OpenMed/multicare-articles huggingface dataset:
Esophageal inlet patch
Authors: C Behrens, Peggy P W Yen
Journal: Radiol Res Pract (2011)
MeSH terms: Case Reports

An inlet patch is a congenital anomaly consisting of ectopic gastric mucosa at or just distal to the upper esophageal sphincter. Most inlet patches are largely asymptomatic, but in problematic cases complications related to acid secretion such as esophagitis, ulcer, web and stricture may occur. The diagnosis of inlet patch is strongly suggested on barium swallow where the most common pattern consists of two small indentations on the wall of the esophagus. The diagnosis of inlet patch is confirmed via endoscopy with biopsy. At endoscopy, the lesion appears salmon-coloured and velvety and is easily distinguished from the normal grey-white squamous epithelium of the esophagus. The prominent margins correlate with the radiological findings of indentations and rim-like shadows on barium swallow. Histopathology provides the definitive diagnosis by demonstrating gastric mucosa adjacent to normal esophageal mucosa. No treatment is required for asymptomatic inlet patches. Symptomatic cases are treated with proton pump inhibitors to relieve symptoms related to acid secretion. Strictures and webs are treated with serial dilatation and should be biopsied to rule out malignancy.
Lymphatic flow restoration after stripping surgery for varicose veins: A case report
Authors: Shuhei Yoshida, Isao Koshima, Hirofumi Imai, Ayano Sasaki, Yumio Fujioka, Shogo Nagamatsu, Kazunori Yokota
Journal: SAGE Open Med Case Rep (2019)
Keywords: lymphedema, stripping surgery, varicose vein
MeSH terms: Case Reports

It has been suggested that the dynamics of the venous and lymphatic systems interact as a mutually dependent dual outflow system and that derangement of lymph flow could be reversed by surgical treatment of venous incompetence. In this report, we describe a patient in whom lymphatic function was restored after stripping of the great saphenous vein for varicosity. The patient was a 79-year-old woman who had varicose veins along the medial side of an edematous left leg. Lymphatic function was investigated using indocyanine green imaging to evaluate for the presence of lymphedema. Based on the findings, we made a diagnosis of bilateral varicosity of the great saphenous vein with left-sided lymphedema. The great saphenous vein was stripped between the groin and ankle on both sides. At 3 months after the stripping procedure, lymphatic flow was observed immediately after injection of indocyanine green in both legs along the medial side from the foot to the groin. We therefore determined that lymphatic flow had been restored after the stripping surgery. The functions of the venous and lymphatic systems are thought to be closely related, and that, if the function of one declines, the other will also be affected. Treatment of venous system, including stripping, may help to break the vicious cycle of lymphatic stasis and venous insufficiency.
Group A Streptococcal Toxic Shock-Like Syndrome in a Male Presenting as Primary Peritonitis: A Case Report and a Review in Japan
Authors: Shunsuke Sakuraba, Shuhei Ueda, Satoshi Tokuda, Tomoaki Ito, Tomoyuki Kushida, Mutsumi Sakurada, Hiroshi Maekawa, Koichi Sato
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Background:
Streptococcal toxic shock-like syndrome (TSLS) is a severe infection caused by group A hemolytic streptococcus. It is clinically characterized by rapidly progressive septic shock and multiple organ failure within just a few hours. TSLS presenting as primary peritonitis is rare, especially in a male. Herein, we report a case of TSLS in a male presenting with primary peritonitis, with a review of 25 cases in Japan.
Case presentation:
A 51-year-old male was referred to our hospital with abdominal pain and hypotension. We made a preoperative diagnosis of peritonitis with septic shock and performed an emergency operation. Intraoperative findings indicated no marked origin of the peritonitis. Preoperative blood culture showed the presence of group A hemolytic streptococcus. The patient required intensive care involving artificial respiration, abdominal drainage and cytokine absorption therapy, and was discharged on postoperative day 25.
Conclusion:
TSLS in a male presenting as primary peritonitis is rare. Although this condition is a severe infection, it can be treated by multimodal therapy.
Mesenteric Cyst in Association with Type-II Jejunoileal Atresia
Authors: Rajat Piplani, Samir Kant Acharya, Nidhi Sugandhi, Deepak Bagga
Journal: J Neonatal Surg (2017)
Keywords: ileal atresia, mesenteric cyst, neonate
MeSH terms: Case Reports

