2.Percutaneous Ethanol Sclerotherapy for Head-and-Neck Lymphatic Malformation: A Systematic Review and Case Report
Xin Ler PANG ; Stephanie He SHENGJIE ; Man Hon TANG ; Joel Lau Wen LIANG ; Wei Keat CHEAH ; Yi-Xiu CHUA ; Hui Seong TEH ; Si Zhao TANG
Journal of Endocrine Surgery 2024;24(4):119-128
Lymphatic malformations (LMs) are one of the more commonly encountered cystic head-and-neck tumors. Surgical excision is the traditional treatment with inherent perioperative risks. Alternative treatment of these tumors using percutaneous sclerotherapy agents has been proposed with no major consensus on the treatment approaches and sclerotherapy agent choices. This paper presents a systematic review of percutaneous ethanol sclerotherapy for neck lymphangioma and a case report of ethanol ablation in a patient with neck lymphangioma with good cosmesis results. Systematic review was conducted on PubMed using key words: “Ethanol” OR “Alcohol” AND “Ablation” OR “Sclerotherapy” OR “Sclerosing” AND “Lymphangioma” OR “Lymphatic Malformation” as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Three hundred fifteen articles from initial PubMed search results were screened by titles and abstracts. Full text was retrieved. 3 studies were included in our systematic review. Overall evidence quality is modest with marked heterogeneity. All 12 patients treated with percutaneous ethanol sclerotherapy for head-and-neck LMs reported favorable response. Only 1 patient (8.3%) encountered a peri-procedural complication. Percutaneous ethanol sclerotherapy of neck lymphangioma in our patient also reported favorable response with no complications. Invasive treatment for LMs should be personalized and dependent on the availability of experienced operators/ centers with appropriate volume in either primary excisional surgery or percutaneous sclerotherapy. Percutaneous ethanol sclerotherapy is an acceptable option with benefits of widespread availability and cost-effectiveness in our South-East Asia region. Limitations of our review are largely due to significant study heterogeneity.
4.Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting.
Ashish CHAWLA ; Jerome Irai BOSCO ; Tze Chwan LIM ; Sivasubramanian SRINIVASAN ; Hui Seong TEH ; Jagadish Narayana SHENOY
Singapore medical journal 2015;56(8):438-quiz 444
Acute cholecystitis is a common cause of right upper quadrant pain in patients presenting at the emergency department. Early diagnosis and recognition of associated complications, though challenging, are essential for timely management. Imaging studies, including ultrasonography, computed tomography and magnetic resonance imaging, are increasingly utilised for the evaluation of suspected cases of cholecystitis. These investigations help in diagnosis, identification of complications and surgical planning. Imaging features of acute cholecystitis have been described in the literature and are variable, depending on the stage of inflammation. This article discusses the spectrum of cholecystitis-associated complications and their imaging manifestations. We also suggest a checklist for the prompt and accurate identification of complications in acute cholecystitis.
Abdominal Pain
;
diagnosis
;
Adult
;
Aged
;
Cholecystitis
;
complications
;
diagnostic imaging
;
Cholecystitis, Acute
;
complications
;
diagnostic imaging
;
Diagnosis, Differential
;
Emergency Medicine
;
methods
;
Emergency Service, Hospital
;
Female
;
Humans
;
Inflammation
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Tomography, X-Ray Computed
;
Ultrasonography
5.Dislocation of the penis: a rare complication after traumatic pelvic injury.
Mei Chin LIM ; Sivasubramanian SRINIVASAN ; Hui Seong TEH ; Chang Peng Colin TEH
Singapore medical journal 2015;56(1):e4-6
Traumatic injury to the male external genitalia is frequently encountered, but acute traumatic dislocation of the penile structure is extremely rare, with only a few reports found in the literature. We herein report the case of a 21-year-old man who sustained blunt trauma to the pelvis following a motor vehicle accident, and had features suspicious of penile dislocation. With the use of computed tomography and bedside ultrasonography, a diagnosis of penile dislocation was made, which was subsequently confirmed intraoperatively. Immediate surgical intervention via gentle manipulation of the penile tissue back to its native position was performed in order to restore normal anatomy. The exact mechanism of penile dislocation is not known. However, circumferential laceration around the foreskin causing degloving injury of the penis is suggested in our patient.
Accidents, Traffic
;
Foreskin
;
Humans
;
Joint Dislocations
;
diagnosis
;
Male
;
Pelvis
;
injuries
;
Penis
;
diagnostic imaging
;
injuries
;
Scrotum
;
diagnostic imaging
;
Tomography, X-Ray Computed
;
Ultrasonography
;
Wounds, Nonpenetrating
;
complications
;
Young Adult

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