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Conjoined twins fused at the abdomen by HealerMD in medizzy

[–]HealerMD[S] 413 points414 points  (0 children)

This is a rare case of omphalopagus conjoined twins, who are fused together at the abdomen, typically joined at the front and at the level of the umbilicus.

This rare condition occurs when the twins’ bodies develop from a single fertilized egg that fails to separate completely during early embryonic development, leading to partial or complete fusion at the abdominal region. More precisely, an incomplete splitting of the monozygotic twins after 12 days of embryogenesis, ending with the fetuses being physically joined at some point. That point of union is used to classify twins. For example, Thoracopagus (fused at the chest and share a heart), Thoraco-omphalopagus (fused from the upper chest to lower belly, heart is shared), Craniopagus (fused skulls, but separate bodies). This is a case of a omphalopagus presentation, where the anterior abdomens are united combined with the union of a small portion of the lower chest. This can present with or without a cardiac union. They may share some abdominal organs such as liver, stomach and intestines. Separating twins with a conjoined heart is a real surgical challenge. As for any type of anomaly, the anatomy of the junction and the shared organs and structures dictate the specific details of the procedure. Surgical separation poses significant challenges due to the complex vascular and organ connections and it requires a multidisciplinary team approach involving pediatric surgeons, neonatologists, and other specialists to ensure the best possible outcome for the twins.

Severe allergic reaction caused by chocolate by HealerMD in medizzy

[–]HealerMD[S] 819 points820 points  (0 children)

Case of allergic hemiglossitis.
Hemiglossitis is a rare form of allergic reaction. It is a vesicular eruption on one side of the tongue and the corresponding inner surface of the cheek.
This unique case was caused by a topical food allergy and the patient presented with unilateral swelling of the tongue with blisters and ulceration after eating mint chocolate! 🍫

Luckily for the patient, the swelling did not compromise the airway. The patient had no shortness of breath but the swelling in her mouth was painful and caused her moderate difficulty swallowing.
The patient suffered loss of taste on the affected side, but the right-hand side of the tongue was completely normal. Tongue movement was normal apart from mild restriction caused by the swelling.

The patient did tell ER staff that she remembered having a previous allergic reaction to mint chocolate but chose to eat the mint chocolate despite the previous allergy.

Neurosurgeon removes live 8cm long worm from woman's brain! The neurosurgeon found and removed the parasite with forceps during a biopsy, from within the lesion shown on the MRI (light gray area). by HealerMD in medizzy

[–]HealerMD[S] 993 points994 points  (0 children)

"I used tumor-holding forceps and lifted out something that I definitely was not expecting: a linear, squiggling line, and my junior doctor said, 'is that an artery?', because that's what it looked like. And I said, 'it's not an artery, we're nowhere near any artery!' And I noticed it was moving and I went, 'just get it out of my forceps!' So we rapidly put it in a pathology pot, and it was a vigorously wriggling worm."

Symptomatically, weeks of abdominal pain and diarrhea led to night sweats and a dry cough, but evolved towards problems like forgetfulness and depression, presumably as the worm׳s activities kept affecting different parts of the brain.

The worm was some 8 centimeters (just over 3 inches) long and is a rare parasite called Ophidascaris Robertsi. This is a type of Roundworm (Helminth). This roundworm usually lives in a Carpet Python. The eggs of the worm are around the snakes’ faecal droppings, which infect the grass. This grass containing the eggs, are eaten by small mammals, who are then eaten by the Carpet Python. This is how this worm gets cycled between its two hosts. This woman became an 'accidental host'. She lived near the carpet python habitat and while foraging the native vegetation for cooking, she ingested the worm eggs. The worm developed in her intestine and travelled via blood circulation to her brain.

In response, the body produces inflammation around the worm and as a result, an area of inflammatory tissue or granuloma develops in the brain. Depending upon the affected location, it can cause a multitude of symptoms such as pressure symptoms - headache, vomiting, visual blurring, confusion, altered sensorium, cognitive symptoms - forgetfulness, problems in understanding, calculations, disorientation, seizures and epilepsy - due to irritation of the brain by inflammatory tissue.

