OpenMed/multicare-articles huggingface dataset:
Laparoscopic Major Vascular Injuries Report of Two Cases and Review
Authors: Nissar Shaikh, Umm E-Amara, Athika Sajeer, Rohma Malik, Shoaib Nawaz, Shajahan Idayathulla, Abdul Gafoor M Tharayil, Abdulqadir J Nashwan
Journal: Int Med Case Rep J (2023)
Keywords: aorta, bladder, bowel, entry injury, hemorrhage, laparoscopy
MeSH terms: Case Reports

Laparoscopic surgery is the standard of care for various abdominal pathologies due to its apparent advantages. Unintentional and accidental injuries of the intraabdominal organs and vessels caused by trocars and Veress needles are rare, but potentially fatal complications of laparoscopic surgery. Veress needle and trocar can cause major vascular, bowel, or urinary tract injuries. We report two cases of vascular laparoscopic entry injuries. Laparoscopic entry injuries are rare but life-threatening and can cause multiple organ dysfunctions. Therefore, early recognition, aggressive resuscitation, and appropriate management of laparoscopic entry injuries are vital for better outcomes.
Iatrogenic Injury to Profunda Femoris During a Dynamic Hip Screw Fixation for Intertrochanteric Fracture
Authors: Anuj Lal, Edwin Jesudason, Rhodri Gwyn
Journal: Cureus (2023)
Keywords: dynamic hip screw (dhs), iatrogenic complication, intertrochanteric hip fracture, lower extremity vascular injury, profunda femoris
MeSH terms: Case Reports

We present a case of a profunda femoris artery injury during a dynamic hip screw fixation for an intertrochanteric fracture. This was identified clinically on the ward and confirmed with a CT angiogram. The bleeder was then treated by coil embolization, and laboratory results showed significant improvement in hemoglobin level after blood transfusion.
Heterotopic pregnancy in natural conception
Authors: Govindarajan Mj, Rajan R
Journal: J Hum Reprod Sci (2008)
Keywords: adnexal mass, assisted conception, heterotopic
MeSH terms: Case Reports

Heterotopic gestation, although common with assisted reproductive techniques, is very rare in natural conception. A high index of suspicion can help in timely diagnosis and appropriate intervention. We report a case of heterotopic pregnancy in a 22-year-old woman presented with hemoperitoneum from ruptured tubal pregnancy with live intrauterine gestation at 10 weeks of amenorrhea, diagnosed on ultrasound examination.
Case Report: Successful Outcome for Refractory Diabetic Peripheral Neuropathy in Patients With Ultrasound-Guided Injection Treatment
Authors: Hua Qiong Hu, Hailun Huang, Jing Huang, Ji Cui Leng, Mi Li, Chao Tang, Yan Li, Shan Wu
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: electrophysiological, hydrodissection, peripheral nerve compression, refractory diabetic peripheral neuropathy, the scoring system of ultrasound
MeSH terms: Diabetic Neuropathies / drug therapy, Vitamin B 12 / analogs & derivatives, Case Reports, Research Support, Non-U.S. Gov't, Adult, Aged, Female, Humans, Male, Middle Aged, Treatment Outcome, Ultrasonography, Interventional, Vitamin B 12 / administration & dosage, Vitamin B 12 / therapeutic use, mecobalamin, Vitamin B 12

