OpenMed/multicare-articles huggingface dataset:
Synchronous sigmoid and transverse volvulus: A case report and qualitative systematic review
Authors: Abdourahmane Ndong, Mohamed Lamine Diao, Jacques Noel Tendeng, Adja Coumba Diallo, Philippe Manyacka Ma Nyemb, Ibrahima Konaté
Journal: Int J Surg Case Rep (2020)
Keywords: colon, sigmoid, simultaneous, transverse, volvulus
MeSH terms: Case Reports

Introduction:
Colonic volvulus is defined as a torsion of a part of the colon causing large bowel obstruction by strangulation which may lead to ischemia and then necrosis. The synchronous occurrence of a sigmoid colon and transverse colon volvulus is exceptional. We describe a case of synchronous sigmoid and transverse volvulus in a patient with a qualitative systematic review of this condition.
Presentation of the case:
This is a 74-year-old patient with a history of chronic constipation, who consulted for bowel obstruction. Plain abdominal radiography showed diffuse gas distension of the colon with the absence of rectal gas. An exploratory laparotomy was performed and showed sigmoid colon volvulus associated with synchronous transverse colon volvulus without bowel necrosis. A left hemicolectomy with loop colostomy was performed. The restoration of bowel continuity was done 3 weeks. The post-operative course was uneventful.
Discussion:
The occurrence of a simultaneous sigmoid and transverse colonic volvulus is an exceptional situation. Due to the rarity of this clinical entity, the literature concerning its description is sparse and the treatment options are poorly codified. There are no guidelines in the treatment and a tailored approach should be used for each patient.
Conclusion:
The dual location of strangulation makes this situation a major surgical emergency with a high risk of gangrene and septic shock. Colectomy with delayed anastomosis should be preferred in the treatment.
Immunoglobulin a (IgA) Vasculitis in the Elderly
Authors: Adriana Girao, José A Fernandes, Filipe S Mira, Rui Pina
Journal: Cureus (2023)
Keywords: elderly population, glomerular iga staining, henoch-schönlein purpura (iga vasculitis), ig a vasculitis, iga nephropathty, palpable purpura
MeSH terms: Case Reports

IgA vasculitis is a small vessel vasculitis mediated by the deposition of IgA immune complexes. It mostly occurs in children and is rare in adults, with increased severity and mortality in the latter. Its aetiology remains largely unknown, and its prognosis depends primarily on the extent of renal involvement. We present the case of a 71-year-old woman with purpuric lesions in both lower and upper limbs associated with fever, abdominal pain, vomiting and blood in her stools for the past month. The patient was diagnosed with IgA vasculitis and the full systemic involvement (renal, dermatological, intestinal, and cerebral) of the disease was identified with excellent response to parenteral corticotherapy.
Everolimus Implicated in Case of Severe Gastrointestinal Hemorrhage
Authors: Paul Gonzales, Seth Klusewitz, Johanna Marowske, John Gancayco, Michael B Osswald, Robert Setlik
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Breast cancer remains the leading cause of cancer and the third leading cause of cancer related deaths among our population with an estimated number of 246,660 new cases and 40,450 deaths in 2016. With treatment advancements, including targeted agents such as Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, survivability and quality of life continue to improve. However, with the use of these agents come adverse effects, some of which are still being characterized. Our case demonstrates recurrent episodes of gastrointestinal bleeding in a 60-year-old woman being treated with Everolimus for progressive metastatic breast cancer. On endoscopy, bleeding was secondary to erosive gastritis. Previous case reports have described bleeding due to gastric antral vascular ectasia (GAVE), which was described in two prior reported cases. In our case, bleeding also occurred on a reduced dose of Everolimus compared to what is previously reported (5 mg versus 10 mg). As a result of her gastrointestinal bleeding, she required multiple endoscopic interventions including argon plasma coagulation and multipolar heater probe to achieve hemostasis. This is the first case reported of gastrointestinal bleeding not consistent with GAVE and occurring while being on a reduced dose of Everolimus. It is important to document our case so that the Gastroenterology and Hematology communities can be educated and made aware for their patient populations on Everolimus.
Seizure and Pulmonary Embolism: A Differential That Can Save a Life
Authors: Seyedmohammad Pourshahid, Sneha Dedhia, Shakeeb Hakim, Mohamed Barakat, Dennis Genin
Journal: Case Rep Pulmonol (2017)
MeSH terms: Case Reports

