OpenMed/multicare-articles huggingface dataset:
Bilateral sleeve fracture of the inferior pole of the patella in children: A case report
Authors: Tangjiang Li, Min Xiang, Xin Lv, Yongqiao Gan, Song Yu
Journal: Front Surg (2022)
Keywords: bilateral patellar fracture, child, pediatric orthopaedics, sleeve fracture, tension band wiring
MeSH terms: Case Reports

Background:
A patellar avulsion fracture is a unique fracture type in children with an extremely low incidence rate in knee joint injuries, most of which are unilateral. Cases of simultaneous bilateral fracture are rare. Due to the physiological and anatomical characteristics of patellar sleeve fractures in children, obvious avulsed bony fragments are seldom seen with plain radiography after trauma; thus, this fracture type is often misdiagnosed or missed on first evaluation. Early diagnosis of patellar sleeve fracture is the key to successful treatment.
Case report:
This paper presents a case of bilateral patellar sleeve fracture in a 10-year-old girl that was missed in another hospital and treated successfully by open reduction and fixation of the osteochondral fragments after the patient was transferred to our hospital, yielding good clinical outcomes at the one-year follow-up.
Conclusion:
Overall, this case report described the clinical and imaging characteristics of inferior pole sleeve fractures in children and highlight clinicians' awareness of this injury to assist in early, accurate diagnosis and reduce the incidence of misdiagnosis and missed diagnosis due to unfamiliarity.
Case report: Aggressive progression of acute heart failure due to juvenile tuberculosis-associated Takayasu arteritis with aortic stenosis and thrombosis
Authors: Wenjie Xuan, Zhaoling Wang, Jinjing Lin, Lixia Zou, Xisheng Xu, Xinghui Yang, Yiping Xu, Yan Zhang, Qi Zheng, Xuefeng Xu, Meiping Lu
Journal: Front Cardiovasc Med (2023)
Keywords: takayasu arteritis, acute heart failure, juvenile, pulmonary hypertension, surgery, thrombosis
MeSH terms: Case Reports

Background:
Takayasu arteritis (TA) is a chronic granulomatous vasculitis with unknown pathophysiology. TA with severe aortic obstruction has a poor prognosis. However, the efficacy of biologics and appropriate timing of surgical intervention remain controversial. We report a case of tuberculosis (TB)-associated TA with aggressive acute heart failure (AHF), pulmonary hypertension (PH), thrombosis, and seizure, who failed to survive after surgery.
Case presentation:
A 10-year-old boy who developed a cough with chest tightness, shortness of breath, hemoptysis with reduced left ventricular ejection fraction, PH, and increased C-reactive protein and erythrocyte sedimentation rate was hospitalized at the pediatric intensive care unit of our hospital. He had strongly positive purified protein derivative skin test and interferon-gamma release assay result. Computed tomography angiography (CTA) showed occlusion of proximal left subclavian artery and stenosis of descending aorta and upper abdominal aorta. His condition did not improve after administration of milrinone, diuretics, antihypertensive agents, and intravenous methylprednisolone pulse followed by oral prednisone. Intravenous tocilizumab was administered for five doses, followed by two doses of infliximab, but his HF worsened, and CTA on day 77 showed complete occlusion of the descending aorta with large thrombus. He had a seizure on day 99 with deterioration of renal function. Balloon angioplasty and catheter-directed thrombolysis were performed on day 127. Unfortunately, the child's heart function continued to deteriorate and died on day 133.
Conclusion:
TB infection may be related to juvenile TA. The biologics, thrombolysis, and surgical intervention failed to achieve the anticipated effect in our case with aggressive AHF due to severe aortic stenosis and thrombosis. More studies are needed to determine the role of biologics and surgery in such dire cases.
Mandibular Canal Widening and Bell's Palsy: Sequelae of Perineural Invasion in Oral Cancer
Authors: Gopinath Thilak Parepady Sundar, Vishwanath Sherigar, Sameep S Shetty, Shree Satya, Sourabh M Gohil
Journal: Case Rep Dent (2016)

