Spontaneous intramural haematoma of the oesophagus is an uncommon condition which may follow rapid increases in intra-oesophageal pressure and is predisposed to by coagulation disorders. The characteristic clinical presentation and findings at radiology and endoscopy frequently result in misdiagnosis and confusion with more sinister pathology. Awareness of the condition and ...

We report the first case of upper lumbar ureteral replacement with the vermiform appendix, in a blunt traumatic ureter rupture with important urinoma. In selected cases, in which the appendix has a required caliber and length, the vermiform appendix is a very good autograft for ureteral substitution. The vermiform appendix ...

Traumatic ruptures of the triceps are very rare among tendon injuries. A unique case of hypocalcemic tetany that induced spontaneous triceps tendon avulsion with associated bilateral quadriceps tendon ruptures is reported. The current orthopaedic literature is reviewed, and a new application of an existing surgical treatment for repair of the ...

Isolated injuries of the scapho-trapezial ligament complex are not well recognized. The ligament complex comprises the stout scapho-trapezial ligament, the floor of the flexor carpi radialis (FCR) tendon sheath and the scapho-capitate ligament. Between August 1991 and May 1992, we diagnosed and treated four cases of partial chronic post-traumatic lesions ...

A supernumerary extensor muscle to the middle finger was found to be present bilaterally in a male cadaver. It originated from the distal end of the ulna and its tendon inserted into the proximal phalanx of the middle finger. The bilateral presence and manner of insertion appear to be unique ...

A unique case of acute compartment syndrome of both lower legs caused by a ruptured tibial artery in a patient with polyarteritis nodosa is reported. No similar cases have been reported in the literature. A review of the literature on ruptured aneurysms in patients with polyarteritis nodosa is discussed.

Ruptured uterus is a grave obstetric complication, associated with high maternal mortality and morbidity, perinatal mortality and loss of future fertility as hysterectomy is inevitable in many cases. This study reviews the incidence, causes and other factors, to define problem areas and propose preventive measures. During 1979-1988, 126 cases of ...

A rare case of metaphyseal cupping of the distal femur resulting from infantile scury in a child is reported. The radiological and surgical aspects of this case are of particular interest. MRI demonstrated central epiphysiodesis of the right knee, surgery achieved rupture of the epiphyseal plate and resulted in femoral ...

The anatomy of the deep transverse metacarpal ligament was examined in cadaveric dissections. Previously unreported findings were transverse muscular slips from abductor digiti minimi that inserted into the medial border of the ligament and, in 1 case, an extension from the medial half of the tendon of extensor carpi ulnaris ...

We investigated consecutive 1000 autopsied cases (average age 82.9 years) clinicopathologically in order to reveal the significance of cerebral amyloid angiopathy (CAA) as a cause of senile intracranial hemorrhages. We found 101 cases with intracerebral hemorrhages, and CAA accounted for 10.9% of them (31.0% of lobar cerebral hemorrhages, and 14.3% ...

We have reported an unusual case of pectoralis major muscle rupture and repair. There were three interesting aspects of this case. First, the injury occurred in a football player with an unusual mechanism of injury. Second, MRI using special techniques was valuable in confirming the diagnosis acutely and in planning ...

A spontaneous rupture of the left iliac vein is described. A 2 cm tear on the anterior surface of the left iliac vein was discovered at emergency laparotomy on a patient who was suspected of having a huge intraabdominal hemorrhage. Prodromal symptoms, cause, and treatment are discussed. The nine previously ...

The authors report a case of splenic aneurysm rupture in a 61-year-old woman. The diagnosis was made by computed tomography in the second phase of a "double rupture phenomenon" in circulatory collapse. This was successfully treated by aneurysmectomy and splenectomy. The case is reported together with the literature review.

Five cases of spontaneous rupture of the oesophagus are reported. All cases had surgery within 12 hours, and all survived, illustrating the value of early diagnosis in this rare condition. None had their diagnosis made before admission to the hospital. Myocardial infarction is the commonest misdiagnosis and frequently results in ...

Splenic hemangioma is rare. The major problem concerning splenic hemangioma is the difficulty of preoperative diagnosis. No characteristic signs allow the specific diagnosis of this tumor. Spontaneous rupture is the main complication, occurring in up to 25% of cases reported. In cases of rupture of the tumor, splenectomy is a ...

Atraumatic splenic ruptures in the course of infectious diseases are rare but have been reported. Various germs of viruses can be at the origin of such rupture. The more often quoted viral disease is infectious mononucleosis. The more frequently involved bacteria are Streptococcus non pneumoniae, Pseudomonas, staphylococci and Clostridium. Rupture ...

