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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    背景:脊髓疝(SCH)对于神经放射科医生来说仍然是一个具有挑战性的诊断,并且对于神经外科医生来说可能需要具有挑战性的治疗。大多数脊髓疝通常在胸前水平发现。
    方法:一位28岁的女性出现在我们部门,有7年的进行性脊髓病病史。MR分析显示外侧胸硬脑膜缺损的脊髓移位。使用显微镜释放疝出的脊髓,患者在手术后6个月明显康复。
    结论:我们提出了一个独特的纯侧位SCH病例。根据综述的文献和手术发现,讨论了潜在的病理生理机制。
    BACKGROUND: Spinal cord herniation (SCH) remains a challenging diagnosis for neuroradiologists and may require treatment challenging for neurosurgeons. Most cord herniations are usually found at anterior thoracic levels.
    METHODS: A 28-year-old woman presented at our department with a 7-year history of progressive myelopathy. MR analysis showed a displacement of the spinal cord in a lateral thoracic dural defect. The herniated cord was released using a microscope and the patient significantly recovered 6 months after surgery.
    CONCLUSIONS: We present a unique case of pure lateral SCH. In the light of reviewed literature and operative findings, the underlying pathophysiological mechanisms are discussed.
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  • 文章类型: Case Reports
    We report the surgical endodontic treatment of a maxillary first premolar with a lateral lesion that originated from an accessory canal. Although lesions originating from accessory canals frequently heal with simple conventional endodontic therapy, some lesions may need additional and different treatment. In the present case, conventional root canal retreatment led to incomplete healing with the need for further treatment (i.e., surgery). Surgical endodontic management with a fast-setting calcium silicate cement was performed on the accessory canal using a dental operating microscope. At the patient\'s 9-month recall visit, the lesion was resolved upon radiography.
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  • 文章类型: Journal Article
    背景:肺外侧疝罕见,而肺疝仅在高能创伤的背景下报道。肺疝的好发部位是前胸。
    方法:我们介绍一个82岁的男性,他因干咳入院,跌倒后呼吸短促和依赖呼吸的左侧胸痛。胸部X光检查提示肺炎,随后患者接受了抗生素治疗。由于12天后症状持续,进行了CT扫描,显示肋间肺疝无骨折。咨询了外科医生并建议进行手术干预。术中可以证实疝并切除坏死的肺组织。患者恢复良好,10天后出院,情况良好。
    结论:胸内压突然升高时,肋间肌损伤导致肺组织突出。特别是外侧疝很少见,因为Serratus肌肉对胸壁进行了额外的外侧加固。虽然在无症状疝和小缺损尺寸的情况下,保守的方法是可能的,手术干预适用于较大的疝,肺组织可能嵌顿,导致梗塞和慢性疼痛或呼吸衰竭等症状。
    结论:对于具有外伤病史和外部体征的胸痛的充分鉴别诊断,即使在低能量创伤后,也应在早期评估CT成像。对于较大的缺陷和持续的症状,需要进行手术。
    BACKGROUND: Lateral lung hernias are rare, and a herniation of the lung is only reported in the context of high-energy trauma. The predilection site for lung hernias is the anterior thorax.
    METHODS: We present the case of a 82-year-old male, who was admitted with dry cough, shortness of breath and breath-dependent left-sided chest pain after a fall. Chest X-ray suggested a pneumonia and subsequently the patient was treated with antibiotics. Due to persistent symptoms after 12days a CT-scan was performed which showed an intercostal lung herniation without fractures. Surgeons were consulted and recommended an operative intervention. Intraoperatively the herniation could be confirmed and necrotic lung tissue was resected. The patient recovered well and was discharged after 10days in good general condition.
    CONCLUSIONS: Herniation of lung tissue occurs as a result of injured intercostal muscles in a sudden increase of intrathoracic pressure. Especially lateral herniation is rare because of the additional lateral reinforcement of the thoracic wall by the Serratus muscle. While a conservative approach is possible in asymptomatic hernias and small defect size, surgical intervention is indicated for larger hernias, possible incarceration of lung tissue with resulting infarction and symptoms like chronic pain or respiratory failure.
    CONCLUSIONS: For an adequate differential diagnosis of thoracic pain with a history and external signs of a trauma, a CT imaging should be evaluated at an early stage even after a low-energy trauma. An operation is indicated for large defect size and persistent symptoms.
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  • 文章类型: Journal Article
    先天性上唇外侧窦畸形,病因不明。这些通过口轮匝肌的盲窦没有口腔内沟通,手术切除是首选的治疗方法。我们提出的病例称我们为创伤后唾液瘘患者。简要讨论了手术治疗和可能的病因。还强调了良好的病史记录和细致的临床检查以准确诊断实体以避免昂贵的支持性放射学检查的重要性。
    Congenital lateral sinuses of upper lip are malformations with uncertain etiology. These blind sinuses through orbicularis oris muscle have no intra-oral communication, with surgical excision being treatment of choice. We present our case referred to us as a patient of posttraumatic salivary fistula. Surgical management and possible etiology is discussed briefly. Also highlighted is the importance good history taking and meticulous clinical examination to accurately diagnose the entity in order to avoid expensive supportive radiological investigations.
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  • 文章类型: Case Reports
    我们报告了一例位于外侧can颞侧的先天性泪囊瘘。一个系统健康的1岁女孩来到门诊诊所,抱怨自出生以来右外侧can的颞侧撕裂。在检查中,在外侧can的颞侧皮肤中发现了一个小孔。在开口内没有炎症或肿胀的迹象。外科医生在全身麻醉下进行了手术。他们将探针穿过泪道,然后将其推向泪囊。接下来,他们将盐水引入下泪点,发现它排入外侧瘘管。当切开的瘘管被拉动时,下盖伸展。手术后,病人没有症状。本文报告1例先天性泪囊瘘位于外侧can的颞侧。
    We report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus. A systemically healthy 1-year-old girl came to the outpatient clinic with a complaint of tearing on the temporal side of the right lateral canthus since birth. On examination, a small orifice was found in the skin on the temporal side of the lateral canthus. There was no evidence of inflammation or swelling within the opening. Surgeons carried out an operation under general anesthesia. They passed a probe through the lacrimal orifice and advanced it toward the lacrimal sac. Next, they introduced saline to the inferior punctum and found that it drained to the lateral fistula. The lower lid stretched as the dissected fistula was pulled. After the operation, the patient was free of the symptom. This paper is to report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus.
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