• 제목/요약/키워드: Delayed Diagnosis

검색결과 610건 처리시간 0.03초

Surgical treatment of postauricular hidradenitis suppurativa with delayed diagnosis: a case report and literature review

  • Inho Kang;Gyu Yong Jung;Min Jun Yong;Yujin Ahn;Joon Ho Lee
    • 대한두개안면성형외과학회지
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    • 제24권2호
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    • pp.73-77
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    • 2023
  • Hidradenitis suppurativa (HS) is a chronic inflammatory condition that is difficult to diagnose, with a period of 10.0±9.6 years from symptom onset to diagnosis. A 32-year-old Asian man presented with bilateral postauricular abscesses that first appeared 5 years previously. Despite several incisions and drainage, the symptoms only temporarily improved and continued to recur. On physical examination, chronic scars and sinus tracts were observed around the lesion. Postauricular HS was diagnosed, and surgical treatment was performed. We performed a wide excision and reconstructed the defect using a posterior auricular artery perforator-based keystone flap. Histological examination confirmed the diagnosis of HS. The reconstruction was successful, and there was no recurrence for 2 years after surgery. HS is difficult to diagnose without specific attention. Although the postauricular region is not a typical site of HS, it can occur in this area. Therefore, if a patient presents with recurrent abscesses in the postauricular region, HS should be considered. Additionally, if HS is diagnosed in the postauricular region, wide excision with reconstruction using a posterior auricular artery perforator-based keystone flap can lead to a favorable outcome.

지연 진단된 외상성 횡격막 손상 1예 (Delayed Diagnosis of a Traumatic Diaphragmatic Injury)

  • 박선욱;김철홍;김지연;이승화;김용욱;현인규;신호승
    • Tuberculosis and Respiratory Diseases
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    • 제66권3호
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    • pp.241-245
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    • 2009
  • 외상성 횡격막 손상은 대부분 교통사고와 관련되어 있다. 특히, 횡격막 파열은 그 진단이 지연되는 경우가 많다. 왜냐하면, 임상적 증상 및 징후가 특이적이지 않기 때문이다. 또한, 가슴 X-선 사진에서도 특징적 소견을 보이지 않으며, 더구나 동반된 다른 외상으로 인해 진단이 은폐될 수 있다. 그래서 다발성 외상 환자를 접근할 때는 횡격막 손상을 의심하고 적절한 검사를 택하는 것이 중요하다. 저자들은 교통사고로 인한 다발성 둔기외상으로 내원한 54세 남자 환자에서 입원 12 병일에 수술적 치료를 요하는 횡격막 파열을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

한방진단시스템 DSOM을 이용한 무월경 및 희발월경의 변증진단 연구 (A Clinical Study on Differentiation of Syndromes of Amenorrhea or Oligomenorrhea with DSOM)

  • 이인선;배경미
    • 대한한방부인과학회지
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    • 제22권2호
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    • pp.189-208
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    • 2009
  • Purpose: In oriental medicine, doctors have mainly made diagnosis and treatment with amenorrhea or delayed menstrual period based on overall analysis of symptoms and signs patients have. We think patients with amenorrhea or delayed menstrual period to have symptoms that are classified into one differentiation of syndromes, and then studied to make the index. This study has been carried out to investigate pattern identifications and classify symptoms according to them. Methods: We examined 52 patients who visited Dong-eui university oriental medical center from June 2005 to February 2009 for undergoing treatment for amenorrhea or delayed menstrual period and made OB & GY questionnaires up Results: We investigated whether the patients had symptoms concerned with symptom types by analyzing the result of DSOM(Diagnos System of Oriental Medicine, hearafter DSOM). It came out 51 cases among 52 with pathogenesis that was related to the symptom types. The symptom types of were surveyed into Insufficiency of Kidney and Liver(肝腎不足), Insufficiency of Qi and Blood(氣血虛弱), Insufficiency of Yin & Dryness of blood(陰虛血燥), stagnation of Qi and Blood(氣滯血瘀), phlegm and damp(痰濕阻滯), coldness of Blood(血寒), Heat of Heart(心火). Conclusion: As a result of the investigation, one case did not have symptoms of differentiation of syndromes of amenorrhea or delayed menstrual period. 29 cases had 1 or 2 differentiation of syndromes. 21 patients had such complex symptoms of diverse differentiation of syndromes that it was difficult to diagnose a differentiation of syndromes in clinical survey. It is necessary to put the priority among the differentiation of syndromes in diagnosis in the future.