A rare case of type-II jejunoileal atresia with mesenteric cyst in a neonate is being reported here with a brief review of literature.
Subacute thyroiditis following ginger (Zingiber officinale) consumption
Authors: Suzan Sanavi, Reza Afshar
Journal: Int J Ayurveda Res (2010)
Keywords: ginger, zingiber officinale, subacute thyroiditis
MeSH terms: Case Reports

A woman with subacute thyroiditis following ginger consumption is presented. The diagnosis was confirmed by physical examination and laboratory tests, in two distinct episodes. The patient was cured and recommended to refuse ginger consumption.
Atypical Presentation of Idiopathic Bilateral Optic Perineuritis in a Young Patient
Authors: Jessica Mani Penny Tevaraj, Evelyn Tai Li Min, Raja-Azmi Mohd-Noor, Lakana Kumar Thavaratnam, Win Mar Salmah, Wan Hazabbah Wan Hitam
Journal: Case Rep Ophthalmol Med (2016)
MeSH terms: Case Reports

A previously healthy 27-year-old Malay male presented with acute onset of painless, severe blurring of vision in his right eye. It was associated with headache and vomiting for the past week. Relative afferent pupillary defect was present in the right eye, with reduced optic nerve function. Patient also had bilateral generalised optic disc swelling, splinter haemorrhages, and tortuous vessels. Initial examination was suggestive of either optic neuritis or raised intracranial pressure. Typical features of bilateral optic perineuritis (OPN) such as tram track and doughnut sign were observed on magnetic resonance imaging. Connective tissue and infective screening were negative. He was diagnosed with bilateral optic perineuritis and treated with high dose intravenous corticosteroids followed by a three-month course of oral steroids. His vision and optic nerve function recovered to baseline levels.
Two Siblings with the Same Severe Form of 21-Hydroxylase Deficiency But Different Growth and Menstrual Cycle Patterns
Authors: Mariarosaria Lang-Muritano, Karine Gerster, Susanna Sluka, Daniel Konrad
Journal: Front Pediatr (2017)
Keywords: adrenal hyperplasia, adult height, congenital, constitutional delay, hydrocortisone treatment, in utero dexamethasone
MeSH terms: Case Reports

Congenital adrenal hyperplasia (CAH) is one of the most frequent autosomal recessive diseases in Europe. Treatment is a challenge for pediatric endocrinologists. Important parameters to judge the outcome are adult height and menstrual cycle. We report the follow-up from birth to adulthood of two Caucasian sisters with salt-wasting CAH due to the same mutation, homozygosity c.290-13A>G (I2 splice), in the 21-hydroxylase gene. Their adherence to treatment was excellent. Our objective was to distinguish the effects of treatment with hydrocortisone (HC) and fludrocortisone (FC) on final height (FH) from constitutional factors. The older girl (patient 1), who showed virilized genitalia Prader scale III-IV at birth, reached FH within familial target height at 18 years of age. Menarche occurred at the age of 15. Her menstrual cycles were always irregular. Total pubertal growth was normal (29 cm). She showed a growth pattern consistent with constitutional delay. The younger sister (patient 2) was born without masculinization of the genitalia after her mother was treated with dexamethasone starting in the fourth week of pregnancy. She reached FH at 16 years of age. Her adult height is slightly below familial target height. Menarche occurred at the age of 12.5, followed by regular menses. Total pubertal growth was normal (21 cm). The average dose of HC from birth to FH was 16.7 mg/m2 in patient 1 and 16.8 mg/m2 in patient 2. They received FC once a day in doses from 0.05 to 0.1 mg. Under such therapy, growth velocity was normal starting from the age of 2.5 years with an overall average of +0.2 SD in patient 1 and -0.1 SD in patient 2, androstenedione levels were always within normal age range. Similarly, BMI and blood pressure were always normal, no acne and no hirsutism ever appeared. In conclusion, two siblings with the same genetic form of 21-hydroxylase deficiency and excellent adherence to medication showed different growth and menstrual cycle patterns, rather related to constitutional factors than to underlying CAH. In addition, the second patient represents an example of successful in utero glucocorticoid treatment to prevent virilization of the external genitalia.
Unique Complications of MIS-C and Its Treatment: Encephalopathy in a Child with MIS-C Who Developed Life-Threatening Gastrointestinal Hemorrhage
Authors: Luke Burton, Ananya Manchikalapati, Chrystal Rutledge, Jeremy M Loberger, Nicholas Rockwell, Joshua Cooper, Maggie Lawrence, William C Sasser
Journal: Case Rep Crit Care (2022)
MeSH terms: Case Reports

