1/41. hematometra and extended vaginal haematoma after laser conization. A case report.A very rare case of haematometra and extended vaginal haematoma in a 53-year-old woman after laser conization is reported. The patient presented with amenorrhea and complete urinary retention. The possible pathogenesis of this complication is discussed. ultrasonography, combined with physical examination were very helpful in determining the diagnosis. Cervical dilation and protection of surrounding tissues from thermal damage is recommended during laser conization to avoid similar complications.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/41. Low-intensity laser therapy for benign fibrotic lumps in the breast following reduction mammaplasty.BACKGROUND AND PURPOSE: Fibrotic masses in the breast secondary to fat necrosis or hematoma are a complication of breast reduction mammaplasty. The treatment commonly recommended for this condition is early surgical debridement of necrotic tissue from the entire area, which causes scarring. This case report describes the use of low-intensity laser therapy for fibrotic lumps following reduction mammaplasty. CASE DESCRIPTION: The patient was a 46-year-old woman who had breast reduction surgery 80 days prior to referral for physical therapy. At the time of referral, the largest mass was 8.0 cm in diameter. The patient reported pain and said she was distressed about the breast disfigurement. Laser irradiation was initiated at an energy density (ED) of 20 J/cm2 and a pulse repetition rate of 5,000 pulses per second. The laser settings were adjusted during the 8-month treatment period. The final ED was 50 J/cm2. OUTCOMES: The mass was 33% of its original size after 3 treatments over the initial 11-day period. Pain relief was immediate. The rate of resolution decreased after the initial period. The patient had some tissue thickening at the time of discharge after 6 months of treatment. DISCUSSION: This case demonstrates the potential use of laser therapy as a treatment for benign breast lumps following mammaplasty.- - - - - - - - - - ranking = 0.11734686407114keywords = physical (Clic here for more details about this article) |
3/41. Lymphocytic hypophysitis in a patient with systemic lupus erythematosus.A case of lymphocytic hypophysitis in a patient with systemic lupus erythematosus is described. A 20-year-old woman was admitted to our hospital with generalized myalgia and facial rash in May 1998. The patient had a medical history, physical examination, and laboratory findings compatible with systemic lupus erythematosus (SLE). headache and nausea had developed 3 months previously and worsened over the following months. Hormonal investigation showed hypopituitarism except for prolactin. A magnetic resonance image of the brain showed a mass lesion in the pituitary fossa. A trans-sphenoidal surgical procedure was performed which revealed a dark-yellowish hematoma. Microscopic examination showed diffuse infiltration of lymphocytes and plasma cells with fibrosis in the anterior pituitary. Post-operatively the patient's headaches and nausea resolved. This indicates that lymphocytic hypophysitis may be associated with SLE.- - - - - - - - - - ranking = 0.11734686407114keywords = physical (Clic here for more details about this article) |
4/41. Vascular injuries of the upper extremity.Vascular injuries of the upper extremity represent approximately 30% to 50% of all peripheral vascular injuries. The majority of injuries are to the brachial artery, and 90% of injuries are due to penetrating trauma. Return of function is often related to concomitant injury to peripheral nerves. However, timely restoration of blood flow is essential to optimize outcome. The diagnosis is made by physical examination and limited Doppler ultrasonography. Arteriography may be helpful if there are multiple sites of injury. Anticoagulation with heparin should be given if not otherwise contraindicated. Revascularization should be completed within the critical ischemic time: 4 hours for proximate injuries and 12 hours for distal injuries. Revascularization methods include resection and primary repair or resection with an interposition graft. The sequence of repair of multiple injuries to the extremity begins with arterial revascularization followed by skeletal stabilization and nerve and tendon repair.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
5/41. Physical restraint and subcutaneous hematoma in an anticoagulated patient.A large subcutaneous hematoma extending from the breastbone region to the left axillary region and left flank developed in a 86-year-old anticoagulated man because of repeated microtrauma from a physical restraint used to prevent his rising from a chair. physicians, nurses, and physiotherapists should recognize that physical restraints causing pressure on the skin increase hemorrhagic risk in patients who take low molecular weight heparin. Accordingly, they should systematically check for hemorrhagic complications and attempt to limit the use of such devices.- - - - - - - - - - ranking = 0.23469372814229keywords = physical (Clic here for more details about this article) |
