Baço errante com isquemia e trombose do hilo esplênico – Um caso raro

O baço errante é refere-se a um estado de hipermobilidade do baço, anormalmente localizado na parte inferior do abdômen ou na pelve, responsável por 0,2% das esplenectomias, acometendo crianças abaixo dos 10 anos e mulheres em idade fértil.O diagnóstico é essencialmente radiológico. Os achados da tomografia computadorizada e da ressonância magnética são a ausência do órgão no local anatômico e a presença de massa com atenuação/sinal de partes moles no andar inferior do abdome.O tratamento de escolha para o baço errante, quando assintomático, é a esplenopexia e, em casos de urgência, esplenectomia.Os autores descrevem um caso desta doença cujo diagnóstico foi realizado pela ressonância e o tratamento foi realizado de forma conservadora e com sucesso

Lower limb bilateral pyomyositis in a diabetic patient: case report and literature review

Pyomiositis is a bacterial infection of skeletal muscle tissue occurring mostly in immunocompromised pa­tients, including diabetics. The main agents are Gram-positive cocci. We report a case of a 42 years old, male, diabetic, who presented the emergency room referring pain in thighs and inability to flex his legs. We performed a magnetic resonance which revealed extensive purulent collections in both lower limbs, thus confirming clinical suspicion, and allowing proper antibiotic treatment. In this case, we showed that imaging tests facilitate early diagnosis and treatment through direct location of the lesions, and guides invasive procedures such as biopsy and abscess aspiration when needed

Metacarpal stress fracture in amateur tennis player - an uncommon fracture

ABSTRACT Most stress fractures occur in the lower limbs and are rarely observed in the , upper limbs. The second metacarpal is the longest of all the metacarpals and has the largest base, articulating with the trapezium, trapezoid, capitate, and third metacarpal. In athletes, stress fractures in non-weight bearing joints are uncommon. Therefore, the shaft of the second metacarpal bone undergoes a higher load - the maximum tension at the base of the second metacarpal is amplified when the hand grasps a tool such as a tennis racquet

Obustronne ropne zapalenie mięśni (pyomyositis) kończyn dolnych u chorego na cukrzycę: opis przypadku i przegląd literatury

Ropne zapalenie mięśni (pyomiositis) to bakteryjne zakażenie mięśni szkieletowych występujące głównie u osób z obniżoną odpornością, w tym u chorych na cukrzycę. Głównymi czynnikami są ziarniaki Gram-dodatnie. W niniejszej pracy przedstawiono przypadek 42-letniego mężczyzny z cukrzycą, który zgłosił się do izby przyjęć z powodu silnego bólu kończyn dolnych, uniemożliwiającego ich zginanie. Przeprowadzono badanie metodą rezonansu magnetycznego, które ujawniło duże zbiorniki ropy w obu kończynach dolnych, co potwierdziło podejrzenie kliniczne i umożliwiło prawidłowe leczenie antybiotykami. Przypadek ten dowodzi, że badania obrazowe ułatwiają wczesne rozpoznanie i leczenie przez zlokalizowanie zmian oraz w razie potrzeby zapewniają wizualne wspomaganie procedur inwazyjnych, takich jak biopsja i aspiracja ropnia

Cerebral Venous Sinus Stenting for the Treatment of Idiopathic Intracranial Hypertension in a Child

Idiopathic intracranial hypertension (IIH) is a disease characterized by an increase in the opening pressure of the cerebrospinal fluid (CSF) associated with symptoms of elevated intracranial pressure (ICP). The condition is more prevalent in women and typically managed clinically. Surgical treatment is reserved for select refractory cases. The well-established surgical procedures for the management of IIH are CSF shunting and fenestration of the optic nerve sheath. These procedures, however, are associated with high rates of complication and recurrence. More recently, venous sinus angioplasty with stents has been employed in cases with documented narrowing of the sigmoid-transverse sinuses. This technique is associated with a significant reduction in the venous pressure gradient at the stenosis site, alleviating the symptoms of intracranial hypertension. We report a case of a previously healthy 12-year-old patient who presented with 10-day history of headaches, blurring of vision, nausea and vomiting, which evolved with worsening of the visual acuity and papilledema. Imaging scans disclosed stenosis of the right transverse and sigmoid sinuses. The patient underwent stenting of the stenotic venous segments and showed good evolution, with significant clinical improvement within 24 hours of the procedure