OpenMed/multicare-articles huggingface dataset:
Idiopathic Spontaneous Intraperitoneal Hemorrhage Due to Vascular Malformations in the Muscularis of the Stomach: A Case Report
Authors: Yuhang Zhou, Yuchen Zhou, Weihua Li, Shengtao Lin
Journal: Front Med (Lausanne) (2022)
Keywords: abdominal apoplexy, case report, endoscopic ultrasonography, idiopathic spontaneous intraperitoneal hemorrhage, vascular malformation
MeSH terms: Case Reports

Idiopathic spontaneous intraperitoneal hemorrhage (ISIH) is a phenomenon caused by spontaneous rupture of intra-abdominal visceral vessels, and vascular malformations (VMs) leading to ISIH are rare in previously reported cases. VMs of the gastric wall, which are commonly located in the mucosa and submucosa, mostly lead to upper gastrointestinal bleeding rather than intraperitoneal hemorrhage. To our knowledge, this is the first report of ISIH caused by VMs in gastric muscularis. In the current case, a 22-year-old male patient presented with sudden abdominal pain for 4 h, accompanied by tachycardia and hypotension. CT revealed a hematoma in the omental bursa and fluids in abdominopelvic cavities. Then intraperitoneal hemorrhage was confirmed after abdominal paracentesis. Furthermore, ultrasonic gastroscopy indicated that vascular malformation in the muscularis of the stomach probably led to intraperitoneal hemorrhage. The patient recovered after conservative treatment based on fluid resuscitation and remained stable for 12 months of follow-up. This case suggests that VMs located in the gastrointestinal tract may lead to ISIH and ultrasonic gastroscopy is helpful in the diagnosis of VMs in the gastrointestinal tract.
Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up
Authors: Vincenzo Luca Zizzari, Gianmarco Tacconelli
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR) with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants' position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.
Left Brachiocephalic Vein Stenosis due to the Insertion of a Temporal Right Subclavian Hemodialysis Catheter
Authors: Eleni I Skandalou, Fani D Apostolidou-Kiouti, Ilias D Minasidis, Ioannis K Skandalos
Journal: Case Rep Vasc Med (2017)
MeSH terms: Case Reports

Central vein stenosis/occlusion is a common well-described sequel to the placement of hemodialysis catheters in the central venous system. The precise mechanisms by which central vein stenosis occurs are not well known. Current concepts in central vein stenosis pathophysiology focus on the response to vessel injury model, emphasizing the process of trauma. A case of left brachiocephalic vein stenosis due to the insertion and function of a temporary right subclavian hemodialysis catheter is presented. The purpose of the manuscript is to emphasize that, with the introduction of a temporary subclavian hemodialysis catheter via the right subclavian vein apart from causing concurrent stenosis/infarction of the right subclavian and right brachiocephalic vein, it is also possible to cause stenosis of the left brachiocephalic vein (close to its contribution to the superior vena cava) although the catheter tip is placed in the correct anatomical position in the superior vena cava.
Trombose venosa profunda e vírus chicungunha
Authors: Marcos Arêas Marques, Fernanda Penza Adami de Sá, Otília Lupi, Patricia Brasil, Arno von Ristow
Journal: J Vasc Bras (2017)
MeSH terms: Case Reports

Abstract:
Some systemic viral infections can be linked to development of deep venous thrombosis and/or pulmonary embolism. This association has already been well described in patients infected by human immunodeficiency virus (HIV), hepatitis C, and influenza. The chikungunya virus is the etiologic agent of chikungunya fever and it has recently been introduced to the American continent. As yet, there is no firm foundation for a relationship between chikungunya and thromboembolism, but the progressive increase in its incidence, the fact that this infection very often causes severe locomotion restrictions due to polyathralgia, and the possibility of direct endothelial injury suggest that cases of venous thromboembolism may begin to be described. In this case report, we describe a patient who developed thrombosis of the right popliteal vein after being admitted for treatment of severe polyathralgia and fever caused by chikungunya virus infection.
Naphthalene induced acute kidney injury in an African patient in Ghana: a case report
Authors: Elliot Koranteng Tannor, Kojo Awotwi Hutton-Mensah
Journal: Pan Afr Med J (2019)
Keywords: naphthalene, acute kidney injury, acute tubular necrosis, glucose-6-phosphate dehydrogenase deficiency
MeSH terms: Acute Kidney Injury / chemically induced, Naphthalenes / poisoning, Renal Dialysis / methods, Case Reports, Acute Kidney Injury / physiopathology, Acute Kidney Injury / therapy, Adult, Ghana, Humans, Male, Urethritis / therapy, Naphthalenes, naphthalene