In this case report, we describe a previously healthy eleven-year-old male diagnosed with multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019. The patient presented with shock and neurologic symptoms including altered mental status and dysarthria. Brain magnetic resonance imaging, obtained to rule out thromboembolic injury, demonstrated cytotoxic edema of the corpus callosum, an imaging finding similar in nature to several previous reports of MRI abnormalities in children with MIS-C. Following administration of intravenous immunoglobulin and pulse-dose steroids, the patient convalesced and was discharged home. Medications prescribed upon discharge included a steroid taper, daily aspirin, and proton pump inhibitor. Four days later, he was readmitted with shock and life-threatening gastrointestinal (GI) hemorrhage. After extensive evaluation of potential bleeding sources, angiography revealed active bleeding from two arterial vessels supplying the duodenum. The patient demonstrated no further signs of bleeding following successful coil embolization of the two vessels. We hypothesize that the vasculitic nature of MIS-C combined with anti-inflammatory and antithrombotic therapy placed him at risk of GI hemorrhage. This case highlights unique radiologic features of MIS-C as well as potential complications of treatment.
Case Report: Using Medtronic AP360 mechanical prosthesis in mitral valve replacement for patients with mitral insufficiency after primum atrial septal defect repair to reduce left ventricular outflow tract obstruction risk
Authors: Lei Guo, Qiqi Yang, Yu Han, Haige Zhao, Liangwei Chen, Junnan Zheng, Yiming Ni
Journal: Front Surg (2023)
Keywords: lvoto, mvr, pasd repair, case report, congenital heart disease
MeSH terms: Case Reports

Background:
Atrial septal defect is one of the most common congenital heart diseases in adults. Primum atrial septal defect (PASD) accounts for 4%-5% of congenital heart defects. Patients with PASD frequently suffer mitral insufficiency (MI), and thus, mitral valvuloplasty (MVP) or mitral valve replacement (MVR) is often required at the time of PASD repair. Unfortunately, recurrent unrepairable severe mitral regurgitation can develop in many patients undergoing PASD repair plus MVP in either short- or long-term after the repair surgery, requiring a re-do MVR. In those patients, the risk of left ventricular outflow tract obstruction (LVOTO) has increased.
Case presentation:
We present five such cases, ranging in age from 24 to 47 years, who had a PASD repair plus MVP or MVR for 14-40 years while suffering moderate to severe mitral regurgitation. Using Medtronic AP360 mechanical mitral prostheses, only one patient experienced mild LVOTO.
Conclusions:
The use of Medtronic AP360 mechanical mitral prostheses to perform MVR in patients with MI who had a history of PASD repair can potentially reduce the risk of LVOTO. Long-term follow-up is required to further confirm this clinical benefit associated with AP360 implantation in patients with PASD.
Old Era Continues in Modern World: A Case Report of Scurvy Induced Myopathy in Patient with Chronic Alcoholism
Authors: Girish Singhania, Namrata Singhania, Neha Chawla
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

We report a case of myopathy in a chronic alcoholic patient with scurvy who presented with generalized weakness, myalgias, and arthralgia. Our case raises awareness regarding rare interaction between vitamin C deficiency and myopathy which is seen more commonly in patients with history of chronic alcoholism and low socioeconomic status. Early treatment with vitamin C replacement is helpful in treatment of the disease and its complications.
Brainstem and Cerebellar Involvement in Ramsay Hunt Syndrome
Authors: Vijay Letchuman, Charles D Donohoe
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

We present a case of a 62-year-old Caucasian male with laryngeal cancer and Ramsay Hunt Syndrome otherwise known as herpes zoster oticus due to reactivation of the varicella zoster virus. Classic findings include the triad of ipsilateral facial paralysis, otic pain, and herpetic lesions in the sensory supply of the facial nerve. The common pathogenesis is associated with anterograde axonal reactivation of the varicella zoster virus in the geniculate ganglion. Unique features of our case include retrograde transaxonal spread of the varicella-zoster virus from the geniculate ganglion into the brainstem and cerebellum including involvement of the abducens nucleus, facial nucleus, middle cerebral peduncle, and inferior cerebellar peduncle. This presented as left facial paralysis, left sixth nerve palsy, horizontal diplopia to the left lateral gaze, profound truncal ataxia, and left-sided dysmetria. Clinical awareness that Ramsay Hunt syndrome may also involve the brainstem and cerebellum is critical in evaluating the clinical neurologic findings and expanding the diagnostic workup to include brain magnetic resonance imaging and cerebrospinal fluid analysis, including varicella zoster polymerase chain reaction. Encephalitis requires longer duration administration of high-dose intravenous acyclovir in conjunction with steroids. Delays in treatment are often associated with unsatisfactory outcomes with extensive residual deficits.
Case report: Findings of automated perimetry during a migraine episode in a patient with glaucoma
Authors: Shunsuke Nakakura, Satomi Oogi, Asaya Tanoue, Teruyuki Miyoshi
Journal: Front Med (Lausanne) (2022)
Keywords: automated perimetry, case report, glaucoma, homonymous hemianopia, migraine, patient
MeSH terms: Case Reports

