Retraction: Lipoma Growing on the Back for 26 Years: A Bizarre Case Report.

[This retracts the article DOI: 10.7759/cureus.56999.].

The Miraculous Diagnostic Role of Indocyanine Green in a Diabetic Foot Ulcer: A Rare Case Report.

Diabetes is a chronic metabolic disorder characterized by elevated levels of glucose in the blood. This causes small nerve polyneuropathy resulting in diabetic foot ulcers. A diabetic foot ulcer is an open sore or wound that develops as a result of chronic diabetes. Indocyanine green angiography (ICGA) near-infrared (NIR) can provide real-time visualization of blood flow within the microvasculature of the underlying organ. Here, we discuss a 63-year-old patient who came with a diabetic foot ulcer over his right great toe. His blood glucose level was 208 mg/dl. He drinks alcohol occasionally and smokes regularly. The tissue perfusion of his right foot was checked using the indocyanine green dye, after which orthopedic surgeons were consulted, and the gangrenous part was amputated.

Lipoma Growing on the Back for 26 Years: A Bizarre Case Report.

Lipoma is one of the most typical and benign tumors. They are typically regarded as a mass that is painless, asymptomatic, and slow-growing. It is composed of fat cells of the adult type. It can occur anywhere in the body and is often called a "universal" or ubiquitous tumor. They can develop in any region containing adipose tissue, with a higher prevalence in the subcutaneous tissue of the trunk and the nape of the neck and the limbs and occasionally in other locations, including the hand. There are three main varieties: encapsulated, diffuse, and multiple lipomas. A few lipomas may contain other tissues: fibrolipoma, neurolemma, and myelolipoma. Lipoma, when present for a long time, may undergo certain changes. This is particularly true in cases of lipoma under subcutaneous tissues of the thigh, buttock, or retroperitoneal lipoma. Such changes can be malignant, sarcomatous, calcification, or saponification. Clinically, a lipoma can occur in different anatomical situations; according to this, a lipoma can be classified into subcutaneous type, subfascial type, intramuscular type, subserous type, submucous type, intra-articular type, or it can be intraglandular. Lipomas, the most prevalent benign mesenchymal tumors, consist of mature lipocytes. Typically, lipomas are small, weighing only a few grams, with a maximum diameter usually under 2 cm. The term "giant" is applied when a lipoma reaches a diameter of at least 10 cm or weighs a minimum of 1,000 g. Due to their substantial size, giant lipomas can lead to functional limitations, such as lymphedema, pain syndromes, or nerve compression. Given the unique nature of this condition, characterized by the considerable size of the lesion and the challenges in both diagnosis and treatment, we present a case involving a 45-year-old woman with a giant lipoma in the suprascapular region.

Role of Indocyanine Green in Diagnosing Diabetic Ulcer: A Case Report.

Diabetic foot is a syndrome complex that presents with a serious complication arising from a diabetic ulcer. Poor blood circulation and nerve injury (neuropathy), especially in the limbs, can result from persistently elevated blood sugar levels. These elements play an important role in the formation of diabetic ulcers, which frequently occur on the feet and are prone to infection and sluggish healing. These ulcers have the potential to worsen and develop diabetic foot, a more serious ailment if left untreated. Diabetic foot issues can lead to increased vulnerability to infections, gangrene, and in severe cases, amputation. Diabetes patients may fail to notice small wounds or infections because of reduced feeling from neuropathy, which can lead to more serious problems. Moreover, decreased blood flow makes it more difficult for the body to mend itself, which makes diabetic foot issues more difficult to manage and cure. Glycemic management, timely medical intervention, and routine foot care are essential for preventing and lessening the severe effects of diabetic foot. We herein highlight the case of a 57-year-old male with a traumatic diabetic foot in whom indocyanine green (ICG) dye was used to identify the uptake of the involved tissue. The aspect of this case is the late presentation of a patient with uncontrolled diabetes. Further, we can better manage the patient in the preoperative phase by using ICG.

The Wonder Dye: Uses and Implications of Indigocyanine Green in Various Surgeries.

Indigocyanine green (ICG) is a fluorophore dye that has been extensively used in recent modern times for bioimaging in numerous surgeries to aid in easier identification of occult and often tricky-to-find anatomical structures. Surgery becomes complex and challenging due to multiple anatomical anomalies, pathological fibrosis, obesity, or previous surgeries. To overcome these obstacles in surgery, the surgeon yearns to know the structures present beyond their white light vision so that while dissecting the organ, they can avoid injuring the critical systems in the vicinity of dissection. Near-infrared (NIR) imaging aids in visualising the tissues at depth/in the area of dissection, thereby preventing any possible surgical catastrophes due to them inadvertently damaging surrounding vital structures. Various advantages in surgeries like gastric sleeve surgery, lymph node and tumour detection, localisation of ureters and biliary tracts, and intraoperative tissue perfusion of flaps have been described in this study. This review article aims to compile a short list of utilities of ICG with NIR imaging in various surgical interventions. The merits and demerits of this imaging technique have been noted. The study points out the uses of ICG fluorescence imaging under different surgical fronts. This review article concludes by comparing the results of studies performed by various authors. Results have been compared to conventional surgical modalities.

Limy Bile Syndrome: A Report of a Rare Case.

Milk of Calcium Bile or Limy Bile Syndrome (LBS) is a sporadic and infrequent complication of cholecystitis in which the gallbladder is filled with radio-opaque, abnormal bile secretion. A 40-year-old female came to a tertiary care hospital with symptoms of recurrent pain upper abdomen for two years. On examination, the patient had mild jaundice and mild tenderness at Murphy's point exacerbated on deep inspiration. Laboratory investigations suggested raised levels of bilirubin and hepatic enzymes. Upper GI endoscopy revealed a normal GI tract. A hepatobiliary iminodiacetic acid-cholecystokinin (HIDA-CCK) scan suggested a gallbladder ejection fraction of 5%. Cholecystectomy was done the next day. Infrared imaging under Indocyanine green (ICG) dye revealed a completely dark gallbladder. The patient was asked to take ursodeoxycholic acid preparation post-operatively for four weeks. This case of LBS was discharged on the third postoperative day. She was asked to regularly follow up with the surgeons. LBS is a rare patho-clinical entity with a need for standardized diagnostic and treatment regimen. Further case reporting and studies are required to understand the disease in more depth.