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Soundarrajan D, Singh R, Subramaniam M, Dhanasekararaja P, Rajkumar N, Rajasekaran S. Takotsubo syndrome after bilateral simultaneous total knee arthroplasty - A case report. J Orthop 2024; 54:1-4. [PMID: 38496261 PMCID: PMC10943950 DOI: 10.1016/j.jor.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Cardiac complications represents a major cause of morbidity and mortality especially after bilateral simultaneous total knee arthroplasty (BS-TKA). Takotsubo syndrome after BS-TKA has not been described in the literature. Case presentation A 60 years-old women underwent BS- TKA and she suddenly developed bradycardia and hypotension after second knee wound closure. The electrocardiography revealed ST elevation and echocardiography showed apical hypokinesia of left ventricle. Coronary angiography revealed normal epicardial coronaries and a provisional diagnosis of Takotsubo cardiomyopathy was made. Serial ECGs revealed resolution of ST elevation and normal LV function within 5 days. On one-year follow up, she was able to do all her normal activities, and 12-lead electrocardiography were back to normal. Conclusion Cardiac complications represents a major cause of morbidity and mortality especially after BS-TKA. Surgeons must be vigilant in the postoperative period for any likely precipitating factors of stress induced cardiomyopathy. Takotsubo syndrome should be considered as a differential diagnosis with features of acute coronary syndrome in elderly post-menopausal patients.
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Affiliation(s)
| | - Rithika Singh
- Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India
| | - Muthiah Subramaniam
- Consultant Cardiologist, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India
| | | | - Natesan Rajkumar
- Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India
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2
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Turner VL, Martinez C, Rocha J, Valenzuela A. Acute calcific tendinitis of the longus colli: A case report. Radiol Case Rep 2024; 19:2650-2653. [PMID: 38645950 PMCID: PMC11031716 DOI: 10.1016/j.radcr.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/23/2024] Open
Abstract
Acute calcific longus colli tendinitis is a differential diagnosis of neck pain. Typical presentation consists in a triad of symptoms including acute onset neck pain, neck stiffness and odynophagia. Computed tomography (CT) is the gold standard for acute calcific longus colli tendinitis diagnosis and the main radiological findings include prevertebral soft tissue swelling and the presence of amorphous calcifications. The case involves a 39-year-old female who presented to the emergency department with acute unilateral cervical pain that resulted in acute calcific longus colli tendinitis.
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Affiliation(s)
| | - Camila Martinez
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Judith Rocha
- Department of Rheumatology and Clinical Immunology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Antonia Valenzuela
- Department of Rheumatology and Clinical Immunology, Pontificia Universidad Católica de Chile, Santiago, Chile
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3
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Chakit M, Zahir RA, Mesfioui A. Giant pyonephrosis related to nephrolithiasis in diabetes woman: A case report. Radiol Case Rep 2024; 19:2625-2628. [PMID: 38645956 PMCID: PMC11026726 DOI: 10.1016/j.radcr.2024.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/12/2024] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
Pyelonephritis is one of the main systemic bacterial infections encountered in emergency departments. We present a case of diabetes woman aged 30 years referred to our urology department of El-Idrissi Hospital, Kenitra (Morocco) for recurrent episodes of urinary tract infection, multiple urolithiasis, chills, unilateral lower back pain, chills and severe hydroureteronephrosis. Abdominal CT showed a non-functioning obstructed kidney with pyelic and ureteral stones. Nephroureterectomy was performed by extraperitoneal nephrectomy for avoiding any more extended nephrectomy incision or second iliac incision, this technic ensures nephroureterectomy with minimal risk of affecting the distal ureter, that sometimes follows nephrectomy. Diabetes and urolithiasis coexistence in a patient may cause severe pyonephrosis leading to nephroureteroctomy.
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Affiliation(s)
- Miloud Chakit
- Biology and Health laboratory, Faculty of Sciences, Ibn Tofail University, Kenitra Morocco
| | | | - Abdelhalem Mesfioui
- Biology and Health laboratory, Faculty of Sciences, Ibn Tofail University, Kenitra Morocco
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4
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Damer A, Hamilton L, Tu A, Johnston DL, Ramphal R, Wilson N. Primary intramedullary extradural Ewing sarcoma. Radiol Case Rep 2024; 19:2381-2389. [PMID: 38572274 PMCID: PMC10987877 DOI: 10.1016/j.radcr.2024.02.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/15/2024] [Accepted: 02/27/2024] [Indexed: 04/05/2024] Open
Abstract
Ewing sarcoma is the second most frequent primary bone tumour of childhood and adolescence. The aim of this report is to describe the imaging, pathology, clinical findings, and treatment of a primary intradural extramedullary Ewing sarcoma with a unique intracranial metastatic component in a pediatric patient. A 14-year-old girl with a history of mood disorders presented to the emergency department with a 3-week history of neck torticollis, cervical pain, paresis, and paresthesia of the upper and lower extremities on the left side. Initially, non-organic causes such as somatization or conversion disorder were suspected. She returned 3 months later when her symptoms worsened. MRI of the head and spine was performed, and demonstrated the presence of a suprasellar, retro-chiasmatic mass lesion. There was also diffuse leptomeningeal enhancement, another well-defined intradural extramedullary lesion the sacral region and several multifocal cauda equina soft tissue nodules. The patient first underwent surgery. The patient was also treated with a combination of chemotherapy (vincristine, doxorubicin and cyclophosphamide alternating with ifosfamide and etoposide (VDC/IE)) and radiation as per the Children's Oncology Group AEWS1221 protocol. Most recent imaging conducted 22 months after the initial mass discovery revealed improvement of the suprasellar mass lesion with residual stable appearance of the prominence and enhancement of the pituitary stalk and tuber cinereum. There was interval improvement of the spinal lesions with no convincing residual. Clinically, at almost three years since initial imaging findings, and 25 months since completing treatment, she is stable from an oncology perspective.
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Affiliation(s)
- Alameen Damer
- University of Toronto, Department of Medical Imaging, Toronto, ON, Canada
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Leslie Hamilton
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Albert Tu
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Donna L. Johnston
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario (CHEO), Division of Hematology/Oncology, Ottawa ON, Canada
| | - Raveena Ramphal
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario (CHEO), Division of Hematology/Oncology, Ottawa ON, Canada
| | - Nagwa Wilson
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
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5
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Rjoop A, Obiedat R, Al-Oqaily A, Abu Baker S, Matalka I. Ovarian collision tumour consisting of a fibroma and a serous cystadenoma: A case report. Case Rep Womens Health 2024; 42:e00602. [PMID: 38577170 PMCID: PMC10987316 DOI: 10.1016/j.crwh.2024.e00602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024] Open
Abstract
This article reports a case of an ovarian collision tumour consisting of an ovarian fibroma and a serous cystadenoma. A 60-year-old woman exhibited symptoms of post-menopausal bleeding and abdominal pain persisting for three months. Computerized tomography identified a solid mass with a cystic component in the right adnexa, and the patient underwent staging laparotomy. Gross examination of the right ovary revealed a cystic tumour with adjacent solid mass. The histopathological analysis identified a cystic mass that matched the characteristics of a serous cystadenoma, with an adjacent solid mass that matched the characteristics of a sex-cord stromal tumour, both located in the right ovary. Additionally, a small cyst that matched the characteristics of a serous cystadenoma was found in the left ovary. There have been only seven previously reported examples of this specific mix of ovarian tumours. Mostly affecting patients above 60 years of age, although tumour markers levels are normal, such cases may present with a complex clinical scenario, as in this case, and demand a comprehensive diagnostic and therapeutic approach.
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Affiliation(s)
- Anwar Rjoop
- Department of Pathology, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Rawan Obiedat
- Department of Obstetrics and Gynecology, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ayat Al-Oqaily
- Department of Pathology, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Shaden Abu Baker
- Department of Pathology, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ismail Matalka
- Department of Pathology, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid 22110, Jordan
- College of Medicine, Ras Al Khaimah Medical Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates
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6
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Wetzler S, Cabrera C, Bernstein PS. Spontaneous uterine rupture complicated by bilateral pulmonary emboli: A case report. Case Rep Womens Health 2024; 42:e00608. [PMID: 38633224 PMCID: PMC11021356 DOI: 10.1016/j.crwh.2024.e00608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
Spontaneous uterine rupture in unscarred uteri complicated by pulmonary emboli is a rare event with major maternal morbidity and mortality. This is a case of a 32-year-old woman, G1P0, at term, with no pertinent past medical/surgical history, who underwent an emergency cesarean delivery for failed induction of labor complicated by uterine rupture. Post-operatively, the patient was tachycardic and hypoxic. CT arteriogram revealed massive bilateral pulmonary emboli, and she was transferred for specialist care. An emergency pulmonary embolectomy and implantation of an extracorporeal right ventricular assist device were performed. Once the patient was clinically stable, an evaluation for thrombophilias and collagen disorders was done, and was positive for a variant of unknown significance in the ELN gene (c.205G > C). This case report highlights a potential connection between uterine ruptures, hemorrhage, and multiple, large pulmonary emboli. The authors propose a multidisciplinary discussion and evaluation to identify risk factors and biologic causes for these rare but life-threatening complications.
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Affiliation(s)
- Sara Wetzler
- Department of Obstetrics, Gynecology and Reproductive Sciences, Icahn School of Medicine at Mount Sinai Hospital, New York, NY 10029, USA
| | - Camila Cabrera
- Department of Obstetrics, Gynecology and Reproductive Sciences, Icahn School of Medicine at Mount Sinai Hospital, New York, NY 10029, USA
| | - Peter S. Bernstein
- Department of Obstetrics, Gynecology and Reproductive Sciences, Icahn School of Medicine at Mount Sinai Hospital, New York, NY 10029, USA
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7
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Faraji N, Goli R, Mohsennezhad P, Mohammadpour Y, Parizad N, Salamat E, Pourbahram R, Bazbandi S. NSAID (nonsteroidal anti-inflammatory drugs) Induced Stevens Johnson Syndrome in a 50-year-old woman: A case study. Toxicol Rep 2024; 12:289-291. [PMID: 38469333 PMCID: PMC10925921 DOI: 10.1016/j.toxrep.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
Stevens-Johnson Syndrome (SJS) is a severe and rare adverse drug reaction associated with significant morbidity and mortality. Although SJS is commonly triggered by multiple drugs, non-steroidal anti-inflammatory drugs (NSAIDs), including diclofenac, have been frequently implicated. A middle-aged woman, who is 50 years old, has a prior medical record of high blood pressure, type 2 diabetes, and has recently suffered from a pulmonary embolism. She was later admitted to the intensive care unit (ICU), where she was ultimately diagnosed with Steven Johnson syndrome. Careful drug selection, close monitoring of patients with predisposing factors, and prompt identification of adverse events are crucial to prevent severe drug reactions.
