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Swelling Revision Dr. Al-Matary

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J
Swelling
Lipoma

)
lipoma
2010
(

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Swelling Revision Dr. Al-Matary

Lipoma

,, subcutaneous lipoma
common back shoulder buttock forehead

,, Lipoma

fascia


Mucous membrane

Lipoma
Lipoma
Limb ,,
subcutaneous lipoma
sufascial lipoma
Inter muscular lipoma
Intra muscular lipoma
:

Inter muscular
Intra muscular

,,, Intra muscular Muscle

,, Inter muscular

abdomen :
lipoma retro peritoneal space
,, extra dural space ) spinal cord ( extra dural
) Intestine ( sub mucous lipoma
Lipoma
dangerous sites
subcutaneous lipoma ,,
subcutaneous lipoma

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Swelling Revision Dr. Al-Matary

Cosmetic disfigurement

lipoma subcutaneous
) (
subcutaneous lipoma ,,
cosmetic disfigurement
malignancy extremely extremely rare

lipoma ,,
Lipoma extra dural space spinal cord
discussion
: brain
,,
fat cells extra dural space brain
spinal cord

extra dural space
: extra dural space lipoma
spinal cord
Never ,, brain fat cells extra dural space brain
,, retro peritoneal lipoma
,, malignancy
malignant
Liposarcoma

examiner retro peritoneal lipoma

malignancy

,,
:
some authors believes that : it is malignant from the start

malignant from the start

turn malignant
malignant from the start

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Swelling Revision Dr. Al-Matary

examiner

sub mucous lipoma
intestinal obstruction

intussusceptions

,,
sub mucous lipoma Intestine
Lipoma
lumen
Intestinal obstruction ,,
intussusceptions
Intussusceptions
intestine Lipoma ,,

lipoma
Intestine ,,
Intestine ,,, as if trying to defecate lipoma
Intestine
Intussusceptions
sub mucous lipoma
intestinal obstruction
Intussusceptions
larynx stridor
dangerous site of lipoma
,, ,, subcutaneous lipoma

,, subcutaneous lipoma
The commonest site
back shoulder buttock
forehead
subfascial lipoma
deep fascia

,,
sub fascial lipoma

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fibrous band not attached to skin Firm

firm and not attached to the skin by fibrous bands sub fascial lipoma

,,
sub fascial lipoma ,, Lipoma
fibrous band Not attached to the skin firm
fibrous band Not attached to the skin ,, Lipoma
firm

firm sub fascial lipoma

Under tension

compartmental syndrome
deep fascia
Under tension
sub mucous lipoma
Larynx Intestine mucous membrane Beneath
intestinal obstruction ,, intestine
stridor ,, larynx
sub serous lipoma

serosa
serosa ,, Intestine
,, serosa lipoma
Intra muscular lipoma Inter

Muscle ,, Inter
Muscle ,, Intra
Muscle superficial deep to muscle lipoma

,, Muscle in action
superficial ,, More prominent
deep ,, less prominent
Muscle lipoma
along ,, Muscle Moves across
fixed ,,
,, ,,
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Swelling Revision Dr. Al-Matary

lipoma swelling
Moves across ,,
fixed
,, inter muscular lipoma superficial deep
muscle in action
,, more prominent superficial
,, less prominent deep
sup periosteal lipoma
Periosteum
intra glandular lipoma

,,
swelling parotid
swelling parotid
endemic parotitis adeno lymphoma
,,, ,,

and extremely rare :
Intra glandular lipoma
lipoma gland
extra dural lipoma

extra dural lipoma
spinal cord
Never brain

fat cells extra dural space brain
retro peritoneal lipoma

) Some authors believes pre cancerous ( pre malignant
And other believe it malignant from the start

,,, ,,

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Swelling Revision Dr. Al-Matary

19 ,,
,, 19

Dercum disease
,, slide ,,
slides

,,
,,
,, Neurofibroma

: ,, swellings soft in consistency
,,
soft in consistency : lipoma
: painful
Painful : Lipoma painful

