Pub Date : 2022-01-01DOI: 10.25270/con.2022.07.00003
Reem Ichoa, Rajesh Savargaonkar, V. Jones
Background. Choledochal cysts are congenital anomalies of the biliary duct. The most common site for the development of cystic dilation is the common bile duct. Although choledochal cysts are a rare disease in children, complications such as perforation of the cyst have been reported. In this literature review, we discuss a case of a choledochal cyst with rupture and pseudocyst formation. Complete excision of the cyst and pseudocyst yields an excellent outcome with a 90% 5-year survival rate postoperatively.
{"title":"Choledochal Cyst With Rupture and Pseudocyst Formation","authors":"Reem Ichoa, Rajesh Savargaonkar, V. Jones","doi":"10.25270/con.2022.07.00003","DOIUrl":"https://doi.org/10.25270/con.2022.07.00003","url":null,"abstract":"Background. Choledochal cysts are congenital anomalies of the biliary duct. The most common site for the development of cystic dilation is the common bile duct. Although choledochal cysts are a rare disease in children, complications such as perforation of the cyst have been reported. In this literature review, we discuss a case of a choledochal cyst with rupture and pseudocyst formation. Complete excision of the cyst and pseudocyst yields an excellent outcome with a 90% 5-year survival rate postoperatively.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.11.000004
R. Rubin
{"title":"A 58-Year-Old Man in Severe Abdominal Pain","authors":"R. Rubin","doi":"10.25270/con.2022.11.000004","DOIUrl":"https://doi.org/10.25270/con.2022.11.000004","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69421323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.03.00001
N. Day, Cameron M. Rosenthal
An 11-month-old boy was brought to our University of Florida Child Protection Team by child welfare services after his foster mother had noticed what appeared to be “10 healing puncture wounds” on the infant’s ears. The child protective investigator reported that the boy had “indentations on his ears as though someone was trying to pierce them.” The boy had been sheltered from his biological mother approximately 2 weeks earlier because of the mother’s substance use. The boy had undergone a mandatory foster care examination within 72 hours of his foster care placement. No ear abnormality was documented at that time. His primary care provider’s medical record was also reviewed. Although the child had a history of ear infections and a hospitalization for bronchiolitis, no mention of an abnormal external ear examination was documented. The boy was brought to the University of Florida Child Protection Team for medical evaluation by a transporter for child welfare services. Since there was no caregiver present, no additional medical or social history was obtained. Physical Examination The boy had average weight and length for his age, with a head circumference that was 25% for his age. He was alert and socially interactive. He had a small umbilical hernia that was reducible. An ear examination revealed multiple indentations on the posterior aspect of the bilateral pinnae (Figures 1-3) that were consistent with bilateral posterior helical pits or posterior earlobe indentations (PELI). The rest of his examination findings were unremarkable. Discussion Most pediatric health care providers are familiar with preauricular sinuses (ear pits), as they are a common abnormality that generally do not require treatment. Preauricular sinuses are usually located adjacent to the external ear and can be unilateral or bilateral. Approximately 25% to 50% of cases are bilateral preauricular sinuses, which increases the likelihood that they are inherited.1 In 3% to 10% of cases, preauricular sinuses are associated with hearing and renal abnormalities.1 Studies suggest that further workup is only necessary when the preauricular sinuses are accompanied by another malformation or dysmorphic feature.1 Our patient had posterior helical ear pits (PHEP) or indentations. Unlike preEar Indentations on an Infant
{"title":"Ear Indentations on an Infant","authors":"N. Day, Cameron M. Rosenthal","doi":"10.25270/con.2022.03.00001","DOIUrl":"https://doi.org/10.25270/con.2022.03.00001","url":null,"abstract":"An 11-month-old boy was brought to our University of Florida Child Protection Team by child welfare services after his foster mother had noticed what appeared to be “10 healing puncture wounds” on the infant’s ears. The child protective investigator reported that the boy had “indentations on his ears as though someone was trying to pierce them.” The boy had been sheltered from his biological mother approximately 2 weeks earlier because of the mother’s substance use. The boy had undergone a mandatory foster care examination within 72 hours of his foster care placement. No ear abnormality was documented at that time. His primary care provider’s medical record was also reviewed. Although the child had a history of ear infections and a hospitalization for bronchiolitis, no mention of an abnormal external ear examination was documented. The boy was brought to the University of Florida Child Protection Team for medical evaluation by a transporter for child welfare services. Since there was no caregiver present, no additional medical or social history was obtained. Physical Examination The boy had average weight and length for his age, with a head circumference that was 25% for his age. He was alert and socially interactive. He had a small umbilical hernia that was reducible. An ear examination revealed multiple indentations on the posterior aspect of the bilateral pinnae (Figures 1-3) that were consistent with bilateral posterior helical pits or posterior earlobe indentations (PELI). The rest of his examination findings were unremarkable. Discussion Most pediatric health care providers are familiar with preauricular sinuses (ear pits), as they are a common abnormality that generally do not require treatment. Preauricular sinuses are usually located adjacent to the external ear and can be unilateral or bilateral. Approximately 25% to 50% of cases are bilateral preauricular sinuses, which increases the likelihood that they are inherited.1 In 3% to 10% of cases, preauricular sinuses are associated with hearing and renal abnormalities.1 Studies suggest that further workup is only necessary when the preauricular sinuses are accompanied by another malformation or dysmorphic feature.1 Our patient had posterior helical ear pits (PHEP) or indentations. Unlike preEar Indentations on an Infant","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.06.00010
