OpenMed/multicare-articles huggingface dataset:
An unusual presentation of gastric fistula following peptic perforation repair: A case report
Authors: Mithilesh Kumar Sinha, Sudipta Mohakud, Tushar Subhadarshan Mishra, Apurba Barman
Journal: Int J Surg Case Rep (2019)
Keywords: gastric fistula, gastrocutaneous fistula, peptic perforation

Introduction:
Peptic perforation repair is a common stomach surgery. This surgery has not been associated with delayed onset gastrocutaneous fistula formation. However such a complication has been reported following a variety of other stomach surgeries. We are reporting this case as it is a rare complication. Also its diagnosis and management is challenging.
Case summary:
We are presenting a case of peptic perforation repair where burst abdomen happened in the immediate post-operative period. The patient was put on conservative management. He responded well to it but his abdominal wound was not healing. After a wait of four months the wound was covered with a skin graft. The graft uptake was satisfactory but a discharging ulcer appeared on it. This condition persisted for one month. Finally a computed tomography Fistulogram (CT Fistulogram) was performed. It revealed an underlying complex gastric fistula. A repeat surgery was performed.
Conclusion:
A gastrocutaneous fistula diagnosed at sixth month following the peptic perforation repair and causing minimal discomfort to the patient is a rare presentation. The abdominal wound following the surgery was possibly not healing because of the underlying fistula.
Recurrent pneumonia and a normal heart: late complication after repair of hemianomalous pulmonary venous drainage-a cautionary tale
Authors: Maryanne Caruana, Victor Grech, Jane Somerville
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Hemianomalous pulmonary venous drainage with intact atrial septum is a rare congenital anomaly and reports of its surgical repair and the long-term complications related to the correction are only infrequently encountered in the literature. We report the case of a patient with hemianomalous pulmonary venous drainage and intact atrial septum who underwent surgical repair using a pericardial baffle and creation of an "atrial septal defect" aged 15 years. Dyspnoea and recurrent chest infections started 7 months after surgery when he was seen by a respiratory physician without cardiac followup. He presented again aged 28 years with a recurrent pneumonia investigated over 6 weeks and heart pronounced normal from examination and echocardiography. Correct diagnosis was made in Grown Up Congenital Heart (GUCH) clinic stimulating review of data and catheterisation with pulmonary artery angiography which confirmed it. We feel that this case highlights the importance of specialist care and followup for GUCH patients.
Larynx Trauma and Hyoid Bone Fracture after Bite Injury in Dog: Case Report
Authors: George Manchi, Mathias M Brunnberg, Muhammad Shahid, Ahmad Al Aiyan, Leo Brunnberg, Silke Stein
Journal: Front Vet Sci (2016)
Keywords: bite, canine, dyspnea, hyoid fracture, larynx trauma, neck, shock
MeSH terms: Case Reports

An 8-year-old male Jack Russell crossbreed dog was admitted to our hospital with dyspnea and shock following a dog-bite injury on the ventral neck. Radiographs revealed subcutaneous emphysema and bilateral thyrohyoid bone fractures. Intraoperatively, rupture of both sternohyoid muscles, both hyoepiglotticus muscles, both thyrohyoid muscles, and a partial cranial rupture of the superficial sphincter colli muscle were detected. Part of the epiglottis was detached from the thyroid cartilage. The patient's severed muscles and torn epiglottis were reattached using a simple interrupted suture pattern. Hyoepiglotticus muscles could not be identified. The bilateral thyrohyoid bone fractures were repaired with intraosseous wire suture. A temporary tracheostomy tube and an esophageal feeding tube were placed postoperatively. The dog was discharged after 8 days, re-examined at 2 and 6 months and laryngeal and pharyngeal function were evaluated as normal. To the authors' knowledge, this is the first report of a dog that presented with laryngeal trauma with hyoid bone fracture and acute dyspnea that underwent surgical treatment resulting in an acceptable outcome.
Acute HIV Infection in Pregnancy: The Case for Third Trimester Rescreening
Authors: Jocelyn Wertz, Jason Cesario, Jennifer Sackrison, Sean Kim, Chi Dola
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

