OpenMed/multicare-articles huggingface dataset:
Hepatic portal venous gas: comparison of two cases
Authors: Iain Rankin, Hemant Sheth
Journal: Case Rep Surg (2013)

Context. Hepatic portal venous gas (HPVG) is a rare and sinister finding. Its mortality is associated with the underlying causative condition. When secondary to bowel ischaemia, mortality rates exceed 50%. Case Report. Two cases of HPVG are described. One case describes HPVG in association with gastric ischaemia, with complete resolution following conservative management. The second case describes HPVG in association with widespread intra-abdominal ischaemia, with resultant mortality. Conclusion. A "watch and wait" management of HPVG associated with gastric ischaemia is suggested in certain patients, with a low threshold for surgical intervention. HPVG associated with bowel ischaemia is an absolute indication for surgical intervention, where intervention may change the clinical course.
Lanreotide Autogel in the Treatment of Persistent Diarrhea following a Total Colectomy
Authors: Patrick Schoeters, Karl De Pooter
Journal: Case Rep Gastrointest Med (2015)

Diarrhea is one of the most common complications following colectomy in patients with slow transit constipation (STC). Early postoperative diarrhea is usually treated with opioid agonists; however, to date, published data on the management of persistent diarrhea after colectomy for STC are scarce. Here, we report a case of severe diarrhea after a total colectomy with ileorectal anastomosis. One year after the surgery, the patient presented with persistent diarrhea. Treatment with a long-acting somatostatin analogue, lanreotide Autogel, was initiated. One month after the first injection of lanreotide Autogel the diarrhea was resolved. The patient's stool transit was markedly improved (type 4 or type 5 according to the Bristol Stool Chart compared to type 7 before the treatment), positively affecting the patient's quality of life (mean score of 2.1 on the Irritable Bowel Syndrome Quality of Life questionnaire compared to 3.9 before the treatment). This case report describes a successful use of lanreotide Autogel in a patient with persistent diarrhea after a total colectomy.
An illustrative case of subcutaneous panniculitis-like T-cell lymphoma
Authors: Farshad Bagheri, Kelly L Cervellione, Belkis Delgado, Luis Abrante, Jose Cervantes, Jitendra Patel, Alan Roth
Journal: J Skin Cancer (2011)
MeSH terms: Case Reports

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a very rare form of skin lymphoma that is localized primarily to the subcutaneous adipose tissue without palpable involvement of the lymph nodes. Diagnosis of SPTCL is a challenge, especially during its early phases when symptoms mimic other, more common conditions, such as benign panniculitis, eczema, dermatitis, psoriasis and cellulitis. Clinical and systemic features are nonspecific and can include fever, chills, and weight loss. Further complicating diagnosis is the high number of false negatives provided by biopsy. Here we present a case of SPTCL that illustrates the full course of the disease, from presentation and multiple misdiagnoses to correct disease recognition and successful treatment. A review of the challenges of diagnosis is provided with recommendations for more accurate and timely recognition of SPTCL.
Perifolliculitis capitis abscedens et suffodiens treatment with tumor necrosis factor inhibitors and baricitinib: A case report and literature review
Authors: Yuanting Yu, Xiaojie Ding, Fei Guo, Kan Ze, Xiaoying Sun, Xin Li
Journal: Front Med (Lausanne) (2023)
Keywords: pcas, adalimumab, baricitinib, case report, isotretinoin
MeSH terms: Case Reports

Rationale:
Perifolliculitis capitis abscedens et suffodiens (PCAS), also known as dissecting cellulitis of the scalp (DCS), is a part of the "follicular occlusion tetrad" that also includes acne conglobate (AC), hidradenitis suppurativa (HS), and pilonidal sinus, which share the same pathogenic mechanism, such as follicular occlusions, follicular ruptures, and follicular infections.
Patient concerns:
A 15-year-old boy had multiple rashes on the scalp accompanied by pain.
Diagnosis:
The patient was diagnosed with PCAS or DCS based on the clinical manifestations and laboratory examinations.
Interventions:
The patient was initially administered adalimumab 40 mg biweekly and oral isotretinoin 30 mg daily for 5 months. Because the initial results were insufficient, the interval between adalimumab injections was extended to 4 weeks, and isotretinoin was changed to baricitinib 4 mg daily for 2 months. When the condition became more stable, adalimumab 40 mg and baricitinib 4 mg were administered every 20 and 3 days, respectively, for two more months until now.
Outcomes:
After 9 months of treatment and follow-up, the original skin lesions of the patient were almost cured, and most inflammatory alopecia patches disappeared.
Conclusion:
Our literature review did not find any previous reports on treating PCAS with TNF-α inhibitors and baricitinib. Accordingly, we presented the first successful treatment of PCAS with this regimen.
Aspergillus march: from ABPA to aspergilloma to subacute invasive aspergillosis
Authors: Vikas Dogra, Ankit Kumar Sinha, Rajat Saxena, Deepak Talwar
Journal: Allergy Asthma Clin Immunol (2016)
Keywords: aspergilloma, aspergillus, asthma
MeSH terms: Case Reports

