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Deep Vein Thrombosis (DVT) is uncommon in children. We describe a case of DVT in children, highlighting importance of early diagnosis of rare disease. Here we report a case of 10-year-old boy presented with persistent pain and swelling of the left thigh. Detailed investigations led to diagnosis of DVT.

Case We present a male patient in his third decade of life who presented with a painful mass in his left thigh 2 weeks after being involved in motor vehicle accident. The mass was found to be a piece of bone from a second person who had been involved in the same accident. Conclusion This report highlights a most unusual type of injury.

Aim There are few publications on the surgical management of a colocutaneous fistula in the thigh. Here, we describe a patient who presented with a 2-year history of fecal fistula in the left thigh, following a history of drainage of a psoas abscess. This is followed by a discussion of appropriate treatment modalities for this type of fistula. Methods To determine the appropriate treatment for our patient with chronic fistula, we thoroughly reviewed the relevant literature in an Internet-based search and selected a staged operative approach for our patient. Results Using a staged surgical procedure, we were able to resolve the colocutaneous fistula without the occurrence of comorbidities. Conclusion Substantial morbidity is associated with the presence of colocutaneous fistulas. The best possible approach is prevention of its occurrence, but this is not always feasible. Measures for management of an acute fistula differ from those in patients with chronic fistula. Medical management can be more effective in acute cases, while chronic cases require surgical management. We used a staged surgical method with a few risks for our patient and he is in good health 1 year after treatment.

Background: Mesh erosion is a well-known complication after use of mesh for pelvic organ prolapse repair. The most common site of mesh erosion is the vagina. Nonvaginal mesh erosions into ...

A 7-year-old boy with left thigh kicking injury and left knee pain progressively worsening for 3 months.

A 49-year-old man with a medical history significant for diabetes mellitus, a left thigh sarcoma that was resected 5 years prior, and a seizure disorder on valproic acid presented with 2 months of progressive numbness and weakness. Symptoms began with painful paresthesias in both thumbs that progressed to numbness. His feet subsequently became numb, and within 3 weeks he noted gait unsteadiness. During this time he also experienced a 25-pound weight loss. He subsequently developed intermittent diplopia, worst on downgaze. He denied recent sick contacts, prior exposure to tuberculosis, or tick bites. He was admitted to an outside hospital and subsequently transferred to our facility for further care.

Rubber projectiles are used as an alternative to metal bullets owing to their lower morbidity and mortality rate. There are few reports of vascular lesions of extremities caused by rubber projectiles in the literature. The authors report the case of a 37-year-old man who was the victim of a penetrating injury to the left thigh with a rubber projectile. He reported only pain at the site of the injury; pulses were decreased in the affected limb. After arteriography confirmed an injury to the superficial femoral artery, he underwent an arterial and venous femorofemoral bypass using a reversed contralateral saphenous vein. Keywords: Vascular trauma, Nonlethal projectile, Penetrating trauma

Echinococcal cysts are usually found in liver and lungs (90%); spleen, heart, and brain are affected more rarely. Muscular hydatidosis accounts for < 1% of all cases, the most common locations being the thigh and paravertebral muscles1,2. A 51-year-old Spanish male with a painless mass in his left thigh was referred to the rheumatology clinic in the University Hospital of Burgos in …

We present a unique case of displaced simultaneous bilateral fractures, Garden 3 type, in a 49 year woman treated with non-cemented total hip arthroplasty. The patient showed a Harris hip score of 86 on the right hip and a 81 on the left side on the fourth postoperative year, besides a bilateral Trendelenburg gait, more pronounced on the right side. She needed a cane to walk, and felt pain in the left thigh. The X-ray showed a shortening of 0.9 cm and a left femoral varus. The other arthroplasty components showed good osseointegration and position. We found that the use of the uncemented total hip arthroplasty to treat a simultaneous bilateral fracture in renal osteodystrophy patients has satisfactory results at a four year follow-up. According to the OCEBM Levels of Evidence Working Group, this study is graded as a Level of Evidence IV.

Introduction. Amniotic band syndrome is a rare congenital disorder with clinical presentation of constricting bands in different parts of extremities or whole extremities. Conservative or surgical treatment is provided depending on the type and severity of the anomaly. Case Outline. The paper presents the case of a neonate patient with constriction bands localized on the left leg. During the second week of life, a surgery was indicated, and a single-stage multiple Z-plasty was performed to correct the anomalies on the left lower leg. Postoperative edema in the distal part of the lower leg was easily managed by incisions and drainage. Two months later, the correction of the stricture of the left thigh was managed using the same procedure. The postoperative course was uneventful and the outcome was satisfactory after a two-year follow-up. Conclusion. Evaluation of a patient with amniotic band syndrome, as well as diagnosis, monitoring, treatment and postoperative care, should always be multidisciplinary. A single-stage correction approach provided satisfactory both functional and aesthetic results. Given many morphological variations of the syndrome, a decision on the strategy of treatment should be made individually for each patient.

