scholarly journals Abdominal Hernias, Giant Colon Diverticulum, GIST, Intestinal Pneumatosis, Colon Ischemia, Cold Intussusception, Gallstone Ileus, and Foreign Bodies: Our Experience and Literature Review of Incidental Gastrointestinal MDCT Findings

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
G. Di Grezia ◽  
G. Gatta ◽  
R. Rella ◽  
D. Donatello ◽  
G. Falco ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Clinical Presentation ◽  
Gallstone Ileus ◽  
Abdominal Hernia ◽  
Palpable Mass ◽  
Intestinal Pneumatosis ◽  
The Past ◽  
Colon Ischemia ◽  
Medical Indications

Incidental gastrointestinal findings are commonly detected on MDCT exams performed for various medical indications. This review describes the radiological MDCT spectrum of appearances already present in the past literature and in today’s experience of several gastrointestinal acute conditions such as abdominal hernia, giant colon diverticulum, GIST, intestinal pneumatosis, colon ischemia, cold intussusception, gallstone ileus, and foreign bodies which can require medical and surgical intervention or clinical follow-up. The clinical presentation of this illness is frequently nonspecific: abdominal pain, distension, nausea, fever, rectal bleeding, vomiting, constipation, or a palpable mass, depending on the disease. A proper differential diagnosis is essential in the assessment of treatment and in this case MDCT exam plays a central rule. We wish that this article will familiarize the radiologist in the diagnosis of this kind of incidental MDCT findings for better orientation of the therapy.

Myoepithelioma of the Skull

Neurosurgery ◽  
2012 ◽  
Vol 71 (4) ◽  
pp. E901-E904 ◽  
Author(s):  
Karen J. Fritchie ◽  
Mitchel D. Bauman ◽  
Quentin J. Durward
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Bone Lesion ◽  
Myoepithelial Cells ◽  
The Past ◽  
Lytic Bone Lesion ◽  
Initial Biopsy

Abstract BACKGROUND AND IMPORTANCE: Myoepithelioma of bone is a rare osseous tumor thought to be related to myoepithelial lesions found at other anatomic sites such as the salivary gland and skin. These tumors are composed of varying proportions of epithelial and myoepithelial cells and exhibit a spectrum of biologic behavior ranging from benign to malignant. We present the first reported case of myoepithelioma of the skull. CLINICAL PRESENTATION: A 20-year-old white woman presented with a persistent right parieto-occipital skull nodule, relating its presence to a fall on the site 2 years previously. The nodule had become painful in the past 2 months. Her past medical history and workup were otherwise unremarkable. The initial biopsy was inconclusive for diagnosis. The lytic bone lesion was subsequently resected, and histopathological examination showed a proliferation of epithelioid cells in a myxochondroid background. Fluorescence in situ hybridization studies revealed a rearrangement of the EWSR1 locus. The morphologic and molecular findings were consistent with the diagnosis of myoepithelioma of bone. CONCLUSION: Six months after surgery, the patient is doing well with no evidence of recurrence. This case illustrates the clinical presentation, histopathology, and molecular findings of a myoepithelioma of the skull with successful surgical treatment. Because myoepitheliomas with benign morphological appearance may rarely act aggressively, long-term clinical follow-up is warranted.

Fifty Years of Experience with Chordomas in Southeast Scotland

Neurosurgery ◽  
1985 ◽  
Vol 16 (2) ◽  
pp. 166-170 ◽  
Author(s):  
P. O'Neill ◽  
B.A. Bell ◽  
J.D. Miller ◽  
I. Jacobson ◽  
W. Guthrie
Keyword(s):  
Clinical Presentation ◽  
Surgical Intervention ◽  
Slow Growth ◽  
Multicenter Trial ◽  
Treatment Modalities ◽  
Therapeutic Approaches ◽  
Slow Growth Rate ◽  
The Past ◽  
New Therapeutic Approaches

Abstract We report the clinical presentation and management of 34 patients with a histologically proven chordoma, treated in the neurosurgical departments in Edinburgh and Dundee, over the past 50 years. Although these tumors are commonly regarded as being locally invasive with a variable, but generally slow growth rate, they can metastasize, and this may precede surgical intervention, as in one of our patients. Our cases are compared to those in previously published series, and a comprehensive review of the treatment modalities for tumors at various sites is presented. The optimal treatment to be recommended from our own experience, and that of others, is aggressive operation and radiotherapy. A combination of hyperthermia and chemotherapy has shown some promise, but remains untested, and highlights the need for a multicenter trial with long follow-up to allow the evaluation of new therapeutic approaches.

