MyMedR

Fulltext Two different surgical approaches for strangulated obturator hernias

Sze Li S, Kenneth Kher Ti V

Malays J Med Sci, 2012 Jan;19(1):69-72.

Obturator hernia is a rare condition that may present in an acute or subacute setting in correlation with the degree of small-bowel obstruction. Pre-operative diagnosis is difficult, as symptoms are often non-specific. A high index of suspicion should be maintained for emaciated elderly women with small-bowel obstruction without a previous abdominal operation and a positive Howship-Romberg sign. When diagnosis is in doubt, computed tomography scan of the abdomen and the pelvis (if available) or laparotomy should be performed immediately, as high mortality rate is related to the perforation of gangrenous bowels. We present 2 cases of strangulated obturator hernia, managed differently with both open and laparoscopic approaches. The diagnostic accuracy of computed tomography scan is highlighted followed by a brief literature review with an emphasis placed on surgical management.

Matched MeSH terms: Tomography

Tumour volume and lung metastasis in patients with osteosarcoma

Munajat I, Zulmi W, Norazman MZ, Wan Faisham WI

J Orthop Surg (Hong Kong), 2008 Aug;16(2):182-5.

PMID: 18725669

To assess the association between tumour volume and occurrence of lung metastasis in patients with osteosarcoma and to determine the cut-off value.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Tumour seeding following percutaneous needle biopsy of hepatocellular carcinoma

Qua CS, Wong CH, Goh KL

Singapore Med J, 2008 Jan;49(1):e8-11.

PMID: 18204759

We report a hepatocellular carcinoma seeding following needle biopsy in a 57-year-old man who first presented with a focal hepatic lesion at another hospital. The patient had been a hepatitis B carrier for 20 years. Initial surveillance ultrasonography showed a lesion in segment IV, in the background of non-cirrhotic liver and normal serum alpha-foetoprotein level (8 ng/ml). A percutaneous needle biopsy was done and histopathology confirmed well-differentiated hepatocellular carcinoma. The patient had refused surgery and preferred to try traditional medicine. He presented to us four months after the initial biopsy with epigastric swelling. This was found to be due to a tumour seeding along the previous biopsy tract. He was given radiofrequency ablation (RFA) of tumour along the needle tract, in addition to the primary tumour. We conclude that the need for percutaneous needle biopsy should be critically evaluated in patients presenting with focal hepatic lesions and the role of RFA in treating tumour seeding needs further evaluation.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Tumour mutation burden of non-small cell lung cancer with pre-existing ILD

Liam CK

Respirology, 2020 08;25(8):784-786.

PMID: 31805607 DOI: 10.1111/resp.13750

Matched MeSH terms: Tomography, X-Ray Computed

Tumour Lysis Syndrome: a Rare Complication of Trans-Arterial Chemo-Embolisation with Doxorubicin Beads for Hepatocellular Carcinoma

Katiman D, Manikam J, Goh KL, Abdullah BJ, Mahadeva S

J Gastrointest Cancer, 2012 Sep;43 Suppl 1:S187-90.

PMID: 22692948 DOI: 10.1007/s12029-012-9373-6

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Tuberous sclerosis with pulmonary lymphangioleiomyomatosis and renal angiomyolipomas

Hui Min Chong, Shien Yee Ng

International e-Journal of Science, Medicine & Education, 2014;8(2):30-34.

MyJurnal

The case report describes the presentation of a 19-year old female with tuberous sclerosis who presented with progressive dyspnoea over 2 days.
Chest radiograph revealed bilateral pneumothorax. Computed tomography showed features of pulmonary lymphangioleiomyomatosis and bilateral renal angiomyolipomas. The coexistence of both conditions may cause devastating morbidity and mortality.

Matched MeSH terms: Tomography, X-Ray Computed

Tuberculous meningitis: diagnostic and management pitfalls

Khairul Azman Mohd. Khalid, Hussain Imam Mohd Ismail, Mohd Sham Kasim

Malaysian Journal of Child Health, 1992;4(1):16-19.