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Affiliation(s)
- Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Pariya Mohsennezhad
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Islamic Azad University, Urmia, Iran
| | - Yousef Mohammadpour
- Department of Medical Education, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Elaheh Salamat
- Department of Anesthesia and Surgical Technology, School of Allied Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Raheleh Pourbahram
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University Chalus, Iran
| | - Samaneh Bazbandi
- Department of Anesthesiology, School of Nursing and Midwifery, Islamic Azad University Tehran Medical sciences, Tehran, Iran
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8
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Oukrid K, Ziani H, Ziani C, Bhallil S, Nasri S, Kamaoui I, Skiker I. Cerebral actinomycosis following a facio-cranial trauma: A case report. Radiol Case Rep 2024; 19:2253-2255. [PMID: 38532910 PMCID: PMC10963192 DOI: 10.1016/j.radcr.2024.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 03/28/2024] Open
Abstract
Cerebral actinomycosis is a rare, chronic, but curable bacterial brain infection. We report the case of an 18-year-old male patient with a history of facio-cranial trauma, admitted in our institution with severe headaches and behavioral disorders. Magnetic resonance imaging (MRI) was performed showing the presence of contiguous multiple small round and ovoid lesions in the right frontal lobe with "the dot in circle" appearance. The diagnosis of cerebral actinomycosis was confirmed by histological study of the biopsy sample. Despite it being a rare condition, it is important to consider this diagnosis in patients with atypical post-traumatic neurological symptoms.
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Affiliation(s)
- Khaoula Oukrid
- Radiology Department, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Oujda Morocco
| | - Hamid Ziani
- Radiology Department, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Oujda Morocco
| | - Chaymae Ziani
- Radiology Department, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Oujda Morocco
| | - Siham Bhallil
- Radiology Department, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Oujda Morocco
| | - Siham Nasri
- Radiology Department, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Oujda Morocco
| | - Imane Kamaoui
- Radiology Department, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Oujda Morocco
| | - Imane Skiker
- Radiology Department, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Oujda Morocco
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9
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Chataut D, Katwal S, Suwal S, Thapa A, Bhusal A. Endovascular embolization for massive hemoptysis in intralobar pulmonary sequestration with celiac artery supply: A comprehensive case report. Radiol Case Rep 2024; 19:2239-2244. [PMID: 38523721 PMCID: PMC10959639 DOI: 10.1016/j.radcr.2024.02.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/16/2024] [Accepted: 02/18/2024] [Indexed: 03/26/2024] Open
Abstract
Pulmonary sequestration (PS) is a rare congenital anomaly characterized by noncommunicative lung tissue supplied by an abnormal systemic vessel. We present a case of a 30-year-old male with intralobar PS, receiving arterial supply from the celiac artery, manifesting as massive hemoptysis. After urgent stabilization, endovascular embolization using polyvinyl alcohol particles was successfully employed. The patient's symptoms resolved, and follow-up confirmed satisfactory recovery. Our case underscores the diverse arterial origins of PS and the efficacy of endovascular embolization as a minimally invasive treatment. The complexity of PS, its diagnostic imaging, and alternative therapeutic options are discussed, emphasizing tailored approaches for optimal outcomes in managing this uncommon congenital anomaly.
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Affiliation(s)
- Dinesh Chataut
- Department of Radiology, Maharajgunj Medical Campus, Kathmandu, Nepal
| | - Shailendra Katwal
- Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura, Nepal
| | - Sundar Suwal
- Department of Radiology, Maharajgunj Medical Campus, Kathmandu, Nepal
| | - Ajit Thapa
- Department of Radiology, Maharajgunj Medical Campus, Kathmandu, Nepal
| | - Amrit Bhusal
- Department of Radiology, BP Koirala Institute of Health Science, Sunsari, Nepal
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10
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Kashyap A, Joshi P, Raj G, Narayan S, Upadhyay P, Hussain N. Hepatic visceral larva migrans: A radiological case report. Radiol Case Rep 2024; 19:2467-2471. [PMID: 38585398 PMCID: PMC10998046 DOI: 10.1016/j.radcr.2024.02.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
Visceral larva migrans (VLM) occurs due to migration of the second stage of larvae of nematodes through human viscera. It is an underdiagnosed entity which commonly affects the liver as eosinophilic abscesses and appears as coalescing, conglomerated cavities on imaging. This case report details the sonographic and CT features of an 8 year old female patient with right upper quadrant pain and peripheral eosinophilia on laboratory reports, diagnosed as a case of VLM on biopsy. Imaging of VLM shows overlap with neoplastic lesions and other infective pathologies hence this case aims to highlight the clinical, laboratory, and radiological features to help narrow the differential diagnosis.
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Affiliation(s)
- Aniket Kashyap
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Pranjali Joshi
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Gaurav Raj
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Shamrendra Narayan
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Piyush Upadhyay
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Nuzhat Hussain
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
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11
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Hariri MM, Farho MA, Kourdy A, AlHammoud HA, Alawad K, ghabreau L. The clinical challenge of a uterine cotyledonoid dissecting leiomyoma with adenomyosis: A case report. Case Rep Womens Health 2024; 42:e00604. [PMID: 38646502 PMCID: PMC11031714 DOI: 10.1016/j.crwh.2024.e00604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/23/2024] Open
Abstract
Cotyledonoid dissecting leiomyoma (CDL) is a rare uterine tumor with unique clinical and histological features. We present a case of a 46-year-old woman with a 3-month history of left-flank pain radiating to the back. The patient had a history of infertility and a previous miscarriage. Ultrasound revealed a solid tissue mass suggestive of a degenerated fibroid. Laparoscopy identified subserosal leiomyoma and leiomyoma in the broad ligament. Histologically, CDL is characterized by disorganized smooth muscle with hyaline degeneration and no evidence of malignancy. Clinically, CDL can present with a variety of symptoms, including heavy menstrual bleeding, pelvic pain, and infertility. The coexistence of CDL and adenomyosis is exceedingly rare. This case highlights the importance of considering CDL in the differential diagnosis of pelvic mass, malignant neoplasms, and infertility, even with atypical symptoms. It also emphasizes the value of cooperation between clinicians and pathologists for accurate diagnosis and management of CDL. Adenomyosis in this case further complicated the diagnosis and highlighted the need for an index of suspicion for this rare condition.
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Affiliation(s)
| | - Mohamad Ali Farho
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Alaa Kourdy
- Faculty of Pharmacy, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Hiba Allah AlHammoud
- Department of Obstetrics and Gynecology, Aleppo University Hospital, Aleppo University, Aleppo, Syrian Arab Republic
| | - Kawthar Alawad
- Department of Pathology, Aleppo University Hospital, Aleppo University, Aleppo, Syrian Arab Republic
| | - Lina ghabreau
- Department of Pathology, Aleppo University Hospital, Aleppo University, Aleppo, Syrian Arab Republic
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12
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Oie AK, Herrmann AA, Rosenbloom MH. Left dural carotid cavernous fistula mimicking an inflammatory process: A case report. Radiol Case Rep 2024; 19:2558-2560. [PMID: 38596179 PMCID: PMC11001617 DOI: 10.1016/j.radcr.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
A female in her 70s presented with altered mental status, left eye pain, ophthalmalgia, and diplopia following a fall. Brain MRI demonstrated contrast-enhancing left peri-insular T2 hyperintense changes that was read as possible herpes simplex encephalitis by neuroradiology. Cerebral angiogram revealed a Barrow Type D left sided carotid cavernous fistula. The patient was subsequently treated with endovascular transvenous coil embolization of the left cavernous sinus resulting in complete occlusion of the fistula. The goal of this case is to present a unique case of a carotid cavernous fistula radiologically mimicking herpes simplex encephalitis. Early recognition of carotid cavernous fistula on neuroimaging is important for prompt treatment of symptoms.
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Affiliation(s)
- Annika K. Oie
- HealthPartners Institute, 8170 33rd Ave St, Bloomington, MN 55425, USA
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13
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Montoya C, Polania-Sandoval C, Almeida JI. Endovascular mechanical thrombectomy of iliofemoral venous stent occlusion with the novel RevCore thrombectomy system: case reports and literature review. J Vasc Surg Cases Innov Tech 2024; 10:101432. [PMID: 38510090 PMCID: PMC10951538 DOI: 10.1016/j.jvscit.2024.101432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/05/2024] [Indexed: 03/22/2024] Open
Abstract
Venous in-stent restenosis is not completely understood, and the currently available treatment is usually unsatisfactory. We describe the cases of two patients treated with the RevCore thrombectomy system (Inari Medical), designed for venous in-stent thrombosis. Case 1 involves a 62-year-old woman with post-thrombotic syndrome from iliac vein stent placement 15 years earlier. Case 2 describes a 30-year-old woman with post-thrombotic syndrome from recurrent iliac vein stent occlusion, despite therapeutic anticoagulation. Both patients had previous recanalization attempts at outside facilities that were unsuccessful. The RevCore system was safe and feasible in these initial cases, and more studies are warranted.
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Affiliation(s)
- Christopher Montoya
- Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
| | - Camilo Polania-Sandoval
- Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
| | - Jose I. Almeida
- Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
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14
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Ziani H, Nasri S, Kamaoui I, Skiker I. An unusual case of diastatic perforation of the transverse colon: Case report and literature review. Radiol Case Rep 2024; 19:2434-2437. [PMID: 38585400 PMCID: PMC10997867 DOI: 10.1016/j.radcr.2024.02.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/24/2024] [Accepted: 02/28/2024] [Indexed: 04/09/2024] Open
Abstract
Diastatic perforation corresponds to a bursting of the cecal wall caused by excessive distension resulting from a remote obstruction of the low large bowel. This perforation could be explained by Laplace's physical law, and by the particular vascular anatomy of the cecal wall. We report the case of a 75-year-old man admitted for peritonitis with an abdominal CT scan highly suggestive of a diastatic perforation of the cecum complicating colonic distension upstream of a stenosing tumor of the rectosigmoid junction. To our surprise, surgical exploration revealed the defect to be in the transverse colon and not in the cecum. Diastatic perforation of the transverse colon is exceptional, and would require other pathophysiological explanations than those for classical cecal perforation.
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Affiliation(s)
- Hamid Ziani
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
| | - Siham Nasri
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
| | - Imane Kamaoui
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
| | - Imane Skiker
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
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Rajab IM, Adas A, Shubietah AR, Khader MI. Successful embolization of an anterior chest wall arteriovenous malformation using combined transfemoral and transradial approaches with onyx. Radiol Case Rep 2024; 19:2151-2155. [PMID: 38515770 PMCID: PMC10950610 DOI: 10.1016/j.radcr.2024.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/23/2024] Open
Abstract
We present a case of successful embolization of an anterior chest wall arteriovenous malformation (AVM) in a 24-year-old male patient. This report aims to highlight the efficacy and safety of using the liquid embolic agent (onyx) as well as the combined approaches (trans-femoral and trans-radial) in managing rare complex chest wall AVMs.
