OpenMed/multicare-articles huggingface dataset:
Recurrent Fistula between Ileal Pouch and Vagina-Successful Treatment with a Gracilis Muscle Flap
Authors: Feride Aydin, Claus Ferdinand Eisenberger, Andreas Raffel, Alexander Rehders, Stefan Benedikt Hosch, Wolfram Trudo Knoefel
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Fistulae between an ileal pouch and the vagina are an uncommon complication of ileal pouch-anal anastomosis following proctocolectomy and mucosectomy in patients with familial adenomatous polyposis coli. Several reports describe the successful use of muscle flaps to close recurrent pouch-vaginal-fistulae (PVF). However, series only contain small numbers and an optimal management has not yet been determined. We report the case of a 26-year old woman with a third recurrence of a PVF after proctocolectomy for treatment of familial adenomatous polyposis in October 2005. Because local approaches failed, definitive closure of the fistula was achieved by interposition of a gracilis muscle flap between the pouch-anal anastomosis and the vagina. The postoperative course was uneventful; the patient was discharged 7 days after surgery and remained free of recurrence and symptomatic complaints for 22 months now. The gracilis muscle flap proved to be an effective method in the treatment of recurrent PVF.
Autochthonous liver cystic hydatid: Past or actual French shepherd's disease?
Authors: Florent Darriet, Nadim Cassir, David J Birnbaum, Jérôme Soussan, Estelle Menu, Stéphane Ranque, Coralie L'Ollivier
Journal: IDCases (2020)
Keywords: french, hydatidosis, indigenous, shepherd
MeSH terms: Case Reports

Autochthonous hydatidosis in France and western Europa are uncommon since the beginning of the 21st century. We report here an authentic indigenous cystic echinococcosis case in a French shepherd. The risk of remerging pathology should not be neglected and measures to interrupt parasite transmission are still relevant.
Abdominal compartment syndrome secondary to chronic constipation
Authors: Helene Flageole, Jodie Ouahed, J Mark Walton, Yasmin Yousef
Journal: Case Rep Pediatr (2011)
MeSH terms: Case Reports

Abdominal compartment syndrome (ACS) is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not.
Case Report: Optic Atrophy and Nephropathy With m.13513G>A/MT-ND5 mtDNA Pathogenic Variant
Authors: Valentina Barone, Chiara La Morgia, Leonardo Caporali, Claudio Fiorini, Michele Carbonelli, Laura Ludovica Gramegna, Fiorina Bartiromo, Caterina Tonon, Luca Morandi, Rocco Liguori, Aurelia Petrini, Rachele Brugnano, Rachele Del Sordo, Carla Covarelli, Manrico Morroni, Raffaele Lodi, Valerio Carelli
Journal: Front Genet (2022)
Keywords: lhon, mt-nd5, mitochondrial nephropathy, cerebellum, m13513g>a mutation
MeSH terms: Case Reports

Isolated complex I deficiency represents the most common mitochondrial respiratory chain defect involved in mitochondrial disorders. Among these, the mitochondrial DNA (mtDNA) m.13513G>A pathogenic variant in the NADH dehydrogenase 5 subunit gene (MT-ND5) has been associated with heterogenous manifestations, including phenotypic overlaps of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes, Leigh syndrome, and Leber's hereditary optic neuropathy (LHON). Interestingly, this specific mutation has been recently described in patients with adult-onset nephropathy. We, here, report the unique combination of LHON, nephropathy, sensorineural deafness, and subcortical and cerebellar atrophy in association with the m.13513G>A variant.
A Case of De Novo CD5+ Disseminated Intravascular Large B-Cell Lymphoma Presenting as Multiorgan Failure
Authors: Daulath Singh, Devika Kapuria, Suparna Nanua, Rakesh Gaur
Journal: Case Rep Hematol (2016)