원발성 폐암의 지연진단에 관한 임상적 고찰 (Delayed Diagnosis of Primary Lung Cancer)

  • 김선영;조해정;김근화;고동석;서재철;신경상;정성수;김주욱
    • Tuberculosis and Respiratory Diseases
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    • 제45권4호
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    • pp.754-759
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    • 1998
  • 연구배경: 폐암은 우리나라에서 문제가 하나 되는 중요한 암종중 하나인데, 여러 가지 의학적 발전에도 불구하고 그 예후는 좋지 않으므로, 가능한한 조기에 발견하여 수술하는 것이 좋다. 그러나 이의 진단이 용이치 않아 지연진단의 원인들이나 임상적 특성들을 분석하여 개선점을 찾고자하였다. 방 법: 1995년 1월부터 12까지에 충남대학교 병원에서 조직학적으로 진단받은 폐암 환자 154명을 대상으로 그 주된 증상, 진단까지의 소요기간, 지연진단을 유발한 질환들을 후향적으로 조사 분석하되 순조롭게 진단된 환자 91명(1군)과 진단이 지연된 환자 63명(2군)으로 나누어 조사하여 비교하였다. 결 과: 병원을 찾게된 주증상들은 일반적인 호흡기 증상들이 대부분이었는데, 객혈이나 흉통의 경우는 진단이 순조로왔고, 객담 및 기침, 호흡곤란의 증상들에서는 진단이 지연되었다. 또한 이의료진들에 의한 지연진단도 후자의 증상들에서 주로 문제가 되었다. 진단이 지연된 경우에는 결핵성 질환(40.9%), 폐염(14.3%) 등으로 오진되거나 만성 폐쇄성 폐질환(9.5%), 심장질환(7.9%) 등의 동반되는 타질환으로 인해 오진되거나 지연전단된 경우들이었다. 결 론: 호흡기 증상이 일단 생기면 특별한 금기증이 없는 한 흉부 방사선 검사를 사행하는 것이 중요하며, 확실치 않을 때는 즉시 3차 전문병원으로 전원하는 것도 중요하고, 기존의 다른 만성질환으로 치료받고 있는 환자들에서도 주기적인 흉부 방사선 검사가 필요할 수 있으므로 이런 점들에 유의하면 지연진단의 문제를 개선할 수 있을 것으로 사료된다.

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외상성 횡격막 파열의 지연성 발현 (Delayed Presentarion of Traumatic Diaphragmatic Rupture)

  • 설영훈;문재영;이경하;이상일;전광식;이준완;송인상
    • Journal of Trauma and Injury
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    • 제27권2호
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    • pp.38-42
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    • 2014
  • Traumatic diaphragmatic rupture is quite uncommon and rarely lethal injury. However, delayed presentation between the injury and the diagnosis can cause a life-threatening condition with various complications such as intestinal hernia, obstruction, strangulation, respiratory distress. Here, we present a case of delayed presentation of traumatic diaphragmatic rupture in a 51-year-old man, and then discuss about the clinical implication of delayed presentation of diaphragmatic rupture with a review.

치유가 지연된 발치창에서 발생한 질환에 대한 임상적, 방사선학적, 조직병리학적 분석 (OLINICAL, RADIOLOGIC, AND HISTOPATHOLOGIC ANALYSIS OF DISEASES DEVELOPED IN DELAYED WOUND HEALING OF EXTRACTION SOCKET)

  • 장현선;김수관
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권1호
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    • pp.15-20
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    • 2001
  • For the earlier diagnosis and treatment of delayed wound healing in extraction socket, we investigated the clinical, radiographic and histopathologic features of 106 patients with delayed wound healing diagnosed by biopsy. The patients were enrolled at the Department of Oral Pathology, Chosun University Dental Hospital. Among 106 delayed wound healing diagnosed by biopsy, cysts showed most significant 25 cases (23%), osteomyelitis showed 13 cases (12%), chronic maxillary sinusitis and squamous cell carcinoma showed 12 (11%) and 11 (10%) cases, respectively. We have analyzed these lesions through relevant literatures.