Naphthalene is commonly used in Ghana as an insecticide and there have been occasional ingestion unintentionally ingestion in children. Naphthalene use has been associated with intravascular haemolysis especially in patients with glucose-6-phoshate dehydrogenase (G6PD) deficiency but its unorthodox use for the treatment of urethritis in a young man and its associated acute kidney injury has not been described in Ghana. This case report bring to fore the indiscriminate use of complementary medicines and the multiple adverse effects on the kidneys after the ingestion of a combination of naphthalene, alcohol and aluminium sulphate (Alum) as a treatment for urethritis upon a friend's suggestion requiring intermittent haemodialysis but recovered completely of his renal functions. Naphthalene ingestion can cause acute tubular necrosis from haemoglobinuria and timely interventions are necessary to restore renal and maintain good renal functions.
Case report: Fulminant type 1 diabetes following paucisymptomatic SARS-CoV-2 infection during late pregnancy
Authors: Lingling Zhou, Huanjia Qu, Qiuling Zhang, Jinhua Hu, Lan Shou
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: case report, coronavirus disease 2019 (covid- 19), fulminant type 1 diabetes, pregnancy, severe acute respiratory syndrome coronavirus 2
MeSH terms: COVID-19 / complications, Diabetes Mellitus, Type 1, Hyperglycemia, Ketosis, Case Reports, Research Support, Non-U.S. Gov't, Female, Humans, Insulin / metabolism, Pandemics, Pregnancy, SARS-CoV-2 / metabolism, Insulin

Background:
Dysregulation of glucose metabolism has been linked to SARS-CoV-2 infection. In addition, the occurrence of new onset diabetes mellitus, including fulminant type 1 diabetes, has been reported after SARS-CoV-2 infection or vaccination.
Methods and results:
A young Chinese woman in her last trimester of pregnancy presented with an abrupt progression of hyperglycemia and ketoacidosis, but with a near-normal glycohemoglobin level following paucisymptomatic SARS-CoV-2 infection. The low C peptide levels, both fasting and postprandial, reflected profound insulin deficiency in the setting of negative islet autoantibody testing, consistent with a diagnosis of fulminant type 1 diabetes. Ketoacidosis and hyperglycemia quickly improved following the introduction of insulin therapy, but not the β cell function. The patient received treatment with insulin pump therapy after being discharged, and the first follow-up revealed a well-controlled glucose profile.
Conclusions:
New-onset FT1D can occur after SARS-CoV-2 infection. Our report raises awareness of this rare but serious situation, promoting early recognition and management of FT1D during the COVID-19 pandemic.
Pre-Peritoneal Dialysis Peritonitis After Saline Infusion Sonohysterogram in a Patient With an Embedded Catheter: A Case Report
Authors: Alexandre Cosmatos, Brendan McCormick, Brian Blew, Pierre Antoine Brown
Journal: Can J Kidney Health Dis (2023)
Keywords: antibiotic prophylaxis, embedded peritoneal dialysis catheter, peritoneal dialysis, peritonitis, pre-peritoneal dialysis peritonitis
MeSH terms: Case Reports

Rationale:
Clear guidelines currently exist regarding antibiotic prophylaxis for patients on peritoneal dialysis (PD) prior to common diagnostic procedures. However, these guidelines do not include patients with subcutaneously embedded PD catheters who are awaiting PD initiation although both these populations share a great deal of risk factors for infections. Issues regarding antibiotic prophylaxis and avoidable infections are bound to keep occurring if physicians are not conscious of the risks of infections shared by all patients suffering from renal failure.
Presenting concerns:
Two weeks after a saline infusion sonohysterography (SIS), a 48-year-old woman with chronic kidney disease (CKD) G5 ND, type 2 diabetes, a subcutaneously embedded PD catheter, and prior abnormal uterine bleeding presented to the emergency department complaining of nausea, vomiting, diarrhea, weakness, and abdominal pain. The patient received no antibiotic prophylaxis prior to her SIS.
Diagnoses:
The final diagnosis of peritonitis was established after acute kidney injury, gastroenteritis, and small bowel obstruction were considered and ruled out. A delay in the final diagnosis occurred because of the complex presentation, the fact that the patient had not yet initiated PD, and the presence of concomitant anion gap metabolic acidosis and an acute elevation of the patient's creatinine.
Interventions:
The patient was started on broad-spectrum intravenous antibiotics when the diagnosis of peritonitis was established. Insulin and intravenous bicarbonate infusions were used to correct the patient's anion gap metabolic acidosis. Surgical debridement of the necrotic subcutaneous tissue and removal of the embedded PD catheter were necessary.
Outcomes:
The patient's infection resolved completely as did her anion gap metabolic acidosis. The patient had to transfer permanently from PD to hemodialysis for her renal replacement therapy.
Teaching points:
This case report serves as a good reminder that physicians should keep in mind the possibility of peritonitis in patients with embedded PD catheters. As these patients are also at risk of infections, antibiotic prophylaxis should be used in patients with embedded catheters in the same way it is used for PD patients prior to obstetrical, gynecological, or gastrointestinal procedures.
Case Report: Significant Efficacy of Pyrotinib in the Treatment of Extensive Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Cutaneous Metastases: A Report of Five Cases
Authors: Nan Wang, Lin Li, Youyi Xiong, Jiangrui Chi, Xinwei Liu, Chaochao Zhong, Fang Wang, Yuanting Gu
Journal: Front Oncol (2021)
Keywords: her2-positive breast cancer, case report, cutaneous metastases, pyrotinib, tyrosine kinase inhibitors (tkis)
MeSH terms: Case Reports