Perineural invasion is an underrecognized route of metastatic spread along the nerve bundles within the nerve sheath into the surrounding tissues. It hinders the ability to establish local control as tumour cells can traverse along nerve tracts well beyond the extent of any local invasion rendering them inoperable and unresectable. Perineural invasion is a marker of poor prognosis. Oral submucous fibrosis with oral cancer constitutes a clinicopathologically distinct disease. Our case highlights an enigmatic presentation of oral submucous fibrosis and its coexistence with oral cancer presenting with unusual neurological disturbance of the inferior alveolar nerve and facial nerve and diffuse widening of the mandibular canal. The objective of this case report is to enumerate the significance of perineural invasion in determining the course of the disease and necessitate the need for future studies that can shed light on molecular mediators and pathogenesis of perineural spread.
Isolated Ovarian Metastasis from Pancreatic Cancer Mimicking Primary Ovarian Neoplasia: Role of Molecular Analysis in Determining Diagnosis
Authors: Catherine M Tucker, Cheryl L Godcharles, Wei Jiang, Charles J Yeo, Norman G Rosenblum, Ethan J Halpern, William E Luginbuhl, Anthony J Prestipino
Journal: J Pancreat Cancer (2021)
Keywords: kras g12r mutation, molecular diagnostics, mucinous tumor, ovarian metastasis, pancreatic adenocarcinoma, pathology
MeSH terms: Case Reports

Background and Presentation: In this study, we present the case of a 64-year-old female with a chief complaint of abdominal pain and bloating, which had been persistent over a period of 4 months. Imaging revealed a 6.1-cm left-sided pancreatic mass as well as a 19.1-cm multiloculated cystic lesion in the pelvis, later revealed to be replacing the left ovary. The pancreatic mass was biopsied through endoscopic ultrasound-guided fine needle aspiration, and diagnosed as adenocarcinoma by cytology. The patient was treated with neoadjuvant chemotherapy and radiation before laparotomy for resection of the pancreas and left adnexal mass. Her response to treatment was followed radiologically and biochemically with cancer antigen (CA) 19-9 (114-35 U/mL), carcinoembryonic antigen (12-4.8 ng/mL), and CA-125 (119-15.3 U/mL) levels. She subsequently underwent an Appleby procedure, and resection of left pelvic mass and bilateral oophorectomy. Permanent sections revealed residual pancreatic ductal carcinoma with treatment effect, and a multicystic epithelial neoplasia of the left ovary for which the differential was primary ovarian carcinoma versus metastatic disease. Conclusions: Molecular mutational analysis was performed on sections of both the ovarian tumor and the pancreatic tumor to aid in diagnosis. The ovarian tumor in this case showed exactly the same mutations, KRAS G12R and TP53 G245S, as in the treated pancreatic cancer. This raised the high probability that these tumors originated from the same clonal event. The findings suggested that the ovarian tumor was an isolated metastasis of the pancreatic primary, despite the morphologic ambiguity between the two sites of neoplasia.
Acute spontaneous hematoma of the corpus callosum in a COVID-19 patient: a case report
Authors: Boubaker Charra, Ayman Ellouadghiri, Touda Kebbou, Omar Ettouki, Naima El Benna, Moulay Hicham Afif, Mohamed Benghanem Gharbi
Journal: Pan Afr Med J (2021)
Keywords: covid-19, case report, corpus callosum, hematoma
MeSH terms: COVID-19 / complications, Corpus Callosum / pathology, Hematoma / diagnosis, Intracranial Hemorrhages / diagnosis, Case Reports, Corpus Callosum / virology, Hematoma / etiology, Hematoma / virology, Humans, Intracranial Hemorrhages / etiology, Intracranial Hemorrhages / virology, Male, Middle Aged

Neurovascular involvement is a frequent occurring reported in COVID-19 patients. However, spontaneous hematomas of the corpus callosum are exceptionally seen. The authors of this article aim to report an unusual case of corpus callosum hematoma in a COVID-19 patient and discuss potential etiologies and mechanisms responsible for intracranial hemorrhage.
Carotid cavernous fistula masquerading as delayed suprachoroidal hemorrhage after trabeculectomy
Authors: Mukesh Jain, Md Shahid Alam, Bipasha Mukherjee, Rajiv Raman
Journal: GMS Ophthalmol Cases (2017)
Keywords: carotid cavernous fistula, delayed suprachoroidal hemorrhage, trabeculectomy
MeSH terms: Case Reports

