scholarly journals Corneal Hydrops in Pellucid Marginal Degeneration: A Case Series

2015 ◽  
Vol 6 (2) ◽  
pp. 191-199 ◽  
Author(s):  
Vipul Bhandari ◽  
Sri Ganesh

Purpose: To report an unusual presentation of pellucid marginal degeneration (PMD) and its management by using air injection and tension sutures. Case Report: We report 2 cases with a history of acute pain and loss of vision. Examination revealed hydrops at the 6-9 o'clock meridian with Descemet's membrane detachment and tear at the same area and advanced PMD in the other eye. Discussion: Air injection with suturing to treat the hydrops in PMD and crescentic excision with lamellar grafting instead of lamellar keratoplasty lead to better results than conservative management. Conclusion: Corneal hydrops and perforation in patients with PMD is a rare presentation and can be managed by tension sutures and air injection.

2016 ◽  
Vol 73 (10) ◽  
pp. 973-975
Author(s):  
Vesna Jovanovic ◽  
Ljubisa Nikolic

Introduction. Urrets-Zavalia syndrome is an uncommon complication of the deep anterior lamellar keratoplasty in keratoconus. The manifestations of this syndrome are an irreversible mydriasis, iris atrophy and secondary glaucoma. Case report. Deep anterior lamellar keratoplasty was done for keratoconus with a presumably healed corneal hydrops in a 21-year-old Caucasian man. The graft remained clear, but the surgery was complicated by a fixed, dilated pupil, patches of iris atrophy, ectropium of the iris pigment layer and glaukomflecken in the lens. Conclusion. Although safer than penetrating keratoplasty, the deep anterior lamellar by not trying to secure an unhealed Descemet?s membrane with air. Instead, a new Descemet?s membrane transplanted within a penetrating graft is a safer choice.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jingli Guo ◽  
Wenyi Tang ◽  
Wei Liu ◽  
Min Zhou ◽  
Qing Chang ◽  
...  

Abstract Background To report undescribed characteristics of patients with bilateral diffuse uveal melanocytic proliferation (BDUMP) on ultrasound biomicroscopy (UBM) and high-frequency B-scan ultrasonography. Case presentation Two of four participants presented with worsening bilateral vision after previously diagnosed primary pulmonary or ovarian carcinoma. The other two patients were diagnosed with lung carcinoma after presentation with BDUMP. All patients had ciliary body nevi-like lesion in combination with iris or ciliary body cysts, and uveal thickening on UBM. Focally elevated choroidal nevi-like lesion and exudative retinal detachment with choroidal thickening were detected with B-scan ultrasonography. Conclusions Our case series demonstrates the uveal characteristics of patients with BDUMP based on high-frequency B-scan ultrasonography and UBM. Ultrasonographic findings are crucial in the diagnosis of BDUMP because it is occult in nature.


2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Aldis P. Siltumens ◽  
Na L. Smith ◽  
Rosalind F. Sharain ◽  
Michael G. Haddock ◽  
W. Michael Hooten

Abstract Background Although epithelioid hemangiomas involving bone have been described in previous case reports and case series, the effects of radiation therapy on vertebral epithelioid hemangioma has not been fully reported. Here we provide a case report of tumor response to radiation therapy in a young adult with a large epithelioid hemangioma involving the fourth lumbar vertebrae. Case presentation A 27-year-old Latino man with a past medical history of type 1 diabetes and a 3-year history of low back pain presented to a hospital emergency department following acute worsening of back pain. On transfer to our tertiary medical center, he described the pain as “shock-like” which originated at the lateral aspect of his right hip and radiated down to his right knee. Paresthesia was also reported along the medial aspect of his lower right leg. Imaging included a computed tomography scan and magnetic resonance imaging which revealed fourth lumbar and right iliac lytic bone lesions. Image-guided biopsies of the lytic lesions were consistent with a diagnosis of epithelioid hemangioma and radiation therapy was recommended as the primary treatment. Our patient’s low back and leg pain were initially managed with acetaminophen, oxycodone, pregabalin, and lidocaine patch 5%. He noted improvement in pain after his third fraction of radiation. Pain intensity continued to decline and oxycodone was discontinued. Conclusions This case report demonstrates an unusual etiology of back and leg pain in a young man and elucidates the palliative effects of radiation therapy for epithelioid hemangioma involving the lumbar spine.