Background:
Breast cancer (BC) is the most common tumor to develop cutaneous metastases. Most BCs with cutaneous metastasis are human epidermal growth factor receptor 2 (HER2)-positive subtypes. Although the molecular mechanisms of breast cancer metastasis to different sites and the corresponding treatment methods are areas of in-depth research, there are few studies on cutaneous metastasis.
Case presentation:
Five HER2-positive BC patients with extensive cutaneous metastases were treated with a regimen containing pyrotinib, a novel small-molecule tyrosine kinase inhibitor that irreversibly blocks epidermal growth factor receptor (EGFR), HER2, and human epidermal growth factor receptor 4 (HER4), then their cutaneous metastases quickly resolved at an astonishing speed and their condition was well controlled during the follow-up period.
Conclusions:
This case series reports the significant therapeutic effect of pyrotinib on cutaneous metastases of HER2-positive BC for the first time. Based on this, we recommend that pyrotinib can be used as a supplement to trastuzumab for HER2-positive BC patients with cutaneous metastases. In addition, we should consider that the pan-inhibitory effect of pyrotinib on EGFR, HER2, and HER4 may provide a dual therapeutic effect against HER2 and mucin 1.
Endodontic management of a maxillary first molar with two palatal canals and a single buccal canal: a case report
Authors: Leila Atash Biz Yeganeh, Mamak Adel, Reza Vahedi, Maryam Tofangchiha
Journal: Case Rep Dent (2012)

Thorough knowledge of root canal morphology is essential for the endodontic therapy. There are rare variations in canal number and configuration in maxillary molars, which could affect treatment outcome. This paper presents the endodontic management of a maxillary first molar with two palatal canals in one root (Vertucci type IV) and a single buccal canal. In this paper cone-beam computed tomography was made to asses this morphology. This paper is intended to reinforce clinician's awareness of the rare morphology of root canals.
Peritoneal Tuberculosis: A Forsaken Yet Misleading Diagnosis
Authors: Joseph Kattan, Fady Gh Haddad, Lina Menassa-Moussa, Carole Kesrouani, Stephanie Daccache, Fady G Haddad, David Atallah
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

In women presenting with an abdominal mass and ascites, the first diagnosis to consider is ovarian cancer. However, clinicians should always consider alternative differentials, namely, peritoneal tuberculosis, especially in the presence of respiratory symptoms and with the increasing prevalence of extrapulmonary tuberculosis. Peritoneal tuberculosis can mimic the clinical presentation of ovarian cancer, and on imaging, it can show similar features of peritoneal carcinomatosis and nodules. Tumor markers can also be elevated in the absence of malignancy. We present the case of a 44-year-old woman with abdominal distension and ascites. Imaging with CT scan, MRI, and PET scan were inconclusive, showing peritoneal nodules. Cytology of ascites was negative. Laparoscopy was done showing Koch bacilli followed by pulmonary sampling showing Mycobacterium tuberculosis. The patient was treated with quadritherapy with resolution of symptoms.
Complete Laparoscopic Nephroureterectomy for the Upper Urinary Tract Urothelial Carcinoma in a Female Patient with Severe Senile Kyphosis: An Initial Case Report
Authors: Hidenori Zakoji, Tatsuya Miyamoto, Satoru Kira, Norifumi Sawada, Yuko Ootake, Hiroshi Shimura, Takahiko Mitsui, Masayuki Takeda
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