MyJurnal

The diagnosis of tuberculous meningitis (TBM) demands a high index of suspicion. The prognosis depends on the stage of the disease the diagnosis is made and how early the treatment is instituted. The outcome of the disease is very poor when the diagnosis and treatment are late. This is what happened to this child, a 7-year-old Malay girl who presented at stage III TBM. The diagnosis was confirmed by a positive culture of M. tuberculosis from the cerebrospinal fluid (CSF). The delay in the diagnosis in this child had catastrophic consequences. She had hydrocephalus at presentation; however ventricular drainage was not done because parental consent was not obtained. She was started on acetazolamide and frusemide, and daily lumbar puncture in an attempt to reduce the raised intracranial pressure (ICP) in addition to anti-tuberculous chemotherapy. However when she showed no improvement, an external lumbar drain was inserted. The CSF was checked daily and the level of protein and glucose became normal after 6 weeks. The CT scan showed improvement of the hydrocephalus. However, the girl remained severely disabled after treatment and had to be fed via nasogastric tube and needed constant nursing care.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Tuberculosis of the skull mimicking a bony tumor

Rosli FJ, Haron R

Asian J Neurosurg, 2016 2 19;11(1):68.

PMID: 26889285 DOI: 10.4103/1793-5482.172594

We present a rare case of calvarial tuberculosis mimicking a solitary bone tumor, which was surgically removed. A 52-year-old female presented with a right forehead swelling, which gradually enlarged over the course of 2 years, with no symptoms or raised intracranial pressure or neurological deficits. Plain and contrast-enhanced brain computed tomography scans were done, revealing a punched-out lesion of the right frontal bone, with a nonenhancing lytic mass. With an initial diagnosis of an intraosseous meningioma, and later on intraoperatively thought to be a metastatic tumor, the mass was excised along with a rim of bone. Histopathological examination results came back as caseous necrosis, highly suggestive of tuberculosis. The patient was then treated with a 1 year regimen of anti-tuberculous medications. Tuberculosis of the cranium is a rare entity, and can mimic tumors or multiple myeloma. A high index of suspicion and knowledge is required for an early diagnosis. A combined surgical and medical therapy is curative.

Matched MeSH terms: Tomography, X-Ray Computed

Tuberculoid granulomatous lesion of the pharynx--review of the literature

Sharma HS, Kurl DN, Kamal MZ

Auris Nasus Larynx, 1998 May;25(2):187-91.

PMID: 9673733

Pharyngeal involvement in tuberculosis is rare and is usually secondary to pulmonary tuberculosis. We report a very rare case of chronic granulomatous pharyngitis, which later turned out to be due to primary tuberculosis of the pharynx. The clinical presentation, diagnosis, treatment and complications of this rare clinical entity are presented.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Triple primary cancers of the larynx, lung and thyroid presenting in one patient

Iqbal FR, Sani A, Gendeh BS, Aireen I

Med J Malaysia, 2008 Dec;63(5):417-8.

PMID: 19803306 MyJurnal

Patients with multiple malignant primary tumours are often described, based on their chronology of presentation, as simultaneous, synchronous or metachronous tumours. Lung malignancies presenting in association with head and neck tumours are well documented while there have been small series of thyroid synchronous cancers presenting with laryngeal lesions in literature. No cases, to our knowledge, have been reported in literature of a single patient with all three laryngeal, lung and thyroid malignancies. We report one such case of a 71-year-old Chinese man who had undergone a total laryngectomy for a recurrent cancer of the larynx only to be found to have tumours of the lung and thyroid in the post-operative period and he eventually died of post-operative complications. We also discuss screening for lung and thyroid malignancies in patients with head and neck squamous cell carcinoma (SCC).

Matched MeSH terms: Tomography, X-Ray Computed

Triple Vessel Coronary Artery Disease and Retinal Nerve Fibre Layer Thickness

Neoh YL, Neoh PF, Salleh A, Yusof ZB, Gurusamy B, Ahmad Tajudin LS

Ann Acad Med Singap, 2018 06;47(6):226-229.

PMID: 30019068

Matched MeSH terms: Tomography, Optical Coherence

Fulltext Treatment outcome of superficial cerebral abscess: an analysis of two surgical methods

Tan WM, Adnan JS, Mohamad Haspani MS

Malays J Med Sci, 2010 Jan;17(1):23-9.

PMID: 22135522 MyJurnal

The purpose of the study is to compare the two surgical methods (burr hole and craniotomy) used as treatment for superficial cerebral abscess and its outcome in terms of radiological clearance on brain CT, improvement of neurological status, the need for repeated surgery, and survival and morbidity at three months after surgery. This report is a retrospective case review of the patients who were treated surgically for superficial cerebral abscess in Hospital Kuala Lumpur (HKL) and Hospital Sultanah Aminah (HSA) over a period of four years (2004 to 2007).

Matched MeSH terms: Tomography, X-Ray Computed

Treatment of macular hole retinal detachment with macular plug in highly myopic eyes: three-year results

Wu AL, Ling KP, Chuang LH, Chen KJ, Chen YP, Yeung L, et al.