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Affiliation(s)
- Islam M. Rajab
- Internal Medicine Department, Al-Israa Speciality Hospital, Tulkarm, Palestine
- Department of Radiology, An-Najah National University Hospital, Nablus, Palestine
| | - Abdelkarim Adas
- Thoracic Surgery, An-Najah National University Hospital, Nablus, Palestine
| | - Abdalhakim R.M. Shubietah
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Internal Medicine Department, An-Najah National University Hospital, Nablus, Palestine
| | - Mohammed I. Khader
- Interventional Radiology, An-Najah National University Hospital, Nablus, Palestine
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16
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Nin OC, Hutnik R, Chheda NN, Hutchinson D. Airway management of a patient with linear immunoglobulin A bullous dermatosis: A case report. World J Clin Cases 2024; 12:2263-2268. [DOI: 10.12998/wjcc.v12.i13.2263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/24/2024] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND There is limited literature on managing the airway of patients with linear immunoglobulin A (IgA) bullous dermatosis, a rare mucocutaneous disorder that leads to the development of friable bullae. Careful clinical decision making is necessary when there is a risk of bleeding into the airway, and a multidisciplinary team approach may lead to decreased patient morbidity during these high-risk scenarios, especially when confronted with an unusual cause for bleeding.
CASE SUMMARY A 45-year-old African American female presented to our ambulatory surgical center for right corneal transplantation due to corneal perforation after blunt trauma in the setting of cicatricial conjunctivitis and diffuse corneal neovascularization from linear IgA bullous dermatosis. The diagnosis of IgA dermatosis was recent, and the patient had been lost to follow-up. The severity of the disease and extent of airway involvement was unknown at the time of the surgery. Significant airway bleeding was noticed upon intubation and the otorhinolaryngology team had to be called to the operating room. The patient required transfer to the intensive care unit where a multidisciplinary team was involved in her case. The patient was extubated on postoperative day 4.
CONCLUSION A multidisciplinary approach to treating this disease is the best course of action before a surgical procedure. In our case, key communication between the surgery, anesthesia, and dermatology teams led to the quick and safe treatment of our patient’s disease. Ambulatory surgery should not be considered for these cases unless they are in full remission and there is no mucous membrane involvement.
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Affiliation(s)
- Olga C Nin
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610, United States
| | - Robert Hutnik
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610, United States
| | - Neil N Chheda
- Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL 32610, United States
| | - David Hutchinson
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610, United States
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17
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Lin HG, Liu M, Huang XY, Liu DS. Intra-thyroid esophageal duplication cyst: A case report. World J Clin Cases 2024; 12:2231-2236. [DOI: 10.12998/wjcc.v12.i13.2231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/09/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Esophageal cysts are relatively rare in clinical practice, with most of the literature comprising case reports. Esophageal cysts protruding into the thyroid gland are easily misdiagnosed as thyroid tumors. No such cases have been reported so far.
CASE SUMMARY This article reports the case of a 31-year-old adult male diagnosed with thyroid nodules before admission. The patient underwent left thyroidectomy and isthmusectomy. During the surgery, esophageal cysts were identified in the esophageal muscle and thyroid glands. The pathology results confirmed a nodular goiter combined with esophageal cysts. Postoperatively, the patient developed a neck infection and underwent another operation and broad-spectrum antibiotic treatment for recovery.
CONCLUSION We report the first clinical case of an esophageal cyst located within the thyroid gland that was successfully treated surgically. Esophageal cyst located within the thyroid gland cause difficulties in diagnosis. In the present study, the contents of the esophageal cysts were calcified foci, and a small amount of fluid mixture, which were easily misdiagnosed as thyroid nodules and misled the surgical methods.
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Affiliation(s)
- Hong-Guo Lin
- Department of Vascular Thyroid Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Ming Liu
- Department of Vascular Thyroid Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Xue-Yang Huang
- Department of Vascular Thyroid Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Da-Sheng Liu
- Department of Vascular Thyroid Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
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18
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Narotam A, Archary M, Naidoo P, Naidoo Y, Naidu V. Atypical presentation of a posterior fossa tumour: A case report. World J Clin Cases 2024; 12:2281-2285. [DOI: 10.12998/wjcc.v12.i13.2281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/19/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory distress. This is of interest as the patient had no other symptomatology, especially given the size of the mass, which would typically cause a pressure effect leading to neurological and auditory symptoms.
CASE SUMMARY This case report described a 48-year-old male who was married with two children and employed as a car guard. He had a medical history of asthma for the past 10 years controlled with an as-needed beta 2 agonist metered dose inhaler. He initially presented to our facility with severe respiratory distress. He reported a 1-wk history of shortness of breath and wheezing that was not relieved by his bronchodilator. He had no constitutional symptoms or impairment of hearing. On clinical examination, the patient’s chest was “silent.” Our initial assessment was status asthmaticus with type 2 respiratory failure, based on the history of asthma, a “silent chest,” and the arterial blood gas results.
CONCLUSION A posterior fossa meningioma of such a large size and with extensive infiltration rarely presents with an isolated unilateral vocal cord palsy. The patient’s chief presenting feature was severe respiratory distress, which combined with his background medical history of asthma, was misleading. Clinicians should thus consider meningioma as a differential diagnosis for a unilateral vocal cord palsy even without audiology involvement.
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Affiliation(s)
- Alisha Narotam
- Department of Internal Medicine, King Edward VIII Hospital - University of Kwazulu-Natal, Durban 4001, Kwa-Zulu Natal, South Africa
| | - Mikara Archary
- Department of Internal Medicine, King Edward VIII Hospital - University of Kwazulu-Natal, Durban 4001, Kwa-Zulu Natal, South Africa
| | - Poobalan Naidoo
- Department of Internal Medicine, Nelson R Mandela, School of Medicine, University of Kwa-Zulu Natal, Durban 4001, Kwa-Zulu Natal, South Africa
| | - Yeshkhir Naidoo
- Department of Radiology, King Edward VIII Hospital - University of Kwazulu-Natal, Durban 4001, Kwazulu-Natal, South Africa
| | - Vanesha Naidu
- Department of Radiology, King Edward VIII Hospital - University of Kwazulu-Natal, Durban 4001, Kwazulu-Natal, South Africa
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Zhang J, Qiao YR, Yang YD, Pan GZ, Lv CQ. Recovering from prolonged cardiac arrest induced by electric shock: A case report. World J Clin Cases 2024; 12:2248-2253. [DOI: 10.12998/wjcc.v12.i13.2248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/29/2024] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Cardiac arrest (CA) induced by electric shock is a rare occurrence, particularly in cases of prolonged CA. Currently, there is limited literature on similar incidents, and we present a relevant case report.
CASE SUMMARY A 27-year-old Asian male man, experiencing respiratory CA due to electric shock, was successfully restored to sinus rhythm after 50 min of cardiopulmonary resuscitation and 8 electrical defibrillation sessions. In the subsequent stages, the patient received multiple organ function protection measures, leading to a successful recovery and eventual discharge from the hospital.
CONCLUSION Prolonging resuscitation time can enhance the chances of survival for patients, this study provide valuable insights into the management of electric shock-induced CA.
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Affiliation(s)
- Jian Zhang
- Department of General Surgery, Shengli Oilfield Central Hospital, Dongying 257000, Shandong Province, China
| | - Yan-Ru Qiao
- Department of General Surgery, Shengli Oilfield Central Hospital, Dongying 257000, Shandong Province, China
| | - Ya-Dong Yang
- Department of Emergency Medicine, Shengli Oilfield Central Hospital, Dongying 257000, Shandong Province, China
| | - Guo-Zheng Pan
- Department of General Surgery, Shengli Oilfield Central Hospital, Dongying 257000, Shandong Province, China
| | - Chong-Qing Lv
- Department of General Surgery, Shengli Oilfield Central Hospital, Dongying 257000, Shandong Province, China
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20
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Chen DX, Wu Y, Zhang SF, Yang XJ. Refractory autoimmune hemolytic anemia in a patient with systemic lupus erythematosus and ulcerative colitis: A case report. World J Clin Cases 2024; 12:2286-2292. [DOI: 10.12998/wjcc.v12.i13.2286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/06/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Ulcerative colitis (UC) and systemic lupus erythematosus (SLE) are both systemic immunoreactive diseases, and their pathogenesis depends on the interaction between genes and environmental factors. There are no reports of UC with SLE in China, but six cases of SLE with UC have been reported in China. The combination of these two diseases has distinct effects on the pathogenesis of both diseases.
CASE SUMMARY A female patient (30 years old) came to our hospital due to dull umbilical pain, diarrhea and mucous bloody stool in August 2018 and was diagnosed with UC. The symptoms were relieved after oral administration of mesalazine (1 g po tid) or folic acid (5 mg po qd), and the patient were fed a control diet. On June 24, 2019, the patient was admitted for treatment due to anemia and tinnitus. During hospitalization, the patient had repeated low-grade fever and a progressively decreased Hb level. Blood tests revealed positive antinuclear antibody test, positive anti-dsDNA antibody, 0.24 g/L C3 (0.9-1.8 g/L), 0.04 g/L C4 (0.1-0.4 g/L), 32.37 g/L immunoglobulin (8-17 g/L), and 31568.1 mg/24 h total 24-h urine protein (0-150 mg/24 h). The patient was diagnosed with SLE involving the joints, kidneys and blood system. Previously reported cases of SLE were retrieved from PubMed to characterize clinicopathological features and identify prognostic factors for SLE.
CONCLUSION The patient was discharged in remission after a series of treatments, such as intravenous methylprednisolone sodium succinate, intravenous human immunoglobulin, cyclophosphamide injection, and plasma exchange. After discharge, the patient took oral prednisone acetate tablets, cyclosporine capsules, hydroxychloroquine sulfate tablets and other treatments for symptoms and was followed up regularly for 1 month, after which the patient's condition continued to improve and stabilize.
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Affiliation(s)
- Dai-Xing Chen
- Department of Digestive System, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
| | - Yue Wu
- Department of Digestive System, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
| | - Sui-Feng Zhang
- Department of Digestive System, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
| | - Xiao-Jun Yang
- Department of Digestive System, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
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21
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Chen CQ, Huang MY, Pan M, Chen QQ, Wei FF, Huang H. Thymic carcinoid with multiple bone metastases: A case report. World J Clin Cases 2024; 12:2275-2280. [DOI: 10.12998/wjcc.v12.i13.2275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/09/2024] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Thymic carcinoid (TC) is a rare entity among anterior mediastinal malignancies. TCs are neuroendocrine carcinomas that constitute approximately 2%–5% of all thymic epithelial tumors.
