OpenMed/multicare-articles huggingface dataset:
Huge hydro pneumoperitoneum reported as complication of perforated duodenal ulcer with interesting images
Authors: Islam Hussam Elrobaa, Abdulhadi Hayder Khan, Muayad Kassim Ahmad, Abraham John Elamatha, Mohamed Darwish Elserhy, Elfatih Eltahir, Khalid Abdulnour Saifeldeen
Journal: Pan Afr Med J (2019)
Keywords: abdominal pain, hydro pneumoperitoneum, perforated duodenal ulcer
MeSH terms: Duodenal Ulcer / complications, Peptic Ulcer Perforation / complications, Pneumoperitoneum / etiology, Case Reports, Abdominal Pain / etiology, Duodenal Ulcer / diagnosis, Duodenal Ulcer / surgery, Humans, Male, Middle Aged, Omentum / surgery, Peptic Ulcer Perforation / diagnosis, Peptic Ulcer Perforation / surgery, Pneumoperitoneum / diagnostic imaging

This case has interesting images of huge hydro pneumoperitoneum. It is a rare view in the medical practice and a good point to learn one of the complications of perforated duodenal ulcer and failure of omental patch operation. We reported a case of acute abdominal pain with hydro pneumoperitoneum that appeared as an air fluid line in X-ray. The patient had an omental patch surgery. Two days after the operation he got severe abdominal pain. The X-ray images showed significant huge hydro pneumoperitoneum. He underwent urgent surgical intervention for exploration that detected a large amount of gases, a biliary free fluid and a leak from duodenal ulcer. Omental buttressing was then performed.
Case report: Multidrug-resistant Streptococcus pseudoporcinus isolated from an infected surgical wound of a 9-year-old spayed female Great Dane dog
Authors: Yesutor K Soku, Athema L Etzioni, Abdelrahman Mohamed
Journal: Front Vet Sci (2023)
Keywords: bacteria, case report, drug resistance, infection, microbiology, purulent discharge
MeSH terms: Case Reports

Streptococcus pseudoporcinus (S. pseudoporcinus) is a β-hemolytic, Gram-positive novel bacterium first identified in 2006. It is a catalase-negative, non-motile coccus arranged in short chains. Furthermore, it has a broad beta-hemolytic reaction on sheep blood agar and cross-reacts with Lancefield group B antigen agglutination reagent. In this study, we report a case of S. pseudoporcinus infection of a surgical wound on the left metatarsus of a dog. The patient is a 9-year-old spayed female Great Dane dog with a brief history of multiple cutaneous masses being removed. Post-surgery, the post-surgical site on the left metatarsus became infected and discharged purulent material with a fetid odor. Upon preliminary diagnostic testing, we detected catalase-negative Gram-positive cocci exhibiting beta-hemolytic growth on sheep blood agar. A VITEK® 2 Compact machine from bioMérieux identified the bacterium as S. pseudoporcinus. Furthermore, antibiotic testing revealed multidrug resistance. Therefore, we document a multidrug-resistant S. pseudoporcinus isolate as a cause of canine post-surgical wound infection. Furthermore, it was the only isolate detected from the sample; hence, it is the cause of the infection. To our knowledge, this case is the first report of S. pseudoporcinus in a dog.
En bloc liver-kidney transplantation with renal artery variation using donor splenic artery and left gastric artery as inflow to the kidney: Case report
Authors: Michelle C Nguyen, Sylvester Black, Ken Washburn, Ashraf El-Hinnawi
Journal: Int J Surg Case Rep (2018)
Keywords: en bloc liver-kidney transplantation, renal artery variation, simultaneous liver-kidney transplantation

