Spontaneous knee dislocation without a history of trauma is a rare entity to witness. Herein, we report a case of a patient who presented to the emergency department (ED) with a history of fever, chills and vomiting associated with progressive right knee swelling, pain and impaired range of motion (ROM). Physical exam of her right knee showed symmetrical swelling with diffuse tenderness and limited ROM due to pain. Joint aspirate and full septic workup confirmed the diagnosis of septic arthritis. Following her management and two events of irrigation and debridement of the septic knee, the patient was discharged. However, after 1-week from discharge, she presented to ED with right leg swelling and tenderness despite being bedbound for 3 months and denying any history of trauma with radiographs showing a posterior knee dislocation. This report aimed to shed a light on this dreadful complication of septic arthritis and highlights the importance of early recognition and management.
Background: Stoma reversal is used to reconnect the area after a colostomy or ileostomy. There are multiple post-operative complications associated with stoma reversal, most commonly surgical site infection (SSI). Aim: The aim is to determine the incidence rate of SSI in stoma reversal and to assess possible risk factors associated with SSI in stoma reversal patients by analyzing operative and non-operative variables. Methods: This retrospective cohort study was done at the surgery department of king Abdulaziz medical city (KAMC) in Riyadh. All stoma reversal surgeries were either emergent or elective, open or laparoscopic and ileostomy or colostomy. Malignant and benign diseases were included. Results: Out of the 123 patients, 14 developed SSI representing 11.4%. The time to reversal was longer among patients with SSI compared to those without SSI. Significance was related to patients undergoing primary vs. secondary skin closure. Conclusion: There was no significance of the patient's primary disease and comorbidities and development of SSI. However, a longer time period between the stoma creation and stoma reversal and primary skin closure were associated with higher risk of SSI.
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