Acta Ophthalmol, 2020 Nov;98(7):e839-e847.

PMID: 32243725 DOI: 10.1111/aos.14418

PURPOSE: To investigate the long-term surgical outcomes of macular hole retinal detachment (MHRD) following vitrectomy with macular plug in highly myopic eyes.

METHODS: Thirty-five cases of highly myopic eyes with MHRD in 35 patients who underwent an initially successful vitrectomy with macular plug and were followed up for at least 3 years were reviewed. The anatomical outcomes were evaluated by fundus examination, fundus photographs and optical coherence tomography (OCT). Myopic features after the surgery were differentiated according to recommendations of the Meta-analysis of Pathologic Myopia (META-PM) Study Group. The best-corrected visual acuities (BCVAs) before and after surgery were analysed as the functional outcome. Main outcome measures time-course changes in BCVA and complications.

RESULTS: The mean patient age was 61.0 ± 11.4 years. The follow-up was 45.2 ± 8.6 months (ranged from 36 to 71 months). The mean axial length was 29.3 ± 1.2 mm. All eyes demonstrated attached retina, but 2 eyes (5.7%) developed reopened macular holes until the last follow-up. Complications of postoperative rhegmatogenous retinal detachment were detected in 2 eyes (5.7%) within 1 year and retina reattached after the secondary vitrectomy. Three cases (8.6%) of prolonged subretinal fluid lasting more than 1 year were detected but finally absorbed completely. Comparing 1-3 years postoperatively, myopic features showed significant progression of myopic maculopathy category (p = 0.035). Functionally, significantly improved BCVA could be maintained postoperatively between 6 months and 3 years. However, vision of 14 eyes (40.0%) worsened within 1-3 years postoperatively, and visual deterioration was associated with progression of myopic maculopathy (p = 0.004) and pre-existing disease of glaucoma (p = 0.006).

CONCLUSIONS: A vitrectomy combined with macular plug provided favourable outcomes in the long term, over the ≥3-year follow-up period.

Matched MeSH terms: Tomography, Optical Coherence

Fulltext Treatment of MOG antibody associated disorders: results of an international survey

Whittam DH, Karthikeayan V, Gibbons E, Kneen R, Chandratre S, Ciccarelli O, et al.

J Neurol, 2020 Dec;267(12):3565-3577.

PMID: 32623595 DOI: 10.1007/s00415-020-10026-y

INTRODUCTION: While monophasic and relapsing forms of myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD) are increasingly diagnosed world-wide, consensus on management is yet to be developed.

OBJECTIVE: To survey the current global clinical practice of clinicians treating MOGAD.

METHOD: Neurologists worldwide with expertise in treating MOGAD participated in an online survey (February-April 2019).

RESULTS: Fifty-two responses were received (response rate 60.5%) from 86 invited experts, comprising adult (78.8%, 41/52) and paediatric (21.2%, 11/52) neurologists in 22 countries. All treat acute attacks with high dose corticosteroids. If recovery is incomplete, 71.2% (37/52) proceed next to plasma exchange (PE). 45.5% (5/11) of paediatric neurologists use IV immunoglobulin (IVIg) in preference to PE. Following an acute attack, 55.8% (29/52) of respondents typically continue corticosteroids for ≥ 3 months; though less commonly when treating children. After an index event, 60% (31/51) usually start steroid-sparing maintenance therapy (MT); after ≥ 2 attacks 92.3% (48/52) would start MT. Repeat MOG antibody status is used by 52.9% (27/51) to help decide on MT initiation. Commonly used first line MTs in adults are azathioprine (30.8%, 16/52), mycophenolate mofetil (25.0%, 13/52) and rituximab (17.3%, 9/52). In children, IVIg is the preferred first line MT (54.5%; 6/11). Treatment response is monitored by MRI (53.8%; 28/52), optical coherence tomography (23.1%; 12/52) and MOG antibody titres (36.5%; 19/52). Regardless of monitoring results, 25.0% (13/52) would not stop MT.

CONCLUSION: Current treatment of MOGAD is highly variable, indicating a need for consensus-based treatment guidelines, while awaiting definitive clinical trials.

Matched MeSH terms: Tomography, Optical Coherence

Fulltext Traumatic transnasal penetrating injury with cerebral spinal fluid leak

Teng TS, Ishak NL, Subha ST, Bakar SA

EXCLI J, 2019;18:223-228.