Background:

Aspergillus is a ubiquitous fungus responsible for allergic as well as saprophytic and invasive manifestations depending on host's immune status. The following case report demonstrates progression of allergic manifestations of Aspergillus to its invasive form in an individual with decreasing immunity. This can lead to uncertainties in diagnosis and management.
Case presentation:
A 28-year-old male, non smoker, known case of ABPA (allergic bronchopulmonary aspergillosis) was admitted with complaints of cough for 1 month, associated with recurrent episodes of hemoptysis for last 5 days. CT Thorax revealed homogenous dense round opacity in right upper lobe which replaced previous fibrocalcific bronchiectatic lesion with cavity and aspergilloma, bulging across the major fissure with fibrotic strands extending to periphery in all directions. Post-pneumonectomy microscopic examination revealed Aspergillus hyphae invading blood vessels.
Conclusion:
There is a need for close clinical and radiologic follow up of patients with Aspergillus and our patient demonstrated overlap of complete spectrum of Aspergillus disease with march from one end to the other end.
Pulmonary Thromboembolism Presenting with Recurrent Bradycardia and Hypotension
Authors: Alireza Khosravi, Elham Andalib, Arsalan Khaledifar, Majid Hajizadeh, Majid Nejati, Mohaddeseh Behjati
Journal: Tanaffos (2017)
Keywords: bradycardia, pulmonary thromboembolism, syncope
MeSH terms: Case Reports

Recurrent short episodes of bradycardia and hypotension are rarely reported as clinical manifestations of pulmonary thromboembolism (PTE). We report a case of acute massive PTE presenting with dyspnea, burning chest pain with physical activity, and recurrent transient bradycardia and hypotension at rest. Echocardiography showed a left ventricular ejection fraction of 45% with global hypokinesia. Computed tomography angiography showed a large pulmonary thromboembolism. Lytic therapy improved the right ventricular function, and the pulmonary artery pressure decreased to 38 mmHg. Recurrent bradycardia and transient hypotension at rest with syncope on activity and recovery without treatment are not common and may suggest a vasovagal mechanism. Evaluation of patients with these clinical findings could enable early diagnosis and treatment of acute PTE, with decreased morbidity and mortality.
Intravenous Leiomyomatosis Complicated by Arteriovenous Fistula: Case Series and Literature Review
Authors: Haoxuan Kan, Yang Cao, Yuexin Chen, Yuehong Zheng
Journal: Front Cardiovasc Med (2022)
Keywords: arteriovenous fistula (avf), coil embolization, intravascular leiomyomatosis (ivl), pelvic mass, vascular surgery

Background:
Uterine intravenous leiomyomatosis (IVL), a rare type of uterine leiomyoma, is defined by the intravascular proliferation of a histologically benign smooth muscle cell tumor. Pelvic arteriovenous fistula (AVF) is a rare vascular malformation that is most commonly congenital, post-traumatic, or iatrogenic. The link between leiomyomatosis and AVF has received little attention in the medical literature.
Results:
We provide a case series of seven patients, four of whom were from our center, who had IVL complicated by a pelvic AVF. The symptoms of right heart failure were noted as swelling in the abdomen and two legs as well as a significant amount of ascites. Coil embolization of AVFs may be beneficial in minimizing bleeding during IVL surgery. A review of all accessible literature published on IVLs from 2000 to 2020 was conducted, and data were retrieved from 78 papers totaling 262 cases. Complications and recurrence were associated with pelvic mass excision and intravascular remnant tumor, respectively.
Conclusion:
Intravenous leiomyomatosis combined with AVF aggravates congestion symptoms of surrounding organs. It is worth noting the uncommon combination of AVF and IVL, stressing the importance of a thorough assessment and surgical approach in IVL treatment.
Mal de Debarquement Syndrome: A Rare Entity-A Case Report and Review of the Literature
Authors: Veronica Nwagwu, Rakesh Patel, Jerome Okudo
Journal: Case Rep Otolaryngol (2015)