Lipoma Painful
Dercum disease
painful
female ,, Post menopausal
multiple swelling Lower limbs
painful
painful
female ,, perimenopausal
Multiple swelling

hemangio lipoma
Neuro lipoma
discussion
: Lipoma firm
Lipoma consistency soft
firm
fibro lipoma
sub fascial lipoma

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Swelling Revision Dr. Al-Matary

sub fascial lipoma firm

tension
fibro lipoma firm
fibrous tissue element
,, Hemangio Lipoma
Lipoma ,, blood vessel partially compressible
Hemangio lipoma partially compressible

Hemangioma compressible ,,
,, hemangio liopma vascular compressible
fat

,, hemangio lipoma Partially compressible

neuro lipoma ,,
Neuro lipoma
Lipoma capsule
benign swelling
benign swelling capsules
expansion

Compression
,, ,, expansion
compression
false capsule
plane of cleavage
gross pictures true capsule false
capsule
treatment
false capsule true false capsule
enucleation

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Swelling Revision Dr. Al-Matary

) ,,
(
Hemangioma simple ganglion ,, neurofibroma
,,
Hemangioma

Hemangioma
Hemangioma
Blood spaces
blood spaces
blood spaces

hemangioma blood spaces

blood spaces ,, Cavernous :
hemangioma
blood spaces ,, capillary hemangioma :
blood spaces capillary hemangioma ,,
blood spaces cavernous hemangioma ,,

capillary hemangioma
:



,, strawberry hemangioma
strawberry hemangioma

,,
few weeks
,,
,, few weeks
,,, ,, few weeks ,,
trunk

,,
,, ,, Strawberry hemangioma
few weeks ,,

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Swelling Revision Dr. Al-Matary

,, Hemangioma
,,
,,
,,
,, ,, ,,

self in cure

,,
,,
Infected ,, lacerated

Infection

,, ,, Infection Indication for laser photo
coagulation
cortisone therapy

,,
,,
laser photo coagulation

:
Portwine hemangioma

,,
,, ,,
Raised

raised
,,

,,

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Swelling Revision Dr. Al-Matary

,, cosmetic ,,

,, portwine hemangioma ,, laser
,,
,,, separate session

:
Portwine hemangioma
Dating since birth, non involuted, not raised, purplish in color

,,
Salmon patch

:

pink forehead )
,, : (
,,

,, Salmon patch

Spider navei spider navei
,, intra arteriole ,, capillary ,,
central arteriole
capillaries

,,
Cavernous Hemangioma
) 14:15

Cavernous Hemangioma


,,, hemangioma Strawberry
Vascular malformation

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Swelling Revision Dr. Al-Matary

MCQ ,, Hemangioma :
strawberry

Hemangioma MCQ Strawberry

vascular malformation
cavernous hemangioma
blood spaces

deoxygenated blood
blood spaces ,,
,,
Compressible

compressible

compressible ,, pathognomonic :
compressible

compressible ,, Land mark hemangioma
Internal organ
hemangioma ,, compressible
,,, Land mark hemangioma Internal organ
,, Usually Liver
,,
hemangioma ,,

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Swelling Revision Dr. Al-Matary

,, Intra peritoneal hemorrhage

,, severe pain shock

rigidity ,, rebound tenderness

hemangioma Liver
,,
,,
swelling ,, bluish in color compressible
suddenly developed abdominal pain
shock rigidity rebound tenderness
,, acute abdomen
!!!

,,
Investigations of choice
ultra sound ,, aspiration
,,
investigations of choice hemangioma of the liver
CT Scan
Investigation of choice Hemangioma Liver CT Scan
:

,,

Diagnostic GIT
Hemangioma ,, center
CT Scan
diagnosis

,,
cavernous hemangioma
compressible
land mark hemangioma Internal organ

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Swelling Revision Dr. Al-Matary

,, hemangioma ,,
laser
Laser photo coagulation

feeding vessels
,, :
feeding vessels
excision

,, ) cryosurgery (

Cersoid Aneurysm
:
,, varicose vein
varicose vein

,, varicose vein

,,
varicose vein
spontaneous thrill
,,
,, varicose vein ,,
varicosity thrilling
Thrilling spontaneous arterio-venous fistula

arterio-venous fistula
,, superficial temporal artery

Cersoid Aneurysm

Varicose vein

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Swelling Revision Dr. Al-Matary

