OpenMed/multicare-articles huggingface dataset:
Perianal tuberculosis: a case report and a review of the literature
Authors: K Ibn Majdoub Hassani, S Ait Laalim, I Toughrai, K Mazaz
Journal: Case Rep Infect Dis (2012)

Extra pulmonary tuberculosis accounts for less than 15% of all cases of tuberculosis whereas the Intestinal one constitutes less than 1% of the extrapulmonary forms of the disease. The lesions of abdominal organs are more common while they rarely occur in the anoperineal area for the spread of the disease to the anus is extremely rare. We report a case of a 37-year-old male patient with large bilateral infected perianal tubercular ulcerations as well as pulmonary and peritoneal tuberculosis. The treatment was both surgical and medical and the therapy lasted for seven months. After six months from the beginning of the treatment, the lesion had totally disappeared and there is still no recurrence after one year of followup. Tuberculosis should generally be taken into consideration in the differential diagnosis of the ulcerative lesions of the anal and perianal regions for these lesions do occur in the said areas despite their rarity. The treatment is usually both surgical and medical so as to get excellent results.
Unusual Presentation of Recurrent Gallstone Ileus: A Case Report and Literature Review
Authors: Osayande Osagiede, Paula Pacurari, Dorin Colibaseanu, Nezar Jrebi
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Background:
Gallstone ileus (GSI) is a rare form of small bowel obstruction (SBO) in patients with cholelithiasis, which is often poorly managed. Enhanced abdominal computed tomography (CT) with contrast is considered the most helpful diagnostic tool, as it is highly sensitive, specific, and accurate. We report an interesting case of recurrent GSI that was not detected by CT but diagnosed intraoperatively.
Case presentation:
A 49-year-old female with a previous history of choledocholithiasis and ERCP presented to the emergency department following episodes of sudden cramping, epigastric pain, and nausea. An abdominal CT revealed evidence of SBO with clear evidence of GSI and a cholecystoduodenal fistula. Laparoscopic exploration of the small bowel revealed a large, calcified 3.5 cm × 3 cm gallstone with evidence of pressure necrosis; segmental bowel resection with stapled anastomosis was performed and patient recovered appropriately after surgery. Cholecystectomy was not performed due to multiple co-morbidities and absence of gallbladder stones. However, she presented two months later with signs and symptoms of SBO. A repeat abdominal CT showed dilated bowel with no clear transition point. This was suspected to be due to adhesions. After an initial conservative treatment which produced mild improvement, laparotomy was performed which revealed a second large non-calcified gallstone and necrotic small bowel with a pocket of abscess.
Conclusion:
The most sensitive diagnostic tool for GSI is enhanced abdominal CT but dilemma arises when GSI is not detected on CT. A high index of suspicion and further exploration are required in order not to miss other vital findings.
Giant Primary Scrotal Lipoma: A Rare Entity with Diagnostic Pitfalls
Authors: Louis Vignot, Elie Saad, Michael Peyromaure, Nicolas Barry Delongchamps
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Primary scrotal lipomas are rare. We describe the case of a 47-year-old male with a giant scrotal lipoma who underwent a surgical excision. We report the clinical and radiological approach as well as the treatment of this atypical benign tumor.
Laparoscopic cholecystectomy in situs inversus totalis: Case report with review of techniques
Authors: Omar AlKhlaiwy, Ahmed Mohammed AlMuhsin, Eman Zakarneh, Mohamed Yassin Taha
Journal: Int J Surg Case Rep (2019)
Keywords: case report, laparoscopic cholecystectomy, situs inversus totalis