Mal de Debarquement Syndrome (MDS) is a rare, understudied, underdiagnosed, and self-limiting condition. Etiology and incidence are unknown. It is characterized by abnormal sensation of motion/balance reported after travel by air, land, and sea; being reexposed to motion/activity relieves it. Symptoms may last from minutes to years. Workup though required reveals no findings; it is a diagnosis of exclusion. While no efficacious treatment exists, amitriptyline and benzodiazepines as well as supportive therapy have proved to be useful. We have described a 40-year-old Caucasian female who presented for the evaluation of persistent rocking and swaying sensation after a ship cruise which lasted for one week. Patient was treated with benzodiazepines after extensive workup and is now stable. A high index of suspicion is required to make a diagnosis.
Case Report and Literature Review: Pulmonary Sclerosing Pneumocytoma With Multiple Metastases Harboring AKT1 E17K Somatic Mutation and TP53 C176Y Germline Mutation
Authors: Qiushi Wang, Chunlin Lu, Minrui Jiang, Mengxia Li, Xiao Yang, Lei Zhang, Yong He, Chengyi Mao, Ping Fu, Ying Yang, Hualiang Xiao
Journal: Front Med (Lausanne) (2021)
Keywords: akt1, tp53, metastasis, pulmonary sclerosing pneumocytoma, whole-exome sequencing
MeSH terms: Case Reports

Pulmonary Sclerosing Pneumocytoma (PSP) is considered as a benign tumor, although a few cases have been reported to have multiple lesions, recurrence, and even regional lymph nodes (LNs) metastasis. Here, we report a case of PSP with atypical histologic features and malignant biological behavior, and explore its molecular genetic changes. The 23-year-old male showed a 6.5-cm pulmonary nodule in the right middle lobe (RML) and enlarged media stinal LNs. He underwent thoracoscopic RML lobectomy, systematic LNs dissection, and mediastinal lymphadenectomy. The metastases to the cervical LNs and liver were detected in a short period and then resected. Postoperative pathological examination confirmed the diagnosis of PSP in all the lesions, based on the histological characteristics and immune phenotypes. Furthermore, whole-exome sequencing identified both AKT1 E17K somatic mutation and TP53 C176Y germline mutation in this case. Thus, we presented an extremely rare case of atypical PSP with rapid recurrence and multiply metastases, which can easily be misdiagnosed as primary lung cancer. In addition, PSP-specific AKT1 E17K somatic E17K somatic mutation accompanied with TP53 C176Y germline mutation may contribute to the malignant clinical course of this tumor.
Robotic complete mesocolic excision using indocyanine fluorescence imaging in colorectal cancer: A case study and technical approach
Authors: R Young, A K S Rajkomar, P Smart, S K Warrier
Journal: Int J Surg Case Rep (2020)
Keywords: case report, complete mesocolic excision, robotic
MeSH terms: Case Reports

Introduction:
Colorectal cancer is the second most common malignancy in developed countries and accurate staging is vital for determining the most appropriate management plan, in particular, whether adjuvant chemotherapy is recommended in addition to surgical resection. There is currently no consensus regarding standard practice for lymph node resection in colorectal cancer although there is increasing evidence to support the use of sentinel lymph node mapping to target lymph node sampling and facilitate ultra-staging of nodes.
Presentation of case:
We present the case of a 49 year old female who underwent a robotic right hemicolectomy and complete mesocolic excision for caecal adenocarcinoma using indocyanine fluorescence imaging (ICG FI) to guide nodal dissection.
Discussion:
ICG FI may be useful for sentinel lymph node mapping in colorectal cancer. This technique can assist to identify the first draining lymph nodes and permit ultra-staging of lymph nodes.
Conclusion:
While there is still limited evidence to support ICG FI, the current body of literature suggests that it is likely to be a feasible and sensitive technique for guiding sentinel lymph node sampling in colorectal cancer.
Characterization of a de novo sSMC 17 detected in a girl with developmental delay and dysmorphic features
Authors: Lana Stavber, Sara Bertok, Jernej Kovač, Marija Volk, Luca Lovrečić, Tadej Battelino, Tinka Hovnik
Journal: Mol Cytogenet (2017)
Keywords: developmental delay, dysmorphic features, small supernumerary marker chromosome, speech delay, fluorescence in situ hybridization
MeSH terms: Case Reports