Intravascular large B-cell lymphoma is an extremely rare extranodal lymphoma that proliferates in the lumen of the blood vessels while sparing the organ parenchyma. It usually presents with CNS and skin involvement. A 65-year-old Caucasian female presented with fevers and chills of 3-4 months' duration. Bone marrow biopsy done 3 months prior showed no significant myelodysplasia or lymphoid aggregates. The patient later died due to multiorgan failure. A bone marrow biopsy showed 20-30% CD5+ B cells consistent with infiltrative large B-cell lymphoma. An autopsy performed revealed diffuse intravascular invasion by lymphoma cells. Multiorgan involvement by intravascular B-cell lymphoma is very rare. Based on our literature review and to the best of our knowledge, there are only 5 case reports describing the presentation of this lymphoma with multiorgan failure. The immunophenotypic studies performed revealed that our patient had de novo CD5+ intravascular large B-cell lymphoma which is known to be aggressive with very poor prognosis. Although it is an extremely rare lymphoma, it should be considered as a potential cause of multiorgan failure when no other cause has been identified. A prompt tissue diagnosis and high-dose chemotherapy followed by ASCT can sometimes achieve remission.
Iris pigment epithelial cysts in a newborn
Authors: Shabnam Zargar, Kevin John Prendiville, Eladio Martinez
Journal: GMS Ophthalmol Cases (2016)
Keywords: amblyopia, iris pigment epithelial cysts, newborn
MeSH terms: Case Reports

Purpose:
We report a case of iris pigment epithelial cysts in a newborn and discuss the importance of an accurate diagnosis for prevention of amblyopia.
Methods:
We describe a case of an abnormal red reflex seen on a newborn exam.
Results:
A full-term female born via normal spontaneous vaginal delivery without any complications was seen in the newborn nursery. She was noted to have an abnormal eye exam. Pupils were large with circular dark excrescences of the iris pigment epithelium. She was referred to a pediatric ophthalmologist where she was noted to fixate and follow faces. No afferent pupillary defect was seen. OD red reflex was normal whereas OS red reflex was blocked mostly by dark excrescences. A 2-3 mm dark brown lesion was seen in the OD iris and a 3-5 mm dark brown lesion was seen in the OS iris, consistent with a pupillary iris pigment epithelial cyst. Central visual axis was clear OU. Glaucoma was not present and patching was not performed. Observations and clinical photographs were recommended with follow-up in three months.
Conclusion:
Iris pigment epithelial cysts are uncommonly seen in children. The primary care provider first seeing a newborn must be aware of lesions obscuring a red reflex with appropriate follow-up. Follow-up in three months with IOP measurements is recommended. Iris pigment epithelial cysts in children may be a cause of amblyopia, thus prompt evaluation is important for prognostic purposes and the prevention of amblyopia.
Successful myomectomy in early pregnancy for a large asymptomatic uterine myoma: case report
Authors: Pawan Jhalta, Sonam Gialchhen Negi, Vikas Sharma
Journal: Pan Afr Med J (2016)
Keywords: pregnancy, myomectomy, uterine myoma
MeSH terms: Leiomyoma / surgery, Pregnancy Complications, Neoplastic / surgery, Uterine Myomectomy / methods, Uterine Neoplasms / surgery, Case Reports, Adult, Female, Humans, Infant, Newborn, Leiomyoma / complications, Male, Pregnancy, Pregnancy Complications, Neoplastic / pathology, Pregnancy Outcome, Uterine Neoplasms / complications

The decision of myomectomy is not usually taken by OBG specialist for uterine fibroids during pregnancy because of its complications which may become hazardous at times. This is why it is generally delayed until after delivery. The current case was a large, asymptomatic subserous uterine myoma diagnosed during pregnancy by ultrasound and successfully managed by antepartum myomectomy retaining the fetus alive in utero at 13 -14 weeks gestation. At term, the patient had spontaneous vaginal delivery of 3 kg male child. This case demonstrates that myomectomy during pregnancy in special circumstances in selected cases to prevent forthcoming events adversely affecting mother and fetus can be considered.
Purulent pericarditis after liver abscess: a case report
Authors: María Fidalgo García, Juan Carlos Rodríguez Sanjuán, María Riaño Molleda, Marta González Andaluz, Hector Real Noval, Manuel Gómez Fleitas
Journal: Case Rep Med (2014)