Clinicians are increasingly confronted with diagnosis and management of malarial complications. In nonfalciparum malaria, severe complications usually involve the spleen, most notably among them the condition termed spontaneous splenic rupture. A case of infection due to Plasmodium malariae resulting in a symptomatic splenic hematoma is presented. Malarial splenic enlargement and ...

We report a case of unusual presentation of a patient with hemangioma of the spleen. The patient had presented with recurrent gastric hemorrhage and significant weight loss, due to ruptured hemangioma of the spleen and associated splenic tuberculosis. The true nature of the lesions remained a diagnostic dilemma despite complete ...

The electromyographic (EMG) diagnosis of spasmophilia is based on the appearance in a susceptible muscle of spontaneous burst (multiplet) discharges after an activation procedure consisting usually in 10 minutes ischemia followed by a pause of a length that varies with the author but does not exceed 5 minutes, and finally ...

We report herein our experience of two cases of spontaneous hemopneumothorax in which the source of bleeding was found to be aberrant vessels. Both patients were successfully treated by early thoracotomy. Case 1 was a 23-year-old female in whom chest X-ray revealed an air-fluid line and a bulla with a ...

At the foot and ankle, stenosing peroneal tendovaginitis has only rarely been described in literature. The superior and inferior peroneal retinacula, however, may cause symptoms of stenosis similar to other tendons in the foot and the hand. A case of a forty-three year-old woman is presented, where posttraumatic stenosing peroneal ...

We compared preoperative echograms and postoperative histological specimens from 16 patients who had undergone radical prostatectomy or radical cystourethrectomy to evaluate the correlation between the so-called capsular echogram obtained on transrectal ultrasonography and histology of the prostatic capsule. The capsular echogram corresponded to the periprostatic fatty tissue in all cases. ...

Nonrheumatoid ruptures of the flexor tendons in the palm are rare. We report a case in which excessive exertion caused rupture of the flexor digitorum profundus tendon to the small finger in the palm at the level of the lumbrical origin. The patient had been practicing Japanese fencing for many ...

We present 6 cases of spontaneous hemothorax and comprehensively review the medical literature on this subject. We categorize the reported causes and offer a rational diagnostic approach to patients with nontraumatic hemothorax. We recommend specific treatments for specific etiologies, and emphasize the importance of well-established surgical principles for the treatment ...

An abundance of literature has been published regarding rupture of the tendo Achillis. Certain studies review various options for management, while others focus on the mechanisms and pathogenesis of injury. There are, however, significant differences in the outcomes of these studies. This article reviews the basic anatomy of the tendo ...

Closed ruptures of both normal flexor tendons in the same finger are extremely rare, only nine cases having been reported in the literature. We describe the case of a patient who sustained a closed rupture of both flexor digitorum profundus and flexor digitorum superficialis of the ring finger, following a ...

A spontaneous tear of the ascending aorta, with or without medial dissection, can cause sudden death from hemorrhage due to aortic rupture. Two representative cases are described. Review of the clinical history and pathological changes showed that the terminal event was delayed allowing healing and reactive changes to occur in ...

Spontaneous pneumoperitoneum without peritonitis is a rare phenomenon which poses a dilemma to the surgeon faced with this problem. Two such cases and their outcome are presented. The first case was caused by barotrauma during positive pressure ventilation and was treated by laparotomy. No perforated viscus was found. The second ...

Electrocardiographic (ECG) alterations in the course of sub-arachnoid hemorrhage (SAH) have frequently been reported. The most frequent anomalies reported were lengthening of the QT interval, very negative or positive deep T waves, elevation or depression of the ST segment and the presence of U waves. We report 70 cases of ...

A case of total puerperal rupture of the pubic symphysis during non-operative delivery is reported and the literature reviewed. The patient in our case was successfully treated by external skeletal fixation. In agreement with the literature the authors recommend external skeletal fixation when lesions are unstable, when inadequate reduction is ...

Isolated involvement of the short head of the biceps in a bicipital rupture is a rare injury. The most common location of an isolated short head rupture is through the tendon. The only reported cases of rupture through the short head muscle belly were described in a series by Gilcreest, ...

Three cases of metastatic Clostridial myonecrosis are reported, two following spontaneous and one following criminal abortion. This particular combination has not been reported before. The two survivors were managed by hysterectomy and disarticulation of the leg through the hip. The patient who died did so before surgery could be undertaken. ...

Splenic rupture, in association with mononucleosis, can be lethal. Most reported cases of splenic rupture in patients with mononucleosis have not responded to conservative splenic preserving measures and have resulted in splenectomy. We report a case of traumatic splenic disruption in a patient with mononucleosis in whom conservative management was ...

Rupture of finger extensor tendons by attrition is an extremely rare complication of Madelung's deformity. We report a case of bilateral rupture in a previously symptom-free woman. The dorsally subluxed distal ulna was resected to prevent further rupture. The mechanism of injury, clinical and radiographic features, and treatment of this ...

