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1.
Traumatic auricular amputation due to human bite is not a common event. Bite wounds are always considered to be complex injuries contaminated with unique poly-microbial inoculum. Human bites are as serious as animal bites because they induce a higher incidence of infectious complications. In bite wounds to the face, infectious complications can create more difficulties than the initial tissue damage itself for the task of restoring an esthetic appearance. In this case report a young male patient had ear lobule injury on interpersonal violence and amputation of ear lobule results. Due to delay in presentation and high chances of infection wound healing by secondary intention achieved. 相似文献
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Narinder Kumar 《Journal of Clinical Orthopaedics and Trauma》2015,6(3):187-189
Intra-articular fractures of calcaneum are known to be difficult to manage and lead to multiple complications including subtalar arthritis and malunion. However, non-union of calcaneum is rarely encountered. Only a total of six studies reporting on 12 patients could be found on reviewing the available literature (English language only). One such case of non-union of calcaneal fracture and its successful management is being reported in this case report. In addition, extremely limited literature available on calcaneal non-union is also briefly reviewed. Role of subtalar arthrodesis with internal fixation of fracture and bone grafting for successful management of this rare complication is highlighted along with the possibility of under-reporting of this relatively unknown complication. 相似文献
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《Egyptian Journal of Anaesthesia》2014,30(4):447-449
Presence of foreign body in thoracic cavity is very uncommon. Most common etiologies for the presence of such foreign bodies are accidental, traumatic or iatrogenic. We report the management of a case with a rare foreign body in the thorax i.e. surgical blade. While inserting ICD the surgical blade slipped from the scalpel and was sucked into the pleural cavity. FB migrated in the mediastinum and Contrast Tomographic scan showed elongated radio-opaque object of metallic density in the mediastinum, just abutting the superior vena cava. An immediate open thoracotomy was planned to retrieve the blade. 相似文献
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《Injury Extra》2014,45(7):45-47
Injuries to the retrohepatic vena cava are extremely rare and are associated with an operative mortality of up to 50% even in high volume trauma centres. We present a patient with such an injury who underwent successful repair using cardiopulmonary bypass and deep hypothermic circulatory arrest.A 23 year old male was transferred to our unit following laparotomy with packing of the abdomen after uncontrolled haemorrhage from the retrohepatic vena cava was experienced. The patient was placed on full cardiopulmonary bypass and cooled to 20 °C before clamping of the supracoeliac aorta and inferior vena cava. This facilitated exposure of the retrohepatic cava and allowed successful primary repair of a 5 cm laceration.Other techniques to allow repair of these injuries, such as atriocaval shunts and total vascular exclusion of the liver, are associated with a high mortality. We believe the technique described in this case report is an alternative strategy that can be used successfully to manage life threatening from the retrohepatic vena cava. 相似文献
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《The Foot》2001,11(2):94-96
Giant cell tumours are uncommon benign osseous neoplasia. Most occur around the epiphysis of long bones after skeletal maturity and are very rarely seen in the foot. We present a case of a fifteen-year-old amateur basketball player who presented with a painful ‘peroneal spastic foot’ that was diagnosed to be due to a giant cell tumour of the cuboid bone. There was a good response to a curettage and bone grafting, with no recurrence at his thirty-month follow-up. 相似文献
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Background
Obstruction of the third part of the duodenum (D3) is a very rare cause of gastric outflow obstruction. Rapid weight loss is the biggest risk factor. Patients seen in acute rehabilitation settings, not uncommonly, have a period of rapid weight loss. We report two cases of superior mesenteric artery (SMA) syndrome and review the literature.Clinical details
The patients presented differently, one with repeated, refractory autonomic dysreflexia and severe spasticity and one with nausea, abdominal discomfort, and vomiting. CT abdomen with contrast identified dynamic duodenal (D3) obstruction against the posterior structures by narrow angled SMA, gastric distension and, in one case, dilation of the left renal vein. Both patients responded well to optimizing nutrition in different ways. Surgery was successfully avoided.Discussion
SMA syndrome is an atypical cause of high intestinal obstruction, frequently occurring in patients who have had rapid weight loss during spinal cord injury (SCI) rehabilitation. It may co-exist with left renal vein dilation “nutcracker phenomena”. The associated neurogenic bowel dysfunction due to the nature of SCI could possibly contribute to delay in diagnosis.Conclusion
Clinicians should consider the risk of SMA syndrome in patients with SCI with rapid weight loss. Early diagnosis is possible by doing a CT abdomen with contrast and angiography if there is a high index of suspicion. SMA syndrome can be successfully treated by aggressive nutritional management. This may include total parenteral nutrition or feeding by a nasojejunal tube. Duodenojejunostomy could be required in refractory cases. 相似文献9.