We present the case of a 49-year-old woman, with previous clinical antecedents of recent hepatic metastasis, who was admitted to the ICU due to respiratory failure and hemodynamic instability. She was found to have purulent pericarditis complicated by pericardial tamponade and pleural effusion, as well as surgical site infection, which was the origin of the disease. Cultures of the surgical wound and the pericardial effusion were positive for Enterococcus faecalis and Escherichia coli. A pericardial tap was performed and the intra-abdominal abscess was surgically drained. Pleural effusion was also evacuated. She received antibiotic treatment and recovered successfully. The only after-effect was a well-tolerated effusive-constrictive pericarditis.
Robot-Assisted Diagnostic Laparoscopy: A Safe and Feasible Adjunct to the Management of Massive Spontaneous Pneumoperitoneum
Authors: Qingwen Kawaji, Sami Shoucair, Ali Darehzereshki, Alain Abdo
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Pneumoperitoneum is the abnormal presence of free air in the peritoneal cavity. Oftentimes, it is a surgical emergency requiring exploratory laparotomy as most cases of pneumoperitoneum are due to perforated hollow viscus. However, not all pneumoperitoneum cases are surgical; nonsurgical pneumoperitoneum can arise from thoracic, abdominal, gynecologic, and other causes. We present a case of a 35-year-old male who developed a non-surgical pneumoperitoneum in the setting of drug overdose. The patient underwent robot-assisted diagnostic laparoscopy without findings of perforation or other pathology. Resolution of pneumoperitoneum was evidenced on follow-up computed tomography scan. This case emphasizes the importance of diagnostic laparoscopy in the setting of a confusing clinical picture and the feasibility of utilizing the robotic approach in hemodynamically stable patients.
Case Report: An Unusual Case of Pulmonary Metastatic Adenocarcinoma From Low-Grade Appendiceal Mucinous Neoplasms
Authors: Xin-Yu Zhao, Chun-Qiang Li, Shi-Yao Zhang, Gang Liu
Journal: Front Oncol (2022)
Keywords: appendiceal tumor, case report, low-grade appendiceal mucinous neoplasm, next-generation sequencing, pulmonary metastases
MeSH terms: Case Reports

Background:
Low-grade appendiceal mucinous neoplasms (LAMNs) are indolent tumors with low-grade cytology. Although peritoneal dissemination is common due to tumor rupture and mucinous deposits on the visceral peritoneal surface, distant involvement, such as lung, is rarely seen due to lack of invasiveness.
Case presentation:
A 70-year-old woman presented to the hospital due to continuously elevated carcinoembryonic antigen (CEA) levels for 10 months without any symptoms. PET/CT revealed two lesions located in the left lung and appendix. The postoperative pathology results revealed pulmonary mucinous adenocarcinoma and LAMN. Then we performed next-generation sequencing (NGS) to clarify the relationship between the two tumors. The sequencing result showed that both tumors harbored the common tumor mutations, KRAS (p.G12D), GNAS (p.R201H), and BRAF (p.R735Q), which indicated that the pulmonary tumor was a metastasis of LAMN.
Conclusion:
This case is unusual in that the primary LAMN and the pulmonary metastasis are present at the time of diagnosis. This study reported the first pulmonary metastasis from LAMN verified by NGS.
Bilateral Orchidopexy in a Hypochondriacal (Somatic Symptom Disorder) Patient and Determination of Fitness for Bilateral Orchidectomy
Authors: A U Nwaopara, Erefagha Leonardo P Allagoa
Journal: Case Rep Psychiatry (2016)

Introduction. DSM-5 identifies two disorders: somatic symptom disorder and illness anxiety disorder, to replace hypochondriasis in DSM-IV. Patients with both disorders are intensely anxious about the possibility of an undiagnosed illness or devote excessive time and energy to health concerns and are not easily reassured. Both disorders cause considerable distress and life disruption, even at moderate levels. However, hypochondriasis (DSM-IV) is an indication for neither orchidopexy nor orchidectomy. This is the rationale for this report which is the first of its kind to the best of available literature. This is an original case report of interest to a particular clinical specialty of mental health but it will have a broader clinical impact across medicine. Case Presentation. A 30-year-old black male presented to a primary care clinic with multiple internet searches on the topic of testicular pain and its differential diagnosis. He had a bilateral orchidopexy for a suspected torsion. He was referred to mental health unit, to determine fitness for further surgery. Conclusions. If hypochondriasis is suspected in a medical or surgical inpatient, a psychological medicine consultation should be performed, to elucidate the diagnosis, to avoid unnecessary procedures, and to optimize patient's care.
Nonunion of the medial cuneiform: a rare case
Authors: Celil Alemdar, Bekir Yavuz Uçar, Azad Yıldırım, Ahmet Kapukaya
Journal: Case Rep Med (2013)