2017 ◽  
Vol 31 (1) ◽  
pp. 126-129 ◽  
Author(s):  
Billy Sin ◽  
Diana Gritsenko ◽  
Grace Tam ◽  
Kimberly Koop ◽  
Eva Mok

Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management. Opioids have been traditionally used for the management of severe acute pain in the ED; however, there are growing concerns for opioid overuse and misuse. As a result, there is growing controversy regarding the appropriate selection of analgesic agents, optimal dosing, and need for outpatient therapy which has contributed to changes in prescribing patterns of opioids in the ED. Lidocaine, a class 1b antiarrhythmic, has been utilized as an analgesic agent. Its use has been documented for the management of intractable chronic pain caused by cancer, stroke, neuropathies, or nephrolithiasis. However, literature describing the use of intravenous lidocaine for the management of acute pain secondary to trauma is limited to a single case series. This case report describes the use of intravenous lidocaine in a 17-year-old male who presented to the ED in acute distress secondary to ankle dislocation and fracture. This report serves to describe additional clinical experience with intravenous lidocaine for the management of acute pain secondary to ankle fracture in the emergency department.


Neurosurgery ◽  
1986 ◽  
Vol 19 (2) ◽  
pp. 267-270 ◽  
Author(s):  
Kenji Yamada ◽  
Takashi Hatayama ◽  
Masahiro Ohta ◽  
Katsuaki Sakoda ◽  
Tohru Uozumi

Abstract We report a patient who had pituitary adenoma and parasellar meningioma coincidentally, with neither irradiation nor a history of head injury. Preoperative computed tomographic (CT) scan had shown a large intrasellar mass with ringlike enhancement; in contact with this mass, another well-enhanced mass had been shown. Histopathologically, the intrasellar mass was diagnosed as chromophobic pituitary adenoma and the other mass as meningotheliomatous meningioma. We present clinical, radiological, and histopathological findings and discuss previously reported cases of coincidental pituitary adenoma and meningioma without irradiation. This is the first case report since the advent of CT that pituitary adenoma and parasellar meningioma in contact with each other could be clearly demonstrated by CT.


2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
A. Gungadeen ◽  
J. Moor

Objective. To present a rare case of extensive subcutaneous emphysema and spontaneous pneumomediastinum following ingestion of Ecstasy in a young adult. We also review the relevant literature and discuss how this case supplements it.Case Report. We report a case of a 19-year-old man with a history of painless neck and chest swelling, and no chest pain or breathlessness, after consuming Ecstasy tablets. Radiological imaging showed evidence of pneumomediastinum and extensive subcutaneous emphysema. The patient remained well under observation and his symptoms improved with conservative management.Conclusions. Subcutaneous emphysema and pneumomediastinum after Ecstasy ingestion is uncommon. Cases are often referred to the otolaryngologist as they can present with neck and throat symptoms. Our case showed that the severity of symptoms may not correlate with severity of the anatomical abnormality and that pneumomediastinum should be suspected in Ecstasy users who present with neck swelling despite the absence of chest symptoms. Although all cases reported so far resolved with conservative management, it is important to perform simple investigations to exclude coexisting serious pathology.


