Scrotal emphysema: a case report

We report a case of scrotal emphysema following the placement of a chest tube and an endotrachial catheter for traumatic pneumothorax. Scrotal emphysema is a rare condition and is considered as a type of pneumoscrotum, for which 4 possible mechanisms have been discussed. It is important to promptly determine the origin of air because this condition may be caused by a life-threatening disease.     

Cystic hygroma in an adult: a case report

Cystic hygromas are benign lesions arising due to an abnormality in lymphatic development and only rarely present in adults. Adequate radiological imaging prior to surgery is important as incomplete excision often leads to recurrence. Several adjunctive therapies have been shown to be beneficial in recurrent or inaccessible lesions but these are not in common use. We describe the case of a cystic lymphangioma appearing in adulthood that presented a diagnostic and therapeutic challenge.     

Traumatic orbital emphysema: a case report

A 30-year-old male presented with sudden diminution of vision, orbital pain, diplopia, and swelling of the eyelid of the right eye after blowing his nose within three days after a blunt ocular trauma. His best-corrected visual acuities were 6/10 in the right eye and 10/10 in the left eye. Anterior segment and fundus examination were normal bilaterally. Limitation of upward ocular motility was noticed in the right eye. Diplopia was detected in both upward and downward motilities. Intraocular pressures were 21 mmHg in OD and 16 mmHg in OS. Hertel exophthalmometry measurements were 21 mm for the right eye and 19 mm for the left eye. The direct computerized tomography image displayed the inferior orbital wall fracture and orbital emphysema in the right orbit. Prophylactic antibiotherapy was applied. The patient was advised not to blow his nose. He had no complaints on the third day after the trauma. Follow-up examinations showed no ophthalmological complications.     

Factitious subcutaneous emphysema: a case report

A case is described of a young man who produced surgical emphysema of his left forearm using a 2-ml syringe with a modified needle. It is believed that this is the second reported example of this type of artefact. Other cases may occur with the present high incidence of drug abuse and increasing general access to syringes.     

Catamenial pneumothorax with diaphragmatic endometriosis: a case report]

A 30-year-old female had twice experienced right pneumothorax within 2 months that was related to the onset of menstruation, suggesting catamenial pneumothorax. Right thoracoscopy revealed the presence of "blue berry spots" and pinhole at the lateral part of central tendon in the diaphragm. No bulla or bleb was found on the right lung. Partial resection of the diaphragm including these lesions was performed under small thoracotomy assisted by thoracoscopy. Histological findings showed endometriosis of the diaphragm. She was followed without hormonal therapy, but recurrent right pneumothorax occurred. Therefore she was given leuprorelin acetate for 5 months, and she is asymptomatic 7 months after surgery.     

Bilateral antrochoanal polyps in an adult: a case report

Antrochoanal polyps (ACP) are almost always unilateral. Only two bilateral cases have been reported to date, both of them in children. There have been no investigations of the aetiology of the bilateral occurrence of these lesions, possibly due to the rarity of bilateral ACPs. In this paper, we report on the first adult case of bilateral ACPs and review the literature.     

Occult Monteggia fracture in an adult: a case report

Injuries with the Monteggia fracture-dislocation pattern necessitate operative fixation of the ulna fracture in an adult. It is important to identify this by taking radiographs of the elbow and wrist joints in all cases of ulna fracture. We present a case of an occult Monteggia fracture-dislocation in an adult, which was not apparent on the initial radiographs. A thorough clinical examination along with an examination under anaesthesia in view of the high index of suspicion helped us to achieve the diagnosis.     

Wilms' tumor in an adult patient: a case report

A case of Wilms' tumor in an adult patient is presented. The tumor in adults is rather rare and has an unfavorable prognosis. A 39-year-old man bruised his left flank while skiing in February, 1983. He noticed severe left flank pain. The pain subsided after a week of rest. However, he complained of left abdominal mass and dull pain again, and consulted our outpatient clinic on May 21, 1983. Left transperitoneal nephrectomy was performed under a diagnosis of left injured renal tumor. Histological diagnosis was nephroblastoma. A combined chemotherapy of actinomycin D (ACD) and vincristine (VCR) was started after operation. A total of 10 mg of ACD and 14 mg of VCR was administered by the end of 1983. In March 1984, however, a local recurrence and pulmonary metastases of the tumor were detected by CT and chest films. Local RF-hyperthermia combined with irradiation, alpha-interferon or chemotherapy using cisplatin and adriamycin was given. The patient died of profound cachexia in December, 1984 after gradual deterioration of general conditions.     

Caeco-colic intussusception in an adult: a rare case report

Intussusception is common in children but rare in adults. Caeco-colic intussusception is an uncommon cause of intestinal obstruction in adults. Very limited information is available about the role of colonoscopy in diagnosis of intussusception in the literature. We present a case of caeco-colic intussusception in a 50-year-old male who presented with the complaints of pain in abdomen and a lump in the right hypochondrium. Colonoscopy and contrast studies revealed the diagnosis of intussusception. Abdominal computed tomography (CT scan) is considered as the most sensitive investigation to diagnose intussusception at present, whereas colonoscopy is sparingly used to diagnose intussusception. In this patient, colonoscopy not only established the diagnosis and malignant nature of the lead point, but also guided the definitive extent of surgical resection. CT scan offers a presumptive diagnosis as compared to the definitive diagnosis of intussusception by colonoscopy. In adult intussusception, colonoscopy can be considered as a complimentary investigation to other diagnostic modalities. Hence regular use of colonoscopy in adult intussusception should be encouraged where presentation is either subacute or chronic.     

马凡综合征合并脊柱侧弯术后自发性气胸一例报告

马凡综合征 (Marfansyndrome ,MFS)是累及全身多系统的常染色体显性结缔组织遗传病 ,临床上以骨骼、心血管、眼组织、肺部、皮肤及硬脊膜病变为主要表现 ,其发病率占普通人群 1/ 5 0 0 0～ 1/30 0 0 [1～ 3] 。约 6 3%的MFS患者合并 >10°的脊柱侧弯畸形。MFS患者脊柱手术后常并发心血管疾病[4～ 7] ,而术后并发自发性气胸国内罕有报道。我科于 2 0 0 3年 9月治疗 1例MFS脊柱侧弯 ,术后早期发生自发性气胸 ,现报告如下。1　资料与方法1.1　临床资料患者 ,女 ,14岁。 10岁时家长无意中发现脊柱稍向右侧倾斜 ,无任何不适 ,未予治疗。 11…     

Spontaneous pneumothorax: report of a case in podiatric surgery

The authors have reviewed the literature concerning the subject of spontaneous pneumothoraces. Included in the review are the types of spontaneous pneumothoraces, such as: primary, secondary, tension, and catamenial. The symptomatology, diagnosis, and treatments were discussed. A case report of a catamenial spontaneous pneumothorax in a preoperative podiatric patient was presented.