OpenMed/multicare-articles huggingface dataset:
Percutaneous intestinal drainage for a refractory enterocutaneous fistula: A case report
Authors: Yoshie Hirayama, Tadashi Koga, Masanori Kai, Kiyoshi Kajiyama
Journal: Int J Surg Case Rep (2020)
Keywords: percutaneous drainage, refractory enterocutaneous fistula, treatment
MeSH terms: Case Reports

Introduction:
Enterocutaneous fistulas (ECFs) that occur following gastrointestinal surgery require long-term hospitalization, and treatment may be difficult in rare cases. Although the morbidity and mortality associated with ECF have decreased with modern medical, the overall mortality is still surprisingly high, up to 30.4 %.
Presentation of case:
The patient was a 79-year-old male who had undergone laparoscopic sigmoidoscopy for sigmoid colon cancer 5 years previously. He was newly diagnosed with sigmoid colon cancer 5 years following surgery. A laparoscopic high anterior resection was performed. On the 4th postoperative day, he was diagnosed with a suture failure which was treated conservatively; however, the fistula could not be closed, and ileostomy construction was performed. Intestinal fluid leaked from the median surgical incision, leading to the formation of a small intestinal fistula on the proximal side from the ileostomy. Conservative treatment did not improve the condition and skin erosion worsened. Two months after the stoma was constructed, a urethral balloon catheter was percutaneously inserted into the intestinal tract from the small intestinal fistula to drain the intestinal fluid. Following the maneuver, the problem of skin erosion was improved, with the resulting closure of the fistula.
Discussion:
The basic principles underlying treatment for ECFs are essentially fasting, drainage, and adequate nutritional management. Some studies reported that the average period of negative pressure therapy was four weeks. It seems that four weeks is the breakpoint.
Conclusion:
Percutaneous intestinal drainage for refractory ECFs following gastrointestinal surgery is minimally invasive and is likely to be extremely useful.
Successful use of therapeutic hypothermia in an opiate induced out-of-hospital cardiac arrest complicated by severe hypoglycaemia and amphetamine intoxication: a case report
Authors: Michael Busch, Eldar Søreide
Journal: Scand J Trauma Resusc Emerg Med (2010)
MeSH terms: Amphetamine / poisoning, Heart Arrest / therapy, Heroin / poisoning, Hypoglycemia / complications, Hypothermia, Induced, Insulin / poisoning, Case Reports, Adult, Brain Injuries / prevention & control, Female, Heart Arrest / blood, Heart Arrest / chemically induced, Heart Arrest / complications, Humans, Hypoglycemia / chemically induced, Prognosis, Insulin, Heroin, Amphetamine

The survival to discharge rate after unwitnessed, non-cardiac out-of-hospital cardiac arrest (OHCA) is dismal. We report the successful use of therapeutic hypothermia in a 26-year old woman with OHCA due to intentional poisoning with heroin, amphetamine and insulin.The cardiac arrest was not witnessed, no bystander CPR was initiated, the time interval from the call to ambulance arrival was 9 minutes and the initial cardiac rhythm was asystole. Eight minutes of advanced cardiac life support resulted in ROSC.Upon hospital admission, the patient's pupils were dilated. Her arterial lactate was 17 mmol/l, base excess -20, pH 6.9 and serum glucose 0.2 mmol/l. During the first 24 hours in the ICU, the patient developed maximally dilated pupils not reacting to light and became increasingly haemodynamically unstable, requiring both inotropic support and massive fluid resuscitation. After 1 week in the ICU, however, she made an uneventful recovery with a Cerebral Performance Category of 1 at hospital discharge and at a follow up examination at 6 months.
Conclusion:
According to most prognostic factors, the patient had a statistical chance for survival of less than 1%, not taking into account her severe state of hypoglyaemia. We suggest that this case exemplifies the need for more studies on the use of TH in non-coronary causes of OHCA.
Calcified wall portal venous aneurysm: a case report
Authors: Safouane Khairallah, Abdelmajid Elmansouri, Hicham Jalal, Mariem Ouali Idrissi, Najat Cherif Idrissi Ganouni
Journal: Pan Afr Med J (2016)
Keywords: computed tomography, portal aneurysm, portal calcifications, ultrasond
MeSH terms: Aneurysm / diagnosis, Gastrointestinal Hemorrhage / etiology, Hypertension, Portal / etiology, Portal Vein / pathology, Case Reports, Aged, Aneurysm / complications, Calcinosis / pathology, Female, Humans