Surgical treatment of spinal cord astrocytomas of childhood

1982 ◽  
Vol 57 (5) ◽  
pp. 685-689 ◽  
Author(s):  
Fred Epstein ◽  
Nancy Epstein
Keyword(s):  
Spinal Cord ◽  
Clinical Presentation ◽  
Therapeutic Option ◽  
Radical Resection ◽  
Surgical Experience ◽  
Total Removal ◽  
Content Type ◽  
The Past ◽  
Spinal Cord Astrocytoma

✓ This report describes the first author's surgical experience with a series of 19 consecutive cases of spinal cord astrocytoma treated over the past 2 years, with a follow-up period of 6 to 24 months. The clinical presentation, neurodiagnostic investigation, surgical technique, and results are analyzed. The authors conclude that radical resection (gross total removal of the tumor) is the optimal therapeutic option.

scholarly journals Uncommon surgical emergencies in neonatology

2014 ◽  
Vol 36 (5-6) ◽  
Author(s):  
R. Angotti ◽  
A.L. Bulotta ◽  
F. Ferrara ◽  
F. Molinaro ◽  
E. Cerchia ◽  
...  
Keyword(s):  
Gestational Age ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Oral Feeding ◽  
Clinical Approach ◽  
Associated Anomalies ◽  
Multiple Factors ◽  
The Past ◽  
Surgical Emergencies

Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

scholarly journals Foreign body in urinary bladder: our experience and review of literature

2019 ◽  
Vol 6 (12) ◽  
pp. 4327 ◽  
Author(s):  
Mohd Hamid Shafique Ahmed ◽  
Prakash W. Pawar ◽  
Ajit S. Sawant ◽  
Jitendra Sakharani ◽  
Amandeep Arora ◽  
...  
Keyword(s):  
Foreign Body ◽  
Urinary Bladder ◽  
Foreign Bodies ◽  
Clinical Presentation ◽  
Presentation Mode ◽  
Medical College ◽  
Urinary Tract Symptoms ◽  
History Of ◽  
Lower Urinary

Background: The objective of the study was to study clinical presentation, mode of insertion, and management of intravesical foreign bodies in patients treated at our hospital.Methods: This was a retrospective study conducted between January 2018 to June 2019. Six patients underwent treatment for urinary bladder foreign body at Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India. Medical records were analyzed retrospectively with regard to nature of foreign body, each patient’s clinical presentation, the mode of insertion and how the foreign was managed.Results: A total of six foreign bodies were retrieved from patients’ urinary bladders. The patients range in age from 28 to 65 years (mean age was 45 years). The Clinical presentation includes Lower urinary tract symptoms. Four patients were male and two were female. Circumstance of insertion was iatrogenic in 5 patients and self-insertion in 1 patient. Five patients were treated endoscopically (cystoscopy retrieval with or without cystolithotrity) and one patient with supra pubic cystostomy. Post-operative hospital stay was of 1 to 2 days. Mean follow up period was 3 months. Psychiatric referral and counseling were done in patients with history of self-insertion of foreign body in urinary bladder.Conclusions: Foreign body in the urinary bladder remain a challenge to the urologist. Removal of the foreign body without injury to the urinary bladder or the urethra gives good outcome.

The management of malignant lower limb ulcers: clinical considerations

2020 ◽  
Vol 29 (15) ◽  
pp. S34-S40
Author(s):  
Paul Ghaly ◽  
Yewon D Kim ◽  
Jim Iliopoulos ◽  
Mehtab Ahmad
Keyword(s):  
Lower Limb ◽  
Care Setting ◽  
Primary Care Setting ◽  
Clinical Presentation ◽  
Therapeutic Modalities ◽  
The Past ◽  
Skin Cancers ◽  
Clinical Considerations ◽  
Review Current

Lower limb malignant ulcers are an uncommon finding, making diagnosis complex and their management costly. Yet, despite this, the increase in skin cancers over the past 30 years means that clinicians require an awareness and understanding of their existence, particularly in the primary care setting. Familiarity with common aetiologies and presentations is vital for prompt recognition, diagnosis and referral of wounds suspicious for malignancy. Lower limb malignant wounds often develop insidiously, with a wide variation in clinical presentation that overlaps between entities. Therefore, a fundamental algorithm for approaching lower limb ulcers that raise suspicion of malignancy should be possessed by all clinicians. This article reviews the clinical features of malignant wounds that should alert clinicians to the need for further evaluation, such as atypical location and appearance. The authors also highlight the various diagnostic and therapeutic modalities available and review current clinical guidelines for the referral and follow-up of suspicious lesions.