Isolated medial cuneiform fractures are quite rare. Conservative treatment is adequate in most cases, while deplaced or unstable fractures are treated surgically. Nonunion is seen extremely rarely after medial cuneiform fractures. There is only one case report in the literature. This case presented here is a 62-year-old male patient who had an isolated medial cuneiform fracture resulting from the impact of a falling metal object. Conservative treatment was performed initially. The patient was diagnosed as nonunion after physical and radiological examinations nine months after he presented to the outpatient clinic. Internal fixation with a mini plate and one staple after reduction was performed surgically. Defective region was filled with a 2 mL of autograft, and the operation was terminated.
Cervical stenosis in a professional rugby league football player: a case report
Authors: Henry Pollard, Lotte Hansen, Wayne Hoskins
Journal: Chiropr Osteopat (2005)

Background:
This paper describes a case of C7 radiculopathy in a professional rugby league player after repeated cervical spine trauma. The report outlines the management of the patient following an acute cervical hyperflexion injury with chiropractic manipulation and soft tissue therapies. It also presents a change in approach to include distractive techniques on presentation of a neurological deficit following re-injury. The clinical outcomes, while good, were very dependent upon the athlete restricting himself from further trauma during games, which is a challenge for a professional athlete.
Case presentation:
A 30-year old male front row Australian rugby league player presented complaining of neck pain after a hyperflexion and compressive injury during a game. Repeated trauma over a four month period resulted in radicular pain. Radiographs revealed decreased disc height at the C5-C6 and C6-C7 levels and mild calcification within the anterior longitudinal ligament at the C6-C7 level. MRI revealed a right postero-lateral disc protrusion at the C6-C7 level causing a C7 nerve root compression.
Conclusion:
Recommendations from the available literature at the present time suggest that conservative management of cervical discogenic pain and disc protrusion, including chiropractic manipulation and ancillary therapies, can be successful in the absence of progressive neurological deficit. The current case highlights the initial successful management of a football athlete, and the later unsuccessful management. This case highlights the issues involvement in the management of a collision sport athlete with a serious neck injury.
Chronic Eosinophilic Pneumonia in an Airbrush Painter With Poor Response to Systemic Steroids
Authors: Ahmed Taha, Roaa Ahmed, Nooraldin Merza, Ravindra Bharadwaj, Thien Vo, Manish Patel
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: acrylic paints, airbrush paint, chronic eosinophilic pneumonia, organizing pneumonia, street artists
MeSH terms: Acrylates / adverse effects, Occupational Exposure / adverse effects, Pulmonary Eosinophilia / diagnosis, Pulmonary Eosinophilia / drug therapy, Steroids / therapeutic use, Case Reports, Chronic Disease, Humans, Lung / diagnostic imaging, Lung / pathology, Male, Middle Aged, Paint, Steroids / pharmacology, Tomography, X-Ray Computed, Treatment Outcome, Acrylates, Steroids, acrylic acid

Airbrush paints contain low-molecular-weight chemicals that can cause occupational asthma, respiratory sensitization, and hypersensitivity pneumonitis; however, its relationship to chronic eosinophilic pneumonia (CEP) has never been reported. In this article, we are presenting a unique association between CEP and prolonged exposure to acrylic airbrush paints. Unlike the vast majority of CEP patients who exhibit an excellent response to systemic steroids, our patient did not respond to systemic steroids. We believe that his prolonged exposure to airbrush paints and the evolution of organizing pneumonia might have contributed to the unsatisfactory response to systemic steroids, prolonged hypoxia, and the overall worse prognosis. There are no current data that correlate acrylic paints to the development of CEP; our report is the first to introduce a probe to further investigate this association.
Case Report: Dubin-Johnson Syndrome Presenting With Infantile Cholestasis: An Overlooked Diagnosis in an Extended Family
Authors: Naglaa M Kamal, Omar Saadah, Hamdan Alghamdi, Ali Algarni, Mortada H F El-Shabrawi, Laila M Sherief, Salma A S Abosabie
Journal: Front Pediatr (2022)
Keywords: abcc2 gene, dubin-johnson syndrome, cholestasis, infant, mutation
MeSH terms: Case Reports