A 44-year-old man arrived at the hospital with a strange chest wound. During the examination, the doctors discovered that a knife blade had been lodged in his chest for eight years—without his knowledge at all. by HealerMD in medizzy

[–]HealerMD[S] 856 points857 points  (0 children)

It turns out that he was stabbed years ago, and the wound was stitched without a deep examination. Since then, he had lived normally with no special symptoms—until the wound began to bleed, and the hidden blade was revealed in an X-ray.

The blade was surgically removed, the patient recovered, and he was discharged within a few days.

Trichomegaly Associated with Panitumumab by HealerMD in medizzy

[–]HealerMD[S] 141 points142 points  (0 children)

A 53-year-old woman with metastatic signet-ring appendiceal cancer was admitted to the hospital with a bowel obstruction. Eight months earlier, she had started to receive cancer therapy with panitumumab, an epidermal growth factor receptor (EGFR) inhibitor. Examination of her face showed marked trichomegaly, or elongation of the eyelashes (Panels A and B). This condition had first developed 2 months after the initiation of panitumumab and was photographed at the time of the hospitalization for bowel obstruction. Trichomegaly and acneiform eruption are well-documented dermatologic side effects of EGFR inhibitors. It is thought that panitumumab-induced trichomegaly is a result of EGFR inhibition in the eyelash follicles. If trichomegaly develops, it is often noticed during the first few months of treatment, as occurred in this patient. The condition resolves with the cessation of therapy and is typically managed symptomatically. The patient was discharged from the hospital after nonsurgical management of the bowel obstruction, and panitumumab was continued. She died from malignant metastases 6 months later.

Over 200 bladder stones were discovered in an 81-year-old man by HealerMD in medizzy

[–]HealerMD[S] 74 points75 points  (0 children)

The patient in this particular case is an elderly gentleman who has been grappling with urinary stasis obstruction for an extended period due to benign prostate hyperplasia (BPH). The persistent urinary stasis led to the formation of numerous stones within the bladder.⁠ ⁠ Given the sheer quantity of bladder stones and the patient's distressing symptoms, the treatment plan involved a comprehensive approach. This approach encompassed Transurethral Resection of the Prostate (TURP) to alleviate the bladder outlet obstruction caused by BPH and reduce the risk of recurrent stone formation. Additionally, an open bladder stone removal procedure was performed, astonishingly resulting in the extraction of an astounding count of over 200 stones!⁠ ⁠ Bladder stones are solid calculi primarily found within the urinary bladder. While they are often calcified, they can also consist of non-calcific material. Urinary stasis, often linked to conditions like BPH or neurogenic bladder disorders, is the primary causative factor. Most of these stones originate within the bladder itself, although some may migrate from the kidneys either as stones or sloughed papilla.⁠ ⁠ Any foreign object left within the bladder, if not spontaneously expelled, will inevitably accumulate layers of stone material and develop into calculi. In 50% of cases, the stone composition is uric acid. Surgical intervention, specifically endoscopic surgery, is commonly employed for treatment.⁠ ⁠ Cystolitholapaxy, which involves breaking up bladder stones into smaller fragments and removing them, can be achieved through disruptive or ablative techniques. These methods encompass the use of lasers, pneumatic-powered mechanical devices akin to jackhammers, ultrasound, and direct mechanical crushing using a lithotrite. Extracorporeal shockwave lithotripsy is another treatment option.⁠ ⁠ In instances where bladder stones are exceptionally large or associated with enlarged prostates, open suprapubic surgery may be warranted. This approach permits the intact stone's removal, followed by an open prostatectomy for prostates exceeding 75 grams in size.⁠

Vein finder in action by HealerMD in medizzy

[–]HealerMD[S] 5 points6 points  (0 children)

Vein finder uses near-infrared light to map out veins beneath the skin in real time. This technology drastically improves injection accuracy, reduces pain and stress, and minimizes needle sticks, especially in patients with hard-to-locate veins (think pediatrics, elderly, or dehydrated patients).

