2009

Tang IP, Shashinder S, Loganathan A, Anura MM, Zakarya S, Mun KS
Correspondence: Dr Ing Ping Tang, ingptang@yahoo.com

ABSTRACT
An aneurysmal bone cyst is a rare bone lesion. Its origin and precise nature remain unknown. It is seen as a locally-destructive, rapidly expandable, benign multicystic mass. We report a 17-year-old boy with an aneurysmal bone cyst of the maxilla, with extensive local involvement and bony destruction that was treated surgically. There was no recurrence noted after four years of follow-up.

Keywords: aneurysmal bone cyst, bone tumour, maxilla
Singapore Med J 2009; 50(9): e326-e328

Mohd Khairi MD, Normastura AR, Wan Zaharah AW
Correspondence: Dr Mohd Khairi Md Daud, khairi@kck.usm.my

ABSTRACT
The prevalence of auditory neuropathy is not known, although the majority of cases are felt to lie within the population of neonatal intensive care unit graduates. We report three cases of auditory neuropathy, out of 211 children with sensorineural hearing loss, seen at our audiology clinic from April 1, 1999 to December 31, 2003. Two patients did not have a risk factor for hearing impairment. Screening policies based solely on transient evoked otoacoustic emissions testing will not detect auditory neuropathy effectively, and may falsely reassure parents and professionals unaware of this condition.

Keywords: auditory neuropathy, deafness, hearing loss, sensorineural hearing loss, transient evoked otoacoustic emissions
Singapore Med J 2009; 50(9): e324-e325

Lau MSK, Tee JCS
Correspondence: Dr Matthew Lau, mattlau@hotmail.com

ABSTRACT
We describe the successful use of a balloon catheter in primary postpartum haemorrhage secondary to placenta praevia. A 29-year-old woman was admitted for cervical priming at 37 weeks. Antenatal screening ultrasonography showed a normally-sited placenta. During the surgical induction of labour, bleeding per vaginum was noted, and a mass was felt at the cervical os. Emergency caesarean section was performed, and a placenta praevia was confirmed. Upon reversal of general anaesthesia, vaginal bleeding was noted despite a well-contracted uterus. The estimated blood loss was 1,200 ml. A hydrostatic catheter was inserted vaginally into the uterine cavity. After 17 hours, it was removed with no vaginal bleeding. The insertion for the balloon catheter was easy and simple, requiring minimal analgesia, and it was without significant complication. As obstetricians become more confident in this technique, surgical intervention may be avoided. This may subsequently lead to a reduction in maternal morbidity and mortality.

Keywords: low placental implantation, placental praevia, postpartum haemorrhage, pregnancy complication, Rusch hydrostatic catheter
Singapore Med J 2009; 50(9): e321-e323

Abbey P, Sharma R, Garg PK
Correspondence: Dr Pooja Abbey, pooja_abbey@yahoo.co.in

ABSTRACT
Spontaneous oesophageal dissection with intramural haematoma formation is an uncommon form of oesophageal injury with a characteristic imaging appearance. We report the clinical and radiological features of a 66-year-old woman presenting with acute onset chest pain, where computed tomography revealed a large haematoma within the wall of the thoracic oesophagus. The patient responded well to conservative management. Magnetic resonance imaging, performed seven days after the initial presentation, confirmed the resolution of the lesion.

Keywords: intramural haematoma, oesophageal dissection, oesophageal haematoma, oesophageal injury, spontaneous oesophageal haematoma
Singapore Med J 2009; 50(9): e318-e320

Sharma R, Priyadarshi RN, Seith A
Correspondence: Dr Ashu Seith, ashubhalla1@yahoo.com

ABSTRACT
Shoulder girdle lipomatosis is an extremely rare condition, with unique clinical and imaging features. We report shoulder girdle lipomatosis in a 46-year-old man who presented with a gradual soft tissue enlargement in his left shoulder. We discuss the magnetic resonance imaging features of this disease and the approach to accurate diagnosis. A review of the clinical and radiological features of shoulder girdle lipomatosis is also presented.

Keywords: fatty tumours, lipectomy, lipomatosis, shoulder girdle lipomatosis, shoulder mass, magnetic resonance imaging
Singapore Med J 2009; 50(9): e315-e317

Seow CJ, Barkham T, Wong PM, Lin L, Pada SK, Tan SH
Correspondence: Dr Seow Cherng Jye, cherngjye.seow@mohh.com.sg

ABSTRACT
Brucellosis, a zoonotic disease of worldwide distribution, is common in many developing countries as well as in countries of the Mediterranean basin. We report brucellosis in a 52-year-old man, who had a recent travel history to Saudi Arabia, and who presented with prolonged fever and deranged liver enzymes. In view of the rarity of brucellosis and its potential life-threatening complications, patients returning from an endemic country need to be questioned for possible Brucella exposure, to ensure that diagnostic tests and treatment are carried out in a timely fashion. In addition to notifying the authorities, the clinician should also warn the laboratory early as cultures of brucellosis are highly transmissible and are one of the most common laboratory-acquired infections.

Keywords: Brucella melitensis, Brucella abortus, Brucellosis, laboratory-acquired infection
Singapore Med J 2009; 50(9): e312-e314