We report a rare case of heparin-induced thrombocytopenia with thrombosis (HITT) following treatment for May–Thurner syndrome complicated by deep vein thrombosis (DVT), which resulted in venous stent thrombosis. A 27-year-old male with acute left lower-limb DVT successfully underwent thrombolysis and stenting for May–Thurner syndrome. However, the patient developed recurrent thrombosis and thrombocytopenia 3 days post-procedure. HITT was confirmed by a positive antiplatelet factor 4-heparin antibody test. After discontinuing heparin, the patient was successfully treated with fondaparinux, followed by repeat thrombectomy and thrombolysis, and then transitioned to warfarin. This is the second reported case of venous stent thrombosis due to HITT in May–Thurner syndrome. This case underscores the importance of early recognition and prompt management of HITT using alternative anticoagulants like fondaparinux to prevent complications such as venous limb gangrene. Further randomized controlled trials are required to evaluate the safety and efficacy of fondaparinux in HITT.

We report a rare case of heparin-induced thrombocytopenia with thrombosis (HITT) following treatment for May–Thurner syndrome complicated by deep vein thrombosis (DVT), which resulted in venous stent thrombosis. A 27-year-old male with acute left lower-limb DVT successfully underwent thrombolysis and stenting for May–Thurner syndrome. However, the patient developed recurrent thrombosis and thrombocytopenia 3 days post-procedure. HITT was confirmed by a positive antiplatelet factor 4-heparin antibody test. After discontinuing heparin, the patient was successfully treated with fondaparinux, followed by repeat thrombectomy and thrombolysis, and then transitioned to warfarin. This is the second reported case of venous stent thrombosis due to HITT in May–Thurner syndrome. This case underscores the importance of early recognition and prompt management of HITT using alternative anticoagulants like fondaparinux to prevent complications such as venous limb gangrene. Further randomized controlled trials are required to evaluate the safety and efficacy of fondaparinux in HITT.

We report a rare case of heparin-induced thrombocytopenia with thrombosis (HITT) following treatment for May–Thurner syndrome complicated by deep vein thrombosis (DVT), which resulted in venous stent thrombosis. A 27-year-old male with acute left lower-limb DVT successfully underwent thrombolysis and stenting for May–Thurner syndrome. However, the patient developed recurrent thrombosis and thrombocytopenia 3 days post-procedure. HITT was confirmed by a positive antiplatelet factor 4-heparin antibody test. After discontinuing heparin, the patient was successfully treated with fondaparinux, followed by repeat thrombectomy and thrombolysis, and then transitioned to warfarin. This is the second reported case of venous stent thrombosis due to HITT in May–Thurner syndrome. This case underscores the importance of early recognition and prompt management of HITT using alternative anticoagulants like fondaparinux to prevent complications such as venous limb gangrene. Further randomized controlled trials are required to evaluate the safety and efficacy of fondaparinux in HITT.

Dermoid cysts originate from embryonic tissues trapped in the cranial fusion lines and typically manifest extra-axially. However, intradiploic dermoid cysts are rare among cranial tumors, and their rupture has been sparsely documented. We present a case showcasing a remarkable phenomenon—the spontaneous rupture of an intradiploic dermoid cyst into the subarachnoid space, displaying a distinct “volcano-like” appearance on CT and MRI scans. This case represents the first documented instance of spontaneous intracranial rupture of an intradiploic dermoid cyst into the subarachnoid space. Although uncommon, this rupture poses a risk of severe complications, such as chemical meningitis and vasospasm. This extraordinary presentation of an uncommon lesion at an atypical location may contribute to a better understanding of the potential mechanisms of rupture, thereby emphasizing the importance of recognition and exploration.

Dermoid cysts originate from embryonic tissues trapped in the cranial fusion lines and typically manifest extra-axially. However, intradiploic dermoid cysts are rare among cranial tumors, and their rupture has been sparsely documented. We present a case showcasing a remarkable phenomenon—the spontaneous rupture of an intradiploic dermoid cyst into the subarachnoid space, displaying a distinct “volcano-like” appearance on CT and MRI scans. This case represents the first documented instance of spontaneous intracranial rupture of an intradiploic dermoid cyst into the subarachnoid space. Although uncommon, this rupture poses a risk of severe complications, such as chemical meningitis and vasospasm. This extraordinary presentation of an uncommon lesion at an atypical location may contribute to a better understanding of the potential mechanisms of rupture, thereby emphasizing the importance of recognition and exploration.

We report a rare case of heparin-induced thrombocytopenia with thrombosis (HITT) following treatment for May–Thurner syndrome complicated by deep vein thrombosis (DVT), which resulted in venous stent thrombosis. A 27-year-old male with acute left lower-limb DVT successfully underwent thrombolysis and stenting for May–Thurner syndrome. However, the patient developed recurrent thrombosis and thrombocytopenia 3 days post-procedure. HITT was confirmed by a positive antiplatelet factor 4-heparin antibody test. After discontinuing heparin, the patient was successfully treated with fondaparinux, followed by repeat thrombectomy and thrombolysis, and then transitioned to warfarin. This is the second reported case of venous stent thrombosis due to HITT in May–Thurner syndrome. This case underscores the importance of early recognition and prompt management of HITT using alternative anticoagulants like fondaparinux to prevent complications such as venous limb gangrene. Further randomized controlled trials are required to evaluate the safety and efficacy of fondaparinux in HITT.

