Masseyraahauge8809

Sterno-manubrium and subpectoral abscess have been rarely reported in literature. If the diagnosis and treatment are not properly performed, a soft tissue abscess can cause serious complications such as sepsis or even death. Therefore, awareness of such conditions is essential for early diagnosis and prompt treatment. Here, we report a case of sterno-manubrial and subpectoral abscess with significant destruction of cartilage due to extension from an infected subclavian porta-a-cath. Our management started with intravenous antibiotic therapy initially; however, due to lack of clinical resolution, incision and drainage followed by serial debridements were performed, highlighting importance of awareness of uncommon presentation.The acute scrotum is defined as a new-onset pain of the intrascrotal contents. The differential diagnosis of acute scrotum includes a variety of etiologies. We report a case of an 18 years old presented with acute scrotal pain with scrotal ultrasound suggestive of testicular torsion, underwent bilateral orchiopexy for suspected testicular torsion. The patient came later with persistent testicular pain. A computerized tomography (CT) scan of the abdomen and pelvis was done and showed a retroperitoneal mass. We suggest that patients with atypical presentation of the acute scrotum should undergo CT scan of the abdomen and pelvis to rule out retroperitoneal pathologies and referred pain.Calcifying fibrous tumour (CFT) is a rare benign tumour with non-specific anatomical distribution. We describe a case of a patient who presented with chronic generalised fatigue secondary to anaemia. Her symptoms did not improve while being on oral iron replacement therapy. Further endoscopic investigations were unremarkable. She had a computed tomography scan showing masses in the right pleural base and in the spleen. She then underwent splenic biopsy that only showed inflammatory changes. As her symptoms persisted, she was worked up for elective laparoscopic splenectomy during which she was found to have multiple peritoneal deposits. Biopsies were taken and the splenectomy was abandoned. The biopsies eventually showed changes consistent with CFT. This was conclusive for diagnosis of multifocal CFT.A case of bilateral traumatic distal femoral Salter-Harris Type I fracture presented to our emergency department. History was of a 9-year-old male playing at a building site when a concrete block fell from height on to his knees, which were extended in a sitting position. Management was with analgesia and transfer to theatre followed by closed reduction and internal fixation-position was assessed under mobile X-ray. The patient made a full clinical recovery within 18 weeks and was followed-up over 5 years. There was no clinical effect on final adult length of femur and no deficit in range of movement. The foot-drop observed at presentation resolved over a period of 12 weeks. This case highlights the importance of performing a thorough neurovascular examination of the patient at presentation, followed by a careful closed reduction and internal fixation under anaesthesia, being careful not to damage the distal femoral growth plates.We present a case of a 79-year-old man with lower abdominal pain and negative Blumberg sign. An indwelling bladder catheter was inserted for urinary retention due to a tight phimosis 2 months earlier. A contrast-enhanced computed tomography scan revealed a huge gastrectasia and small bowel distention due to a suspected adherent bridle. The clinical signs and the laboratory tests were highly suspicious for bowel obstruction and emergency surgery was indicated. Exploratory laparoscopy showed a bladder hole tamponade by an ileum loop. The perforation was sutured laparoscopically and the patient was discharged on the 14th postoperative day. In our case, emergency laparoscopic exploration was useful for the diagnosis and the treatment of spontaneous bladder rupture. We hope this case report can be useful to give these patients better outcomes. Notably we would like to emphasize that the presence of a urinary catheter can be a risk factor for intraperitoneal bladder rupture.Laryngotracheal stenosis (LTS) is a rare but serious condition characterized by narrowing of the airway. Iatrogenic injury from endotracheal intubation or tracheostomy insertion is the most common cause of LTS. We present the first reported experience of managing a patient diagnosed with subglottic stenosis (a subtype of LTS) following previous intubation and tracheostomy for coronavirus disease 2019 (COVID-19). This patient required an urgent surgical tracheostomy and subsequent referral to a tertiary airway surgery unit for definitive treatment, which included microlaryngoscopy, laser excision and balloon dilatation. This case highlights that LTS should be included in the differential diagnosis for patients re-presenting with breathing difficulties after prolonged intubation or tracheostomy for COVID-19. Furthermore, it raises the concern of a rise in the incidence of this condition and an increased burden on the few units specializing in airway surgery.This is an unusual case of an obstructive rectal squamous cell carcinoma (SCC), causing perforation and a pelvic abscess, requiring source control and diverting colostomy. A 50-year-old female with chronic constipation presented with worsening right buttock pain for 1 month. On exam, the patient reported right hip tenderness. A computer tomography (CT) revealed rectal wall thickening with a presacral abscess. Due to the concern of rectal perforation with abscess she was taken to the operating room for proctoscopy with biopsy, colostomy diversion and drainage of the abscess over the right buttock. Pathology reported invasive rectal SCC. click here Rectal SCC presents similarly to rectal adenocarcinoma but its diagnosis must include special markers for cytokeratins. The treatment approach is controversial but adequately treated offers better survival than rectal ADC. Rectal SCC is rare and treated with chemoradiation however it must also be tailored to the variable acute presentations.Multiple myeloma is a hematologic malignancy frequently presenting with spinal lytic lesions. The authors report the case of a patient with an extensively destructive osteolytic MM lesion in the cervical spine treated exclusively with radiotherapy. Computed tomography and magnetic resonance imaging scans showed an arrest of further progression of instability and resolution of the lytic lesion, showing signs of new bone formation. Whereas surgery should be considered for cases of spinal instability and potential neurological injury, this case demonstrates that isolated radiotherapy can be used in select cases to treat MM lesions and restore the structural integrity of the spinal elements.This case of bowel obstruction with multiple postoperative complications provides unique insight into the challenges faced by providers caring for intellectually disabled patients with acute surgical abdominal pathology and poor compliance. link2 In this case, the component separation was utilized as a method of facilitated wound closure and compliance in a postoperative course highlighted by both dehiscence and wound infection. The patient, only able to communicate the presence of abdominal pain due to his disability, was surgically managed for a bowel obstruction secondary to a cecal volvulus. link3 The difficulty in initial communication and patient noncompliance help illustrate the individualized care these patients require. This report will demonstrate both the challenges present in the management of intellectually disabled patients with abdominal wounds, as well as the use of component separation in providing both initial wound closure and continued wound integrity with the goal of reducing postoperative complications in patients with decreased compliance.Liposarcoma is one of the common soft tissue tumors but barely arises from the mediastinum. Complete surgical resection with a negative surgical margin is required for the treatment; however, mediastinal liposarcomas tend to be large due to its slow-growing nature. A 57-year-old man was referred to us for having an abnormal mediastinal shadow in a chest X-ray. Computed tomography scanning revealed a giant posterior mediastinal tumor, completely involving the esophagus. Because of the unusual size and location of the tumor, we took a bilateral video-assisted thoracoscopic approach. First, the soft lipomatous compartment of the tumor was dissected from the esophagus and the descending aorta via the left thoracic cavity complete thoracoscopic procedure. Then, the patient was placed in the left lateral position, and the solid part of the tumor was completely resected using 13 cm of right-side thoracotomy. There was no complication or local recurrence in the first 26 months of follow-up.Intussusception is an infrequent cause of mechanical bowel obstruction in adults and surgical resection is warranted in most cases. Small bowel is a common site of recurrence from cutaneous melanoma but early diagnosis is still a challenge. Acute peritonitis, haemorrhage and obstruction are known clinical presentations. Wide surgical excision with free margins and accompanied mesentery is the treatment of choice and may improve the prognosis. We present a case of small bowel obstruction due to three intussusceptions by metastatic malignant melanoma submitted to surgery.