Diabetic peripheral neuropathy is the most prevalent chronic complication of diabetes and is based on sensory and autonomic nerve symptoms. Generally, intensive glucose control and nerve nourishment are the main treatments. However, it is difficult to improve the symptoms for some patients; such cases are defined as refractory diabetic peripheral neuropathy (RDPN). In this paper, we present five patients treated with saline and mecobalamin by ultrasound-guided injection. The Visual Analog Scale and Toronto Clinical Scoring System were used to evaluate the symptoms, and the neuro-ultrasound scoring system and electrophysiological severity scale were evaluated by ultrasound and electrophysiological examination. In brief, ultrasound-guided hydrodissection may be a safe way to treat RDPN.
Case Report: Living on the Edge-Transcatheter Mitral Valve Repair Related Infective Endocarditis
Authors: Nicole Lewandowski, Ehssan Berenjkoub, Eduard Gorr, Marc Horlitz, Peter Boekstegers, Mirko Doss, Sami Sirat, Dennis Rottländer
Journal: Front Cardiovasc Med (2022)
Keywords: proteus mirabilis, edge-to-edge repair, endocarditis, mitral valve replacement, sepsis
MeSH terms: Case Reports

Background: Infective endocarditis (IE) following mitral valve edge-to-edge repair is a rare complication with high mortality. Case summary: A 91-year-old male patient was admitted to intensive care unit with sepsis due to urinary tract infection after insertion of a urinary catheter by the outpatient urologist. Two weeks ago, the patient was discharged from hospital after successful transcatheter edge-to-edge mitral valve repair (TEER) using a PASCAL Ace device. The initially withdrawn blood revealed repeatedly Proteus mirabilis bacteremia as causal for the sepsis due to urinary tract infection. An antibiotic regime with Ampicillin/Sulbactam was initiated and discontinued after 7 days. During the clinical course the patient again developed fever and blood cultures again revealed P. mirabilis. In transesophageal echocardiography (TOE), IE of the PASCAL Ace device was confirmed by a vegetation accompanied by a mild to moderate mitral regurgitation. While the patient was stable at this time and deemed not suitable for cardiac surgery, the endocarditis team made a decision toward a prolonged 6-week antibiotic regime with an antibiotic combination of Ampicillin 2 g qds and Ciprofloxacin 750 mg td. Due to posterior leaflet perforation severe mitral regurgitation developed while PASCAL Ace vegetations were significantly reduced by the antibiotic therapy. Therefore, the patient underwent successful endoscopic mitral valve replacement. Another 4 weeks of antibiotic treatment with Ampicillin 2 g qds followed before the patient was discharged. Discussion: P. mirabilis is able to form biofilms, resulting in a high risk for endocarditis following transcatheter mitral valve repair especially when device endothelization is incomplete. Endoscopic mitral valve replacement could serve as a bailout strategy in refractory Clip-endocarditis.
Germline c.1A>C heterozygous pathogenic variant in SDHA reported for the first time in a young adult with a gastric gastrointestinal stromal tumour (GIST): a case report
Authors: Sergio Carrera, Elena Beristain, Aintzane Sancho, Eluska Iruarrizaga, Pilar Rivero, Juan Manuel Mañe, Guillermo López Vivanco
Journal: Hered Cancer Clin Pract (2019)
Keywords: cancer genetic counseling, gist, hereditary, kit, pdgfrα, paraganglioma, sdh
MeSH terms: Case Reports

