BMJ case reports
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Case Reports
Transvenous sclerotherapy of a large symptomatic orbital venous varix using a microcatheter balloon and bleomycin.
An orbital venous varix is rare and can present with diplopia, proptosis, or hemorrhage. Treatment can be challenging, especially if the varix is in a posterior location within the orbit, since surgical exposure becomes difficult. A few case reports have been published describing transcatheter embolization of an orbital varix with coils, direct percutaneous injection of n-butyl cyanoacrylate glue, and the percutaneous injection of bleomycin. We present a case of a symptomatic orbital venous varix of the left inferior ophthalmic vein successfully treated with transvenous endovascular sclerotherapy using a microcatheter balloon and bleomycin.
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Optic neuropathy due to cat scratch disease (CSD) is a rare occurrence associated with macular star formation and is characterised by sudden mostly unilateral painless loss of vision. The aetiological agent in CSD is Bartonella henselae. ⋯ Ocular bartonelosis is usually self-limited. A case of a man patient with neuroretinitis caused by B. henselae is reported.
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Typical configurations of extracorporeal membrane oxygenation (ECMO) include venovenous (VV) and venoarterial (VA) configurations; however, other configurations of ECMO may be necessary in certain situations. We performed VA ECMO for a 71-year-old man who experienced refractory hypoxaemia associated with a brief cardiac arrest after resection of the small intestine showing necrosis. ⋯ Therefore, we performed VA-venous ECMO, which further improved his cardiac function and allowed him to be converted to VV ECMO. It is very important to consider different configuration strategies of ECMO by adjusting the patient's cardiopulmonary conditions appropriately.
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Transient osteoporosis of the hip is a rare, self-limiting condition, occurring most commonly in middle-aged men, but also sometimes in women, usually in late pregnancy. It is characterised by gradual onset of hip pain aggravated by weight bearing without any associated history of trauma and systemic illness. It is usually of unknown aetiology, but pregnancy is a recognised risk factor for women. ⋯ We present a case of a 38-year-old non-pregnant woman with transient osteoporosis of the hip, managed conservatively, leading to a full recovery. Treatment is conservative, including protected weight bearing, physical therapy and non-steroidal analgesics. The patient was completely painless and symptom free at 2-year follow-up.