Seizures is a relatively common presentation with a wide differential diagnosis. However, seizures presenting secondary to underlying pulmonary emboli are rare and, without prompt recognition and management, this easily treatable condition can be potentially fatal. The few available case reports discussing seizures and PE reveal a high mortality rate which underscores the importance of prompt diagnosis. A 38-year-old woman presented to the emergency room having experienced loss of consciousness and a generalized tonic-clonic seizure at home. In the emergency room, her presenting signs and symptoms included tachycardia, worsening dyspnea, mild hypoxemia, and elevated D-dimer. Pertinent history findings revealed she recently received depot hormonal contraceptive treatments. Her initial workup included an EKG which showed sinus tachycardia without evidence of right heart strain. Subsequently a chest CT with angiography revealed massive bilateral pulmonary emboli. DVT studies also revealed a unilateral acute DVT. The patient was promptly started on therapeutic anticoagulation and stabilized. Fortunately, the patient remained symptom-free and eventually was discharged with close follow-up. The goal of this report is to make clinicians more aware of the possibility that seizures, along with the appropriate clinical findings, can be caused by acute PE.
COVID-19 and Guillain-Barré Syndrome: A Case Report and Review of Literature
Authors: Antonio Zito, Enrico Alfonsi, Diego Franciotta, Massimiliano Todisco, Matteo Gastaldi, Matteo Cotta Ramusino, Mauro Ceroni, Alfredo Costa
Journal: Front Neurol (2020)
Keywords: amsan, covid-19, sars-cov-2, guillain–barré syndrome, miller fisher syndrome, post-infectious
MeSH terms: Case Reports

During the recent coronavirus disease 2019 (COVID-19) outbreak in Northern Italy, we observed a 57-year-old man developing acute motor-sensory axonal neuropathy, a variant of Guillain-Barré syndrome (GBS), 12 days after severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. Similarly to other bacterial and viral infections, dysregulation of the immune system due to post-infectious mechanisms, such as the molecular mimicry, could lead to an indirect damage of the peripheral nervous system related to SARS-CoV-2. GBS causes motor dysfunctions that are not easily recognizable in non-neurological settings or in patients requiring ventilatory assistance. Several reports also suggested that GBS and Miller Fisher syndrome (MFS) could be neurological complications of COVID-19. Therefore, we performed a review of the 29 articles so far published, describing 33 GBS cases and five MFS cases associated with SARS-CoV-2 infection. We recommend awareness of this rare, but treatable, neurological syndrome, which may also determine a sudden and otherwise unexplained respiratory deterioration in COVID-19 patients.
Ulcerative Gastritis and Esophagitis in Two Children with Sarcina ventriculi Infection
Authors: Tim G J de Meij, Michiel P van Wijk, Aart Mookhoek, Andries E Budding
Journal: Front Med (Lausanne) (2017)
Keywords: is-pro, sarcina ventriculi, children, esophagitis, gastritis, microbiota
MeSH terms: Case Reports

Sarcina ventriculi is a Gram-positive, obligate anaerobic coccus, with a characteristic morphology. Only 22 cases of human infections by this microorganism, including 7 in children, have been reported in literature so far. Affected subjects usually present with abdominal pain, nausea, vomiting, and delayed gastric emptying. However, life-threatening complications, like emphysematous gastritis and gastric perforation have also been described. Gastroparesis and gastric outlet obstruction have been considered as a potential etiologic factor. All pediatric cases described thus far presented with concomitant gastrointestinal pathology, such as Helicobacter pylori gastritis, celiac disease, infection with Giardia lamblia or Candida spp. Here, we report two children with S. ventriculi infection, in whom the diagnosis was established by typical histological findings in mucosal biopsies. The first child presented with hematemesis due to ulcerative esophagitis and gastritis, the second child with a history of esophageal stricture had ulcerative gastritis. Confirmation of S. ventriculi infection is feasible by molecular microbiota detection methods, since this microorganism cannot be detected by classical culture techniques. Prompt treatment with antibiotics could prevent life-threatening complications.
A clinical update on massive ovarian oedema - a pseudotumour?
Authors: Rs Praveen, Vr Pallavi, K Rajashekar, A Usha, K Umadevi, Ud Bafna
Journal: Ecancermedicalscience (2013)
Keywords: massive ovarian oedema, fertility-sparing surgery, ovarian drilling, ovarian reconstruction, pseudotumour of ovary