Background:
Gastrointestinal stromal tumors (GISTs) represent the most frequent mesenchymal tumor of the gastrointestinal tract. Less than 5% of them seem to be hereditary, being succinate dehydrogenase complex (SDHx) deficient disorders and neurofibromatosis type 1 the more related inherited conditions. Wild type (WT) KIT and PDGFRα GISTs constitute a clue for a hypothetical underlying germline condition.
Case presentation:
We present a case of a 20 years old female diagnosed of a gastric WT GIST who developed hepatic metastases during her clinical course. No significant or typical phenotypic features suggestive of a specific syndrome were detected by physical examination. Also, her family history seemed to be irrelevant, since no other cases of GISTs, paragangliomas or pheochromocytomas were reported. Her paternal grandfather died as a consequence of a pituitary adenoma. In light of the age of tumor presentation and somatic features of gastric GIST, we performed genetic testing of SDHx genes. Analysis obtained from peripheral blood sample revealed the presence, in heterozygous state, of the c.1A > C; p.(Met1?) pathogenic variant in the SDHA.
Conclusions:
To the best of our knowledge, this is the first published report in which the c.1A > C; p.(Met1?) pathogenic variant in the SDHA is associated with a GIST. SDHA pathogenic variants increase the risk of paraganglioma, pheochromocytoma, GIST, pituitary adenoma and renal cancer in an autosomal dominant inherited condition named paraganglioma syndrome type 5. The absence of family history of tumors in SDHA pathogenic variants carriers could be related to its low penetrance. All patients diagnosed with WT GISTs should be referred to a hereditary cancer genetic counseling unit regardless of the age at presentation or the absence of a suspicious family history.
Case report: Disseminated pulmonary mucormycosis involving spleen in diabetic patient with aggressive surgical approach
Authors: Saleh Alqhamdi, Bandar Idress, Ashwag Alharbi, Nawaf Aljurais
Journal: Int J Surg Case Rep (2019)
Keywords: diabetic, disseminated mucormycosis, pulmonary mucormycosis

Introduction:
Mucormycosis is a life threatening fungal infection that occurs in immunocompromised patients.
Presentation of case:
A 36-year-old Saudi male with known case of Insulin-Dependent Diabetes Mellitus (IDDM), who was presented with productive cough and diarrhea. Computed tomography (CT) revealed a disseminated fungal invasion of the lungs and spleen with invading the fundus of the stomach. An aggressive surgical approach and amphotericin B treatment resolved his condition.
Discussion:
Disseminated Mucormycosis in one organ can spread hematogenously to other organs and can cause severe morbidity and mortality in high risk individuals. The diagnosis of mucormycosis is usually delayed, Antifungal therapy alone is insufficient for mucormycosis, and surgical debridement for all infected tissue is often required.
Conclusion:
Mucormycosis is a life threating infection, and usually the diagnosis late because of non-specific clinical, radiological feature and need biopsy for confirmation of the organism. The cornerstone for the management and increase the survival rate remain on rapid diagnosis, treatment of the underlying predisposing condition, and urgent surgical debridement.
Fibrolipoma Causing Carpal Tunnel Syndrome
Authors: Anthony Timmerman, Filip Vanhoenacker, Lucas Walschot
Journal: J Belg Soc Radiol (2021)
Keywords: carpal tunnel syndrome, fibrolipoma, magnetic resonance imaging, median nerve, ultrasound
MeSH terms: Case Reports

Teaching point: A space-occupying lesion should be considered in the differential diagnosis of progressive unilateral carpal tunnel syndrome.
Tracheal Chondrosarcoma: Systematic Review of Tumor Characteristics, Diagnosis, and Treatment Outcomes with Case Report
Authors: Emily A Kutzner, Joshua S Park, Salman Zaheer, Jared C Inman
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

To our knowledge this is the first systematic review of tracheal chondrosarcoma treatment outcomes. Management insights are thoroughly discussed. Men constitute 93.8% of cases, and most of these occur in the distal trachea. The most common symptom, dyspnea, occurs in virtually all patients. Extratracheal extension had occurred in 78.6% of patients. Definitive treatment with tracheal resection showed no recurrences in 10 patients with mean follow-up of 3.1 years. Adjuvant radiotherapy may be utilized for improving local control when open complete resection cannot be performed, but only after endoscopic excision of gross tumor.
Invasive Aspergillosis Mimicking Metastatic Lung Cancer
Authors: Michiel J E G W Vanfleteren, Anne-Marie C Dingemans, Veerle F Surmont, Karim Y Vermaelen, Alida A Postma, Astrid M L Oude Lashof, Cordula C M Pitz, Lizza E L Hendriks
Journal: Front Oncol (2018)
Keywords: aspergillosis, brain abscess, brain metastasis, brain neoplasms, differential diagnosis, lung cancer, lung neoplasms
MeSH terms: Case Reports