Introduction:
Situs inversus totalis (SIT) is a congenital disorder in which the visceral organs are mirrored from their normal anatomical position. Diagnosis and management of cholelithiasis in patient with SIT poses a challenge due to the underlying anatomical variation.
Presentation of case:
We report a case of a 40-year-old male patient who presented with an intermittent history of epigastric and left upper quadrant pain for one month. Clinical assessment and radiological investigations confirmed the presence of cholelithiasis with evidence of SIT. The patient underwent elective laparoscopic cholecystectomy with no complication and he had an uneventful recovery. Various intraoperative modification has been made to overcome the technical difficulties encountered due to the underlying anatomical variation.
Discussion:
Since the first successful laparoscopic cholecystectomy in patient with SIT performed in 1991, 85 cases have been reporsted in the literature. Surgeons managed to overcome the technical difficulties by adopting various modification in the techniques compared to the conventional laparoscopic cholecystectomy.
Conclusion:
The anatomical variation in SIT can influence the localization of symptoms in patient with cholelithiasis leading to a delay in diagnosis and management. Laparoscopic cholecystectomy can be safely performed in these cases. However, it is considered technically challenging procedure and often requires alteration in the technique.
A rare combination of an endocrine tumour of the common bile duct and a follicular lymphoma of the ampulla of Vater: a case report and review of the literature
Authors: Panagiotis G Athanasopoulos, Nikolaos Arkadopoulos, Vania Stafyla, Aliki Tympa, Evi Kairi, Charlotte Ryzman-Louloudis, Vassilios Smyrniotis
Journal: World J Surg Oncol (2011)
MeSH terms: Ampulla of Vater, Carcinoid Tumor / pathology, Common Bile Duct Neoplasms / pathology, Endocrine Gland Neoplasms / pathology, Lymphoma, Follicular / pathology, Neoplasms, Multiple Primary / pathology, Case Reports, Review, Adult, Carcinoid Tumor / surgery, Common Bile Duct Neoplasms / surgery, Endocrine Gland Neoplasms / surgery, Follow-Up Studies, Humans, Lymphoma, Follicular / surgery, Male, Neoplasms, Multiple Primary / surgery

Carcinoid tumours of the common bile duct represent an extremely rare entity. Similarly, primary follicular lymphomas of the ampulla of Vater constitute an infrequent neoplasia. Herein, we report the first case of a synchronous development of a carcinoid tumour of the common bile duct and an ampullary follicular lymphoma that was treated surgically with a Whipple's procedure, due to inability to establish definitive preoperative diagnosis despite the extensive diagnostic investigation.
Ketogenic Diet-Induced Severe Ketoacidosis in a Lactating Woman: A Case Report and Review of the Literature
Authors: Benedicta Nneoma Nnodum, Eziafa Oduah, David Albert, Mark Pettus
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

The ketogenic diet (KD) is a high-fat, adequate-protein, and low-carbohydrate diet that leads to nutritional ketosis and weight loss. It is known to induce ketosis but is not an established cause of clinically significant ketoacidosis. Lactation ketoacidosis is well established in bovine literature but remains a rare phenomenon in humans. Here we present a life-threatening case of severe ketoacidosis in a nondiabetic lactating mother on a strict ketogenic diet. We review the available case reports of lactation ketoacidosis in humans and the mechanisms thereof. Although ketogenic diet has been shown to be safe in nonpregnant individuals, the safety of this diet in lactating mothers is not known. Health professionals and mothers should be made aware of the potential risk associated with a strict ketogenic diet when combined with lactation. Prompt diagnosis and immediate treatment cannot be overemphasized. To our knowledge, this is the first reported case of life-threatening lactation ketoacidosis associated with ketogenic diet while consuming an adequate number of calories per day.
Recurrent Wheezing in Pre-school Age: Not Only Airway Reactivity!
Authors: Marco Roversi, Federica Porcaro, Paola Francalanci, Adriano Carotti, Renato Cutrera
Journal: Front Pediatr (2020)
Keywords: airways abnormalities, asthmatic bronchitis, bronchogenic cyst, pediatrics, wheezing
MeSH terms: Case Reports

Background: About a fifth of all mediastinal masses are primary cysts arising in the absence of other underlying pathology. Bronchogenic cysts, although rare, are the most frequent type responsible for lower airways compression as they often develop in the peripheral branches of the tracheobronchial tree. Case presentation: We report the case of a 6-months-old child admitted for acute respiratory distress and wheezing not responsive to asthma treatment. Digestive and airway endoscopy proved a mild and a marked reduction of the esophageal and tracheal lumen, respectively. The nocturnal polygraphy showed an underlying obstructive disorder and the chest CT scan confirmed the presence of a wide mediastinal cyst compressing the trachea. The mass, later identified as a bronchogenic cyst, was surgically removed with complete resolution of the patient's respiratory symptoms. Discussion: Our case shows that differential diagnosis of wheezing in pre-school aged children should encompass causes others than airway reactivity, thus prompting further evaluation and management.
Minilaparotomy a good option in specific cases: a case report of bilateral ovarian germ cell tumor
Authors: D Bolla, N Deseö, A Sturm, A Schöning, C Leimgruber
Journal: Case Rep Obstet Gynecol (2012)
MeSH terms: Case Reports

Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6 cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue.
Perioperative FOLFOX in management of peritoneal metastases of colorectal cancer. Case report of 2 patients
Authors: Paul H Sugarbaker, O Anthony Stuart
Journal: Int J Surg Case Rep (2020)
Keywords: 5-fluorouracil, adjuvant treatment, chip, case report, colorectal cancer, cytology, cytoreductive surgery, folfox, hipec, leucovorin, oxaliplatin, peritoneal metastases, peritonectomy, regional chemotherapy
MeSH terms: Case Reports

Introduction:
Colorectal cancer can disseminate malignant cells to the peritoneal surfaces which over time progress to peritoneal metastases. Management of this type of metastatic disease has been approached using a combined treatment that consists of cytoreductive surgery and perioperative chemotherapy. To optimize these treatments a more effective chemotherapy that is used as planned part of the surgical procedure is required.
Presentation of cases:
Pharmacologic studies to initiate a new perioperative chemotherapy treatment were modeled after the successful systemic treatments of metastatic colorectal cancer referred to as FOLFOX. A management plan that included all of the essential features of successful systemic chemotherapy was formulated. Pharmacokinetic studies of 5-fluorouracil given both intravenously and intraperitoneally and oxaliplatin given intraperitoneally were investigated.
Discussion:
The compatibility of 5-fluorouracil and oxaliplatin was documented showing no degradation of either drug when they were mixed in-vitro over 24 h. The pharmacokinetic analysis of hyperthermic intraperitoneal chemotherapy (HIPEC) with oxaliplatin showed cytotoxic concentrations for 120 min. In order to maximize oxaliplatin's effect, both intravenous bolus and continuous infusion 5-fluorouracil was combined with early postoperative intraperitoneal chemotherapy (EPIC). In total, 200 mg/m2 of oxaliplatin was combined with a minimum of 1600 mg of 5-fluorouracil over the 24 -h treatment plan.
Conclusion:
This perioperative FOLFOX treatment was completed in 2 patients and the clinical effectiveness as a result of this in-depth case reports was presented. Formal phase II studies, as a result of these pharmacokinetic and clinical investigations, have been initiated.
Uterine Rupture with Cesarean Scar Heterotopic Pregnancy with Survival of the Intrauterine Twin
Authors: Kimberly R Lincenberg, Eric R Behrman, James S Bembry, Christine M Kovac
Journal: Case Rep Obstet Gynecol (2016)
MeSH terms: Case Reports

Background. Heterotopic pregnancy is a multiple gestation with both intrauterine and ectopic fetuses. A cesarean scar ectopic pregnancy is when the fetus has implanted over the previous hysterotomy site. A known complication of cesarean scar ectopic pregnancy is uterine rupture, which can cause great morbidity and mortality. Case. 28-year-old G5P3105 at 10 weeks with a dichorionic diamniotic gestation was found to have a ruptured uterus with expulsion of a cesarean scar ectopic pregnancy and retention of the intrauterine fetus. After uterine repair, the singleton gestation reached viability was delivered by emergent cesarean section for placental abruption. Conclusion. Safe management of cesarean ectopic pregnancy requires early diagnosis by ultrasonography. With early detection, management can focus on preventing maternal morbidity of uterine rupture and life-threatening hemorrhage.
Cutaneous metastases of embryonal rhabdomyosarcoma in a black African child: the role of dermoscopy in reducing time to and cost of diagnosis
Authors: Nkechi Enechukwu, Ezejiofor Ogochukwu Ifeanyi, Gabriel Olabiyi Ogun, Adebola Olufunmilayo Ogunbiyi
Journal: Ecancermedicalscience (2021)
Keywords: africa, cutaneous metastases, dermoscopy, embryonal rhabdomyosarcoma
MeSH terms: Case Reports