《The journal of spinal cord medicine》2013,36(4):544-547
AbstractBackgroundObstruction of the third part of the duodenum (D3) is a very rare cause of gastric outflow obstruction. Rapid weight loss is the biggest risk factor. Patients seen in acute rehabilitation settings, not uncommonly, have a period of rapid weight loss. We report two cases of superior mesenteric artery (SMA) syndrome and review the literature.Clinical detailsThe patients presented differently, one with repeated, refractory autonomic dysreflexia and severe spasticity and one with nausea, abdominal discomfort, and vomiting. CT abdomen with contrast identified dynamic duodenal (D3) obstruction against the posterior structures by narrow angled SMA, gastric distension and, in one case, dilation of the left renal vein. Both patients responded well to optimizing nutrition in different ways. Surgery was successfully avoided.DiscussionSMA syndrome is an atypical cause of high intestinal obstruction, frequently occurring in patients who have had rapid weight loss during spinal cord injury (SCI) rehabilitation. It may co-exist with left renal vein dilation “nutcracker phenomena”. The associated neurogenic bowel dysfunction due to the nature of SCI could possibly contribute to delay in diagnosis.ConclusionClinicians should consider the risk of SMA syndrome in patients with SCI with rapid weight loss. Early diagnosis is possible by doing a CT abdomen with contrast and angiography if there is a high index of suspicion. SMA syndrome can be successfully treated by aggressive nutritional management. This may include total parenteral nutrition or feeding by a nasojejunal tube. Duodenojejunostomy could be required in refractory cases. 相似文献
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Raymond Ladu 《International journal of surgery case reports》2014,5(3):159-160
INTRODUCTION
We are presenting a case of schistosomiasis in a 41 year old lady who presented with right iliac fossa pain for 3 years. The pain worsened and the frequency increased in the last 3 months prior to referral. The ultrasound was unremarkable. Her bowel habits were normal and there was no vomiting. There was no blood in the stool or in the urine.PRESENTATION OF CASE
The abdomen was soft except on deep palpation. There was slight tenderness in the right lower quadrant. A repeat ultrasound was unremarkable. The full blood count was within the normal range. A diagnosis of recurrent acute appendicitis was made and an interval appendicectomy was performed.DISCUSSION
Histopathology results revealed schistosomiasis of the appendix. There was no acute inflammation but there was fibrous obliteration of the distal lumen of the appendix and reactive lymphoid hyperplasia.CONCLUSION
This is the first case in a country with relatively clean drinking water. There are no irrigation schemes but there are seasonal rivers and streams. The patient admits to swimming in these streams during childhood. Clinical features of schistosomiasis were not elicited. 相似文献11.