Combination testing with anti-HIV Elisa and Western blot is both sensitive and specific for diagnosis of established HIV-1 infection but could not detect acute HIV infection (AHI). AHI is a time of extremely high viral load, which may correlate to increased risk of horizontal or vertical transmission. Thus, early identification of AHI could allow for interventions to decrease transmission. However, recognition of AHI can be challenging as symptoms could be absent or nonspecific, therefore, AHI is often not detected, particularly in pregnancy. We present a case report of AHI in a pregnant woman who presented with headache and fever. She tested negative for HIV in the first trimester and at time of AHI at 26 3/7 weeks by anti-HIV Elisa, but was diagnosed with AHI based on an HIV RNA viral load of 434,000 copies/mL. This report presents a case for improved awareness of AHI in pregnancy, and the need for repeat HIV testing in late pregnancy, and highlighted that early detection of AHI might be possible with adding HIV RNA testing at time of standard anti-HIV Elisa screening test in pregnancy. Novel laboratory approaches including pooling of sera for HIV RNA could reduce the cost of HIV RNA testing.
Cyclist Endofibrosis (Exercise-Induced Arterial Endofibrosis) Treated by Drug-Coated Balloon Angioplasty
Authors: Ahmed S Zugail, Hossam I Shaabi, Slimane Idir, Jean-Pierre Becquemin
Journal: Case Rep Vasc Med (2020)
MeSH terms: Case Reports

Exercise-induced arterial endofibrosis is an uncommon entity that is most frequently identified in high-performance athletes, especially cyclists. We present this disease in a male professional cyclist of 22 years of age. The course of his condition, clinical manifestations, modalities of investigation, and a nonprecedent treatment plan are demonstrated.
Uncommon cause of fever in a child with steroid-dependent nephrotic syndrome
Authors: Sidharth Kumar Sethi, Shyam Bansal, Ronith Chakraborty, Rahul Jain, Nikita Wadhwani, Rupesh Raina
Journal: Clin Nephrol Case Stud (2020)
Keywords: cmv disease, mycoplasma pneumoniae, fever of unknown origin, mixed opportunistic infection, steroid-dependent nephrotic syndrome
MeSH terms: Case Reports

Background:
Children with nephrotic syndrome are vulnerable to developing infections due to a state of relative immunodeficiency, malnourishment, and use of immunosuppression. Case characteristics: We herein report the case of a 3-year-old child with steroid-dependent nephrotic syndrome who presented to us with fever of unknown origin.
Observation:
The child was found to have an atypical mixed infection with mycoplasma and cytomegalovirus.
Outcome:
The infection completely resolved with appropriate treatment and lowering of immunosuppression. Message: Persistently febrile pediatric patients, especially in the setting of recent immunosuppression and absence of otherwise-identified infectious pathogens, should be screened for atypical mixed infections.
Case report: Total percutaneous post-closure of femoral arterial access sites after veno-arterial extracorporeal membrane oxygenation
Authors: Lun Tian, Libin Zhang, Naiding Zhang, Xin Xu, Yongshan Xu, Zhenjie Liu, Man Huang
Journal: Front Med (Lausanne) (2022)
Keywords: perclose proglide, va-ecmo, arteriotomies, integrated algorithm, suture-mediated closure device
MeSH terms: Case Reports

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) which is a form of circulatory and gas exchange support. Following VA-ECMO, total percutaneous closure of the site of femoral arterial puncture with perclose Proglide (PP) has become widespread, enhancing patient comfort and lessening the incidence of wound infections and lymphatic fistulas in a short closure time. The preclose technique with perclose Proglide provides numerous benefits, however, it prolongs extra time during the VA-ECMO procedure, adds additional post-operative care to workloads, and increases the potential for Proglide stitch infection. The modified technique-percutaneous post-closure, described here by a case of a 65-year-old man with heart attack who underwent VA-ECMO, is a simple, rapidly applied technique to wean VA-ECMO also suitable for emergency cannulation. The patient was administered mechanically ventilated and sedated and the femoral artery access site and evaluated by ultrasound for precise positioning, then the VA-ECMO arterial cannula was withdrawn, and a 0.035-in guidewire was left in the artery. The first set of sutures was deployed after the Proglide device was inserted over the guidewire. The second sutures were then replaced in the same way but at a different angle. After hemostasis was achieved, the guidewire was removed, and additional manual compression was used to control any residual blood seeping. No hematoma, pseudoaneurysm, major bleeding, minor bleeding, acute arterial thrombosis, arteriovenous fistula, groin infection, lymphocele, or arterial dissection and stenosis occurred during the periprocedural period or during the 30-day post-procedural follow-up. In conclusion, the standardized algorithm we established, total percutaneous post-closure of femoral arteriotomies utilizing Perclose ProGlide device is feasible and safe with a low incidence of access site complications.
Hydatid cyst involving Right Pectoralis Major Muscle: A case report
Authors: ZakaUllah Jan, Salma Zeb, Azam Shoaib, Kaleem Ullah, Muhammad Muslim, Humaira Anjum, Hina Wazir, Mahmud Aurangzeb
Journal: Int J Surg Case Rep (2019)
Keywords: echinococcosis, hydatid cyst, pectoralis major