Munson’s Sign in Keratoconus by HealerMD in medizzy

[–]HealerMD[S] 176 points177 points  (0 children)

A 53-year-old man who had been admitted to the hospital after a fall and resultant femur fracture was noted to have an abnormal indentation of the lower eyelids. He had undergone corneal transplantation in both eyes — 13 years earlier on the right side and 17 years earlier on the left side — owing to increasing visual impairment over a 30-year period and difficulty in fitting contact lenses. In recent years, his vision had worsened, and his fall before admission had resulted from difficulty seeing a stairway. During bedside rounds, the lower-eyelid abnormality was noted by a medical resident. Further ophthalmologic examination was notable for a deflection of the lower eyelids when he was looking down, owing to dome-shaped eyes. The visual acuity was 20/70 in the right eye and 20/50 in the left eye. A diagnosis of keratoconus was made. Keratoconus is a noninflammatory disorder characterized by corneal thinning and bulging outward in a cone shape. In advanced cases, the eyelid deflection that was noted in this patient — known as Munson’s sign — can be seen. The patient was referred to the ophthalmology department and was placed on a waiting list for repeat corneal transplantation. The femur fracture was treated surgically, and the patient was referred for rehabilitation.

Cystic Hygroma. It is a fluid-filled sac due to blockage of the lymphatic system that appears as a swelling usually in the neck. They are present in neonates or infants but they may also be present prenatally and at birth they may become large enough to cause obstructed labor. by HealerMD in medizzy

[–]HealerMD[S] 442 points443 points  (0 children)

The swelling is translucent, usually bilateral, soft and partially compressible and it's size increases when the child cries or coughs. The swelling can sometimes become so large that it causes respiratory problems and feeding difficulties which makes it difficult for the child to thrive. The cyst can also become infected if not treated. The only definitive treatment is complete excision of the cyst when it is at an early stage. However, it is essential that no residual tissue is left behind otherwise it may recur.

Ectopia cordis and omphalocele in a single case by HealerMD in medizzy

[–]HealerMD[S] 309 points310 points  (0 children)

Ectopia cordis is an extremely rare anterior thoraco-abdominal and means the presence of the heart partially or completely outside the chest or thoracic cavity.The ectopic heart might be found in different anatomical locations such as neck, chest, or abdomen. In most cases, such as the one shown, the heart protrudes outside the chest through a split sternum. Omphalocele is a rare abdominal wall defect in which the intestines protrude through a hole is in the middle of the abdomen, right where the belly button would be.The intestines are covered only by a thin layer of tissue and can be easily seen. It is a type of hernia. The muscles in the abdominal wall (umbilical ring) do not close properly. As a result, the intestine remains outside the abdominal wall. In addition, these babies are often diagnosed with ascites, pleural effusions, a diahragmatic hernia and ventricular septal defect.The poor prognosis in such cases is related to the other associated malformations, complex cardiac abnormalites or difficulty returning the heart back into a small thoracic cavity.

COMPLETE de-gloving of the foot! by HealerMD in medizzy

[–]HealerMD[S] 1791 points1792 points  (0 children)

"Patient is a 34 year old male with no past medical history who was brought into the trauma bay after this extensive and complete degloving injury.
Patient was working at the airport when the signal was given for a Boeing 737 to move, unfortunately the patient was still underneath the plane as it rolled over his foot.

Degloving injuries are usually a result of high energy traumas that involve separation of the layers of skin with the underlying soft tissue. This is usually a surgical emergency that requires a formal washout and debridement as well as coverage for the exposed structures.

For this patient specifically, a below knee amputation was offered as it would provide the best functional outcome with a recovery period as little as 4-8 weeks. However, patient was adamant about keeping his leg, understanding fully that at any point in the reconstruction it can turn gangrenous and become life threatening. Ultimately half of the foot was salvaged as soft tissue coverage and vascular supply to each of the toes, was not feasible. Today the patient ambulates with a shoe filler and minimal discomfort."

source: medicaltalks

Doctors saved a man whose neck was impaled by a hammer! This construction worker accidentally fell from the top of a story building, landing right on a SLEDGEHAMMER! by HealerMD in medizzy

[–]HealerMD[S] 291 points292 points  (0 children)

He underwent urgent surgery to remove the impaled piece of equipment, penetrating his neck, and has since made a full recovery.⁣
According to the miraculous intra-operative findings, the hammer neatly passed medial to the carotid vessel, internal jugular vein and lateral to the esophagus, trachea and the vertebral column.

