OpenMed/multicare-articles huggingface dataset:
Acute Clinical Manifestation of Mesenteric Heterotopic Pancreatitis: A Pre- and Postoperative Confirmed Case
Authors: Bente M de Kok, Fleur I de Korte, Lars E Perk, Valeska Terpstra, J Sven D Mieog, Frank M Zijta
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Heterotopic pancreas is a relatively uncommon congenital anomaly, defined as pancreatic tissue in ectopic sites without an anatomic and vascular continuity with the main body of the pancreas. We report the case of a 58-year-old woman who was admitted to the hospital with the clinical suspicion of a mild, acute pancreatitis. Computed tomography, magnetic resonance imaging, transabdominal ultrasound, and endoscopic ultrasound revealed a normal orthotopic pancreas and the suspicion of a large heterotopic pancreas in the small bowel mesentery with signs of acute inflammation. The diagnosis of mesenteric heterotopic pancreatitis was preoperatively confirmed by endoscopic ultrasound-guided fine-needle aspiration and consequently histologically established after surgical resection.
Breakage of fascial closure device during laparoscopic surgery
Authors: A N Katara, D S Bhandarkar, R S Shah, T E Udwadia
Journal: J Minim Access Surg (2005)
Keywords: laparoscopic surgery, breakage, instrument
MeSH terms: Case Reports

Breakage of instruments during laparoscopic surgery is rare. However, when it does occur, locating and retrieving the broken part of the instrument can be cumbersome. Moreover, inability to do so may carry serious medicolegal implications. We report a patient in whom the tip of a fascial closure device broke during laparoscopic surgery. This was located by intraoperative fluoroscopy and retrieved from the extraperitoneal plane via a small incision. The paper discusses the probable factors responsible for breakage of the fascial closure device in our patient and reviews the previously reported cases of the rare complication of breakage of instruments during laparoscopic surgery.
Aortic Valvuloplasty as Bridging for TAVI in High-Risk Patients with Heyde's Syndrome: A Case Report
Authors: Cosmo Godino, Anna Giulia Pavon, Antonio Mangieri, Alberto Margonato
Journal: Case Rep Med (2012)

There is a frequent association between aortic valve stenosis and gastrointestinal bleeding, also known as Heyde's syndrome. In these patients, the aortic valve replacement should be recommended as "gold standard." In high-surgical-risk patients, the Transcatheter Aortic Valve Implantation (TAVI) is an alternative option. However, the risk of bleeding recurrence, related to double antiplatelet therapy started after TAVI, cannot be excluded especially in the first months. We present a case of a patient with a severe aortic valve stenosis and a history of previously documented angiodysplasia and recurrence of gastrointestinal bleeding initially treated only with balloon aortic valvuloplasty that excluded recurrence of bleeding during the subsequent six months of followup. Therefore, a definite transfemoral Edwards XT valve implantation was planned to be performed in case of recurrence of aortic stenosis.
Case report of surgical treatment of scoliosis caused by neurofibroma located posterior mediastinum
Authors: Nozomu Motono, Masahito Kawaguchi, Norio Kawahara, Hidetaka Uramoto
Journal: Int J Surg Case Rep (2018)
Keywords: case report, neurofibromatosis type 1, posterior mediastinum, scoliosis, spinal fusion