Kyphosis is usually described as the deformity of the spine that results in an abnormally round back. Patients with kyphosis form a challenging group to laparoscopic surgeons because of difficulties in positioning and abdominal approach. The narrow abdomen causes difficulty with trocar insertion and some operative procedures. Here we report the transperitoneal complete laparoscopic nephroureterectomy in a case of kyphosis. An 81-year-old woman underwent this operation for urothelial carcinoma of the upper urinary tract. We took best care of the positioning and the trocar insertion; we could have accomplished utilizing four ports at semilateral position without any troubles and complications. This procedure is safe and feasible, and not thought to be a contraindication for the patients with senile kyphosis.
Utilization of a Continuous Pericapsular Nerve Group (PENG) Block with an Opioid-Sparing Repair of a Femoral Neck Fracture in a Pediatric Patient
Authors: Karla Wyatt, Moustafa Zidane, Chyong-Jy Joyce Liu
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

In the pediatric population, femoral neck fractures are usually associated with high-impact trauma and often present with pain in the groin area. Regional anesthesia can offer adjunctive therapy for acute pain management. Various techniques have been employed to circumvent pain related to hip fractures and resultant hip surgery. Neuraxial, lumbar plexus, caudal, epidural, fascia iliaca, and femoral continuous nerve block techniques are advantageous in mitigating hip pain. However, these approaches require patient repositioning during placement and carry the potential for motor blockade with resultant weakness. A newly described method, the Pericapsular Nerve Group (PENG) block, allows for analgesia of the anterior hip capsule via the obturator, accessory obturator, and femoral nerves while sparing motor blockade. PENG blockade has demonstrated efficacy in both adult and pediatric patients. Herein, we describe the perioperative course of a 9-year-old girl with a transcervical femoral neck fracture who underwent an opioid-sparing open repair with the utilization of a continuous PENG block. PENG blockade via a continuous nerve block resulted in optimal analgesia and markedly reduced perioperative opioid consumption with preserved motor function. Our experience facilitated early discharge and rehabilitation mobility while reducing potential rebound hyperalgesia and enabling parental/patient satisfaction.
POLG1 mutations and stroke like episodes: a distinct clinical entity rather than an atypical MELAS syndrome
Authors: Antonella Cheldi, Dario Ronchi, Andreina Bordoni, Bianca Bordo, Silvia Lanfranconi, Maria Grazia Bellotti, Stefania Corti, Valeria Lucchini, Monica Sciacco, Maurizio Moggio, Pierluigi Baron, Giacomo Pietro Comi, Antonio Colombo, Anna Bersano, Lombardia GENS collaborators
Journal: BMC Neurol (2013)
MeSH terms: DNA-Directed DNA Polymerase / genetics, MELAS Syndrome / genetics, Mutation / genetics, Stroke / genetics, Case Reports, Research Support, Non-U.S. Gov't, Aged, DNA Polymerase gamma, Electron Transport Complex IV / metabolism, Genetic Testing, Humans, MELAS Syndrome / complications, MELAS Syndrome / pathology, Magnetic Resonance Imaging, Male, Muscle, Skeletal / pathology, Stroke / complications, Stroke / pathology, Electron Transport Complex IV, DNA Polymerase gamma, DNA-Directed DNA Polymerase, POLG protein, human

Background:
POLG1 mutations have been associated with MELAS-like phenotypes. However given several clinical differences it is unknown whether POLG1 mutations are possible causes of MELAS or give raise to a distinct clinical and genetic entity, named POLG1-associated encephalopathy.
Case presentation:
We describe a 74 years old man carrying POLG1 mutations presenting with strokes, myopathy and ragged red fibers with some atypical aspects for MELAS such as late onset, lack of cerebral calcification and presence of frontal and occipital MRI lesions better consistent with the POLG associated-encephalopathy spectrum.
Conclusion:
The lack of available data hampers a definite diagnosis in our patient as well as makes it difficult to compare MELAS, which is a clearly defined clinical syndrome, with POLG1-associated encephalopathy, which is so far a purely molecularly defined syndrome with a quite heterogeneous clinical picture. However, the present report contributes to expand the phenotypic spectrum of POLG1 mutations underlining the importance of searching POLG1 mutations in patients with mitochondrial signs and MELAS like phenotypes but negative for common mtDNA mutations.
Rapunzel Syndrome-An Extremely Rare Cause of Digestive Symptoms in Children: A Case Report and a Review of the Literature
Authors: Cristina Oana Marginean, Lorena Elena Melit, Maria Oana Sasaran, Razvan Marginean, Zoltan Derzsi
Journal: Front Pediatr (2021)
Keywords: rapunzel syndrome, children, trichobezoar, trichophagia, trichotillomania
MeSH terms: Case Reports

