scholarly journals Surgical treatment of hand vascular anomalies: A case report

2014 ◽  
Vol 71 (1) ◽  
pp. 73-77
Author(s):  
Jefta Kozarski ◽  
Dragomir Pavlovic ◽  
Goran Sijan ◽  
Srdjan Cvetanovic ◽  
Goran Stankovic
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Compartment Syndrome ◽  
Clinical Picture ◽  
Vascular Anomaly ◽  
Diagnostic Procedures ◽  
Functional Results ◽  
Vascular Anomalies ◽  
Diagnostic Methods ◽  
Acute Increase

Background. Vascular anomalies in the hand do not occur frequently. Their presence in the metacarpal region can cause different functional disorders. The extent of such disorders directly depends on the localization and size of vascular anomalies, duration and the nature of the anomaly growth as well as on eventual secondary complications such as ulceration or bleeding. The aim of this case report was to show the specifics in the clinical picture, pathogenesis and evolution of such anomalies, applied diagnostic procedures (radiography, ultrasound, magnetic resonance, electromyography) and surgical treatment as well as postoperative functional results. Case report. In the Clinic for Plastic Surgery and Burns, Military Medical Academy Belgrade, two patients were treated surgically for vascular anomalies of the middle palmar region of the hand. The first patient, a 36-year-old male, a former active sportsman (professional handball player) was treated for acute increase in the vascular anomaly of hand in the metacarpal region and proximal phalange of III and IV fingers of his right hand. The anomaly was detected 6 months prior to his hospitalization while two weeks before the hospitalization there was a sudden growth and increase in the change. The second case, a 15-year-old male patient actively pursuing a career in professional basketball was treated for a tumor localized in the metacarpal zone of his left hand. According to the information provided by his parents, the anomaly had been present since his birth. Initially, the anomaly manifested itself as a discoloration of the skin with a marked capillary drawing, gradually increasing throughout the last five years to the present dimension. The growth of the malformation was noticed to coincide in both patients with more active pursuit of their professional sports career. Conclusion. The clinical picture of hand vascular anomalies is dominated by the symptoms of compression of neurovascular structures (paresthesia, intense hand pain, swollen fingers). If it is a chronic progressive process, signs of ischemic intrinsic muscle fibrosis with corresponding functional deficit, as well as tissue defect (usura) of bone and joint structures represent the basic pathological findings. Acute increase is accompanied by compartment syndrome symptoms and ischemic fibrosis of intrinsic hand musculature and development of irreversible dysfunction of the hand. In the presented cases rapid response implies accurate diagnostic methods followed by surgical extirpation in order to treat compartment syndrome.

scholarly journals Alkaptonuria with extensive ochronotic degeneration of the Achilles tendon and its surgical treatment: a case report and literature review

2021 ◽  
Vol 15 (3) ◽  
pp. 129-136
Author(s):  
Nesrin Mwafi ◽  
Ali Alasmar ◽  
Monther Al-Momani ◽  
Sattam Alazaydeh ◽  
Omar Alajoulin ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Sudden Onset ◽  
Flexor Hallucis Longus ◽  
History Of ◽  
Complete Disruption ◽  
Collagenous Tissues

Abstract Background Alkaptonuria is a rare genetic metabolic disorder due to deficiency of homogentisate 1,2-dioxygenase (HGD), an enzyme catalyzing the conversion of homogentisate to 4-maleylacetoacetate in the pathway for the catabolism of phenylalanine and tyrosine. HGD deficiency results in accumulation of homogentisic acid and its pigmented polymer. Ochronosis is a bluish-black discoloration due to the deposition of the polymer in collagenous tissues. Extensive ochronotic involvement of the Achilles tendon in alkaptonuria and its surgical treatment is rarely reported. Case report A 43-year-old man presented to our clinic in March 2019 with sudden onset of left Achilles tendon pain with no history of prior trauma. Surgical exploration revealed a complete disruption of the tendon at its attachment to the calcaneus. Black pigmentation was extensive and reached the calcaneal tuberosity, extending about 7 cm from the insertion. Discussion Achilles reconstruction was performed using flexor hallucis longus tendon transfer. The patient experienced uncomplicated healing with satisfactory functional results. Conclusion Orthopedic surgeons should be aware of the progressive nature of alkaptonuria. Extensive degenerative changes of the ruptured tendon should be suspected so that physicians can plan tendon repair and facilitate prompt surgical intervention.

BENIGN TUMORS BREAST GLASS

2021 ◽  
Vol 7 (2) ◽  
pp. 2-11
Author(s):  
Arif Guseynov ◽  
T. Guseynov ◽  
V. Odincov
Keyword(s):  
Surgical Treatment ◽  
General Practitioners ◽  
Clinical Picture ◽  
Relevant Information ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Differential Diagnostics ◽  
Benign Tumors

The lecture provides relevant information for doctors of various specialties: oncologists, surgeons, mammologists, general practitioners on the problems of diagnosis and treatment of benign breast formations. The issues of etiology and pathogenesis, classification and clinical picture of various formations are highlighted, diagnostic methods, differential diagnostics, treatment tactics and methods of surgical treatment are described in detail.

