RESUMO
Pott's puffy tumor, a rare complication of frontal sinusitis, poses a diagnostic challenge due to its infrequency and diverse clinical manifestations. Recognizing this condition promptly is crucial due to the potential for severe neurological compromise. We present the case of a 32-year-old male who presented with a one-week history of frontal headache, tenderness, and swelling following an upper respiratory tract infection. The physical examination revealed a tense, erythematous swelling over the frontal region. Laboratory results showed elevated inflammatory markers. Computed tomography revealed an epidural abscess secondary to frontal sinusitis. An emergent craniotomy was performed to evacuate the collection, followed by intravenous antibiotic therapy. The patient recovered with no neurological deficits. This case emphasizes the importance of considering Pott's puffy tumor in patients with frontal swelling and associated symptoms. Despite its rarity, a multidisciplinary approach involving imaging, microbiological analysis, and surgical intervention enables an accurate diagnosis and successful management. Timely recognition and appropriate treatment, including surgical drainage and targeted antibiotics, are critical for achieving favorable outcomes.
RESUMO
The spleen is typically located in the left upper quadrant and is held in position by the suspensory ligaments, which include the gastrosplenic ligament, the splenorenal ligament, and the phrenicocolic ligament. Abnormalities within these ligaments result in the mobility of the spleen, so it may be located in the pelvis or iliac region, which is termed a wandering spleen. We present a case of a middle-aged man who presented to the emergency department with generalized abdominal pain and diffuse guarding and tenderness. The patient had a previous history of peptic ulcer disease and multiple emergency department visits for gastritis. Given the assumed diagnosis of perforated viscus, the patient underwent a computed tomography scan that demonstrated the absence of the spleen in its usual location and showed an ectopic pelvic spleen. The patient underwent successful surgical treatment with splenopexy. The wandering spleen is a rare medical condition that presents a clinical diagnostic challenge and requires a high index of suspicion. Despite its rarity, the wandering spleen should be considered in patients with recurrent abdominal pain.