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At least 199 records · Page 11Linked to original sources

PubMed1991

Acquired hypoprothrombinaemia and lupus anticoagulant: response to steroid therapy.

An iliac crest bone marrow aspiration in a 24-year-old man was followed by severe haemorrhage into the iliopsoas muscle. A lupus anticoagulant and severe hypoprothrombinaemia, as well as clinical and laboratory pointers to suggest the presence of a systemic lupus erythematosus-like syndrome, were demonstrated. Therapy with prednisone was commenced following recurrent severe epistaxis. His prothrombin time, activated partial thromboplastin time and prothrombin activity improved promptly and his bleeding ceased. The lupus anticoagulant is commonly encountered in the laboratory, but acquired hypoprothrombinaemia is extremely rare. The condition is reviewed and its treatment discussed.

Adult↗

PubMedDate not supplied

Computed tomography vs barium studies in the acutely symptomatic patient with Crohn disease.

Gastrointestinal contrast studies and CT performed on 43 patients with known Crohn disease with acute symptoms were retrospectively reviewed to assess the ability of each study to define the location and extent of disease. In 39 of 43 (91%) patients the contrast studies and CT agreed on the location of active disease. However, in 15 of 43 (35%) patients, contrast studies demonstrated additional areas of mucosal disease remote from the major area of activity that were not suggested by CT. In addition to demonstrating more extensive mucosal disease, contrast studies proved superior in demonstrating enteroenteric fistulae, sinus tracts, strictures, postsurgical anatomy, and relation of recurrence to anastomosis. Computed tomography proved superior in demonstrating mesenteric inflammation, abscesses, enterovesical and enterocutaneous fistulae, fistula to iliopsoas muscle and to sacrum. We conclude that in the patient with suspected abscess, enterovesical or enterocutaneous fistula, CT is the study of choice. In other clinical circumstances both CT and contrast studies should be performed since they are complementary.

Acute Disease↗

PubMed1999

Anatomic study of the lateral femoral cutaneous nerve with respect to the ilioinguinal surgical dissection.

OBJECTIVE: To report on the anatomic variations of the lateral femoral cutaneous nerve with respect to the ilioinguinal surgical dissection. DESIGN: Cadaveric anatomic study. PATIENTS/PARTICIPANTS: Sixty-eight ilioinguinal dissections performed in fifty cadavers. INTERVENTION: The lateral femoral cutaneous nerve was identified, and certain location variables were recorded. MAIN OUTCOME MEASURE: The distance in millimeters from the medial edge of the anterior superior iliac spine (ASIS), whether the nerve was lateral or medial to the ASIS, and the layer in which the nerve crossed the dissection. RESULTS: In seven dissections, the nerve was twenty-one to twenty-five millimeters medial to the ASIS; in ten dissections, the nerve was twenty-six to thirty millimeters from the ASIS; and in fourteen dissections, the nerve was more than thirty millimeters medial to the superior border of the ASIS. The average medial distance from the ASIS was 20.4 millimeters, with a range of three to forty-six millimeters. In no specimen did the nerve pass lateral to the ASIS. The lateral femoral cutaneous nerve was found to lie anterior to the iliopsoas muscle in all specimens. CONCLUSION: The course of the lateral femoral cutaneous nerve is highly variable; the nerve was most commonly found at ten to fifteen millimeters from the ASIS and as far medially as forty-six millimeters. When using the illioinguinal surgical approach, if the lateral femoral cutaneous nerve is not encountered immediately adjacent to the ASIS, dissection up to five centimeters medial to the ASIS may be necessary to locate the nerve.

Cadaver↗

PubMed1999

Multiple gigantic arteriovenous malformations with destruction of lumbar vertebral bodies. A case report.

STUDY DESIGN: This case report describes a patient with massive intramuscular and paravertebral arteriovenous malformations with destruction of vertebral bodies. OBJECTIVES: To demonstrate successful interbody fusion of the involved vertebral bodies after embolization for arteriovenous malformation. SUMMARY OF BACKGROUND DATA: Although arteriovenous malformations in the spinal cord are well documented in the literature, arteriovenous malformation in the paravertebral and iliopsoas muscles with destruction of vertebral bodies is an extremely rare clinical condition. METHODS: After careful investigation with angiography, the arteriovenous malformations were managed with embolization, and the scoliosis caused by the collapsed vertebral bodies was managed surgically by anterior spinal fusion with segmental spinal instrumentation. RESULTS: The patient's scoliosis caused by vertebral collapse was corrected by surgery, and good alignment of the lumbar spine was achieved. The preoperation pain had subsided completely by follow-up assessment 1 year and 10 months after fusion. However, the arteriovenous malformations still remained. Careful observation should be maintained continuously in the coming days. CONCLUSION: In arteriovenous malformations with destruction of the vertebral bodies, embolization and spinal fusion with segmental instrumentation may be necessary to relieve pain and prevent the progression of spinal deformity. Arteriovenous malformation should be considered in the diagnostic evaluation of a patient who has experienced vertebral collapse with no inflammatory signs.

