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Auris, Nasus, Larynx 1981A case of bilateral peritonsillar abscesses is reported. The patient was a 31-year-old male presenting with a severe sore throat, dysphagia, trismus and bilateral...
A case of bilateral peritonsillar abscesses is reported. The patient was a 31-year-old male presenting with a severe sore throat, dysphagia, trismus and bilateral swelling of the soft palate causing no displacement of the uvula. Incision and drainage (I and D) and an interval tonsillectomy cured this condition. On review of the literature, it was noted that bilateral peritonsillar abscesses are not uncommon. Peritonsillar abscesses possibly occur bilaterally, but as the developmental stages of the abscesses are not simultaneous, immediate tonsillectomy or intensive antibiotic treatment following I and D controls the formation of the opposite side abscess in most cases.
Topics: Adult; Drainage; Humans; Male; Peritonsillar Abscess; Tonsillectomy
PubMed: 6945087
DOI: 10.1016/s0385-8146(81)80013-2 -
International Journal of Surgery Case... Sep 2021Sciatic hernias are the rarest form of pelvic floor hernias as well as an uncommon cause of sciatica. A high index of suspicion is required to make the diagnosis due to...
INTRODUCTION
Sciatic hernias are the rarest form of pelvic floor hernias as well as an uncommon cause of sciatica. A high index of suspicion is required to make the diagnosis due to its variable clinical presentation. This is the first case describing bilateral intestinal sciatic hernia, diagnosis, and robotic surgical repair.
PRESENTATION OF CASE
A 77-year-old female with history of chronic back pain and diverticulitis presented with three weeks of abdominal pain, radiating down her legs bilaterally. Computed tomography (CT) revealed bilateral sciatic notch hernias without evidence of bowel obstruction. Magnetic resonance imaging (MRI) confirmed compression of the sciatic nerves within the sciatic notch bilaterally. She underwent robotic bilateral retroperitoneal sciatic notch hernia repair successfully.
DISCUSSION
There are several independent causes of abdominal pain and bilateral radiating leg pain. Sciatic hernias are an unusual cause of both. Aside from bowel, the hernia can involve other structures, such as the bladder, ureters, or ovaries, potentially creating drastically different clinical pictures. Laparoscopic or robotic repair have been proven superior to open surgery in the literature.
CONCLUSION
This case demonstrates that bilateral sciatic hernias can present as uncomplicated sciatica in an elderly patient, but the addition of seemingly unrelated abdominal pain should warrant further investigation. Minimally invasive robotic repair can successfully treat sciatic hernias.
PubMed: 34454211
DOI: 10.1016/j.ijscr.2021.106333 -
Clinical Practice and Cases in... Feb 2020Luxatio erecta is a description for a specific and rare type of shoulder dislocation where the humeral head dislocates directly inferior. This rare form of glenohumeral...
Luxatio erecta is a description for a specific and rare type of shoulder dislocation where the humeral head dislocates directly inferior. This rare form of glenohumeral dislocation accounts for only 0.5% of shoulder dislocations. It is even less common for both shoulders to be bilaterally dislocated inferiorly with the characteristic "hands up" posture. A limited number of these bilateral occurrences are described in the literature to date and most have been from higher energy trauma. We have described a low energy case of bilateral luxatio erecta and the reduction method used and the continued instability following successful reduction under procedural anesthesia.
PubMed: 32064422
DOI: 10.5811/cpcem.2019.9.44205 -
Journal of Clinical and Experimental... Feb 2023To evaluate bilateral symmetry and anatomical variations of root morphology of permanent mandibular second molar using systematic evaluation of CBCT scans.
BACKGROUND
To evaluate bilateral symmetry and anatomical variations of root morphology of permanent mandibular second molar using systematic evaluation of CBCT scans.
MATERIAL AND METHODS
This cross-sectional study involved the mandible which were imaged using serial axial cone-beam computed tomography (CBCT) from 680 North Indian patients who visited dental hospital for various reasons unrelated to the study. CBCT Records with presence of bilateral fully erupted permanent mandibular second molars with fully formed apexes were selected.
RESULTS
Bilaterally present two root and three canal configurations were most consistently seen (75.88 % and 59.11 %, respectively). The occurrence of two roots with two canals and four canals was 15.14% and 1.61% respectively. Mandibular second molar present with one extra root, radix entomolaris with three canals and four canals was 0.44% and 3.53% while radix paramolaris present with three canals and four canals 1.32% and 1.03% respectively. The occurrence of C-shaped root bilaterally with C shaped canal was 15.88% whereas the presence of one fused root bilaterally was 0.44%. The presence of four roots bilaterally with four canals was identified in only one CBCT scanned image (0.14%). The frequency distribution of root morphology on bilateral symmetrical analysis revealed 98.58 % bilateral symmetry.
