Welchcheng8677
Single lung resection remains a challenge due to the preservation of the respiratory reserve. This report presents that case of a female patient with bilateral fibrotic-cavitary pulmonary tuberculosis complicated with empyema on the right lung. Only 3.5 lung segments were left after a multistage surgery.
The first stage included draining of empyema and transsternal transmediastinal right main bronchus occlusion. Then, upper lobectomy with partial S6 resection of the left lung, followed by pleuropneumonectomy was performed. At a follow-up of two years and 10 months, patient's condition was good.
Although single lung surgery has been possible over half a century ago, it remains a high-risk intervention.
With the removal of the non-functioning parenchyma and elimination of the air/vascular shunt, single lung resection volume exceeding lobectomy is possible, which may improve cardiorespiratory function.
With the removal of the non-functioning parenchyma and elimination of the air/vascular shunt, single lung resection volume exceeding lobectomy is possible, which may improve cardiorespiratory function.Urogenital tuberculosis is a rare and severe disease since it causes serious consequences. Often, diagnosis may be delayed because of its multiple presentation forms and clinical features. Usually, the recognition is easy to hold, but in certain cases the presentation form can be misleading which can exclude the diagnosis. We present two cases of unusual form of urogenital tuberculosis from which clinical features were taken for a malignant cancer at the beginning. The first case is about a young woman with renal lesions then proceeding to radical nephrectomy. The second case is about a 48 years old patient who had a radical cystectomy to treat an urothelial carcinoma (classified as pT1G3) along with squamous metaplasia (25 %). In both cases, the histologic investigation revealed the presence of a granulomatous reaction with giant cells and caseous necrosis which confirms the diagnosis of tuberculosis. Through the study of these two cases and literature review, we mark the different diagnosis and treatment difficulties handling these unusual presentation forms.
Implant-based genioplasty is a simple and safe but not complication-free cosmetic procedure. Patients are commonly briefed about anticipated complications and their management pre-operatively, but few unexpected complications may arise; and this case report is an example. This paper is the first to report a radicular cyst fistulating through chin implant pocket to the skin. Moreover, we present our prevention strategy and recommendations.
A 39-year-old-lady underwent a silicone implant-based genioplasty that was uneventful. Later, she developed a reddish nodule on the chin necessitating fistulectomy followed by a recurrence leading to explantation. It was not until the second recurrence that a fistulating radicular cyst was discovered and was treated with the help of a dentist.
Radicular cysts are benign, inflammatory cysts that arise in a background of dental trauma or caries. No link has been discovered yet between silicone implants and radicular cysts or fistulating cysts. Moreover, we propose that poor oral hygiene could be implicated in the development of these cysts. Dental panoramic X-ray has been used to diagnose radicular cysts, but its efficacy as a screening tool needs to be studied. Finally, the recurrence rate of radicular cysts is unknown.
In a patient with chin implant, radicular cysts could lead to a disastrous outcome. Through history and physical examination, a plastic surgeon should identify patients with poor oral hygiene and dental trauma prior to implant-based genioplasty to arrange for a dental panoramic X-ray. Patients known to have radicular cysts should not undergo an implant-based genioplasty.
In a patient with chin implant, radicular cysts could lead to a disastrous outcome. Through history and physical examination, a plastic surgeon should identify patients with poor oral hygiene and dental trauma prior to implant-based genioplasty to arrange for a dental panoramic X-ray. Patients known to have radicular cysts should not undergo an implant-based genioplasty.
Gastrointestinal basidiobolomycosis (GIB) is an uncommon fungal infection caused byBasidiobolus ranarum, with less than 80 cases reported in the literature.
A 36-year-old woman presented with colicky upper abdominal pain for 2 months and inability to pass stool for 2 days. Computed tomography of the abdomen and colonoscopy both showed a mass in the transverse colon. Colonoscopic biopsy suggested a zygomycosis. Laparotomy revealed a perforated mass in the transverse colon; the mass also involved the small bowel and stomach. En bloc resection was performed, and the incision was closed for a second-look procedure. The patient was admitted to the intensive care unit and placed on a ventilator and inotropes; however, her condition deteriorated, and she died on day 24 post admission. The histopathology report (obtained after the patient's death) was consistent with GIB.
Gastrointestinal basidiobolomycosis presents with nonspecific signs and symptoms and so the diagnosis is easily missed or delayed. Timely, accurate diagnosis is crucially important, especially when there is intestinal obstruction and sepsis. Persistent severe abdominal pain in a patient with neutropenia should alert the physician to the possibility of a fungal infection. There are reports from several countries of basidiobolomycosis in immunocompetent hosts. The disease shows no age predilection, but males may be more susceptible. Treatment is with surgical debridement and antifungal drugs-ideally the lipid formulation of amphotericin B.
Gastrointestinal basidiobolomycosis is a rare infection that can be fatal if not diagnosed and treated early.
Gastrointestinal basidiobolomycosis is a rare infection that can be fatal if not diagnosed and treated early.
Morel-Lavallée syndrome (MLS) is considered as a rare entity and hemorrhagic shock as a complication is uncommon.
We report the case of a 56-year- old man who presented to the emergency department after a road traffic accident. Initially, the patient was hemodynamically unstable (heart rate 160 beats/min and blood pressure 65/30). Physical examination revealed multiple lacerations on his back and a gradually expanding large subcutaneous hematoma on the left flank extending to the hip and left leg. Fluid resuscitation was rapidly initiated. After stabilizing his hemodynamic status, a full-body computed tomography was performed revealing, apart from a small unilateral pneumothorax and a stable pelvis fracture, an extensive Morel-Lavallée lesion in the lumbar region extending to the hip and both legs. The patient was then transferred to a surgical intensive care unit for further resuscitation and surgical drainage of the collection followed by continuous suction was performed. check details Even though rare, Hemorrhagic shock is one of the threatening complications of Morel-Lavallée lesions and should be kept in mind by every traumatologist and emergency doctor.
