Thursday, 10 April 2025

CASE 823: PERFORATED STOMACH due to FISHBONE, Dr PHAN THANH HẢI , Dr VÕ THỊ THANH THẢO, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 61 year-old man with epigastric pain for one month.

Ultrasound detected accidentally a # 26 mm fishbone which perforated his stomach. On transverse section the fishbone looked like a gastric ulcer. Lab data were in normal values.







MSCT confirmed a fishbone perforating the stomach with the free end into the abdominal cavity.


Endoscopic surgery removed the fishbone from the pyloric wall of the stomach to outside the stomach into the peritoneum.



Saturday, 5 April 2025

CASE 822: TUBERCULOSIS of KNEE SOFT TISSUE, Dr PHAN THANH HẢI , Dr NGUYỄN SÀO TRUNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A 43 year-old female nurse with her right knee pain and slight swelling for 3 months. Her 20 year old history noted she got TB cervical lymph nodes.

Ultrasound detected a #36x35mm mass of the right lateral femoral muscle [biceps femorii] at the 1/3 lower thigh. The muscular mass has unclear border, mixed echogenic and hypovascular. Maybe  it was a tuberculous myositis ?

There was edema of the synovial membrane into the knee joint # 46x48 mm. 

No fluid collection nor bone destruction existed of the right knee joint.





MRI confirmed the right knee mass which was between the femoral biceps and popliteal muscle but could not differentiate  hemangioma, tenosynovial giant cell tumor, soft tissue sarcoma...from each others.





Core biopsy was done and the result was a TB knee soft tissue inflammation which had TB cysts composed caseum and degenerated Langhans cells and lymphocytes.


A TB -treatment -8 -month regimen  for the nurse was planned.