Portal vein aneurysms are extremely rare, less than 200 cases have been reported until late 2015. They are defined as a portal vein diameter exceeding 19 mm for cirrhotic patients and 15 mm in normal livers. Most patients are asymptomatic, but complications may occur. We report a case of a 68-year-old female admitted for etiological assessment of a portal hypertension revealed by an upper gastro intestinal bleeding, who was incidentally diagnosed with a portal vein aneurysm.
An early abdominal wall ectopic pregnancy successfully treated with ultrasound guided intralesional methotrexate: a case report
Authors: Paynesha M Anderson, Erin K Opfer, Jeanne M Busch, Everett F Magann
Journal: Obstet Gynecol Int (2009)
MeSH terms: Case Reports

Background. The upper anterior abdominal wall is a very unusual location for an ectopic pregnancy making optimal management uncertain. Case. We report the case of a 26-year-old gravida 4, para 1, aborta 2 with a rising quantitative human chorionic gonadotropin level following a negative diagnostic laparoscopic examination. She was subsequently diagnosed with an abdominal wall ectopic pregnancy 2 cm inferior to the liver. A single percutaneous intralesional injection of methotrexate was successful after initial failure with systemic methotrexate. Conclusion. Systemic methotrexate is a logical first choice for management of a stable early abdominal wall pregnancy. Direct intralesional injection of methotrexate as the next treatment choice may avoid the morbidity linked with operative management.
Dengue hemorrhagic fever as a rare cause of chronic immune thrombocytopenic purpura-a pediatric case report
Authors: V Thadchanamoorthy, Kavinda Dayasiri
Journal: Trop Med Health (2020)
Keywords: dengue, immune thrombocytopenic purpura (itp), steroids
MeSH terms: Case Reports

Background:
Dengue is a common mosquito-borne infection in tropical countries. Dengue incidence in Sri Lanka is generally showing a rising trend. Both chronic immune thrombocytopenia purpura (ITP) children and chronic ITP triggered by dengue fever in the pediatric age group are rarely reported. This unusual presentation is a diagnostic challenge to clinicians. The authors have reported a pediatric patient who presented with chronic ITP following recovery from dengue hemorrhagic fever.
Case presentation:
A 14-year-old previously healthy boy was initially managed as for dengue hemorrhagic fever. Following initial detection of persistent thrombocytopenia at 2 weeks post-discharge, his parents defaulted follow-up for 1 year as he remained asymptomatic. However, 1 year after initial admission, the child re-presented with ecchymotic patches and a platelet count of 30 × 103/cumm. Review of serial blood counts performed during previous hospital admission and by his parents themselves revealed persistent thrombocytopenia over preceding 12 months. Subsequently, the child had an in-depth evaluation. The diagnosis of ITP was confirmed by ruling out differential diagnosis and he was managed as for chronic ITP. His platelet counts showed good response to oral corticosteroids and he is currently being followed up at the pediatric hematology clinic.
Conclusion:
While reporting, a 14-year-old boy who developed chronic ITP following dengue hemorrhagic fever, this report highlights importance of frequent monitoring of blood counts to accurately detect and manage critical phase of dengue fever. The report also highlights the value of monitoring platelet counts in post-recovery phase to ensure they have normalized.
Partial Molar Pregnancy Presenting as a Tubal Ectopic Pregnancy
Authors: Mariam Ayyash, Monica Kole, Quoc Le, Yulei Shen, Monique Swain
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Background:
Tubal molar pregnancy is extremely rare, with no more than 200 cases reported in the literature. The incidence is approximated at 1.5 per 1,000,000 pregnancies.
Case:
We report the case of a 22-year-old woman with an overall initial stable clinical presentation who was noted to have a ruptured ectopic pregnancy. She was surgically treated, and pathology revealed partial hydatidiform molar ectopic pregnancy. At the time of surgical intervention, the treating physicians had not considered molar ectopic pregnancy within the differential diagnosis, since this is a very rare presentation. Once the pathology was discovered, the patient was contacted to be scheduled for close follow-up and counseling to reduce progression to choriocarcinomas.
Conclusion:
This case report highlights the importance of sending, reviewing, and following up on pathologic specimens for all patients undergoing surgical intervention for presumed ectopic pregnancy and ensuring that appropriate follow-up is in place for those patients.
Case Report: A giant myopericytoma involving the occipital region of the scalp - a rare entity
Authors: Sunil Munakomi, Pramod Chaudhary
Journal: F1000Res (2016)
Keywords: myopericytoma, scalp, subcutaneous lesion

