Cases reported "Edema"

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11/68. life-threatening upper airway edema caused by a distal rattlesnake bite.

    A 36-year-old man captured a timber rattlesnake and was accidentally envenomated in the thumb by the severed head. At a local emergency department, hypotension and confusion developed. Facial and glossal edema were also observed. oxygen was delivered by face mask, and crystalloids and dopamine were administered. Respiratory distress developed with progressive hypoxemia. intubation was unsuccessful because of massive glossal and epiglottic (laryngeal) edema, and an emergency cricothyrotomy was performed. High-dose antivenom therapy was administered, and mechanical ventilation was started. Recovery was rapid, and the patient was discharged from the hospital a week later. This is the first report of life-threatening upper airway edema caused by snake envenomation not in the vicinity of the head or neck.
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12/68. sternoclavicular joint swelling after surgery of the head and neck region: a case report and differential diagnostic review.

    BACKGROUND: Very few published reports in the otolaryngologic literature discuss sternoclavicular joint swelling encountered in the postoperative setting. methods: The authors document a case of sternoclavicular joint swelling after medialization laryngoplasty. This report is supplemented with a review of the medical literature related to pertinent conditions affecting the sternoclavicular joint. CONCLUSIONS: In our patient, swelling was thought to be related to joint trauma experienced during surgery secondary to standard shoulder roll extension in a patient with preexisting postmenopausal arthritis. This case stands in contrast to the body of documented cases of postoperative sternoclavicular swelling in which the surgical procedure itself was responsible for such findings.
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keywords = neck
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13/68. An unusual cervical swelling in a child.

    Congenital thymic cysts are rare benign lesions, frequently seen in the neck and mediastinum, but because of their infrequent occurrence and similarity to other more common cystic swellings, their preoperative diagnosis is not considered. Congenital thymic cysts although rare should be considered in the differential diagnosis of cervical and mediastinal cystic swellings in children. This is a case report of a multilocular cervical thymic cyst in a child.
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14/68. Airway compromise after routine alpha-hydroxy facial peel administration.

    High concentration alpha-hydroxy facial "peels" are widely used for cosmetic anti-aging purposes. We report a case of secondary burns to the neck and face resulting in airway compromise after a professionally applied citric acid facial treatment.
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keywords = neck
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15/68. Successful outcome after surgical management in two cases of the "painful variant" of Hashimoto's thyroiditis.

    OBJECTIVE: To describe two cases of the rare "painful variant" of Hashimoto's thyroiditis (HT) that were refractory to medical management and in which surgical intervention provided the definitive treatment. methods: We thoroughly review the clinical history as well as the laboratory, imaging, and surgical pathology data in these cases, and follow-up of the clinical response over time is provided. The relevant literature is also discussed. RESULTS: A 56-year-old woman, who had remotely undergone a left hemithyroidectomy and had been diagnosed with HT, sought further assessment because of neck pain and edema. Treatment with corticosteroids was partially successful but led to the development of Cushing's syndrome. A 32-year-old man had pain and swelling of the thyroid and was diagnosed with HT shortly thereafter. Levothyroxine treatment was unsuccessful. Both patients underwent thyroidectomy. Chronic lymphocytic thyroiditis (HT) with a variable degree of fibrosis was found on assessment of pathology specimens. The patients remained asymptomatic after the surgical procedure and did not require any further anti-inflammatory therapy. CONCLUSION: In selected cases, surgical treatment may become necessary for effective and permanent control of symptoms and local signs in painful HT. Access to experienced endocrine surgeons is important in order to avoid postoperative complications because the thyroid gland may be small or fibrosed in this rare variant of HT.
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keywords = neck
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16/68. What do you do when the baby is winking at you? Case report of a face presentation.

    face presentation is an uncommon presentation at birth. The identification of a fetus with a hyperextended neck on ultrasound antenatally warrants close scrutiny for other anomalies. A fetus who presents as a face presentation in labor that is of average estimated fetal weight and has no anomalies in a woman with an adequate pelvis is likely to deliver vaginally if the mentum rotates to anterior prior to birth. Persistent mentum posteriors are best left alone without manual intervention and delivered by cesarean section. Prolonged labor is common. The clinician must be patient and closely monitor descent and rotation. Infants born as face presentations should be assessed closely after birth for normal respiratory transition and the presence of significant pain warranting analgesics.
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17/68. Unusual local complications of Vipera palaestinae bite.