Spontaneous thrilling

,, arterio-venous fistula
superficial temporal artery veins
,,
,,
,,

: ,,

varicose vein ,,
,, varicose vein

,,


,,
Pulsating headache

,,
Pulsating headache

,, ,,
It is bloody surgery ,,,
Vascular
,, skull Intra cranial extension
vascular malformation skull

) ,,, ,,

,,

,, ,,
,,

,,
,, ,,,

(
vascular malformation skull
vascular malformation skull
,, skull sandwiched blood vessel ,, blood vessel
skull
skull

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Swelling Revision Dr. Al-Matary

intra cranial : extra cranial

communication
very vascular
intra cranial extension ,, very vascular
extra cranial extension
angio X - ray skull
,,, X - ray skull

X - ray skull skull
angio
,,

,,
Bleeding

: ,, semi-sitting position ,,
venous drainage

: ,,, bleeding

: ,, clamp external carotid artery

superficial temporal external carotid

bleeding vessel
it is bloody surgery ,,

bleeding
Cersoid aneurysm :
,, it is bloody surgery bleeding
bleeding
semi-sitting position
semi-sitting
Hypotensive anesthesia

,, external carotid clamp

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Swelling Revision Dr. Al-Matary

cersoid aneurysm

,,
,,

hemangioma
capillary hemangioma ,,
.1
.2
.3
,, cavernous hemangioma compressible ,,

hemangioma internal organ

liver
cersoid aneurysm
Arterio-venous fistula
varicose vein
pulsating headache
Intra cranial extension

,,
Hamrtoma vascular malformation
,, Hamrtoma vascular malformation

,, Blood vessel normal mal-arranged
,, tumor strawberry hemangioma
proliferative phase
proliferative phase
hamrtoma
disease ,,
,,

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Swelling Revision Dr. Al-Matary

ganglion

Ganglion
simple ganglion
compound palmar ganglion

Simple Ganglion
simple ganglion
tendon


ganglion
tendon


,,
tendon ,, fibers
,, mucoid degeneration
tendon


,,
tendon

,,

tendon


tendon fibers fibers

,,
common wrist ankle
tendon wrist ankle

tendon ,,
simple ganglion ,, common wrist ankle

tendons
swelling
tendon

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Swelling Revision Dr. Al-Matary

Cystic

cystic
,, Paget test
cystic ,, clinically Paget test
swelling

tendon

,, across tendon
along it
tendon fixed
across tendon along it
tendon fixed

simple ganglion
,, tendon


common wrist ankle
tendons

,,
cystic ganglion cystic
Paget test cyst clinically
,,
simple ganglion swelling
tendon
across tendon
along it

,, tendon
,,
simple ganglion
For fear of complications

rupture ,, Infection ,, calcification

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Swelling Revision Dr. Al-Matary

hand infection ,, general anesthesia
good light tourniquet
: hand infection

General anesthesia
Good light
tourniquet

,,
simple ganglion ,,
,,
,, ,, tourniquet

,, ,,

) ,,
(

Compound Palmar Ganglion

compound palmar ganglion
T.B. of the ulnar bursae

ulnar bursae
little finger palm
distal collar proximal collar
hypothenar palm
forearm
Little finger ,, palm
hypothenar Palm
forearm
swelling ,, little finger palm forearm

: swelling palm forearm cross fluctuation
forearm
,, palm
palm
,, forearm

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Swelling Revision Dr. Al-Matary

cross fluctuation
,,
,,
,, T.B. ,, under bursae
under bursae
droplet
,,
Ingestion
blood Lymphatic spread
T.B. of the ulnar burase
,, T.B. of the ulnar bursae .T.B
,,

open

Sanatorial treatment anti tuberculous
,, ulnar
ulnar
bursa ,, radial ulnar
affected ,, ulnar bursa
,,
ulnar bursa ,, radial bursa communicated
,, ,,
radial bursa

ulnar bursa
,, ,, radial bursa ulnar
bursa communicated
Infection Ulnar radial

sanatorial treatment
anti tuberculous therapy

) (

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Swelling Revision Dr. Al-Matary

