Cases reported "Tick Bites"

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1/3. Primary repair of cornual rupture occurring at 21 weeks gestation and successful pregnancy outcome.

    The successful delivery in a 31 year old woman at 33 weeks gestation is reported, after repair to a cornual rupture which occurred at 21 weeks gestation. The patient exhibited acute abdominal pain and pending shock. Emergency laparotomy showed a cornual rupture and an intrauterine vital fetus having intact amnion membrane. On the patient's family's insistence, primary repair for a cornual rupture was performed and preservation of the fetus attempted. Postoperatively, tocolytic agent with ritodrine hydrochloride was administered and close follow-up of the patient was uneventful. The patient had a smooth obstetric course until 33 weeks gestation when premature rupture of the membranes occurred, soon followed by the onset of labour. She underwent an elective Caesarean section and delivered a normal male fetus weighing 2140 g with Apgar scores at 1, 5 and 10 min of 6, 8, and 9 respectively. Because of this successful outcome, we suggest that primary repair for such an unusual patient should be accepted.
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keywords = bite
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2/3. Cystic intra-abdominal testicular torsion in an infant.

    We report on a 3-month-old infant with cystic intra-abdominal testicular torsion. He presented with abdominal distension and pain. physical examination showed a movable, well delineated mass in the right iliac and lumbar fossae. Exploration revealed that the mass was connected to the abdominal aorta by a thin vascular cord that was twisted before reaching the mass. The histological study showed that the mass corresponded to a testis with cystic formations. The testicular parenchyma was necrotized, although isolated seminiferous tubules were found. The cystic cavities were filled by hematic and necrotic material, and exhibited no epithelial lining. A fibrous layer in continuity with interstitial hemorrhage surrounded the cysts. The twisted vascular cord corresponded to a spermatic cord with dilated pampiniform plexus veins. The differential diagnosis and the etiopathogenesis of the lesion are discussed.
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3/3. black widow spider bite in a child.

    An 8-year-old boy who was bitten by a black widow spider was seen in the emergency department twice, as well as by his private family physician, within a 24-hour period of time before being admitted to the hospital. This patient should have been observed for a longer period of time in the emergency department or admitted to the hospital on the day of presentation for observation with conservative management. The current literature is reviewed with special emphasis on the pediatric patient, and management guidelines are recommended.
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keywords = bite
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