Browsing by Author "Radović, Tijana (57203317503)"

Background: This is the first reported case of a primary intraosseous angioleiomyoma and the second case of a primary leiomyoma of the rib, irrespective of age. Angioleiomyomas mostly occur in patients of advanced age, in any part of the body, particularly the lower extremities and present as painful, slow-growing nodules in the dermis, subcutaneous fat or deep fascia. Other localizations, especially bone, are considered extremely rare, as well as their occurrence in paediatric patients. Case presentation: A 10-year-old girl was admitted to the orthopaedic surgery department for further assessment of a pain localized in the posterior part of the right hemithorax. After magnetic resonance imaging (MRI) and surgical biopsy, intraosseus angioleiomyoma of the fourth rib was diagnosed by histopathology examination. Atypical costal localization of this type of a benign tumour presents diagnostic difficulty, especially in children. The differential diagnoses included cartilaginous tumours, Ewing sarcoma, fibrous dysplasia, Langerhans cell histiocytosis, intraosseous haemangioma and metastatic tumours. We report a detailed diagnostic procedure including MRI, selective angiography and histopathologic examination. Conclusion: Diagnosis of intraosseous angioleiomyoma is difficult due to the extreme rarity of this tumour and absence of pathognomonic radiological signs. Although very rarely identified in bones and young age group, radiographers and reporting doctors should be aware of this possible angioleiomyoma presentation and supported by the provided detailed diagnostic information. © 2018 The Author(s).

Introduction. Empyema thoracis, defined as the accumulation of pus in the pleural space, is rare in the neonatal population. Limited data are reported in the medical literature, and still, no treatment guidelines are available for this age. Case report. We present a term 12-day-old neonate (born healthy) who developed sepsis caused by methicillin-resistant Staphylococcus aureus (MRSA) and pneumonia associated with advanced-stage empyema. The child was admitted to our hospital with a few-hours history of difficulty breathing and lethargy. On admission, the child was cyanotic with desaturation and in severe respiratory distress; therefore, the child was intubated, and mechanical ventilation was started. Imaging tests were performed in an emergency, hence chest computed tomography (CT) scan was done without contrast. Suspected congenital pulmonary airway malformation with trapped air collections, significant mediastinal shift on CT scan, and deterioration of the patient’s condition indicated urgent surgery. Intraoperatively, the diagnosis of stage II empyema was established, and decortication of thickened parietal and visceral pleura was performed. Afterward, the baby showed quick and progressive clinical improvement. Conclusion. The diagnosis and management of empyema in neonates may be challenging, especially in the case of unremarkable history, fulminant progression of the disease, and incomplete imaging tests. © 2023 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction/Objective The objective was to evaluate sonographic and laboratory findings as predic-tors of complicated and uncomplicated appendicitis in order to decide on further treatment options. Methods This is a retrospective cohort study of 174 pediatric patients who had laboratory tests and ultrasound done before appendectomy during a one-year period. Results were compared with the intra-operative and histopathological findings of complicated (gangrenous or perforated) or uncomplicated (phlegmonous) appendicitis and assessed by binary logistic regression with backward elimination. The initial model included eight predictors. After backward elimination four remained: periappendiceal fluid, hyperechoic periappendiceal fat, white blood cell (WBC) count and C-reactive protein (CRP). The final model included the interaction between periappendiceal fluid and hyperechoic periappendiceal fat. Diagnostic performance of each parameter was presented with sensitivity and specificity. Results Out of all patients, 86 had uncomplicated and 88 had complicated appendicitis (37 gangrenous, and 51 perforated). In the final model three predictors were significantly associated with complicated appendicitis: interaction between periappendiceal fluid and hyperechoic periappendiceal fat, WBC count > 11 × 109 /l, and CRP > 100 mg/l. Inclusion of interaction between periappendiceal fluid and hyper-echoic periappendiceal fat excluded them as individual predictors. The maximum outside appendiceal diameter of more than 6 mm had the highest sensitivity (93.2%), while wall thickness > 3 mm was the most specific (95.2%). Conclusion Using periappendiceal fluid and hyperechoic periappendiceal fat as sonographic predictors and WBC and CRP as laboratory predictors can differentiate uncomplicated from complicated appendicitis in children and help a physician decide on antibiotic or surgical treatment. © 2024, Serbia Medical Society. All rights reserved.