Adult↗

PubMed1999

Surgical treatment of far lateral lumbar disc herniation. Identification of compressed root and discectomy by lateral approach.

STUDY DESIGN: A new method is described of compressed root identification and discectomy for extraforaminal disc herniation, by a lateral intertransversalis approach. OBJECTIVES: To describe a safe surgical approach that does not require resection of adjacent bone structures during extraforaminal discectomy. SUMMARY OF BACKGROUND DATA: Most earlier series have reported approaches that damaged bordering bone structures with wide laminoarthrectomy. This is an attempt at a safer, simpler surgical approach. METHODS: Thirteen patients with lateral hernia have undergone this surgical procedure since 1995. Herniectomy was performed after identification of the compressed root within the iliopsoas muscle. RESULTS: All the patients resumed the upright position with the aid of semirigid brace 24 hours after surgery. Upon awakening from the anesthesia, no patient reported peripheral pain. Motor deficits resolved after physical rehabilitation in all but one patient. At a mean follow-up of 14 months, there was no report of back pain. CONCLUSION: The procedure described in this article offers a simple alternative to the valid procedures presently at hand. It offers the advantage of no bone resection and of minimizing nerve structures manipulation.

Adult↗

PubMed1994

Distended iliopsoas bursa: case reports and anatomical dissection.

Distension of the iliopsoas bursa is usually seen in association with underlying hip joint disease. The computed tomography (CT) appearance is characteristic and allows a diagnosis to be readily made. Computed tomography will also facilitate needle placement for aspiration of bursa contents and the injection of water-soluble contrast media for CT bursography. Three cases of iliopsoas bursa enlargement of varying underlying aetiology are presented. The dissection of seven cadavers demonstrated the anatomy of the normal bursa and highlighted its important role in the normal functioning of the iliopsoas muscle.

Aged↗

PubMed1997

Dedifferentiated liposarcoma with an inflammatory malignant fibrous histiocytoma-like component presenting a leukemoid reaction.

A rare case of dedifferentiated liposarcoma (well-differentiated liposarcoma with an inflammatory malignant fibrous histiocytoma (MFH)-like anaplastic component) occurring in a 69-year-old male is presented. The patient had noticed a dull pain in his left loin and thigh for about 1 month. Computed tomography examination revealed a low-density mass lesion, measuring about 6 cm in diameter, in the left iliopsoas muscle, and it was surgically removed. Grossly, the lesion was composed of an encapsulated, soft, whitish mass and an adjacent, well-demarcated, yellowish hard nodule, measuring about 2.5 cm in diameter. Microscopically, both lesions showed features of an inflammatory variant of MFH and a sclerosing type of well-differentiated liposarcoma, respectively. To our knowledge, only two cases of dedifferentiated liposarcoma combined with inflammatory MFH as a dedifferentiated component have been recorded in the literature. The salient feature of the present case is a systemic inflammatory reaction, as shown by prominent leukocytosis (up to 73,900/mm3) and the elevated serum value of C reactive protein (up to 26.0 mg/dL), which were transiently reduced after surgery. The inflammatory reaction was suggested to be induced by cytokines, such as granulocyte colony-stimulating factor and interleukin-6, which were probably produced by the tumor cells in the present case, because the elevated serum values of those cytokines were decreased after surgery.

Aged↗

PubMed2004

Iliopsoas abscess with iliac and femoral vein thrombosis in an adult Siberian husky.

A nine-year-old, male Siberian husky was presented with fever, decreased appetite and activity, non-weightbearing lameness, and oedematous swelling of the right inguinal and preputial area and the right hindlimb. An abscess within the right iliopsoas muscle, with severe thrombosis of the iliac and femoral vein, was diagnosed by haematology and diagnostic imaging. The abscess and adjoining lymph node were removed surgically through a median coellotomy. The isolated pathogen was Staphylococcus intermedius. Clinical signs resolved completely after surgery. Antimicrobial therapy was continued for four weeks. Within the follow-up period of six months, no recurrence of the clinical signs was detected.

Animals↗

PubMed1991

[A case of adult T-cell leukemia (ATL) complicated with multiple nocardial abscesses].