2021 ◽  
Author(s):  
Hassan Hashemi ◽  
Mohammadreza Aghamirsalim ◽  
Saied Shahhoseini ◽  
Alireza Moghaddasi ◽  
Soheila Asgari

Abstract PurposeTo determine the two-year results of small incision lenticule extraction (SMILE) for correcting post-keratoplasty myopia and myopic astigmatism.MethodsIn this case-series study, 10 eyes of 10 patients with a 6-10-year history of successful deep lamellar keratoplasty (DALK) underwent SMILE using VisuMax laser platform. Ophthalmologic examinations and visual acuity and refraction measurement were done pre- and 1, 3, 6, 12, and 24 months postoperatively. Pentacam and Sirius imaging was done in the first and last follow-up session.ResultsThe mean age of the patients was 39.60±7.86 years. Six subjects were male. After two years, uncorrected distance visual acuity did not change in one eye and improved 1-6 lines in other eyes. Corrected distance visual acuity decreased in one eye, did not change in four eyes, and improved 1-8 lines in other eyes. The mean decrease of spherical equivalent, spherical error, and cylinder power was 1.92±1.96 diopter (D) (P=0.013), 0.70±3.05D (P=0.213), and 2.42±2.91D (P=0.024), respectively. The vector mean target induced astigmatism, surgical induced astigmatism, and difference vector was 1.30D@44˚, 1.11D@24˚, and 0.86D@73˚, respectively. Two years after surgery, vertical coma, horizontal coma, and spherical aberration increased by 0.44±0.51, 0.23±0.32, and 0.02±0.16µm respectively (all P>0.05) while trefoil reduced by 0.29±0.75µm (P=0.428).ConclusionSMILE is a successful procedure for reducing refraction and astigmatism after DALK in patients with moderate myopia and moderate to severe astigmatism and improves the visual acuity in these patients. Axis rotation during surgery may result in under-correction of astigmatism. Refinement of SMILE treatment nomogram for post-DALK cases seems necessary.


2020 ◽  
pp. 1-3
Author(s):  
Bhuvana Lakshmi Sundararajan ◽  
Siddartha Gowthaman ◽  
Arul Kumar ◽  
Ramanathan M

INTRODUCTION: Pica is common in patients with developmental disabilities and can be life-threatening. It is important to identify pica and manage it appropriately. CASE REPORT:A 19-year-old male presented with history of abdominal pain and vomiting for two days.On imaging he was found to have multiple foreign bodies within the small and large bowel.After trial of conservative management,he was taken up for exploratory laparotomy. He was found to have trichobezoar and lithobezoar obstructing the bowel at terminal ileum.Bezoars when removed via enterotomy. DISCUSSION: Bezoars are conglomerates of non-absorbable food or fibre formed in the alimentary tract.Trichobezoar forms following ingestion of hair and usually leads to gastric outlet obstruction.Lithobezoar refers to the accumulation of stones in the GIT. Reports of colonic lithobezoar are rare. Pica is the persistent ingestion of non-nutritive substances beyond a developmentally inappropriate age. Patients should be referred to a psychologist/behaviour analyst and caregivers should also be educated


Author(s):  
Sium AF ◽  
◽  
Tilahun A ◽  
Mersha A ◽  
Yihun S ◽  
...  

Background: Compound presentation occurs in approximately 1/700 deliveries. Being the rarest type, there is scarce literature about the recommended management for vertex-hand-feet variety of compound presentation. We report a similar type of compound presentation. Case Summary: A 25 years-old primigravida who claimed to be 9 months ammenorric presented with a history of pushing down pain of 12 hours duration with associated history of passage of liquor of 4 hours duration. Up on physical examination she was in active first of labor at cervical dilation of 5 centimeters and the presentation was compound- a vertex-hand-feet variety. Cesarean delivery was done after two hours of conservative management and the outcome was an alive 2300grams male neonates with no perinatal or maternal complication. Conclusion: In the rarest variety of compound presentation, which is a vertex, hand, and feet type, spontaneous correction is unusual if the fetus is alive and interference is usually necessary.


2020 ◽  
pp. 102-105
Author(s):  
Melissa Kyriakos Saad ◽  
Toufic Saber ◽  
George Cortas ◽  
Elias Saikaly

Colonic perforation post colonoscopy is rarely seen; however, when coupled with massive pneumoperitoneum in haemodynamically stable patients, a real dilemma for surgeons is created. The decision between watchful waiting versus surgical intervention is the real challenge and while most surgeons will urge for surgical intervention, conservative management on the other hand can be safely applied in selected haemodynamically stable patients.


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