6/41. Operative laparoscopy and vulvar hematoma: an unusual association.Few cases of intraoperative or postoperative complications associated with laparoscopic adnexal surgery have been reported in the literature. We describe a case of laparoscopic abdominal vascular injury and persistent bleeding in the matrix of the ovary following laparoscopic cystectomy. During the first postsurgical day, the patient was syncopal. The physical examination showed a vulvar hematoma and minimal bleeding from a laparoscopic incision in the abdominal wall. Vulvar hematoma and an unstable patient may signal serious vascular bleeding.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/41. An unusual cause of pelvic mass.BACKGROUND: pelvic pain with an associated pelvic mass is a common problem in the emergency room (ER) or physician's office. Concerns about ectopic pregnancy, infection, or malignancy usually dominate the diagnostic evaluation. At the same time, domestic violence as the cause of a pelvic mass is seldom suspected by physicians. CASE: A 38-year-old woman came to the ER with left lower quadrant pain and a left pelvic mass. After four hospital days and multiple diagnostic imaging studies, the diagnosis of hematoma caused by physical trauma to the abdomen was elucidated. CONCLUSION: Proper diagnosis of the cause of the pelvic mass could have been made earlier by careful attention to the social history and by recognizing the high incidence of domestic violence as opposed to the relative infrequency of some other diagnostic entities for which the patient was tested.- - - - - - - - - - ranking = 0.11734686407114keywords = physical (Clic here for more details about this article) |
8/41. Airway compromise secondary to lingual hematoma complicating administration of tissue plasminogen activator for acute ischemic stroke.Hemorrhagic complications of tissue plasminogen activator (tPA) are well known. We report a case of a lingual hematoma that developed after tPA administration for an acute ischemic stroke that necessitated orotracheal intubation to maintain the patient's airway. This case demonstrates the need for thorough preadministration physical examination, as well as careful monitoring during infusion and after administration of this potent therapeutic agent.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
9/41. Rectus sheath hematoma in an elderly woman under anti-coagulant therapy.Rectal sheath hematoma has been a well-known clinical entity from the ruin of the ancient greece. It is relatively rare, however, to encounter this abdominal disorder in the clinical setting. Furthermore, the initial symptoms of rectus sheath hematoma are often similar to those of acute abdominal disorders. Therefore, the majority of the patients with rectus sheath hematoma have been treated with operative procedures because of the difficulty of a differential diagnosis from other abdominal disorders. We recently treated a 74-year female diagnosed with rectus sheath hematoma with the anticoagulants after an episode of cerebral infarction. From the findings of the physical examinations, ultrasound, and computed tomography, we could correctly diagnose, and could treat her with completely conservative methods without any invasive techniques. It is stressed that it is important to recognize this entity of rectus sheath hematoma when patients are examined, after complaining of acute abdominal pain and with evidence abdominal masses in the clinical setting.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
10/41. Acute femoral neuropathy secondary to an iliacus muscle hematoma.We present a patient with a spontaneous iliacus muscle hematoma, appearing immediately after a minor physical maneuver, presenting with pain and femoral neuropathy initially evidenced by massive quadriceps muscle fasciculations. A magnetic resonance imaging (MRI) study of the pelvic area confirmed the diagnosis, showing a hematoma secondary to a partial muscle tear. The patient was managed conservatively, and the continuous muscle activity ceased in 3 days, with progressive improvement of the pain and weakness. The recovery was complete. femoral neuropathy is uncommon and usually due to compression from psoas muscle mass lesions of diverse nature, including hematomas. Usually subacute, femoral neuropathy may present acutely in cases of large or strategically placed compressive femoral nerve lesions, and may require surgical evacuation.The case presented herein is remarkable since the muscle hematoma appeared after a nonviolent maneuver, fasciculations were present at onset, and conservative management was sufficient for a full recovery.- - - - - - - - - - ranking = 0.11734686407114keywords = physical (Clic here for more details about this article) |
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