Comorbidities like glaucoma and migraine are often observed among middle-aged individuals, especially women. Herein, we report a rare case of a patient who underwent automated perimetry during a migraine attack. A 52-year-old woman with a 1-year history of blurred vision in the nasal field of her right eye visited Miyoshi Eye Clinic. The intraocular pressures of the right and left eyes were 22 and 24 mm Hg, respectively. Retinal imaging revealed a retinal nerve fiber defect in the temporal superior macula with corresponding thinning of the superior ganglion cell complex in the right eye. The left eye appeared normal. Primary open-angle glaucoma was suspected, and the patient underwent a visual field examination on the same day. Perimetry showed that the mean deviations in the right and left eyes were -5.00 and -7.68 dB, respectively. A visual field defect in the inferior nasal aspect of the right eye corresponded to the retinal nerve fiber defect. However, right-sided homonymous hemianopia-like visual field defects were observed in both eyes. After the examination, the patient stated that a migraine attack had started 5 min before the examination and continued till after its end (attack duration was ∼20 min). In the follow-up examinations without migraine, homonymous hemianopia-like visual field defects disappeared, and only a glaucomatous visual field defect in the right eye was observed. Hence, the initial visual field examination findings reflected the effects of a migraine attack alongside glaucoma. Detailed interviews with patients may be beneficial for understanding visual field findings and preventing their untimely examination.
Sarcoidosis vs. Colon Cancer Metastasis: Diagnostic Dilemma and the Role of PET Scan in Monitoring Disease Activity
Authors: Raai Mahmood, Kadhim Al Banaa, Israa Ibrahim, Ahmed Hashim, Luis Torregrosa
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

Sarcoidosis is a systemic inflammatory disorder characterized by "noncaseating granulomas." It primarily affects the lungs, but multiple other organs can be involved. Sarcoidosis has been increasingly reported in association with cancer. It can precede, follow or occur at the same time as the diagnosis of cancer. We report a case of sarcoidosis that was diagnosed concomitantly with colon cancer, highlighting the diagnostic dilemma of sarcoidosis vs. cancer metastasis, the relationship between the two, and the value of PET scan in follow-up and monitoring of disease activity.
Allergy to cooked, but not raw, peas: a case series and review
Authors: Elissa M Abrams, Thomas V Gerstner
Journal: Allergy Asthma Clin Immunol (2015)
Keywords: food allergy, legume, pea
MeSH terms: Case Reports

Allergic reactions to legumes are common.Food allergy to cooked, but not raw, pea has been rarely reported in the literature. This case series describes five children who had various IgE-mediated symptoms upon consumption of cooked pea, but tolerated raw pea. Skin testing then confirmed positive responses to cooked, but not raw, peas. It is important to consider allergy to cooked legumes, even in the context of raw legume tolerance.
A Rare Presentation of a Rare Entity: Wellens Syndrome with Subtle Terminal T Wave Changes
Authors: Mohammed J Arisha, Ahmad Hallak, Ahmad Khan
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Wellens syndrome is an electrocardiographic (ECG) pattern involving T waves in precordial leads that was first described in 1982 among a group of patients presenting with unstable angina suggestive of critical stenosis of the proximal left anterior descending (LAD) coronary. It is crucial for emergency physicians and internists to be able to recognize these patterns, as they occur in the symptom-free periods and represent a pre-infarction state that needs early intervention. Type A, which is characterized by biphasic T waves, mainly in V2 and V3, poses a significant challenge to recognize the pattern, and failure to do so can lead to devastating outcome. We report a case of type A Wellens syndrome with subtle T wave changes that went unnoticed during the initial assessment and led to start off on a wrong foot.
Transcranial Alternating Current Stimulation: A Potential Risk for Genetic Generalized Epilepsy Patients (Study Case)
Authors: Daniel San-Juan, Carlos Ignacio Sarmiento, Axel Hernandez-Ruiz, Ernesto Elizondo-Zepeda, Gabriel Santos-Vázquez, Gerardo Reyes-Acevedo, Héctor Zúñiga-Gazcón, Carol Marina Zamora-Jarquín
Journal: Front Neurol (2016)
Keywords: juvenile myoclonic epilepsy, neuromodulation, transcranial alternating current stimulation
MeSH terms: Case Reports

