BMJ case reports
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Flagellate dermatitis shows very characteristic lesions: linear erythema or hyperpigmentation in various areas of the skin. It is a side effect of bleomycin, an immunosupressive drug used for several types of cancers. All physicians must be aware of this disease so they can make a rapid diagnosis and interrupt the causative agent. Our patient presented during chemotherapy for a Hodgkin's lymphoma pruritic, erythematous lesions on the lower limbs and the back diagnosed as flagellate dermatitis due to bleomycin.
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Isolated or primary intraventricular haemorrhage (PIVH) is rare and usually caused by hypertension, vascular malformations, aneurysms and moyamoya disease. Lenticulostriate artery aneurysm (LSA) is also a rare entity, and LSA aneurysm rupture causing primary intraventricular haemorrhage is extremely rare. There are only a few case reports. ⋯ They are usually associated with various vascular conditions. We report two rare cases of LSA aneurysms presenting as PIVH, one being medial and other being lateral distal LSA aneurysm. Both were normotensives, and one was associated with arteriovenous malformation.
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Postdural puncture headache (PDPH) is the most common complication of obstetric regional anaesthesia and the most likely cause of headache in a woman who underwent epidural anaesthesia during delivery. Cerebral venous sinus thrombosis (CVST) is an uncommon cause of postpartum headache. Anaesthesia in obstetrics may lead to long-lasting intracranial hypotension resulting in CVST. ⋯ The latter condition may be treated either by an epidural blood patch or bed rest and hydration. We report a case of a 36-year-old woman who developed CVST and multiple venous infarcts after an attempted epidural procedure during delivery. She was treated conservatively with bed rest, hydration and low-molecular-weight heparin and the patient recovered completely.
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Parastomal hernia is a recognised complication following stoma formation, representing a challenging problem to surgeons. At least three approaches for parastomal hernia repair have been described: fascial suture repair, relocation of stoma and local repair with use of mesh. In simple fascial suture repair only open techniques have been described. ⋯ The recurrence rate and complications of parastomal hernia repair remain very high. We have invented a simple fascial suture laparoscopic repair of parastomal hernia with the use of the Crochet hook needle (EndoClose). This new technique may result in reduced pain, earlier discharge from hospital and reduced risk of infection as there is no mesh used as well as reduced risk of seroma formation.
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Nasogastric tube insertion is a common clinical procedure carried out both by doctors and other paramedical personnel. Misplacement of the nasogastric tube into the tracheobronchial tree is not uncommon. ⋯ Laryngospasm is not uncommon in anaesthetic practice; however, reports of recurrent laryngospasm are very sparse. We report a case of misplaced nasogastric tube causing recurrent laryngospasm.