    BACKGROUND: Vipera palaestinae is the commonest venomous snake in israel. V. palaestinae-specific antivenom is indicated for both systemic effects and marked progressive local signs. In our experience, clinicians are often not aware of the morbidity associated with the local effect of the venom and consequently do not administer the antivenom in envenomations with local effects only. OBJECTIVE: To describe unusual local complications of inadequately treated V. palaestinae envenomation. CASE SERIES: Three cases of V. palaestinae bites involving distal parts of the limbs are reported. Within 36-48h tense swelling progressed to the trunk. Swelling involved the neck in two patients and was severe enough to cause dysphagia and to suggest impending upper airway obstruction. In the third patient, the swelling led to urine retention necessitating introduction of urinary catheter. V. palaestinae antivenom administration resulted in regression of swelling in two patients and in allergic reaction in the third. CONCLUSION: Inadequately treated swelling caused by V. palaestinae envenomation may involve the trunk even when the site of the bite is remote. In some cases this may pose a threat to the function of vital structures such as the upper airways, call for unnecessary interventions and prolong hospitalization. It is recommended that V. palaestinae antivenom be administered whenever there is marked and progressive swelling even in the absence of systemic signs.
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keywords = neck
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18/68. Subacute mandibular and hypoglossal nerve denervation causing oedema of the masticator space and tongue.

    We report the MRI of five patients with denervation oedema in the head and neck. Four had denervation oedema in one masticator space caused by a skull-base tumour invading the ipsilateral foramen ovale. Another case had denervation oedema confined to the half of the tongue ipsilateral to oral reconstruction surgery which involved mandibulectomy, free flap repair and wide excision of a buccal mucosal carcinoma. Inversion-recovery and/or T2-weighted spin-echo images showed increased signal in the affected areas. Contrast-enhanced T1-weighted images revealed enhancement of the muscles. There was no evidence of tumour or infection in the masticator space or tongue. It is important to differentiate denervation oedema from other disease processes causing high signal on T2-weighted images, such as tumour infiltration and soft-tissue infection.
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ranking = 1
keywords = neck
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19/68. Traumatic atypical brown-sequard syndrome: case report and literature review.

    A man was kicked on the neck, 10 days after which he noted right-sided numbness. Clinically, he had diminished deep tendon reflexes over the left upper limb, absent left superficial abdominal reflexes, a left extensor plantar response, mild left hemiparesis, diminished pinprick, temperature and vibratory sensation up to the right T(4-5) dermatome and diminished proprioceptive sensation in the right upper and lower limbs. Cervicothoracic magnetic resonance imaging (MRI) revealed a left C(6-7) posterolateral disc prolapse with indentation and oedema of the cord at the same level. He was given intravenous dexamethasone, with mild resolution of his motor but not his sensory symptoms. transcranial magnetic stimulation and evoked potentials performed 3 days later were unremarkable. He was discharged soon after, preferring to seek traditional therapy in his country. We attempt to explain the anatomical basis for his clinical signs, review the literature for similar cases, and examine the usefulness of available treatment and investigations.
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keywords = neck
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20/68. Irbesartan-associated persistent edema of the eyelids, face, and neck.

    Irbesartan, an angiotensin ii receptor antagonist (AIIRA), is an antihypertensive agent that inhibits the activity of angiotensin ii by selectively binding to angiotensin ii type 1 (AT1) receptors. The new onset of sustained periorbital, facial, and neck edema following the initiation of irbesartan therapy is described in a hypertensive 52-year-old woman. The patient's edema was not life threatening, remained unchanged following discontinuation of the medication, and persisted when treatment with the drug was subsequently reinstituted. Facial edema is a very uncommon adverse event that may occur in patients receiving irbesartan.
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ranking = 5
keywords = neck
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