Kent Axcell, J. Beaton, Aidan Maxwell, P. Wirth
{"title":"Sun Exposure Habits and Sun Protection Practices of Collegiate Athletes","authors":"Kent Axcell, J. Beaton, Aidan Maxwell, P. Wirth","doi":"10.25270/con.2022.06.00010","DOIUrl":"https://doi.org/10.25270/con.2022.06.00010","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.01.00004
Iris Hunt, Christina T. Hanos, Tara Paolini, T. Helm
{"title":"What Is This Reticulated, Erythematous Eruption on a Woman’s Buttocks?","authors":"Iris Hunt, Christina T. Hanos, Tara Paolini, T. Helm","doi":"10.25270/con.2022.01.00004","DOIUrl":"https://doi.org/10.25270/con.2022.01.00004","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.03.00002
Sean Sims, Matt Snow
{"title":"Cervical Ribs in a Teenaged Athlete","authors":"Sean Sims, Matt Snow","doi":"10.25270/con.2022.03.00002","DOIUrl":"https://doi.org/10.25270/con.2022.03.00002","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.02.00007
Ahish Chitneni, Annina Giannuzzi, Kaushik Manthani, S. Gandhi
Diagnostic testing Initial abdominal radiography scans showed diffuse bowel ileus vs distal large bowel obstruction. A computed tomography scan of the abdomen and pelvis showed a mildly distended, fluid-filled stomach and small bowel, suggestive of enterocolitis (Figure). Laboratory study findings were significant for an elevated white blood cell count of 14.67 × 109/L. Initial blood cultures resulted in growth of gram-positive cocci in pairs and chains, but no growth was seen in the urine culture. The patient was initially started on ceftriaxone and vancomycin. Three days after hospital admission, blood cultures grew Granulicatella adiacens, and the patient underwent an echocardiography scan, results of which revealed bacterial endocarditis on the aortic valve. The patient was educated on the need for outpatient colonoscopy and dental follow-up and was discharged on 4 weeks of intravenous ceftriaxone outpatient parenteral antibiotic therapy.
{"title":"Infective Endocarditis Secondary to Granulicatella adiacens","authors":"Ahish Chitneni, Annina Giannuzzi, Kaushik Manthani, S. Gandhi","doi":"10.25270/con.2022.02.00007","DOIUrl":"https://doi.org/10.25270/con.2022.02.00007","url":null,"abstract":"Diagnostic testing Initial abdominal radiography scans showed diffuse bowel ileus vs distal large bowel obstruction. A computed tomography scan of the abdomen and pelvis showed a mildly distended, fluid-filled stomach and small bowel, suggestive of enterocolitis (Figure). Laboratory study findings were significant for an elevated white blood cell count of 14.67 × 109/L. Initial blood cultures resulted in growth of gram-positive cocci in pairs and chains, but no growth was seen in the urine culture. The patient was initially started on ceftriaxone and vancomycin. Three days after hospital admission, blood cultures grew Granulicatella adiacens, and the patient underwent an echocardiography scan, results of which revealed bacterial endocarditis on the aortic valve. The patient was educated on the need for outpatient colonoscopy and dental follow-up and was discharged on 4 weeks of intravenous ceftriaxone outpatient parenteral antibiotic therapy.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.04.00004
R. Rubin
{"title":"A 72-Year-Old Woman With an Abnormality on Incidental Blood Testing","authors":"R. Rubin","doi":"10.25270/con.2022.04.00004","DOIUrl":"https://doi.org/10.25270/con.2022.04.00004","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.06.00011
Lucas M. Walden, J. Prescott, V. Jain
A 67-year-old man who developed new-onset neurological symptoms was found to have bilateral internal carotid artery (ICA) pseudoaneurysms on computed tomography angiography. Pseudoaneurysms of the ICA are a rare diagnosis and can lead to significant morbidity and mortality including infarcts and, in some cases, hemorrhagic transformation of infarcts. The primary risk factors for the formation of ICA pseudoaneurysms are trauma and surgery. Other causes include infiltrating metastatic disease, infection, fibromuscular dysplasia, Ehlers-Danlos syndrome, Marfan syndrome, irradiation, and Behçet disease. Endovascular repair with stenting is a highly effective treatment option and preferred in patients with large symptomatic pseudoaneurysms. Depending on the etiology, open repair may be necessary. Individuals with smaller asymptomatic lesions are managed nonoperatively with antithrombotic therapy and are followed with serial imaging for significant changes in aneurysm size, which would necessitate procedural intervention.
{"title":"Bilateral Cervical Internal Carotid Artery Pseudoaneurysms","authors":"Lucas M. Walden, J. Prescott, V. Jain","doi":"10.25270/con.2022.06.00011","DOIUrl":"https://doi.org/10.25270/con.2022.06.00011","url":null,"abstract":"A 67-year-old man who developed new-onset neurological symptoms was found to have bilateral internal carotid artery (ICA) pseudoaneurysms on computed tomography angiography. Pseudoaneurysms of the ICA are a rare diagnosis and can lead to significant morbidity and mortality including infarcts and, in some cases, hemorrhagic transformation of infarcts. The primary risk factors for the formation of ICA pseudoaneurysms are trauma and surgery. Other causes include infiltrating metastatic disease, infection, fibromuscular dysplasia, Ehlers-Danlos syndrome, Marfan syndrome, irradiation, and Behçet disease. Endovascular repair with stenting is a highly effective treatment option and preferred in patients with large symptomatic pseudoaneurysms. Depending on the etiology, open repair may be necessary. Individuals with smaller asymptomatic lesions are managed nonoperatively with antithrombotic therapy and are followed with serial imaging for significant changes in aneurysm size, which would necessitate procedural intervention.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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