Thread lifting is widely used in aesthetic medicine, and complications are generally minor. Impaired wound healing caused by patient’s hair acting as a retained foreign body, however, is rarely reported. A 38-year-old woman presented with persistent discomfort and delayed healing at a preauricular entry site two months after undergoing a PDO thread lifting performed elsewhere. Examination revealed a small open wound containing multiple stands of her own hair, whi
Gastrointestinal stromal tumours (GIST) are mesenchymal tumours primarily located in the gastrointestinal tract, representing the majority of gastrointestinal mesenchymal tumours. Primary gallbladder GIST are exceptionally rare, with fewer than 20 cases documented in the existing literature.
Intrinsic congenital duodenal obstruction (ICDO) is a common and unique congenital malformation. It is characterized by several important features including its variable presentation and the high incidence of associated anomalies. This is a review of our experience with 130 newborns, infants and children with ICDO outlining aspects of clinical features, associated anomalies, management and outcome.
1.1. Introduction and Importance Degeneration of the central lymphatic system is reported to account for pathogenesis of aging-associated Alzheimer's disease (AD) through accumulation of metabolic waste of large molecules in the mouse brain. The findings remain to be translated into a clinic therapy of AD. 1.2. Methods Fluorescence dye of indocyanine green was used to identify blockage of deep cervical lymphatic system in an AD patient. Lymphaticovenular anastomosis (LVA), a super- microsurgical technique, was conducted to connect the influx lymphatics of obstructed lymph nodes into the jugular vein to fix the blockage. 1.3. Outcomes Obstruction was found in lymph nodes of the district 3 (area III) of deep cervical area on both sides of the AD patients. The surgery resolved the obstruction and improved behaviour, memory and psychiatry of the AD patient. The improvement was confirmed in the follow-up studies at 1st, 4th and 6th months. p-tau181 level was decreased in the peripheral blood from 4.26 pg/ml before surgery to 0.64 pg/ml at 6th month post surgery. The PET-CT image of glucose utilization demonstrated that the neuronal functions were increased in multiple areas of the brain. 1.4. Conclusion: The deep cervical lymphatic system was dysfunctional in the AD patient due to obstruction of lymph nodes in the district 3. The LVA surgery fixed the obstruction and generated a consistent therapeutic effect independent of anaesthetics in the patient for months.
Non-melanoma skin cancers commonly affect the lower extrem- ities and scalp, where Mohs micrographic surgery (MMS) often leaves wounds with complex healing challenges due to limited vascularity, thin skin, and patient comorbidities. Secondary in- tention healing (SIH) remains a standard method but can result in prolonged recovery and suboptimal cosmetic outcomes. This case series evaluated a bioengineered collagen-honey-hydroxy- apatite dressing (CHD) applied to eight post-Mohs wounds - five on the lower leg and three on the scalp - managed by SIH. Patients received the CHD through a durable medical equipment (DME) home- delivery model and self-applied the dressing at home per manufacturer guidelines. Healing progression was documented through before-and-after images and assessed qualitatively for granulation, re-volumization, erythema/inflammation, and epi- thelialization. Across all cases, CHD use was associated with visible wound improvement, including reduced depth, increased granulation tissue, diminished redness, and progressive closure, even in wounds with exposed fascia or periosteum. These re- al-world findings suggest that the CHD supports effective heal- ing in post-Mohs surgical wounds managed by SIH and that the DME model improves accessibility and adherence among MMS patients. The CHD represents a practical, cost-effective, and pa- tient-centered solution for enhancing wound outcomes in der- matologic surgery.
Internal hernias represent a rare but clinically significant cause of intestinal obstruction, with paraduodenal hernias (PDHs) accounting for 53% of cases. Left PDHs, occurring through Landzert's fossa, present diagnostic challenges due to their nonspecific symptoms and rare incidence.
Chondro-osseous respiratory epithelial (CORE) hamartoma is a rare sinonasal lesion and is considered a benign tumor-like lesion. However, a growing body of evidence suggests that CORE hamartoma may represent a benign neoplasm which could potentially undergo malignant transformation. An oncocytic variant of CORE hamartoma has not yet been described. Herein, we present the first case of oncocytic CORE hamartoma in an 85-year-old patient. We summarize the current state of knowledge on CORE hamartoma, including epidemiological/clinical, histopathological and immunohistochemical findings, and discuss potential diagnostic pitfalls that may lead to erroneous diagnosis.