Cutaneous metastases are an uncommon feature of solid organ malignancies. The cost of multiple investigations and prolonged processing time of biopsies may lead to diagnostic delays especially in resource limited practice settings. Dermoscopy can provide useful clues and has been found to be useful in the diagnosis of cutaneous metastases. Dermoscopic findings of skin lesions may limit unnecessary investigations and shorten time to diagnosis. There are limited data on dermoscopic features of embryonal rhabdomyosarcoma in the literature. We report dermoscopic features of cutaneous metastasis of embryonal rhabdomyosarcoma seen in a black African child.
Intravitreal Ziv-Aflibercept in Treatment of Naïve Chronic Central Serous Chorioretinopathy Related Choroidal Neovascular Membrane
Authors: Nishant Radke, Charudutt Kalamkar, Amrita Mukherjee, Snehal Radke
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Purpose. To study the effect and outcome of intravitreal Ziv-Aflibercept (IVZ) in treatment of Chronic Central Serous Chorioretinopathy (CSCR) related Choroidal Neovascular Membrane (CNVM). Methods. A case report of 48-year-old male patient treated with 1.25 mg/0.05 ml IVZ (total 3 doses at monthly intervals) in CSCR related CNVM. Pre- and posttreatment fundus fluorescein angiography (FFA) and Optical Coherence Tomography (OCT) were done to document response along with improvement in visual acuity. Patients. Single eye of a 48-year-old male patient. Results. Regression of CNVM was noted with improvement of macular contour and thickness on OCT and cessation of leakage on FFA. Visual acuity improved from 3/60, <N36 to 6/12, N12. Discussion. Anti-VEGF injections have shown benefit in treatment of CNVM. There is very little information about benefit of IVZ in CSCR related CNVM. Conclusion. IVZ is effective in regression of CSCR related CNVM and is associated with better macular anatomy and improved visual function.
Parotid Oncocytoma as a Manifestation of Birt-Hogg-Dubé Syndrome
Authors: Kazuki Yoshida, Masao Miyagawa, Teruhito Kido, Kana Ide, Yoshifumi Sano, Yoshifumi Sugawara, Hiroyuki Takahata, Nobuya Monden, Mitsuko Furuya, Teruhito Mochizuki
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Birt-Hogg-Dubé syndrome (BHD) is a rare autosomal dominant disease characterized by skin fibrofolliculomas, pulmonary cysts, spontaneous pneumothoraces, and renal cancers. Oncocytomas are benign epithelial tumors that are also rare. Recently, there have been a few case reports of BHD with a parotid oncocytoma that appears to have a BHD phenotype. Here we document the eighth known case and describe the magnetic resonance imaging features of the parotid oncocytoma, which mimicked Warthin's tumor. Radiologists should be aware of the association between these rare disorders.
Multimodal Stepped Care Approach Involving Topical Analgesics for Severe Intractable Neuropathic Pain in CRPS Type 1: A Case Report
Authors: David J Kopsky, Jan M Keppel Hesselink
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

A multimodal stepped care approach has been successfully applied to a patient with complex regional pain syndrome type 1 and severe intractable pain, not responding to regular neuropathic pain medication. The choice to administer drugs in creams was made because of the intolerable adverse effects to oral medication. With this method, peak-dose adverse effects did not occur. The multimodal stepped care approach resulted in considerable and clinically relevant decrease in pain after every step, using topical amitriptyline, ketamine, and dimethylsulphoxide.
Galactocele in the Axillary Accessory Breast Mimicking Suspicious Solid Mass on Ultrasound
Authors: Donya Farrokh, Ali Alamdaran, Farhad Yousefi, Bita Abbasi
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Galactoceles are the most common benign breast lesions during breastfeeding period that can mimic carcinomas. We report a galactocele with malignant appearance on ultrasound in the accessory breast. The patient was a 32-year-old lactating woman presented to our hospital for considerable swelling in the left axilla. Ultrasound examination revealed a hypoechoic mass with heterogeneous echogenicity and irregular shape and margins. Sonography-guided aspiration was performed. Aspiration of milky fluid and resolution of the axillary lump after aspiration confirmed the diagnosis of galactocele. Galactocele can present as a suspicious tumoral lesion in the axillary accessory breast and diagnostic aspiration can help in correct diagnosis of this rare lesion in the accessory breast.
Splinting of Longitudinal Fracture: An Innovative Approach
Authors: Rashmi Bansal, Priyanka Chowdhary, Anuraag Gurtu, Nakul Mehrotra, Abhinav Kishore
Journal: Case Rep Dent (2016)

