• Title/Summary/Keyword: Delayed Diagnosis

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Delayed Diagnosis of Traumatic Rupture of Anterior Papillary Muscle of Tricuspid Valve; Importance of Trans-Esophageal Echocardiogram in the Evaluation of Major Blunt Chest Trauma

  • Bylsma, Ryan;Baldawi, Mustafa;Toporoff, Bruce;Shin, Matthew;Cochran-Yu, Meghan;Ramsingh, Davinder;Parwani, Purvi;Rabkin, David G.
    • Journal of Trauma and Injury
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    • v.34 no.2
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    • pp.136-140
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    • 2021
  • We present a case of delayed diagnosis of traumatic tricuspid valve rupture in a patient who was emergently brought to the operating room for repair of lacerations to the heart and liver without intraoperative transesophageal echocardiography (TEE). Initial postoperative transthoracic echocardiography (TTE) did not show structural pathology. One week later, TTE with better image quality showed severe tricuspid regurgitation. Subsequently, TEE clearly demonstrated rupture of the anterior papillary muscle and flail anterior tricuspid leaflet. The case description is followed by a brief discussion of the utility of TEE in the setting of blunt thoracic trauma.

Management of Ameloblastic Fibro-odontoma Associated with Impacted Tooth in the Posterior Mandible: Case Reports

  • Gahui, Jeong;Nanyoung, Lee;Myeongkwan, Jih;Hyewon, Shin
    • Journal of Korean Dental Science
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    • v.15 no.2
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    • pp.172-180
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    • 2022
  • Ameloblastic fibro-odontoma (AFO) is a rare odontogenic tumor, which occurs in young children before the age of 20 years. Radiologically, it is a well-defined radiolucent lesion containing radiopaque masses. Histopathologically, AFO is composed of odontogenic epithelium in a primitive-appearing connective tissue and hard tissue consisting of enamel and dentin. It is commonly found in the mandibular posterior region. AFO may be asymptomatic and is often associated with delayed tooth eruption. As it shows similar characteristics clinically and radiologically to odontoma, differential diagnosis through histopathological examination is important. Treatment of AFO is conservative enucleation, and teeth enclosed or associated with the lesion may require extraction. In this report, 2 young patients who visited our clinic with a chief complaint of delayed eruption were diagnosed as AFO with radiological and histopathological examination. After the surgery, the healing status was found to be favorable, and no evidence of recurrence was observed.

Chronic Longitudinal Rupture of the Tibialis Anterior Tendon: A Case Report (외상 후 발생한 전경골건의 진구성 종파열: 증례 보고)

  • Jiyoun Kim
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.3
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    • pp.99-102
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    • 2023
  • Acute rupture of the tibialis anterior tendon is rare, but the diagnosis is often delayed when it occurs. Acute rupture of the tibialis anterior tendon is often caused by minor trauma or it occurs spontaneously. Therefore, the diagnosis is more likely to be delayed. Among ruptures of the tibialis anterior tendon, longitudinal ruptures are less common and difficult to diagnose. Thus far, there are no reports of ruptures of the tibialis anterior tendon caused by direct trauma in Korea. This paper reports a case of chronic longitudinal tear of the tibialis anterior tendon caused by trauma in a 50-year-old male patient with no specific history of the disease, along with a review of the relevant literature.

Dental Prosthesis Causing Pneumonia in a Delirious Elderly Patient after Hip Fracture Surgery (고관절 골절 수술후 발생한 섬망환자의 치과보철물에 의한 폐렴)

  • Lee, Young-Kyun;Ha, Yong-Chan;Koo, Kyung-Hoi
    • Journal of Trauma and Injury
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    • v.25 no.3
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    • pp.97-100
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    • 2012
  • We report a case of delayed diagnosed pneumonia due to an aspirated metallic crown, which had been detached from a molar tooth. Dental prosthesis should be checked and a careful review of the chest radiograph is mandatory when an elderly patient with delirium after hip fracture surgery develops pneumonia postoperatively.

Two Cases of Delayed Tension Pneumocephalus

  • Hong, Won-Jin;Yoo, Chan-Jong;Park, Cheol-Wan;Lee, Sang-Gu
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.59-62
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    • 2005
  • We describe two cases of tension pneumocephalus, one caused by ventriculoperitoneal shunt for communicating hydrocephalus, and the other caused by craniocerebral trauma. In the first case report, we examined the relationship between cerebrospinal fluid leakage and delayed onset tension pneumocephalus. The second case report, we addressed issues such as the diagnosis, management, and pathogenesis, as well as computerized tomography(CT) findings.