Dermoid cysts originate from embryonic tissues trapped in the cranial fusion lines and typically manifest extra-axially. However, intradiploic dermoid cysts are rare among cranial tumors, and their rupture has been sparsely documented. We present a case showcasing a remarkable phenomenon—the spontaneous rupture of an intradiploic dermoid cyst into the subarachnoid space, displaying a distinct “volcano-like” appearance on CT and MRI scans. This case represents the first documented instance of spontaneous intracranial rupture of an intradiploic dermoid cyst into the subarachnoid space. Although uncommon, this rupture poses a risk of severe complications, such as chemical meningitis and vasospasm. This extraordinary presentation of an uncommon lesion at an atypical location may contribute to a better understanding of the potential mechanisms of rupture, thereby emphasizing the importance of recognition and exploration.

We report a rare case of heparin-induced thrombocytopenia with thrombosis (HITT) following treatment for May–Thurner syndrome complicated by deep vein thrombosis (DVT), which resulted in venous stent thrombosis. A 27-year-old male with acute left lower-limb DVT successfully underwent thrombolysis and stenting for May–Thurner syndrome. However, the patient developed recurrent thrombosis and thrombocytopenia 3 days post-procedure. HITT was confirmed by a positive antiplatelet factor 4-heparin antibody test. After discontinuing heparin, the patient was successfully treated with fondaparinux, followed by repeat thrombectomy and thrombolysis, and then transitioned to warfarin. This is the second reported case of venous stent thrombosis due to HITT in May–Thurner syndrome. This case underscores the importance of early recognition and prompt management of HITT using alternative anticoagulants like fondaparinux to prevent complications such as venous limb gangrene. Further randomized controlled trials are required to evaluate the safety and efficacy of fondaparinux in HITT.

Dentoalveolar (DA) trauma, which can involve tooth, alveolar bone, and surrounding soft tissues, is a significant dentofacial emergency. In emergency settings, physicians might lack comprehensive knowledge of timely procedures, causing delays for specialist referral. This systematic review assesses the literature on isolated DA fractures, emphasizing intervention timing and splinting techniques and duration in both children and adults. This systematic review adhered to PRISMA guidelines and involved a thorough search across PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 1980 to December 2022. Inclusion and exclusion criteria guided study selection, with data extraction and analysis centered on demographics, etiology, injury site, diagnostics, treatment timelines, and outcomes in pediatric (2-12 years) and adult (>12 years) populations. This review analyzed 26 studies, categorized by age into pediatrics (2-12 years) and adults (>12 years). Falls were a common etiology, primarily affecting the anterior maxilla. Immediate management involved replantation, repositioning, and splinting within 24 hours (pediatric) or 48 hours (adult). Composite resin-bonded splints were common. Endodontic treatment was done within a timeframe of 3 days to 12 weeks for children and 2-12 weeks for adults.Tailored management based on patient age, tooth development stage, time elapsed, and resource availability is essential.

PURPOSE: The study aimed to identify the risk factors of recurrence in chronic osteomyelitis (COM) and to document the microbiological patterns pre- and intra-operatively and at recurrence, if any. METHODS: We performed retrospective review on COM patients treated with surgical debridement and a 6-week course of antibiotics. The patients with symptoms of osteomyelitis for at least 6 weeks, present or past episodes of discharging sinus, documentation of bone sequestration in operative notes or preoperative images were included in the study. Patients with symptoms of osteomyelitis < 6 weeks, lack of history of discharging sinus or lack of evidence of sequestration in preoperative images or intraoperative notes were excluded. Logistic regression models were used to assess the impact of risk factors of recurrence. Cohen-Kappa scores were derived to see the concordance between pre-operative and intra-operative isolates and at recurrence. RESULTS: Totally, 147 COM patients (115 males and 32 females, mean age (33 ± 19) years) were included in this study. Recurrence was noted in 28 patients (19.0%). Polymicrobial growth and extended spectrum beta-lactamase producing Enterobacteriaceae increased the chance of recurrence. Cierny-Mader stage-1, hematogenous aetiology and negative intraoperative culture reduced the chance of recurrence. Concordance between pre-operative and intra-operative cultures was 59.85% (Kappa score 0.526, p < 0.001) and between index surgery and at recurrence was 23.81% (Kappa score 0.155, p < 0.001). Lack of knowledge of causative organism preoperatively did not affect outcome. At mean follow-up (42 ± 15) months, all patients were apparently infection free for at least 1 year. CONCLUSION Polymicrobial growth and multi-drug resistant organisms increase the risk of recurrence in COM. Patients' age, gender, diabetes mellitus, previous failed treatment, duration of symptoms, haemoglobin, white cell count, C-reactive protein and erythrocyte sedimentation rate at presentation did not have any impact on the recurrence of infection. Pre-operative isolation of organism is of questionable value. Recurrences of infections do occur and are more of re-infections than relapses. Diligent isolation of organism must be attempted even in re-debridements. Even patients with recurrences do well with appropriate debridement and antibiotic therapy.
Male ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Debridement ; Anti-Bacterial Agents/therapeutic use* ; Treatment Outcome ; Osteomyelitis/surgery* ; Recurrence ; Retrospective Studies