Herein we report a rare case of a giant myopericytoma presenting in a 16-year-old girl as a slowly progressive swelling involving the scalp in the occipital region. It was managed by complete excision. Histological examination of the lesion revealed spindle-shaped cells forming characteristic rosettes around the blood vessels, and positive staining with smooth muscle actin.
Impacted Palatal Canines and Diode Laser Surgery: A Case Report
Authors: Marina Consuelo Vitale, Maria Gloria Nardi, Matteo Pellegrini, Francesco Spadari, Federica Pulicari, Roberto Alcozer, Martina Minardi, Maria Francesca Sfondrini, Karin Bertino, Andrea Scribante
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Introduction:
Maxillary canine is the most frequent dental element that could likely remain impacted in the bone structure, with a percentage between 1 and 5%. This study presents a case report using a diode laser for surgical-orthodontics disinclusion of a palatal mucosal impacted permanent left upper canine (2.3) and the simultaneous application of an orthodontic bracket.
Methods:
After cementation of the trans-palatal bar to the upper first molars with a hook for orthodontic traction, local anaesthesia with articaine was performed, followed by surgical operculectomy using a diode laser (810 nm wavelength, continuous wave mode with a power output of 3 W, and a 0.4 mm diameter optical fiber), and the orthodontic bracket with a passive metal looped ligature was applied. Subsequently, active elastic traction was applied on 2.3 and the upper arch was bonded for the application of a series of orthodontic wires, lace-back, and metal ligatures. A progressive reactivation of the elastic traction and extraction of 6.3 was necessary to translate the canine into the correct arch position.
Results:
Diode laser surgical-orthodontic disinclusion of impacted upper canine was performed successively, resulting in a dry surgical field ideal for orthodontic bracket adhesion. No pain and no swelling have been reported from the patient. The orthodontic treatment allowed the canine to be moved to the correct position in the arch.
Conclusions:
This case showed that the diode laser is a valid alternative for the surgical-orthodontic disinclusion of an included tooth element.
Case Report: A gambling-related suicide in rural Malawi
Authors: Junious Mabo Sichali, Albert Dube, Lackson Kachiwanda, Heather Wardle, Amelia C Crampin, Christopher Bunn
Journal: Wellcome Open Res (2021)
Keywords: betting, gambling, malawi, mental health, suicide
MeSH terms: Case Reports

Background As in many other countries across sub-Saharan Africa, Malawi's commercial gambling sector has grown considerably in recent years. Driven by the widespread availability of internet through mobile devices, the industry has penetrated both urban and rural settings. In Malawi the model commonly implemented by gambling companies is similar to that used by mobile phone operators. Agents equipped with cellular devices connect to providers' servers to place wagers for customers and print receipts using simple printers attached to their devices. This has produced lucrative returns for providers. While increasing attention is being paid to this trend, most research focusses on sports betting and there is a deficit of papers that document gambling-related harms. Methods Here we present a narrative case report of a 16-year-old boy, 'Wati' (pseudonym), who lived in rural Malawi and took his own life after gambling and losing money that did not belong to him. As his community is part of a demographic surveillance site, a verbal autopsy was conducted, later supplemented with interviews with Wati's close friend and uncle, to whom his mother referred us. We triangulated data from these three sources to create a narrative case report of Wati's suicide and its relationship to his gambling practices. Results We found that the gambling harms leading up to Wati's suicide were recurrent, that his gambling practices were diverse (lottery, football betting, digital games and cards) and that signs of distress were apparent before his suicide. Conclusions From this case report, we learn that underage individuals participate in gambling in Malawi, can develop harmful habits and that their gambling is not confined to sports betting. We also learn that there is a lack of accessible services for people who develop harmful gambling practices. Wati could have benefited from such services and they may have saved his life.
Case Report: Autoimmune Lymphoproliferative Syndrome vs. Chronic Active Epstein-Barr Virus Infection in Children: A Diagnostic Challenge
Authors: Aleksandra Szczawińska-Popłonyk, Elzbieta Grześk, Eyal Schwartzmann, Anna Materna-Kiryluk, Jadwiga Małdyk
Journal: Front Pediatr (2021)
Keywords: autoimmune lymphoproliferative syndrome, children, chronic active epstein-barr virus infection, immunodeficiency–primary, lymphoproliferation
MeSH terms: Case Reports