1.1. Aim Pancreatic pathology is relatively rare in children. We report a child whounderwent near total laparoscopic pancreatectomy. 1.2. Results An infant underwent near total pancreatectomy for congenitalhyperinsulinism and made an excellent postoperative recovery. 1.3. Conclusion Laparoscopic near total pancreatectomy is feasible, safe andbeneficial for infants with congenital hyperinsulinism. Every attempt should bemade to preserve the spleen during surgery and these children should beimmunized preoperatively to avoid the risk of post-splenectomy sepsis.
1.1. Aim and Objectives: To review the management of head and neck infections due to odontogenic origin in medically compromised and non-compromised patients. Specifically, to observe their severity, response to common first-line broad-spectrum antibiotics, responsible bacterial microflora, and complications thereof. 1.2. Material and Methods: 45 cases of odontogenic oro-facial and cervico-facial cellulitis reporting or referred to the maxillofacial surgery outpatient department (OPD) were included in the study. Out of these, 38 were those diagnosed with some form of systemic debilitating condition and 7 were systemically healthy individuals. All the cases were managed by the same team of surgeons. Presenting cellulitis was surgically decompressed by incision and drainage. Pus specimens were subjected to culture sensitivity testing and antibiotic sensitivity testing (ABST). All patients were postoperatively monitored for wound healing, Lenth of Stay (LOS), complications, and incidence of morbidity and mortality. A prospective cohort study design was employed for the compilation and review of data
Background: Aortic stenosis is a progressive and degenerative disease, which at some stage needs an aortic valve replacement (AVR). Despite an almost equal prevalence of aortic stenosis, female referral to AVR is lower and unexplained, although partly explained in the differences in risk and outcome. The introduction of transcatheter aortic valve replacement (TAVR) increased the treatment palette of especially of older and high-risk patients. It was suggested that lower female referral would likely change as primary result of TAVR showed survival in women than men.
A 66-year-old male presented with several episodes of right upper quadrant pain, fever, and elevated inflammatory markers, suggesting a biliary infection. The patient’s initial presentation was complicated by the unusual manifestation of Cryptococcus neoformans infection in the duodenum, leading to obstructive jaundice in a patient without known immunodeficiency. This atypical presentation and subsequent diagnosis of ascending cholangitis with duodenal stricture preventing ERCP significantly complicated the diagnostic and management process. Conservative management with antibiotics initially proved ineffective, necessitating further investigation and, ultimately, a Whipple procedure. Histopathology revealed a complex picture, confirming fungal infection of the gallbladder and IgG4-related disease involving the duodenum. This case throws light in the importance of considering rare diagnoses and underscores the challenges of differentiating between infectious and autoimmune processes in complex biliary conditions. It serves as a reminder of the need for a multidisciplinary approach involving infectious disease and surgical specialties to manage these challenging cases effectively.
A 15-year-old male sustained an isolated gunshot wound to the right buttock. There was no associated exit wound. At the time of admission, he was alert and oriented. He was able to move all of his extremities with normal strength and sensation. His vital signs were BP – 145/98 Pulse-75, Respirations – 18 Temp 100.1 degrees. The abdomen was soft, non-distended and non-tender. Gross blood was present on the rectal exam. The FAST was negative. A pelvic film revealed a bullet fragment at the level of the left proximal femur. A left inferior pubic ramus fracture was also noted. The hemoglobin was 14.7 and the serum lactate was 2.4. The patient was taken to the operating room for exploration. Antibiotic prophlaxis included intravenous levaquin and flagyl. A rigid proctosigmoidoscopy was performed to 15 cm. Blood was present throughout the rectal vault. A foley catheter was placed. The urine was clear. Abdominal exploration ensued. The intraabdominal viscera were normal. A loop sigmoid colostomy was fashioned and the midline incision closed. The skin was stapled. Three days later the patient had an episode of bright red blood per rectum. A CT scan was done. No blush was evident in the rectum. A rectal wall hematoma was present (Figure 1). There was enhancement of the corpus spongiosum. The left inferior pubic ramus fracture was evident. Aside from these findings the exam was negative. He continued to progress and was discharged to home tolerating a normal diet with good colostomy function. Four and a half months later, the patient had colostomy reversal. His post-operative course was benign. Normal bowel activity returned and he was discharged to home in good condition.
