Search

Background and Purpose. Ultrasound (US) is one of the most common modalities used in intervention for musculoskeletal disorders, although its effectiveness is debated. The purpose of this case report is [...]

HISTORY A 91-year-old woman is seen because of a large, painful lump on the shin that just arose, she says, from an accidental--not abusive--blunt traumatic injury. PHYSICAL EXAMINATION Talkative, pleasant [...]

Sharpen Your Diagnostic Skills HISTORY A 51-year-old physician presents for evaluation and treatment of a green toenail. Has no history of this condition. Reports that after starting to wear new [...]

Liver hemorrhage, usually a complication of severe preeclampsia, may occur spontaneously. A case in which this happened prompted a review of the literature. No association with preeclampsia was found in 10 of 68 reported cases of liver rupture or hematoma during pregnancy. No mothers died, although a third or more of babies did. The data suggest that obstetricians should use the same guidelines for treatment as for liver trauma. Surgery should be performed when blood pressure cannot be stabilized, bleeding continues, pain increases, or there are signs of infection. A specialist in liver surgery should be available.

Rectus sheath hematoma (RSH) is characterized by an accumulation of blood between the abdominal muscle and its sheath. This results in a painful mass that causes nausea, vomiting, abdominal tenderness, and fever. It has a number of causes including excess stress or strain on the abdominal muscle. RSH is often misdiagnosed, frequently leading to unnecessary surgery. The case is reported of a 24-year-old female who developed RSH after minor strain. The woman developed pain and bulging in her lower left abdomen following a mild bout of coughing. Examination led to an initial diagnosis of hernia. Before surgery, ultrasound imaging was performed to confirm the diagnosis. Results showed that the mass was actually a RSH. No surgery was performed, and the patient was treated with a heating pad. The RSH resolved in a few days. This case illustrates how RSH is often misdiagnosed which can lead to unnecessary surgery. Patients with abdominal pain and palpable masses should be examined carefully and a complete medical history should be taken. Diagnostic imaging is recommended when there is any uncertainty regarding diagnosis. Treatment of RSH is usually conservative unless it is enlarging or occurs in a pregnant patient. (Consumer Summary produced by Reliance Medical Information, Inc.), Rectus sheath hematoma is an unusual cause of painful abdominal mass.[1-5] It is frequently misdiagnosed, which may result in the performance of unnecessary surgical procedures.[2,3] In most cases, a precipitating [...]

A high school football player who was kneed in the groin during a game, and encouraged by his coach to ''get back in there,'' developed pain and swelling on the right side of the scrotum. When examined, the testicle had swollen to the size of a tennis ball and was tender. Four hours later, the testicle was the size of a grapefruit. Possible diagnoses are described and evaluated. These include: rupture of the scrotal contents; testicular torsion (twisting of the testicle in the scrotum); or a tumor, which could make the organ unusually sensitive to trauma. The most likely diagnosis for the case described was traumatic hematocele, in which blood leaks into the cavity of the tunica vaginalis (the space surrounding the testicle). Urinalysis proved normal. Results from other noninvasive diagnostic tests are presented. The scrotum was opened surgically and examined before all test results had been obtained because the swelling did not abate. Surgical repair was performed. In such cases, early intervention is desirable to preserve testicular function, and waiting for test results can cost precious time. Six months after surgery, the patient's testicles were the same size. He returned to football, with the caveat that a protective cup should be worn. (Consumer Summary produced by Reliance Medical Information, Inc.)

A case report of a successful nonsurgical, conservative management of ruptured subcapsular liver hematoma in a patient with preeclampsia who had hemoperitoneum, seen at cesarean section is presented. On the basis of blood pressure measurement and laboratory findings, the patient was diagnosed with preeclampsia.

A 26-year-old woman was referred for evaluation of a left orbital mass. At first the patient was unable to recall an injury to the left orbit. Further inquiry revealed that [...]

Spontaneous intramural small bowel hematoma is a rare complication of anticoagulant therapy. The authors report a case of small bowel intramural hematoma resulting from sodium Warfarin toxicity in a patient with prosthetic mitral valve. The patient presented with colicky abdominal pain, vomiting and melena. Typical findings on abdominal Sonography and MDCT with elevated INR value suggested the diagnosis. Patient was treated conservatively. The history of anticoagulant use with prolonged INR value in patients presenting with abdominal complaints should alert clinician and radiologist to look for this entity. The essence of prompt and accurate diagnosis of this condition lies in the conservative management to avoid an un-indicated surgery. Keywords: Intramural hematoma | Anticoagulant | Small bowel | Spontaneous, Case report A 54 year old man presented to the emergency department with complaints of acute onset colicky abdominal pain, vomiting and melena since 2 days. He had undergone prosthetic [...]