Autoimmune lymphoproliferative syndrome (ALPS) is a disorder characterized by a disruption of the lymphocyte apoptosis pathway, self-tolerance, and immune system homeostasis. Defects in genes within the first apoptosis signal (FAS)-mediated pathway cause an expansion of autoreactive double-negative T cells leading to non-malignant lymphoproliferation, autoimmune disorders, and an increased risk of lymphoma. The aim of the study was to show the diagnostic dilemmas and difficulties in the process of recognizing ALPS in the light of chronic active Epstein-Barr virus (CAEBV) infection. Clinical, immunological, flow cytometric, biomarkers, and molecular genetic approaches of a pediatric patient diagnosed with FAS-ALPS and CAEBV are presented. With the ever-expanding spectrum of molecular pathways associated with autoimmune lymphoproliferative disorders, multiple genetic defects of FAS-mediated apoptosis, primary immunodeficiencies with immune dysregulation, malignant and autoimmune disorders, and infections are included in the differential diagnosis. Further studies are needed to address the issue of the inflammatory and neoplastic role of CAEBV as a triggering and disease-modifying factor in ALPS.
A Case of Odontogenic Infection by Streptococcus constellatus Leading to Systemic Infection in a Cogan's Syndrome Patient
Authors: Masanobu Abe, Yoshiyuki Mori, Ryoko Inaki, Yae Ohata, Takahiro Abe, Hideto Saijo, Kazumi Ohkubo, Kazuto Hoshi, Tsuyoshi Takato
Journal: Case Rep Dent (2014)

Odontogenic infection in immunocompromised patients tends to extend systemically beyond the oral cavity. Our case report presents a patient with sepsis due to a Streptococcus constellatus (S. constellatus) odontogenic infection in a 64-year-old-immunocompromised woman with Cogan's syndrome. She had been suffering from chronic mandibular osteomyelitis which was thought to have been caused by dental caries and/or chronic periodontitis with furcation involvement of the left mandibular first molar. We suspect that the acute symptoms of the chronic osteomyelitis due to S. constellatus led to the systemic infection. This infection could be accelerated by the use of a corticosteroid and an alendronate. This is the first report which represents the potential association between odontogenic infection and Cogan's syndrome.
Hematuria after orthopedic tuina: a case report and brief review of literature
Authors: Xiao-Ming Ying, Peng Wang, Ben-Shun Yao, Hai-Yang Gu, Quan-Zhen Xu
Journal: Evid Based Complement Alternat Med (2011)

We present a case of a 24-year-old man who presented hematuria after the orthopedic tuina, which has not been recorded previously in the literature. We review complications of tuina in the literature too.
Acute "Pseudoischemic" ECG Abnormalities after Right Pneumonectomy
Authors: Nada Vasic, Sanja Dimic-Janjic, Ruza Stevic, Branislava Milenkovic, Verica Djukanovic
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

New onset of electrocardiographic (ECG) abnormalities can occur after lung surgery due to the changes in the position of structures and organs in the chest cavity. The most common heart rhythm disorder is atrial fibrillation. So-called "pseudoischemic" ECG changes that mimic classic ECG signs of acute myocardial ischemia are also often noticed. We report the case of a 68-year-old male, with no prior cardiovascular disease, who underwent extensive surgical resection for lung cancer. On a second postoperative day, clinical and electrocardiographic signs of acute myocardial ischemia occurred. According to clinical course, diagnostic procedures, and therapeutic response, we excluded acute coronary syndrome. We concluded that physical lesion of the pericardium, caused by extended pneumonectomy with resection of the pericardium, provoked the symptoms and ECG signs that mimic acute coronary syndrome. Our final diagnosis was postpericardiotomy syndrome after extended pneumonectomy and further treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) was recommended. It is necessary to consider possibility that nature of ECG changes after extended pneumonectomy could be "pseudoischemic."
Fatal meningitis in a previously healthy young adult caused by Streptococcus pneumoniae serotype 38: an emerging serotype?
Authors: Carolyn I Baker, Christopher P Barrozo, Margaret A K Ryan, Lisa A Pearse, Kevin L Russell
Journal: BMC Infect Dis (2005)
MeSH terms: Meningitis, Pneumococcal / microbiology, Streptococcus pneumoniae / classification, Case Reports, Research Support, U.S. Gov't, Non-P.H.S., Adolescent, Anti-Bacterial Agents / therapeutic use, Fatal Outcome, Humans, Male, Meningitis, Pneumococcal / drug therapy, Meningitis, Pneumococcal / epidemiology, Serotyping, Streptococcus pneumoniae / genetics, Streptococcus pneumoniae / isolation & purification, Anti-Bacterial Agents