Dubin-Johnson syndrome (DJS) is an often-missed diagnosis of neonatal cholestasis. We report two patients with DJS, who presented with neonatal cholestasis. The first patient underwent extensive investigations for infantile cholestasis with no definitive etiology reached; the diagnosis of DJS was missed until the age of 14 years old. The diagnosis was confirmed genetically with c.2273G > T, p.G758V mutation in exon 18 of the ABCC2 gene. The 2nd patient is a 7-day-old baby, the son of the 1st patient who gave birth to him at the age of 21 years old. He was diagnosed with DJS at the age of 2 weeks based on normal clinical and laboratory workup apart from direct hyperbilirubinemia. He had the same mutation as his mother in homozygous status. The husband was heterozygous for the same mutation. DJS is one of the often-missed differential diagnoses of neonatal cholestasis. It should be suspected in patients of infantile cholestasis, who have an, otherwise, normal physical examination, and laboratory investigations to avoid unnecessary lengthy, invasive, and expensive workups.
Immune checkpoint inhibitor-induced myocarditis and myositis in liver cancer patients: A case report and literature review
Authors: Haoran Mei, Wu Wen, Kang Fang, Yuanpeng Xiong, Weiqi Liu, Jie Wang, Renhua Wan
Journal: Front Oncol (2023)
Keywords: hepatocellular carcinoma, immune checkpoint inhibitors, immune myocarditis, immune myositis, iraes (immune-related adverse events)
MeSH terms: Case Reports

With the development of immunotherapy, immune checkpoint inhibitors (ICIs) are widely used in clinical oncology and have achieved good results. ICIs could induce immune-related adverse events (irAEs) in cancer treatment, which warrant sufficient attention. Among them, immune myositis can manifest severe symptoms affecting the whole body, and immune myocarditis occurs with a low incidence but high fatality rate. Here we report a case of grade 3/4 adverse reactions in a patient with partial hepatectomy for malignancy after using ICIs and describe the clinical presentation, laboratory results, treatment, and prognosis. It emphasizes that clinicians should focus on being alert to irAEs in liver cancer patients who have received ICI therapy. The case we present is a 56-year-old male diagnosed with hepatocellular carcinoma. Right hepatic lobectomy was performed in April 2019. Postoperative follow-up showed that transcatheter arterial chemoembolization (TACE) combined with sorafenib (400 mg twice daily) failed to stop the recurrence of the tumor. In December 2020, the patient started to use Camrelizumab injections (200mg/injection every 21 days as a cycle). After 3 cycles, the patient had decreased muscle strength in both lower extremities with chest tightness, dyspnea, and expectoration (whitish sputum). The diagnosis was ICIs injection-induced immune myocarditis and myositis accompanied. The patient's condition improved considerably by steroid pulse therapy timely. The case emphasizes that clinicians should focus on being alert to irAEs in liver cancer patients who have received ICI therapy.
Phantom limb pain: low frequency repetitive transcranial magnetic stimulation in unaffected hemisphere
Authors: Andrea Di Rollo, Stefano Pallanti
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Phantom limb pain is very common after limb amputation and is often difficult to treat. The motor cortex stimulation is a valid treatment for deafferentation pain that does not respond to conventional pain treatment, with relief for 50% to 70% of patients. This treatment is invasive as it uses implanted epidural electrodes. Cortical stimulation can be performed noninvasively by repetitive transcranial magnetic stimulation (rTMS). The stimulation of the hemisphere that isn't involved in phantom limb (unaffected hemisphere), remains unexplored. We report a case of phantom limb pain treated with 1 Hz rTMS stimulation over motor cortex in unaffected hemisphere. This stimulation produces a relevant clinical improvement of phantom limb pain; however, further studies are necessary to determine the efficacy of the method and the stimulation parameters.
Expanding spontaneous pneumothorax in COVID-19 pneumonia: Case report and review of literature
Authors: Afshin Mohammadi, Behdad Boroofeh, Alisa Mohebbi, Mohammad Mirza-Aghazadeh-Attari
Journal: J Cardiovasc Thorac Res (2021)
Keywords: covid-19, ct, chest, pneumothorax
MeSH terms: Case Reports

Coronavirus disease 2019 has presented itself with a variety of clinical signs and symptoms. One of these has been the accordance of spontaneous pneumothorax which in instances has caused rapid deterioration of patients. Furthermore pneumothorax may happen secondary to intubation and the resulting complications. Not enough is discussed regarding cases with COVID-19 related pneumothorax and proper management of these patients. The present article reports an elderly patient with spontaneous pneumothorax secondary to COVID-19 and reviews the existing literature.