Background:
Neurofibromatosis type 1 (NF-1) is often associated with various orthopedic disorders, especially scoliosis. Spinal deformity in patients with NF-1 can be induced by localized neurofibromas.
Case presentation:
Scoliosis can be induced by a localized neurofibroma. A 12-year-old boy diagnosed with neurofibromatosis type 1 had severe scoliosis caused by a neurofibroma located in the posterior mediastinum. We performed two-stage procedure involving the extirpation of the neurofibroma in the lateral position, and posterior spinal fusion with segmental spinal instrumentation for the scoliosis in the prone position.
Discussion:
The optimum surgical approach for the extirpation of neurofibroma located in the posterior mediastinal remains to be established. It may be difficult to extirpate a tumor in this position via a posterior approach alone, as the tumor is surrounded by several tissue, e.g. azygos vein, trachea and esophagus. In our case, we first extirpated the tumor located in the posterior mediastinum via a posterolateral incision in the right lateral position. With this approach, it may be easy to confirm the safe relationship between the tumor and surrounding tissue.
Conclusions:
We safely performed a two-stage procedure involving the extirpation of a neurofibroma in the lateral position, and posterior spinal fusion with segmental spinal instrumentation for scoliosis in the prone position.
Speciation of arsenic trioxide metabolites in peripheral blood and bone marrow from an acute promyelocytic leukemia patient
Authors: Noriyoshi Iriyama, Yuta Yoshino, Bo Yuan, Akira Horikoshi, Yukio Hirabayashi, Yoshihiro Hatta, Hiroo Toyoda, Jin Takeuchi
Journal: J Hematol Oncol (2012)
MeSH terms: Arsenicals / blood, Arsenicals / pharmacology, Bone Marrow / metabolism, Leukemia, Promyelocytic, Acute / drug therapy, Leukemia, Promyelocytic, Acute / metabolism, Neoplasm Recurrence, Local / drug therapy, Oxides / blood, Oxides / pharmacology, Case Reports, Research Support, Non-U.S. Gov't, Antineoplastic Agents / blood, Antineoplastic Agents / pharmacokinetics, Antineoplastic Agents / pharmacology, Arsenic Trioxide, Arsenicals / pharmacokinetics, Chromatography, High Pressure Liquid, Drug Monitoring, Female, Humans, Mass Spectrometry, Middle Aged, Neoplasm Recurrence, Local / diagnosis, Neoplasm Recurrence, Local / metabolism, Oxides / pharmacokinetics, Prognosis, Remission Induction, Salvage Therapy, Tissue Distribution, Antineoplastic Agents, Arsenicals, Oxides, Arsenic Trioxide

Background:
Speciation of arsenic trioxide (ATO) metabolites in clinical samples such as peripheral blood (PB) from acute promyelocytic leukemia (APL) patients has been conducted. However, speciation of arsenicals in bone marrow (BM) has not yet been performed. Profiles of arsenic speciation in plasma of BM were thus investigated and compared with those of PB plasma from a relapsed APL patient. The total arsenic concentrations in high molecular weight fraction (HMW-F) of BM and PB plasma were also determined.
Methods:
Response assessment was evaluated by BM aspirate examination and fluorescence in situ hybridization analysis. The analyses of total arsenic concentrations and speciation were preformed by inductively coupled plasma mass spectrometry (ICP-MS), and high-performance liquid chromatography (HPLC)/ICP-MS, respectively.
Results:
Response assessment showed that the patient achieved complete remission. The total arsenic concentrations in BM plasma increased with time during the consecutive administration. The PB plasma concentrations of methylated arsenic metabolites substantially increased after the start of administration, while those of inorganic arsenic were still kept at a low level, followed by substantially increase from day-14 after administration. The arsenic speciation profiles of PB plasma were very similar to those of BM plasma. Furthermore, the total arsenic concentrations of HMW-F in BM plasma were much higher than those in PB plasma.
Conclusions:
The behaviors of arsenic speciation suggested for the first time that arsenic speciation analysis of PB plasma could be predicative for BM speciation, and showed relatively higher efficiency of drug metabolism in the patient. These results may further provide not only significance of clinical application of ATO, but also a new insight into host defense mechanisms in APL patients undergoing ATO treatment, since HMW proteins-bound arsenic complex could be thought to protect BM from the attack of free arsenic species.
Two Case Reports of Intravenous Leiomyomatosis with Hyaluronan Expression
Authors: Haruhisa Konishi, Iemasa Koh, Noriyuki Shiroma, Yukie Kidani, Satoshi Urabe, Norifumi Tanaka, Eiji Hirata, Koji Arihiro, Yoshiki Kudo
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Intravenous leiomyomatosis (IVL) is a rare benign neoplasm. Herein, we describe two cases of IVL at different levels of progression. The tumor in Case 1 was extensive, invading the right atrium after a hysterectomy for a uterine myoma. The tumor temporarily responded to hormonal treatment; however, tumor regrowth occurred. In contrast, the tumor in Case 2 extended only to the pelvic veins and was revealed preoperatively. Hysterectomy and bilateral salpingo-oophorectomy were performed, resulting in the complete surgical resection of the tumor. In Case 2, no recurrence has been observed. Tumor samples were evaluated for hyaluronan expression using Alcian blue staining (with and without hyaluronidase digestion). The tumor in Case 1 stained strongly positive for hyaluronan while the tumor in Case 2 stained weakly positive for hyaluronan. In contrast, a large non-IVL uterine leiomyoma (control) stained negative for hyaluronan. These results suggest a relationship between tumor hyaluronan expression and IVL progression, similar to that in other cancers.
Papillary Thyroid Cancer Affecting Multiple Family Members: A Case Report and Literature Review of Familial Nonmedullary Thyroid Cancer
Authors: Khaled Ahmed Baagar, Buthina Ibrahim Alowainati
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Familial nonmedullary thyroid cancer (FNMTC) represents 5-10% of NMTC cases. Many controversies are associated with the FNMTC, namely, the minimum required number of affected family members to define the condition, aggressiveness, prognosis, and treatment and screening recommendations. Moreover, the genetic basis of the FNMTC has not yet been identified. We report a family diagnosed with FNMTC and present a comprehensive literature review of the condition. The index case was a 26-year-old male who was diagnosed with locally advanced papillary thyroid cancer (PTC). Then, his family members became worried and asked for a neck ultrasound. Four of his six siblings, in addition to his father, were diagnosed with PTC. In addition, two of his cousins were diagnosed. The patient underwent total thyroidectomy with bilateral neck dissection, and he received 2 doses of radioactive iodine (100 mCi each). Furthermore, one of his siblings required a second surgery with repeated radioactive iodine therapy. The index case genetic screening and whole-exome sequencing did not show any abnormalities. Future genetic and clinical research should focus on kindred with 3 or more affected individuals for better identification of the FNMTC susceptibility genes and to better guide management and screening recommendations.
The hidden cause of chronic finger pain: Glomus Tumor - A Case Report
Authors: Anca Bordianu, Dragos Zamfirescu
Journal: J Med Life (2019)
Keywords: finger, glomus tumor, hand surgery, pain, pathology
MeSH terms: Fingers / pathology, Glomus Tumor / pathology, Pain / etiology, Case Reports, Adult, Antigens, CD34 / metabolism, Cell Proliferation, Female, Glomus Tumor / diagnostic imaging, Glomus Tumor / surgery, Humans, Ki-67 Antigen / metabolism, Magnetic Resonance Imaging, Mitosis, Thumb / diagnostic imaging, Thumb / surgery, Antigens, CD34, Ki-67 Antigen

