We present the case of a 46-year old man with a two-year history of losing his denture presenting with cachexia and a two-month history of dysphagia to both liquids and solids associated with odynophagia. Review at th...We present the case of a 46-year old man with a two-year history of losing his denture presenting with cachexia and a two-month history of dysphagia to both liquids and solids associated with odynophagia. Review at the ENT department where a diagnostic rigid oesophagoscopy was done under general anaesthesia showed a denture impacted to the wall of the oesophagus at 17 cm from the incisor. Attempts at retrieval were unsuccessful as the denture was deeply embedded in the oesophageal wall <em>and bled easily on attempted removal</em>. He subsequently underwent a 2-stage surgical management approach by the cardiothoracic surgical team. Patient first underwent nutritional rehabilitation for a month through a created feeding gastrostomy tube via a limited midline laparotomy. He then had a open cervical oesophagotomy and removal of the denture. Currently doing well six months after surgery and tolerating normal oral diet.展开更多
Arteriovenous malformation (AVM) are vascular anomalies that arise due to abnormal connection with shunting of blood from arteries to veins without an intervening capillary network. They are mostly found intracraniall...Arteriovenous malformation (AVM) are vascular anomalies that arise due to abnormal connection with shunting of blood from arteries to veins without an intervening capillary network. They are mostly found intracranially but extracranially, the scalp AVM cases are also well reported. However, arteriovenous malformation (AVM) of the scalp is a rare lesion whose natural history is not clearly understood. The clinical manifestation of AVM includes asymptomatic state, local discomfort, headaches and occasional scalp necrosis leading to massive haemorrhage. CT or MR angiography remains the cornerstone for investigation. The options of treatment include complete surgical excision, embolization or a combination of the two modalities. We present the successful management of a young man who presented with a torrential bleeding from a ruptured scalp arteriovenous malformation and had to undergo emergency complete excision followed with a rotational flap for the scalp reconstruction.展开更多
Gastric perforation into the thoracic cavity through a diaphragmatic rupture is rare but, when it occurs, patients present in severe distress, with mortality approaching 50%. We present our experience of two rare and ...Gastric perforation into the thoracic cavity through a diaphragmatic rupture is rare but, when it occurs, patients present in severe distress, with mortality approaching 50%. We present our experience of two rare and unusual cases of traumatic diaphragmatic rupture from penetrating chest injury associated with herniated intrathoracic gastric perforation over a five-year period from January 2015 to December 2020 at the cardiovascular and thoracic surgery department of the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Both patients underwent successful surgical repair through standard posterolateral thoracotomy with one having earlier negative exploratory laparotomy. The essence of the paper is to share and discuss the clinical presentation, diagnostic challenges, surgical management and the postoperative care of this very rare complication of traumatic diaphragmatic rupture.展开更多
文摘We present the case of a 46-year old man with a two-year history of losing his denture presenting with cachexia and a two-month history of dysphagia to both liquids and solids associated with odynophagia. Review at the ENT department where a diagnostic rigid oesophagoscopy was done under general anaesthesia showed a denture impacted to the wall of the oesophagus at 17 cm from the incisor. Attempts at retrieval were unsuccessful as the denture was deeply embedded in the oesophageal wall <em>and bled easily on attempted removal</em>. He subsequently underwent a 2-stage surgical management approach by the cardiothoracic surgical team. Patient first underwent nutritional rehabilitation for a month through a created feeding gastrostomy tube via a limited midline laparotomy. He then had a open cervical oesophagotomy and removal of the denture. Currently doing well six months after surgery and tolerating normal oral diet.
文摘Arteriovenous malformation (AVM) are vascular anomalies that arise due to abnormal connection with shunting of blood from arteries to veins without an intervening capillary network. They are mostly found intracranially but extracranially, the scalp AVM cases are also well reported. However, arteriovenous malformation (AVM) of the scalp is a rare lesion whose natural history is not clearly understood. The clinical manifestation of AVM includes asymptomatic state, local discomfort, headaches and occasional scalp necrosis leading to massive haemorrhage. CT or MR angiography remains the cornerstone for investigation. The options of treatment include complete surgical excision, embolization or a combination of the two modalities. We present the successful management of a young man who presented with a torrential bleeding from a ruptured scalp arteriovenous malformation and had to undergo emergency complete excision followed with a rotational flap for the scalp reconstruction.
文摘Gastric perforation into the thoracic cavity through a diaphragmatic rupture is rare but, when it occurs, patients present in severe distress, with mortality approaching 50%. We present our experience of two rare and unusual cases of traumatic diaphragmatic rupture from penetrating chest injury associated with herniated intrathoracic gastric perforation over a five-year period from January 2015 to December 2020 at the cardiovascular and thoracic surgery department of the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Both patients underwent successful surgical repair through standard posterolateral thoracotomy with one having earlier negative exploratory laparotomy. The essence of the paper is to share and discuss the clinical presentation, diagnostic challenges, surgical management and the postoperative care of this very rare complication of traumatic diaphragmatic rupture.