Transcranial alternating current stimulation (tACS) is a re-emergent neuromodulation technique that consists in the external application of oscillating electrical currents that induces changes in cortical excitability. We present the case of a 16-year-old female with pharmaco-resistant juvenile myoclonic epilepsy to 3 antiepileptic's drugs characterized by 4 myoclonic and 20 absence seizures monthly. She received tACS at 1 mA at 3 Hz pulse train during 60 min over Fp1-Fp2 (10-20 EEG international system position) during 4 consecutive days using an Endeavor™ IOM Systems device® (Natus Medical Incorporated, Middleton, WI, USA). At the 1-month follow-up, she reported a 75% increase in seizures frequency (only myoclonic and tonic-clonic events) and developed a 24-h myoclonic status epilepticus that resolved with oral clonazepam and intravenous valproate. At the 2-month follow-up, the patient reported a 15-day seizure-free period.
Rudimentary Horn Pregnancy Diagnosed after Laparotomy
Authors: Kurabachew Mengistu, Tufa Bobe, Gashaw Tilahun, Kibru Kifle, Dereje Geleta
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Müllerian abnormalities are present in 0.17% of fertile women and 3.5% of infertile women, and a unicornuate uterus is observed in 0.4% of women. The uterus is normally formed during embryogenesis by the fusion of the two Müllerian ducts. If one of the ducts does not develop, only one Müllerian duct contributes to the uterine development. We report a case of Gravida II, abortion I referred from a primary hospital with a referral paper and sonography stating she had IUFD. She had regular antenatal care follow-up at the primary hospital and had 8 months of amenorrhea. Our ultrasound assessment confirmed the intrauterine fetal demise, but the rudimentary horn pregnancy was missed. Repeated attempts at the induction of labor were tried but unsuccessful. The diagnosis was confirmed at laparotomy. She underwent cesarean section with right intact rudimentary horn removal. A nonviable male fetus with birth weight of 1.2 kg was delivered. Women with this abnormality are asymptomatic and unaware of having a unicornuate uterus. Abdominal pain is the most common presenting symptom with the rudimentary horn, but communicating horn pregnancy is generally asymptomatic in early pregnancy. Early awareness of this rare clinical condition is so crucial especially in developing countries where the availability of new technologies is scarce to explore uterine abnormalities. The patient had uneventful postoperative recovery and was discharged after 3 postoperative days.
Clinical and pathological features of hepatoid carcinoma of the ovary
Authors: Lina Wang, Yanping Zhong, Lingling Sun, Heng Zhou, Wei Chen, Xiaoxia Zhang
Journal: World J Surg Oncol (2013)
MeSH terms: Carcinoma, Hepatocellular / pathology, Liver Neoplasms / pathology, Ovarian Neoplasms / pathology, Case Reports, Research Support, Non-U.S. Gov't, Biomarkers, Tumor / analysis, Carcinoma, Hepatocellular / therapy, Combined Modality Therapy, Female, Humans, Immunoenzyme Techniques, Liver Neoplasms / therapy, Middle Aged, Ovarian Neoplasms / therapy, Prognosis, Tomography, X-Ray Computed, Biomarkers, Tumor

Hepatoid carcinoma of the ovary (HCO), a rare invasive malignant tumor composed mainly of epithelioid cells, presented with unilateral or bilateral ovarian masses and elevated serum α-fetoprotein (AFP), has been found mainly in post-menopausal women. We hereby report on the case of a 53-year-old Chinese woman who presented with abdominal distension and a lower abdominal mass with high serum levels of CA-125 and AFP. She was later diagnosed with bilateral HCO. After surgery and following chemotherapy, the patient had no recurrence of tumor or ascites. The hepatoid cells were positive for AFP, p53 and CK7 by immunohistochemistry. Her serum CA-125 and AFP levels had decreased significantly after surgery. Our results suggest that testing and monitoring of serum levels of AFP and CA-125 are considered as potential biomarkers in the diagnosis and progression of this malignancy, and that tissue immunohistochemical staining for AFP, p53 and CK7, plays an important role in distinguishing HCO from other ovarian tumors.