CASE SUMMARY The study reported a rare TC with multiple bone metastases. A 77-year-old man presented with a 2-month history of lower back pain and weight loss of 5 kg. Magnetic resonance imaging scans revealed damage to the lumbar spine, sacrocaudal vertebrae and iliac crest, suggesting bone metastasis; computed tomography (CT) scan of the thorax showed a calcified anterior mediastinal mass; positron emission tomography-CT demonstrated multiple abnormal bone signals; and laboratory work-up showed no endocrine abnormalities. Fine-needle aspiration biopsy revealed predominantly single small, round to oval cells with scant cytoplasm and some loose clusters, suggesting endocrine manifestations. The pathological diagnosis was atypical carcinoid, which tend to originate from the thymus and was classified as intermediate-highly invasive. The patient underwent anlotinib-targeted therapy. Anlotinib (12 mg) was administered daily for 2 wk, after which the patient was allowed to rest for 21 d. Follow-up CT after one year demonstrated that the tumor had shrunk by approximately 29% after therapy. Treatment has a long stable disease benefit of more than 2.5 years.
CONCLUSION These findings demonstrated that anlotinib is a promising treatment regimen for patients with TC and multiple bone metastases.
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Affiliation(s)
- Chun-Qiao Chen
- Department of Oncology, People’s Hospital of Guilin, Guilin 541000, Guangxi Zhuang Autonomous Region, China
| | - Ming-Yue Huang
- Department of Oncology, People’s Hospital of Guilin, Guilin 541000, Guangxi Zhuang Autonomous Region, China
| | - Min Pan
- Department of Oncology, People’s Hospital of Guilin, Guilin 541000, Guangxi Zhuang Autonomous Region, China
| | - Qiu-Qiu Chen
- Department of Oncology, People’s Hospital of Guilin, Guilin 541000, Guangxi Zhuang Autonomous Region, China
| | - Fei-Fei Wei
- Department of Oncology, People’s Hospital of Guilin, Guilin 541000, Guangxi Zhuang Autonomous Region, China
| | - Hui Huang
- Department of Oncology, People’s Hospital of Guilin, Guilin 541000, Guangxi Zhuang Autonomous Region, China
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Al Nooryani A, Aboushokka W, Beleslin B, Nedeljkovic-Beleslin B. Deferred revascularization in diabetic patient according to combined invasive functional and intravascular imaging data: A case report. World J Clin Cases 2024; 12:2269-2274. [DOI: 10.12998/wjcc.v12.i13.2269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/25/2024] [Accepted: 03/20/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Invasive functional evaluation by fractional flow reserve (FFR) is considered as a gold standard for the evaluation of intermediate coronary stenosis. However, in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.
CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain. Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent. Patient undergone invasive functional testing of intermediate lesion with preserved FFR (0.88), low coronary flow reserve (1.2) and very high index of microvascular resistance (84). Due to discrepancy in invasive functional parameters, intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma. Because of the preserved FFR and no signs of vulnerable plaque, the interventional procedure was deferred and the patient continued with optimal medications.
CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.
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Affiliation(s)
- Arif Al Nooryani
- Department of Cardiology, Al Qassimi Hospital, Sharjah 1234, United Arab Emirates
| | - Wael Aboushokka
- Department of Cardiology, Al Qassimi Hospital, Sharjah 1234, United Arab Emirates
| | - Branko Beleslin
- Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade 11000, Serbia
| | - Biljana Nedeljkovic-Beleslin
- Institute of Endocrinology, Diabetes and Metabolic Disorders, Univeristy Clinical Center of Serbia, Belgrade 11000, Serbia
- Department of Internal Medicine/Endocrinology, Medical faculty, University of Belgrade, Belgrade 11000, Serbia
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23
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Wu WP, Lee CW. Magnetic resonance imaging findings of radiation-induced breast angiosarcoma: A case report. World J Clin Cases 2024; 12:2237-2242. [DOI: 10.12998/wjcc.v12.i13.2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/17/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Breast conservation surgery (BCS) with adjuvant radiotherapy has become a gold standard in the treatment of early-stage breast cancer, significantly reducing the risk of tumor recurrence. However, this treatment is associated with adverse effects, including the rare but aggressive radiation-induced angiosarcoma (RIAS). Despite its rarity and nonspecific initial presentation, RIAS presents a challenging diagnosis, emphasizing the importance of imaging techniques for early detection and accurate diagnosis.
CASE SUMMARY We present a case of a 48-year-old post-menopausal woman who developed skin ecchymosis on the right breast seven years after receiving BCS and adjuvant radiotherapy for breast cancer. Initial mammography and ultrasound were inconclusive, showing post-treatment changes but failing to identify the underlying angiosarcoma. Contrast-enhanced breast magnetic resonance imaging (MRI) revealed diffuse skin thickening and nodularity with distinctive enhancement kinetics, leading to the diagnosis of RIAS. This case highlights the crucial role of MRI in diagnosing and determining the extent of RIAS, facilitating timely and appropriate surgical intervention.
CONCLUSION Breast MRI is crucial for detecting RIAS, especially when mammography and ultrasound are inconclusive.
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Affiliation(s)
- Wen-Pei Wu
- Department of Medical Imaging, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Chih-Wei Lee
- Department of Radiology, Changhua Christian Medical Foundation Changhua Christian Hospital, Changhua 50006, Taiwan
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24
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Lu XR, Jiao XG, Sun QH, Li BW, Zhu QS, Zhu GX, Qu JJ. Young patient with a giant gastric bronchogenic cyst: A case report and review of literature. World J Clin Cases 2024; 12:2254-2262. [DOI: 10.12998/wjcc.v12.i13.2254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/09/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Gastric bronchogenic cysts (BCs) are extremely rare cystic masses caused by abnormal development of the respiratory system during the embryonic period. Gastric bronchial cysts are rare lesions that were first reported in 1956; as of 2023, only 33 cases are available in the PubMed online database. BCs usually have no clinical symptoms in the early stage, and imaging findings also lack specificity. Therefore, they are difficult to diagnose before histopathological examination.
CASE SUMMARY A 34-year-old woman with respiratory distress presented at our hospital. Endoscopic ultrasound revealed an anechoic mass between the spleen, left kidney and gastric fundus, with hyperechogenic and soft elastography textures and with a size of approximately 6.5 cm × 4.0 cm. Furthermore, a computed tomography scan demonstrated high density between the posterior stomach and the spleen and the left kidney, with uniform internal density and a small amount of calcification. The maximum cross section was approximately 10.1 cm × 6.1 cm, and the possibility of a cyst was high. Because the imaging findings did not suggest a malignancy and because the patient required complete resection, she underwent laparotomy surgery. Intraoperatively, this cystic lesion was found to be located in the posterior wall of the large curvature of the fundus and was approximately 8 cm × 6 cm in size. Finally, the pathologists verified that the cyst in the fundus was a gastric BC. The patient recovered well, her symptoms of chest tightness disappeared, and the abdominal drain was removed on postoperative day 6, after which she was discharged on day 7 for 6 months of follow-up. She had no tumor recurrence or postoperative complications during the follow-up.
CONCLUSION This is a valuable report as it describes an extremely rare case of gastric BC. Moreover, this was a very young patient with a large BC in the stomach.
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Affiliation(s)
- Xu-Ren Lu
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong Province, China
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Xu-Guang Jiao
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Qi-Hang Sun
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong Province, China
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Bo-Wen Li
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong Province, China
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Qing-Shun Zhu
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Guang-Xu Zhu
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Jian-Jun Qu
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
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25
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Hu YA, Guo YX, Huang QF. Rim 18F-fluorodeoxyglucose uptake of hepatic cavernous hemangioma on positron emission tomography/computed tomography: A case report. World J Clin Cases 2024; 12:2243-2247. [DOI: 10.12998/wjcc.v12.i13.2243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/21/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Peripheral FDG accumulation in a hepatic hemangioma presenting in a patient with prolonged fever is rare. Therefore, clinicians should pay close attention to patients with hepatic mass.
CASE SUMMARY A 54-year-old woman with a 4-wk history of daily fevers was admitted to our hospital. A whole body 18F-Fluordesoxyglucose (PET-FDG) positron emission tomography/computed tomography (PET/CT) was performed to elucidate the source of the fever. However, whole body 18F-FDG PET/CT raised the suspicion of a malignant lesion because of peripheral FDG accumulation (SUVmax 3.5 g/mL) higher than that of the normal liver parenchyma (SUVmax 1.6 g/mL) surrounding a hypoactive area, and no other abnormalities were showed. Subsequently, the patient underwent liver mass resection. Histopathology showed a hepatic cavernous hemangioma with fatty infiltration around the lesion. The fever disappeared four days after surgery and the patient did not present any complications during follow-up.
CONCLUSION Fatty infiltration in the peripheral parts of hepatic cavernous hemangioma may lead to subacute inflammation which further activate the Kupffer cells. This may cause prolonged fever and peripheral rim FDG accumulation on PET/CT.
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Affiliation(s)
- Yong-An Hu
- Department of Nuclear Medicine, Jinhua Hospital of Zhejiang University, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
| | - Ya-Xin Guo
- Department of Nuclear Medicine, Jinhua Hospital of Zhejiang University, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
| | - Qi-Feng Huang
- Department of Nuclear Medicine, Jinhua Hospital of Zhejiang University, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
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Zebbakh H, Imrani K, Benbrahim F, Moatassim Billah N, Nassar I. Acute toxic hippocampal encephalopathy in heavy cannabis users: A case report. Radiol Case Rep 2024; 19:1913-1916. [PMID: 38425776 PMCID: PMC10904197 DOI: 10.1016/j.radcr.2024.01.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Cannabis use is increasing rapidly among young people worldwide despite the deleterious effects of this toxic substance on health. We report a case of acute hippocampal encephalopathy in a heavy cannabis user (8-10 joints/d for 6 years) who presented with a nonfebrile status epilepticus. Brain magnetic resonance imaging revealed bilateral and symmetrical high-signal abnormalities in the hippocampal regions. The damage to these regions is often severe, long-lasting, and sometimes irreversible. Therefore, every doctor (emergency doctor, resuscitator, neurologist...) is asked to request a brain MRI in case of neurological signs in a young cannabis user.
