OpenMed/multicare-articles huggingface dataset:
Isovaleric acidemia presenting as diabetic ketoacidosis: a case report
Authors: Mustafa Kılıç, Nazan Kaymaz, Rıza Köksal Özgül
Journal: J Clin Res Pediatr Endocrinol (2014)
MeSH terms: Amino Acid Metabolism, Inborn Errors / diagnosis, Diabetic Ketoacidosis / diagnosis, Hyperglycemia / diagnosis, Isovaleryl-CoA Dehydrogenase / deficiency, Case Reports, Child, Preschool, Diagnosis, Differential, Female, Humans, Isovaleryl-CoA Dehydrogenase, Acidemia, isovaleric

Isovaleric acidemia (IVA) is characterized by periodic vomiting, lethargy, coma, ketoacidosis and a 'sweaty feet' odor. Hyperglycemia, ketonemia, ketonuria and metabolic acidosis are the main clinical features of diabetic ketoacidosis (DKA) and these same symptoms can also be seen in acute attacks of metabolic diseases. We report a 2-year-old patient who presented with acute encephalopathy, hyperglycemia, metabolic acidosis, increased anion gap, ketosis and a preliminary diagnosis of DKA. Further investigation revealed IVA. This case is of interest because of the rarity of this presentation and detection of a splicing mutation in the isovaleryl-CoA dehydrogenase gene.
Unexpected disseminated histoplasmosis detected by bone marrow biopsy in a solid organ transplant patient
Authors: Caroline T Simon, Carlos A Murga-Zamalloa, Michael A Bachman, Lindsay A Petty, Sarah M Choi
Journal: Clin Case Rep (2017)
Keywords: bone marrow, ferritin, hemophagocytic lymphohistiocytosis, histoplasmosis
MeSH terms: Case Reports

Disseminated histoplasmosis and hemophagocytic lymphohistiocytosis show overlapping features, which require careful contextual interpretation. Histopathologic evaluation can potentially rapidly identify cases of possible histoplasmosis. A high index of clinical suspicion, particularly in endemic areas and in a setting of immunosuppression, is critical to appropriate diagnosis and treatment.
Aftermath of Grade 3 Ureteral Injury from Passage of a Ureteral Access Sheath: Disaster or Deliverance?
Authors: Roshan M Patel, Zhamshid Okhunov, Kamaljot Kaler, Ralph V Clayman
Journal: J Endourol Case Rep (2016)
Keywords: endopyelotomy stent, ureteral access sheath, ureteral injury, ureteral stent, ureteral stones, ureteroscopy, urolithiasis
MeSH terms: Case Reports

Background: The ureteral access sheath (UAS) has revolutionized the management of urinary pathology in the upper tract by providing rapid repeatable access to the upper urinary tract. However, in many practices, it remains a controversial tool in endourology given concerns of possible ureteral injury and presumed long-term sequela from those injuries. This case suggests that these concerns may be more hypothetical than real. Case Presentation: A 32-year-old female with a history of recurrent nephrolithiasis presented with left-sided symptomatic renal colic. She was found to have bilateral nephrolithiasis plus a left 6 × 5 mm proximal ureteral stone with associated moderate hydroureteronephrosis. The patient failed a trial of passage and as such was taken to the operating room for an elective ureteroscopy (URS) during which she sustained a Grade 3 ureteral splitting injury, measuring ∼2-3 cm, to the distal ureter from passage of the 16F UAS. At the end of the procedure a 7/10F endopyelotomy stent was placed. On follow-up URS at 6 weeks, there was no visual evidence of ureteral injury. A Lasix renal scan obtained 8 weeks after stent removal showed no evidence of obstruction. Conclusion: High-grade ureteral injuries sustained from UAS passage are rare. However, when injuries of this nature occur, the concern over long-term damage to the ureter may well be overstated.
Gastric stricture following corrosive agent ingestion: A case report
Authors: Gunadi, Mukhamad Arif Munandar, Aditya Rifqi Fauzi, Susan Simanjaya, Wahyu Damayanti
Journal: Int J Surg Case Rep (2020)
Keywords: corrosive agent, endoscopic examination, gastric outlet obstruction, gastric stricture, gastrojejunostomy and braun anastomosis, pediatric case
MeSH terms: Case Reports