PMID: 31217785 DOI: 10.17179/excli2018-1971

CSF leak in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture. We report a 5-year-old boy presented with epistaxis and impacted pencil into the left nostril. The child was hemodynamically stable without any neurological deficit. Intraoperatively, there was a nasal septal defect posteriorly with anterior skull base fracture associated with CSF leak. The pencil was removed from the left nostril and the CSF leak was repaired using harvested abdominal fat under the same setting. Computed Tomography (CT) of the brain showed right cribriform plate fracture with small pneumocranium. Postoperatively, a prophylactic antibiotic was given for seven days and he was discharged well. Subsequent clinic visits up to one-year postoperative period showed no recurrence of the CSF leak. History taking, physical examination and CT imaging give valuable diagnostic values in managing the penetrating skull base injury. Early intervention for removal of the foreign body and repair of the CSF leak is advocated to prevent catastrophic complication.

Matched MeSH terms: Tomography; Tomography, X-Ray Computed

Fulltext Traumatic transection of aorta

Ho CK, Yip KT, Eng JB, Rajan L, Tan BH

Med J Malaysia, 2001 Sep;56(3):374-7.

PMID: 11732086

A 16 year-old man presented with fracture of both his femurs after a road traffic accident. Chest radiograph revealed mediastinal widening. Subsequent CT scan and arch aortogram confirmed the findings of traumatic aortic arch transection at the isthmus. He underwent successful surgical repair. High index of suspicion and prompt actions are important in managing this potentially fatal but treatable condition.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Traumatic posterior rotatory fracture-dislocation of lumbo-sacral spine

Mukundala VV, Lim HH

Singapore Med J, 2001 Feb;42(2):82-4.

PMID: 11358198

Fracture-dislocation of the lumbo-sacral spine was an unusual injury and was divided into anterior, posterior and lateral types depending on the displacement of the cephalad portion of the spine over the caudal portion. According to the authors' knowledge, only 31 cases of traumatic fracture-dislocation of the lumbo-sacral spine were reported in the English literature. Only 3 previous reports referred to this injury with a posterior displacement, which was an even rarer injury. This was the fourth report of this type of injury.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Traumatic globe displacement into anterior cranial fossa

Patricia Ann John, Sylves Patrick, Mohtar Ibrahim, Adil Hussein

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):325-327.

MyJurnal

A 64-year-old Malay gentleman alleged occupational injury when a malfunctioned metal hydraulic door hit on his face while unloading sand from his tipper-truck. Post-trauma, he complained of right eye (RE) pain and total loss of vision. On examination, noted RE visual acuity was unable to be assessed and left eye (LE) was 6/24 with pinhole 6/9. No eyeball could be seen in the right socket with superior orbital rim step deformity and left periorbital haema- toma. Computed tomography scan of the brain and orbit confirmed displaced right eye globe into the right anterior cranial fossa with right and left multiple orbital wall fractures. He then underwent successful right eye globe reposi- tioning. Traumatic orbital roof fracture is a rare condition. Repositioning of the eye globe was done to salvage the eye globe for a cosmetic reason and to avoid localised inflammatory reaction at the anterior cranial fossa.

Matched MeSH terms: Tomography

Fulltext Traumatic brain injury patterns on ct scan: a comparison of motorcyclist versus passenger vehicle patients involved in road traffic accidents

Radhiana Hassan, Muniruddin Mohamad, Muhamad Zaim Azami, Husin Ali, Hafizah Pasi

International Medical Journal Malaysia, 2017;16(11):48-48.

MyJurnal

Traumatic brain injury following road traffic accidents is a common cause
of morbidity and mortality in Malaysia. We aim to determine the differences of traumatic
brain injury patterns based on CT findings among motorcyclist versus passenger vehicle
patients involved in road traffic accidents. (Copied from article).

Matched MeSH terms: Tomography, X-Ray Computed

Traumatic abdominal wall hernia - a case of handlebar hernia

Vincent K, Cheah SD

Med J Malaysia, 2018 12;73(6):425-426.

PMID: 30647222

Traumatic abdominal wall hernia (TAWH) after blunt injury is uncommon. Diagnosis requires careful examination and high index of suspicion. We report a case of a 12-year-old boy who complained of painful abdominal swelling over the left iliac fossa after a bicycle-handlebar hit his abdomen. TAWH was diagnosed clinically and confirmed with ultrasound and computed tomography (CT) scan. He developed incarceration after 12 hours of admission and subsequently underwent primary repair without mesh. As TAWH is usually associated with other concomitant injuries, it is important that we are meticulous to rule out other serious concomitant injuries.

Matched MeSH terms: Tomography, X-Ray Computed

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