A 45-year-old woman was admitted to our hospital with complaints of fever and lumbago. She was treated for adult T-cell leukemia and thrombocytopenia with 20 mg/day of prednisolone. CT scan showed multiple abscesses in right peri-kidney, right iliopsoas muscle, left subcutaneous region in the abdominal wall and the brain. Left subcutaneous abscess was drained. Gram-positive organisms consisting of filaments were found, and Nocardia farcinica was grown in cultures. After two months of chemotherapy (FMOX, MINO and AMK), all abscesses except one in the brain disappeared. Cerebral abscess was cured fifty days after the start of the treatment with oral administration of Sulfamethoxazole-trimethoprim (SMX/TMP). The mortality of Nocardial cerebral abscess is high. This patient is a very rare case in which multiple Nocardial abscesses including brain abscess was cured by chemotherapy.

Abscess↗

PubMed1999

[Aeromonas hydrophila septicemia with necrotizing myofascitis in a patient with hypoplastic leukemia].

A 54-year-old male was admitted to Kawasaki Medical School Hospital with the complaint of fever. His diagnosis of hypoplastic leukemia had been made one year ago. After the admission, cecal mass with pain and high fever were noted. Four days later, he suddenly lost consciousness and died. Aeromonas hydrophila was isolated from blood cultures and also from the myofascitis specimen. Autopsy specimen of the iliopsoas muscle showed necrotizing myofascitis. The specimen obtained from the cecum showed submucosal hemorrhage with edema and these findings were compatible to ischemic colitis. This pathogen is widely distributed in nature, especially in water fields. Therefore, it would be advised to consider the Aeromonas hydrophila as one of the pathological organisms pathognomonic for the septicemia, when one may see febrile and gastrointestinal symptoms in a patient with hematological malignancies.

Aeromonas hydrophila↗

PubMed2004

[A case of rhabdomyolysis associated with Kaposi's varicelliform eruption].

Kaposi's varicelliform eruption is a common disease for dermatologists. In general, it is caused by Herpes simplex virus-1 (HSV-1) infection to skin which is affected by atopic dermatitis. There are some case reports which document a relationship between rhabdomyolysis and virus infection, in those cases, the major pathogenic virus of rhabdomyolysis is a influenza virus. It is exceedingly rare that rhabdomyolysis is caused by Herpes simplex virus. We introduce a case of rhabdomyolysis associated with Kaposi's varicelliform eruption induced by HSV-1. It was localized in the iliopsoas muscles. Since severe rhabdomyolysis may induce fatal acute renal failure, it is important to recognize that rhabdomyolysis can complicate Herpes simplex virus infection.

Adult↗

PubMed1983

Soft-tissue hemorrhage in hemophiliac patients. Computed tomography and ultrasound study.

Fifty-four hemophiliac patients underwent a total of 94 studies using computed tomography (CT), ultrasound, or both. Not only common bleeding sites such as the iliopsoas muscles but also several unusual sites were encountered: these included the iliac bone, bowel wall, mesentery, rectus abdominis muscle, retroperitoneum, bladder wall, and scrotum. Both modalities gave comparable results, and each was helpful in (a) establishing the diagnosis, (b) evaluating the extent of bleeding and its effect on adjacent organs, and (c) demonstrating regression after treatment.

Abdomen↗

PubMed1987

Abscesses in Crohn disease: percutaneous drainage.

Fifteen patients with Crohn disease underwent percutaneous catheter drainage of related abdominal abscesses. The abscesses were located in the right lower quadrant (five patients); in the quadratus lumborum and/or iliopsoas muscles (four patients); in the left paracolic gutter (two patients); and in the right gluteal muscles, the liver, the left subphrenic space, and the pelvis (one patient each). All abscesses were evacuated successfully (n = 15 of 15), and no patient required surgery for abscess drainage. Existing fistulas closed in four of seven patients; the other three patients underwent surgery for excision of diseased bowel and enteric fistulas. No patient developed an enterocutaneous fistula as a result of catheter drainage. Percutaneous abscess drainage is effective for abscesses related to Crohn disease and should be regarded as the procedure of choice. An operation for the abscess can be avoided, and early results suggest that bowel surgery may be obviated in selected patients.

Abscess↗

PubMed1992

High-attenuation lymphadenopathy in AIDS patients: significance of findings at CT.

A retrospective evaluation was performed of the location and attenuation characteristics of abdominal and pelvic lymphadenopathy, identified at dynamic sequential bolus computed tomography (CT) in 69 patients with acquired immunodeficiency syndrome (AIDS). Lymph node appearance at CT was characterized as hyperattenuating, isoattenuating, or hypoattenuating relative to the iliopsoas muscle. The significance of finding hyperattenuating adenopathy in the patient population was evaluated. Thirty-three patients had hyperattenuating adenopathy, including 26 with the epidemic form of Kaposi sarcoma (KS). Of 38 patients with epidemic KS, 26 had hyperattenuating, 11 had isoattenuating, and one had hypoattenuating lymphadenopathy. The positive predictive value of hyperattenuating adenopathy for epidemic KS was 79%. These findings were statistically significant at the 95% confidence interval (P < .005). Hyperattenuating lymphadenopathy, identified on dynamic sequential bolus CT scans in AIDS patients, was seen with disseminated KS in approximately 80% of cases.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Inflammatory pseudotumor.

