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  1. Article ; Online: Sarcoidosis of the pancreas mimicking adenocarcinoma.

    Mayne, Alistair Ivan William / Ahmad, Jawad / Loughrey, Maurice / Taylor, Mark A

    BMJ case reports

    2013  Volume 2013

    Abstract: Primary sarcoidosis of the pancreas is extremely rare. Clinical presentation is often identical to that of pancreatic adenocarcinoma. Preoperative diagnosis of primary pancreatic sarcoidosis is always challenging. We present a 52-year-old man who ... ...

    Abstract Primary sarcoidosis of the pancreas is extremely rare. Clinical presentation is often identical to that of pancreatic adenocarcinoma. Preoperative diagnosis of primary pancreatic sarcoidosis is always challenging. We present a 52-year-old man who developed weight loss and obstructive jaundice. Abdomino-pelvic CT scan showed a mass in the pancreatic head. After hepatopancreaticobiliary MDT discussion, a Whipple's procedure was attempted but the mass was deemed unresectable due to invasion of the superior mesenteric vein. Upon completion of palliative chemotherapy, repeat imaging showed significant mass shrinkage. A reattempt Whipple's procedure was successfully undertaken. Histology showed changes of chronic pancreatitis and peripancreatic granulomatous inflammation with no evidence of malignancy and a diagnosis of sarcoidosis was made. Owing to the devastating nature of pancreatic adenocarcinoma, any mass in the pancreas must be thoroughly investigated before a definitive diagnosis is made.
    MeSH term(s) Adenocarcinoma/diagnosis ; Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/physiopathology ; Adult ; Aged ; Combined Modality Therapy ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Diseases/diagnosis ; Pancreatic Diseases/diagnostic imaging ; Pancreatic Diseases/physiopathology ; Pancreatic Diseases/therapy ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/physiopathology ; Sarcoidosis/diagnosis ; Sarcoidosis/diagnostic imaging ; Sarcoidosis/physiopathology ; Sarcoidosis/therapy ; Tomography, X-Ray Computed
    Language English
    Publishing date 2013-06-19
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2013-009118
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Acute carpal tunnel syndrome in a patient with haemophilia.

    Mayne, Alistair Ivan William / Howard, Anthony / Kent, Matthew / Banks, Joanne

    BMJ case reports

    2012  Volume 2012

    Abstract: Acute carpal tunnel syndrome (CTS) is a rare surgical condition usually resulting from wrist trauma. We present the case of a young haemophilic man who developed acute CTS following trivial injury. The patient was initially managed conservatively but ... ...

    Abstract Acute carpal tunnel syndrome (CTS) is a rare surgical condition usually resulting from wrist trauma. We present the case of a young haemophilic man who developed acute CTS following trivial injury. The patient was initially managed conservatively but symptom progression resulted in carpal tunnel decompression. A literature review and management approach are presented. This is an important complication of haemophilia to be aware of as prompt conservative management can obviate the need for surgery. This case is useful in (a) highlighting the importance of considering a patient's medical history when formulating differential diagnoses and (b) outlining a management approach to this condition.
    MeSH term(s) Acute Disease ; Carpal Tunnel Syndrome/etiology ; Carpal Tunnel Syndrome/surgery ; Decompression, Surgical/methods ; Hemophilia A/blood ; Hemophilia A/complications ; Humans ; Male ; Partial Thromboplastin Time ; Risk Factors ; Young Adult
    Language English
    Publishing date 2012-07-03
    Publishing country England
    Document type Case Reports ; Journal Article ; Review
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-03-2012-6152
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Documentation of neurovascular status in supracondylar fractures and the development of an assessment proforma.

    Mayne, Alistair Ivan William / Perry, Daniel C / Stables, Gareth / Dhotare, Satish / Bruce, Colin E

    Emergency medicine journal : EMJ

    2013  Volume 30, Issue 6, Page(s) 480–482

    Abstract: Background: Supracondylar fractures are associated with a high incidence of neurovascular complications. Comprehensive clinical evaluation is a necessity when children with these injuries present to the emergency department. Neurovascular assessment can ...

    Abstract Background: Supracondylar fractures are associated with a high incidence of neurovascular complications. Comprehensive clinical evaluation is a necessity when children with these injuries present to the emergency department. Neurovascular assessment can be difficult due to pain, anxiety and the young age of these patients; however, it is crucial findings are well documented to identify patients requiring urgent surgical intervention, in addition to allowing the neurovascular status to be monitored over time. The aim of this study was to evaluate the preoperative neurovascular documentation in children presenting with displaced supracondylar fractures and devise an emergency department assessment proforma to facilitate comprehensive evaluation.
    Methods: A retrospective case-note review was performed on patients with Gartland grades 2 and 3 supracondylar fractures observed in a 2-year period from July 2008 to July 2010.
    Results: 137 patients were included; only 12 patients (8.8%) and 19 patients (13.9%), respectively, had a complete preoperative neurological or vascular assessment documented. Regarding the individual nerves, 59 (43.1%) patients had median nerve integrity documented, 55 (40.1%) ulnar nerve and 49 (35.8%) radial nerve integrity documented. Only 18 patients (13.1%) had their anterior interosseous nerve (AIN) function documented.
    Conclusions: Preoperative documentation of neurovascular status in children with displaced supracondylar fractures was poor. Documentation of AIN examination was particularly poor. The introduction of a proforma (Liverpool upper limb fracture assessment) is proposed to increase documentation of neurovascular assessment and optimise emergency department evaluation of children presenting with upper limb injuries.
    MeSH term(s) Blood Vessels/injuries ; Child ; Elbow/injuries ; Female ; Humans ; Humeral Fractures/physiopathology ; Humerus/blood supply ; Humerus/innervation ; Injury Severity Score ; Joint Dislocations/physiopathology ; Male ; Median Nerve/injuries ; Peripheral Nerve Injuries/diagnosis ; Peripheral Nerve Injuries/etiology ; Preoperative Care ; Radial Nerve/injuries ; Retrospective Studies ; Risk Assessment ; Treatment Outcome ; Ulnar Nerve/injuries
    Language English
    Publishing date 2013-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emermed-2012-201293
    Database MEDical Literature Analysis and Retrieval System OnLINE

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