Sanatorial treatment
Anti tuberculous therapy

Rest of the affected organ
,, Pott's disease of the spine

,,
Open
,, plastic collar
Rest of the affected organ
Pott's ,, thoracic region
Pott's thoracic region

,,
Open

rest of the affected organ

,, sanatorial treatment anti tuberculous therapy

rest of the affected organ
,,
open drainage
,,
simple ganglion compound palmar ganglion


,,
,,

tendon

:

tendon tendon



tendon tendon

,,,

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Swelling Revision Dr. Al-Matary

compound palmar ganglion

T.B. of the ulnar bursa

Neurofibroma tongue
Neurofibroma

Neurofibroma
,,
Nerve
nerve axis

Neurofibroma
connective tissue axons
Neurofibroma
connective tissue axons
neurofibroma
connective tissue axons
neurofibroma tumor of the connective tissue
connective tissue
axons
,, axons giant cells
,, Schwannoma

,,
Neurofibroma Schwannoma
,,
,, axon Schwann cells
axon ,, axon connective tissue
neurofibroma connective tissue
Schwannoma Schwann cells
Schwannoma ,,
,, acoustic neuroma cranial nerve

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Swelling Revision Dr. Al-Matary

,,
,, acoustic neuroma

,,

,,
increased intra cranial tension

headache blurring of vision vomiting papilloedema
acoustic neuroma
.E.N.T

,, acoustic neuroma
:
neurofibroma
.E.N.T neurofibroma
: acoustic neuroma ,,
neurofibroma

,, acoustic neuroma
neurofibroma
Schwannoma

acoustic neuroma ,, Schwann cells

,, Schwannoma

,,
,, neurofibroma connective tissue
neurofibroma
,,
,,


:
: neurofibroma connective tissue of the nerve
,,
,, Schwannoma
Schwannoma acoustic neuroma

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Swelling Revision Dr. Al-Matary

:
Neurofibroma firm in consistency,,
tingling numbness
) (
across Nerve along it


across ,, Nerve along it
: ,, Caf au lait
patches

:
Neurofibroma single Neurofibroma multiple
Multiple Von Reckling Hausen's disease
,,

,,
,,


Neurofibroma
connective tissue Nerve
Schwannoma
Schwann cells
Schwannoma
acoustic neuroma
Neurofibroma ,, consistency
Firm in consistency

Tingling numbness

Across ,, Nerve along it
across ,, Nerve along it
,,
Caf au lait patches

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Swelling Revision Dr. Al-Matary

single ,, multiple multiple

Von Reckling Hausen's disease

,,


,,
,, ,, ,, :
presented firm swelling ) ( forearm
,,
forearm right side ,, firm swelling
patchy pigment ,,

,,
,,

,,
Firm swelling Caf au lait patches neurofibroma

,, firm swelling ,, ,,

,, Neurofibroma Caf au lait
patches

:
melanocyte Neural crest
Melanocyte embryology neural crest
,, Nerve melanocytes
Melanocyte ,, ,, neural crest
nerve ,, neurofibroma
melanocyte

Neurofibroma ,,
firm
firm ,,, ,, data

tingling : moves across nerve along it

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Swelling Revision Dr. Al-Matary

Firm ,, Neurofibroma


:
,, firm
tingling numbness
firm ,,
across Nerve along it
: ) (

,,
general examination
Blood pressure

,,


blood pressure pheochromocytoma
neck
,, Medullary carcinoma
thyroid
:
,, medullary carcinoma Hyper
parathyroidism Pheochromocytoma
multiple endocrinal neoplasia type two
type two b
neurofibroma

neurofibroma
neurofibroma
: ,, neurofibroma Investigation general
examination

Pheochromocytoma

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Swelling Revision Dr. Al-Matary

www.facebook.com/dr.tafreegh

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