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Affiliation(s)
- Hajar Zebbakh
- Hajar Zebbakh, Radiology, Ibn Sina University Hospital, Rabat, Morocco
| | - Kaoutar Imrani
- Hajar Zebbakh, Radiology, Ibn Sina University Hospital, Rabat, Morocco
| | | | | | - Ittimade Nassar
- Hajar Zebbakh, Radiology, Ibn Sina University Hospital, Rabat, Morocco
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27
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Vi TNH, Tri TT, Duy HP, Kiet PT, Cuong NM, Tuan HX, Duc NM. Laparoscopic treatment for median arcuate ligament syndrome in children: A case report. Radiol Case Rep 2024; 19:2004-2007. [PMID: 38449485 PMCID: PMC10917635 DOI: 10.1016/j.radcr.2024.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
In median arcuate ligament syndrome (MALS), the median arcuate ligament compresses the celiac trunk and surrounding nerves leading to chronic functional abdominal pain and vague gastrointestinal symptoms. MALS can be effectively treated by dividing the arcuate ligament through open surgery or laparoscopy. This is a rare vascular condition and mostly encountered in adult patients. We hereby report a case of a pediatric patient diagnosed with MALS and treated successfully by laparoscopic approach. An 11-year-old girl presented with severe abdominal cramps for 3 months, accompanied by nonbilious vomiting. Computed tomography (CT) angiography demonstrated clear images of celiac trunk compression suggesting MALS. Laparoscopic surgery to cut the ligament and decompress the celiac artery was performed. The patient was discharged on day 7 postoperative with no recurrence of symptoms after 12 months of follow-up. This report suggested the diagnostic value of CT scan, and the safety and the feasibility of laparoscopic surgical techniques to treat MALS in children.
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Affiliation(s)
- Trinh-Nguyen Ha Vi
- Department of Pediatric Surgery, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Tran Thanh Tri
- Department of Hepato-Pancreato-Biliary Diseases and Liver Transplantation, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Ho Phi Duy
- Department of Hepato-Pancreato-Biliary Diseases and Liver Transplantation, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Phan Tuan Kiet
- Department of Hepato-Pancreato-Biliary Diseases and Liver Transplantation, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Nguyen Manh Cuong
- Department of Pediatrics, Vietnam Military Medical University, Hanoi, Vietnam
| | - Ho Xuan Tuan
- Department of Medical Imaging, Da Nang University of Medical Technology and Pharmacy, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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28
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De Innocentiis C, Buonpane A, Totaro A, Restaino G, Astore P, Guarino M, Langella V, Gallina S, Santamaria M. It's a long way to the top! Congenital venous anomalies and left isomerism limiting atrial fibrillation transcatheter ablation. Curr Probl Cardiol 2024; 49:102467. [PMID: 38369208 DOI: 10.1016/j.cpcardiol.2024.102467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Atrial fibrillation is the most common sustained cardiac arrhythmia in adults and it is associated with a high burden of mortality and morbidity worldwide. Catheter ablation is increasingly used to improve symptoms and prognosis in selected patients. Lower limb venous access with subsequent transseptal approach to the left atrium is the standard procedure for atrial fibrillation catheter ablation. CASE PRESENTATION We report an unusual case of complex venous anomaly with a left-sided inferior vena cava with hemiazygos continuation to a persistent left superior vena cava draining in an enlarged coronary sinus in a patient with persistent atrial fibrillation scheduled for transcatheter ablation. DISCUSSION Lower limb venous anomalies may limit a standard transseptal approach to the left atrium thus precluding an effective catheter ablation procedure for atrial fibrillation. Alternative interventions, such as unconventional percutaneous access, thoracoscopic approach and "ablate and pace" procedures, may be necessary in patients with symptomatic atrial fibrillation and complex venous anomalies.
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Affiliation(s)
- Carlo De Innocentiis
- Arrhythmology and Electrophysiology Unit, Responsible Research Hospital, Largo Agostino Gemelli, 1. 86100, Campobasso (CB), Campobasso, CB, Italy.
| | - Angela Buonpane
- Agostino Gemelli IRCCS University Hospital Foundation, Rome, Italy
| | - Antonio Totaro
- Interventional Cardiology Unit, Responsible Research Hospital, Campobasso, CB, Italy; Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, CB, Italy
| | - Gennaro Restaino
- Radiology Unit, Responsible Research Hospital, Campobasso, CB, Italy
| | - Pasquale Astore
- Arrhythmology and Electrophysiology Unit, Responsible Research Hospital, Largo Agostino Gemelli, 1. 86100, Campobasso (CB), Campobasso, CB, Italy
| | | | | | - Sabina Gallina
- Department of Neurosciences, Imaging and Clinical Sciences, Institute of Cardiology, Heart Department, "G. d'Annunzio" University Chieti-Pescara and University Cardiology Division, SS Annunziata University Hospital, Chieti, Italy
| | - Matteo Santamaria
- Arrhythmology and Electrophysiology Unit, Responsible Research Hospital, Largo Agostino Gemelli, 1. 86100, Campobasso (CB), Campobasso, CB, Italy
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29
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Lahmouch N, Britel D, Mouine N, Asfalou I, Lakhal Z, Benyass A. Rare case of cardiac angiosarcoma and alveolar hemorrhage in an adolescent patient initially suspected COVID19 infection: A case report and literature review. Radiol Case Rep 2024; 19:1722-1728. [PMID: 38384711 PMCID: PMC10877114 DOI: 10.1016/j.radcr.2024.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 02/23/2024] Open
Abstract
Primary cardiac tumors are a rarity, and sarcomas emerge as the prevailing form of primary malignant cardiac tumors across age groups, encompassing both children and adults. Within this category, angiosarcoma stands out, constituting around 31% of all primary malignant cardiac tumors. Primary cardiac angiosarcoma displays a notably aggressive nature, characterized by early systemic metastasis, and is accompanied by a generally unfavorable prognosis. We describe a case concerning a previously healthy teenage girl who displayed persistent constitutional symptoms and hemoptysis for 15 days. Subsequent investigation uncovered alveolar hemorrhage, ultimately linked to a cardiac angiosarcoma. The difficulty in this instance arose from the vague nature of the initial symptoms, posing a challenge to promptly and accurately diagnose the condition. This case highlights the aggressive nature of primary cardiac angiosarcoma. The vague initial symptoms underscore the need for early detection and optimized treatment to improve the generally unfavorable prognosis associated with this condition. Increased awareness and a multidisciplinary approach are crucial in addressing the diagnostic and therapeutic challenges posed by primary cardiac angiosarcoma.
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Affiliation(s)
- Nouhaila Lahmouch
- Department of Cardiology, Mohammed V University, Faculty of Medicine and Pharmacy in Rabat Morocco, Mohammed V Military Hospital, Morocco
| | - Driss Britel
- Department of Cardiology, Mohammed V University, Faculty of Medicine and Pharmacy in Rabat Morocco, Mohammed V Military Hospital, Morocco
| | - Najat Mouine
- Department of Cardiology, Mohammed V University, Faculty of Medicine and Pharmacy in Rabat Morocco, Mohammed V Military Hospital, Morocco
| | - Ilyasse Asfalou
- Department of Cardiology, Mohammed V University, Faculty of Medicine and Pharmacy in Rabat Morocco, Mohammed V Military Hospital, Morocco
| | - Zouhair Lakhal
- Department of Cardiology, Mohammed V University, Faculty of Medicine and Pharmacy in Rabat Morocco, Mohammed V Military Hospital, Morocco
| | - Aatif Benyass
- Department of Cardiology, Mohammed V University, Faculty of Medicine and Pharmacy in Rabat Morocco, Mohammed V Military Hospital, Morocco
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Rais K, Darkaoui A, Mqaddem OE, Koulali H, Zazour A, Jabri R, Ismaili Z, Kharrasse G. A rare cause of acute esophageal necrosis: A case report. Radiol Case Rep 2024; 19:1740-1744. [PMID: 38384703 PMCID: PMC10877425 DOI: 10.1016/j.radcr.2024.01.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Acute esophageal necrosis (AEN) or black esophagus is a rare entity characterized by diffuse circumferential black pigmentation of the esophageal mucosa due to ischemic necrosis. It may be lethal, especially among elderly patients with multiple comorbidities and hemodynamic instability. Diagnosis is based on gastroscopy. Treatment consists of intravenous fluids, proton pump inhibitors, and additional therapies to treat the underlying illness. We report a rare case of a woman in her 50s with cervical cancer who presented with hematemesis and sepsis. Upper gastrointestinal endoscopy showed a black esophagus and an ulcerobudding duodenal process. Few days later, she developed abdominal distension with diffuse pain. Abdominal CT scan demonstrated perforation of gastroduodenal tumor. The treatment was based on resuscitation, proton pump inhibitors, antibiotics, and surgery of the perforated tumor. Unfortunately, the patient died 2 days later because of septic shock. The black esophagus is a fatal complication, thus diagnosis at an early stage and timely management may improve survival. This is the first case reported of AEN due to perforated duodenal tumor explained by septic shock leading to an ischemic esophageal injury.
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Affiliation(s)
- Kaouthar Rais
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Diseases Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Anas Darkaoui
- Department of General Surgery, Mohammed VI University Hospital Center, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Ouiam El Mqaddem
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Diseases Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Hajar Koulali
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Diseases Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Abdelkrim Zazour
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Diseases Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Rachid Jabri
- Department of General Surgery, Mohammed VI University Hospital Center, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Zahi Ismaili
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Diseases Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Ghizlane Kharrasse
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Diseases Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
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31
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Pokharel S, KC S, Lamichhane S, Pokharel M, Sah RP, Yadav SK, Bhusal A, Poudel S, Shah SK, Pokharel M. Asymptomatic spontaneous expulsion of a long foreign body through the gastrointestinal tract - a curious case report. Radiol Case Rep 2024; 19:1940-1944. [PMID: 38449486 PMCID: PMC10915782 DOI: 10.1016/j.radcr.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Foreign body ingestion and its natural elimination are common in children. However, this is uncommon for long foreign bodies. Here, we report the spontaneous removal of an ingested pencil in an asymptomatic child. To our knowledge, this is the first case report of asymptomatic spontaneous elimination of a normally-sized ingested pencil. A 7-year-old male child presented with a history of ingestion of a pencil 4 hours back, without any complaints. Immediate abdominal radiography revealed a pencil in the stomach with an estimated length of approximately 10 cm and no signs of complications. He was conservatively treated under a semi-solid diet, presumably due to lack of available endoscopic option. Subsequently, he passed the pencil in stool within 24 hours of ingestion. He was asymptomatic and playful during the course and at discharge. Conservative management of a quickly moving long foreign body initially located below the esophagus in an asymptomatic child is possible with the help of imaging guidance, particularly in settings lacking an endoscopy. Although, this should not be considered a norm. However, this suggests that the treatment of ingested foreign bodies must be individualized. Thus, multiple factors related to the child and the foreign body must be assessed before committing to invasive procedures like laparotomy. Similarly, plain X-rays can be helpful even for radiolucent foreign bodies, for diagnosis and ruling out complications. All of these are vital in underdeveloped countries, where endoscopy and computed tomography facilities might be either lacking or unaffordable by patients.