Background:
The majority of small supernumerary marker chromosome cases arise de novo and their frequency in newborns is 0.04%. We report on a girl with developmental delay and dysmorphic features with a non-mosaic de novo sSMC that originated from the pericentric region of q arm in chromosome 17.
Case presentation:
The girl presented with developmental delay, speech delay, myopia, mild muscle hypotonia, hypoplasia of orbicular muscle, poor concentration, and hyperactivity. Main dysmorphic features included: round face, microstomia, small chin, down-slanting palpebral fissures and small lobules of both ears. At present, her developmental abilities are still delayed for her chronological age but she is making evident progress with speech. A postnatal array comparative genomic hybridization showed a 2.31 Mb genomic gain indicating microduplication derived from pericentric regions q11.1 and q11.2 of chromosome 17. Additional conventional cytogenetic analysis from peripheral blood characterized the karyotype as 47,XX,+mar in a non-mosaic form. The location of microduplication was confirmed with fluorescence in situ hybridization.
Conclusion:
The proband's microduplication encompassed approximately 40 annotated genes, several of which have been associated with phenotypic characteristics of the proband. This is the first report of sSMC 17 including this particular chromosomal region in non-mosaic form.
Case report: a COVID-19 reactivation case
Authors: Mohamed Anass Fehdi, Anas Erragh, Amine Zerhouni, Ouissal Aissaoui, Afak Nsiri, Rachid Alharrar
Journal: Pan Afr Med J (2020)
Keywords: ards, covid-19, sars-cov-2, virus reactivation
MeSH terms: COVID-19 / complications, Respiratory Distress Syndrome / virology, Virus Activation, Case Reports, Aged, COVID-19 / virology, Humans, Male

The novel Coronavirus, named SARS-COV-2, is responsible of the COVID-19. It is a viral pneumonia that appeared in December 2019 in Wuhan, China, and is causing a pandemic. Most of patients present mild symptoms, but in many other patients, acute respiratory distress (ARDS) is more likely to be developped. The actual problematic is the appearance of cases with virus reactivation. We report a case of virus reactivation in a COVID-19 patient with ARDS.
Case report: Rare novel MIPEP compound heterozygous variants presenting with hypertrophic cardiomyopathy, severe lactic acidosis and hypotonia in a Chinese infant
Authors: Ling Wang, Pengtao Lu, Jie Yin, Kangkang Xu, Dandan Xiang, Zhongman Zhang, Han Zhang, Bixia Zheng, Wei Zhou, Chunli Wang, Shiwei Yang
Journal: Front Cardiovasc Med (2023)
Keywords: mipep, combined oxidative phosphorylation deficiency-31, hypertrophic cardiomyopathy, mitochondrial disease, oxidative phosphorylation
MeSH terms: Case Reports

Background:
Mitochondrial intermediate peptidase, encoded by the MIPEP gene, is involved in the processing of precursor mitochondrial proteins related to oxidative phosphorylation. Only a few studies have shown that mutations in MIPEP can cause combined oxidative phosphorylation deficiency-31 (COXPD31), an autosomal recessive multisystem disorder associated with mitochondrial dysfunction. We report herein a rare case of an 8-month-old boy in China with hypertrophic cardiomyopathy (HCM), severe lactic acidosis, and hypotonia caused by novel MIPEP compound heterozygous variants.
Methods:
Trio-whole-exome sequencing and copy number variation sequencing were performed to identify mutated genetic loci. Sanger sequencing and quantitative real-time PCR were used to validate the candidate single nucleotide variants and copy number variants, respectively.
Results:
The proband was an 8-month-old boy with HCM, severe lactic acidosis, and hypotonia who died 2 months after his first admission. Two novel compound heterozygous variants, c.1081T > A (p. Tyr361Asn) and a whole deletion (Ex1-19 del), were found in the MIPEP gene, which were inherited from his healthy parents respectively. Additionally, his mitochondria DNA copy number was significantly reduced.
Conclusion:
We are the first to report a patient with rare MIPEP variants in China. Our findings expand the mutation spectrum of MIPEP, and provide insights into the genotype-phenotype relationship in COXPD31.
Abnormal Dexamethasone Suppression Tests in a Rifapentine-Treated Patient With Primary Aldosteronism
Authors: Hongman Wang, Ying Song, Zhixin Xu, Ying Jing, Wenwen He, Zhengping Feng, Qifu Li, Shumin Yang
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: dexamethasone suppression tests, hypercortisolism, hypertension, primary aldosteronism, rifapentine
MeSH terms: Cushing Syndrome / diagnosis, Hyperaldosteronism / drug therapy, Rifampin / analogs & derivatives, Case Reports, Research Support, Non-U.S. Gov't, Cushing Syndrome / blood, Diagnostic Errors, Humans, Hyperaldosteronism / blood, Male, Middle Aged, Pituitary-Adrenal Function Tests, Rifampin / therapeutic use, Rifampin, rifapentine

