Background: Extra-abdominal manifestations of fat necrosis, like subcutaneous fat necrosis, polyarthritis, and polyserositis may appear with an occurrence rate of about 0.8%, wherein intraosseous fat necrosis is a more rare complication of pancreatitis, with few reports in English literature. Case report: A 34-year-old male with a 15-year-history of alcohol abuse was hospitalized several times in the last few years because of attacks of relapsed chronic pancreatitis. After the last attack, pancreatitis came in a stable state (“burned out”) with no symptoms and signs of the disease. The patient had been free of symptoms for 28 months since the last admission when he came with sub-febrile temperature, huge pain, swelling, and erythema in the area of the left lateral malleolar region with propagation in the foot. Blood biochemistry was normal. Conventional radiography showed multiple sites of osteolysis in the left calcaneus. Images on multislice computed tomography (MSCT) with 3D reconstruction revealed hypodense focuses that corresponded to osteonecrosis areas and bone marrow edema in the left calcaneus. Conclusions: The possibility of intraosseous fat necrosis should be considered in situations of unexplained polyarthritis or panniculitis, particularly in individuals with alcohol abuse or pancreatic disease.
Background and Aims: The aim of this study was to evaluate potential of prognostic cardiac biomarkers by predicting fatal events during perioperative period and the significance of their increased values in all patients and with coronary artery disease (CAD). Methods: The study included 87 patients who underwent major abdominal and vascular surgery. Blood samples were taken from all patients prior to surgery and levels of high-sensitive troponin T (hsTnT) and N-Terminal Pro B-type natriuretic peptide (NT-proBNP) were measured. It was analyzed how their increased values (above the predefined cutoffs of > 14 ng/L and > 300 pg/mL respectively) was associated with perioperative mortality in both all subjects and in patients with CAD.
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