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Glomus tumour of the elbow: an unusual cause of intestinal perforation.

Donnelly KJ, Thompson NW, O'Longain D, Cameron I - Ulster Med J (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Orthopaedic Surgery, Altnagelvin Hospital Glenshane Road Derry, Northern Ireland BT47 6SB.

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Editor, A 72 year-old-female presented to the Emergency Department with a twelve hour history of sudden onset generalised abdominal pain and distension... On further questioning, she reported a 10 month history of an exquisitely tender swelling over the posterior aspect of her left elbow, which had been treated as bursitis, causing her to take excessive amounts of codeine- based analgesia... Clinically, cutaneous glomus tumours appear as solitary, small bluish subcutaneous lesions with the classic triad of point tenderness, severe pain and cold intolerance... However, magnetic resonance imaging (MRI) has been deemed more sensitive for the detection of glomus tumours... Treatment is by local excision... Delayed diagnosis of glomus tumours can prolong unnecessary pain resulting in the excessive use of analgesia which may result in significant morbidity... Stercoral perforation is a rare cause of intestinal perforation with a high mortality... The association of stercoral perforation and analgesic use has previously been documented... Although rare, we recommend that the diagnosis of a glomus tumour is considered in cases that present with a cutaneous swelling associated with severe pain and exquisite point tenderness... Analgesics must be prescribed with caution.

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Doppler ultrasound image of the area of maximal point tenderness showing a well circumscribed subcutaneous lesion measuring 14x12x7mm with increased vascularity
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fig02: Doppler ultrasound image of the area of maximal point tenderness showing a well circumscribed subcutaneous lesion measuring 14x12x7mm with increased vascularity

Mentions: An emergency laparotomy revealed a stercoral perforation of the sigmoid colon with gross faecal contamination of the peritoneal cavity. A Hartmanns procedure was performed and 38mm of colon was resected. There was no histopathological evidence of malignancy or diverticular disease in the resected specimen. Postoperatively an orthopaedic opinion was requested in relation to her left elbow swelling. An ultrasound scan revealed a 14x12x7mm localised subcutaneous lesion with increased vascularity (Figure 2).


Glomus tumour of the elbow: an unusual cause of intestinal perforation.

Donnelly KJ, Thompson NW, O'Longain D, Cameron I - Ulster Med J (2014)

Doppler ultrasound image of the area of maximal point tenderness showing a well circumscribed subcutaneous lesion measuring 14x12x7mm with increased vascularity
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4255838&req=5

fig02: Doppler ultrasound image of the area of maximal point tenderness showing a well circumscribed subcutaneous lesion measuring 14x12x7mm with increased vascularity
Mentions: An emergency laparotomy revealed a stercoral perforation of the sigmoid colon with gross faecal contamination of the peritoneal cavity. A Hartmanns procedure was performed and 38mm of colon was resected. There was no histopathological evidence of malignancy or diverticular disease in the resected specimen. Postoperatively an orthopaedic opinion was requested in relation to her left elbow swelling. An ultrasound scan revealed a 14x12x7mm localised subcutaneous lesion with increased vascularity (Figure 2).

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Orthopaedic Surgery, Altnagelvin Hospital Glenshane Road Derry, Northern Ireland BT47 6SB.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Editor, A 72 year-old-female presented to the Emergency Department with a twelve hour history of sudden onset generalised abdominal pain and distension... On further questioning, she reported a 10 month history of an exquisitely tender swelling over the posterior aspect of her left elbow, which had been treated as bursitis, causing her to take excessive amounts of codeine- based analgesia... Clinically, cutaneous glomus tumours appear as solitary, small bluish subcutaneous lesions with the classic triad of point tenderness, severe pain and cold intolerance... However, magnetic resonance imaging (MRI) has been deemed more sensitive for the detection of glomus tumours... Treatment is by local excision... Delayed diagnosis of glomus tumours can prolong unnecessary pain resulting in the excessive use of analgesia which may result in significant morbidity... Stercoral perforation is a rare cause of intestinal perforation with a high mortality... The association of stercoral perforation and analgesic use has previously been documented... Although rare, we recommend that the diagnosis of a glomus tumour is considered in cases that present with a cutaneous swelling associated with severe pain and exquisite point tenderness... Analgesics must be prescribed with caution.

Show MeSH
Related in: MedlinePlus