CONCLUSIONS
In 402 CBCT scans, bilateral presence of two roots with three canals was the most typical root structure seen in mandibular second molars (59.11%). A rare variation found was the presence of four roots occurring bilaterally, seen in only 1 CBCT scan. Bilateral symmetrical analysis of root morphology revealed 98.58 % bilateral symmetry. Anatomic root variations, mandibular second molar, Cone Beam Computed Tomography scans, bilateral symmetry.
PubMed: 36911156
DOI: 10.4317/jced.60063 -
Journal of the American Veterinary... Oct 2019An 11-month-old sexually intact male red kangaroo () was examined because of bilateral radial and ulnar fractures.
CASE DESCRIPTION
An 11-month-old sexually intact male red kangaroo () was examined because of bilateral radial and ulnar fractures.
CLINICAL FINDINGS
Radiography of the forelimbs revealed bilateral, short oblique fractures in the proximal to mid diaphyses of the radii and ulnae. Fractures were overriding and moderately displaced. Wider than expected gaps were evident in the humeroulnar and humeroradial joints bilaterally. Although several physes remained open, no proximal radial physis was radiographically evident.
TREATMENT AND OUTCOME
Dual bone fixation was performed bilaterally, and dynamic luxation of the left radial head was identified and stabilized intraoperatively. Although satisfactory function of both forelimbs was evident at 8 weeks and 26 months after surgery, a persistent gait abnormality affecting the right forelimb was noted. Twenty-six months after surgery, radiography revealed bilateral proximal radial physes and resolution of the abnormally wide gaps in the humeroradial and humeroulnar joints. Despite dual bone fixation, synostoses formed bilaterally and may have contributed to the persistent lameness in the kangaroo's right forelimb.
CLINICAL RELEVANCE
Veterinarians treating kangaroos should be aware of difficulties in determining skeletal maturity and planning fracture stabilization because of potential differences in skeletal growth and fracture healing, compared with other species. We described critical issues observed in the treatment and outcome of the kangaroo of the present report and provided lessons learned as well as potential explanations of these issues to facilitate future treatment of kangaroos with forelimb fractures.
Topics: Animals; Forelimb; Fracture Fixation, Internal; Joint Dislocations; Macropodidae; Male; Radius; Radius Fractures; Treatment Outcome; Ulna Fractures
PubMed: 31573862
DOI: 10.2460/javma.255.8.942 -
American Journal of Ophthalmology Case... Sep 2019To report a case of hypertensive choroidopathy with bilateral bullous serous retinal detachments (SRDs), retinal pigment epithelial detachments (PEDs), and giant retinal...
PURPOSE
To report a case of hypertensive choroidopathy with bilateral bullous serous retinal detachments (SRDs), retinal pigment epithelial detachments (PEDs), and giant retinal pigment epithelial (RPE) tears.
OBSERVATIONS
A 68-year-old man with a history of hypertension and diabetes mellitus presented with bilateral visual loss of about 10 day's duration. He discontinued his oral medications for 2 months without the advice of a physician. At his first visit, the best-corrected visual acuities (BCVAs) were 0.02 in the right eye and 0.3 in the left eye (decimal notation), and the respective intraocular pressures were 15 and 13 mmHg. Bullous SRDs, large PEDs, and giant RPE tears were present bilaterally. Blot retinal hemorrhages and hard exudates were seen in the left eye. The systemic blood pressure was 231/77 mmHg, and bilateral lower leg edema was observed. Biochemical blood tests showed deteriorated renal function, hypoalbuminemia, and hyperglycemia. Ultra-wide-field fundus fluorescein angiography showed leakage at the areas of the SRDs and hyperfluorescent areas corresponding to the RPE tears bilaterally. Indocyanine green angiography showed hypofluorescent areas corresponding to the PEDs. Systemic computed tomography and magnetic resonance imaging were performed, and no malignancy was found. Based on these findings, hypertensive choroidopathy was diagnosed. A week after antihypertensive treatment, the SRDs and PEDs resolved bilaterally, and the BCVAs improved to 0.4 and 0.5 in the right and left eyes, respectively. The RPE tears remained in both eyes, although the SRDs and PEDs did not recur.
CONCLUSIONS AND IMPORTANCE
Hypertensive choroidopathy must be considered in the differential diagnosis of SRDs and/or PEDs.
PubMed: 31388604
DOI: 10.1016/j.ajoc.2019.100525 -
Orthopedics Jan 1982Radiocarpal dislocation is an uncommon orthopedic injury;15 even more uncommon is a bilateral radiocarpal dislocation associated with compression of the median nerve in...
Radiocarpal dislocation is an uncommon orthopedic injury;15 even more uncommon is a bilateral radiocarpal dislocation associated with compression of the median nerve in the carpal canal bilaterally.