Rapunzel syndrome is an extremely rare condition seen in adolescents or young females with psychiatric disorders consisting of a gastric trichobezoar with an extension within the small bowel. The delays in diagnosis are common since in its early stages, it is usually asymptomatic. We report the case of a 13-year-old girl admitted in our clinic for abdominal pain, anorexia, and weight loss. The clinical exam pointed out diffuse alopecia, a palpable mass in the epigastric area, and abdominal tenderness at palpation, the patient weighing 32 kg. The laboratory tests showed anemia. The abdominal ultrasound showed a gastric intraluminal mass with a superior hyperechoic arc. The upper digestive endoscopy revealed a mass formed by hair, mucus, and food occupying the gastric cavity with the extension into the duodenum confirming the diagnosis of Rapunzel syndrome. The giant trichobezoar of 511 g, measuring 17 × 7 × 6.5 cm with a tail of approximately 3 cm, was successfully removed through laparotomy. Although rare, Rapunzel syndrome must never be forgotten as a differential diagnosis for digestive symptoms since its early detection hinders the occurrence of further complications.
Histologically confirmed isolated IgG4-related hypophysitis: two case reports in young women
Authors: Gabriela Alejandra Sosa, Soledad Bell, Silvia Beatriz Christiansen, Marcelo Pietrani, Mariela Glerean, Monica Loto, Soledad Lovazzano, Antonio Carrizo, Pablo Ajler, Patricia Fainstein Day
Journal: Endocrinol Diabetes Metab Case Rep (2014)

IgG4-related hypophysitis is a recently described entity belonging to the group of IgG4-related diseases. Many other organs can also be affected, and it is more common in older men. To date, 32 cases of IgG4-related hypophysitis have been reported in the literature, 11 of which included confirmatory tissue biopsy and the majority affecting multiple organs. The aim of this report is to present two cases of biopsy-proven IgG4-related hypophysitis occurring in two young female patients with no evidence of involvement of other organs at the time of diagnosis.
Learning points:
IgG4-related hypophysitis belongs to the group of IgG4-related diseases, and is a fibro-inflammatory condition characterized by dense lymphoplasmacytic infiltrates rich in IgG4-positive plasma cells and storiform fibrosis.It is more common in older men, but young women may also present this type of hypophysitis.Although involvement of other organs is frequent, isolated pituitary disease is possible.Frequent clinical manifestations include anterior hypopituitarism and/or diabetes insipidus.THE DIAGNOSIS MAY BE CONFIRMED WITH ANY OF THE FOLLOWING CRITERIA: a pituitary biopsy with lymphoplasmacytic infiltrates, with more than ten IgG4-positive cells; a sellar mass and/or thickened pituitary stalk and a biopsy-proven involvement of another organ; a sellar mass and/or thickened pituitary stalk and IgG4 serum levels >140 mg/dl and sellar mass reduction and symptom improvement after corticosteroid treatment.Glucocorticoids are recommended as first-line therapy.
Systemic Lupus Erythematosus Presenting with Alveolar Hemorrhage
Authors: Omar Tolaymat, Florentina Berianu
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

Introduction:
Diffuse alveolar hemorrhage is a rare presentation of systemic lupus erythematosus. Early diagnosis and appropriate treatment can improve outcome.
Case report:
An 18-year-old male presented with hemoptysis and respiratory distress requiring orotracheal intubation. Laboratory tests showed positive anti-nuclear antibody and anti-dsDNA and low C3 and C4. Bronchoalveolar lavage became progressively hemorrhagic after each aliquot. He was treated with pulse methylprednisolone, cyclophosphamide, and plasma exchanges.
Discussion:
Alveolar hemorrhage is a rare initial presentation of lupus, with mortality rates reported at about 50%. Lupus should be considered in those presenting with alveolar hemorrhage since delay in therapy may cause a rapid deterioration of the patient. The diagnosis of SLE is illusive when DAH is the presenting symptom. Since early diagnosis and appropriate institution of treatment improve outcome, it is important to keep lupus in mind as an etiology of alveolar hemorrhage. Pulse methylprednisolone, cyclophosphamide, and plasmapheresis therapy resulted in rapid improvement of respiratory function in our patient.