Objective: Carotid cavernous fistulae (CCFs) are abnormal communications between the cavernous sinus and the carotid arterial system. Based on the etiology, CCFs can be traumatic, spontaneous and rarely iatrogenic. We report an interesting case of new onset CCF associated with shallow choroidal detachment after trabeculectomy surgery. Method: Observational case report Result: A 69-year-old male patient presented with complain of proptosis, congestion, and gross diminution of vision in the left eye following trabeculectomy elsewhere. Delayed suprachoroidal hemorrhage was diagnosed by the primary physician and the patient was on oral steroids. On USG-B scan, choroidal detachment and a dilated superior ophthalmic vein were seen. A digital subtraction angiogram showed type D CCF. In view of nil visual prognosis, he was treated conservatively and was referred to a neuroradiologist for further management. Conclusion: CCFs have been rarely reported after intraocular surgeries. Till date, there is one case report of CCF complicating cataract surgery. Interestingly, CCFs has not been reported complicating trabeculectomy surgery. Dural CCFs although uncommon should be considered a close differential of hemorrhagic choroidal detachment, a relatively common complication following intraocular surgery.
Case Report: Key Role of the Impella Device to Achieve Complete Revascularization in a Patient With Complex Multivessel Disease and Severely Depressed Left Ventricular Function
Authors: Giovanni Monizzi, Luca Grancini, Paolo Olivares, Antonio L Bartorelli
Journal: Front Cardiovasc Med (2021)
Keywords: impella, lv assistance, pci, coronary intervention, ventricular fibrillation
MeSH terms: Case Reports

Background: Left ventricle (LV) assist devices may be required to stabilize hemodynamic status during complex, high-risk, and indicated procedures (CHIP). We present a case in which elective hemodynamic support with the Impella CP device was essential to achieve complete revascularization with PCI in a patient with complex multivessel disease and severely depressed LV function. Case Summary: A 45-year-old male with no previous history of cardiovascular disease presented to the emergency department for new onset exertional dyspnoea. Echocardiography showed severely depressed LV function (EF 27%) that was confirmed with cardiac magnetic resonance. Two chronic total occlusions (CTOs) of the proximal right coronary artery (RCA) and left circumflex coronary artery (LCx) were found at coronary angiography. After Heart Team evaluation, PCI with Impella hemodynamic support was planned. After crossing and predilating the CTO of the LCx, ventricular fibrillation (VF) occurred. No direct current (DC) shock was performed because the patient was conscious thanks to the support provided by the Impella pump. About 1 min later, spontaneous termination of VF occurred. Afterwards, the two CTOs were successfully treated with good result and no complications. Recovery of LV function was observed at discharge. At 9 months, the patient had no symptoms and echocardiography showed an EF of 60%. Discussion: In this complex high-risk patient, hemodynamic support was essential to allow successful PCI. It is remarkable that the patient remained conscious and hemodynamically stable during VF that spontaneously terminated after 1 min, likely because the Impella pump provided preserved coronary perfusion and LV unloading. This case confirms the pivotal role of Impella in supporting CHIP, particularly in patients with multivessel disease and depressed LV function.
Spastic paraparesis following cocaine inhalation
Authors: Henry Oluwasefunmi Savage, Malin Roesner, David Cohen
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Cocaine use is reaching epidemic proportions in the UK and the consequences are a number of debilitating effects. Strokes may result from a number of mechanisms related to cocaine use. This report describes a case of cocaine induced stroke in an apparently healthy young man with unusual patterns of radiological findings on his brain MRI.
Solitary cecal diverticulitis: an unusual cause of acute right iliac fossa pain-a case report and review of the literature
Authors: Nikolaos Mudatsakis, Marinos Nikolaou, Konstantinos Krithinakis, Michail Matalliotakis, Nikolaos Politis, Emmanouil Andreadakis
Journal: Case Rep Surg (2014)

Solitary cecal diverticulitis is a rare cause of acute abdominal pain in the Western world. Its clinical presentation, in most cases, mimics acute appendicitis. A 38-year-old Caucasian man presented with acute abdomen and clinical signs of acute appendicitis. Laparotomy was performed and revealed an inflammatory, solitary diverticulum of the cecum. A typical appendectomy was performed and a catheter was inserted for draining percutaneously the inflamed diverticulum of the cecum. The patient had an uneventful recovery and was discharged on the 4th postoperative day. This frequently misdiagnosed condition, in most cases, is being suspected and identified intraoperatively as acute appendicitis. The aim of this study is to review the available different surgical management options and to present an alternative therapeutic approach that may be valuable under specific circumstances.
Clinical, Biochemical, and Molecular Characterization of Neonatal-Onset Dubin-Johnson Syndrome in a Large Case Series From the Arabs
Authors: Abdulrahman Al-Hussaini, Badr AlSaleem, Hamad AlHomaidani, Ali Asery, Muhanad Alruwaithi, Mohammed Alameer, Waleed Afashah, Bashir Muhammed Salman, Naif Almontashiri
Journal: Front Pediatr (2021)
Keywords: abcc2 gene, dubin-johnson syndrome, saudi arabia, direct hyperbilirubinemia, neonatal cholestasis, normal alanine aminotransferase