Until now, harvesting of flap elevations from the ipsilateral thigh twice in the same patient in two operations has not been reported. We harvested thigh flaps twice from the ipsilateral thigh of a single patient in separate operations. A 44-year-old man had skin defects of the right thumb and the left middle finger. In the first operation, his right thumb was reconstructed by the hemi-pulp flap. The anterolateral thigh flap harvested from the left thigh transferred to the donor site defect of the hemi-pulp flap. Sixteen days after the first operation, another anterolateral thigh flap harvested from the left thigh transferred to the defect of the left middle finger. This operative procedure is very useful for cases requiring multi-flap transfer.

The current report aimed to introduce the history of wound treatment in a 1-month-old infant that was taken care by modern dressing with Aquasel tender wet plus and Colactive R plus collagen. The patient was admitted to the hospital with seizure, but after complete physical examination, it was revealed that her left thigh had experienced burning, and an extensive necrosis had occurred at the child’s skin. Injury debridement was conducted owing to vastness of the area of injury, and according to consultation with the children plastic surgeon, skin graft of patient was recommended. However, modern dressing with Aquasel tender wet plus and Colactive R plus collagen was used for treatment besides the combination dressing of Aquasel Ag+, foam Aquasel, and colactive collagen. Finally, the patient was treated with modern dressing and healed completely after 45 days.

Marjolin's ulcer is an aggressive disease arising in chronic wounds and cutaneous scars. Corbo et al define Marjolin's ulcer an often overlooked or misdiagnosed tumor. We report a case of Marjolin's ulcer arose in a burn scar of a 51-year-old man who sustained a burn in childhood. A punch biopsy showed squamous cell carcinoma. The lesion was surgically removed with wide excision. The loss of substance was covered with a partial-thickness skin graft, harvested from the left thigh with dermatome. Histological examination confirmed a well-differentiated squamous cell carcinoma. Burn scars are the most commonly associated with these tumors, but other lesions may initiate this malignant transformation. The most common type of tumor reported in a Marjolin's ulcer is squamous cell carcinoma, but Pavlovic et al reported other malignancies.

Muscular involvement with Echinococcusgranulosus is rare, even in endemic countries where the frequency is estimated to be less than 3%, particularly in the countries of the Mediterranean basin, North Africa and Latin America. We report the rare observation of a hydatid cyst of the internal thigh room in a 57-year-old patient of rural origin and who has no notable sickness antecedents and was hospitalized in our department for the exploration of a tumefaction of the internal surface of the left thigh appeared gradually and insidiously for 3 years. Magnetic resonance imaging (MRI) showed an oval mass evoking an intramuscular hydatid cyst and its relationship to neighboring structures. He underwent surgical excision under locoregional anesthesia. Solitary hydatid localization in muscle tissue is exceptional, but it is useful to know that its diagnosis is often delayed, its treatment is surgical, but recurrences are possible.

An 18-year-old man presented with mid left thigh pain after sequential lacrosse injuries 1 month and 2 weeks prior. Physical examination was significant for a tender mass in the mid left thigh.

In order to assess the impact of the early and late tissue repair of Kombucha extract on incised wounds in animal models, 24 Wistar male rats were used and divided into three groups: one of the groups received a topical cure on the wound with Brosin, and the other received the Kombucha extract. The third group did not receive any treatment, working as a control group. The objective was to evaluate and compare the Kombucha extract with a commercial healing product. Each one of the animals took a 1 cm wound in depth and length at a femur level on a side of the left thigh. The healing process was evaluated on an early and late phase by performing a morphometric and morphological analysis under the assumption of a faster recovery with the use of Kombucha. The results showed that there was a poor recovery in the control group. On the other hand, the other two groups, Brosin and Kombucha, were similar, with little inflammation and a high cell proliferation and migration along with basal array pulls of elastin and collagen which served for angiogenesis, repair and renovation of the new tissue.