Objective:
Benign massive ovarian oedema is a rare clinical entity arising from the ovaries, and it poses a significant clinical challenge as it can be easily mistaken for neoplasm. Due to the lack of pathognomonic clinical features or characteristic hallmarks on non-invasive diagnostic modalities and the dependence on the final histopathology, the efforts of the surgeon have been deviated from performing fertility-sparing surgery on young women. The lack of standardised guidelines due to the rarity of this condition calls for a review of the literature to enable the clinician to formulate treatment guidelines.
Methods and material:
A Medline search on the PubMed database for literature published in English from 1969 to 2011 was done using the keywords 'massive ovarian oedema, massive ovarian oedema case report or case series, and pseudotumour of ovary'. A total of 177 women who had undergone a variety of treatments were retrieved. We also report the management options we used for four women presenting to us between August 2000 and October 2011, as well as a review of the literature.
Result:
A total of 177 cases of massive ovarian oedema were identified. Out of these cases 151 (85.3%) were primary massive ovarian oedema; secondary massive ovarian oedema was identified in 26 (14.7%) cases. A salpingo-oophorectomy was done in 145 (81.9%) cases, 12 (6.8%) cases had an abdominal hysterectomy with bilateral salpingo-oophorectomy. A total of 76 (42.9%) cases intraoperatively were found to have ovarian torsions, and one patient with primary massive ovarian oedema had ascites. Conservative treatment was carried out in 20 (11.3%) patients; 14 of these had a wedge biopsy with frozen section and with or without ovarian suspension, one patient had diagnostic laparotomy, and five cases had only ultrasonographic or magnetic resonance imaging monitoring and symptomatic treatment. The four cases treated at the regional cancer institute from 2000 to 2011 revealed that the first three cases had salpingo-oophorectomy and the fourth case received a successful conservative treatment.
Conclusion:
The majority of massive ovarian oedemas will respond to judicious use of intraoperative wedge resection and frozen section for the confirmation of diagnosis. The detorsion and transfixation of the ovary or partial debulking and drainage of fluid accumulated in the cyst may be more appropriate to preserve hormonal function and fertility in these young women.
An unusual case of fatty posterior mediastinal ganglioneuroma
Authors: Abdelrahman M Abdelazim, Smita A Patel, Shawn Haji-Momenian, M I Almira-Suarez, M Reza Taheri
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Ganglioneuromas, which arise from neural crest cells, are typically seen in adolescent and young adults. We describe an unusual case of posterior mediastinal ganglioneuroma with a large fatty component in a middle-aged male. This imaging feature has only been reported in five published manuscripts in the English literature.
Secondary Subcutaneous Rhizopus Infection in a Posttransplant Recipient with Calcific Uremic Arteriolopathy
Authors: Urmila Anandh, Rakesh Kumar, Vishnu Rao
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Calcific uremic arteriolopathy is a rare condition affecting chronic kidney disease (CKD) patients on long-term dialysis. The clinical manifestations include subcutaneous skin necrosis and ulcers secondary to calcification of the subcutaneous blood vessels. The necrotic tissue often becomes a nidus of infection. The prognosis is often poor. We present a case of a renal allograft recipient who developed a subcutaneous necrotic lesion which was subsequently infected by Rhizopus spp. The patient underwent surgical debridement and antifungal therapy. The infection resolved completely. Our case represents agrave underlying condition predisposing a rare and serious posttransplant infection. The outcome was favourable because of early identification and treatment of the infection.
The current status of the case report: Terminal or viable?
Authors: Nh Abu Kasim, Bjj Abdullah, J Manikam
Journal: Biomed Imaging Interv J (2009)
Keywords: case reports, relevance

The case report, which has a long history in medicine, has seen its fortune wax and wane with time. We discuss the challenges facing the continued survival of the case report, including the inability of journals to cope with the increased load and increased cost of publication, ethical issues, the impact factor and the rise of evidence-based medicine. We highlight the important role that the case report will continue to play in medical research and education, as a means of sharing information and detecting novelty through observations. Most importantly, the case report serves as a stepping stone for young physicians and practitioners into the world of medical writing.
Case Report of Multiple Tracheostomy Revisions due to Persistent, Recurrent Cuff Leak
Authors: Jian P Azimi-Bolourian, Issa A Hanna, George W Williams
Journal: Case Rep Anesthesiol (2015)

