Isolated calcaneocuboid joint tuberculosis: A rare case report

Tubercular arthritis affecting the foot is uncommon. Isolated calcaneocuboid joint tuberculosis has never been reported in the literature. Herein we report a case of 43-year-old male who presented with insidious onset pain in hindfoot of 4 months duration. Radiograph revealed destruction of calcaneocuboid joint along with cuboid. Computed Tomography scan further consolidated the findings. Diagnosis was confirmed from aspiration from joint with culture of mycobacterium tuberculosis. Anti-tubercular chemotherapy was started and good clinical response was noted. We reported this case because of its rarity to involve calcaneocuboid joint and the excellent outcome with medical treatment.     

Mediastinal ganglioneuroma: a rare and often asymptomatic tumour. A case report

Ganglioneuroma is a very rare tumour characterised by a slow evolution and arising from cells originating in the neural crest. This type of tumour occurs most commonly in the posterior mediastinum and is considered malignant in childhood and benign thereafter. It grows very slowly and can usually grow to a substantial size without giving rise to an evident clinical picture. We report the case of an 18-year-old asymptomatic patient, who had undergone a medical examination in a military hospital where a chest X-ray revealed a roundish mass in the right lung displacing the trachea to the left. Computed tomography showed that the mass was located in the posterior mediastinum. Surgical resection was performed. The tumour was encapsulated and adhered tightly to the pleura of the costovertebral angle. Histological examination revealed a ganglio-neuroma composed of Schwann cells and mature ganglion cells without any neuroblastomatous elements. This case of a mediastinal ganglioneuroma in a young male patient is a typical example of this rare pathological entity. The totally asymptomatic clinical picture could be explained by the very slow growth of this type of tumour which can displace the surrounding anatomical structures without infiltration.     

脊柱内固定术后手术部位感染并脊柱结核1例

正手术部位感染(surgical site infection,SSI)是脊柱内固定术后常见并发症之一,指在无内置物材料30d内或有内置物材料手术12个月内发生的与手术相关的感染~([1]),包括表浅切口感染、切口深部感染及邻近器官和组织间隙的感染~([2])。临床上,脊柱术后感染病原菌以金黄色葡萄球菌多见(45.2%),其次是表皮葡萄球菌(31.4%),其他常见的致病菌还有肠球菌、大肠杆菌、消化链球菌等~([3])。笔者所在医     

A case of ruptured aneurysm associated with spinal arteriovenous malformation presenting with hematomyelia: case report

BACKGROUND

Spinal cord arteriovenous malformation (AVM) associated with spinal aneurysm is not particularly rare, but cases presenting with hematomyelia are relatively rare compared to those with subarachnoid hemorrhage (SAH). We report a rare case of successfully treated spinal AVM associated with ruptured aneurysm presenting with hematomyelia.

CASE DESCRIPTION

A 52-year-old male was admitted to our hospital with sudden onset of tetraplegia, respiratory disturbance, and superficial sensory disturbance. Computed tomography revealed hematomyelia at the level of C3–4. Gadolinium-enhanced magnetic resonance imaging showed small, enhanced lesions. Angiography revealed an intradural perimedullary arteriovenous malformation associated with two aneurysms on the feeding arteries. Administration of high-dose methylprednisolone gradually ameliorated his symptoms. Direct surgical obliteration was performed on the 30th day after the onset. The bilateral C3 cervical radicular arteries and the nidus were coagulated. Angiography performed after surgery showed neither the aneurysms nor the nidus. He was discharged with only mild weakness in the left upper extremity and mild left hypesthesia 3 months after surgery, and was fully independent.

CONCLUSION

We report a case of hematomyelia caused by ruptured aneurysm associated with spinal arteriovenous malformation that was successfully treated with surgical obliteration.     

The human tail: rare lesion with occult spinal dysraphism--a case report

Human tail or tail-like caudal cutaneous appendage is a rare fingerlike, midline protrusion at the lumbosacrococcygeal region, often associated with occult spinal dysraphism. A 2-month-old male child presented here had a lumbosacral tail-like appendage with underlying spinal dysraphism without any appreciable neurological deficit. In contradiction to a previous report, true vestigial tails are not benign because they may be associated with underlying dysraphic state. About 50% of the cases were associated with either meningocele or spina bifida occulta. Management of such lesions must include complete neurological history and examination as well as magnetic resonance or computed tomographic imaging. After diagnosis, microsurgery should be performed if there is any intraspinal component to avoid any damage and neurological deficit.     