Patient initials or identifier number O.C.C ### Relevant clinical history and physical exam A 41 year-old male smoker Presented as intermittent claudication

In arteriovenous graft cases with severe stenosis of the venous anastomosis, it may be very difficult to pass a guidewire across the site. Frequently, the use of a vascular catheter to stiffen the wire and direct its tip leads to success. However, there are instances in which even after multiple attempts, the stenotic lesion cannot be crossed. In these cases, advancing the guidewire from the opposite direction may solve the problem. This chapter discusses the case of a patient with left thigh graft with stenosis at the venous anastomosis. In order to treat the lesion, the site had to be crossed in a retrograde direction.

Hydatid disease is prevalent throughout much of the world. However, bone and muscle echinococcosis are rare and often misdiagnosed. We report three cases: the first case, 38-year-old man had a primary sacral hydatid cyst, the second one, 37-year-old man, and the third one both had a primary muscle hydatidosis of the adductors of left thigh. The treatment was surgical for all three patients. Healing was obtained for the 2 muscular sites whereas the recurrence was the characteristic of the osseous localization despite several surgical resections.

We report a case study on a patient who presented with low back and thigh pain of one month duration. He was eventually diagnosed with left thigh pyomyositis. Tissue from thigh grew Staphylococcus aureus. With commencement of antibiotics and surgical drainage, patient made recovery despite prolonged hospital stay. The underlying mechanism of the extensive abscess accompanied by lack of systemic symptoms; is related to relative immunocompromised state of having underlying diabetes mellitus.

A 29-year-old Marine was treated after he was injured by an IED in Afghanistan. The explosion caused traumatic amputations of the right leg and hand, as well as blast and fragmentation injuries of the left arm, left hand, left thigh, abdomen, corneas, and tympanic membranes.

Background Pyoderma gangrenosum (PG) is a rare dermatological condition characterized by the rapid progression of a painful, necrolytic ulcer with an irregular, undermined border and commonly affects the lower extremities, mainly in the pretibial area. The diagnosis of PG is not easy. Due to lack of diagnostic laboratory test and histopathological findings indicative of PG, it is often misdiagnosed as an infection. This results in delayed or inappropriate treatment of the condition, which leads to devastating consequences such as limb amputation and death. Main observations We report a rare case of a 51-year-old female who was initially diagnosed as having infected ulcers and underwent serial debridements, which resulted in extensive PG at three different sites (abdominal, left thigh, and sacral). Conclusion This case highlights the challenges in diagnosing PG, emphasizes the key clinical features to aid diagnosis, and the clinical consequences of delayed or misdiagnosis of this condition.

A 22-year-old patient, who had been bedridden since childhood following mitochondrial encephalopathy was hospitalized for a pulmonary infection. Following the discovery of a voluminous painless tumefaction of the left thigh, lower extremity Doppler examination and X-rays showed a well-defined soft-tissue mass surrounding the femur, with no signs of hypervascularization on the Doppler sonography.

Bisphosphonates are mainstay of anti-resorptive therapies for osteoporosis. They prevent osteoporotic fractures by 40 to 70 % in women and men with osteoporosis. Use of these medications is not free from complications. A case of 62 year old female who presented with left thigh pain after trivial fall at home. X-ray diagnosed as atypical femur fracture of left femur which was fixed internally with interlock nailing. On 1st postoperative day, she complained of pain in right thigh. X-ray revealed an atypical femur fracture of left femur shaft which was also fixed internally with nailing. Biochemical investigations were suggestive of effectiveness of zoledronic therapy. We report this first case of bilateral sequential atypical femur fractures that was treated with zoledronate for 2 years. To our knowledge there are reports of oral alendronate therapy with atypical femoral fractures but none on zoledronic acid.

We report on a 46-year-old woman with a sciatic nerve schwannoma. Magnetic resonance imaging revealed a well-defined, lobulated, intensely enhancing mass posterior to the left hip joint along the left sciatic nerve suggestive of neurogenic tumour. The Tinnel sign was positive on the posterior aspect of the left thigh. The tumour was excised without neural damage. Postoperatively, the patient showed no signs of any neurological deficit, and recovery was uneventful.

A patient started anticoagulation for secondary prevention of stroke, achieving a prothrombin time-international normalized ratio within the optimal therapeutic range. The patient subsequently complained of pain in the left thigh on hospital day 25, and ultrasonography showed a large intramuscular hematoma in the left hamstring. The intramuscular hematoma gradually reduced without surgical intervention. Ultrasound examination plays an important role in precisely diagnosing intramuscular hematoma and monitoring changes in hematoma size.