In a patient with a medical history of cancer, the most probable diagnosis of an 18FDG-avid pulmonary mass combined with intracranial abnormalities on brain imaging is metastasized cancer. However, sometimes a differential diagnosis with an infectious cause such as aspergillosis can be very challenging as both cancer and infection are sometimes difficult to distinguish. Pulmonary aspergillosis can present as an infectious pseudotumour with clinical and imaging characteristics mimicking lung cancer. Even in the presence of cerebral lesions, radiological appearance of abscesses can look like brain metastasis. These similarities can cause significant diagnostic difficulties with a subsequent therapeutic delay and a potential adverse outcome. Awareness of this infectious disease that can mimic lung cancer, even in an immunocompetent patient, is important. We report a case of a 65-year-old woman with pulmonary aspergillosis disseminated to the brain mimicking metastatic lung cancer.
Traumatic Epiglottitis following a Blind Insertion of the Hand during Convulsion
Authors: Koji Yokoyama
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Traditionally, it has been recommended that first-responders should place chopsticks or their hand in a child's mouth to prevent the child from biting their tongue during convulsion. The practice persists locally in parts of Japan and can cause adverse events. We report a traumatic epiglottitis following the thrusting of a guardians' hand into a 13-month-old girl's mouth to prevent her from biting her tongue.
Airway Management of Esophageal Atresia and Tracheoesophageal Fistula Combined with Anal Atresia
Authors: Jieshu Zhou, Hao Li, Xuemei Lin
Journal: Case Rep Anesthesiol (2022)
MeSH terms: Case Reports

Esophageal atresia (EA) associated with tracheoesophageal fistula (TEF) is a common congenital airway anomaly and may be associated with other gastrointestinal abnormalities. Neonates with EA/TEF are at high risk of gastrointestinal distension due to the shunting of air via the fistula, leading to progressive diaphragmatic elevation and regurgitation of the gastrointestinal contents. EA/TEF associated with anal atresia in a neonate makes airway management even more challenging particularly when managed for the repair of TEF through thoracotomy. Here, we report a case where we succeeded in conducting the flexible bronchoscopy insertion through a laryngeal mask to block the fistula by bronchial blocker under spontaneous breathing.
Thyrotoxic Periodic Paralysis: Case Reports and an Up-to-Date Review of the Literature
Authors: Abbi Lulsegged, Christina Wlodek, Michela Rossi
Journal: Case Rep Endocrinol (2011)
MeSH terms: Case Reports

Objectives. To describe 2 cases of thyrotoxic periodic paralysis. Methods. We report of 2 cases of thyrotoxic periodic paralysis in 2 individuals from 2 different backgrounds with emphasis on their presentation and treatment. We also conducted a literature search to put together an update review of thyrotoxic periodic paralysis. Results. A 47-year-old Chinese and 28-year-old Caucasian male presented with profound yet reversible weakness associated with hypokalemia on admission bloods and thyrotoxicosis. Both were given definitive therapy to prevent recurrence of attacks with any future relapse of thyrotoxicosis. Conclusion. Thyrotoxic periodic paralysis (TPP) is a rare but potentially serious complication of thyrotoxicosis resulting in temporary but severe muscle weakness. Recent discovery of a novel mutation in the KCNJ18 gene which codes for an inwardly rectifying potassium channel and is controlled by thyroid hormones may provide greater insight into the pathogenesis of TPP.
Horner's Syndrome Incidental to Medullary Thyroid Carcinoma Excision: Case Report and Brief Literature Review
Authors: Nicholas S Mastronikolis, Sofia P Spiliopoulou, Vassiliki Zolota, Theodoros A Papadas
Journal: Case Rep Otolaryngol (2016)