Introduction:
Gastric stricture due to corrosive ingestion is a rare cause of obstruction in the upper gastrointestinal tract in children. However, only a few reports highlight the management of the stricture of the gastric antrum and pylorus, i.e. gastric outlet obstruction (GOO) due to corrosive ingestion, particularly in children.
Presentation of case:
We report a 1-year-old male who presented with chief complaints of upper abdominal pain and profuse vomiting after accidentally ingesting sulfuric acid one month prior. On physical examination, minimal epigastric distension was found. Endoscopic examination showed oesophagitis, erosive gastritis, multiple gastric ulcers and suspicion of pyloric stricture. We decided to perform an exploratory laparotomy and found severe strictures from the major curvature to the gastric pylorus. Subsequently, we conducted gastrojejunostomy and Braun anastomosis. The patient was discharged on the eighth postoperative day uneventfully.
Discussion:
Endoscopy is a reliable technique for assessing upper digestive tract mucous membranes after caustic agent ingestion because it helps in making a definitive diagnosis, especially to define the anatomic location and injury severity. The timing and type of surgery for GOO is controversial. We performed Braun anastomosis in addition to gastrojejunostomy because of several advantages over other surgical methods.
Conclusion:
We recommend choosing an appropriate supporting examination to precisely diagnose gastric stricture due to corrosive ingestion. Gastojejunostomy and Braun anastomosis show a good outcome for gastric stricture due to corrosive ingestion, particularly in children.
Off pump coronary artery bypass surgery in a Nigerian teaching hospital
Authors: Michael Sanusi, Bode Falase, Salisu Ismail, Adetinuwe Majekodunmi, Adeyemi Johnson, Ifeoluwa Ajose, David Oke
Journal: Pan Afr Med J (2013)
Keywords: coronary artery bypass surgery, lagos, nigeria, left anterior descending coronary artery, left internal mammary artery, off pump
MeSH terms: Coronary Artery Bypass, Off-Pump, Coronary Artery Disease / surgery, Case Reports, Female, Hospitals, Teaching, Humans, Middle Aged, Nigeria

Coronary artery bypass grafting has not been previously reported in the Nigeria medical literature. We report the case performed in our institution of a 56 year old Nigerian female who underwent off pump coronary artery bypass surgery (OPCAB) for an ostial lesion of the left anterior descending coronary artery. The left internal mammary artery was successfully anastomosed to the left anterior descending coronary artery. The patient was discharged home after 2 weeks, following correction of problems with glycemic control.
A Case of Perilymphatic Fistula with Inner Ear Anomaly Diagnosed Preoperatively by the Cochlin-Tomoprotein Detection Test
Authors: Kana Lee, Naoki Ochi, Kohei Yamahara, Kunihiko Makino, Tetsuo Ikezono
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

We present a case of perilymphatic fistula (PLF) with inner ear anomalies having sudden, progressive sensorineural hearing loss and describe the fistula repair surgeries. We focus on the diagnosis methods of PLF and clinical course of PLF with inner ear anomaly. The cochlin-tomoprotein (CTP) detection test is very useful for the surgeons to encourage the earlier operation to sudden hearing loss cases. It is also helpful to define the diagnosis of PLF after operation. We could not get the good result as to hearing from the fistula repair surgery mainly because surgery was held 1 month after the onset. The results of the case, as well as recommendations of other reports, suggest that patients with sudden sensorineural hearing loss and PLF may need repair surgery within at most 2 weeks from the onset. We describe how to diagnose PLF more accurately using CTP detection combined with intraoperative findings.
Pericardial Effusion With Tamponade in Lung Cancer Patients During Treatment With Nivolumab: A Report of Two Cases
Authors: Masahiro Yamasaki, Wakako Daido, Naomi Saito, Kunihiko Funaishi, Takenori Okada, Kazuma Kawamoto, Yu Matsumoto, Naoko Matsumoto, Masaya Taniwaki, Nobuyuki Ohashi, Noboru Hattori
Journal: Front Oncol (2019)
Keywords: nivolumab, non-small cell lung cancer, pericardial effusion, pseudo-progression, tamponade
MeSH terms: Case Reports

