Journal of surgical case reports
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Case Reports
Extensive subdural spread of a glioblastoma associated with subdural hygroma: case report.
Despite its highly malignant behaviour, glioblastoma very rarely spread beside the arachnoid layer. We describe a very rare case of a 67-year-old patient with glioblastoma, who developed a recurrent subdural hygroma associated with the subdural spread of the glioblastoma, which was confirmed histologically. Possible predisposing factors and management suggestions are discussed.
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A COVID-19 pandemic was declared on March 11 by the World Health Organization (WHO). The first cases of COVID-19 were confirmed on January 31 in Sweden and on February 26 in Norway. Despite being similar countries with universal healthcare systems, the governmental approaches to mitigation of the epidemic have varied considerably. ⋯ Sweden has initiated a more laxed and gradual strategy based on the appeal for a strong personal sense of responsibility to mitigate the viral spread. In both countries, the first weeks of preparation has seen a strong reduction in elective surgery, with several implemented principles to mitigate SARS-CoV-2 spread and prepare for surgical care for COVID-19 diseases as needed. This invited leading article gives a brief overview of some of the early experiences of the outbreak in two Scandinavian countries.
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Vomiting-induced pneumomediastinum can be a result of barotrauma causing alveolar rupture or Boerhaave's syndrome. Although a rare cause of secondary pneumomediastinum, Boerhaave's syndrome allows extravasation of air and fluid due to oesophageal perforation. We report a case of a 20-year-old female who presented with prolonged vomiting during a panic attack. ⋯ A source of oesophageal rupture was not visualised on cross-sectional computed tomography imaging following contrast ingestion. A complication of mediastinitis provided the evidence that this was a case of Boerhaave's syndrome whereby microscopic perforation of the oesophagus led to secondary pneumomediastinum, rather than vomiting-induced spontaneous pneumomediastinum caused by barotrauma. Recurrent Boerhaave's syndrome in this case is owed to the patient having previously experienced identical symptoms which spontaneously resolved.
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Case Reports
Penetrating thoracic injury from a bean bag round complicated by development of post-operative empyema.
Bean bag guns were developed as a nonlethal means for law enforcement personnel to subdue individuals. The large surface area and lower velocities of the bean bag round theoretically result in transfer of most of the energy to the skin/subcutaneous tissue and minimize the likelihood of dermal penetration, thereby 'stunning' intended victims without causing injury to deeper structures. ⋯ Although the bean bag was successfully removed, the patient developed a postoperative empyema requiring operative management. We discuss the unique aspects of thoracic trauma from bean bag ballistics as well as considerations in management of patients with this uncommon mechanism of injury.
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Case Reports
Inguinal hernia with complete urinary bladder herniation: a case report and review of the literature.
Although inguinal hernias are common, inguinal herniation of the urinary bladder wall is rare. Moreover, the complete migration of the urinary bladder into the scrotum is considered less frequent. The majority of patients with bladder hernias are asymptomatic and diagnosis is made intraoperatively; however, difficulties in urination may lead to the correct diagnosis. We report about a case of a large right-sided scrotal hernia with complete bladder herniation presenting without urological symptoms.