Electrical shock can cause a direct myocardial damage and different types of arrhythmias, which are uncommon and occur more often when there is a high voltage exposure. We report a 19-year-old male that received a high voltage shock, falling thereafter from an altitude of four meters. On admission to the emergency room, he had second and third degree burns in the right hand and the left thigh. The electrocardiogram showed a nodal rhythm of 72 beats per minute. After four hours of monitoring, sinus rhythm returned spontaneously.

A 24-year-old male presented with a subcutaneous tumour measuring approximately 10 cm in diameter on his left thigh. The tumour appeared firm on palpation and did not show epidermal alterations (figure 1A). The patient reported that the lesion had been slowly growing in size over a period of a few months. He denied symptoms such as pain, itching or bleeding. Since the patient had already been diagnosed with neurofibromatosis type 1 (NF1) several years before, and since he suffered from multiple [...]

A 31-year-old French woman presented with typical cutaneous larva migrans following a 1-week visit to Gabon. Five days after her return to France, a serpiginous skin rash appeared on the anteromedial side of the left thigh (figure 1A). It had progressed for 1 week before consultation, and a contralateral lesion also appeared (figure 1B). Both lesions were itchy. The patient did not report other symptoms, such as asthenia, abdominal pain or intestinal disorder. Clinical examination did not reveal any other abnormalities. Biologically, there was no anaemia, …

We discuss a case of a female runner who presented with burning left groin and thigh pain and positional swelling after a long run. The workup revealed May-Thurner syndrome. May-Thurner syndrome anatomy is a common anatomical variant present in approximately 20% of the population. Compression of the iliac vein may result in venous stasis in the lower limb with a predisposition to deep venous thrombosis. We identify 4 reported cases of May-Thurner syndrome in female runners and review the importance of diagnosis and appropriate treatment of this condition. Level of Evidence V

Bullet embolism is rare complication of penetrating gunshot trauma. We are presenting a case of a single gunshot with entrance wound located on external side of a left thigh. The upward directed trajectory extends to the left lateral side of the neck, but the bullet has been recovered from right external iliac vein. The bullet migration was explained due to one rare variation of the mouth of vena cava superior and inferior.

Stabbing is the most common method of homicide in developing countries like Bangladesh, due to poverty, over population, joblessness, political unrest, etc. The reported case is of a 27 years old man stabbed on the front of the left thigh, a relatively unusual site by a sharp pointed knife by some snatchers while sitting on a rickshaw. On medicolegal point of view the injury was homicidal in nature to run away without having a motive to kill the person. The site was easily approachable for the snatchers. We need to create awareness among general population about the circumstances and probable mishaps that can happen unexpectedly. DOI: http://dx.doi.org/10.3329/dmcj.v2i1.17795 Delta Med Col J. Jan 2014; 2(1): 36-38

An 18-year-old Japanese woman noticed a progressive appearance of nodules on both forearms and on the left cubital fossa and left thigh one year before her initial consultation at our department. Physical examination showed elastic hard, slightly elevated, shiny and yellowish to skin-colored nodules of 6 to 10 mm in size on her extremities. From laboratory and histopathological findings, nodular-type lichen myxedematosus was diagnosed and nodules showed complete remission following local injection of triamcinolone acetonide.

To evaluate the effect of electrical stimulation (ES) combined with foam dressing on wound healing in rats with spinal cord injury.Complete spinal cord injury was induced in 49 male Sprague-Dawley rats at the T11-L1 level, after which a pressure ulcer was induced on the left thigh. The newly invented surface electrode, which was fitted with foam inside, was applied to the ulcers. Rats were divided into 2 groups as follows: the ES group, which received foam dressings and ES (2 Hz and 200-microsecond duration, 15 mA) for 4 times a day, 30 minutes each, for 3 weeks; and the control group, which received the foam dressings without ES. The ulcer area was measured by taking a photograph daily from day 0 to day 21. Histopathologic and immune-histochemical evaluations were performed on day 1 and days 7, 14, and 21.The area of the ulcers of the ES group was smaller than that of the control group after day 14 (P.05). In the ES group, the vascularity was significantly greater on day 14 and more decreased on day 21 compared with day 7 than that in the control group (P.05). In the ES group, the area of positive reaction to anti-α-SMA antibody was increased compared with the control group on days 7 and 14 and decreased on day 21 (P.05).Electrical stimulation combined with foam dressing by means of newly invented surface electrodes facilitates and accelerates the wound-healing process.

A 77-year-old man presented with painful eruptions on the left chest, right lower groin, and left thigh.

