1/3. Necrotizing perineal fasciitis in two paraplegic nursing-home residents: CT imaging findings.Necrotizing fasciitis is a severe infection of the superficial fascia. Early recognition and aggressive management are essential to the treatment of this highly morbid disease. The clinical and physical findings are often the initial clues leading to the correct diagnosis. Computed tomography can play a crucial role in delineating the anatomy, evaluating for the extent of the infection, and for eventual complications. Before the advent of cross-sectional imaging, the majority of suspected patients underwent extensive surgical debridement procedures with resultant morbidity and mortality. We present two cases in which computed tomography played a major role in determining the need for emergent surgery and conservative management.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/3. Ultrasonographic appearance of necrotizing gangrene: aid in early diagnosis.In 2 seriously ill patients with scrotal swelling of uncertain origin, scrotal and perineal ultrasonography demonstrated gas in the soft tissue before crepitus was detected on physical examination. Necrotizing infections of the scrotum and perineum have characteristic ultrasonographic features that can facilitate earlier diagnosis and treatment.- - - - - - - - - - ranking = 22.496575562168keywords = physical examination, physical (Clic here for more details about this article) |
3/3. Selecting the appropriate urinary diversion procedure in the spinal cord injured: a poignant reminder.Lower urinary tract reconstruction has been performed on the spinal injured population at our institution since 1988. Careful pre-operative evaluation including a detailed history, physical examination and radiographic and/or urodynamic studies are usually obtained to determine which type of procedure would be most beneficial for each individual patient. Typically, patients receive either a cutaneous (i.e., Kock or indiana) diversion or undergo a form of bladder augmentation (usually ileocystoplasty). Pre-operative findings and the patient's history are carefully considered prior to choosing the appropriate procedure. Occasionally, a particular finding influences the decision. We describe a patient who received a hemi-Kock ileocystoplasty with a continent abdominal stoma who, in retrospect, would have benefitted from a supravesical diversion.- - - - - - - - - - ranking = 22.496575562168keywords = physical examination, physical (Clic here for more details about this article) |