• Title/Summary/Keyword: Delayed Diagnosis

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Surgical treatment of postauricular hidradenitis suppurativa with delayed diagnosis: a case report and literature review

  • Inho Kang;Gyu Yong Jung;Min Jun Yong;Yujin Ahn;Joon Ho Lee
    • Archives of Craniofacial Surgery
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    • v.24 no.2
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    • pp.73-77
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    • 2023
  • Hidradenitis suppurativa (HS) is a chronic inflammatory condition that is difficult to diagnose, with a period of 10.0±9.6 years from symptom onset to diagnosis. A 32-year-old Asian man presented with bilateral postauricular abscesses that first appeared 5 years previously. Despite several incisions and drainage, the symptoms only temporarily improved and continued to recur. On physical examination, chronic scars and sinus tracts were observed around the lesion. Postauricular HS was diagnosed, and surgical treatment was performed. We performed a wide excision and reconstructed the defect using a posterior auricular artery perforator-based keystone flap. Histological examination confirmed the diagnosis of HS. The reconstruction was successful, and there was no recurrence for 2 years after surgery. HS is difficult to diagnose without specific attention. Although the postauricular region is not a typical site of HS, it can occur in this area. Therefore, if a patient presents with recurrent abscesses in the postauricular region, HS should be considered. Additionally, if HS is diagnosed in the postauricular region, wide excision with reconstruction using a posterior auricular artery perforator-based keystone flap can lead to a favorable outcome.

Delayed Diagnosis of a Traumatic Diaphragmatic Injury (지연 진단된 외상성 횡격막 손상 1예)

  • Park, Seon-Wook;Kim, Cheol-Hong;Kim, Ji-Youn;Lee, Seung-Hwa;Kim, Young-Wook;Hyun, In-Gyu;Shin, Ho-Seung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.241-245
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    • 2009
  • Traumatic diaphragmatic rupture is uncommon, but requires a prompt diagnosis and repair. Diaphragmatic injury is most commonly associated with automobile accidents. The diagnosis is difficult and may be delayed because there are no specific symptoms, signs, or radiographic studies that are pathognomic for diaphragmatic injury. The most important factor in the diagnosis is a high suspicion and the use of proper diagnostic studies. We report a case involving the delayed presentation of diaphragmatic rupture in a 54 year old man, requiring surgical repair 12 days following multiple blunt trauma. It should be noted that early recognition for diaphragmatic injury is important in patients with multiple trauma to avoid the potential fatal complications.

A Clinical Study on Differentiation of Syndromes of Amenorrhea or Oligomenorrhea with DSOM (한방진단시스템 DSOM을 이용한 무월경 및 희발월경의 변증진단 연구)

  • Lee, In-Seon;Bae, Geung-Mee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.2
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    • pp.189-208
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    • 2009
  • Purpose: In oriental medicine, doctors have mainly made diagnosis and treatment with amenorrhea or delayed menstrual period based on overall analysis of symptoms and signs patients have. We think patients with amenorrhea or delayed menstrual period to have symptoms that are classified into one differentiation of syndromes, and then studied to make the index. This study has been carried out to investigate pattern identifications and classify symptoms according to them. Methods: We examined 52 patients who visited Dong-eui university oriental medical center from June 2005 to February 2009 for undergoing treatment for amenorrhea or delayed menstrual period and made OB & GY questionnaires up Results: We investigated whether the patients had symptoms concerned with symptom types by analyzing the result of DSOM(Diagnos System of Oriental Medicine, hearafter DSOM). It came out 51 cases among 52 with pathogenesis that was related to the symptom types. The symptom types of were surveyed into Insufficiency of Kidney and Liver(肝腎不足), Insufficiency of Qi and Blood(氣血虛弱), Insufficiency of Yin & Dryness of blood(陰虛血燥), stagnation of Qi and Blood(氣滯血瘀), phlegm and damp(痰濕阻滯), coldness of Blood(血寒), Heat of Heart(心火). Conclusion: As a result of the investigation, one case did not have symptoms of differentiation of syndromes of amenorrhea or delayed menstrual period. 29 cases had 1 or 2 differentiation of syndromes. 21 patients had such complex symptoms of diverse differentiation of syndromes that it was difficult to diagnose a differentiation of syndromes in clinical survey. It is necessary to put the priority among the differentiation of syndromes in diagnosis in the future.

Delayed Diagnosis of Primary Lung Cancer (원발성 폐암의 지연진단에 관한 임상적 고찰)

  • Kim, Sun-Young;Cho, Hae-Jeong;Kim, Geun-Hwa;Ko, Dong-Seok;Suh, Jae-Chul;Shin, Kyoung-Sang;Jeong, Seong-Su;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.754-759
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    • 1998
  • Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.

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Delayed Presentarion of Traumatic Diaphragmatic Rupture (외상성 횡격막 파열의 지연성 발현)

  • Sul, Young Hoon;Moon, Jae Young;Lee, Kyung Ha;Lee, Sang Il;Cheon, Kwang Sik;Lee, Jun Wan;Song, In Sang
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.38-42
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    • 2014
  • Traumatic diaphragmatic rupture is quite uncommon and rarely lethal injury. However, delayed presentation between the injury and the diagnosis can cause a life-threatening condition with various complications such as intestinal hernia, obstruction, strangulation, respiratory distress. Here, we present a case of delayed presentation of traumatic diaphragmatic rupture in a 51-year-old man, and then discuss about the clinical implication of delayed presentation of diaphragmatic rupture with a review.

