Cases reported "Epistaxis"

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1/348. Metastatic testicular teratoma of the nasal cavity: a rare cause of severe intractable epistaxis.

    Malignant neoplasms of the nasal cavity and paranasal sinuses are uncommon. choriocarcinoma is a highly malignant germ cell tumour occurring in the reproductive organs. Metastasis may be principally by the lymphatic route as in other germ cell tumours but choriocarcinoma is also known to spread haematogenously. We present a rare case of metastatic choriocarcinoma to the nasal cavity from testicular teratoma presenting with intractable epistaxis in a 32-year-old Caucasian male, who ultimately succumbed to this disease. ( info)

2/348. The liver in hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease).

    The livers of four patients with hereditary hemorrhagic telangiectasia--including the original case of Osler--were examined at autopsy. Characteristic random focal fibrovascular lesions were found in all. The importance of recognizing the apparently common and seemingly benign hepatic involvement in this disease is emphasized in view of its possible confusion with more serious types of liver disease that may complicate the condition. ( info)

3/348. Intracranial haemorrhage due to factor v deficiency.

    factor v deficiency is a rare coagulation disorder which is inherited autosomal recessively. factor v deficiency should be considered in infants with bleeding disorders and prolonged prothrombin and activated partial thromboplastin times if bleeding continues in spite of vitamin k injection. In this article, the case of an infant with an intracranial haemorrhage due to congenital factor v deficiency is reported. ( info)

4/348. spinal cord arteriovenous malformations in two patients with hereditary hemorrhagic telangiectasia.

    We report two cases, in first cousins, of spinal arteriovenous malformations (AVMs) of the perimedullary fistula type and hereditary hemorrhagic telangiectasia (HHT). Spinal AVMs are a rare clinical presentation of HHT, but can be the first manifestation in a child with this disorder. The importance of considering a coexisting disorder of vascular dysplasia, such as HHT, when a child presents with a spinal AVM is discussed. ( info)

5/348. Complications resulting from treatment of severe posterior epistaxis.

    Recent advances in nasal endoscopy and arterial embolization have improved the treatment of severe posterior epistaxis. This report reviews the therapeutic options, including a case of epistaxis that did not respond to nasal packing but was successfully controlled with superselective arterial embolization. The discussion includes an outline of potential complications of epistaxis treatment, including a case of nasal septal perforation. ( info)

6/348. Primary hypothyroidism-associated TSH-secreting pituitary adenoma/hyperplasia presenting as a bleeding nasal mass and extremely elevated TSH level.

    A 41-year-old male with primary hypothyroidism and a huge TSH-secreting pituitary tumor presented with a bleeding nasal mass that was initially misdiagnosed as a paraganglioma. Other unique features of the case include lack of complaints related to hypothyroidism, an extremely elevated TSH level of 3474 mU/l, and a low prolactin level. The presence of primary hypothyroidism made differentiating TSH-secreting pituitary adenoma from secondary thyrotroph hyperplasia difficult. A low molar ratio of alpha-subunit to TSH on presentation, together with normalization of TSH level and a 50% reduction in the size of the tumor after 6 weeks of thyroxine replacement therapy, suggested the presence of thyrotroph hyperplasia. However, the lack of further decrease in the size of the tumor that was associated with increased metabolic activity on 18-FDG PET scan, intense uptake on octreotide scan, and an elevated alpha-subunit to TSH molar ratio despite the normalization of free T4 and TSH levels for 16 months suggested the coexistence of thyrotroph adenoma. Together, the findings support the view that thyrotroph adenoma/irreversible hyperplasia can result from long standing primary hypothyroidism. ( info)

7/348. CT of intranasal pleomorphic adenoma.

    Intranasal pleomorphic adenoma is rare. We report the CT features this tumor in a 41-year-old woman who presented to us with right nasal obstruction and a 2-day history of epistaxis. ( info)

8/348. Case report of a bleeding nasal polyp during pregnancy.

    We report a case of pregnant woman who had a pyogenic granuloma that had caused chronic epistaxis for 1 week's duration. The lesion was excised and the patient recovered fully. ( info)

9/348. Balloon compression of the intramaxillary sinus for intractable post-traumatic bleeding from the maxillary artery. Case report.

    We present a case of severe intractable epistaxis after midfacial trauma in which the bleeding was identified as coming from the descending palatine artery, a branch of the maxillary artery. It could not be controlled by simple packing, and was stopped by inserting a balloon into the maxillary sinus, tamponading the injured vessel in the sphenopalatine fossa (pterigopalatine fossa). We describe an easy and practical emergency manoeuvre to control bleeding from inaccessible branches of the maxillary artery and to prevent rebleeding after embolisation. ( info)

10/348. Vestibular closure with a silastic obturator--an alternative to Young's procedure in bleeding diathesis.

    epistaxis is a common and difficult problem to manage in patients with bleeding disorders. We present a case of recurrent epistaxis in a patient with bernard-soulier syndrome (a platelet disorder) and describe a non-invasive but effective method of closing the nasal vestibule using a silastic obturator thus preventing the drying effects of airflow on the nasal mucosa which may precipitate epistaxis in patients with a bleeding diathesis. ( info)
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