MyMedR

Fulltext Case of a non-pulsatile groin swelling

Razif MA, Rajasingam V, Abdullah BJJ

Med J Malaysia, 2002 Dec;57(4):499-502.

We report a case of a non-pulsatile groin swelling in a 38 years old male drug addict without the typical clinical signs of an aneurysm. Ultrasound revealed a left femoral artery pseudo-aneurysm. He was surgically treated and the vessels were ligated without revascularisation.

Matched MeSH terms: Groin/blood supply; Groin/physiopathology*; Groin/ultrasonography

Fulltext Kimura's Disease with Atypical Musculoskeletal Presentation

Hafiz A., Yusuf, A., Rosmaliza, I., Premchandran, N., Kalavathy, R.

Malays Orthop J, 2010;4(2):44-47.

MyJurnal

We would like to highlight an unusual clinical presentation of Kimura's disease, a rare, benign, idiopathic condition, usually seen as swelling and lesions of the head and neck region and commonly affecting young men of Asian descent. It is rare for this disorder to present with lesions on other parts of the body, especially the lower limbs. We report a 27-year-old man who presented with a large mass located at the inguinal region and extending down to the upper thigh. Due to the large size of the mass (28 x 18 cm), our provisional diagnosis was a soft tissue sarcoma. Open biopsy showed that the lesion was benign.

Matched MeSH terms: Groin

Salvaging the chemoport using catheter-assisted deflection during stenting of the superior vena cava

H'ng MWC, Dennien B

Med J Malaysia, 2020 11;75(6):754-755.

PMID: 33219194

Patients with malignancy who develop superior vena cava (SVC) obstruction may require stenting to relieve their symptoms. Some of these individuals also have an indwelling chemoport for concomitant chemotherapy. We present a case where stenting was accomplished after catheter-assisted deflection of the chemoport catheter tubing via a single groin access. It can save procedure time whilst salvaging the device.

Matched MeSH terms: Groin

Fulltext Kimura's disease in Malaysian patients : three case reports

Roslan Abdul Rahman, Fadzilah Ismail, Roszalina Ramli, Ghazali Mat Nor, Sha Primuharsa Putra

Jurnal Sains Kesihatan Malaysia, 2005;3(1):1-8.

MyJurnal

Kimura's disease is a chronic inflammatory disorder which affects the subcutaneous tissues of the head and neck, axilla and upper limb as well as the groin region. In the head and neck region, major salivary glands and regional lymph nodes are mainly involved with associated eosinophilia and an elevated IgE concentration. Three cases of Kimura's disease involving the parotid glands, lymph nodes and cheek are presented with a brief review of the literature.

Matched MeSH terms: Groin

Candida albicans--saprophyte or pathogen?

Jaafar R, Pettit JH

Int J Dermatol, 1992 Nov;31(11):783-5.

PMID: 1428429

Skin scrapings taken from toe spaces of 200 healthy volunteers and from toe webs and groins of 150 pediatric patients were cultured for Candida albicans using the serum germ-tube test. The results showed that Candida albicans can be isolated in about 15% of normal toe spaces and 14% of children with normal groins. Although Candida albicans can be found in various grades of athlete's foot and also in some abnormal groins, we believe that it is not necessarily responsible for these conditions and is often present at these sites only as a saprophyte.

Matched MeSH terms: Groin/microbiology

Superficial tumours

Harrower G

Malayan Medical Journal, 1932;7:133-6.

Matched MeSH terms: Groin

Fulltext Hidradenitis Suppurativa in Kuala Lumpur, Malaysia: A 7-Year Retrospective Review

Ahmad Kamil MA, Mohd Affandi A

Dermatol Res Pract, 2018;2018:2017959.

PMID: 29951091 DOI: 10.1155/2018/2017959

Introduction: Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition characterized by inflamed nodules, abscesses, sinus tracts, and scarring, which can occur in any skin containing folliculopilosebaceous units. We aim to identify the demographic and clinical characteristics and treatment modalities in patients with HS.