This case is a patient with amyotrophic lateral sclerosis who was unable to be separated from mechanical ventilator support and required a tracheostomy. The patient underwent an initial open tracheostomy utilizing flexible fiberoptic tracheoscopy (FFT) in the operating room (OR). Subsequently, he developed recurrent leaks in the tracheal tube cuff requiring multiple trips back to the operating room. The recurrent cuff leak occurred following each tube placement until the etiology of the leak was discovered during the fourth procedure. In the fourth procedure, the wound was explored more extensively, and it was found that there was a sharp, calcified, aberrant fragment of a tracheal cartilage ring protruding into the tracheal lumen, which was damaging the cuff of each tube. This fragment was not visible by multiple FFTs, nor was it visible in the wound by the surgeons until wider exploration of the wound occurred. The cartilage fragment was ultimately excised and the patient had no further cuff leaks. Aberrant tracheal cartilage should be on the differential diagnosis for cuff leaks subsequent to surgical tracheostomy (ST) or percutaneous dilatational tracheostomy (PDT).
Successful Elimination of Gallbladder Ascariasis by Conservative Therapy, Followed by Cholecystectomy due to Developing Cholecystitis
Authors: Ahmad Alhamid, Ziad Aljarad, Ahmad Ghazal, Ahmad Mouakeh, Ahmad Sankari Tarabishi, Majed Joudeh, Mohammad Mohammad, Aos Alhamid, Jawhar Aljarad, Maen Mousa
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Background:

Ascaris lumbricoides is the most common parasitic infection in human. The worm is usually located in the small intestine, but may invade into the pancreatic or biliary tree, but rarely into gallbladder because of the anatomic features of the cystic duct.
Case presentation:
We report a case of gallbladder ascariasis that was diagnosed incidentally in a 70-year-old man, with negative ova and parasite test and no eosinophilia. We also compared echography and computerizied tomograph as diagnostic tools for gallbladder ascariasis. The patient was managed conservatively, but he underwent cholecyctectomy later because of developing cholecystitis.
Conclusion:
Depending on this case, we suggest cholecyctectomy as an initial management of gallbladder ascariasis.
Extramedullary acute myeloid leukemia: leukemic pleural effusion, case report and review of the literature
Authors: Naveen Pemmaraju, Elaine Chang, Naval Daver, Keyur Patel, Jeffrey Jorgensen, Bradley Sabloff, Srdan Verstovsek, Gautam Borthakur
Journal: Front Oncol (2014)
Keywords: acute myeloid leukemia, extramedullary aml, malignant pleural effusion

Objective and importance:
Malignant pleural effusions occur in the setting of both solid and hematologic malignancies. Pleural effusion caused by leukemic infiltration is an unusual extramedullary manifestation of acute myeloid leukemia (AML) with fewer than 20 cases reported (1-11). We report a case of pericardial and pleural effusions in a patient with AML and review the literature.
Clinical presentation:
In this case, a 55-year-old man with previous history of myeloproliferative neoplasm experienced transformation AML, heralded by appearance of leukemic pleural effusions. The patient was identified to have leukemic pleural effusion based on the extended cytogenetic analysis of the pleural fluid, as morphologic analysis alone was insufficient.
Intervention:
The patient was treated with hypomethylator-based and intensive chemotherapy strategies, both of which maintained resolution of the effusions in the remission setting.
Conclusion:
Due to the rarity of diagnosis of leukemic pleural effusions, both cytogenetic and fluorescence in situ hybridization testing are recommended. Furthermore, systemic chemotherapy directed at the AML can lead to complete resolution of leukemic pleural effusions.
Port-Site Metastasis of Undiagnosed Pancreatic Adenocarcinoma After Laparoscopic Radical Prostatectomy: Case Report and Literature Review
Authors: Gotardo Zini Pinho, Gustavo Ruschi Bechara, Samira Pereira das Posses, Carla Regina Santos De Carli, Marcio Maia Lamy de Miranda
Journal: J Endourol Case Rep (2018)
Keywords: laparoscopic radical prostatectomy, port-site metastasis, prostate cancer, review
MeSH terms: Case Reports