Trauma may result in craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior teeth, and vertical fracture of root. Out of these, management of some fractures is of great challenge and such teeth are generally recommended for extraction. Literature search reveals attempts to manage such fractures by full cast crown, orthodontic wires, and so forth, in which consideration was given to extracoronal splinting only. However, due to advancement in materials and technologies, intracoronal splinting can be achieved as well. In this case report, longitudinal fractures in tooth #27, tooth #37, and tooth #46 had occurred. In #27, fracture line was running mesiodistally involving the pulpal floor resulting in a split tooth. In teeth 37 and 46, fractures of the mesiobuccal cusp and mesiolingual cusp were observed, respectively. They were restored with cast gold inlay and full cast crown, respectively. Longitudinal fracture of 27 was treated with an innovative approach using intracanal reinforced composite with Ribbond, external reinforcement with an orthodontic band, and full cast metal crown to splint the split tooth.
Massive Acute Spinal Subdural Hematoma Causing Sudden Onset Paraplegia in a Patient on Anticoagulation
Authors: Jacob Kosarchuk, Courtney Lewis, Martin H Pham
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Spinal subdural hematoma (SSDH) is a rare but known entity that can cause severe and irreversible motor, sensory, and autonomic dysfunction if not decompressed in a timely manner. We present here a 74-year-old female on anticoagulation who developed sudden onset back pain with rapidly progressive paraplegia. On neurologic exam, she was completely flaccid in the bilateral lower extremities with absent sensation from the umbilicus down. Imaging demonstrated a massive extra-axial spinal hematoma from T12 to S1 that initially was believed to be epidural in origin. She was taken emergently to the operating room for a T11-L5 decompressive laminectomy, and dural opening demonstrated a thick subdural clot encasing the conus and cauda equina confirming the subdural pathology. Despite decompression and partial evacuation of the subdural hematoma, she did not recover neurologic function.
Unilateral pigmentary retinopathy--a review of literature and case presentation
Authors: Alina-Cristina Stamate, Marian Burcea, Mihail Zemba
Journal: Rom J Ophthalmol (2016)
MeSH terms: Retinitis Pigmentosa / diagnosis, Visual Field Tests / methods, Case Reports, Review, Adult, Diagnosis, Differential, Disease Progression, Electroretinography, Female, Fundus Oculi, Humans, Retinitis Pigmentosa / physiopathology, Scotoma / physiopathology, Severity of Illness Index, Visual Acuity

Objectives:
To report a rare case of unilateral pigmentary retinopathy and describe the clinical and visual field characteristics of this particular case.
Methods:
We present the case of a 30-year-old male patient with a gradual loss of the visual field on his left eye (LE) for the past 10 years, with further gradual painless loss of his central visual field in the last year, and no similar symptoms in his right eye. His past medical and ocular history were unremarkable. No family history of acquired or inherited diseases was determined.
Results:
Based on the history, clinical findings, and visual field examination, the diagnosis of unilateral pigmentary retinopathy was established. Visual acuity and visual field in the left eye (LE) were severely affected, while in the right eye (RE), they were completely normal.
Conclusions:
In this case, distinct features of pigmentary retinopathy were observed only in one eye, with the fellow eye being unaffected. The diagnosis requires a long follow-up period, visual field and electrophysiological testing to rule out a delayed onset of a bilateral form of pigmentary retinopathy.
Listeria monocytogenes Meningitis in an Immunosuppressed Patient with Autoimmune Hepatitis and IgG4 Subclass Deficiency
Authors: Shahin Gaini
Journal: Case Rep Infect Dis (2015)

A 51-year-old Caucasian woman with Listeria monocytogenes meningitis was treated and discharged after an uncomplicated course. Her medical history included immunosuppressive treatment with prednisolone and azathioprine for autoimmune hepatitis. A diagnostic work-up after the meningitis episode revealed that she had low levels of the IgG4 subclass. To our knowledge, this is the first case report describing a possible association between autoimmune hepatitis and the occurrence of Listeria monocytogenes meningitis, describing a possible association between Listeria monocytogenes meningitis and deficiency of the IgG4 subclass and finally describing a possible association between Listeria monocytogenes meningitis and immunosuppressive therapy with prednisolone and azathioprine.