Methods: A retrospective analysis involving records of patients diagnosed with HS in Hospital Kuala Lumpur from July 2009 to June 2016.

Results: Sixty-two patients were identified, with equal cases involving males and females. Majority of patients were Malays (41.9%), followed by Indians (35.5%), Chinese (17.7%), and other ethnicities (4.8%). Median age at diagnosis was 25 (IQR: 14) years. There is a delay in diagnosis with a median of 24 (IQR: 52) months. Most of the patients had lesions on the axilla (85.5%), followed by groin (33.9%) and gluteal region (29%). Gluteal lesions were more common in males. Nodules (67.7%), sinuses (56.5%), and abscesses (33.9%) were the main clinical features, with 43.5% classified under Hurley stage 2. There was no difference in terms of symptoms and types of lesions among different ethnicities and genders. Majority received systemic antibiotics, more than half had retinoid, and third of the patients had surgical intervention.

Conclusions: A prompt recognition of HS is imperative, to screen for comorbidities and to initiate early treatment to reduce physical and psychological complications.

Matched MeSH terms: Groin

Fulltext Transient Osteoporosis of the Hip: A Case Report

Pande K, Aung TT, Leong JF, Bickle I

Malays Orthop J, 2017 Mar;11(1):77-78.

PMID: 28435582 DOI: 10.5704/MOJ.1703.012

Transient osteoporosis of the hip (TOH) is a benign, selflimiting condition characterised by acute onset groin pain in adults. Early diagnosis is important to differentiate it from progressive conditions such as osteonecrosis. We report on a middle-aged male who presented with right groin pain without any prior trauma. The diagnosis of transient osteoporosis of hip was confirmed by Magnetic Resonance Imaging (MRI) and he was successfully treated with a course of Alendronate sodium, anti-inflammatory analgesics and a period of non-weight bearing ambulation.

Matched MeSH terms: Groin

Extra-anatomical veno-venous surgical bypass for central vein occlusion in patients with ipsilateral arterio-venous fistula (AVF) for haemodialysis - A single centre experience

Saravana KS, Zainal AA

Med J Malaysia, 2017 02;72(1):3-6.

PMID: 28255132 MyJurnal

OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face.

MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention. They underwent extra-anatomical vein to vein surgical bypass. The axillary and iliac or femoral veins were approached via infraclavicular and extraperitoneal groin incisions respectively. In all the patients, an externally supported 6 or 8 mm polytetrafluoroethylene (PTFE) graft was used as a conduit and was tunnelled extra-anatomical. All patients had double antiplatelet (Aspirin and Clopidogrel) therapy post-operatively.

RESULTS: Substantial improvement in the facial, neck and upper limb swelling was noticed following this diversion surgery. The vein to vein bypass was patent at 12 months in 10 out of 20 patients. Graft infection occurred in two (10%) cases. Re-thrombectomy or assisted patency procedure (stent/plasty) was done in four (20%) cases. The patients with preoperative fistula flow rate of more than 1500 ml/min and post-operative graft flow rate of more than a 1000 ml/min were patent at 12 months (P=0.025 and p=0.034 respectively).

CONCLUSION: Axillary to iliac/femoral vein bypass can salvage functioning ipsilateral fistula threatened by occluded upper central vein.

Matched MeSH terms: Groin

Kostmann's syndrome

Joazlina ZY, Wastie ML, Kamarulzaman A

Clin Imaging, 2005 Sep-Oct;29(5):364-6.

PMID: 16153548

Kostmann's syndrome is a rare congenital disorder of neutrophil production due to impairment of myeloid differentiation in the bone marrow, with the neutrophil count being characteristically less than 500 x 10(3) cells/l (normal: 2-7 x 10(9)/l). Severe persistent neutropenia results in an increased susceptibility to frequent bacterial infections. The condition can be treated with recombinant human granulocyte colony-stimulating factor (G-CSF). Although several articles have addressed the clinicopathological and haematological aspects of this disorder, little or no information has been available concerning the radiological findings in this disorder. This report summarizes the clinical features, radiological findings and management of a patient with Kostmann's syndrome.