Background: There are only a few case reports and small case series on neonatal-onset Dubin-Johnson syndrome (DJS), particularly from Far-East Asia, Iranian and Moroccan Jews, and Europe. Objectives: In this first study from the Arabs and the largest series reported to date, we characterized the clinical, laboratory, and molecular features and outcome of gene-confirmed neonatal-onset DJS. Methods: We reviewed our database of 533 cases of neonatal cholestasis that presented to our center during the period from 2008 to 2019. We identified neonates with a disease-causing mutation in ABCC2 gene. Results: Twenty-eight neonates with DJS were diagnosed (5.3%). All of the 28 were full-term, well looking neonates without hepatosplenomegaly, with cholestasis, and normal liver synthetic function since the 1 week of life that resolved within 3-6 months of age, followed by a benign course punctuated by recurrent episodes of jaundice in 43% during a median follow up period of 9.25 (range 2.5-14 years). Alanine aminotransferase levels were within normal range in 26 patients (92%) and mildly elevated in two patients. ALT levels were significantly lower in neonates with DJS than in other cases with neonatal cholestasis from other causes (p < 0.001). The median urinary coproporphyrin I% was 88% (IQ1-IQ3 = 84.2-92.7%). We identified four homozygous variants in the ABCC2 gene (from 22 unrelated families), one splicing variant (c.3258+1G>A; p.?), and three were missense variants; two of which were novel missense variants [c.1594G>A (p.Glu532Lys) and c.2439G>C (p.Lys813Asn)]. The p.Gly758Val mutation has occurred in 23 patients (from 19 unrelated families). Conclusions: Our study suggests that normal ALT-cholestasis in a well-looking neonate should trigger evaluation for DJS. The p.Gly758Val variant in ABCC2 is the most predominant mutation among Arabs with "founder effects." Identification of the predominant ABCC2 variant in any population is likely to facilitate rapid molecular analysis by future targeting of that specific mutation.
First Reported Case of Neuroleptospirosis Complicated With Anton's Syndrome
Authors: Nasheeda Saeed, Ching Soong Khoo, Rabani Remli, Zhe Kang Law, Petrick Periyasamy, Syazarina Sharis Osman, Hui Jan Tan
Journal: Front Neurol (2018)
Keywords: anton's syndrome, cortical blindness, electroencephalogram, neuroleptospirosis, seizures
MeSH terms: Case Reports

Leptospirosis is a spirochetal zoonotic disease with a wide clinical spectrum, often underdiagnosed especially when presented as an acute neurological manifestation. We report a case of a 24-year-old man with serologically positive leptospirosis, who presented with altered sensorium, seizures and subsequently developed cortical blindness. His brain MRI revealed bilateral occipital and later parietal lobe cerebritis.
Managing a mandibular second premolar with three-canal and taurodontism: a case report
Authors: Hadi Mokhtari, Mahdi Niknami, Vahid Zand
Journal: Iran Endod J (2013)
Keywords: cone-beam computed tomography, taurodontism, tooth abnormalities
MeSH terms: Case Reports

Root canal anatomy diversity and aberrations are common especially in permanent dentition. A thorough understanding of the basic root canal anatomy and its diversities are necessary for successful endodontic treatment. Mandibular second premolars are usually single-rooted and have one root canal. Incidence of three separate root canals in this tooth is quite rare and taurodontism with three separate canals has never been reported in literature so far. The use of cone-beam computed tomography scan in this rare case greatly contributed to making a confirmatory diagnosis and successful nonsurgical endodontic management thereafter.
En bloc giant cell tumor resection following direct hemiarthroplasty shoulder reconstruction-functional outcome: A case report
Authors: Muhammad Andry Usman, Andi Dhedie Prasatia Sam, Marcell Wijaya, Roichan Muhammad Firdaus, Khrisna Yudha
Journal: Int J Surg Case Rep (2019)
Keywords: cementless endoprosthetic implant, en bloc resection, giant cell tumor, hemiarthoplasty, proximal humerus

