as a cause of mediastinitis is important. In treating mediastinitis caused by abdominal surgery, transabdominal drainage may be a minimally invasive yet effective method if the inflammation is mainly located below the bifurcation of the trachea.

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The Effect of Anterior Uterocervical Angle on Primary Dysmenorrhea and Disease Severity

Pain Research and Management ◽

10.1155/2018/9819402 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Mefkure Eraslan Sahin ◽

Erdem Sahin ◽

Yusuf Madendag ◽

Ilknur Col Madendag ◽

Ahter Tanay Tayyar ◽

...

Keyword(s):

Disease Severity ◽

Severe Pain ◽

Longitudinal Axis ◽

Primary Dysmenorrhea ◽

Uterine Corpus ◽

Significant Family History ◽

Significant Difference ◽

History Of ◽

Secondary Dysmenorrhea ◽

The Mean

Background. Primary dysmenorrhea, defined as painful menstrual cramps originating in the uterus without underlying pathology, is a gynecological disease that affects quality of life and school success. Our goal was to determine the effect of anterior uterocervical angle on primary dysmenorrhea and disease severity. Methods. A total of 200 virgin adolescents, 16 to 20 years of age, were included in the study. The Andersch and Milsom scale was used to determine dysmenorrhea severity. Those with pathologies causing secondary dysmenorrhea were excluded from the study. Study subjects were grouped based on severity of pain. Demographic characteristics and uterocervical ultrasonographic measurements were compared among groups. Results. Of the 200 participants enrolled in the study, 50 were healthy controls and 150 had primary dysmenorrhea. Those with primary dysmenorrhea had a significant family history of primary dysmenorrhea compared with controls (P<0.001). Age (P=0.668), body mass index (P=0.898), menarche age (P=0.915), and length of menstrual cycles (P=0.740) were similar in all groups. The uterine corpus longitudinal axis, uterine corpus transverse axis, and uterine cervix longitudinal axis were also similar (P=0.359, P=0.279, and P=0.369, resp.). The mean uterocervical angle was 146.8 ± 6.0 in controls and 143.3 ± 7.3 in those with mild pain with no significant difference between the groups. In those with moderate pain, the mean uterocervical angle was 121.2 ± 7.3 compared with 101 ± 9.2 in those with severe pain, which was a significant difference. Additionally, there was also a significant difference in the uterocervical angle among those with mild, moderate, and severe pain (P<0.001). Conclusion. Our results indicate that a narrower anterior uterocervical angle is associated with primary dysmenorrhea and disease severity.

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Natural history of osteoid osteoma of the spine

The American Journal of Surgery ◽

10.1016/0002-9610(56)90314-2 ◽

1956 ◽

Vol 91 (6) ◽

pp. 880-889 ◽

Cited By ~ 21

Author(s):

Alvina O. Sabanas ◽

William H. Bickel ◽

John H. Moe

Keyword(s):

Natural History ◽

Osteoid Osteoma ◽

History Of

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Congenital Toxoplasmosis presenting as multiple ring enhancing lesions in brain on neuroimaging

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20183552 ◽

2018 ◽

Vol 5 (5) ◽

pp. 2020

Author(s):

Pareshkumar A. Thakkar ◽

Aakashi Shah ◽

Bakul B. Javadekar ◽

Saurabh Modasia

Keyword(s):

Ct Scan ◽

Past History ◽

Stable Condition ◽

Congenital Toxoplasmosis ◽

Cellular Reaction ◽

Protein Levels ◽

Elevated Protein ◽

Intravenous Antibiotics ◽

History Of ◽

Multiple Ring

We report a case of congenital toxoplasmosis in a male child who presented at 1 month 21 days of life. He had a past history of meningitis on third day of life which resolved with intravenous antibiotics. This time, the child presented with progressive enlargement of head and CSF (Cerebrospinal fluid) showed elevated protein levels with cellular reaction and CT scan showed dilated ventricular system with aqueductal obstruction and multiple ring-enhancing lesions in bifrontal and bioccipital regions with a right porencephalic cyst. Repeat CSF after 14 days of intravenous antibiotics showed elevated protein with no cellular reaction. Fundus examination was normal. Toxoplasma blood serology (IgG and IgM) in baby and mother were positive. The child received treatment with Pyrimethamine, Clindamycin, Folinic acid and Prednisolone. CSF parameters got normalized and multiple ring-enhancing lesions disappeared on repeat CT scan. He underwent a Ventriculo-Peritoneal shunt surgery for the hydrocephalus and was discharged in a stable condition.

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Falco-Tentorial Meningioma Producing Irreversible Midbrain Damage

Romanian Neurosurgery ◽

10.2478/romneu-2014-0040 ◽

2014 ◽

Vol 21 (3) ◽

pp. 301-304

Author(s):

Amit Agrawal

Keyword(s):

Ct Scan ◽

Obstructive Hydrocephalus ◽

Fatal Outcome ◽

Surgical Decompression ◽

Cerebral Veins ◽

Tentorial Meningioma ◽

Brain Surface ◽

Deep Cerebral Veins ◽

History Of ◽

The Brain

Abstract Meningiomas arising from the falcotentorial junction are the rarest subgroup of tentorial menigiomas. Because of the distance from the brain surface and the surrounding deep cerebral veins these lesions are difficult and dangerous to treat surgically. A 45-year-old female presented with the history of progressive headache, disorientation, unsteadiness, and urinary incontinence for over 6 months. The patient developed difficulty in swallowing, and weakness of all four limbs for the last 7 days. CT scan brain plain and contrast showed a large well defined, homogenously enhancing mass lesion in the peineal region with compression of the upper brain stem and obstructive hydrocephalus. Inspite of the good surgical decompression the patient did not do well. As described in the literature, the compression of the midbrain can cause severe respiratory disturbances with fatal outcome; probably the similar mechanism resulted in poor outcome in present case. As we noticed the diffuse hypodensity in midbrain on CT scan, similar findings have been described in literature in cases of transtentorial herniation with poorer outcome.

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