Doppelter Aortenbogen: Die Diagnose wurde 29 Jahre verpaßt

VASA ◽  
2000 ◽  
Vol 29 (1) ◽  
pp. 77-79 ◽  
Author(s):  
Christiane Brockes ◽  
Vogt ◽  
Roth ◽  
Turina
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Operative Therapy ◽  
Vascular Anomaly ◽  
Diagnostic Procedures ◽  
Late Complications ◽  
Surgical Operation ◽  
Magnetic Imaging ◽  
Symptomatic Woman ◽  
Prompt Diagnosis

Double aortic arch is a rare vascular anomaly which causes tracheal and esophageal compression usually in the first months of life. Typical symptoms in the early childhood should lead to prompt diagnosis and surgical treatment of this malformation. In adults this anomaly is extremely rare. A case of a severely 29-year-old symptomatic woman is presented. Despite characteristic symptoms, the diagnosis was missed during childhood. The importance of different diagnostic procedures and operative therapy is discussed. Preoperative angiography can be replaced by the less invasive magnetic imaging and computed tomography. Surgical operation should also be performed in oligosymptomatic patients to prevent late complications.

scholarly journals Tuberculous Coxitis: Diagnostic Problems and Varieties of Treatment: A Case Report§

2012 ◽  
Vol 6 (1) ◽  
pp. 445-448 ◽  
Author(s):  
H Klein ◽  
JB Seeger ◽  
I Schleicher
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Reconstructive Surgery ◽  
Unusual Case ◽  
Diagnostic Procedures ◽  
Industrial Countries ◽  
Detailed History ◽  
X Ray ◽  
Microbiological Examination ◽  
Significant Disease

Although the prevalence of tuberculosis reduces, it still belongs to the most important infectious diseases worldwide even in industrial countries. We report an unusual case of tuberculous coxitis in a 28-year-old healthy native female with recurrent hip pain. While X-ray and microbiological examination of the aspirate showed no abnormality, only extended diagnostic measurements and detailed history led to the diagnosis of TBC. Although the patient did not show any pulmonary symptoms open tuberculosis was confirmed. After a course of antibiotic treatment she underwent reconstructive surgery which consecutively improved range of motion. This case report emphasizes that tuberculosis should still be considered as a significant disease even in healthy patients with uncertain complaints in joints without significant initial radiographic abnormalities. We recommend the described diagnostic procedures as well as an antibiotic and surgical treatment.

scholarly journals Ultrasonography as the First Method of Choice in the Diagnosis of Primary Extrahepatic Echinococcosis: Case Report

2019 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Vladislav Stoyanov ◽  
Nikolay Damianov
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Human Liver ◽  
Diagnostic Methods ◽  
Greater Omentum ◽  
Serological Evidence ◽  
Larval Form ◽  
Primary Localization

The aim of this presentation is to show the high informative value of ultrasonography as the first method of choice in the diagnosis of atypical extra-hepatic forms of echoconcosis. Echinococcosis is zooanthroponosis and is most commonly caused by the larval form of E. granulosus. Echinococcal cysts develop, most commonly in the human liver and second - in the lung. Rare primary localization is echinococcus cysts of greater omentum and spleen. Ultrasonography is first method of ch?ice for diagnostic. The main clinical and laboratory diagnostic methods are immunoelectrophoresis and serological evidence of echinococcosis by ELISA. Timely surgical treatment give it a chance to cure. The use of post-operative antiparasitic chemoprophylaxis and therapy is recommended.

scholarly journals Surgical treatment of orbital floor blowout fracture in children: A case report

2015 ◽  
Vol 72 (9) ◽  
pp. 841-844 ◽  
Author(s):  
Sasa Tabakovic ◽  
Ivana Ilic-Dimitrijevic
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Functional Results ◽  
Orbital Floor ◽  
Traumatic Lesion ◽  
Blowout Fracture ◽  
Orbital Floor Fracture ◽  
Aesthetic Appearance ◽  
Orbital Floor Reconstruction ◽  
Craniofacial Complex

Introduction. Orbital floor blowout fracture is a common traumatic lesion of the craniofacial complex, but rarely in children population, consequently representing challenge in surgical treatment. Timely diagnosis and surgical treatment prevent the probability of the occurrence of the functional complications. Case report. We presented surgical treatment of on 8-year-old girl with a blowout orbital floor fracture one month after the injury. The predominant symptoms were: ocular bulb motility disorder with consecutive strabismus and double vision. Orbital floor reconstruction was made by an autogenous mandibular symphyseal graft. A year after the orbital floor reconstruction additional correction of strabismus was performed due to functional disorder of the bulbomotor muscles. Conclusion. Delayed surgical treatment of blowout orbital floor fracture in children leads to unsatisfactory functional results in the majority of cases. In such a situation surgical correction of strabismus is necessary in order to obtain functionally quality vision and satisfactory aesthetic appearance.