Introduction:
En bloc liver-kidney transplantation can be difficult with renal artery variations for which the risk of multiple anastomoses can outweigh the benefits.
Presentation of case:
This report is the first to describe an en bloc liver-kidney transplantation using a donor kidney with double renal arteries. The indication for a combined liver-kidney transplant was non-alcoholic steatohepatitis (NASH) cirrhosis with chronic kidney disease secondary to hypertension and diabetes compounded by hepato-renal syndrome. The explant pathology was consistent with steatohepatitis, but did have PAS/D-positive intracytoplastic globules which suggest an additional component of alpha-1-antitrypsin deficiency.
Discussion:
Diminished arterial inflow to the inferior renal pole was noted intraoperatively, requiring re-anastomosis of the inferior renal polar artery to the donor left gastric artery. The post-operative course was uncomplicated with patient discharge on post-operative day six.
Conclusion:
With increasing numbers of simultaneous liver-kidney transplants being performed, kidneys with multiple renal arteries can successfully be transplanted en-bloc without compromising ischemia time.
Case Report: Implantation of Dedifferentiated to Poorly Differentiated Thyroid Carcinoma After Endoscopic Thyroid Surgery
Authors: Jin Hu, Xia Xu, Shuntao Wang, Fang Dong, Ximeng Zhang, Jie Ming, Tao Huang
Journal: Front Oncol (2022)
Keywords: breast implantation, case report, endoscopic thyroidectomy, poorly differentiated thyroid carcinoma, thyroid carcinoma
MeSH terms: Case Reports

Background:
Endoscopic thyroidectomy is widely accepted for its advantages. However, implant metastasis remains a significant complication of endoscopic thyroidectomy.
Methods:
This is the first report of breast implantation diagnosed with poorly differentiated thyroid carcinoma following endoscopic thyroidectomy.
Results:
We present a case of a 35-year-old woman who was initially diagnosed with a 3.0 cm conventional papillary thyroid carcinoma after endoscopic thyroidectomy via total areola. Two years later, she was reported to have recurring poorly differentiated thyroid carcinoma in the right areola. Implantation after endoscopic thyroidectomy is rare, and even rarer is dedifferentiated papillary thyroid carcinoma around the implant site.
Conclusions:
Stringently evaluated endoscopic surgery indications, appropriate preoperative evaluation, meticulous surgical technique, and adequate protective measures can significantly reduce the incidence of local implantation or recurrence.
Hypercalcemia and Neurological Symptoms: A Rare Presentation of Hyperfunctioning Parathyroid Adenoma in an Adolescent
Authors: Valeria Calcaterra, Gloria Pelizzo, Andreana Pipolo, Giulio Montecamozzo, Valentina Fabiano, Roberta Grazi, Patrizia Carlucci, Gianvincenzo Zuccotti
Journal: Front Surg (2022)
Keywords: adenoma children, adolescents, hypercalemia, hyperparathyroidism, neuropsychiatric symptoms, parathyroid
MeSH terms: Case Reports