Matched MeSH terms: Groin*

Fulltext Acute Ischaemic Stroke Successfully Treated with Thrombolytic Therapy and Endovascular Thrombectomy with Non-Contrast Computed Tomography and Computed Tomography Angiogram Protocol

Toh TH, Abdul Kadir KA, Tai MS, Tan KS

Case Rep Neurol, 2020 12 14;12(Suppl 1):15-21.

PMID: 33505267 DOI: 10.1159/000501820

Early endovascular thrombectomy leads to improved outcomes for patients with proximal occlusions when started within 6 h from onset of symptoms. We present a case illustrating the flow of events for a patient who underwent endovascular thrombectomy in our centre after conventional imaging - a brain non-contrast computed tomography (NCCT) and CT angiogram (CTA) - achieving a door-to-groin time of 195 min. The patient is a 65-year-old who presented with signs and symptoms of a left middle cerebral artery (MCA) territory infarct. His National Institute of Health Stroke Scale (NIHSS) score was 15 on presentation and his brain NCCT showed an Alberta Stroke Programme Early CT Score (ASPECTS) of 8. His CTA showed a left MCA distal M1 occlusion with focal calcification and stenosis of the proximal left internal carotid artery. He was subsequently thrombosed and underwent thrombectomy successfully, with a door-to-groin-puncture time of 195 min. A TICI 2b reperfusion was achieved. His NIHSS score improved to 9 over the next 2 days. For cases with straightforward NCCT and CTA with no contraindications, endovascular thrombectomy should be pursued without delay. A review of the current available literature for the usage of NCCT and CTA as well as the importance of ASPECTS scoring in patient selection for endovascular thrombectomy was included.

Matched MeSH terms: Groin

Amelanotic spitzoid melanoma in a prepubescent boy

Goh EH, Zarina AL, Thambidorai CR, Maizaton AA, Siti AM, Somasundram S

Pediatr Surg Int, 2008 Apr;24(4):447-9.

PMID: 17437116

The diagnosis of malignant melanoma (MM) in children is difficult due to its uncommon occurrence as well histological similarities to Spitz nevus. A case of MM of the foot in an 11-year-old boy is reported illustrating the histological overlap between Spitz nevus and MM. In our patient, both the primary foot lesion and the regional inguinal metastases were amelanotic, further increasing the diagnostic difficulty. The literature on MM in children is limited and the documentation of such unusual cases is necessary to improve the knowledge on this disease.

Matched MeSH terms: Groin

Fulltext A clinical trial of tissue adhesive (histoacryl) in skin closure of groin wounds

Teoh MK, Bucknall TE

Med J Malaysia, 1989 Jun;44(2):122-8.

PMID: 2696870

The use of tissue adhesives has been widely studied since the 1960s. Since then they have found use in specialties like plastic surgery, neurosurgery, ENT surgery and dental surgery. Several papers have reported their safe use, both clinically and experimentally, particularly of the newer homologue n-butyl/2-cyanoacrylate (Histoacryl). In this study 43 patients (46 wounds) whose operations involved a groin incision were randomised into two groups for skin closure either with Dexon subcuticular suture (23 wounds) or Histoacryl glue (23 wounds). We found that both sets of wounds healed well with no wound infections or excessive inflammation when assessed at one week and four weeks. However the glued wounds had consistently better cosmesis scores (mean score 4.71 at four weeks) compared to the subcuticular Dexon wounds (mean score 4.00 at four weeks) and P value of less than 0.05. We feel that there is a place for tissue adhesives in skin closure for some general surgical wounds.

Matched MeSH terms: Groin

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