ABSTRACT
Intramuscular hemangiomas are benign lesion that rarely occurs within the skeletal muscle of the head and neck regions. These lesions present with nonspecific symptoms resulting in only a few instances of accurate preoperative diagnosis. Case Presentation: A 20-year-old male presented with swelling over the nape of the neck on the right side. On clinical examination, the solitary swelling was 4×4 cm on measurement, soft on consistency with regular margin, fluctuant, with no skin changes over the swelling, nontender, no restriction in range of motion of the neck, and no pulsation felt. Clinical Findings and Investigations: Ultrasonography and contrast-enhanced MRI revealed intramuscular hemangioma involving the right splenius capitis muscle with no extension to adjacent muscles and minimal extension to the subcutaneous tissue. Interventions and Outcome: Excision of the lesion along with splenius capitis was performed with stable postoperative hemodynamics. Conclusion: Since intramuscular hemangiomas pose a challenge in preoperative diagnosis, it requires the sensible use of imaging modalities. Although several treatment modalities have surfaced, intramuscular hemangiomas require definitive operative management to reduce their recurrence.
ABSTRACT
Injuries from animal attack are one of the major public health problems at present scenario globally. Proper documentation is required for the study of different types of injuries caused by animal attacks so that early intervention can be done during life-threatening conditions. Case Presentation: A 36-year-old male presented with an alleged history of attack by two rhinoceros sustaining injuries over the abdomen, chest, shoulder and thigh. Clinical Findings and Investigations: There was a lacerated abdomen with evisceration of the stomach, small intestine, transverse colon and omentum and a lacerated wound over the left lateral thigh and left buttock along with the right shoulder. Extended Focused Assessment with Sonography in Trauma ultrasound showed minimal free fluid in the pelvis. Blood profile revealed reduced haemoglobin and deranged prothrombin time/international normalized ratio. Interventions and Outcome: Patient underwent exploratory laparotomy twice with repair of diaphragmatic injury, excision of avulsed greater omentum in the first setting and repair of gastric perforation in the second setting with stable haemodynamic status. Conclusion: Abdominal evisceration injury by rhinoceros attack is life threatening though rare. Its management should consist of assessing for and controlling associated haemorrhage, assessing for bowel content leakage, covering the eviscerated abdominal contents and early reduction of viscera if there is no active bleeding.
ABSTRACT
a Introduction and Importance: Angiomyolipomas of kidney are benign lesions that are generally an incidental finding on imaging. Rupture of angiomyolipoma is rare and fatal complication that requires early intervention. b Case Presentation: A 38 year old male patient presented with symptoms of right flank pain for 2 days. On clinical examination patient looked anxious, pale with right flank tenderness, guarding and signs of shock. c Clinical findings and investigations: CT scan showed renal angiomyolipoma with aneurysm formation and bleed from the lesion. Blood profile revealed low hemoglobin. d Interventions and Outcome: Right nephrectomy performed along 6 cycles of cardiopulmonary reususcitaion done with stable post operatively vitals. e Conclusion: Early diagnosis of complication of angiomyolipoma requires thorough clinical examination and judicious use of imaging. Immediate embolization or surgery must be performed for better outcome and survival rate.
