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Here, we present a description of Poland syndrome from the second session of the Anatomical Society (Paris, France) on 11 December 1803 of congenital mammary absence and muscular atrophy on the right side. This case report predates the first official description of the disease published by Alfred Poland in Guy's Hospital Reports (London, 1841). Consequently, perhaps would it be necessary to do justice to its French discoverer, and to name from now on this nosological entity the "syndrome of Marandel"?
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Síndrome de Poland/história , Anatomia/história , Mama/anatomia & histologia , Feminino , França , História do Século XIX , Humanos , Músculos Peitorais/anatomia & histologia , Sociedades Científicas/históriaRESUMO
Background/Aim: Intestinal malrotation (IM) often remains undetected until adulthood, being discovered during testing or surgery for other comorbidities. Preoperative understanding of this anatomical abnormality is crucial. Case Report: An 80-year-old woman presented with cecal cancer. Three-dimensional computed tomography (CT) revealed that the cecum was located at the midline of the abdominal cavity, the duodenum did not cross the midline, and the ileocolic vein ran to the left. Clinically diagnosed with stage IVc cecal cancer complicated by IM, the patient underwent laparoscopic surgery. The ascending colon and cecum were not fixed to the retroperitoneum. The duodenum lacked the second, third, and fourth portions and the small bowel was distributed on the left and right sides of the abdominal cavity. Adhesions had shortened the mesentery, which were released close to their normal positions. Conclusion: Although laparoscopic surgery is superior to open surgery in terms of securing the field of view in a narrow space, providing a magnifying effect, and minimal invasiveness, it has a limited field of view and is inferior in terms of grasping the overall anatomy, which may be disadvantageous in cases of anatomical abnormalities. Colorectal cancer with IM is rare; however, the rate of preoperative diagnosis seems to be increasing thanks to improvements in diagnostic imaging, such as three-dimensional CT scans. In this study, we also reviewed 49 cases of colorectal cancer associated with IM.
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Purpose: The purpose of this study was to investigate the incidence of anomalies in patients who underwent endoscopic carpal tunnel release and their relationship with clinical outcomes. Methods: This retrospective study included 65 hands of 57 patients (8 men and 49 women; mean age, 64.9 years) who underwent endoscopic carpal tunnel release for carpal tunnel syndrome at our hospital between March 2016 and April 2022. The patients were diagnosed with carpal tunnel syndrome based on clinical observations and electrophysiological studies. On T2-weighted magnetic resonance axial images, the height of the hook of the hamate was measured from the bottom to the tip of the hook, and the total height of the hamate was measured from the dorsal surface of the hamate to the tip of the hook. A hook-to-height ratio of less than 0.34 was defined as hypoplastic, and its incidence was investigated. In addition, electrodiagnostic testing of sensory and motor nerve conduction of the median nerve and patient-reported outcome measurements, including Quick Disabilities of the Arm, Shoulder and Hand score, Boston carpal tunnel questionnaire, and visual analog scale score, were investigated at 6 months after surgery. Adverse events were collected from patient records. Results: The mean hook-to-height ratio was 0.40. Hypoplasia with a ratio ≤0.34 was observed in seven hands (10.8%), and adverse events were observed only in the two cases that had a hypoplastic hook of the hamate (3.07%). The patient-reported outcome measurements and the result of electrodiagnostic testing at 6 months after surgery did not correlate with the height of the hook of the hamate. Conclusions: The incidence of a hypoplastic hook of the hamate is common in patients with carpal tunnel syndrome, and preoperative evaluation of the morphology of the hooks and indications for endoscopic carpal tunnel release in cases of hypoplastic hooks may help predict adverse events. Type of study/level of evidence: Therapeutic â £.
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Splenic infarction (SI) is often associated with circulatory and hematological diseases and infections. Here, we report a rare case of SI in an adult with infectious mononucleosis (IM) caused by the Epstein-Barr (EB) virus. A 31-year-old male with an unremarkable medical history presented with abdominal pain and fever. Contrast-enhanced computed tomography revealed focal SI. The splenic artery branching from the superior mesenteric artery was <5 mm in diameter. The diagnosis of EB virus infection was made based on physical examination and blood test results. As no evidence of cardiogenic disease, malignant lymphoma, or other infections were present, a diagnosis of SI associated with IM was made. A symptomatic treatment was administered, and the splenomegaly and SI improved two weeks after discharge. IM was assumed as the cause of the focal SI.
