Atraumatic intraoral buccal fat pad herniation in a neonate.

An approximately 2-day-old neonate was brought with a fleshy intraoral mass and an inability to suckle adequately, without a preceding history of trauma. Contrast-enhanced CT revealed a fat density mass-like lesion occupying and partially filling the oral cavity. Following detection of a defect in the buccinator muscle with associated herniation of the buccal pad of fat into the mouth, a surgical approach was adopted to tackle the condition. Intraoperatively, the defects in the buccinator muscle and buccal mucosa were repaired after excision of the prolapsed fat pad. Age-appropriate feeding practices were initiated following surgery without residual anatomical or functional limitation. Early radiological diagnosis directing surgical intervention was helpful in management of a benign but functionally impeding lesion.

Transfacial venous embolisation of a spontaneous indirect paediatric caroticocavernous fistula.

We present a rare case of a spontaneous indirect caroticocavernous fistula (CCF) in an early adolescent, who exhibited a 1-month history of redness, decrease in vision and proptosis of the right eye without a history of trauma or connective tissue disorder. An MRI of the brain and orbit and a digital subtraction angiography confirmed the diagnosis of Barrow type D CCF. The same was then treated with coiling and a liquid embolising agent using the transfacial venous route, resulting in complete obliteration. Reduction in conjunctival congestion with mild improvement in visual acuity was noted postprocedure. Complete recovery was noted at the 6-month follow-up visit. CCF, though rare in the paediatric population, should be highly considered in the differential diagnosis when the above-mentioned complaints are present. Early diagnosis and intervention have favourable outcomes.

The Effectiveness of Gelfoam as the Sole and Primary Embolization Agent in the Management of Hemoptysis: A Retrospective Study from a Tertiary Care Center.

OBJECTIVES: The objective of this study was to evaluate the role of Gelfoam as an effective embolizing agent in patients with hemoptysis presenting to a tertiary care center in developing nations. MATERIAL AND METHODS: A retrospective analysis of data from 30 patients treated by Interventional radiologist at St. John's Medical College, Bangalore, India, was performed. The study included 22 males (73.3%) and 8 (26.65%) female patients. Gelfoam was used as the sole embolizing agent and arteries with features of abnormal blush and hypertrophy were targeted. Analysis of the etiology, immediate, and short-term outcome and complications, when present, was performed. The median follow-up period was 45 days following an embolization procedure at this center. RESULTS: A high short-term efficacy was noted following embolization procedures with Gelfoam as the sole agent. Twenty-eight out of 30 procedures were deemed successful, and post-tubercular changes were noted to be the cause for hemoptysis in 23 patients. The high short-term efficacy (93.3%), evidenced by a complete stoppage of hemoptysis, along with a relatively low rate of complications (spinal cord ischemia in only 2.3%), strengthens the position of Gelfoam as the sole embolizing agent in a resource-limited setting. CONCLUSION: In an economically constrained setting, Gelfoam proves to be a useful first choice single embolization agent, while polyvinyl alcohol particles coupled with microcatheter systems remain within reach of only those who can afford them.