Freezing of gait (FOG) is a debilitating and incompletely understood symptom in Parkinson's disease (PD).

To determine the principal clinical factors predisposing to FOG in PD, their interactions, and associated nonmotor symptoms.

164 PD subjects were assessed in a cross-sectional retrospective study, using the MDS-UPDRS scale, MMSE, and Clinical Dementia Rating Scale. Clinical factors associated with FOG were determined using univariate analysis and nominal logistic regression. Receiver operating characteristic curves were computed, to obtain measures of sensitivity and specificity of predictors of FOG. Subgroups of patients with FOG were compared with those without FOG, based on defining aspects of their clinical phenotype.

Relative to non-FOG patients, those with FOG had a longer disease duration, higher PIGD and balance-gait score, higher LED, and more motor complications (

< 0.0001) and were more likely to exhibit urinary dysfunction (

< 0.0003), cognitive impairment, hallucinations, antor fluctuations. These findings may help to inform clinical management and highlight distinct subgroups of patients with PD-FOG, which are likely to differ in their network pathophysiology.Social cognition (SC) deficits have been linked to Parkinson's disease (PD) but have been less well researched than general cognitive processes, especially in early-onset PD (EOPD), despite this population often having greater social and family demands. Most studies focus on recognition of facial emotion, theory of mind (ToM), and decision-making domains, with limited research reporting on social reasoning. The main objective of this work was to compare SC ability across four domains emotional processing, social reasoning, ToM, and decision-making between patients with EOPD and healthy controls. Twenty-five nondemented patients with EOPD and 25 controls matched for sex, age, and educational level were enrolled. A battery that included six SC tests was administered to all study participants; a decision-making scale was completed by participants' partners. Statistically significant differences were found between patients with EOPD and controls in all subtests across the four SC domains studied. The EOPD group demonstrated worse performance on all tasks, with large effect sizes.