Background and aim:
Hydatid disease is caused by Echinococcus granulosus; a tapeworm. They rarely affect the musculoskeletal system of the body (<5% of cases). The objective of this case report is to discuss about hydatid cyst disease involving the right pectoralis major muscle.
Case presentation:
Herein, we report a case of a 35 years old lady who came to the outpatient department with a gradually increasing soft swelling at the right upper chest below the clavicle. The final diagnosis was made with the help of a CT scan. The cyst was excised and the area was washed with a scolicidal agent. There was no recurrence after six months of follow up and the patient was doing well.
Conclusion:
Hydatid cyst of the Pectoralis Major is rare and must be considered in the differential of any muscular swelling in the body in endemic areas. These cysts should be treated with enucleation/excicion followed by irrigation of the area with a scolicidal agent.
Ovarian cyst regression with levothyroxine in ovarian hyperstimulation syndrome associated with hypothyroidism
Authors: Roghieh Molaei Langroudi, Fatemeh Ghazanfari Amlashi, Mohammad Hassan Hedayati Emami
Journal: Endocrinol Diabetes Metab Case Rep (2013)

Background:
Spontaneous ovarian hyperstimulation syndrome (sOHSS) can occur following hypothyroidism. Ultrasonography facilitates diagnosis and monitoring of this syndrome. We describe ovarian sonographic changes in a hypothyroid patient with sOHSS after treatment with levothyroxine (l-T4).
Case presentation:
A 15-year-old girl presented with abdominal pain and distension for a few months. On examination, she had classical features of hypothyroidism. Abdominal and pelvic ultrasound revealed enlarged ovaries with multiple thin-walled cysts and mild ascitic fluid. On follow-up, abdominal ultrasound showed significant reduction of ovary size after 6 weeks of initiation of l-T4. Normal ovary size with complete regression of ovarian cysts was seen after 4 months.
Conclusion:
Serial ultrasound in sOHSS associated with hypothyroidism showed regression of ovarian cysts and ovarian volume after 4 months whereas in other studies, it is reported to happen in various durations, presumably according to its etiology.
Learning points:
OHSS can rarely occur due to hypothyroidism.This type of OHSS can be simply treated by l-T4 replacement, rather than conservative management or surgery in severe cases.Ultrasound follow-up shows significant regression of ovarian size and cysts within 6 weeks of initiation of l-T4.Ultrasound follow-up shows normal ovarian size with complete resolution of ovarian cysts 4 months after treatment.
Vertebral Stenting and Vertebroplasty Guided by an Angiographic 3D Rotational Unit
Authors: Escobar-de la Garma Víctor Hugo, Jorge-Barroso Henry Luis, Padilla-Vázquez Felipe, Balderrama-Bañares Jorge Luis
Journal: Case Rep Orthop (2015)

Introduction. Use of interventional imaging systems in minimally invasion procedures such as kyphoplasty and vertebroplasty gives the advantage of high-resolution images, various zoom levels, different working angles, and intraprocedure image processing such as three-dimensional reconstructions to minimize complication rate. Due to the recent technological improvement of rotational angiographic units (RAU) with flat-panel detectors, the useful interventional features of CT have been combined with high-quality fluoroscopy into one single machine. Intraprocedural 3D images offer an alternative way to guide needle insertion and the safe injection of cement to avoid leakages. Case Report. We present the case of a 72-year-old female patient with insidious lumbar pain. Computed tomography revealed a wedge-shaped osteoporotic compression fracture of T10 vertebrae, which was treated successfully with the installation of vertebral stenting system and vertebroplasty with methacrylate guided with a rotational interventional imaging system. Conclusion. Rotational angiographic technology may provide a suitable place for the realization of high-quality minimally invasive spinal procedures, such as kyphoplasty, vertebroplasty, and vertebral stenting. New software programs available nowadays offer the option to make three-dimensional reconstructions with no need of CT scans with the same degree of specificity.
Double-chambered right ventricle in an adult patient diagnosed by transthoracic echocardiography
Authors: Minna M D Romano, Rogério G Furtado, Cinthia G F Dias, Mauro Jurca, Oswaldo C Almeida-Filho, Benedito C Maciel
Journal: Cardiovasc Ultrasound (2007)
MeSH terms: Echocardiography, Heart Defects, Congenital / diagnostic imaging, Case Reports, Adult, Heart Defects, Congenital / surgery, Heart Ventricles, Humans, Hypertrophy, Right Ventricular / diagnostic imaging, Male