Surgical Approach to Frontal Sinus Osteoma: A Systematic Review

2019 ◽  
Vol 33 (5) ◽  
pp. 462-469 ◽  
Author(s):  
Duncan C. Watley ◽  
Eric R. Mong ◽  
Nikunj A. Rana ◽  
Elisa A. Illing ◽  
Mohamad R. Chaaban
Keyword(s):  
Systematic Review ◽  
Surgical Approach ◽  
Frontal Sinus ◽  
Clinical Presentation ◽  
Sagittal Plane ◽  
Residual Disease ◽  
Complete Removal ◽  
Open Approach ◽  
The Past

Background Osteoma of the paranasal sinuses are benign bony masses most commonly found in the frontal sinus. In the past, due to the anatomical complexity of the frontal sinus, these often required an open approach, but with the invention of angled tools and endoscopes, many rhinologists are now attempting endoscopic or combined resections. No large systematic reviews currently exist that describe the surgical management of frontal sinus osteoma. Objective To perform a systematic review detailing the surgical resection of frontal sinus osteoma. Review Methods: A systematic literature review was performed using PubMed, Embase, and Ovid databases. Data extracted included demographics, clinical presentation, radiologic, histologic findings, surgical approach, and recurrence. Results A total of 32 studies, with 477 surgically resected tumors, were included in the analysis. Sex data were available for 179 patients (M:F, 93:86), with a mean age of 43.2 years. All resected tumors presented symptomatically: facial pain/headache (80.2%), recurrent sinusitis (30.5%), mucocele (4.3%), cosmetic deformity other than proptosis (12.8%), and proptosis (5.5%). Transnasal endoscopic surgery alone was the most common surgical approach utilized (44.9%), followed by open osteoplastic flaps (36.9%) and endoscopic assisted (18.2%). Osteoma with anterior (79%) and posterior (73%) attachments were treated statistically more often with endoscopic approach compared with floor (42%) and extrasinus (50%) attachment ( P < .0005). There was no statistical difference in approach to masses that crossed the sagittal plane extending from the lamina papyracea (63% endoscopic, 29% endoscopic assisted, 8% open, P = .21). Mean follow-up was 29.7 months, with recurrence or persistent residual disease occurring in 12 patients. Conclusion Despite the increasing use of endoscopic alone procedures for expanding indications, patients may still require an open or endoscopic assisted approach for complete removal.

scholarly journals Modified Cantwell–Ransley repair for isolated continent epispadias in adult: Our experience

2017 ◽  
Vol 50 (01) ◽  
pp. 068-073
Author(s):  
Venkat Arjunrao Gite ◽  
Hitesh Mahendra Jain ◽  
Sachin M. Bote ◽  
Jayant Vijay Nikose
Keyword(s):  
Skin Infection ◽  
Clinical Presentation ◽  
Surgical Techniques ◽  
Urethrocutaneous Fistula ◽  
The Past ◽  
Secondary Intention ◽  
Absorbable Sutures ◽  
Superficial Skin

ABSTRACTPurpose: We evaluate here our experience with modified Cantwell–Ransley technique described by Gearhart for correction of isolated continent epispadias in adults with respect to its long-term functional outcome and complications. Introduction: Isolated male epispadias is a rare anomaly with a reported incidence of 1 in 11,700 males. Many surgical techniques with various modifications described to correct epispadias as treatment are debatable and challenging. The majority of the cases are treated at childhood as clinical presentation is striking at birth; hence, presentation in adulthood is extremely rare. Materials and Methods: During the past 5 years, modified Cantwell–Ransley technique described by Gearhart was performed in five cases of isolated continent epispadias which includes two cases of proximal penile, two distal penile and one penopubic. All cases were fresh except one had prior failed repair. Corporal rotation was done by delayed absorbable sutures without incision and anastomosis and suprapubic diversions placed in all the cases. Results: All cases followed up ranging from 6 months to 5 years and were having horizontal and downwards angled penis. No case had urethrocutaneous fistula or stricture. One case had superficial skin infection which healed by secondary intention did not require any secondary procedure. All cases maintained erection post-operatively too. Catheterisation with soft tube revealed easily negotiable channel in all cases on follow-up. Conclusion: Modified Cantwell–Ransley repair described by Gearhart has excellent cosmetic, functional and anatomical results in isolated continent epispadias in the adult.