Chronic exertional compartment syndrome of the foot. A case report

1998 ◽  
Vol 88 (1) ◽  
pp. 21-24 ◽  
Author(s):  
MB Mollica
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Compartment Syndrome ◽  
Clinical Examination ◽  
Subjective Symptoms ◽  
Compartment Pressure ◽  
Chronic Exertional Compartment Syndrome ◽  
Pressure Testing ◽  
Exertional Compartment Syndrome

The author describes a case of chronic exertional compartment syndrome of the foot affecting a 19-year-old male triathlete. Relevant anatomy, subjective symptoms, and clinical examination are discussed. Diagnostic confirmation, as achieved with compartment-pressure testing, is also presented, as is surgical treatment through decompressive fasciotomy of the affected compartment.

The role of FDG PET/CT discovering the cause of fever of unknown origin

2012 ◽  
Vol 153 (6) ◽  
pp. 227-231
Author(s):  
Bernadett Szűcs ◽  
Edit Nagy ◽  
Stefan Talev ◽  
Ildikó Garai ◽  
László Galuska
Keyword(s):  
Case Report ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diagnostic Procedures ◽  
Clinical Problem ◽  
Diagnostic Techniques ◽  
Diagnostic Methods ◽  
Pet Ct ◽  
Fdg Pet Ct

The fever of unknown origin from time to time constitutes a serious clinical problem and nearly all diagnostic methods are involved to discover urgently its cause. According to literature data 18F-fluoro-deoxyglucose PET/CT was successful in 25-70% of cases even in patients without any positive findings with conventional diagnostic techniques. The Hungarian National Health Fund does not include fever of unknown origin in the list of reimbursed 18F-fluoro-deoxyglucose PET/CT indications. The authors try to illustrate the clinical problem with this case report. Fever of unknown origin persisted in a patient for a year, but conventional diagnostic procedures were unsuccessful to find the cause of the fever. Finally, 18F-fluoro-deoxyglucose PET/CT indicated a metabolically active focus between the pancreas tail and the spleen. After a long-lasting antibiotic therapy the patient became symptomfree. Orv. Hetil., 2012, 153, 227–231.

scholarly journals Septic shock caused by community-acquired urinary tract infection caused by Klebsiella pneumoniae ESBL+: A case report

2020 ◽  
Author(s):  
Małgorzata Braczkowska ◽  
Lidia Glinka ◽  
Marcin Mieszkowski ◽  
Bułat Tuyakov ◽  
Aleksandra Gutysz-Wojnicka
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Organ Failure ◽  
Diagnostic Procedures ◽  
Multiple Organ ◽  
The Body ◽  
Diagnostic Methods ◽  
Tract Infections

Introduction: Septic shock is defined as a life-threatening organ failure caused by an abnormal response of the body to infection. Urinary tract infections (UTIs) constitute about 10%–20% of all community-acquired infections and about 40%–50% of hospital-acquired infections. In patients with impaired immunity they may lead to sepsis. Strains of Klebsiella pneumoniae are often multidrug resistant, and therapeutic chances are limited where they occur. Aim: The aim of this paper is to discuss the most recent guidelines in diagnosing and treating sepsis, referring to a clinical case report. Case study: The study presents a case of septic shock in a 44-year-old female patient in a community-acquired UTI caused by K. pneumoniae extended-spectrum β-lactamases (ESBL+). Results and discussion: The course of septic shock proved fatal. As the stay in the intensive care unit (ICU) was short, this precluded implementing full diagnostic procedures and identifying the source of infection. A post mortem examination was performed to establish the cause of death and aetiology of the infection. Conclusions: K. pneumoniae ESBL+ has become a growing epidemiological problem in Poland and all over the world. This pathogen increasingly often leads to community-acquired infections and its multidrug resistance makes the applied therapies ineffective. Diabetes, one of the modern lifestyle diseases, impairs resistance and accelerates rapidly progressing septic shock with multiple organ failure. Late diagnosis of sepsis, because of considerable metabolic and cellular changes, brings about tragic results. Despite implementing new diagnostic methods and therapies, the mortality rate in sepsis still remains very high.

scholarly journals Successful surgical treatment of abdominal compartment syndrome in patient with pancreatic necrosis

2018 ◽  
Vol 23 (2) ◽  
pp. 119-124
Author(s):  
S. G. Shapovaliyants ◽  
A. G. Pankov ◽  
A. I. Mikhalev ◽  
T. I. Gerasimov
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Compartment Syndrome ◽  
Pancreatic Necrosis ◽  
Clinical Effect ◽  
Abdominal Pressure ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Linea Alba ◽  
Abdominal Compartment

Case report of patient with severe autonomous advanced pancreatic necrosis followed by compartment syndrome is presented. Augmentation of intra-abdominal pressure from 18 to 30 mm Hgwas accompanied by aggravation of respiratory, renal and intestinal insufficiency. Urgent video-assisted fasciotomy was applied with dissection of linea alba while peritoneum was preserved. Postoperative period was characterized by reduced intra-abdominal pressure followed by its normalization after 24 hours. Favorable clinical effect was achieved. Subsequent medication was able to avoid surgery and minimally invasive procedures. Patient was discharged after 28 days.

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