Cases reported "Edema"

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1/11. Extensive acronecrosis as a manifestation of mixed cryoglobulinaemia: a case report.

    Cryoglobulinaemia is a systemic disorder characterized by circulating antibodies that precipitate in the cold and resolve on rewarming. Three different types have been described, distinct in the class of immunoglobulins and their clonality. The clinical expression varies from purpura and arthralgia to progressive renal failure and even acronecrosis (1-3). Associated conditions are lymphoproliferative disorders, auto-immune diseases and chronic infections, but several cases occur in the absence of identifyable other disease states. The present communication reports on a case of mixed cryoglobulinaemia. Of particular interest are the rapidly progressive clinical evolution to acronecrosis of the four limbs, necessitating amputation, the presence of spurious leucocytosis and the absence of other systemic symptoms.
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2/11. Intraoral etiology of a life-threatening infection in an immunocompromised patient: report of case.

    Oral infections are one of the major causes of morbidity and mortality in patients with hematologic malignancies. Total body irradiation and chemotherapy suppress the ability of the immune system to respond to the more virulent pathogens that can attack the compromised patient. The case of an 8.5-year-old girl is reported, in which an oral infection and a clinically observed motility resulted in a communication with the submandibular space; a significant hard, brawny edema of her right submandibular area resulted. Surgery, strict oral hygiene, and regular irrigation with a chlorhexidine gluconate solution resulted in successful healing.
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3/11. Traumatic fistula between internal iliac artery and external iliac vein.

    Traumatic iliac arteriovenous fistulas (AVFs) are extremely rare, with only two cases reported in literature involving the internal iliac artery and the external iliac vein. We report the case of a 23-year-old man who sustained a gunshot injury to the left lower quadrant of his abdomen and subsequently developed unilateral leg edema of "elephantiasic proportions." Intra-arterial digital subtraction angiography six years later was essential for diagnosis and comprehension of the pathomechanism. The angiographic examination showed an internal iliac false aneurysm, as well as a high-flow arteriovenous communication between the left internal iliac artery and external iliac vein complicated by thrombotic occlusion of the left common iliac vein. The initial vascular injury and the surgical management of simple ligation were thought to be responsible for the iliac AVF and the subsequent thrombosis of the common iliac vein. On the one hand, the thrombotic occlusion of proximal vein led to a sharp increase of mean pressure in the proximal and distal arteries and in the distal vein, resulting in chronic venous insufficiency with incompetent varicose veins. On the other hand, the restriction of venous outflow produced extreme peripheral edema and large superficial veins serving as collaterals to bypass the fistula. Vascular surgery could repair the lesion by closing and bypassing the AVF.
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4/11. Rheumatoid iliopsoas bursitis presenting as unilateral leg edema.

    A 66-year-old woman with rheumatoid arthritis presented with unilateral leg edema attributable to an enlarged iliopsoas bursa with presumed impedance of lymphatic drainage. The adjacent hip joint was not severely involved by arthritis. ultrasonography and computed tomography were used to delineate the bursal mass and demonstrate communication with the joint space.
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5/11. Bicipital swelling in adult-onset Still's disease.

    A patient with typical features of adult-onset Still's disease is described in whom bicipital swellings were a feature. arthrography of shoulders and elbow joints failed to demonstrate communication with the cyst, suggesting the swelling was due to inflammation in a bursa overlying biceps muscle.
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6/11. Peripheral veno-lymphatic communications.

    Though there have been a number of articles on lympho-venous anastomoses, there have been no reports of the opposite situation, namely veno-lymphatic communication. A case of veno-lymphatic communication is presented, and possible explanations for this finding are described.
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7/11. Therapist's management of the replanted hand.

    The treatment of the patient with a replanted hand is a challenge to both the surgeon and the therapist. Because of multiple system involvement, we must be able to assess each structure individually to determine the best treatment protocol for that structure and then compile it into one treatment program. The communication among the triad of physician, therapist, and patient is the only way to guarantee successful results.
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8/11. Perilymphatic fistula: a histopathologic study.

    Over the last two decades, clinical criteria for perilymphatic fistulae have been defined to the extent that differentiation can be made between such fistulae and other balance-affecting disorders such as Meniere's syndrome. On the assumption that the specimens in the temporal bone bank of the University of chicago Medical School that had been obtained from patients having vertigo, hearing loss, or both, before those clinical criteria were so defined might have been classified incorrectly, we proposed a retrospective histopathologic study, with prediction of two independent variables: a clinical history and physical findings consistent with the diagnosis of perilymphatic fistula and communication between the vestibule and the middle ear adjacent to or via the fissula ante fenestram. Eleven pairs of temporal bones with the histologic diagnosis of idiopathic labyrinthine hydrops were evaluated before the clinical histories relevant to those specimens were reviewed. In one specimen, a communication between the vestibule and the middle ear space was identified. In none of the other specimens was there a similar communication. As this study continued, significance was given to the histologic details of the communication between the middle ear and posterior canal ampulla. The temporal bones without these communications did not have clinical histories consistent with the diagnosis of perilymphatic fistula.
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9/11. Evaluation of scrotal edema in a patient on peritoneal dialysis. A case report.

    A 50-year-old man placed on peritoneal dialysis for end stage renal disease developed unilateral (left) scrotal edema following infusion of dialysis fluid into the peritoneum. The left side of the scrotum and left inguinal canal were surgically explored and a left hydrocele was removed. Following surgery, the patient again demonstrated left scrotal edema during peritoneal dialysis. Tc-99m MAA (5.0 mCi, 185 mBq) was injected into a 2-liter bag of dialysis fluid, which was subsequently infused into the peritoneum. The communication between the peritoneal cavity and the left inguinal canal was demonstrated.
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10/11. edema of the papilla of Vater simulating retained common duct stone.

    A prominent or edematous papilla of Vater may prodce a rounded filling defect in the duodenum. During T tube or operative cholangiography, this may simulate a calculus impacted in the distal or intramural portion of the common bile duct. This communication reports such an occurrence. Recognition of this potential cause for a false positive cholangiogram should prevent some instances of unnecessary instrumentation of the common bile duct.
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