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Behçet's disease (BD) is a systemic disease of inflammatory origin that appears most often in the third or fourth decade of life. Behçet's disease is hallmarked predominantly by mucocutaneous lesions and ocular involvement. Vertebral artery dissection and neurological manifestations are rare complications in Behçet's disease. We examine the case of a medically free 33-year-old male who was admitted to the emergency department complaining of sudden-onset dizziness, vomiting, and tinnitus. Neurological examination revealed fluctuating consciousness, multiple gaze nystagmus, motor deficit in the upper and lower limbs, bilateral Babinski sign, and truncal ataxia. Magnetic resonance imaging (MRI) showed a right pontine hyperintense lesion on T2-weighted images (T2WI). A right vertebral angiogram four months after the incident showed a dissection in the mid-cervical third of an anomalous duplicated origin arm of the right vertebral artery. This case describes an uncommon form of initial presentation of Behçet's disease via a pontine infarction triggered by a dissecting aneurysm in an anatomically rare variant of the vertebral artery.
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BACKGROUND: An extremely tortuous superior cerebellar artery is a rare anomaly. We report a case of an extremely tortuous superior cerebellar artery mimicking an aneurysm. CASE DESCRIPTION: A 77-year-old woman was initially diagnosed with unruptured cerebral aneurysm at the right basilar artery-superior cerebellar artery junction by magnetic resonance angiography. Catheter angiogram revealed that there was no apparent aneurysm at the basilar artery-superior cerebellar artery junction and the lesion was actually an extremely tortuous superior cerebellar artery. CONCLUSION: Although an extremely tortuous superior cerebellar artery is rare, it should be considered when examining other vascular lesions.
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This report describes the case of a 45-year-old woman with Noonan syndrome who developed cubital tunnel syndrome secondary to hypoplasia of the humeral trochlea. Cubital tunnel syndrome, the second-most common peripheral compression neuropathy, is caused by compression of the ulnar nerve at the elbow. Noonan syndrome, an autosomal dominant multisystem disorder, is characterized by variable cognitive deficit and skeletal, ectodermal and hematologic anomalies. Results show three distinctive anatomical features such as (1) hypoplasia of the humeral trochlea and medial epicondyle, (2) absence of the medial intermuscular septum and (3) lack of Osborn's ligament.
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Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has been utilized as an alternative endoscopic technique for patients with acute cholecystitis. In addition to EUS-guided hepaticogastrostomy and EUS-guided cystogastrostomy, EUS-GBD has been reported as being useful for biliary drainage in cases with distal malignant biliary obstruction instead of conventional endoscopic retrograde cholangiopancreatography. We present a case of successful EUS-GBD for malignant obstruction of an aberrant hepatic duct draining directly into the cystic duct.
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BACKGROUND: Reversed rotation of the midgut is the rarest variation of midgut malrotations, which are congenital disorders that result from aberrant rotation and fixation of the midgut during embryological development. Common complications of these disorders are small bowel obstruction by volvulus or peritoneal bands, usually occurring in early infancy. CASE PRESENTATION: A 23-year-old Caucasian woman presented with recurrent abdominal pain. A contrast-enhanced multidetector computed tomography study revealed a novel variant of reversed rotation of the midgut. Besides the specific finding of a retro-arterial transverse colon, we also found the proximal jejunum to cross posterior to the mesenteric root, a variation that has not been reported in the literature so far. In this case, substantial symptomatic relief was achieved with conservative management. CONCLUSIONS: The hypothesis of a double reversed rotation of the pre-arterial segment of the umbilical loop around the superior mesenteric artery axis provides a possible explanation for this anomaly. There is no evidence-based consensus on the management of patients presenting with non-symptomatic or mildly symptomatic intestinal malrotations. In this case, radiologic and clinical presentations excluded acute small bowel obstruction, and surgical intervention was avoided.