Background: Nivolumab is an immune checkpoint inhibitor (ICI) that has shown efficacy for treating non-small cell lung cancer and has become a standard therapy for previously treated non-small cell lung cancer. Moreover, immune-related adverse events of ICI therapy are well-known. Malignant pericardial effusions occasionally arise in patients with lung cancer. There have been a few reports of pericardial effusion in non-small cell lung cancer after nivolumab administration. However, the cause of this condition is controversial; the possibilities include serositis as an immune-related adverse event or pseudo-progression. Case Presentation: This report presents two cases of pericardial effusion with tamponade in lung cancer during treatment with nivolumab. Both patients experienced temporal increases in pericardial effusions followed by effusion regression. In one case, nivolumab administration was continued after performance of pericardiocentesis, without an increase in pericardial effusion. In the other case, temporal simultaneous increases in both the pericardial effusion and the primary tumor were detected, followed by simultaneous regression in both the effusion and the tumor. These findings support the fact that the pericardial effusions were caused by pseudo-progression. Conclusions: Pericardial effusion with tamponade can occur in lung cancer patients being treated with nivolumab; moreover, some of these effusions might be caused by pseudo-progression. In the case of putative pseudo-progression, continuation of nivolumab administration might be allowable with strict follow up.
Perforated Duodenal Diverticulum Treated Conservatively: Another Two Successful Cases
Authors: Jad A Degheili, Mohammed H Abdallah, Ali A Haydar, Ahmad Moukalled, Ali H Hallal
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Diverticula of the duodenum proceed those of the colon in respect to frequency of location. Incidence at times of autopsy ranges from 15 to 23%. Despite the fact that more than 90% of duodenal diverticulum cases are asymptomatic, complications if they do occur can be calamitous. Perforation is one of these rare complications. Surgical intervention has always been the mainstay for symptomatic/complicated duodenal diverticula, but with the advancement of imaging, medical treatment, and proper intensive observation, conservative treatment came forth. We hereby present two cases of duodenal diverticula, complicated by perforation and fistulization into the retroperitoneal cavity, both treated conservatively by Taylor's approach of upper gastrointestinal tract perforation. Review of other cases of duodenal diverticulum perforation has also been presented.
Intrascrotal Testicular and Extratesticular Epidermoid Cysts: About Two Cases
Authors: Jean-Sebastien Bertrand, Ana Falticeanu, Olivier Lebecque
Journal: J Belg Soc Radiol (2022)
Keywords: epidermoid cyst, scrotum, testis
MeSH terms: Case Reports

Painless solid testicular masses on ultrasonography are commonly malignant. However, if the lesion is well demarcated, rounded, and hypoechoic with alternating hyperechoic and hypoechoic layers, and no internal vascular flow, the possibility of an epidermoid cyst should be considered. Epidermoid cysts are uncommon benign testicular lesions and are extremely rare in the intrascrotal extratesticular region. Including these cysts in the differential diagnosis may allow the urologist to perform testis-sparing surgery. Teaching Point: The possibility of an epidermoid cyst should be considered when a scrotal mass shows an 'onion ring' appearance on sonography and no vascularity on Doppler.
A large multifocal aggressive osteoblastoma of mandible: an immunohistochemistry case study report
Authors: Vinuth D P, Poonam Agarwal, Dilip Gadewar, Gunjan Dube, Rajesh Dhirawni
Journal: J Dent Res Dent Clin Dent Prospects (2014)
Keywords: aggressive osteoblastoma, cytokeratin, immunohistochemistry, mandible, p53
MeSH terms: Case Reports

Aggressive osteoblastoma (AO) is a benign osteoblastic tumor which is rare in the head and neck region. Clinical and histo-logical features are therefore overlap with other benign and low-grade malignant tumors. The aim of this article is to report and discuss the differential diagnosis of an aggressive osteoblastoma in the mandible. A 25-year-old male patient reported with pain and asymmetry on the left side of the face since 8 months previously. Radiographic evaluation showed a mixed lesion extending from approximately the lower left premolar to the third molar region. After incisional biopsy, resection with continuity defect was carried out. Microscopic findings showed woven bone and bony trabeculae with varied degrees of mineralization along with sheets of osteoblast cells. Immunohistochemistry showed that p53 and cytokeratin (CK) were negative and ki-67 index was 7%. Postoperative follow-up for 15 months showed no evidence of recurrence.
Mitral valve surgery in patients with systemic lupus erythematosus
Authors: Mahnoosh Foroughi, Manouchehr Hekmat, Mohsen Ghorbani, Hamid Ghaderi, Masoud Majidi, Mahmood Beheshti
Journal: ScientificWorldJournal (2014)
MeSH terms: Lupus Erythematosus, Systemic / surgery, Mitral Valve Insufficiency / surgery, Mitral Valve Stenosis / surgery, Case Reports, Review, Systematic Review, Adolescent, Female, Heart Valve Prosthesis Implantation / trends, Humans, Lupus Erythematosus, Systemic / complications, Lupus Erythematosus, Systemic / diagnosis, Mitral Valve Insufficiency / complications, Mitral Valve Insufficiency / diagnosis, Mitral Valve Stenosis / complications, Mitral Valve Stenosis / diagnosis