Background:
Double-chambered right ventricle is a rare congenital disease frequently misdiagnosed in the adult patient. An anomalous muscle band divides the right ventricle in two cavities causing variable degree of obstruction. Although echocardiography is considered a useful method for the diagnosis of this pathology in children, it has been recognized the transthoracic scanning limitation in adults.
Case presentation:
A 29 year-old patient with double-chambered right ventricle presenting mild exercise intolerance referred for follow up of a known ventricular septal defect in whom a complete diagnosis was obtained based only on transthoracic two dimensional echocardiography without the needing of cardiac catheterization.
Conclusion:
Based on non invasive echocardiographic diagnosis, patient was referred to surgical correction, which was completely successful.
Frameshift mutation in SQSTM1 causes proximal myopathy with rimmed vacuoles: A case report
Authors: Rui Wu, Sai Shao, Ling Yin, Jianwen Deng, Shougang Guo, Lin Lu
Journal: Front Neurol (2023)
Keywords: sqstm1, frameshift mutation, multisystem proteinopathy, myopathy, rimmed vacuoles

p62/Sequestosome-1 (SQSTM1) is a stress-inducible scaffold protein involved in multiple cellular processes, including apoptosis, inflammation, cell survival, and selective autophagy. SQSTM1 mutations are associated with a spectrum of multisystem proteinopathy, including Paget disease of the bone, amyotrophic lateral sclerosis, frontotemporal dementia, and distal myopathy with rimmed vacuoles (MRV). Herein, we report a new phenotype of SQSTM1-associated proteinopathy, a novel frameshift mutation in SQSTM1 causing proximal MRV. A 44-year-old Chinese patient presented with progressive limb-girdle weakness. She had asymmetric proximal limb weakness and myopathic features on electromyography. The magnetic resonance images showed fatty infiltration into muscles, predominantly in the thighs and medial gastrocnemius, sparing the tibialis anterior. Muscle histopathology revealed abnormal protein deposition, p62/SQSTM1-positive inclusions, and rimmed vacuoles. Next-generation sequencing showed a novel pathogenic SQSTM1 frameshift mutation, c.542_549delACAGCCGC (p. H181Lfs*66). We expanded the pathogenic genotype of SQSTM1 to include a new, related phenotype: proximal MRV. We suggest that SQSTM1 variations should be screened in cases of proximal MRV.
Mixed Epithelial and Stromal Tumor: A Rare Renal Neoplasm-Case Report with Clinicopathologic Features and Review of the Literature
Authors: Mukund Tinguria, Katherine Chorneyko
Journal: Case Rep Pathol (2023)
MeSH terms: Case Reports

Mixed epithelial and stromal tumor (MEST) is a rare benign renal neoplasm composed of epithelial and stromal components. Here, we report a 61-year-old woman presenting with a left complex cystic renal mass. The lesion was found incidentally on ultrasound for abdominal discomfort. CT scan and MRI showed a 7.4 cm complex cystic lesion in the left kidney. The differential diagnoses included complex renal cyst and cystic renal cell carcinoma. Laparoscopic nephrectomy showed a large 7.5 cm multicystic tumor with thick and thin septae and smooth walled-cysts containing clear watery fluid. Histologic examination showed variable sized cysts lined by flattened, cuboidal to columnar epithelium with focal hobnailing. No significant cytologic atypia or mitoses were noted. The cyst lining epithelium was positive for CK7 and high molecular weight cytokeratin (34Be12). The stroma was positive for alpha smooth muscle actin, CD10, estrogen receptor, and progesterone receptor. This report contributes an additional case to our collective knowledge of these lesions and summarizes the literature around these rare neoplasms.
Unexplained First Trimester Intrahepatic Cholestasis of Pregnancy: A Case Report and Literature Review
Authors: Anastasia A Salame, Mohammad J Jaffal, Marco A Mouanness, Amal R Nasser Eddin, Labib M Ghulmiyyah
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Intrahepatic cholestasis of pregnancy (ICP) is a condition that usually affects the 3rd trimester-pregnant women and is associated with adverse pregnancy outcomes. We present a 31-year-old G2P1 patient with symptoms of ICP as early as 10 weeks of gestation (WG). Her pruritis was initially attributed to eczema. Due to the intensity of her discomfort and failure of topical treatment, ICP was suspected, total bile acid salt levels were taken and ursodeoxycholic acid was subsequently started at 18 WG. The patient was followed closely during her pregnancy to adjust the dose of the medication accordingly. Induction of labor was performed at 37 WG without complications. This case demonstrated the importance of clinical suspicion in the setting of such symptomatology in order not to miss or delay treatment of threatening conditions such as ICP.
Confirmed Invasive Pulmonary Aspergillosis and COVID-19: the value of postmortem findings to support antemortem management
Authors: Monique Freire Santana, Guilherme Pivoto, Márcia A Araujo Alexandre, Djane Clarys Baía-da-Silva, Mayla Gabriela da Silva Borba, Fernando Almeida Val, Jose Diego Brito-Sousa, Gisely Cardoso Melo, Wuelton Marcelo Monteiro, João Vicente Braga Souza, Silviane Bezerra Pinheiro, Luiz Carlos Lima Ferreira, Felipe Gomes Naveca, Valdinete Alves Nascimento, André Lima Guerra Corado, Ludhmila Abrahão Hajjar, João Ricardo Silva Neto, George Alan Villarouco Siva, Alessandro C Pasqualotto, Marcus Vinícius Guimarães Lacerda
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: Aspergillus / isolation & purification, Betacoronavirus, Coronavirus Infections / pathology, Invasive Pulmonary Aspergillosis / pathology, Pneumonia, Viral / pathology, Case Reports, Aged, Aspergillus / genetics, Autopsy, COVID-19, Coronavirus Infections / complications, Fatal Outcome, Humans, Invasive Pulmonary Aspergillosis / complications, Lung / microbiology, Male, Pandemics, Pneumonia, Viral / complications, SARS-CoV-2