Glomus tumors are frequently associated with pain, tenderness and cold sensitivity. We report the diagnosis and successful surgical management of a case of a classic glomus tumor in a young woman. The clinical diagnosis was made on the basis of medical history and MRI findings. The lesion was excised via a dorsolateral subungual approach, leading to the complete resolution of symptoms. Histology confirmed the lesion to be a glomus tumor. Glomus tumors are painful subungual lesions. They produce a throbbing or lancinating local discomfort, cold-sensitivity, and severe pain following minor trauma. The diagnosis is confirmed by histology, but the clinical diagnosis is highly suggestive. Complete excision will usually relieve pain. Recurrence is common following incomplete resection.
Fatal sclerosing mesenteritis: a 7-year-old male autopsy case report
Authors: Juan Carlos Celis Pinto, Lucía Hernández Peláez, Guillermo Mendoza Pacas, Juan Mayordomo Colunga, Milagros Balbín, Ana Pitiot, Héctor-Enrique Torres-Rivas, Verónica Blanco Lorenzo
Journal: Autops Case Rep (2023)
Keywords: autopsy, case reports, fatal outcome, panniculitis, peritoneal, pediatrics
MeSH terms: Case Reports

Sclerosing Mesenteritis (SM) is a rare diagnosis, particularly in pediatric patients, and is typically non-fatal when appropriately treated. Although molecular and immunohistochemical alterations have been described, no pathognomonic signature has been identified for this entity. This report presents a case of a seven-year-old boy who suffered sudden cardiorespiratory arrest. Upon autopsy, he was found to have multicentric SM on the upper mesentery, which led to bowel wall thinning and abdominal bleeding with bacterial translocation. We performed comprehensive morphological, immunohistochemical, and molecular analyses. SM is an atypical disorder with diverse clinical manifestations, including a rare but potentially fatal course. Early diagnosis is critical, given its potential severity. To our knowledge, this is the first case report of pediatric mortality linked to SM. Our findings emphasize the importance of increased awareness and early detection of SM in pediatric patients.
Insulin Independence in Newly Diagnosed Type 1 Diabetes Patient following Fenofibrate Treatment
Authors: Karsten Buschard, Laurits J Holm, Ulla Feldt-Rasmussen
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

