Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsRetropharyngeal Abscess Presenting as Torticollis.
Retropharyngeal abscess (RPA) is a deep neck infection with life-threatening complications such as airway obliteration, necrotizing mediastinitis, and pulmonary empyema, which must be diagnosed early and treated promptly. We herein present a patient who was admitted to the emergency room with limited neck movement, torticollis, difficulty in swallowing, and a feeling that something is stuck in the throat and diagnosed with RPA. Plain lateral radiograph of the neck revealed air levels at the level of C3-C5. ⋯ It is important to recognise and treat RPA, which has a high mortality due to its complications. RPA should be kept in mind in the differential diagnosis of patients with neck pain and torticollis, particularly in adults. Key Words: Retropharyngeal abscess, Drainage, Trendelenburg position, Torticollis.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsDigital Necrosis Due to Septic Embolism: An Unseen Complication of Gangrenous Cholecystitis.
Gangrenous cholecystitis is one of the most severe complications of cholelithiasis. It causes serious morbidity and mortality. The main pathology in this complication is progressive vascular insufficiency, which may lead to necrosis and perforation of the gallbladder wall. ⋯ Embolism and necrosis in distant organs as a complication of gangrenous cholecystitis have not been reported till date. In this case, we present a patient, who developed necrosis of the fingers and toes due to septic embolism as a complication of gangrenous cholecystitis. Key Words: Cholelithiasis, Acute cholecystitis, Gangrene, Necrosis.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsIntraoperative Monitoring and Preservation of Anatomic Integrity of Palsied Recurrent Laryngeal Nerve is Extremely Meaningful During Redo Thyroid Surgery.
Redo thyroid surgery on patients with unilateral recurrent laryngeal nerve (RLN) palsy certainly poses a great surgical challenge. We present a case of a patient with unilateral vocal cord (VC) palsy who underwent redo thyroid surgery under intraoperative neuromonitoring. The patient's normal speaking voice was maintained after the primary surgery, even though preoperative laryngoscopy showed an immobile right VC with a normal structure. ⋯ A positive signal delineates at least partial neural transmission despite VC palsy. The preservation of anatomical integrity of palsied RLN for eventual partial conductivity may be vital in preserving the normal structure of VC and maintaining the patient's voice despite its immobility. Key Words: Surgery, Redo thyroidectomy, Recurrent laryngeal nerve injury, Vocal cord palsy.