PubMed: 24822992
DOI: 10.3928/0147-7447-19820101-06 -
Ceska a Slovenska Oftalmologie :... 2023The aim of the present paper is to describe the case study of a female patient with bilateral AMN, suffering from active acute infection with COVID-19.
AIM
The aim of the present paper is to describe the case study of a female patient with bilateral AMN, suffering from active acute infection with COVID-19.
METHODS
A 32-year-old female patient with impaired vision bilaterally persisting for 2 days reported to the emergency Department of Ophthalmology at the Central Military Hospital in Ružomberok, Slovakia. The patient manifested symptoms of COVID-19 infection persisting for 3 days before the onset of visual complaints.
RESULTS
At the primary examination, initial best corrected central visual acuity was 20/40 bilaterally, paracentral scotomas were present more in the right eye. Upon examination of the ocular fundus, the edges of the optic nerve disc were out of focus more in the left eye; brownish red petaloid lesions were present around the fovea, the periphery was without pathological findings. OCT and OCTA were performed, with a conclusion of bilateral AMN upon a background of COVID-19 infection. Low molecular weight heparin (LMWH) was administered in a preventive dose.
CONCLUSION
The number of documented ocular complications of COVID-19 infection, including microvascular events, is currently increasing.
Topics: Humans; Female; Adult; Retinal Diseases; Heparin, Low-Molecular-Weight; Macula Lutea; COVID-19; Tomography, Optical Coherence
PubMed: 37344217
DOI: 10.31348/2023/21 -
American Journal of Ophthalmology Case... Mar 2022To describe a novel optical coherence tomography (OCT) finding in a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) and to report the clinical response...
PURPOSE
To describe a novel optical coherence tomography (OCT) finding in a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) and to report the clinical response to plasmapheresis.
OBSERVATIONS
We report the case of a 54-year-old man who was being treated with adjuvant immune checkpoint inhibitors for metastatic renal cell carcinoma. He had suffered from bilateral progressive vision loss without ocular pain. At presentation in the retina clinic, visual acuity was counting fingers bilaterally. Examination revealed characteristic findings suggestive of a peculiar paraneoplastic intraocular syndrome called BDUMP. Multiple choroidal nevi-like melanocytic tumors were noted bilaterally. The diagnosis was confirmed using multimodal imaging with fluorescein angiography and fundus autofluorescence, which revealed a typical leopard pattern. Ultrasonography revealed choroidal thickening extending to the ciliary body. OCT showed multiple pockets of serous retinal detachment (SRD) and bacillary layer detachment (BALAD), a newly recognized and rarely described manifestation of the disease. The clinical response to plasmapheresis was robust with resolution of the BALAD and SRD and improvement of the vision to 20/30 in both eyes at the seven-month follow-up.
CONCLUSIONS AND IMPORTANCE
BALAD is a newly recognized manifestation of BDUMP. Early recognition of this paraneoplastic syndrome and prompt initiation of plasmapheresis has the potential to improve and stabilize vision.
PubMed: 35243136
DOI: 10.1016/j.ajoc.2022.101349 -
Case Reports in Ophthalmology 2021We report a bilateral case of type 1 idiopathic macular telangiectasia (IMT) in a female patient. A 40-year-old otherwise healthy female with gradual vision loss since 2...
We report a bilateral case of type 1 idiopathic macular telangiectasia (IMT) in a female patient. A 40-year-old otherwise healthy female with gradual vision loss since 2 years ago with best-corrected visual acuity of 20/400 in both eyes was referred. Her past medical history was negative for any systemic disease including diabetes and systemic hypertension. Color fundus photography showed bilateral loss of normal foveal reflex with macular edema. Fluorescein angiography demonstrated symmetric perifoveal telangiectasia mainly in the superior and nasal macula in both eyes with late staining and leakage. Spectral-domain optical coherence tomography revealed significant intraretinal fluid bilaterally and subretinal fluid in the left eye. Optical coherence tomography angiography (OCTA) revealed obvious saccular parafoveal capillary telangiectasia and capillary dropout as well as decreased vascular density in both superficial and deep capillary plexus. Deep capillary plexus involvement in OCTA was more evident than superficial plexus. Based on the patient's medical history and multimodal imaging, the diagnosis of bilateral IMT type 1 was made. The patient underwent 5 intravitreal monthly injection of bevacizumab in both eyes, which resulted in macular edema resolution. However, after 3 months of discontinuation of intravitreal bevacizumab, macular edema relapsed. In conclusion, type 1 IMT can occur bilaterally in an otherwise healthy female patient as a very rare presentation. To the best of our knowledge, this case is the 4th case of bilateral type 1 IMT reported in a female.
PubMed: 34054487
DOI: 10.1159/000513095