Aldosterone-producing adenoma (APA) is a main cause of primary aldosteronism (PA). Given that a large benign-appearing unilateral masse (>1 cm in diameter) may represent an aldosterone and cortisol-co-secreting adenoma, dexamethasone suppression testing is required in such patients to exclude or confirm the diagnosis of hypercortisolism. Tuberculosis is highly prevalent in China, and rifamycins are often used in these patients. Rifapentine belongs to the rifamycin family, and we herein for the first time report a case of misdiagnosis of hypercortisolism due to rifapentine use in a patient with APA. Thus, in patients treated with rifapentine, diagnosis of hypercortisolism based on dexamethasone suppression tests can be very misleading.
Successful surgical treatment for squamous cell carcinoma arising from hidradenitis suppurativa: A case report and literature review
Authors: Cheng Huang, Zhichao Lai, Mu He, Biyun Zhai, Liangrui Zhou, Xiao Long
Journal: Medicine (Baltimore) (2017)
MeSH terms: Carcinoma, Squamous Cell / surgery, Hidradenitis Suppurativa / complications, Skin Neoplasms / surgery, Skin Ulcer / surgery, Case Reports, Review, Carcinoma, Squamous Cell / etiology, Humans, Male, Middle Aged, Skin / pathology, Skin Neoplasms / etiology, Skin Neoplasms / pathology, Skin Ulcer / etiology, Skin Ulcer / pathology

Rationale:
Hidradenitis suppurativa (HS) is a disabling inflammatory disease mainly affecting apocrine glands. Marjolin ulcer (MU) is a term used to describe a rare type of squamous cell carcinoma (SCC) arising within sites of chronic wounds or preexisting scars. Chronic HS may result in a rare type of SCC, MU, which has a poor prognosis due to its high metastatic rate.
Concerns of the patient:
Here we reported a 60-year-old male who developed SCC on the right buttock after suffering from HS for 15 years.
Interventions:
Radical resection with clear margin was performed, after which topical negative pressure (TNP) was applied followed by split-thickness skin grafting.
Outcomes:
In a 1-year follow-up, there was no recurrence of malignancy.
Lessons:
Cases reported in English literature since 1991 were reviewed to get a general grasp of status quo. The authors conclude that chronic HS lesion especially in the gluteal region should be cautiously observed. Once tumor arisen from HS lesion, immediate radical excision should be performed. With assured clear margin, TNP could be chosen to offer a favorable environment for the survival of skin grafting.
Prenatal repair of gastroschisis using partial carbon dioxide insufflation fetoscopy: lessons learned
Authors: Gustavo Henrique de Oliveira, Gregório Lorenzo Acácio, Rodrigo Tadeu Russo Gonçalves, Javier Svetliza, Gustavo Yano Callado, Cristiane de Moraes Dias, Denise Cristina Mós Vaz-Oliani, Ramen H Chmait, Denise Araújo Lapa
Journal: Einstein (Sao Paulo) (2023)
MeSH terms: Gastroschisis / diagnostic imaging, Gastroschisis / surgery, Insufflation, Case Reports, Carbon Dioxide, Female, Fetoscopy / methods, Fetus, Humans, Infant, Newborn, Pregnancy, Carbon Dioxide

We report the long-term outcomes of a case of prenatal gastroschisis repair using a fully percutaneous fetoscopic approach with partial carbon dioxide insufflation. Surgery was performed as an experimental procedure before the scheduled elective birth. The fetal intestines were successfully returned to the abdominal cavity without any fetal or maternal complications. Ultrasonography performed 24 hours later revealed bowel peristalsis and no signs of fetal distress. After 48 hours, partial extrusion of the small bowel was observed, and the fetus was delivered. Gastroschisis repair was immediately performed upon delivery using the EXIT-like procedure as per our institutional protocol. The newborn did not require assisted mechanical ventilation, was discharged at 14 days of age and was then exclusively breastfed. At 3-year follow-up, the patient had no associated gastroschisis-related complications. This is the first case of prenatal repair of gastroschisis, which provides baseline knowledge for future researchers on the potential hurdles and management of prenatal repair.
Case Report: Elevated CPK, an indicator of idiopathic inflammatory myopathy?
Authors: Hina N Khan, Usman Jilani, Shitij Arora
Journal: F1000Res (2016)
Keywords: idiopathic inflammatory myopathy, myasthenia, polymyositis

Polymyositis is a rare disease with incidence rates at about 1 per 100,000 people annually. In this case report we will review a case of proximal muscle weakness with an elevated creatine phosphokinase that was initially misdiagnosed twice as rhabdomyolysis. Therefore, emphasizing that idiopathic inflammatory myopathy is a potential cause of myasthenia that must be considered in the differential. The case will also describe the current treatment and treatment response in polymyositis.