We present postmortem evidence of invasive pulmonary aspergillosis (IPA) in a patient with severe COVID-19. Autopsies of COVID-19 confirmed cases were performed. The patient died despite antimicrobials, mechanical ventilation, and vasopressor support. Histopathology and peripheral blood galactomannan antigen testing confirmed IPA. Aspergillus penicillioides infection was confirmed by nucleotide sequencing and BLAST analysis. Further reports are needed to assess the occurrence and frequency of IPA in SARS-CoV-2 infections, and how they interact clinically.
Stick a Needle in My Eye: A Case Report of Penetrating Needlefish Injury Causing Cavernous Sinus Thrombosis and Carotid Cavernous Fistula
Authors: Maimonah Alfaheed, Sarah Campos, Joel Gupta, Jabeen Fayyaz, Sasha Litwin
Journal: Cureus (2023)
Keywords: case report, cerebral vein thrombosis (cvt), needlefish, orbital cellulitis, orbital injury, pediatric emergency department (ped), traumatic carotid cavernous fistula
MeSH terms: Case Reports

While swimming in the ocean on vacation in Cuba, a previously healthy 17-year-old female was unexpectedly stabbed through her orbit and into her brain by a needlefish. This is a unique case of a penetrating injury causing orbital cellulitis, retro-orbital abscess, cerebral venous sinus thrombosis and carotid cavernous fistula. After initial management at a local emergency department, she was transferred to a tertiary care trauma centre where she was treated by a team of emergency, neurosurgery, stroke neurology, ophthalmology, neuroradiology and infectious disease physicians. The patient faced a significant risk of a thrombotic event. There was careful consideration from the multidisciplinary team about the utility of thrombolysis or an interventional neuroradiology procedure. Ultimately, the patient was treated conservatively with intravenous antibiotics, low molecular weight heparin and observation. The patient continued to show clinical improvement several months later, which supported the challenging decision to opt for conservative management. There are very few cases to guide the treatment of this type of contaminated penetrating orbital and brain injury.
Optic Disk Pit and Iridociliary Cyst Precipitating Angle Closure Glaucoma
Authors: Sushmita Kaushik, Parul Ichhpujani, Savleen Kaur, Surinder Singh Pandav
Journal: J Curr Glaucoma Pract (2014)
Keywords: angle closure glaucoma, optic disk, pit
MeSH terms: Case Reports

Primary angle closure glaucoma is usually a bilateral disease, though it may be asymmetrical. However, it is unusual to see advanced glaucoma in one eye and no disk damage in the other. We present a case of unilateral angle closure glaucoma complicated by an optic disk pit and iridociliary cysts. How to cite this article: Kaushik S, Ichhpujani P, Kaur S, Pandav SS. Optic Disk Pit and Iridociliary Cyst Precipitating Angle Closure Glaucoma. J Current Glau Prac 2014;8(1): 33-35.