Salvi PF Lombardi A Puzzovio A Stagnitti F Tisba M Gaudinieri A Pappalardo G 《Annali italiani di chirurgia》2004,75(1):91-95
Neurofibromatosis (NF) is a relatively common disorder characterized by cutaneous pigmented maculas, multiple neurofibromas and Lisch nodules (pigmented iris hamartomas). This disorder is retained being a neurocristopathy. Melanocytes are neural crest derivates too. Twenty-six patients with neurofibromatosis associated to cutaneous malignant melanoma have been reported till now, but data on association between these two pathologies are lacking. One more case of malignant cutaneous melanoma in a patient with neurofibromatosis is reported and the hypothesis of a more frequent association than usually believed of these two pathologies is discussed. 相似文献
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IntroductionEosinophilic and lymphoeosinophilic cholecystitis are uncommonly encountered causes of acalculous cholecystitis characterised by a clinical presentation of acute cholecystitis with eosinophilic infiltration of the gallbladder. Acalculous cholecystitis is a disease that is traditionally associated with patients who are critically unwell and immunosuppressed.Presentation of caseA fit and well 37-year-old man presented to the emergency department with a 12 -h history of constant upper abdominal pain radiating through to his back. Abdominal examination revealed tenderness in the right upper quadrant with a positive Murphy’s sign. An abdominal ultrasound was performed, revealing a thickened gallbladder wall with probe tenderness, but no gallstones. He proceeded to an uneventful emergency laparoscopic cholecystectomy. Histological examination of the gallbladder revealed mucosal and transmural inflammation comprising of lymphocytes and more than 50 % eosinophils. No gallstones were found. A diagnosis of lymphoeosinophilic cholecystitis was made. The patient had improvement in his symptoms and was discharged home. He was well at follow-up.DiscussionThere is a small subset of immunocompetent patients who are not critically unwell who present with acalculous cholecystitis. There is significant hesitancy in offering a cholecystectomy to these patients without radiological evidence of gallstones or sludge preoperatively. Cholecystectomy should be offered to these patients if the clinical picture fits acute cholecystitis.ConclusionEosinophilic and lymphoeosinophilic cholecystitis are important causes of acalculous cholecystitis that can occur in immunocompetent patients. The decision to offer the patient a cholecystectomy should be based on clinical presentation and examination, rather than the absence or presence of gallstones. 相似文献
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IntroductionPrimary small cell neuroendocrine carcinoma of the breast (SCNCB) is a very uncommon type of breast cancer. Histology and morphology are virtually indistinguishable from small cell neuroendocrine carcinomas of the lung (SCNCL), mandating a search for a primary site elsewhere in the body. There is no standard approach to treatment as there are only a limited number of cases reported in the literature. This report summarizes a case of primary SCNCB and presents a review of the literature.Presentation of caseA 65-year-old female presented to her gynecologist with a right breast mass. After biopsy, she was diagnosed with a primary SCNCB with regional lymph node involvement. She was treated with chemotherapy and radiation therapy with a good clinical response.DiscussionDue to the rare nature of this tumor, no standard treatment exits. Case reports have described breast conserving therapy combined with neoadjuvant or adjuvant chemotherapy as well as chemoradiation therapy alone for metastatic disease. Both chemotherapy regimens, those used to treat SCNCL and invasive breast cancer, have been described in these reports.ConclusionPrimary SCNCB is a very rare type of breast cancer with no standard treatment. Further research is needed to better understand the behavior of this rare tumor in order to develop a standard approach to treatment. 相似文献
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Chondroblastoma, a rare benign bone tumour arising from the epiphysis, accounts for approximately 1% of all primary bone tumours and is known to be locally aggressive with potential for metastases and local recurrence. Open surgical curettage is associated with high risk of recurrence and potential for damage to the physis resulting in growth disturbances. We report a 14-year-old girl with chondroblastoma involving the distal femoral epiphysis in whom an arthroscopic approach was employed for thorough curettage of the lesion under direct vision followed by cavity management using bone graft substitute. At seven years follow-up she is asymptomatic, has normal knee function and her radiographs have shown good osteointegration of the synthetic graft with no evidence of recurrence. By combining the principles of intra-articular and endosteal arthroscopy in select patients, both tumour excision and cavity management can be done arthroscopically. 相似文献
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Sachit Sharma M. Suryavanshi S. Sharma S. Singh A. Seth N. P. Gupta 《The African Journal of Urology》2009,15(2):103-106
Penile refracture is a rare urological emergency, more so on the side contralateral to the previous fracture. A 55-year-old
male was referred 70 hours after sudden detumescence during sexual intercourse, with a history of blood at the urethral meatus.