In this article, we describe an anticoagulated patient who developed a large prevesical space hematoma while recovering from an acute respiratory illness. This diagnosis should be considered in the anticoagulated patient who develops abdominal pain, a lower abdominal wall mass and an anemic syndrome. Diagnosis is usually confirmed by CT scan or ultrasound. Non-operative management is recommended, A 67-year-old woman hospitalized for acute pulmonary failure of unknown etiology developed a one-day history of increasing lower abdominal pain and distension associated with new-onset tachycardia and hypotension. The patient [...]

Introduction: Epidural haematomas are almost always traumatic in origin. The occurrence of spontaneous cranial epidural hematoma (SCEH) is rare and its incidence is not known. In literature scanning; two cases of non-traumatic SCEH has been reported, but no case of warfarin induced SCEH has been reported. We want to attract attention to a case which cannot be seen in literature scanning: SCEH caused by warfarin. Case: A 76-year-old woman applied to our emergency room with suddenly depressed consciousness level. There were no external signs of any trauma to the scalp or face and there was no previous history of any trauma. She had undergone cardio embolic stroke ten years before. She had been taking warfarin. Computed tomography of the brain revealed bilateral chronic subdural effusions with a large left temporal epidural haematoma but no evidence of skull fracture or cephalohaematoma.Conclusion: Long-term anticoagulant drug therapy may cause spontaneous epidural haematoma. Many clinicians continue to perceive that older persons who are at increased risk of falling have an unacceptably high risk of antithrombotic-related major hemorrhage. Keywords: Spontaneous | Intracranial Epidural Hematoma | Warfarin | Emergency room, Introduction The occurrence of spontaneous cranial epidural haematoma (SCEH) is rare and its incidence is not known. Typically, there is no history of any head trauma. It is associated with [...]

In this article, we describe an anticoagulated patient who developed a large prevesical space hematoma while recovering from an acute respiratory illness. This diagnosis should be considered in the anticoagulated patient who develops abdominal pain, a lower abdominal wall mass and an anemic syndrome. Diagnosis is usually confirmed by CT scan or ultrasound. Non-operative management is recommended., Case Report A 67-year-old woman hospitalized for acute pulmonary failure of unknown etiology developed a one-day history of increasing lower abdominal pain and distension associated with new-onset tachycardia and hypotension. [...]

We present a case of severe head injury who developed contralateral extradural hematoma during evacuation of contused brain. The lesion was suspected due to sudden brain swelling at the site of surgery and was confirmed by computed tomography and was evacuated in emergency. Keywords: Contralateral extradural hematoma, brain contusion, computed tomography., Table of Contents Abstract Introduction Case report Discussion Conclusion References Introduction Development of acute brain swelling during evacuation of traumatic brain lesion is a serious complication ion neurosurgery. The occurrence [...]

Airway haematoma is rare and life threatening condition. It occurs almost exclusively in patients with coagulopathies, often in those receiving warfarin. We present a case of an extensive laryngo-pharyngeal haematoma causing acute airway compromise in an over-warfarinised patient. Emergency tracheotomy was required within 8 hours of presentation. We advocate a high index of suspicion of airway haematomas in coagulopathic patients presenting with upper aerodigestive tract symptoms, detailed airway evaluation and monitoring with flexible laryngoscopy, and timely intervention as necessary. Keywords: Larynx, pharynx, hematoma, hemorrhage, tracheotomy, warfarin, Table of Contents Abstract Introduction Case Report Discussion Conclusion References Introduction Warfarin is a commonly used anticoagulant drug (0.5-1% of the UK population (1), with common indications including artificial heart [...]

Table of Contents Abstract Introduction Case Report Discussion References Abstract We present a 75-year-old female patient admitted to our clinic with the diagnosis of acute coronary syndrome (ACS) (high risk [...]

Table of Contents Abstract Introduction Case report Discussion References Abstract Testicular trauma is a common problem faced by surgeons all over. It is often managed conservatively based on clinical and [...]

A case study of a 72 year old father with symptoms of sever headaches, forgetfullness and confusion is discussed. An assessment shows that the father has a subdural hematoma common to people his age, as a result emergency surgery was conducted and he returned home after an uneventful recovery.

Abstract It is possible to perform many diagnostic and therapeutic procedures using minimally invasive techniques. Examination of the appendix is a new area where laparoscopy is being used. These techniques [...]

Intramural Hematoma of the Aorta Abstract & Commentary With Comment by Michael H. Crawford, MD, Professor of Medicine, Chief of Clinical Cardiology, University of California, San Francisco, Editor, Clinical Cardiology [...]

A 42-year-old woman was admitted to the intensive care unit because her right forearm was cyanotic. The patient had received a diagnosis of primary adult respiratory distress syndrome and had [...]