scholarly journals Thyroglossal Cyst in Children: Presentation, Diagnosis and Managment Outcome in the Context of Bangladesh

2016 ◽  
Vol 4 (2) ◽  
pp. 37-42
Author(s):  
Syed Hasan Imam Al Masum ◽  
Ali Jacob Arsalan
Keyword(s):  
Clinical Presentation ◽  
Preoperative Evaluation ◽  
Anatomical Location ◽  
Fluid Level ◽  
Thyroglossal Cyst ◽  
Eligibility Criteria ◽  
Duct Cyst ◽  
The Past ◽  
Ultrasonographic Assessment

Background and Objectives: Thyroglossal duct cyst (TDC) is considered to be the most common congenital neck swelling in children. But its diagnosis can sometimes be challenging, because of abnormal presentation or associated infection. The aim of the present study is to describe the clinical features, anatomical location and management given to these children in the context of Bangladesh. Methods: This retrospective review of the past 7 years' (between June 2008 and July 2015) records of all children with a histopathologically confirmed diagnosis of TDC was done at the Department of Pediatric Otolaryngology, Dhaka Shisu Hospital, Sher-e-Bangla Nagar, Dhaka. Thirty patients fulfilled the predefined eligibility criteria and were included in the study. Preoperative evaluation consisted of physical examination with regard to movement of the mass with protrusion of the tongue and ultrasonographic assessment of the mass. All the patients were operated by Sistrunk's approach and outcome was assessed in terms uneventful cure, infection and recurrence. Result: In the present study the children presented with TDC were on an average 7.1 (range: 3.5 - 11 years) years old and were predominantly girls (60%). Majority of patients belonged to middleclass (70%). Urban and rural representations were almost equal. Half of the patients were diagnosed between 5 - 10 years of age. Majority (80%) of the TDCs were located in infrahyoid region just lateral to the midline, 16.7% were located close to the hyoid bone (juxtahyoid) and 3.3% to the suprahyoid region in the midline. All the 30 cases presented with painless cystic swelling which moved upwards with protrusion of tongue. No signs of infection or associated diseases (myxoedema or thyroglossal fistula) were present. An anechoeic character with absence of fluid level was detected with ultrasono imaging of the mass. Conclusion: Clinical presentation and anatomical location and management were almost same as elsewhere in the world. But in the absence of a complete database including the follow up data, it is not feasible to plan for further improvement of the children with TDC. Ibrahim Cardiac Med J 2014; 4(2): 37-42

scholarly journals Nontuberculous Mycobacterial Ocular Infections: A Systematic Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Wajiha J. Kheir ◽  
Huda Sheheitli ◽  
Maamoun Abdul Fattah ◽  
Rola N. Hamam
Keyword(s):  
Foreign Bodies ◽  
Clinical Presentation ◽  
Contact Lenses ◽  
Case Reports ◽  
Visual Outcome ◽  
Delay In Diagnosis ◽  
The Past ◽  
Ocular Infections ◽  
History Of ◽  
Multiple Antibiotics

Nontuberculous or atypical mycobacterial ocular infections have been increasing in prevalence over the past few decades. They are known to cause periocular, adnexal, ocular surface and intraocular infections and are often recalcitrant to medical therapy. These infections can potentially cause detrimental outcomes, in part due to a delay in diagnosis. We review 174 case reports and series on nontuberculous mycobacterial (NTM) ocular infections and discuss etiology, microbiology, risk factors, diagnosis, clinical presentation, and treatment of these infections. History of interventions, trauma, foreign bodies, implants, contact lenses, and steroids are linked to NTM ocular infections. Steroid use may prolong the duration of the infection and cause poorer visual outcomes. Early diagnosis and initiation of treatment with multiple antibiotics are necessary to achieve the best visual outcome.

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