Horner's syndrome is characterized by a combination of ipsilateral miosis, blepharoptosis, enophthalmos, facial anhidrosis, and iris heterochromia in existence of congenital lesions. The syndrome results from a disruption of the ipsilateral sympathetic innervation of the eye and ocular adnexa at different levels. Though rare, thyroid and neck surgery could be considered as possible causes of this clinical entity. We present a case of Horner's syndrome in a patient after total thyroidectomy and neck dissection for medullary thyroid cancer with neck nodal disease and attempt a brief review of the relevant literature.
LRP5, Bone Density, and Mechanical Stress: A Case Report and Literature Review
Authors: Nicholas G Norwitz, Adrian Soto Mota, Madhusmita Misra, Kathryn E Ackerman
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: lrp5, wnt-β-catenin signaling, bone mineral density, mechanical stress, osteoporosis
MeSH terms: Case Reports

The Wnt-β-catenin pathway receptor, low-density lipoprotein receptor-related protein 5 (LRP5), is a known regulator of bone mineral density. It has been hypothesized that specific human polymorphisms in LRP5 impact bone density, in part, by altering the anabolic response of bone to mechanical loading. Although experiments in animal models support this hypothesis, there is limited evidence that LRP5 polymorphisms can alter the anabolic response of bone to mechanical loading in humans. Herein, we report a young male who harbors a rare LRP5 missense mutation (A745V) and who provides potential proof of principle for this mechanotransduction hypothesis for low bone density. The subject had no history of fractures until age 18, a year into a career in competitive distance running. As he continued to run over the following 2 years, his mileage threshold to fracture steadily and rapidly decreased until he was diagnosed with severe osteoporosis (lumbar spine BMD Z-score of -3.2). By contextualizing this case within the existing LRP5 and mechanical stress literature, we speculate that this represents the first documented case of an individual in whom a genetic mutation altered the anabolic response of bone to mechanical stress in a manner sufficient to contribute to osteoporosis.
Using Functional Near-Infrared Spectroscopy to Study the Effect of Repetitive Transcranial Magnetic Stimulation in Concussion: A Two-Patient Case Study
Authors: Joan M Stilling, Chris C Duszynski, Ibukunoluwa Oni, Eric Paxman, Jeff F Dunn, Chantel T Debert
Journal: Front Neurol (2019)
Keywords: concussion, functional near infrared spectroscopy (fnirs), post-concussion symptom, rehabilitation, transcranial magnetic stimulation (repetitive)
MeSH terms: Case Reports

Background: Approximately 25% of concussion patients experience persistent post-concussion symptoms (PPCS). Repetitive transcranial magnetic stimulation (rTMS) has been explored as a treatment, and functional near-infrared spectroscopy (fNIRS) may be a cost-effective method for assessing response. Objectives: Evaluate rTMS for the treatment of PPCS and introduce fNIRS as a method of assessing treatment response. Methods: Design: Two-patient case study. Setting: Calgary Brain Injury Program. Participants: 47 and 49 years. male, with PPCS for 1-2 years (headache, cognitive difficulties, nausea, visual difficulties, irritability, anxiety, poor mood, sleep, and fatigue). Intervention: 10 sessions of rTMS therapy to the left dorsolateral prefrontal cortex (DLPFC), at 10 Hz (600 pulses) and 70% of resting motor threshold amplitude. Participants completed an 8-week headache diary and a battery of clinical questionnaires prior to each fNIRS session. fNIRS: Hemodynamic changes were recorded over the frontoparietal cortex during rest, finger tapping, and a graded working memory test. fNIRS was completed pre-rTMS, following rTMS (day 14), and at 1-month post-rTMS (day 45). For comparison, two healthy, sex-matched controls were scanned with fNIRS once daily for five consecutive days. Results: Clinical scores improved (headache severity, MoCA, HIT-6, PHQ-9, GAD-7, QOLIBRI, RPSQ, BCPSI) or remained stable (PCL-5, headache frequency) post-rTMS, for both participants. Participant 1 reported moderate symptom burden, and a fNIRS task-evoked hemodynamic response showing increased oxyhemoglobin was observed following a working memory task, as expected. Participant 2 exhibited a high symptom burden pre-treatment, with abnormal fNIRS hemodynamic response where oxyhemoglobin declined, in response to task. One month following rTMS treatment, participant 2 had a normal fNIRS hemodynamic response to task, corresponding to significant improvements in clinical outcomes. Conclusion: This case study suggests fNIRS may be sensitive to physiological changes that accompany rTMS treatment. Further studies exploring fNIRS as a cost-effective technology for monitoring rTMS response in patients with PPCS are suggested.
Case Report: Inguinal Myxofibrosarcoma Arising From the Surgical Site of Resected Squamous Cell Carcinoma
Authors: Hongyu Hu, Xianwen Hu, Dandan Li, Jiong Cai, Pan Wang
Journal: Front Oncol (2022)
Keywords: case report, magnetic resonance imaging, myxofibrosarcoma, positron emission computed tomography, squamous cell carcinoma
MeSH terms: Case Reports