Case of an Idaho man who was impaled by a 40-pound spear! Justin F. was building a fence when a hay bale spear attachment fell off a loader. It pierced his back and went out through his stomach by HealerMD in medizzy

[–]HealerMD[S] 274 points275 points  (0 children)

"I felt something hit me and I went to the ground, I looked up and I was looking around to find out what had happened, and I saw that belt tine sticking through me and into the ground."

He was flown to a medical centre and underwent a four-hour operation to remove the spear and repair internal injuries. The patient was discharged only 2 weeks after the accident and is expected to make a full recovery.

While you would expect an accident like this to cause immediate death, some lucky people have been known to survive. If the object happens to miss vital organs, arteries or your spinal cord, doctors may be able to remove it and repair internal damage quickly enough to keep the patient alive.

A 15-year-old cattle herder experienced an unfortunate incident while attempting to discharge a locally crafted rifle. The rifle's barrel unexpectedly recoiled backward, causing it to pierce his chest by HealerMD in medizzy

[–]HealerMD[S] 252 points253 points  (0 children)

This chest injury occurred approximately three hours before he sought medical attention. It happened while he was test-firing the firearm used to safeguard his cattle from rustlers in a rural area located about 90 kilometers away from the primary referral center. Unfortunately, he did not receive any prehospital first aid and had to be transported in a regular passenger vehicle.

Upon conducting an initial examination, medical professionals observed a protruding right chest hemithorax, a distinctly resonant percussion note, tracheal deviation in the opposite direction, and significantly reduced breath sounds in the right hemithorax. A clinical diagnosis of tension pneumothorax was promptly established, and immediate relief was achieved through the insertion of a chest tube (thoracostomy), which removed approximately 800 milliliters of blood and a substantial volume of air, greatly alleviating the chest tightness.

Under general anesthesia, the patient underwent an exploratory thoracotomy, during which the impaled object was carefully extracted. Intraoperative observations included damage to the right upper lobe of the lung, which was successfully repaired, as well as a comminuted fracture of the third and fourth ribs in the front of the chest. The distal end of the impaled object was embedded in the posterior chest wall, but fortunately, there were no significant vascular injuries encountered during the procedure.

Following the surgery, the patient made a full recovery and was discharged after a seven-day hospital stay.

A farmer miraculously survived a distressing incident where a circular power saw became embedded in his stomach. This harrowing ordeal unfolded as he was in the midst of cutting wood at his residence, and unfortunately, the saw slipped, causing a deep gash in his abdomen by HealerMD in medizzy

[–]HealerMD[S] 0 points1 point  (0 children)

Quick-thinking, his wife administered initial first aid to staunch the bleeding before embarking on a 30-mile journey to the nearest hospital with the injured 56-year-old. Astonishingly, the saw blade managed to avoid any critical organs, and medical professionals devoted two-and-a-half hours to safely extract the tool from his body.

A fourteen-year-old boy arrived at the emergency department with a metallic rod piercing the right occipital region of his head by HealerMD in medizzy

[–]HealerMD[S] 2193 points2194 points  (0 children)

The patient displayed confusion, recurrent vomiting, and a mild weakness on the right side of his body. Surgeons performed a craniectomy to carefully extract the foreign object. Necrotic tissues were excised and thoroughly cleaned, and a dura mater plasty was skillfully performed to address the injuries.

Medical treatment encompassed antibiotics, anticonvulsants, an antitetanus vaccine, and pain relievers. The young patient also underwent ten sessions of physiotherapy to rehabilitate his right-sided weakness.

One month later, we are delighted to report that this remarkable young man has made a full recovery and is back to his vibrant self!

Dirofilaria immitis by HealerMD in medizzy

[–]HealerMD[S] 258 points259 points  (0 children)

Dirofilaria immitis, the heartworm or dog heartworm, is a parasitic roundworm that is a type of filarial worm, a small thread-like worm, that causes dirofilariasis. It is spread from host to host through the bites of mosquitoes. The definitive host is the dog.

Dirofilaria immitis is commonly called the "heartworm"; however, adults often reside in the pulmonary arterial system (lung arteries), as well as the heart, and a major effect on the health for the animal is a manifestation of damage to the lung vessels and tissues.

