Embolization of Ruptured Hepatic Hydatid Cyst to Pulmonary Artery in an Elderly Patient : Multidetector computed tomography findings

Pulmonary embolism due to hydatid disease is an unusual condition resulting from the rupture of a hydatic heart cyst or the opening of liver hydatidosis into the venous circulation. A 78-year old male patient complaining of dyspnea, cough and severe chest pain was admitted to our emergency department. A multidetector computed tomography of the chest revealed the presence of multiple nodules in both lungs especially in left and multiple hypodense filling defect in left main pulmonary artery and its branches. In addition, coronal reformatted multidetector computed tomography images also showed two hypodense cystic parenchymal masses on the left lobe of the liver with a cystic embolus in the right atrium. Pulmonary embolism should be kept in mind in patients who have hepatic hydatidosis if suddenly chest pain and dyspnoea occurs, especially in regions where hydatidosis is endemic

A biomechanical comparison of two cephalomedullary nails; one using a single lag screw with antirotator blade and a nail using two lag screws for unstable intertrochanteric fractures

Background: Implant choice for fixation of intertrochanteric fractures remains controversial despite being one of the most commonly performed operations. Although use of sliding hip screws is still considered a gold standard in treatment of these fractures, there is a wide tendency in using cephalomedullary nails because of their biomechanical superiority over sliding hip screws. This trial was initiated in order to compare the biomechanical properties of two different cephalomedullary nails, aPFN and the PROFIN under axial loading, based on the questions that can a single lag screw with an antirotator blade render better rotational stability? Is there a difference between one lag screw or two lag screws with respect to superior migration or cut-out of the screws? And do different nail designs cause different types of failure and what are the pros and cons of classical and new designs from the view point of biomechanical aspects?Methods: Ten pairs of third generation synthetic bone models simulating unstable intertrochanteric fracture were used for biomechanical testing.Results: No posterior displacement of screws was recorded in both groups suggesting rotational unstability.  There was not a significant difference between forces values loaded at the time of failure.Conclusions: Although there was no statistically significant difference between compressive strengths at the time of failure, aPFN may provide equal rigid fixation with less possible cut-out which may have an important consequences in real clinical applications

A case of diaphragmatic mesothelial cyst with US and MRI findings

[Arch Clin Exp Surg 2015; 4(3.000): 176-177

Type 3B Malrotation Presented With Acute Appendicitis As Left Renal Colic

Midgut malrotation is a rare anatomic anomaly that complicates the diagnosis and managemant of acute abdominal pain. It is a congenital anomaly that arises from incomplete rotation or abnormal position of the midgut during embryonic development. We report a case of a patient who have very rare form (Nonrotation of the proximal loop associated with partial rotation of the distal loop) of malrotation with ruptured appendicitis. Left-sided acute appendicitis should be considered in the differential diagnosis of patients with pain with localized in the left lower quadrant.PubMe

Evalution of renal involvement in patients with Behçet disease : need to be aware about potential hypertension in long term follow up?

BACKGROUND: The aim of this study was to evaluate frequency and severity of kidney involvement with some clinical, ultrasonography and color Doppler measurements in patients with Behçet disease. MATERIAL AND METHODS: This study was including 32 patients with Behçet disease and 32 healthy sex and age-matched control subjects. Patients were divided into two groups as period of disease 0-6 years and 7 years and above to evaluate effect of duration of disease. We evaluated some biochemical tests in both blood and urine related to renal functions, blood pressure values. Gray scale and color Doppler findings were noted. RESULTS: Renal artery volume flow in patients with a duration of 7 years or above was significantly decreased compared to control group (p<0.05). However, gray scale ultrasound and color Doppler measurements reveal there was not statistically significant change compared to control group. There was no biochemical abnormalities in any patient. Four patients had elevated blood pressure but mean blood pressure values were not statistically different compared to volunteers. CONCLUSIONS: Renal involvement ratios varies in different studies but not common. End stage renal failure can be seen very rare. Furthermore, vasculitic changes can lead renal artery narrowness and can result to decrease in renal blood flow. It has a potential to activate renin angiotensin aldosterone cascade to elevate blood pressure. We must be aware about blood pressure of patients with Behçet disease, especially with long term follow up

Successful Treatment With Enoxaparin of Glans Ischemia Due to Local Anesthesia After Circumcision

The severe ischemia or necrosis of the glans penis is a rarely seen complication after circumcision. We report the case of a 7-year-old boy with severe glans penis ischemia occurring 24 hours after circumcision with local anesthesia (0.1% xylocaine containing ephedrine). His hemogram and levels of proteins C and S and fibrinogen were normal, but the D-dimer level was higher than normal (2.57 mg/L; normal level 0-0.5 mg/L). Normal blood flow was indicated on color Doppler ultrasonography. The severe ischemia in the glans penis was successfully treated with subcutaneous injection of enoxaparin (low-molecular-weight heparin) for 5 days, and the appearance of the glans was close to normal on the fifth day. The patient did not require any surgical intervention and was discharged without sequelae. As a result, we consider that ischemia of the glans penis may initially be managed with enoxaparin, especially in cases in which the D-dimer level is higher than normal. Pediatrics 2013; 131: e608-e61

Zoledronic acid: Treatment option for Gorham-Stout disease

Gorham-Stout disease is arare bone resorption disease, the etiology and prognosis of which is uncertain but it is thought to be benign. It can involve one or more bones and can cause pain, swelling, deformity and fractures in affected bones. Diagnosis is made with acombination of clinical, radiological and histopathological examinations once other causes of osteolysis have been excluded. Due to its rarity, there is no standard therapeutic approach. ZusammenfassungDas Gorham-Stout-Syndrom ist eine seltene Erkrankung, bei der es zu einem Knochenabbau kommt. Atiologie und Prognose sind ungewiss, aber es gilt als benigne. Es kann ein oder mehrere Knochen betreffen, dabei kann es zu Schmerzen, Schwellungen, Deformitaten und Frakturen in den betroffenen Knochen kommen. Die Diagnose wird anhand einer Kombination aus klinischen, radiologischen und histopathologischen Untersuchungen gestellt, sofern andere Ursachen fur die Osteolyse ausgeschlossen wurden. Aufgrund seiner Seltenheit gibt es keine Standardtherapie fur diese Erkrankung