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Affiliation(s)
- Sushan Pokharel
- Department of Pediatric Surgery Division, Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Suraj KC
- Department of Pediatric Surgery Division, Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Samiksha Lamichhane
- Department of Radiodiagnosis and Imaging, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Mohir Pokharel
- Department of General Surgery, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Rajesh P. Sah
- Department of Pediatric Surgery Division, Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sanjaya K. Yadav
- Department of Pediatric Surgery Division, Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Amrit Bhusal
- Department of Radiodiagnosis and Imaging, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sishir Poudel
- Department of Pediatric Surgery Division, Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Siddhartha K. Shah
- Department of Pediatric Surgery Division, Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Moneec Pokharel
- Birat Medical College and Teaching Hospital, Biratnagar, Nepal
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32
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Machado CR, Andrades GRH, Mattiello R, Feoli AMP, Cuervo MRM, Costa CAD. Feeding therapy in a neurotypical child with feeding difficulties: A case report. Nutrition 2024; 121:112364. [PMID: 38401195 DOI: 10.1016/j.nut.2024.112364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 02/26/2024]
Abstract
A feeding therapy developed in Brazil integrates aspects from diverse approaches and has increasingly been acknowledged as an adjunctive approach for addressing childhood feeding difficulties. In children, problems with eating are a common issue that affects their nutritional well-being, health, and overall quality of life, and can greatly hinder their social, emotional, and physical growth. In the realm of pediatrics, feeding therapy uses food and nutritional education, interactive games, and activities tailored to age groups and individualized treatment plans. The primary objective is to transform mealtime experiences and gradually foster children's acceptance of previously rejected foods. However, this treatment approach is new and recent in Brazil and lacks studies that explore and elucidate the topic. Therefore, this report aims to describe the follow-up and effects of feeding therapy in a 3-y and 8-mo-old neurotypical male patient with feeding difficulties who underwent feeding therapy conducted by a dietitian over a period of 19 wk. The feeding therapy consisted of 45-min sessions once a week in which food and nutrition education activities, games, and interactive activities, personalized according to the treatment plan, were carried out. The effects of feeding therapy were evaluated according to the patient's feeding progression throughout the sessions and their stepwise progress in the eating hierarchy. Based on our observations, the findings of this study suggest that feeding therapy practiced in Brazil can be a viable treatment approach for addressing feeding difficulties within this population. The feeding therapy originated in Brazil stands out from traditional nutritional care with its nurturing and compassionate approach that prioritizes respect for the child.
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Affiliation(s)
- Cátia Regina Machado
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela Rupp Hanzen Andrades
- Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rita Mattiello
- Graduate Program in Epidemiology, Faculty of Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ana Maria Pandolfo Feoli
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Rita Macedo Cuervo
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Caroline Abud Drumond Costa
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
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33
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Ramirez-Amoros C, Estefania-Fernandez K, Moratilla-Lapeña L, Vilanova-Sanchez A, Lopez Pereira P, Martinez Urrutia MJ. Bladder duplication in a patient with a persistent urogenital sinus: Case report and systematic review of the literature. Urol Case Rep 2024; 54:102736. [PMID: 38645772 PMCID: PMC11033084 DOI: 10.1016/j.eucr.2024.102736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/23/2024] Open
Abstract
Bladder duplication (BD) is a rare malformation that is often associated to other anomalies. We report a newborn diagnosed with BD in the sagittal plane, associated to persistent urogenital sinus (UGS), given the opening of the vagina immediately below the bladder neck. It is the fourth time this association is reported. Surgical repair was made: both bladders were joined, the common channel was left as urethra and the vagina was descended with a vaginoplasty with an intestinal segment. She also presented an anterior anus, that required posterior mobilization. The patient is currently 3 years old with good sphincter control.
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Affiliation(s)
- Carla Ramirez-Amoros
- La Paz Children's University Hospital, Department of Paediatric Surgery, Madrid, Spain
| | | | | | | | - Pedro Lopez Pereira
- La Paz Children's University Hospital, Department of Paediatric Surgery, Madrid, Spain
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34
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Li TL, Huang CP, Lin CY, Ho MW, Cho CH, Chen YH, Chen WC. Hemophagocytic syndrome in A patient of upper urinary tract urothelial cancer after Bacillus Calmette-Guérin instillation: A case report. Urol Case Rep 2024; 54:102730. [PMID: 38601084 PMCID: PMC11004083 DOI: 10.1016/j.eucr.2024.102730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024] Open
Abstract
Bacillus Calmette-Guérin (BCG) therapy is an adjuvant treatment for urothelial carcinomas of the upper urinary tract (UTUC). BCG therapy can result in various side effects. We present a case of a 67-year-old female with a history of UTUC who developed disseminated tuberculosis following BCG instillation into the upper urinary tract after conservative management. This complex clinical scenario required a multidisciplinary approach, including antibiotic therapy, immunoglobulin infusion, and tailored tuberculosis treatment. The case underscores the importance of vigilance, early detection, and tailored interventions in managing disseminated tuberculosis arising from BCG therapy and rare complications like hemophagocytic syndrome.
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Affiliation(s)
- Ting-Lien Li
- Department of Urology, China Medical University Hospital, Taichung, 404332, Taiwan
| | - Chi-Ping Huang
- Department of Urology, China Medical University Hospital, Taichung, 404332, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 404332, Taiwan
| | - Chia-Yu Lin
- Department of General Medicine, China Medical University Hospital, Taichung, 404332, Taiwan
| | - Mao-Wang Ho
- Department of Infection, China Medical University Hospital, Taichung, 404332, Taiwan
| | - Chia-Hui Cho
- Department of Infection, China Medical University Hospital, Taichung, 404332, Taiwan
| | - Yung-Hsiang Chen
- Department of Urology, China Medical University Hospital, Taichung, 404332, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, 404332, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, 413305, Taiwan
| | - Wen-Chi Chen
- Department of Urology, China Medical University Hospital, Taichung, 404332, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, 404332, Taiwan
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35
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Garabet R, Herr S, Griffin N, Reddy K. Statin-induced immune-mediated necrotizing myopathy with concomitant increase of anti-HMGCR and anti-ACHR antibodies. Rheumatol Int 2024; 44:955-959. [PMID: 38461445 DOI: 10.1007/s00296-024-05559-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/09/2024] [Indexed: 03/12/2024]
Abstract
Statin-induced immune-mediated necrotizing myopathy (IMNM) is a rare systemic neuromuscular condition. We present a case of a patient with a severe phenotype of the disease that was found to have an increase in anti-HMGCR and anti-ACHR antibodies. A potential association between these antibodies have not been previously described. A 67-year-old male with hyperlipidemia, who was recently initiated on atorvastatin therapy, presented to the ED with progressive muscle weakness. Within a few days of admission, the patient developed complete flaccid paralysis and respiratory distress requiring intubation. The patient's CK was elevated to 24,000 and there was an increase of anti-HMGCR and anti-ACHR antibodies. Impressions from MRI and thigh biopsy solidified a diagnosis of statin-induced IMNM. The patient was treated with methylprednisolone, IVIG, and rituximab, which provided resolution of symptoms.
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Affiliation(s)
- Razmig Garabet
- Medical Student, Drexel University College of Medicine, Philadelphia, PA, USA.
| | - Sanjeev Herr
- Medical Student, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Nicole Griffin
- Department of Rheumatology, Kaiser Permanente Northern California, Walnut Creek, CA, USA
| | - Kuruganti Reddy
- Department of Pulmonary Medicine, Kaiser Permanente Northern California, Walnut Creek, CA, USA
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36
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Cho DY, Kim HJ, Kim JY. Renal cell carcinoma metastasis to the penis: A case report and literature review. Urol Case Rep 2024; 54:102724. [PMID: 38571550 PMCID: PMC10990721 DOI: 10.1016/j.eucr.2024.102724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/05/2024] Open
Abstract
Metastasis to the penis from RCC or any other primary cancer site is unusual; when it does occur, it often involves multiple organs. A 75-year-old man presented with penile pain and swelling. Three months earlier, he had open radical nephrectomy with thrombectomy and was diagnosed with clear-cell RCC with tumor thrombosis in the IVC. The follow-up imaging indicated metastasis in the penis, prompting a total penectomy due to worsening pain. The excised mass displayed features consistent with metastatic RCC. This case underscores the need to consider rare metastatic sites, such as metastasis of RCC to the penis, in RCC patients.
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Affiliation(s)
- Dae Yeon Cho
- Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea
| | - Hyun Jung Kim
- Department of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea
| | - Jae Yoon Kim
- Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea
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37
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Tuan HX, Hung ND, Quang NN, Tam NT, Anh NTH, Hoa T, Dung BT, Duc NM. Pulmonary artery penetration due to fish bone ingestion: A rare case report. Radiol Case Rep 2024; 19:1900-1906. [PMID: 38425774 PMCID: PMC10904187 DOI: 10.1016/j.radcr.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 03/02/2024] Open
Abstract
Accidental fish bone ingestion is a common manifestation at emergency departments. In most cases, ingested foreign bodies usually pass uneventfully through the gastrointestinal tract and complications only present in less than 5% of all patients. In this report, we present the first documented case of pulmonary artery injury due to a fish bone in a 63-year-old male patient hospitalized with hemoptysis after accidentally swallowing a fish bone 30 days ago. This patient subsequently had surgery and endoscopy to safely remove the foreign body and then recovered well on a follow-up examination. For cases of fish bone ingestion, contrast-enhanced chest computed tomography is one of the most essential tools to assess vascular problems and associated mediastinal infections-risk factors for life-threatening and long-term recurrent inflammation. Reconstructing planes along the foreign body axis and changing windows when analyzing CT scans is necessary to avoid missing lesions and dilemmas.
