ABSTRACT
Gastrointestinal perforations usually lead to pneumoperitoneum and peritonitis. Rarely, if ever described, a complete giant staghorn renal stone might cause a nephrocolic fistula with sigmoid impaction and perforation similar to gallstone ileus. Few nephrointestinal fistulae have been described in the literature and none of them were presented as an acute abdomen with pneumoperitoneum and pneumoretroperitoneum. To our knowledge, this is the only case showing CT and radiographic findings of a pathology not yet described in the literature. We named the sigmoid perforation by a renal stone ileus "Lorenzi's syndrome" after the physician who hypothesized this rare differential diagnosis based only on history and clinical examination.
Subject(s)
Intestinal Fistula/etiology , Intestinal Perforation/etiology , Kidney Calculi/complications , Pneumoperitoneum/etiology , Sigmoid Diseases/etiology , Urinary Fistula/etiology , Abdomen, Acute/diagnostic imaging , Abdomen, Acute/etiology , Aged , Female , Humans , Intestinal Fistula/diagnostic imaging , Intestinal Perforation/diagnostic imaging , Kidney Calculi/diagnostic imaging , Pneumoperitoneum/diagnostic imaging , Sigmoid Diseases/diagnostic imaging , Tomography, X-Ray Computed , Urinary Fistula/diagnostic imagingABSTRACT
We report a case of patient with a suspected goiter which proved ganglioneuroma adjacent to the thyroid gland. Preoperative studies were not diagnostic. Ganglioneuroma should be kept in mind during the differential diagnosis of goiter. Surgery offers effective cure.
Subject(s)
Ganglioneuroma/diagnosis , Head and Neck Neoplasms/diagnosis , Diagnosis, Differential , Diagnostic Imaging , Ganglioneuroma/surgery , Goiter/diagnosis , Head and Neck Neoplasms/surgery , Humans , Male , Middle AgedABSTRACT
Timely repair of mandibular fractures remains an effective means to reduce pain, restore function, and prevent complications. This study addresses the effect of the time interval between injury and treatment on the overall complication rate, the complication rate between various treatment modalities (mandibular-maxillary fixation [MMF] alone, MMF with intraosseous wire bone fixation, and MMF with rigid internal fixation), and the relationship of inpatient vs. outpatient management. Cost was also examined with respect to choice of management. We report a retrospective series of 308 consecutive patients managed at the University of Miami/Jackson Memorial Hospital. Patients who received treatment 3 to 10 days following injury were found to have a lower complication rate than earlier or later repair. We postulate that most patients with mandibular fractures may be managed on an outpatient basis, which represents a considerable savings in cost.
