UNASSIGNED: Hydrocephalus is a brain abnormality frequently encountered in neonates. There are several known etiologies of hydrocephalus, which can be classified as either congenital or acquired. Occlusion of the foramen of Monro (FOM) is a cause of hydrocephalus and can be either congenital or secondary to various disorders. Idiopathic obstruction of the FOM presenting as prenatal ventriculomegaly is extremely rare but has been reported.
UNASSIGNED: We present the case of a preterm newborn with severe bilateral hydrocephalus due to FOM occlusion in the prenatal period. Although the neonate had normal head circumference and no clinical symptoms after birth, brain sonography revealed progressive ventriculomegaly. Further image revealed bilateral ventriculomegaly with normal-sized third and fourth ventricles. We suspected a complete obstruction of the right and a partial obstruction of the left of the FOM. The neonate underwent endoscopic septostomy and foraminotomy, resulting in improvement.
UNASSIGNED: We report a case of preterm FOM occlusion in the youngest and smallest neonate to date. Endoscopic septostomy and foraminotomy were performed in order to avoid ventriculoperitoneal shunt-related complications, highlighting the viability of endoscopic procedures which should be the primary treatment in preterm neonates with FOM occlusion.

A hydatid cyst is a parasitic infestation most frequently caused by the larval tapeworm known as Echinococcus granulosus. Breast hydatidosis is a very uncommon condition that may be the main site or one of its components in cases of extensive hydatidosis. We discussed a 28-year-old female patient who had been experiencing left breast pain for a year prior to her presentation.

Hydatid cyst is a zoonotic disease caused by a tapeworm of the genus Echinococcus granulosus either in its adult or larval forms. Original pelvic cysts are rare; however, the majority of abdominal and pelvic hydatid cysts are believed to result from inadvertent surgical inoculation or spontaneous rupture from a primary hepatic focus. We present a 35-year-old female patient who visited our facility complaining of lower abdominal pain that had persisted for the last 5 months.

Cardiac tamponade is a leading cause of death in blunt thoracic trauma. Ultrasound improved the recognition of cardiac tamponade and therefore has a vital role in acute critical situations in the Emergency Department and in the Intensive Care Unit. Besides recognition of cardiac tamponade, treatment protocols are important. In trauma patients with hemodynamic stable cardiac tamponade, time should be taken for a proper workup for an explorative sternotomy. In hemodynamic unstable trauma patients, the pericardium should be drained, and fluid resuscitation should be performed followed by emergency sternotomy. In this case report we describe a blunt thoracic trauma victim, a 28-year-old male patient without any medical history. He suffered from the unique combination of a tear in the left atrial appendage and a papillary muscle rupture of the right ventricle because of blunt thoracic trauma. Transthoracic echocardiography revealed massive pericardial effusion with diastolic collapse of the right ventricle in our patient. Due to his hemodynamic situation, the patient was brought into the OR for immediate sternotomy and cardiac repair. The patient made a full recovery, was discharged home, and is back to work. This case report emphasizes the relevance of early recognition and treatment of cardiac tamponade in blunt thoracic trauma victims and suggests a multidisciplinary management strategy.

AVID (Asymmetric ventriculomegaly, interhemispheric cyst, and dysgenesis of corpus callosum) spectrum is a rare phenomenon as such in its whole and the defects are not exclusive to the condition. Each may occur in isolation or together and have characteristic clinical and imaging findings. The vast array of mimics coexisting with the condition makes it a harder diagnosis to make and requires a great length of experience and observation which may explain the limited recordings of AVID. Sonography and fetal magnetic resonance imaging goes a long way and provide accurate diagnosis ruling out the mimics and aiding in prenatal visualization of the defects. Accurate diagnosis aids in effective management and counseling regarding outcomes and the potential timeline of the severity of the symptoms. In its rarity, this case report of AVID is one of the first report of its kind reported from Nepal.

UNASSIGNED: Minimally invasive carpal tunnel release has recently emerged as the primary surgical approach for recalcitrant carpal tunnel syndrome. A major concern related to surgical failure with this technique is the incomplete release of the flexor retinaculum.
UNASSIGNED: We developed a technique using dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release. This novel imaging method was applied to two patients who showed significant symptom relief after the intervention. This case study also provides details of the dynamic ultrasound protocol and highlights the advantages of this technique.
UNASSIGNED: Dynamic ultrasound imaging can be used to confirm the completeness of carpal tunnel decompression. A large-scale prospective trial should be conducted to validate whether additional dynamic ultrasound examination can improve the outcome of minimally invasive carpal tunnel release.