Background: Laparoscopic port-site metastases remain rare for urologic tumors, despite the increasing use of laparoscopic techniques on the approach of urologic malignancy. Herein, we report a case of port-site mass after laparoscopic radical prostatectomy whose immunohistochemistry demonstrated metastasis from a pancreatic lesion. Case Presentation: A 62-year-old man presented to our ambulatory clinic with an elevated prostate-specific antigen (PSA) of 7.7 ng/mL. Transrectal biopsies revealed prostate cancer Gleason 6 (3 + 3) on the right side. He was subjected to a transperitoneal laparoscopic radical prostatectomy at our institution. The PSA on postoperative week 6 was 0.04 ng/mL. Three months after the surgery, he comes back to the emergency department complaining of an abdominal pain especially on the right flank. Our examination of the abdomen revealed a small palpable mass at the right upper port-site scar. Computed tomography of the abdomen and pelvis, with contrast, revealed a hypodense nodular lesion located on the abdominal wall near the upper port site and adjacent to the pancreatic tail. An excisional biopsy of the lesion confirmed the presence of metastatic adenocarcinoma. Immunohistochemistry demonstrated metastasis from a pancreatic lesion. Conclusion: Port-site mass after laparoscopic radical prostatectomy is uncommon especially in quite different tumors like this one with Gleason score 6 (3 + 3). Generally, port-site recurrences after a urologic laparoscopic surgery are uncommon and are not associated with diffused peritoneal carcinomatosis. Therefore, in this situation, another tumor site should be investigated as the primary source.
Modified systemic inflammatory response syndrome and provider gestalt predicting adverse outcomes in children under 5 years presenting to an urban emergency department of a tertiary hospital in Tanzania
Authors: Meera R Nariadhara, Hendry R Sawe, Michael S Runyon, Victor Mwafongo, Brittany L Murray
Journal: Trop Med Health (2019)
Keywords: africa, emergency medicine, pediatrics, sepsis, tanzania, msirs

Background:
Modified systemic inflammatory response syndrome (mSIRS) criteria for the pediatric population together with the provider gestalt have the potential to predict clinical outcomes. However, this has not been studied in low-income countries. We investigated the ability of mSIRS and provider gestalt to predict mortality and morbidity among children presenting to the ED of a tertiary level hospital in Tanzania.
Methods:
This prospective observational study enrolled a convenience sample of children under 5 years old, presenting to the Emergency Medicine Department of Muhimbili National Hospital from September 2015 to April 2016. Trained researchers used a structured case report form to record patient demographics, clinical presentation, initial provider gestalt of severity of illness, and the mSIRS criteria. Primary outcomes were 24-h mortality and overall in-hospital mortality. Data was analyzed using simple descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and chi-squared tests.
Results:
We enrolled 1350 patients, median age 17 months (interquartile range 8-32 months), and 58% were male. Provider gestalt estimates of illness severity were recorded for all patients and 1030 (76.3%) had complete data for mSIRS categorization. Provider gestalt classified 97 (7.2%) patients as healthy, 546 (40.4%) as mildly ill, 457 (33.9%) as moderately ill, and 250 (18.5%) as severely ill. Of the patients, classifiable by mSIRS, 411/1030 (39.9%) had ≥ 2 mSIRS criteria. In predicting 24-h mortality, the ≥ 2 mSIRS and gestalt "severely ill" had sensitivities of 82% and 81%, respectively, and specificity of 61% and 84%, respectively. In predicting overall in-hospital mortality, the ≥ 2 mSIRS and gestalt "severely ill" had sensitivities of 66% and 70% with a specificity of 62% and 86% respectively.
Conclusion:
Both the mSIRS and provider gestalt were highly specific for predicting 24-h and overall in-hospital mortality in our patient population. The clinical utility of these assessment methods is limited by the low positive predictive value.
Bile duct adenocarcinoma with minor micropapillary component: a case report
Authors: Takeshi Kondo
Journal: Cases J (2009)

Invasive micropapillary carcinoma (IMPC) is defined as a carcinoma composed of small clusters of tumor cells lying within clear spaces which simulate lymphovascular channels. This histologic pattern has been described in various organs, including the breast, lung, urinary bladder, ovary, stomach, pancreas, and major salivary glands. Although rarely observed as a pure histologic component, IMPC is usually mixed with conventional carcinoma, and is therefore often referred to as carcinoma with a micropapillary component. IMPCs are invariably associated with a high degree of aggressiveness, extensive lymphovascular invasion, extensive lymph node metastases, and poor prognosis. Here a case of bile duct adenocarcinoma with minor micropapillary component is described.