*/
What is a Lymphangioma ?
Oct 27th
A lymphangioma is a group of dilated lymphatics that project into the surface of the skin.
It occurs due to the failure of the lymphatic vessels to join one of the lymph sacs in the body.
Discontinuity of the lymphatic drainage system hence results in the localized accumulation of lymphatic fluid under the skin.
They can be congenital or acquired. Congenitally present lymphangiomas are commonly associated with chromosomal abnormalities like the Turner’s syndrome.
The commonest sites of occurrence are the posterior triangle of the neck, the axilla, mediastinum and the groin.
A lymphangioma is called a cystic hygroma if it is largely confined to the subcutaneous plane. In a cystic hygroma, the lymph accumulated in the swelling is absorbed and replaced by a thin watery fluid (mucus) secreted by the endothelium.
If it occurs in the neck, the condition is called a hydrocoele of the neck.
Read further >>
What is a Ranula ?
Sep 25th
A ranula is a cystic swelling arising from the sublingual salivary glands. It may also arise from the accessory salivary glands.
It derives its name from the frog Rana hexadactyla, as the swelling resembles the belly of the frog.
Etiopathogenesis
The ranula occurs due to obstruction of the mucus secreting ducts of the salivary glands.
This leads to retention of the secretions leading to the formation of a retention cyst.
This cystic swelling Is also considered an extravasation cyst by some surgeons.
Read further >>
What is a Meningocoele ?
Sep 21st
A meningocoele is the herniation of the meninges through a weak spot in the spine.
Etiology
Meningocoele is a presentation occurring in conditions affecting the fusion of the posterior part of the vertebrae. The conditions which present with meningocoele are –
- Spina Bifida Cystica.
- Teratomas and other tumors of the vertebrae.
- Currarino syndrome.
- Bony defects with outpouching of meninges.
- Dehiscence in the base of the skull. These are classified by location into occipital, frontoethmoidal, or nasal.
Commonest sites of occurrence of a meningocoele are the lumbosacral region and the occipitocervical region of the vertebral column.
Rarely, the meningocoele may also occur at the root of the nose.
Read further >>
Deep Vein Thrombosis | Management & Prophylaxis
Sep 17th
Deep Vein Thrombosis (DVT) has been discussed under the following titles -
- What is Deep Vein Thrombosis ?
- Deep Vein Thrombosis | Investigations & Complications
- Deep Vein Thrombosis | Management & Prophylaxis
In this article we shall see how a case of Deep Vein Thrombosis (DVT) is managed and the prophylactic measures that can be employed to prevent its occurrence.
Management
- Complete bed rest with elevation of the limbs is advised.
- Anticoagulants – The patient is started on anticoagulant therapy to combat the thrombosis.
A bolus dose of heparin is injected intravenously which is then maintained with a continuous daily infusion for 7-10 days. During this time, the activated partial thromboplastin time (APTT) is maintained at twice the normal value while the International Normalized Ratio (INR) is between 2.0 and 3.0
Oral anticoagulant therapy with Warfarin is started 2-3 days before heparin therapy is to be withdrawn. This is done to compensate for the slow onset time of warfarin. Warfarin therapy is continued for 6 months to 1 year. During this time, duplex scanning is done to check for recanalisation of the veins and the treatment is monitored with prothrombin time and INR.
Low Molecular Weight Heparin (LMWH) is preferred as it is associated with a lesser incidence of bleeding. It is given as an injection once or twice a day. No blood monitoring is required.