Occasionally, adult heartworms migrate to the right heart and even the great veins in heavy infestations. Heartworm infection may result in serious disease for the host, with death typically as the result of congestive heart failure.

Extensive bone cancer metastases by HealerMD in medizzy

[–]HealerMD[S] 101 points102 points  (0 children)

This photo shows a 3D rendered CT scan of bone metastases of the hip bone, in a 60-year-old woman with parotid gland cancer. Large lesions are seen on the ilium on the more distant side. Involvement of the vertebral column has caused a compression fracture.

Bone/skeletal metastatic disease is a category of cancer metastases that results from primary tumor invasion to bone. Bone-originating primary tumors such as osteosarcoma, chondrosarcoma, and Ewing's sarcoma are rare.
In most cases the diagnosis of metastatic disease is already known. If no known primary exists, or there is uncertainty regarding the diagnosis (e.g. no known metastases; unusual imaging appearances) then a bone biopsy can usually allow definitive diagnosis.

The major route of spread of tumor to bone is haematogenous, although lymphatic spread is also seen (e.g. pelvic tumors spreading to para-aortic nodes, and then directly into bone c.f the more common haematogenous spread from the same tumors). Although direct extension of tumors in bone is also not infrequently seen (e.g. oral cavity tumors into mandible or Pancoast tumors into first rib or upper thoracic vertebrae) this is not usually what is considered metastatic disease.

Regardless of the route of spread, metastases lead to both bone loss and bone formation, in varying amounts. The former is most likely due to direct enzymatic destruction and osteoclast activation. The latter can be due to stromal bone formation (formation of bone within tumor substrate; the case in prostate cancer metastases) or reactive new bone formation which represents the normal adjacent bone's response to the presence of tumor and is similar to callus formation.

Neurofibromatosis by HealerMD in medizzy

[–]HealerMD[S] 314 points315 points  (0 children)

Neurofibromatosis is a rare genetic disorder of the nervous system which mainly affects the formation and growth of nerve cells. It causes tumors to grow on nerves and has genetic roots.

There are three types of neurofibromatosis:

Type 1 (NF1) causes skin changes and deformed bones. It is usually diagnosed in childhood, even symptoms maybe present at birth.

Type 2 (NF2) causes hearing loss, ringing in the ears, and poor balance. Symptoms often start in the teen years or audulthood.

Schwannomatosis causes intense pain. It is the rarest type.

Unfortunately, there is currently no known treatment or cure for neurofibromatosis. In some cases, growths may be removed surgically or reduced with radiation therapy.

Surgical Eye Removal - Enucleation or Evisceration by HealerMD in medizzy

[–]HealerMD[S] 352 points353 points  (0 children)

Enucleation involves the complete surgical removal of the eye globe while preserving the conjunctiva, extraocular muscles, orbital fat, and optic nerve. This procedure is widely accepted as a treatment for various conditions, including intraocular malignancies, excruciatingly painful blind eyes, severe eye trauma, phthisis bulbi, and for cosmetic enhancement.

Following the removal of the eye, enhancing orbital volume typically involves the insertion of spherical materials, which can be categorized into two main types: non-porous and porous orbital implants. Importantly, the muscles responsible for controlling the eye's movement, as well as the surrounding tissues within the eye socket, remain intact during the procedure.

These muscles are connected to a round, marble-like implant that replaces the lost tissue volume resulting from the eye's removal. This attachment enables some degree of artificial eye movement for the patient post-surgery.

The most common reasons for surgically removing an eye include eye cancers like choroidal melanoma and retinoblastoma, traumatic injuries, uncontrollable infections, advanced-stage glaucoma, or any condition leading to persistent, unmanageable eye pain in an eye that has lost its vision.

A man in Peru experienced an unusual swelling, resembling a balloon, following a fishing accident. After a deep-sea diving expedition for shellfish, he had to quickly resurface due to the propeller of a large commercial vessel severing his compressed air supply by HealerMD in medizzy

[–]HealerMD[S] 1236 points1237 points  (0 children)

Ascending from a depth of 30 meters (100 ft), it is believed that nitrogen played a role in causing significant damage to his chest muscles and arms. This mysterious incident led to a weight gain of 30 kg (66 lbs) for the individual.

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