We report a case of spontaneous splenic rupture in a patient with metastatic melanoma. Spontaneous splenic rupture without previous trauma has been observed in various pathological conditions such as infectious mononucleosis, malaria, typhoid fever and, rarely, neoplasms affecting the spleen. There have been several reported cases of splenic rupture in ...

We report a patient who presented with abruptio placenta and hepatic rupture at 30 weeks gestation. The latter is a recognised but rare complication of pre-eclampsia and eclampsia. The typical features of this entity as described in the literature and as seen in this patient are emphasized as increased awareness ...

A case report of uterine rupture in labor with epidural anesthesia is presented. The woman had good analgesia on the left side, but complained of severe labor pais on her right side. Uterine rupture occurred which was manifested by sudden vaginal bleeding, fainting, low blood pressure and fetal distress. She ...

A case of dehiscence of a previously repaired bladder rupture occurring 3 years after the original repair is reported. There was no obvious predisposing cause to this event. As this occurrence is very rare, it brings into question the need for long-term review of patients with conservatively treated bladder rupture.

Bilateral rupture of the patellar ligament in a 49-year-old woman is reported. She sustained a relatively minor trauma and no underlying systemic disease could be found. This is the 14th case of simultaneous spontaneous rupture of the patellar tendons reported in the literature. The diagnostic features were diffuse swelling around ...

Traumatic rupture of the quadriceps tendon is well known to occur in middle-aged men in patients on hemodialysis for renal failure and in patients with diabetes, but only very rarely in young and healthy women. We report a case of traumatic rupture of the quadriceps tendon of a girl without ...

Attrition ruptures of the flexor tendons in the carpal tunnel are uncommon. A case of rupture of the flexor digitorum profundus tendon to the little finger secondary to osteoarthritis of the pisotriquetral joint is reported. Mechanical attrition against the radial side of the pisiform was thought to be responsible for ...

Splenic rupture in blunt and penetrating trauma is well documented. Other etiologies include hematologic and inflammatory disorders. The case presented documents occult splenic rupture. There was no history of trauma. Furthermore, no evidence of systemic disease or pathology could be found. Occult, spontaneous splenic rupture is rarely diagnosed, although the ...

Rupture of an abdominal aortic aneurysm into the venous system such as the inferior vena cava, the iliac vein or the renal vein occurs rarely. Our own experience illustrating this uncommon lesion is presented, and 25 reported cases in Japan including our own were clinically analysed. The physician's awareness of ...

Two cases of splenic uptake of Tc-99m MDP are presented, in which there was preserved reticuloendothelial activity (Tc-99m sulfur colloid accumulation). In addition to the literature data, data from these cases were used to show the disassociation of uptake of bone agents and radiocolloid in the spleen. Prior reports, in ...

A case of acute traumatic rupture of the thoracic aorta was diagnosed by dynamic CT. Angiographic conformation was required, delaying surgical repair and contributing to the fatal outcome. If reliable findings of acute traumatic rupture of the thoracic aorta are shown by CT, we question the usefulness of angiographic confirmation ...

Spontaneous pneumothorax is a known complication of Pneumocystis carinii pneumonia (PCP) in patients with acquired immunodeficiency syndrome. From a series of 61 patients with PCP, we identified two cases, not associated with aerosolized pentamidine, that presented with spontaneous pneumothorax and cystic changes seen on chest radiographs. Bronchoalveolar lavage cell findings ...

Since 1988 there have been 15 reported cases of late, spontaneously ruptured intestinal cystoplasties at bowel sites remote from the anastomosis. Ischemic necrosis has been suggested as a possible etiology. We examined this hypothesis by quantifying the uptake of intravascular fluorescein in the augmented bowel of adult mongrel canines. There ...

The authors report three cases of distal anterior cerebral artery aneurysm presenting as acute subdural hematoma (SDH). Two patients were comatose on admission and died of massive SDH. One patient underwent aneurysmal neck clipping in the chronic stage and returned to normal daily life. A convexity SDH continuous with a ...

Prostaglandin E2 is a powerful oxytocic agent that reliably initiates labor, even in the presence of an unripe cervix. The low incidence of fetomaternal complication contributes to its universal use. We report a rare case of uterine rupture after intracervical application of prostaglandin E2 gel. Thus far no prostaglandin compound ...

Life-threatening spontaneous chylothorax is a rare clinical entity. Correct diagnosis and understanding of its pathogenesis is paramount in order to apply definite surgical treatment. A case of a ruptured multilocular chylocyst around the thoracic duct and cysterna chyli is presented. Multiple bilateral aspirations, right thoracostomy, right thoracotomy, a frustrated attempt ...