This study aimed to evaluate the number of laser irradiation sessions, process duration, and hair removal rate required for robot-assisted automatic versus physician-directed laser hair removal.This research group previously developed and tested an automatic laser hair removal (LHR) system to provide uniform laser treatment distribution.Six subjects 20-40 years of age, with skin types III-IV completed this study. A home-use LHR device with an 810 nm diode laser was used to treat equal-sized areas of both upper thighs; a random computer generator determined the use of a robot-assisted automatic LHR system or physician-directed LHR on the right or left thigh. The treatment schedule comprised five visits; subjects were photographed and shaved, and received LHR during the first through the fourth visits at 2-week intervals. The fifth visit occurred 1 month after the fourth, and only involved photography.All subjects successfully completed the clinical trial with no noticeable or permanent side effects. The average hair removal rates were 49.0% (standard error of the mean [SEM]: 4.0) and 29.5% (SEM: 4.0) for robot-assisted and physician-directed LHR, respectively. The average treatment duration and number of irradiation shots were 18 min, 30 sec (SEM: 33 sec) and 260 (SEM: 5.7) for robot-assisted LHR and 3 min, 11 sec (SEM: 15 sec) and 73 (SEM: 5.9) for physician-directed LHR.This clinical study successfully demonstrated the safety and effectiveness of robot-assisted LHR. The proposed novel system will benefit both patients and clinicians.

Usually, intramuscular hydatid cysts are secondary, resulting from the spread of cysts from other areas either spontaneously or after operations for hydatidosis in other regions. We present an unusual case of a primary hydatid cyst found in the left thigh of a 35-year-old woman, presenting as an enlarging soft-tissue tumour. Ultrasound, computed tomography and magnetic resonance imaging examinations revealed a multilocular intramuscular cyst in the anterior aspect of her left thigh, and no disease at any other location. We removed the entire cyst surgically, and macroscopic and microscopic histopathological examinations confirmed the diagnosis of muscular hydatidosis. Three years after the operation there had been no recurrence. In regions where hydatidosis is endemic, a tumour in any part of the body should be considered a hydatid cyst until proven otherwise.

El presente reporte muestra un efecto tóxico inusual asociado al uso de metimazol en el tratamiento del hipertiroidismo. Una niña de 14 años se presentó con fiebre, compromiso general y una tumoración eritematosa en el muslo izquierdo. Dos meses antes había sido diagnosticada de hipertiroidismo e iniciado metimazol a razón de 30 mg/d. El laboratorio mostró: leucocitos en 1 200 /mm³ con 25 % de neutrófilos, hematocrito en 31 % y plaquetas en 350 000/ mm³. Se inició antibióticos y filgastrim y se debridó el abceso. Nueve días después los leucocitos estaban en 9 200 /mm³ con 55 % de neutrófilos. La MO mostró una celularidad baja pero representada en un 80 % por células plasmáticas, muchas de ellas atípicas. En resumen una mujer con enfermedad de Graves estando con metimazol desarrolló una severa agranulocitosis con plasmacitosis medular que simula mieloma múltiple y que mejoró con tratamiento.(Rev Med Hered 2005;16:157-161). This case report shows the unusual toxic effects associated with methimazol in the treatment of hyperthyroidism. A 14 year old girl presented with fever, malaise and erythematous mass in her left thigh. She had a diagnosis of Graves disease two months prior and she started Methimazol 30mg/day. The initial test showed leukocytes of 1.200/mm³ with neutrophils 25%, hematocrit 31% and platelets 350,000/mm³. Antibiotics and filgastrim were started and the abscess was incised. Nine days after, leucocytes increased to 9200 with 55% neutrophyls. The bone marrow smear showed a low cellularity, 80 % were plasma cells with some atypical. She recoved completely with the treatment. (Rev Med Hered 2005;16:157-161).

We report a case of posttraumatic skin and soft-tissue infection in a patient with a left thigh wound after a traffic accident.Pseudomonas fulvawas isolated from a wound aspirate and was identified to the species level by Maldi-tof. The patient responded to drainage, debridement of wound, and two weeks of intravenous antibiotic therapy. Follow-up after 3 weeks was satisfactory with healthy cover of the injured area.

The liposarcoma are not rare in the thigh area. Two patients both men, 56 and 39 years of age were operated within a few months because of giant liposarcoma in the left thigh region. The liposarcoma of these patients was strikingly similar. Upon suspicion of malignancy, resection of the tumor without prior diagnostic biopsy is recommended. The early postoperative period of both patients passed smoothly. The full range of movement was achieved in left hip and knee joints. Operative wounds healed per primam intentionem. Up till now, several months after tumors removal, both patients have no data of local or distant metastases.