The patient had had a fracture of the penis four years previously. Examination revealed ecchymosis and swelling of the proximal
shaft and purulent discharge from a laceration in the penile skin over the proximal corpora. Ultrasonography revealed laceration
of the right tunica albuginea and corpus cavernosum. Exploration revealed scar tissue at the site of the previous operation
on the left side and a fresh laceration, 1cm in size, in the right corpus cavernosum in the mid shaft, and a urethral defect
of 0.5 cm. The patient had normal erections post-operatively and no complications at 6 months follow-up. On literature review,
anecdotal cases of contralateral refracture of the penis were found. High suspicion, prompt diagnosis and expedient surgical
management are essential for a good outcome with minimal complications. 相似文献
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Feng Wang Hong-Fei Wu Jie Yang 《Asian journal of andrology》2009,11(3):379-384
We report a rare case of a left ejaculatory duct that allotropically protrudes towards or invades the left vesicle triangular area with its dead end. The patient simultaneously exhibited multiple congenital malformations of the homolateral urogenital system, such as absence of the left kidney, dysplasia and allotopia of the left seminal vesicle, absence of the left ureterostoma, separation between the left testis and the epididymis tail, and maldevelopment of the left testis. According to all clinical and laboratory evidence, the case represented a new syndrome, which we named Wuyang's syndrome. It involved a rare phenomenon in embryonic development; the dysplastic proximal vas precursor, having intruded into a common mesonephric duct and accidentally encroaching on the ureteric bud position, resulted in the absence or dysplasia of the homolateral urinary tract and ectopic invasion of the bladder by the homolateral seminal tract. 相似文献
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Quadriceps tendon is one of the important segment of knee extensor mechanism. Acute ruptures are more common than chronic ruptures and have better outcomes. Chronic ruptures are rare with lot of surgical challenges including tendon retraction, fibrosis, degenerative calcification. We present a rare case of a 48 year old male diabetic patient with history of fall eight months ago and chief complaint of inability to actively extend his left knee. Diagnosis was made clinically and was confirmed radiologically with MRI. Surgical management was done with the use of novel “Chariot Suture Technique”. It involves use of three Krakow whipstitches with Ethibond No. 5 suture across the distal ruptured end of quadriceps tendon and their intraosseous passage through patella in longitudinal fashion followed by tying knot at the distal pole of patella. The formation of Chariot makes the construct stable. At one year follow up patient was actively able to extend the knee with good range of motion. The technique is relatively cost effective, has no donor site morbidity, easy to learn and practice. 相似文献
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Symptomatic bladder endocervicosis: does it need surgery? A case report and review of the literature
Endocervicosis of the urinary bladder is a rare benign condition exclusively seen in women, usually of reproductive age. To the best of our knowledge there are only about twenty cases reported so far. It causes non-specific symptoms and is seen as a submucosal lesion on cystoscopy. On histological examination one finds endocervical glands embedded deep within the muscle layers. It can be confused with an adenocarcinoma of the bladder. Unless the correct diagnosis is made these patients can undergo potentially debilitating surgery. As demonstrated in our patient even symptomatic endocervicosis can be managed conservatively. 相似文献
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Background
The term "gossypiboma" denotes a mass of cotton that is retained in the body following surgery. Gossypiboma is a medico-legal problem especially for surgeons. To the best of our knowledge, the patient presented herein is the second reported patient in whom the exact site of migration of a retained surgical textile material into the intestinal lumen could be demonstrated by preoperative imaging studies. 相似文献20.
George Melich Michael Weber Barry Stein Vincenzo Minutolo Manuel Arena Goffredo O. Arena 《International journal of surgery case reports》2014,5(7):403-407