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Affiliation(s)
- Ho Xuan Tuan
- Department of Medical Imaging, Da Nang University of Medical Technology and Pharmacy, Danang, Vietnam
| | - Nguyen Duy Hung
- Department of Radiology, Hanoi Medical University, Hanoi, Vietnam
- Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam
| | | | - Nguyen-Thi Tam
- Department of Radiology, Hanoi Medical University, Hanoi, Vietnam
| | | | - Tran Hoa
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Bui The Dung
- Department of Cardiology, University Medical Center HCMC, Ho Chi Minh City, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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Reier-Nilsen T, Grønneberg C, Røine S, Nordlund B. Assessment of lung function variability documents airflow limitation in many patients with long covid. Heliyon 2024; 10:e29261. [PMID: 38628706 PMCID: PMC11019201 DOI: 10.1016/j.heliyon.2024.e29261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 03/23/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
Background It is estimated that 65 million people worldwide suffer from long covid (LC). Many LC symptoms are also reported by patients with airflow limitation, used to confirm asthma. The primary aim was to detect airflow limitation in LC patients by a methacholine bronchial provocation test (BPT) and if negative, by evaluation of diurnal variability in forced expiratory flow in 1 second (FEV1) over a two-weeks' period. The second aim was to assess responsiveness to asthma treatment on diurnal FEV1 variability and LC symptoms. Methods Patients with LC for at least six months were recruited in this open diagnostic study. Burden of LC symptoms were reported on a 10-point Likert scale (0 = not troubled, 10 = extremely troubled) at inclusion and after three weeks' asthma treatment. A positive methacholine BPT was defined by an accumulated provocation dose (PD20)<8 μmol causing 20% fall in FEV1. App-based spirometer was used for diurnal FEV1 variability, deemed positive by diurnalvariability in FEV1 ≥12%. Results Airflow limitation was documented by positive methacholine BPT in 8/30 (27%), or by excessive diurnal variability in FEV1 in 21/22 (95%) of the BPT negative LC patients. One patient dropped out due to personal issues. Three weeks' asthma treatment normalised mean diurnal FEV1 variability from 18.0% to 7.3%, p < 0.001. Significant reductions were observed for fatigue and dyspnoea, from 8.3 to 6.1, p < 0.001, and 3.0 to 0, p < 0.001, respectively. Conclusion This study indicate that airflow limitation may be detected in many LC patients if evaluation of diurnal variability in FEV1 is included in the diagnostics.
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Affiliation(s)
- Tonje Reier-Nilsen
- The Norwegian Sports Medicine Centre – Football Association, Oslo, Norway
- The Norwegian Olympic Sports Centre, Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | | | - Stephanie Røine
- The Norwegian Sports Medicine Centre – Football Association, Oslo, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Stockholm, Sweden
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Zha F, Li X, Yin H, Huang D, Du Y, Zhou C. Case report: A 56-year-old woman presenting with torsades de pointes and cardiac arrest associated with levosimendan administration and underlying congenital long QT syndrome type 1. Heliyon 2024; 10:e29300. [PMID: 38644859 PMCID: PMC11033119 DOI: 10.1016/j.heliyon.2024.e29300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 03/30/2024] [Accepted: 04/04/2024] [Indexed: 04/23/2024] Open
Abstract
Torsades de Pointes (TdP) is a malignant polymorphic ventricular tachycardia with heart rate corrected QT interval (QTc) prolongation, which may be attributed to congenital and acquired factors. Although various acquired factors for TdP have been summarized, levosimendan administration in complex postoperative settings is relatively uncommon. Timely identification of potential causes and appropriate management may improve the outcome. Herein, we describe the postoperative case of a 56-year-old female with initial normal QTc who accepted the administration of levosimendan for heart failure, suffered TdP, cardiac arrest, and possible Takotsubo cardiomyopathy, further genetically confirmed as long QT syndrome type 1 (LQT1). The patient was successfully treated with magnesium sulfate, atenolol, and implantable cardioverter defibrillator implantation. There should be a careful evaluation of the at-risk populations and close monitoring of the electrocardiograms, particularly the QT interval, to reduce the risk of near-fatal arrhythmias during the use of levosimendan.
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Affiliation(s)
- Fengyan Zha
- Department of Surgical Intensive Care Unit, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, SZ, China
| | - Xing Li
- Department of Surgical Intensive Care Unit, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, SZ, China
| | - Hui Yin
- Department of Surgical Intensive Care Unit, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, SZ, China
| | - Di Huang
- Department of Surgical Intensive Care Unit, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, SZ, China
| | - Yu Du
- Department of Surgical Intensive Care Unit, Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, BJ, China
| | - Chuzhi Zhou
- Department of Surgical Intensive Care Unit, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, SZ, China
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Yu HC, Pu TW, Kang JC, Chen CY, Hu JM, Su RY. Stercoral perforation of the cecum: A case report. World J Gastrointest Surg 2024; 16:1189-1194. [DOI: 10.4240/wjgs.v16.i4.1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/11/2024] [Accepted: 03/18/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND With less than 90 reported cases to date, stercoral perforation of the colon is a rare occurrence. Stercoral ulceration is thought to occur due to ischemic pressure necrosis of the bowel wall, which is caused by the presence of a stercoraceous mass. To underscore this urgent surgical situation concerning clinical presentation, surgical treatment, and results, we present the case of a 66-year-old man with a stercoral perforation.
CASE SUMMARY A 66-year-old man with a history of hypertension, hyperlipidemia, and gout presented at the emergency department with lower abdominal pain and a low-grade fever lasting for a few hours. Abdominal computed tomography indicated a suspected bezoar (approximately 7.6 cm) in the dilated cecum, accompanied by pericolic fat stranding, mild proximal dilatation of the ileum, pneumoperitoneum, and minimal ascites. Intraoperatively, feculent peritonitis with isolated cecal perforation were observed. Consequently, a right hemicolectomy with peritoneal lavage was performed. A histopathological examination supported the intraoperative findings.
CONCLUSION In stercoral perforations, a diagnosis should be diligently pursued, especially in older adults, and prompt surgical intervention should be implemented.
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Affiliation(s)
- Hung-Chun Yu
- Department of Surgery, Taichung Armed Forces General Hospital, Taichung 411228, Taiwan
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Ta-Wei Pu
- Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei 105, Taiwan
| | - Jung-Cheng Kang
- Division of Colon and Rectal Surgery, Department of Surgery, Taiwan Adventist Hospital, Taipei 105, Taiwan
| | - Chao-Yang Chen
- Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei 105, Taiwan
| | - Je-Ming Hu
- Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Ruei-Yu Su
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 105, Taiwan
- Department of Pathology and Laboratory Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan
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Lin C, Wang ZY, Dong LB, Wang ZW, Li ZH, Wang WB. Percutaneous transhepatic stenting for acute superior mesenteric vein stenosis after pancreaticoduodenectomy with portal vein reconstruction: A case report. World J Gastrointest Surg 2024; 16:1195-1202. [DOI: 10.4240/wjgs.v16.i4.1195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/24/2024] [Accepted: 03/19/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein (PV)/superior mesenteric veins (SMV) stenosis/occlusion. It has been widely used after liver transplantation surgery; however, reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are rare.
CASE SUMMARY Herein, we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic surgery. The patient was successfully treated using stent grafts. Although the stenosis resolved after stent placement, complications, including bleeding, pancreatic fistula, bile leakage, and infection, made the treatment highly challenging. The use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of bleeding. After careful treatment, the patient stabilized, and stent placement effectively managed postoperative PV/SMV stenosis.
CONCLUSION Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.
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Affiliation(s)
- Chen Lin
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zi-Yan Wang
- Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China
| | - Liang-Bo Dong
- Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China
| | - Zhi-Wei Wang
- Interventional Section, Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Ze-Hui Li
- Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China
| | - Wei-Bin Wang
- Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China
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Zhu GZ, Ji DH. Successful splenic artery embolization in a patient with Behçet’s syndrome-associated splenic rupture: A case report. World J Gastrointest Surg 2024; 16:1184-1188. [DOI: 10.4240/wjgs.v16.i4.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/02/2024] [Accepted: 03/06/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Splenic rupture associated with Behçet’s syndrome (BS) is extremely rare, and there is no consensus on its management. In this case report, a patient with BS-associated splenic rupture was successfully treated with splenic artery embolization (SAE) and had a good prognosis after the intervention.
CASE SUMMARY The patient was admitted for pain in the left upper abdominal quadrant. He was diagnosed with splenic rupture. Multiple oral and genital aphthous ulcers were observed, and acne scars were found on his back. He had a 2-year history of BS diagnosis, with symptoms of oral and genital ulcers. At that time, he was treated with oral corticosteroids for 1 month, but the symptoms did not alleviate. He underwent SAE to treat the rupture. On the first day after SAE, the patient reported a complete resolution of abdominal pain and was discharged 5 d later. Three months after the intervention, a computed tomography examination showed that the splenic hematoma had formed a stable cystic effusion, suggesting a good prognosis.
CONCLUSION SAE might be a good choice for BS-associated splenic rupture based on good surgical practice and material selection.
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Affiliation(s)
- Guang-Zhao Zhu
- Department of Interventional Therapy, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Dong-Hua Ji
- Department of Interventional Therapy, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
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Liu KR, Zhang S, Chen WR, Huang YX, Li XG. Intermittent melena and refractory anemia due to jejunal cavernous lymphangioma: A case report. World J Gastrointest Surg 2024; 16:1208-1214. [DOI: 10.4240/wjgs.v16.i4.1208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/14/2024] [Accepted: 03/21/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Lymphangiomas in the gastrointestinal tract are extremely rare in adults. As a benign lesion, small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis. However, lymphangiomas can give rise to complications such as abdominal pain, bleeding, volvulus, and intussusception. Here, we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult.
CASE SUMMARY A 66-year-old man presented with intermittent melena, fatigue and refractory anemia nine months prior. Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding. Conservative management, including transfusion, hemostasis, gastric acid secretion inhibition and symptomatic treatment, was performed, but the lesions tended to recur shortly after surgery. Ultimately, the patient underwent capsule endoscopy, which revealed a more than 10 cm lesion accompanied by active bleeding. After single-balloon enteroscopy and biopsy, a diagnosis of jejunal cavernous lymphangioma was confirmed, and the patient underwent surgical resection. No complications or recurrences were observed postoperatively.
CONCLUSION Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding. Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis. Surgical resection is an effective management method.
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Affiliation(s)
- Kai-Rui Liu
- Department of Abdominal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
| | - Sheng Zhang
- Department of Abdominal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
| | - Wei-Run Chen
- Department of Abdominal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
| | - You-Xing Huang
- Department of Abdominal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
| | - Xu-Guang Li
- Department of General Surgery, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
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Li WF, Gao RY, Xu JW, Yu XQ. Endoscopic treatment of bleeding gastric ulcer causing gastric wall necrosis: A case report. World J Gastrointest Surg 2024; 16:1203-1207. [DOI: 10.4240/wjgs.v16.i4.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/26/2024] [Accepted: 03/04/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Gastric wall necrosis is a rare complication of endoscopic treatment for bleeding gastric ulcer, which may exacerbate the patient’s condition once it occurs and may even require surgical intervention for treatment.
CASE SUMMARY A 59-year-old man was admitted to our department with melena. Endoscopy revealed a giant ulcer in the gastric antrum with a visible vessel in its center, which was treated with sclerosants and tissue glue injection and resulted in necrosis of the gastric wall.
CONCLUSION Injection of sclerosants and tissue glue may lead to gastric wall necrosis, which is a serious complication. Therefore, before administering this treatment to patients, we should consider other more effective methods of hemostasis to avoid gastric wall necrosis.