A 19-year-old girl was diagnosed with type 1 diabetes and showing polydipsia and polyuria. She was double autoantibody-positive and had a diabetes-prone tissue type. She was immediately started on insulin. Fenofibrate treatment (160 mg daily) was initiated seven days after diagnosis. The need for insulin quickly declined, and she took her last dose of insulin 19 days after the first dose of fenofibrate, having regained endogenous control of blood glucose concentrations. She has now been insulin independent for one year and 9 months. Unstimulated C-peptide has increased by 51% (317 to 479 pmol/l), and IA-2 autoantibody level has decreased by 65% (49 to 17 × 103 arbitrary units). Fenofibrate is a widely used drug for reducing triglyceride and cholesterol levels. Fenofibrate reverses and prevents autoimmune diabetes in nonobese diabetic (NOD) mice by increasing the amount of the sphingolipid sulfatide in islets. Sphingolipid metabolism is otherwise abnormal in the islets at diagnosis of type 1 diabetes. In conclusion, we describe a 19-year-old patient with classical newly diagnosed type 1 diabetes, which following fenofibrate treatment has been without insulin for 21 months.
Anaphylactic Shock During Pediatric Anesthesia: An Unexpected Reaction to Sevoflurane
Authors: Alessandro Simonini, Etrusca Brogi, Brunella Gily, Mariangela Tosca, Claudia Barbieri, Francesca Antonini, Genny Del Zotto
Journal: Front Pediatr (2018)
Keywords: sevoflurane, allergy, anaphylactic shock, anaphylaxis, pediatric anesthesia, perioperative complications
MeSH terms: Case Reports

During general anesthesia, while muscle relaxants, latex and antibiotics are normally considered as very common causes of anaphylactic reactions, there are no documented cases of anaphylaxis due to inhalational agents. We report the case of a 6-year-old child scheduled for adenotonsillectomy who had an anaphylactic shock reaction due to Sevoflurane. Several allergic tests were performed to detect the trigger. Drugs used during operation were tested on both patient and three matched controls. While controls were negative, the patient displayed a positive reaction to Sevoflurane. To our knowledge, this is the first published report describing an allergic reaction caused by a volatile anesthetic.
Concurrent atypical diffused tuberculosis and macrorhabdosis in a canary (Serinus canaria)
Authors: Seyed Ahmad Madani, Mohammad Reza Haddad-Marandi, Fatemeh Arabkhazaeli
Journal: Vet Res Forum (2015)
Keywords: atypical tuberculosis, canary, macrorhabdosis, megabacteriosis, mycobacteriosis
MeSH terms: Case Reports

A dead canary from a mixed species zoological garden was presented for diagnostic necropsy. Cachexia with prominent atrophy of pectoral muscles, yellowish brown discoloration of the liver and kidney, dark brown to black intestinal contents and moderate proventricular dilatation with some degree of catarrhal gastritis were the significant macroscopic findings. Parenchymatous organs like the liver, the spleen, the lung and the kidneys were extremely affected by massive diffuse necrosis and heavy infiltration of mononuclear inflammatory cells, histopathologically. Many giant bacilli resembling Macrorrhabdus ornithogaster were seen microscopically in the wet smear of the isthmus mucosa. Ghost-like unstained bacilli were revealed in the Giemsa stained contact smears of the liver and spleen. No typical mycobacterial granulomatous lesion was found in different tissues, but in Ziehl-Neelsen stained thin layer histologic sections from the liver, spleen, lung and kidney, numerous acid fast organisms were diffusely distributed. The case was diagnosed an atypical avian tuberculosis with concurrent macrorhabdosis. Mycobacterium sp. are capable of giving rise to a progressive disease in humans, especially in immunocompromised individuals. Cases of avian tuberculosis might be overlooked for lack of pathognomonic lesions suggestive of mycobacteriosis.
Case Report: Two Cases of Watershed Phenomenon in Mechanical Circulatory Support Devices: Computed Tomography Angiography Imaging and Literature Review
Authors: Guiying Du, Jiwang Zhang, Junbo Liu, Lijuan Fan
Journal: Front Cardiovasc Med (2022)
Keywords: aortic root thrombus formation, case report, computed tomography angiography, extracorporeal membrane oxygenators, left ventricular assist devices, watershed phenomeno
MeSH terms: Case Reports