1.1. Introduction: Pyogenic liver abscesses develop most commonly following peritoneal infection via the portal circulation. PET-CT for diagnosis and suction drainage as effective therapeutic procedure are distinguished. 1.2. Case Report: A 61-year-old male, with no past medical history except cholecystectomy performed two months ago to treat calculous acute cholecystitis, presented to the Service complaining of anorexia and weight loss, since the procedure, without pain or fever. An intra-hepatic fluid collection was noted in the ultrasound, and the Positron Emission Tomography using F-18 fluorodeoxyglucose combined with computed tomography (PET-CT) revealed a rounded image, with a centre less dense than the periphery, 7 cm in diameter, in segment VIII of the liver, with no radiotracer uptake, characterizing a pyogenic liver abscess. The patient then underwent US-guided pigtail drainage, aspirating about 60 mL of thick purulent secretion, sent for bacterioscopy and culture, and then keeping the drain under continuous suction. A Hickman catheter was inserted for antibiotic therapy, using ertapenem. Three weeks later the drain was removed, and antibiotic therapy was terminated. Six-month follow-up demonstrated a healthy patient with body weight recovery.
Introduction: Lipedema is a very common occurrence in women worldwide, occurring in around 11% of females. It is also a common problem for females from Egypt and the Middle East [E& ME]. Unfortunately, there are neither official reports on the incidence of this condition in the region, nor information on the outcome of its treatment. In our center, a high percentage of patients from different regions of E&ME attend seeking body shaping procedures, including the removal of Fat from different parts of the body. The standard technique [traditional liposuction-TL] to remove the lipedema of the arm has been the treatment of choice globally, and in our center before 2019. 1.2. Methodology: In our center, the TL technique using a 4 mm Mercedes cannula was performed. Unfortunately, the results were not satisfactory for the patients or for us. Here we report our center’s experience for the treatment of arm lipedema for females from E&ME treated between January 2019 and December 2023 using a new technique, the combination of Vaser and MicroAire technique [V&M], compared to patients who underwent TL.
The latissimus dorsi myocutaneous flap (LDMF) is a pivotal surgical technique for breast reconstruction, celebrated for its reliable anatomy and minimal morbidity. Initially introduced by Iginio Tansini in 1896, the latissimus dorsi flap involved a dorsal skin flap for closing breast cancer surgeries. Despite early challenges, Tansini’s insights into vascular anatomy established a foundation for its use. After a decline due to radical mastectomy approaches, the flap was revitalized in 1939 by Elliot Hutchins, who demonstrated its efficacy in restoring axillary lymphatic drainage. The LDMF regained popularity in the late 1970s for immediate breast reconstruction, often paired with silicone implants. Subsequent innovations, including fat grafting and robotic dissection techniques, have further enhanced its applications. While the transverse rectus abdominis myocutaneous (TRAM) flap has become a popular alternative, the LDMF remains a versatile and effective option in reconstructive surgery, consistently providing satisfactory aesthetic outcomes.
Aims To determine whether the degree of histologic damage to the liver after cholecystectomy bile duct injury (BDI) is correlated with a patient’s clinical course.
Gunshot injuries have been on the rise in the south west region of Cameroon for the past 6 years due to the current socio-political crisis. With the increasing violence in the South West Region of Cameroon due to the socio-political crisis, proper management of Gunshot injuries at the local referral health facilities is very crucial. The outcome of management varies depending on factors such as firearm used, injury site, clinical presentation, and the time between injury and medical intervention. There is limited data on the management and outcome gunshot injuries in Cameroon, especially in the South West region .The aim was to provide data on the characteristics, management and outcome of gunshot injuries. We had as objective to describe the characteristics, treatment and outcome of gunshot injuries in South West, Cameroon