Introduction:
Giant cell tumor is a type of benign tumor which has the characteristic of rapidly growing and a chance to metastasis. It is however locally aggressive and would typically affect young patients. They commonly present with pain and associated with pathological fracture.
Presentation of case:
This is an uncommon case of 29 years old male with pathological fracture and giant cell tumor in proximal humerus. A plain radiograph revealed pathological fracture in head of humerus and histopathology examination was consistent with giant cell tumor. The patient had surgical option with en bloc giant cell tumor resection following hemiarthroplasty with cementless endoprosthetic implant for humerus, which aimed to provide a single step surgery without any interval debulking surgery. The patient had achieved bony union between 6 weeks after the surgery and recurrence was not found by the time of the last follow-up.
Discussion:
Based on Campanacci's classification the tumor is divided into 3 stages. The management of giant cell tumors continues to be one of the most challenging areas in orthopedic oncology. Surgery is the first line option; however, it is depending on the tumor staging and can vary from intralesional curettage to total resection of the tumor. Since the local behavior of giant cell tumors has a high risk of local recurrence, en bloc resection and reconstruction were chosen for these Grade III lesions.
Conclusion:
The aim of this procedure is to preserve the shoulder joint shown satisfaction in a clinical, radiological, functional and esthetic result.
Acute Epiploic Appendagitis: A Nonsurgical Abdominal Pain
Authors: Marco Di Serafino, Francesca Iacobellis, Piero Trovato, Ciro Stavolo, Antonio Brillantino, Antonio Pinto, Luigia Romano
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Epiploic appendagitis is a relatively rare disease characterized by an inflammation of fat-filled serosal outpouchings of the large intestine, called epiploic appendices. Diagnosis of epiploic appendagitis is made challenging by the lack of pathognomonic clinical features and should therefore be considered as a potential diagnosis by exclusion first of all with appendicitis or diverticulitis which are the most important causes of lower abdominal pain. Currently, with the increasing use of ultrasound and computed tomography in the evaluation of acute abdominal pain, epiploic appendagitis can be diagnosed by characteristic diagnostic imaging features. We present a case of epiploic appendagitis with objective of increasing knowledge of this disease and its diagnostic imaging findings, in order to reduce harmful and unnecessary surgical interventions.
Inflammatory Myofibroblastic Tumor of the Hilar Bile Duct: A Case Report and Literature Review
Authors: Sheng-Qiang Gao, Yong-Jin Bao, Jian-Sheng Luo
Journal: Front Surg (2022)
Keywords: case report, hilar bile duct, inflammatory, myofibroblastic, tumor
MeSH terms: Case Reports

Background:
Inflammatory myofibroblastic tumor (IMT) is a very rare tumor and occurs seldom in the biliary tract. IMT can occur in any part of the body and in people of any age; however, it most commonly occurs in children or adolescents. Its etiology and pathogenesis are currently unknown. The clinical manifestations of a hilar inflammatory myofibroblastic tumor are atypical, and the imaging examination is nonspecific. The diagnosis is mainly based on histopathology and immunohistochemistry findings, and surgical resection is the preferred treatment method.
Case description:
Herein, we report a rare case of hilar bile duct IMT and review the related literature. Our patient was a 54-year-old woman presenting with a 1-day history of upper abdominal pain as the main clinical symptom. She was misdiagnosed as having cholangiocarcinoma before the surgery. She underwent surgery and was ultimately diagnosed with IMT based on histopathology and immunohistochemistry findings. On 1-year follow-up, no tumor recurrence or related complications were noted.
Conclusions:
We hope this case report helps clinicians gain a deeper understanding of biliary IMT of the hilum.
Reconstruction of a Subtotal Maxillectomy Defect Using a Customized Titanium Implant in a 4-Year-Old Child: An 8-Year Follow-Up Report
Authors: Maurice Yves Mommaerts
Journal: Front Surg (2020)
Keywords: craniotomy, facial bones, follow-up studies, paranasal sinuses, titanium
MeSH terms: Case Reports

Condition: This case report demonstrates the use of alloplastic reconstruction in young children. Method: A three-dimensionally printed titanium implant was used to reconstruct a subtotal maxillectomy defect in a 4-year-old child. Results: We report an 8-year follow-up. The endoprosthesis was split at the midline to address transverse growth. The main finding is that the stigma surrounding resection and surgical reconstruction in pre-adolescents can be prevented by the use of alloplastic reconstruction based on titanium osseointegration. An additional finding is that shear forces should be prevented at the insertion points of the fixation screws in the facial walls by providing a vertical support for the maxillary/palatal shelves. Lastly, transverse maxillary growth in the circumferential sutures and functional matrix was not hampered by splitting the endo- and exoprostheses in the middle (where the mid-palatal suture would normally be located). Conclusion: Alloplastic reconstruction of maxillectomy defects in childhood can offer a viable temporary solution.