Medical

Another bizarre case straight from the ER, a beer bottle up in a butt hole. Nothing can stop humanity from trying new things huh! 

Photo credit : @kevinabdon

The parotid gland and Warthin's tumor, what they have in common?

This photo shows the resection of a so-called Warthin tumor (or papillary cystadenoma lymphomatosum), which is a benign cystic and sharply demarcated tumor of the parotid gland. 

It typically occurs in elderly and is the 2nd most common (up to 10% of all parotid tumours) benign parotid tumors, after pleomorphic adenoma.

It is associated with irradiation and smoking and has the greatest tendency to undergo cystic changes than any other salivary gland tumor. 

They are benign with extremely low incidence of malignant transformation, thus a surgical excision is the gold treatment. The facial nerve has a relation with the parotid gland as it passes right through the gland (but does not innervate it), so a resection of the tumor should be done with a great caution for the preservation of the nerve along with its branches. 

Photo credit : @liegegraebin

A brain aneurysm is a bulge/ballooning in a blood vessel in the brain. Most of the aneurysms will cause noticeable symptoms only if they rupture.

The following photo shows an unruptured aneurysm of the trifurcation of the right middle cerebral artery (MCA), which is one of the three major paired arteries that supply blood to the brain, arising from the internal carotid artery. 

One of the treatment options for a brain aneurysm is a surgical clipping. 

It is an effective, well researched surgical procedure with excellent results. The goal of clipping is to place a small metallic clip or clips along the neck of the aneurysm (bottom left). This prevents blood from entering into the aneurysm sac so that it can no longer pose a risk for bleeding. Once an aneurysm is clipped, the clip remains in place for life. The aneurysm will shrink and scar down permanently after clipping.

The yellow one (bottom right photo) is a transitory clip, 8mm long, which is sometimes used to obstruct the artery that leads to the aneurysm. It is then taken off after using the blue 10mm one, the definitive/permanent clip, to clip the actual aneurysm. 

Photo credit : @rpaglioli

"Medicine is a science of uncertainty and an art of probability", that is how William Osler described medicine as he practiced it. 

We can take this to a long discussion, but one thing's for sure, medicine is a combination of art and science. 

Although doctors' medical practice is not itself science, it is based on science and on training that is supposed to teach doctors to apply scientific knowledge to people in a rational way.

Applied science is nothing but the application of pure science to particular classes of problems, and that's the beauty in it.

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Devolving injury of the finger! 

This was sent to me by @shneeeblyy , on May 25th she decided to hop a fence and both her ring and her right ring finger decided not to join her. Her ring got caught on the fence and degloved half her finger (top left photos) and snapped the bone, artery and a few nerves along with it. 

After the surgery that night all was well for a few days, until about a week later when the circulation decreased and her finger suddenly turned black (top right and bottom left photos). She went to the ER and the doctor suggested UCLA's medical center hyperbaric oxygen therapy that uses a special pressure chamber to increase the amount of oxygen in the blood. 

After two weeks of treatment the finger regained blood flow and turned pink. She had a surgery to remove the dead tip but because of the treatment at UCLA she was able to keep the majority of her finger.

There's an interesting case of a bifid nose! It's a relatively uncommon malformation that is characterized by the nose being divided into two parts (left photo), due to failure of the paired nasal processes to fuse to a single midline organ during early gestation. 

The severity of the condition can vary, ranging from a minimally noticeable groove down the center of the nasal tip to a complete clefting of the underlying bones and cartilage, resulting in 2 complete half noses, as seen in this case. Notice that there's an association with a midline cleft of the lip as well. 

There are usually no symptoms or complications, in most cases the airway is adequate despite the cosmetic appearance of the nose. 

Treatment is typically a surgical reconstruction to repair the malformation (right photo). Photo by @cpmantrana

If one heart isn't enough for dissection, two might do the trick.

The hand is a very complex organ with multiple joints, different types of ligament, tendons, muscles and nerves. With constant use, it is no wonder that hand traumatic injuries are common in society. This is an urgent reconstructive surgery to a severe injury caused by an auto accident.

Breathtaking photo of a baby delivered via c-section but was still inside the amniotic sac! 

The amniotic sac is an opaque bubble that covers all babies in the womb from right after conception. As the baby grows, it fills with fluid, amniotic fluid. The sac cushions the baby from bumps and jostles during mom's daily ups and downs.

It is rare for a baby to be born with the sac still completely intact as most sacs split open during labour on their own, releasing its protective fluid. This is what people mean when they refer to a mother's waters breaking. In some situations the sac is broken by the doctor when a woman is ready to give birth.

This is a real device known as the LVAD (Left Ventricular Assist Device), which is a surgically implanted mechanical heart pump used in case of heart failure and other heart diseases. 

This device is sometimes called a "bridge to transplant," but is now used in long-term therapy. People awaiting a heart transplant often must wait a long time before a suitable heart becomes available. During this wait, the patient's already-weakened heart may deteriorate and become unable to pump enough blood to sustain life. An LVAD can help a weak heart and "buy time" for the patient or eliminate the need for a heart transplant. 

The LVAD doesn't replace the heart, It just helps it do its job. This can mean the difference between life and death for a person whose heart needs a rest after open-heart surgery or is too weak to effectively pump on its own or who is waiting for a heart transplant. 

Its function is pretty simple, the LVAD has a tube that pulls blood from the left ventricle into a pump. The pump then sends blood into the aorta (the large blood vessel leaving the left ventricle). This effectively helps the weakened ventricle to do its job properly, and relieves symptoms such as shortness of breath. 

A permanent LVAD is currently being used in some terminally ill patients whose condition makes them ineligible for heart transplantation.