Background:
In December 2001, a fatal case of pneumococcal meningitis in a Marine Corps recruit was identified. As pneumococcal vaccine usage in recruit populations is being considered, an investigation was initiated into the causative serotype.
Case presentation:
Traditional and molecular methods were utilized to determine the serotype of the infecting pneumococcus. The pneumococcal isolate was identified as serotype 38 (PS38), a serotype not covered by current vaccine formulations. The global significance of this serotype was explored in the medical literature, and found to be a rare but recognized cause of carriage and invasive disease.
Conclusion:
The potential of PS38 to cause severe disease is documented in this report. Current literature does not support the hypothesis that this serotype is increasing in incidence. However, as we monitor the changing epidemiology of pneumococcal illness in the US in this conjugate era, PS38 might find a more prominent and concerning niche as a replacement serotype.
Case Report: First Report of Fatal Legionella pneumophila and Klebsiella pneumoniae Coinfection in a Kidney Transplant Recipient
Authors: Maria Scaturro, Luna Girolamini, Maria Rosaria Pascale, Marta Mazzotta, Federica Marino, Giulia Errico, Monica Monaco, Antonietta Girolamo, Maria Cristina Rota, Maria Luisa Ricci, Sandra Cristino
Journal: Front Med (Lausanne) (2022)
Keywords: klebsiella pneumoniae, legionella pneumophila, legionnaires' disease, coinfection, incubation period
MeSH terms: Case Reports

A very rare case of pulmonary Klebsiella pneumoniae-Legionella pneumophila coinfection in a double kidney transplanted man affected by the chronic renal disease is described. Cases of Legionnaires' disease with an incubation period of 14 days have rarely been documented. Despite the long period of hospitalization, typing of clinical and environmental L. pneumophila strains demonstrated that the patient's home water distribution system was the source of infection, highlighting that Legionella house contamination can be a hidden risk, especially for immune-compromised people.
Unusual combination of elbow dislocation with a retained intraarticular fragment and trochlear fracture and ipsilateral distal radius fracture in an amateur snowboarder: A case report and review of literatures
Authors: Dong Kyu Moon, Sun Chul Hwang, Jun Il Yoo, Jin Sung Park
Journal: Int J Surg Case Rep (2019)
Keywords: dislocation, distal radius, elbow, fracture, snowboard injury

Introduction:
The most common damage caused by snowboarding is wrist injury. However, Elbow injuries are relatively rare. In general, elbow dislocation with ipsilateral distal radius fracture is also very rare.
Presentation of case:
We present an 18-year-old right hand dominant male with distal radius extra-articular fracture and elbow fracture dislocation. Computed tomographic scan and Magnetic resonance image of elbow joint showed retained intra-articular fragment, trochlear fracture, and the humeral attachment site of lateral collateral ligament (LCL) with rupture. The ruptured LCL was repaired, and then, the distal radius fracture was fixed with a volar distal radius locking plate. At one year after surgery, the patient did not complain of any subjective symptoms or functional deficit.
Discussion:
The injury mechanism would fall into the outstretched arm state, leading first to hyperextension of the wrist, resulting in fracture of the distal radius. The remaining force is then applied to the elbow joint by an external rotation and valgus moment arm, resulting in the rupture of the LCL of the elbow joint. In this state, the remaining force is transmitted through the olecranon to the trochlea as a shear force, resulting in osteochondral fracture and subsequent dislocation of the elbow joint.
Conclusion:
Combined injury of extremity from snowboarding is relatively rare, but we experienced a case of elbow dislocation combined with distal radius fracture caused by fall on outstretched hand on the snow surface during snowboarding in a young adult.