Myxofibrosarcoma (MFS) is a rare soft tissue sarcoma that originates in the mesenchymal tissue and occurs mainly in the limbs of elderly patients. Herein, we present the case of a 64-year-old woman who underwent extensive left vulvar resection and bilateral lymphadenectomy for vulvar squamous cell carcinoma 6 months previously. A mass was found again at the original surgical site of the left groin 3 months prior, and its size had increased significantly in the past 1 month, with ulceration and pus. Magnetic resonance imaging (MRI) showed a 10-cm mass in the left groin area; fluoro18-labeled deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) showed a marked increase in mass metabolism in the left groin area, which was highly suspected to be a recurrence of squamous cell carcinoma. Subsequently, the patient underwent surgery and the postoperative pathology and immunohistochemistry confirmed MFS. In conclusion, MFS has rarely been reported to arise from the surgical site of squamous cell carcinoma. Our case study demonstrates that MFS should be included in the differential diagnosis of superficial masses in patients with a prior surgical history who present with a soft tissue mass at the surgical site, especially for recently developed rapidly increasing masses. This study aimed to systematically review the clinical features, diagnosis, differential diagnosis, treatment, and prognosis of this disease based on our case and related published literature and to provide clinicians with a broader perspective on the differential diagnosis of soft tissue tumors.
Pneumomediastinum and Bilateral Pneumothoraces Causing Respiratory Failure after Thyroid Surgery
Authors: Michael Koeppen, Benjamin Scott, Joseph Morabito, Matthew Fiegel, Tobias Eckle
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

We report the first case of severe respiratory failure after thyroid surgery requiring venovenous extracorporeal membrane oxygenation (vvECMO). The patient was a 41-year-old woman with metastatic thyroid cancer. She underwent thyroidectomy, including left lateral and bilateral central neck dissection. During surgery, the patient developed pneumomediastinum with bilateral pneumothoraces. Despite early treatment with bilateral chest tubes and no evidence of a tracheal perforation, the patient developed severe respiratory failure after extubation on the intensive care unit. Because pneumothorax and pneumomediastinum might be more common than reported, and considering increasing cases of thyroid surgery, staff should remain vigilant of pulmonary complications after thyroid surgery.
Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera
Authors: Shuhei Ito, Nobuyuki Fujita, Naobumi Hosogane, Narihito Nagoshi, Mitsuru Yagi, Akio Iwanami, Kota Watanabe, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Ken Ishii
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Extramedullary hematopoiesis (EMH) occasionally occurs in patients exhibiting hematological disorders with decreased hematopoietic efficacy. EMH is rarely observed in the spinal epidural space and patients are usually asymptomatic. In particular, in the patients with polycythemia vera, spinal cord compression due to EMH is extremely rare. We report a case of polycythemia vera, in which operative therapy proved to be an effective treatment for myelopathy caused by spinal EMH.