BACKGROUND: An impalement-related injury to the oral cavity is common in pediatric patients at emergency department. A computed tomography evaluation is not always suitable in these cases. Herein, we aimed to present oral sonography findings from six pediatric patients presenting with impalement-related injury to the oral cavity.
METHODS: All included patients were younger than 4 years and sustained injuries with a toothbrush, chopstick, water gun, and fork to the tonsils, submandibular gland area, uvula, and under the tongue.
CONCLUSIONS: Ultrasound imaging appeared useful in helping diagnose impalement-related injuries lateral to the midline.

UNASSIGNED: Abscess of the tongue is a very rare disease that potentially compromises the airway. Acute tongue abscess symptoms include swelling or a lump in the deep tissues of the tongue, throbbing local pain, a discomfort that radiates to the ears, fever, difficulty swallowing, deliberate fixation of the tongue due to pain, and eventually, difficulties breathing.
UNASSIGNED: This is a 50-year-old male patient who presented with a complaint of severe tongue pain and swelling of three days duration. Associated with this, he had pain while swallowing, difficulty opening his mouth, shortness of breath, and drooling saliva. Likewise, he had a high-grade fever and a global type of headache. On physical examination, there was significant tongue swelling on the left anterolateral area, fluctuant on palpation, and had erythematous border. After informed consent was taken the patient was transferred to the operation room with the diagnosis of tongue abscess. Subsequently, incision and drainage were done under general anesthesia, and about 30mL of thick pus was drained. The pocket was washed with normal saline and 2% hydrogen peroxide. The patient was transferred to the surgical ward with stable vital signs and had been on antibiotics. He was discharged after two days of hospital stay.
UNASSIGNED: Abscesses in the tongue are quite uncommon due to its rich vascular supply, lymphatic drainage, and saliva\'s immunologic advantage. Thorough diagnosis and successful treatment of tongue abscess prevent potential airway compromise. Antibiotic treatment should cover gram-positive and gram-negative anaerobes.

Polyorchidism is a congenital abnormality with distinct sonographic characteristics. In most cases, sonography is sufficient for diagnosis. In instances of complicated polyorchidism, an MRI may provide further information. Conservative treatment with sonographic follow-up is the best management option in uncomplicated cases. We present a rare case of polyorchidism with no associated complications that were managed conservatively with periodic follow-up imaging.

Eosinophilic fasciitis (EF, also known as Shulman syndrome) is an uncommon connective tissue disease characterized by inflammatory thickening of the fasciae as well as swelling and hardening of the skin. It mostly affects the lower extremities. Swollen and indurated skin, together with the groove sign, are typical clinical signs. So far, biopsy evidence of inflammation and thickening of the fascia has been the gold standard for diagnosis. Magnetic resonance imaging (MRI) is mentioned in the literature as an alternative method for confirming the diagnosis. We present a case of asymmetric EF in a 54-year-old German male. He came with painful induration of the right forearm, with a characteristic groove sign and limitation of motion of the right hand. The blood count revealed eosinophilia with 0.57 G/l or 9.6% (normal: 0.05-0.5 G/l and 0.5-5.5%), ANA and ENA were negative. The diagnosis was confirmed histologically and we were able to detect a thickened fascia in MRI and ultrasound imaging. The EF also appeared in the left lateral malleolus during the course of the illness. Treatment was carried out with prednisolone and methotrexate.
UNASSIGNED: Die eosinophile Fasziitis (EF, auch Shulman-Syndrom) ist eine seltene Erkrankung des Bindegewebes mit entzündlicher Verdickung der Faszien sowie Schwellung und Verhärtung der Haut. Betroffen sind v. a. die distalen Extremitäten. Typische klinische Befunde stellen eine lokalisierte Schwellung und Verhärtung der Haut sowie das Groove-Sign (deutsch: Rillenzeichen/negatives Venenzeichen/Matratzenphänomen) dar. Der Goldstandard für die Diagnosesicherung ist bisher der bioptische Nachweis entzündlich verdickter Faszien. In der Literatur wird alternativ die Diagnosesicherung durch MRT-Bildgebung diskutiert. Wir berichten über einen Fall von asymmetrischer EF bei einem 54 Jahre alten, männlichen Deutschen. Die Vorstellung erfolgte mit schmerzhafter Verhärtung im Bereich des rechten Unterarms sowie charakteristischem Groove-Sign und einer Bewegungseinschränkung der rechten Hand. Im Blutbild zeigte sich eine Eosinophilie mit 0,57 G/l bzw. 9,6 % (norm. 0,05–0,5 G/l und 0,5–5,5 %), ANAs und ENAs waren negativ. Die Diagnosesicherung erfolgte histologisch, zusätzlich konnten wir verdickte Faszien sowohl im MRT als auch in der Sonographie nachweisen. Im Verlauf manifestierte sich die EF auch am linken Malleolus lateralis. Die Therapie erfolgte mit Prednisolon und Methotrexat.