Valvular heart disease is the common cardiac manifestation of systemic lupus erythematosus (SLE) with a tendency for mitral valve regurgitation. In this study we report a case of mitral valve replacement for mitral stenosis caused by Libman-Sacks endocarditis in the setting of SLE. In addition, we provide a systematic review of the literature on mitral valve surgery in the presence of Libman-Sacks endocarditis because its challenge on surgical options continues. Surgical decision depends on structural involvement of mitral valve and presence of active lupus nephritis and antiphospholipid antibody syndrome. Review of the literature has also shown that outcome is good in most SLE patients who have undergone valvular surgery, but association of antiphospholipid antibody syndrome with SLE has negative impact on the outcome.
Splenic Artery Aneurysm Case Report
Authors: Pouya Abhari, Sina Abhari, Anwar Jackson, Ahmed S Z Moustafa, Leo Mercer, Mohammad Ashraf
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Splenic artery aneurysm rupture is a rare complication of pregnancy with very high maternal and fetal mortality rate. In this paper, a case of splenic artery aneurysm rupture at 34 weeks of gestation with both maternal and fetal survival is presented.
Metastatic melanoma: An unusual cause of gastrointestinal bleeding and intussusception-A case report
Authors: Sílvia Silva, Nádia Tenreiro, Ana Melo, José Lage, Herculano Moreira, Fernando Próspero, Paulo Avelar
Journal: Int J Surg Case Rep (2018)
Keywords: intussusception, malignant melanoma, melanoma metastasis, small bowel bleeding, small bowel obstruction, case report

Introduction:
Malignant melanoma is responsible for 1-3% of all malignancies being the gastrointestinal tract one of the most common metastatic locations.
Presentation of case:
We present the case of a 71-year old male with previous history of cutaneous melanoma. Seven years later, while being studied due to suspected small bowel bleeding, he developed small bowel obstruction after being submitted to double balloon enteroscopy. Further investigation revealed small bowel intussusception. He was taken up for emergency laparotomy that confirmed ileal intussusception secondary to an intraluminal mass. We performed segmental enterectomy with primary anastomosis. Histology confirmed intestinal melanoma metastasis.
Discussion:
Malignant melanoma frequently spreads to the gastrointestinal tract. The presentation is mainly asymptomatic and the diagnosis is often made only after complications develop. Small bowel intussusception and gastrointestinal bleeding are unusual presentations of metastatic melanoma, with few cases reported. Surgical resection not only provides symptom control but also positively affects prognosis.
Conclusion:
Although usually asymptomatic, melanoma metastasis should always be considered in a patient with intestinal symptoms or chronic anemia and personal history of melanoma. Surgical resection is the treatment of choice, leading to an increase in overall survival.
Anterior maxillary dentigerous cyst
Authors: Monika Rohilla, Nikhil Marwah, Rishi Tyagi
Journal: Int J Clin Pediatr Dent (2009)
Keywords: dentigerous cyst, enucleation
MeSH terms: Case Reports

Dentigerous cyst is a development odontogenic cyst, which apparently develops by accumulation of fluid between reduced enamel epithelium and the tooth crown of an unerupted tooth. It is one of the most prevalent types of odontogenic cysts associated with an erupted, developing or impacted tooth, particularly the mandibular 3rd molars, the other teeth that are commonly affected are maxillary canines and third molars. The present case report describes the surgical enucleation of a dentigerous cyst involving permanent lateral incisor, the surgery was followed by oral rehabilitation.
Diagnosis of Systemic Lupus Erythematosus in a Polynesian Male with a History of Rheumatic Fever: A Case Report and Literature Review
Authors: Charyse Diaz, Matthew A Lim, Chloe A Liu, Chloe S Miwa, Darcy Tokunaga, Faith D Hamamura, Kara Yamamoto, David Kurahara
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