Intra-ocular tuberculosis associated with a penetrating injury. A case report

A case of histologically proven intra-ocular tuberculosis is described. The condition was preceded by penetrating trauma, and no evidence of systemic tuberculosis other than a positive Mantoux test was found. Numerous acid-fast bacilli were seen in pathological sections of the eye. We suspect that a tuberculosis bacillaemia from an undetected healed focus coincided with the trauma and thereby produced intra-ocular tuberculosis.     

Intramedullary spinal cord metastasis associated with hemorrhage: a case report

A rare case of intramedullary spinal cord metastasis associated with hemorrhage was reported. A 74-year-old man had a subacute onset of paraparesis. He became almost paraplegic within a few days. MRI revealed an intramedullary spinal lesion in the epiconus at the Th 11 and Th 12 level, but spinal angiography did not show any abnormality. Since repeated MRI showed enlargement of the lesion, surgery was performed under the diagnosis of an intramedullary spinal cord tumor. Under general anesthesia, a midline myelotomy of about 3 cm was performed and a grayish, elastic and circumscribed tumor as well as a liquefied hematoma in the caudal part was observed. Both the tumor and the hematoma were removed almost totally. The patient's paraparesis improved slightly after surgery. The histological diagnosis was adenocarcinoma. The primary source was unknown, but multiple small metastatic tumors were found in the lung, liver and brain, etc. Hemorrhage from intramedullary spinal cord metastasis is extremely rare with only 6 reported cases in the recent literature. Rapid deterioration of symptoms caused by the hematoma may make the diagnosis more difficult. Indication of surgical treatment should be carefully determined because prognosis of intramedullary spinal cord metastasis is generally very poor.     

A single-stage posterior approach in the treatment of spinal tuberculosis: case report

Abstract We describe a case of dorsal vertebral tuberculosis that was initially treated non-surgically. Despite apparent clinical improvement, the patient suffered sudden partial paralysis of the legs and surgery was required. Spinal decompression, transpeduncular abscess drainage and posterior vertebral stabilisation were carried out.     

Adult respiratory distress syndrome associated with miliary tuberculosis. A case report

In this report we describe a patient with miliary tuberculosis who presented with the adult respiratory distress syndrome. The diagnostic problems are discussed and the value of transbronchial lung biopsy is emphasized. Our experience with this patient stresses the need for maintaining a high index of suspicion for treatable causes of adult respiratory distress syndrome.     

Congenital constriction band associated with pseudarthrosis and impending gangrene. A case report

A newborn baby with a severe congenital constriction band associated with pseudarthrosis and impending gangrene of the foot is described. Early one-stage circumferential excision of the band with immediate wound closure by multiple Z-plasties salvaged the compromised foot. The pseudarthrosis indicated the severely compressive nature of the fibrous band. The uneventful healing of the pseudarthrosis and the full recovery of neurovascular function points to essential normal tissue underlying the constricting band.     

A case report of a spinal epidural haematoma associated with warfarin therapy

Spinal epidural haematoma is an uncommon, but recognised, clinical entity that needs emergency management. The association of spinal epidural haematomata with warfarin therapy has been described and, in 1956, Alderman stated that this diagnosis should be entertained in any patient receiving anticoagulants presenting with low back pain or sciatic pain. The purpose of this case report is to increase the awareness of this entity among medical personnel and to stress the urgency of management.     

Isolated gallbladder tuberculosis in an 84-year old man: A rare case report

IntroductionIsolated gallbladder tuberculosis is extremely rare even in endemic regions posing diagnostic challenges as the presentation mimics other gallbladder diseases such as cholecystitis and gallbladder carcinoma. Preoperative suspicion index is negligible with most cases being diagnosed postoperatively from resected specimen.Case presentationHerein, we report an elderly man who presented with jaundice, and was clinically diagnosed with gallbladder carcinoma.DiscussionHistopathology of resected gallbladder revealed gallbladder tuberculosis. No features of tuberculous infection were found elsewhere.ConclusionHealthcare providers should have a high index of suspicion particularly for patients in endemic areas presenting with cholecystitis to obtain a pre-operative diagnosis.     

Congenital lumbar hernias: A case report

Congenital lumbar hernias are rare and associated with other malformations. There have been 42 cases reported to date. The authors report the first case in the literature of isolated bilateral congenital lumbar hernias. J Pediatr Surg 37:921-922.