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회전근개 파열과 유사한 양상을 보인 피부 대상 포진의 지연성 근육 마비 - 증례 보고 - (Delayed-onset Muscular Paralysis after Cutaneous Herpes Zoster Mimicking Rotator Cuff Tear -Case Report-)

  • 오주한;공현식;김형호
    • Clinics in Shoulder and Elbow
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    • 제7권2호
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    • pp.94-97
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    • 2004
  • Herpes zoster presents clinically with cutaneous vesicular eruption and pain along the dermatome, but it can sometimes cause muscular paralysis. When the disease involves cervical root, it is included in the differential diagnosis of shoulder diseases. A sixty-six year old patient, complaining of severe pain and weakness of his left shoulder, was referred to the authors as having a partial tear of the supraspinatus tendon on MRI. However, the authors found out a paralysis of the sixth cervical root in the patient by electrophysiologic studies, noting that the patient had been affected with a herpes eruption in the neck and arm two months before. Zoster paresis has been reported to be associated with the cutaneous eruption within two weeks of its onset, making its diagnosis not so difficult. The authors report a case of delayed-onset muscular paralysis after cutaneous herpes zoster, which presented just like a rotator cuff tear.

임상가를 위한 특집 1 - 구치부 맹출 장애의 진단과 치료 (Diagnosis and Treatment of the Eruption Disturbance of posterior teeth)

  • 양연미
    • 대한치과의사협회지
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    • 제50권6호
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    • pp.304-311
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    • 2012
  • Eruption of the teeth can be disturbed by crowding, ectopic eruption path, retention for pathologic condition of follicle and periodontal ligament, local disturbances in the innervation, and delayed eruption for overlying obstacles in the eruption path. Eruption disturbance of permanent posterior teeth is taken with diverse therapeutic approaches according to the patient age, cooperation of patient, tooth position and maturity, degree of impaction, clinical features, and repercussion on the neighboring teeth. However, delayed treatment usually results in less favorable outcomes. Therefore, In order to prevent this situation, periodically radiographic examinations during the early mixed dentition period and early diagnosis of eruption disturbances of permanent posterior teeth are recommended.

측두하악관절 장애를 보인 두개저 골수염: 증례보고 (Temporomandibular Joint Disorder from Skull Base Osteomyelitis: A Case Report)

  • 류병길;윤현중;이상화
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권6호
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    • pp.484-487
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    • 2012
  • Skull base osteomyelitis is a very rare disease that affects the bone marrow of the temporal bone, sphenoid bone, occipital bone. It occurs typically chronic ear canal infections by malignant otitis externa, but some of atypical osteomyelitis have been reported. It most commonly presents old diabetic patients, and have high morbidity and mortality rate if diagnosis and treatment are delayed. However with respect to pain or dysfunction, it appeared similar to the initial symptoms of temporomandibular joint disorder. So frequently, definitive diagnosis is tend to delayed. We have clinical experience that a patient who presented with symptom similar to temporomandibular disorder, and differential diagnosised by skull base osteomyelitis. We will report this case with literature review.

Delayed diagnosis of a primary intraosseous squamous cell carcinoma: A case report

  • Abdelkarim, Ahmed Z.;Elzayat, Ahmed M.;Syed, Ali Z.;Lozanoff, Scott
    • Imaging Science in Dentistry
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    • 제49권1호
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    • pp.71-77
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    • 2019
  • Primary intraosseous squamous cell carcinoma is a rare malignant central jaw tumor derived from odontogenic epithelial remnants. Predominantly, it affects mandible, although both jaw bones may be involved. This report describes a 60-year-old man who was initially misdiagnosed with a periapical infection related to the right lower wisdom tooth. After four months, the patient presented to a private dental clinic with a massive swelling at the right side of the mandible. Panoramic radiographs and advanced imaging revealed a lesion with complete erosion of the right ramus, which extended to the orbital floor. A biopsy from the mandibular angle revealed large pleomorphic atypical squamous cells, which is the primary microscopic feature of a poorly differentiated squamous cell carcinoma.