The presence of rheumatic heart disease (RHD) and systemic lupus erythematosus (SLE) has rarely been described in one patient. This report describes an adolescent Polynesian male with RHD who developed SLE years later. Initially, he fulfilled modified Jones criteria for rheumatic fever with aortic insufficiency, transient arthritis, elevated streptococcal titers, and a high erythrocyte sedimentation rate with a negative antinuclear antibody (ANA). He responded well to nonsteroidal anti-inflammatory and penicillin prophylaxis, which supported the diagnosis of rheumatic fever. Five years after his RHD diagnosis, he developed pancreatitis with glomerulonephritis, nephrosis, and pancytopenia. In addition, laboratory results revealed that he had multiple autoantibodies: anti-Sm and extremely elevated anti-dsDNA and ANA, fulfilling diagnostic criteria for SLE. The patient was treated, and he responded to pulse steroids followed by oral steroid therapy. To our knowledge, there are no known reported cases of a patient who was diagnosed with both RHD and SLE and met the clinical criteria for both diseases. The rarity of this concurrent disease process in one patient suggests a possible overlap in humoral immunity toward self-antigens as well as ethnic variability that increases predisposition to rheumatologic diseases.
Salvage splenopexy for torsion of wandering spleen in a child
Authors: Ram Babu Goyal, Rahul Gupta, Girish Prabhakar, Praveen Mathur, Tariq Ahmed Mala
Journal: APSP J Case Rep (2014)
Keywords: salvage splenopexy, splenic torsion, wandering spleen
MeSH terms: Case Reports

The wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all of the splenic suspensory ligaments that resulting in increased splenic mobility and rarely torsion. Preventing infarction is the aim of a prompt surgery by splenopexy. We report a case of salvage splenopexy in torsion of a wandering spleen in a three year old girl presented with severe abdominal pain for three days.
A primary retroperitoneal mucinous tumor
Authors: Alicia A Heelan Gladden, Max Wohlauer, Martine C McManus, Csaba Gajdos
Journal: Case Rep Surg (2015)

A twenty-five-year-old female presented with a large retroperitoneal mass. Workup included history and physical exam, imaging, biopsy, colonoscopy, and gynecologic exam. After surgical resection, the mass was determined to be a primary retroperitoneal mucinous tumor (PRMT). Clinically and histologically, these tumors are similar pancreatic and ovarian mucinous neoplasms. PRMTs are rare and few case reports have been published. PRMTs are divided into mucinous cystadenomas, mucinous borderline tumors of low malignant potential, and mucinous carcinoma. These tumors have malignant potential so resection is indicated and in some cases adjuvant chemotherapy and/or surveillance imaging.
Hyperandrogenism in menopause: a case report and literature review
Authors: Andrey V Dolinko, Elizabeth S Ginsburg
Journal: Fertil Res Pract (2015)
Keywords: androgenization, gnrh agonist, menopause, postmenopausal androgenization, testosterone
MeSH terms: Case Reports

Hyperandrogenism is an uncommon diagnosis in postmenopausal women. In this case, we report on a 69-year-old postmenopausal woman who presented with several months of worsening hirsutism of the face, neck, and chin, which was confirmed on examination. Laboratory testing revealed markedly elevated testosterone levels and typical post-menopausal gonadotropin levels. Transvaginal ultrasonography and pelvic and abdominal magnetic resonance imaging (MRI) failed to reveal an ovarian or adrenal abnormality. The patient was a poor surgical candidate and was counseled to start on gonadotropin releasing hormone (GnRH) agonist therapy. Administration of leuprolide resulted in a dramatic decline in testosterone levels. The patient reported significant "hot flashes", difficulty sleeping, anxiety, and depression secondary to treatment, and patient discontinued leuprolide therapy 3 months after initiation. To our knowledge, this is the first case that describes a woman being treated with a GnRH agonist for hyperandrogenism subsequently discontinuing GnRH agonist treatment due to significant side-effects. This case also highlights the difficulty of prescribing appropriate but off-label use of expensive medications not covered by insurance in a senior population of limited income.
Correlative imaging and histopathology of a complicated sinonasal teratocarcinosarcoma
Authors: Tineke van Zyl, Leon Janse van Rensburg, Komeela Naidoo, Marc Merven, Johan F Opperman
Journal: SA J Radiol (2023)
Keywords: sinonasal teratocarcinosarcoma, computerised tomography, diffusion-weighted imaging, histopathology, intracranial, magnetic resonance imaging
MeSH terms: Case Reports

Sinonasal teratocarcinosarcoma (SNTCS) is a highly malignant and rare tumour characterised by a complex admixture of teratomatous and carcinosarcomatous components. In the head and neck area, it almost exclusively occurs in the sinonasal cavities; however, rare instances of nasopharyngeal and oral cavity involvement have been reported, with fewer than 100 cases reported in the literature.
Contribution:
The contributed case involves the correlative CT, MRI and histopathology of a sinonasal teratocarcinosarcoma with intracranial involvement.