Inflammatory pseudotumor is a quasineoplastic lesion that most commonly involves the lung and the orbit, but it has been reported to occur in nearly every site in the body. The pathogenesis, natural history, clinical presentation, imaging findings, and treatment options for inflammatory pseudotumor in the lung, heart, gastrointestinal tract, adrenal gland, iliopsoas muscle, orbit, and central nervous system are discussed. Because inflammatory pseudotumors mimic malignant tumors both clinically and radiologically, the radiologist should be familiar with this entity and help avoid unnecessary radical surgery when possible.

Diagnosis, Differential↗

PubMedDate not supplied

Various approaches for CT-guided percutaneous biopsy of deep pelvic lesions: anatomic and technical considerations.

Access route planning for computed tomography-guided biopsy of deep pelvic masses remains challenging because vital structures often obstruct the projected needle path. The classical approach through the lower anterior abdominal wall allows access to lesions located anterior, superior, or lateral to the urinary bladder. However, this approach has limitations: Deep masses are difficult to reach because of intervening structures, the bowel or bladder may be unavoidably traversed, and peritoneal transgression is often painful. A transgluteal approach is useful for biopsy of presacral and perirectal lesions and lesions located posterolateral to the bladder. An anterolateral approach through the iliopsoas muscle allows safe extraperitoneal access to external and internal iliac nodes, masses located along the lateral pelvic sidewall, and adnexal lesions. A transosseous (transsacral or transiliac) approach can occasionally be used for otherwise inaccessible lesions. Use of a curved needle, change in patient position, or injection of saline solution to displace intervening structures may also be helpful. Familiarity with normal cross-sectional pelvic anatomy facilitates planning of a safe access route and helps avoid injury to adjacent structures. A thorough understanding of the advantages and disadvantages of each approach allows the clinician to choose the most appropriate approach in a given situation.

Biopsy, Needle↗

PubMed1992

Ki-1-positive large-cell anaplastic lymphoma with protean manifestations including central nervous system involvement.

A 26-year-old female with Ki-1-positive large-cell anaplastic lymphoma is reported. The neoplastic cells were phenotypically and genotypically of T cell origin. Initially, neoplastic cells invaded the skin and lymph nodes, and then invaded the sternal and vertebral bones, ribs and the iliopsoas muscle. Central nervous system (CNS) involvement with paraplegia, large tumor mass formation in her breast and pleural infiltration ensued in succession. This case illustrates the protean manifestations of Ki-1-positive large cell anaplastic lymphoma complicated with CNS involvement.

Adult↗

PubMedDate not supplied

Antihypertensive effect of riboflavin analogs in rats with mineralocorticoid-induced hypertension.

This study investigated whether the riboflavin analogs, 7,8-dimethyl-10-formylmethyl isoalloxazine (FMI) and 7,8-dimethyl-10-(2'-hydroxyethyl) isoalloxazine (HEI), are effective antihypertensive agents in mineralocorticoid-induced or deoxycorticosterone acetate (DOCA)-salt hypertension. These studies are based on our previous observation tht aldosterone enhances the biosynthesis of renal flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD) from riboflavin, and that FMI and HEI competitively inhibit conversion of riboflavin to FMN and reabsorption of Na+ in the kidney of adrenalectomized rats. When 1.6 mg of FMI or HEI were administered simultaneously with 3.0 mg of DOCA, the tail systolic blood pressure (SBP) of unanesthetized rats rose only to 136 +/- 5 mm Hg (standard error of the mean, SEM) compared to 163 +/- 5 mm Hg during DOCA therapy alone (p less than 0.0005). This hypotensive effect of FMI or HEI was noted after the fourth week of treatment and persisted through the ninth week. The rats tolerated the medication well and had no signs of riboflavin deficiency. DOCA administration alone resulted in a 24% increase in iliopsoas muscle Na+ concentration (p less than 0.0005), and a 0.8% increase in the water content of the muscle (p less than 0.025), suggesting a positive Na+ balance. Administration of FMI or HEI blunted the ability of DOCA to increase muscle Na+ concentration (p less than 0.025), water content (p less than 0.01). HEI treatment of the Kyoto strain of spontaneously hypertensive rats (SHR) did not lower their mean SBP. Thus it appears that the hypotensive actions of FMI or HEI are closely associated with their ability to modify the effects of mineralocorticoids on NA+ balance.

Animals↗