OLINICAL, RADIOLOGIC, AND HISTOPATHOLOGIC ANALYSIS OF DISEASES DEVELOPED IN DELAYED WOUND HEALING OF EXTRACTION SOCKET (치유가 지연된 발치창에서 발생한 질환에 대한 임상적, 방사선학적, 조직병리학적 분석)

  • Jang, Hyun-Seon;Kim, Su-Gwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.1
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    • pp.15-20
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    • 2001
  • For the earlier diagnosis and treatment of delayed wound healing in extraction socket, we investigated the clinical, radiographic and histopathologic features of 106 patients with delayed wound healing diagnosed by biopsy. The patients were enrolled at the Department of Oral Pathology, Chosun University Dental Hospital. Among 106 delayed wound healing diagnosed by biopsy, cysts showed most significant 25 cases (23%), osteomyelitis showed 13 cases (12%), chronic maxillary sinusitis and squamous cell carcinoma showed 12 (11%) and 11 (10%) cases, respectively. We have analyzed these lesions through relevant literatures.

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Delayed-onset Muscular Paralysis after Cutaneous Herpes Zoster Mimicking Rotator Cuff Tear -Case Report- (회전근개 파열과 유사한 양상을 보인 피부 대상 포진의 지연성 근육 마비 - 증례 보고 -)

  • Oh Joo Han;Gong Hyun Sik;Kim Hyun Ho
    • Clinics in Shoulder and Elbow
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    • v.7 no.2
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    • pp.94-97
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    • 2004
  • Herpes zoster presents clinically with cutaneous vesicular eruption and pain along the dermatome, but it can sometimes cause muscular paralysis. When the disease involves cervical root, it is included in the differential diagnosis of shoulder diseases. A sixty-six year old patient, complaining of severe pain and weakness of his left shoulder, was referred to the authors as having a partial tear of the supraspinatus tendon on MRI. However, the authors found out a paralysis of the sixth cervical root in the patient by electrophysiologic studies, noting that the patient had been affected with a herpes eruption in the neck and arm two months before. Zoster paresis has been reported to be associated with the cutaneous eruption within two weeks of its onset, making its diagnosis not so difficult. The authors report a case of delayed-onset muscular paralysis after cutaneous herpes zoster, which presented just like a rotator cuff tear.

Diagnosis and Treatment of the Eruption Disturbance of posterior teeth (임상가를 위한 특집 1 - 구치부 맹출 장애의 진단과 치료)

  • Yang, Yeon-Mi
    • The Journal of the Korean dental association
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    • v.50 no.6
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    • pp.304-311
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    • 2012
  • Eruption of the teeth can be disturbed by crowding, ectopic eruption path, retention for pathologic condition of follicle and periodontal ligament, local disturbances in the innervation, and delayed eruption for overlying obstacles in the eruption path. Eruption disturbance of permanent posterior teeth is taken with diverse therapeutic approaches according to the patient age, cooperation of patient, tooth position and maturity, degree of impaction, clinical features, and repercussion on the neighboring teeth. However, delayed treatment usually results in less favorable outcomes. Therefore, In order to prevent this situation, periodically radiographic examinations during the early mixed dentition period and early diagnosis of eruption disturbances of permanent posterior teeth are recommended.

Temporomandibular Joint Disorder from Skull Base Osteomyelitis: A Case Report (측두하악관절 장애를 보인 두개저 골수염: 증례보고)

  • Ryu, Byoung-Gil;Yoon, Hyun-Joong;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.484-487
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    • 2012
  • Skull base osteomyelitis is a very rare disease that affects the bone marrow of the temporal bone, sphenoid bone, occipital bone. It occurs typically chronic ear canal infections by malignant otitis externa, but some of atypical osteomyelitis have been reported. It most commonly presents old diabetic patients, and have high morbidity and mortality rate if diagnosis and treatment are delayed. However with respect to pain or dysfunction, it appeared similar to the initial symptoms of temporomandibular joint disorder. So frequently, definitive diagnosis is tend to delayed. We have clinical experience that a patient who presented with symptom similar to temporomandibular disorder, and differential diagnosised by skull base osteomyelitis. We will report this case with literature review.

Delayed diagnosis of a primary intraosseous squamous cell carcinoma: A case report

  • Abdelkarim, Ahmed Z.;Elzayat, Ahmed M.;Syed, Ali Z.;Lozanoff, Scott
    • Imaging Science in Dentistry
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    • v.49 no.1
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    • pp.71-77
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    • 2019
  • Primary intraosseous squamous cell carcinoma is a rare malignant central jaw tumor derived from odontogenic epithelial remnants. Predominantly, it affects mandible, although both jaw bones may be involved. This report describes a 60-year-old man who was initially misdiagnosed with a periapical infection related to the right lower wisdom tooth. After four months, the patient presented to a private dental clinic with a massive swelling at the right side of the mandible. Panoramic radiographs and advanced imaging revealed a lesion with complete erosion of the right ramus, which extended to the orbital floor. A biopsy from the mandibular angle revealed large pleomorphic atypical squamous cells, which is the primary microscopic feature of a poorly differentiated squamous cell carcinoma.