Mechanical circulatory support (MCS) has become a processing technique used in end-stage heart failure (ESHF) because it can significantly improve survival and quality of life in patients with ESHF as either a transitional support therapy or a permanent replacement therapy before heart transplant. However, various potential complications associated with MCS need to be considered, especially aortic root thrombus formation. It's critical to have an appropriate diagnosis of aortic root thrombus and "watershed" because the prognosis and treatment are different. Both "watershed" and aortic root thrombus formation can be characterized by computed tomography angiography. The CT manifestations of two patients who had MCS device implantation in our hospital (one with intra-aortic balloon pumps + extracorporeal membrane oxygenators, the other with left ventricular assist devices) were reported, and a literature review that recognized of "watershed" phenomenon in the aortic root was conducted.
Psychopathology Related to Energy Drinks: A Psychosis Case Report
Authors: Daniel Hernandez-Huerta, Maria Martin-Larregola, Jorge Gomez-Arnau, Javier Correas-Lauffer, Helen Dolengevich-Segal
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

Energy drinks (ED) are nonalcoholic beverages that have caffeine as their most common active substance. The rapid expansion of ED consumption has created concern in the scientific community as well as in the public opinion. We report a psychotic episode probably triggered by ED abuse in a young adult without previous psychotic disorders. We have reviewed the literature regarding the relationship between caffeine, energy drinks, and psychopathology. Few articles have been published about mental health effects of energy drinks and caffeine abuse. Nevertheless, this relationship has been suggested, specifically with anxiety disorders, manic episodes, suicide attempts, psychotic decompensation, and substance use disorder. ED consumption could represent a global public health problem because of the potential severe adverse effects in mental and physical health. To our knowledge, this article is probably the first case of psychosis related to ED abuse in an individual without previous psychotic disorders.
Multiple remote epidural hematomas following pineal gland tumor resection
Authors: Jeong-Wook Lim, Seung-Hwan Yang, Jong-Soo Lee, Shi-Hun Song
Journal: J Pediatr Neurosci (2010)
Keywords: hydrocephalus, multiple epidural hematoma, pineal tumor
MeSH terms: Case Reports

In cases of pineal tumor combined with obstructive hydrocephalus, preoperative ventriculostomy or ventriculoperitoneal shunting is typically required prior to tumor resection. The objectives of preoperative ventriculostomy are gradual reduction of intracranial pressure and consequent preoperative brain protection. Here we report a case of pineal tumor resection with preoperative ventriculostomy that was complicated by multiple epidural hematomas. While postoperative intracranial hemorrhage may occur at any site, it is rare in those areas remote from the operative field. In the present case, multiple remote sequential epidural hematomas developed following resection of a pineal gland tumor. We also discuss the pathophysiologic mechanisms and provide a literature review.
An atypical etiology of suprasphincteric fistula: a forgotten surgical material
Authors: Melih Paksoy, Volkan Ozben, Fadil Ayan, Arife Simsek
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

While the majority of fistulas in ano result from infection of the anal crypts, complex, recurrent, and/or nonhealing fistulas should always raise the suspicion of a chronic underlying condition. In this paper, we present a 30-year-old male patient with a diagnosis of a complex suprasphincteric fistula caused by a surgical thread left behind after an orthopedic hip operation performed sixteen years ago. Partial fistulectomy, extraction of the foreign material, and debridement procedures were performed. Few cases of such complex fistulas in ano due to foreign materials have been described in the literature. After careful history-taking, meticulous physical examination under general anesthesia should be done in order to deal with this rare type of fistula.
Port site intramuscular abscess from retained gallstone post laparoscopic cholecystectomy - an unusual complication
Authors: Faisal Syed, Gaik Si Quah, Angelina Di Re
Journal: J Surg Case Rep (2023)
MeSH terms: Case Reports

Perforation of the gallbladder and the spillage of gallstones can be a cause of ongoing morbidity and mortality in patients post cholecystectomy. We report on an unusual case of a 58-year-old male who developed a right upper quadrant lump 8 years after laparoscopic cholecystectomy which was eventually determined to be an abscess from a retained gallstone that had become embedded in the musculature of his abdominal wall. We have also discussed some of the considerations taken in the surgical management of this case.