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Dor Abdominal/etiologia , Colo Transverso/diagnóstico por imagem , Anormalidades do Sistema Digestório/diagnóstico por imagem , Volvo Intestinal/diagnóstico por imagem , Jejuno/diagnóstico por imagem , Dor Abdominal/terapia , Colo Transverso/anormalidades , Colo Transverso/enzimologia , Anormalidades do Sistema Digestório/complicações , Anormalidades do Sistema Digestório/embriologia , Feminino , Humanos , Volvo Intestinal/congênito , Jejuno/anormalidades , Jejuno/embriologia , Tomografia Computadorizada Multidetectores , Recidiva , Rotação , Adulto JovemRESUMO
PURPOSE: The anatomical anomaly of the number of vertebral bones is one of the major anomalies in the human body, which can cause confusion of the spinal level in, for example, surgery. The aim of this study is to develop an automatic detection system for this type of anomaly. METHODS: We utilized our previously reported anatomical landmark detection system for this anomaly detection problem. This system uses a landmark point distribution model (L-PDM) to find multiple landmark positions. The L-PDM is a statistical probabilistic model of all landmark positions in the human body, including five landmarks for each vertebra. Given a new volume, the proposed algorithm applies five hypotheses (normal, 11 or 13 thoracic vertebrae, 4 or 6 lumbar vertebrae) to the given spine and attempts to detect all the landmarks. Then, the most plausible hypothesis with the largest posterior likelihood is selected as the anatomy detection result. RESULTS: The proposed method was evaluated using 300 neck-to-pelvis CT datasets. For normal subjects, the vertebrae of 211/217 (97.2%) of the subjects were successfully determined as normal. For subjects with 23 or 25 vertebrae without a transitional vertebra (TV), the vertebrae of 9/10 (90%) of the subjects were successfully determined. For subjects with TV, the vertebrae of 71/73 (97.3%) of subjects were judged as partially successfully determined. CONCLUSION: Our algorithm successfully determined the number of vertebrae, and the feasibility of our proposed system was validated.
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Vértebras Lombares/diagnóstico por imagem , Reconhecimento Automatizado de Padrão , Intensificação de Imagem Radiográfica/métodos , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Algoritmos , Humanos , Modelos Anatômicos , Modelos Estatísticos , ProbabilidadeRESUMO
Superior Thyroid Artery (STA) usually arises from the ventral surface of the External Carotid Artery (ECA) just below the level of tip of greater cornu of hyoid bone and it runs anteriorly, downwards and medially. Lingual artery arises at the level of tip of greater cornu of hyoid bone and it runs anteriorly, upwards and medially. Rarely, both STA and lingual artery may originate as a common trunk called thyrolingual trunk. But a thyrolingual trunk arising from Common Carotid Artery (CCA) is very rare. We report a case of patient diagnosed to have carcinoma of right lower alveolus with nodal recurrence; with thyrolingual trunk arising from the medial aspect of CCA, which was detected incidentally during neck dissection.
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BACKGROUND: There are several anatomical variations of the pulmonary vein which can cause serious complications in pulmonary lobectomy. CASE PRESENTATION: We inadvertently divided the left superior pulmonary vein during thoracoscopic left lower lobectomy in a lung cancer patient. Retrospective review of the preoperative computed tomography showed extra-pericardial common trunk of the left pulmonary venous system. Left superior pulmonary vein was reimplanted into stump of divided common trunk via thoracotomy. CONCLUSIONS: Awareness of vascular anomalies will help thoracic surgeons to prevent potential morbidity and mortality from complications.
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Complicações Intraoperatórias , Neoplasias Pulmonares/cirurgia , Erros Médicos , Pneumonectomia/efeitos adversos , Veias Pulmonares/lesões , Idoso , Humanos , Complicações Intraoperatórias/diagnóstico por imagem , Masculino , Veias Pulmonares/anormalidades , Veias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
A wide variety of anatomic variations of the median nerve at wrist have been reported and the awareness of these variations are essential for the surgeon treating carpal tunnel pathologies to avoid inadvertent injury to the nerve during surgery. We report a rare case of bifid median nerve accompanied by a persistent median artery found incidentally in a patient who underwent flexor tendon reconstruction for subcutaneous tendon rupture. The current literature regarding the anomaly is reviewed and surgically relevant aspects are discussed.
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Síndrome do Túnel Carpal/cirurgia , Nervo Mediano/cirurgia , Procedimentos Ortopédicos/métodos , Articulação do Punho/inervação , Síndrome do Túnel Carpal/patologia , Humanos , Masculino , Nervo Mediano/patologia , Pessoa de Meia-IdadeRESUMO
This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.