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Affiliation(s)
- Wei-Feng Li
- Department of Gastroenterology, Shenzhen Luohu People’s Hospital, Shenzhen 518020, Guangdong Province, China
| | - Ruo-Yu Gao
- Department of Gastroenterology, Shenzhen Luohu People’s Hospital, Shenzhen 518020, Guangdong Province, China
| | - Jing-Wen Xu
- Department of Gastroenterology, Shenzhen Luohu People’s Hospital, Shenzhen 518020, Guangdong Province, China
| | - Xi-Qiu Yu
- Department of Gastroenterology, Shenzhen Luohu People’s Hospital, Shenzhen 518020, Guangdong Province, China
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Yu KQ, Li HX, Wu J. Suspected coexistence of perianal necrotizing sweet syndrome in chronic myelomonocytic leukemia: A case report. World J Gastrointest Surg 2024; 16:1176-1183. [DOI: 10.4240/wjgs.v16.i4.1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/02/2024] [Accepted: 03/11/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Chronic myelomonocytic leukemia (CMML) complicated with Sweet syndrome (SS) is a rare hematological neoplasm. However, cases of concomitant development of perianal necrotizing SS (NSS) have not been reported.
CASE SUMMARY We report a case of a 49-year-old male patient who underwent sequential procedures for hemorrhoids and perianal abscess. He developed postoperative incision infection and was referred to the department where the authors work. Initially, perianal necrotizing fasciitis secondary to incision infection after perianal abscess surgery was suspected. Despite receiving antibiotic therapy and undergoing surgical debridement, deeper necrotic areas formed in the patient’s perianal wounds, accompanied by persistent high fever. Blood and fungal cultures yielded negative results. The final diagnosis was corrected to be CMML with suspected concomitant perianal NSS.
CONCLUSION CMML with perianal NSS is a rare condition, often misdiagnosed as perianal abscess or perianal necrotizing fasciitis. Conventional antibiotic therapy and surgical debridement are ineffective in managing this condition.
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Affiliation(s)
- Ke-Qiang Yu
- Clinical Medicine School, Chengdu University of Chinese Medicine, Chengdu 610072, Sichuan Province, China
- Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hui-Xiang Li
- Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jing Wu
- Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Kang MI, Kwon HC. Systemic lupus erythematosus in a 15-year-old female with multiple splenic nodules: A case report. World J Clin Cases 2024; 12:2128-2133. [DOI: 10.12998/wjcc.v12.i12.2128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/09/2024] [Accepted: 03/28/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is a chronic inflammatory disease primarily affecting young females. SLE can invade any organ, and various forms of splenic invasion have been reported. Manifestations include splenomegaly and splenic infarction, rupture, and calcification. The study encountered a rare case of splenic involvement, with nodules of various sizes without calcifications or ruptures.
CASE SUMMARY A 15-year-old girl presented with arthralgia, weight loss, fever, increased levels of inflammatory markers, and positive antinuclear antibody test results. The patient was diagnosed with SLE. She was asymptomatic while taking steroids and hydroxychloroquine. Ten months after discharge, the patient developed a fever and abdominal pain. Lupus enteritis was suspected, and abdominopelvic computed tomography (AP-CT) was performed. There were no specific findings in the gastrointestinal tract, but multiple splenic nodules were observed. Infection or hemangioma was considered; however, no specific radiological findings were observed. A biopsy of the spleen was performed to determine the possibility of malignancy. The histological findings of the spleen included extensive periarteriolar necrosis with hematoxylin bodies and numerous karyorrhectic debris. Based on the biopsy results, the patient was diagnosed with an SLE flare-up and was maintained on high-dose steroids and immunosuppressants.
CONCLUSION As disease activity increased, multiple nodules in the spleen that were previously unseen were observed using AP-CT and histologically confirmed. Spleen invasion by SLE can appear in multiple nodular forms and patterns. Therefore, physicians should consider these findings when differentiating these nodules from infections and malignancies.
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Affiliation(s)
- Mi Il Kang
- Division of Rheumatology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan-si 31116, South Korea
| | - Hyeok Chan Kwon
- Division of Rheumatology, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan-si 31116, South Korea
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Hu CD, Lv R, Zhao YX, Zhang MH, Zeng HD, Mao YW. Basilic vein variation encountered during surgery for arm vein port: A case report. World J Clin Cases 2024; 12:2086-2091. [DOI: 10.12998/wjcc.v12.i12.2086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/05/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Venous variations are uncommon and usually hard to identify, and basilic vein variation is particularly rare. Basilic vein variation usually presents without any clinical symptoms and is often regarded as a benign alteration. This case was a patient with congenital basilic vein variation encountered during surgery for an infusion port.
CASE SUMMARY We documented and analyzed an uncommon anatomical variation in the basilic vein encountered during arm port insertion. This peculiarity has hitherto remained undescribed in the literature. We offer remedial strategies for addressing this anomaly in the future and precautionary measures to circumvent its occurrence. We conducted a comprehensive review of analogous cases in the literature, offering pertinent therapeutic recommendations and solutions, with the aim of enhancing the efficacy and safety of future arm port implantations.
CONCLUSION Venous variation is rare and requires detailed intraoperative and postoperative examination to ensure accuracy, so as not to affect subsequent treatment.
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Affiliation(s)
- Cheng-Da Hu
- Department of Breast Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Rui Lv
- Department of Breast Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Ya-Xin Zhao
- Department of Breast Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Ming-Hao Zhang
- Department of Breast Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Hong-Dou Zeng
- Department of Breast Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Yi-Wen Mao
- Department of Breast Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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Tang ZW, Yang HF, Wu ZY, Wang CY. Crossed renal ectopia with rectal cancer: A case report. World J Clin Cases 2024; 12:2122-2127. [DOI: 10.12998/wjcc.v12.i12.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/04/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Crossed renal ectopia (CRE) occurs when one kidney crosses the midline from the primary side to the contralateral side while the ureter remains on the primary side. Rectal cancer, one of the most common malignant tumors of the digestive tract, refers to cancer from the dentate line to the rectosigmoid junction. The concurrent presentation of CRE alongside rectal cancer is an uncommon clinical observation.
CASE SUMMARY Herein, we report a 69-year-old male patient with rectal cancer who was diagnosed with CRE via computed tomography during hospitalization. Following thorough preoperative evaluations, the patient underwent Dixon surgery.
CONCLUSION We performed laparoscopic radical resection of rectal cancer and adequate lymph node removal in a patient with CRE with no postoperative discomfort.
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Affiliation(s)
- Zhen-Wei Tang
- Department of General Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, Hebei Province, China
| | - Hui-Feng Yang
- Department of General Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, Hebei Province, China
| | - Zhao-Yu Wu
- Department of General Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, Hebei Province, China
| | - Chang-You Wang
- Department of General Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, Hebei Province, China
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He YS, Qin XH, Feng M, Huang QJ, Zhang MJ, Guo LL, Bao MB, Tao Y, Dai HY, Wu B. Human immunodeficiency virus-associated dementia complex with positive 14-3-3 protein in cerebrospinal fluid: A case report. World J Clin Cases 2024; 12:2065-2073. [DOI: 10.12998/wjcc.v12.i12.2065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/22/2023] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)-associated dementia (HAD) is a subcortical form of dementia characterized by memory deficits and psychomotor slowing. However, HAD often presents with symptoms similar to those of Creutzfeldt-Jakob disease (CJD), particularly in patients with acquired immune deficiency syndrome (AIDS).
CASE SUMMARY We report the case of a 54-year-old male who exhibited cognitive dysfunction and secondary behavioral changes following HIV infection and suspected prion exposure. The patient was diagnosed with HIV during hospitalization and his cerebrospinal fluid tested positive for 14-3-3 proteins. His electroencephalogram showed a borderline-abnormal periodic triphasic wave pattern. Contrast-enhanced magnetic resonance imaging revealed moderate encephalatrophy and demyelination. Initially, symptomatic treatment and administration of amantadine were pursued for presumed CJD, but the patient’s condition continued to deteriorate. By contrast, the patient’s condition improved following anti-HIV therapy. This individual is also the only patient with this prognosis to have survived over 4 years. Thus, the diagnosis was revised to HAD.
CONCLUSION In the diagnostic process of rapidly progressive dementia, it is crucial to rule out as many potential causes as possible and to consider an autopsy to diminish diagnostic uncertainty. The 14-3-3 protein should not be regarded as the definitive marker for CJD. Comprehensive laboratory screening for infectious diseases is essential to enhance diagnostic precision, especially in AIDS patients with potential CJD. Ultimately, a trial of diagnostic treatment may be considered when additional testing is not feasible.
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Affiliation(s)
- Yun-Sen He
- Department of Neurosurgery, Sichuan Lansheng Brain Hospital & Shanghai Lansheng Brain Hospital Investment Co., Ltd., Chengdu 610036, Sichuan Province, China
| | - Xiao-Hong Qin
- Department of Psychiatry, Sichuan Provincial Center for Mental Health, Chengdu 610072, Sichuan Province, China
| | - Min Feng
- Department of Geriatrics, Municipal People’s Hospital in Luzhou, Luzhou 646000, Sichuan Province, China
| | - Qin-Jiang Huang
- Department of Neurosurgery, Wenjiang District People’s Hospital of Chengdu, Chengdu 611100, Sichuan Province, China
| | - Meng-Jun Zhang
- Department of Psychiatry, Sichuan Provincial Center for Mental Health, Chengdu 610072, Sichuan Province, China
| | - Li-Li Guo
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu, Chengdu 610072, Sichuan Province, China
| | - Ming-Bin Bao
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu, Chengdu 610072, Sichuan Province, China
| | - Ye Tao
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu, Chengdu 610072, Sichuan Province, China
| | - Hong-Yuan Dai
- Department of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
| | - Bo Wu
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China Chengdu, Chengdu 610072, Sichuan Province, China
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Hou TY, Tzeng WJ, Lee PH. Small intestine angioleiomyoma as a rare cause of perforation: A case report. World J Clin Cases 2024; 12:2116-2121. [DOI: 10.12998/wjcc.v12.i12.2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/13/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Angioleiomyoma is a rare and benign stromal tumor typically found in subcutaneous tissue. It rarely occurs in the gastrointestinal tract. Among the reported cases, the most common complication was gastrointestinal bleeding. Perforation has only been reported as a complication in the last few decades.
CASE SUMMARY This case report detailed the discovery of intestinal angioleiomyoma in a 47-year-old male presenting with abdominal pain that had persisted for 3 d. After suspecting hollow organ perforation, surgical intervention involving intestinal resection and anastomosis was performed.
CONCLUSION The report underscores the significance of early surgical intervention in effectively treating angioleiomyoma while emphasizing the pivotal role of timely and appropriate measures for favorable outcomes.
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Affiliation(s)
- Teng-Yuan Hou
- Department of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Wei-Juo Tzeng
- Department of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Pei-Hang Lee
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
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