Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Radiology Quiz Case 3

Radiology Quiz Case 3 A 15-year-old boy presented with right-sided anterior epistaxis after undergoing anterior packing at an outside hospital. He had experienced approximately 4 episodes of right-sided epistaxis per year for 10 years. He had no history of antecedent trauma, nasal surgery, or bleeding diatheses and no facial numbness or pressure. His medical and family histories were noncontributory. The patient had age-appropriate vital signs, and the results of examination of his eyes, face, oral cavity, larynx, neck, and cranial nerves were normal. After his nasal packing was removed, he developed brisk anterior bleeding from the right side. The bleeding was localized to the lateral nasal wall, near the middle meatus. No discrete mass was seen, but the site appeared purpuric. Hematologic laboratory tests showed no abnormalities. Computed tomographic and magnetic resonance imaging was performed (Figures 1, 2, and 3). Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload A formal endoscopic examination showed a lesion superior to the inferior turbinate, anterior to the horizontal attachment of the middle turbinate. The lesion was soft and purpuric, with a fibrous capsule, extending into the middle meatus. Biopsy specimens and cultures were obtained. Before the results returned, infraorbital numbness developed. The biopsy specimens showed only inflammatory changes, and the cultures were negative for organisms. Because of the patient's paresthesia and radiologic infraorbital dehiscence, he was taken back to the operating room for complete excision of the mass. The histopathologic features are shown in Figure 4. The patient has done well since surgery, with no further episodes of bleeding and complete resolution of the paresthesias. Figure 4. View LargeDownload What is your diagnosis? Return to Quiz Case 1. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Radiology Quiz Case 3

Abstract

A 15-year-old boy presented with right-sided anterior epistaxis after undergoing anterior packing at an outside hospital. He had experienced approximately 4 episodes of right-sided epistaxis per year for 10 years. He had no history of antecedent trauma, nasal surgery, or bleeding diatheses and no facial numbness or pressure. His medical and family histories were noncontributory. The patient had age-appropriate vital signs, and the results of examination of his eyes, face, oral cavity, larynx,...
Loading next page...
 
/lp/american-medical-association/radiology-quiz-case-3-aSNRz1Fs6g
Publisher
American Medical Association
Copyright
Copyright © 2011 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archoto.2011.42-a
Publisher site
See Article on Publisher Site

Abstract

A 15-year-old boy presented with right-sided anterior epistaxis after undergoing anterior packing at an outside hospital. He had experienced approximately 4 episodes of right-sided epistaxis per year for 10 years. He had no history of antecedent trauma, nasal surgery, or bleeding diatheses and no facial numbness or pressure. His medical and family histories were noncontributory. The patient had age-appropriate vital signs, and the results of examination of his eyes, face, oral cavity, larynx, neck, and cranial nerves were normal. After his nasal packing was removed, he developed brisk anterior bleeding from the right side. The bleeding was localized to the lateral nasal wall, near the middle meatus. No discrete mass was seen, but the site appeared purpuric. Hematologic laboratory tests showed no abnormalities. Computed tomographic and magnetic resonance imaging was performed (Figures 1, 2, and 3). Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload A formal endoscopic examination showed a lesion superior to the inferior turbinate, anterior to the horizontal attachment of the middle turbinate. The lesion was soft and purpuric, with a fibrous capsule, extending into the middle meatus. Biopsy specimens and cultures were obtained. Before the results returned, infraorbital numbness developed. The biopsy specimens showed only inflammatory changes, and the cultures were negative for organisms. Because of the patient's paresthesia and radiologic infraorbital dehiscence, he was taken back to the operating room for complete excision of the mass. The histopathologic features are shown in Figure 4. The patient has done well since surgery, with no further episodes of bleeding and complete resolution of the paresthesias. Figure 4. View LargeDownload What is your diagnosis? Return to Quiz Case 1.

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Apr 18, 2011

Keywords: radiology specialty

There are no references for this article.