Hypertrophic Pyloric Stenosis Occurring in Fasting State with Gastrostomy After Surgery for Esophageal Atresia with Tracheoesophageal Fistula (선천성 식도 폐쇄 환자에서 출생 후 위루관 삽입술과 계속적인 금식상태에서 근본수술 후 발생한 비후성 유문 협착증 - 1예 보고 -)

  • Jung, Eun-Young;Choi, Soon-Ok;Park, Woo-Hyun
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.88-92
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    • 2011
  • The onset of hypertrophic pyloric stenosis in the postoperative course of esophageal atresia with tracheoesophageal fistula is rarely reported. The diagnosis could be delayed due to its mimicking symptoms of other postoperative complications including gastroesophageal reflux or anastomotic stricture. We present an infant who had surgery for esophageal atresia with tracheoesophageal fistula. He had never fed since birth. The infant presented with an increased amount of orogastric tube drainage and consistently distended gastric air on simple abdominal X-ray. Abdominal ultrasonography showed hypertrophic thick pyloric muscle. The diagnosis of pyloric stenosis was confirmed d is rarely reported. The diagnosis could be delayed due to its mimicking symptoms of other postoperative complications including gastroesophageal reflux or anastomotic stricture. We present an infant who had surgery for esophageal atresia with tracheoesophageal fistula. He had never fed. The infant presented with uring surgery, After pyloromyotomy, the patient's condition improved.

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Clinical Analysis of Traumatic Pyomyositis in Emergency Patients (응급실로 내원한 외상성 화농성 근염 환자의 분석)

  • Na, Ji Ung;Song, Hyoung Gon
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.81-88
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    • 2006
  • Purpose: Pyomyositis is a rare disease in temperature climate region. The diagnosis of pyomyositis is often delayed, and pyomyositis is often misdiagnosed in the emergency department. Methods: The medical records of 11 patients who were diagnosed as having traumatic pyomyositis in the emergency department at Samsung Medical Center in Seoul, Korea, between 2000 and 2006 were reviewed. Their clinical features, such as history, symptoms, clinical findings, duration from onset of symptoms to diagnosis, medical history, laboratory data, results of imaging studies and clinical course were collected. Results: The psoas muscles were most commonly involved. Computer tomography and magnetic resonance imaging aided in accurate diagnosis of the infection and of the extent of involvement. Incision, drainage, and antibiotics therapy eradicated the infectioin in all patients Conclusion: Pyomyositis should be a part of the differential diagnosis for patients with traumatic muscle pain. Radiologic evaluation, such as computer tomography and magnetic resonance imaging, must be considered in the diagnosis of traumatic pyomyositis.

Iatrogenic Ureteral Injury: When and How to Treat? (의인성 요관손상: 언제, 어떻게 치료할 것인가?)

  • Seo, Kang Il;Lee, Jong Bouk
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.8-14
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    • 2008
  • Iatrogenic ureteral injury is a complication that can occur during a variety of pelvic or abdominal surgeries. The most frequent causes are gynecological ones, followed by colon and vascular surgeries. Management of ureteric injury depends on the time of diagnosis and the severity of organ damage. Injuries diagnosed intraoperatively should be treated immediately. Occasionally, intraoperative ureteral injury is overlooked, and symptoms of the late diagnosis of ureteral injury are usually nonspecific; therefore, the diagnosis is delayed for days or weeks postoperatively. Management of injuries diagnosed postoperatively is more complex. There are differing opinions on whether an initial conservative or immediate operative intervention is the best line of action. Delayed repair is suggested on the grounds that it will reduce inflammation and tissue edema. However, many authors are in favor of early repair, perhaps because tissue planes are easier to find before fibrosis becomes too dense. Ureteral injuries occurring at the level of the pelvic brim should be best managed with an end-to-end anastomosis, preferably around a ureteric stent. More distal injuries also should be ideally managed with an end-to-end anastomosis, after excision of the crushed or compromised segments. However, if the remaining distal segment is short, ureteral reimplantation is the procedure of choice. The Boari flap technique for ureteral reimplantation is invaluable in cases with a short proximal segment. Delayed recognition of iatrogenic ureteral injury may be associated with serious complications, so prompt recognition of ureteral injuries is important. Recognition of the injury before closure is the key to easy, successful, and complications-free repair. Increased awareness of the risk for ureteral damage during certain operative maneuvers is vital to prevent injury, and to decrease the incidence of iatrogenic injury. A sound knowledge of abdominal and pelvic anatomy is the best prevention.