Clinical diagnosis of pararectal masses remains a challenge to this day. Despite the availability of advanced imaging facilities, we often fail to reach a definitive diagnosis and have to resort to surgery. We describe a case of a 60-year-old female with a painless perianal swelling gradually increasing in size for 6 months with spontaneous reduction on assuming a supine position. Clinical examination of this patient was suggestive of a pelvic floor hernia. However, radiological investigations were suggestive of an ischiorectal abscess. In view of lack of radiological corroboration of clinical findings, patient underwent diagnostic laparoscopy which ruled out a hernia. A wide local excision of the mass was performed, which on histopathology with immunohistochemistry examination revealed an aggressive pararectal angiomyxoma.
Delayed tension pneumocephalus is a rare entity. Twelve cases of posttraumatic delayed tension pneumocephalus have been reported. This study is a case report of a patient presenting with delayed posttraumatic tension pneumocephalus, and highlights the nuances of management.
Introduction:
Pond fracture also called ping-pong fracture in children is caused due to direct impact on the skull. It is rare and many types of treatment modalities have been described. In this report, we describe a makeshift vacuum-assisted device to elevate the fracture, which is both cost-effective and efficient.
Case presentation:
A 5-month-old infant was brought to the emergency department with a history of fall of heavy object on the head resulting in pond fracture over the left parietal area and an episode of focal motor seizures. After ruling out an intracranial injury with a computer tomogram, we elevated the depressed fracture by a makeshift vacuum suction device using a plastic funnel connected to vacuum chamber. Post-procedure child had one episode of focal seizure and was discharged after a brief period of observation.
Conclusion:
Plastic funnel vacuum suction can be effectively used to elevate the Pond fractures in infants with appropriate precautions.
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