Neuropsychiatric symptoms are rarely described as a manifestation of hyperparathyroidism, especially in children. We describe the case of an adolescent with hypercalcemia related to and hyperfunctioning parathyroid adenoma presenting with acute neuropsychiatric symptoms. A 14-year-old-girl presented into the Emergency Service Department because of an acute onset of marked asthenia, muscle weakness with difficulty in walking, and altered mental status, which included nonsensical speech. No other neurological signs were present. Abdominal, cardiac, and thoracic examination were unremarkable. There was no recent history of trauma or infection. Family history was negative for neurologic disorders. Her past medical history was unremarkable. A head CT scan showed negative results. The laboratory work-up showed elevated levels of calcium level (14.35 mg/dl; nv 9-11 mg/dl), parathyroid hormone (PTH; 184 pg/ml; nv 3.5-36.8 pg/ml), and creatinine (1.23 mg/dl; nv 0.45-0.75 mg/dl). Sodium, potassium, chloride, thyroid function, glycemia, and insulin values were normal. Neck ultrasonography showed a solid, oval, capsulated, hypoechoic neoformation, with discrete vascularization localized to the inferior pole of the right thyroid lobe, referring to parathyroid tissue. Scintigraphy revealed a hyperfunctioning parathyroid tissue at the inferior pole of the right thyroid lobe. Massive intravenous hydration and diuretic therapy were started. The signs and symptoms of hypercalcemia improved after the initiation of therapy. The patient was submitted to right cervicotomy and muscle sparing for the removal of the adenoma of the right superior parathyroid gland. After surgery, a decrease in PTH levels (<4 pg/ml) and calcium levels (9.1 mg/dl) was recorded. During follow-up, calcium values remained stable; a progressive normalization of PTH was obtained. The oral calcium therapy was suspended after 3 months from surgery. No neuropsychiatric symptoms recurred. An evaluation of the serum calcium level is mandatory in children and adolescents with unexplained neurological signs or symptoms, and a check for hyperparathyroidism should be considered.
Uterine transarterial embolization as nonsurgical management for uterine rupture following vaginal delivery: A report of two cases
Authors: Rémi Grange, Laure-Elie Digonnet, Alexandre Mayaud, Céline Chauleur, Claire Boutet, Tiphaine Raia-Barjat, Sylvain Grange
Journal: Radiol Case Rep (2022)
Keywords: coils, embolization, hemorrhage, uterine rupture
MeSH terms: Case Reports

Uterine rupture (UR) is an unexpected, rare, and serious obstetrical condition, occurring in less than 0.1% of pregnancies. Complete UR is defined as a direct communication between the uterine cavity and the peritoneum due to a complete rupture of the myometrium. Here, we present 2 cases of non-surgical management of UR following vaginal delivery, which were both treated by uterine transarterial embolization (UAE). A 26-year-old woman (G0P0) was referred to the emergency ward at 35 weeks of amenorrhea to treat the rupture of membranes, in the context of twin pregnancy. A vaginal delivery was performed and blood loss exceeded 2 liters. Gelatin sponge was injected in an attempt to occlude the right uterine artery. The injection was unsuccessful. After the medical team's discussion, it was decided to definitively occlude the right uterine artery. A 37-year-old woman (G3P3) was referred for a vaginal delivery for a medical termination at 38 weeks of amenorrhea. The ultrasound revealed a left latero-uterine pelvic hematoma, suggestive of UR. Four fibered coils were used to definitively occlude the left uterine artery. Computed tomography scan showed a progressive resorption of hematoma and satisfactory enhancement of the uterine wall in the 2 cases. Transarterial embolization may allow for bleeding to stop without resorting to exploratory laparotomy, with ad-integrum restitution of the uterine wall, and thus prevent a potential hysterectomy. The findings in these 2 cases suggest that UAE should be considered if pregnant women develop UR after delivery.
Microscopic polyangiitis initially presenting with idiopathic pulmonary fibrosis: a case report
Authors: Chi Shao, Ruxuan Chen, Hui Huang, Yang Zhao, Keqi Chen, Kai Xu
Journal: Front Med (Lausanne) (2023)
Keywords: anca antibody, antifibrotic therapy, idiopathic pulmonary fibrosis, microscopic polyangiitis, usual interstitial pneumonia pattern
MeSH terms: Case Reports

Usual interstitial pneumonia is the most common type of microscopic polyangiitis (MPA)-associated interstitial lung disease, and patients may initially present with isolated pulmonary fibrosis, which often leads to a misdiagnosis of idiopathic pulmonary fibrosis (IPF). Here, we describe a patient who developed fever of unknown origin, microscopic hematuria and renal insufficiency, who then tested positive for antineutrophil cytoplasmic antibody (ANCA) and was diagnosed with MPA after receiving antifibrotic medication for IPF (original diagnosis) for almost 10 years. The patient's symptoms were ameliorated after administration of additional glucocorticoids and immunosuppressants.
Cigarette Lighter Fluid Induced Gastric Ulcer: A Severe Complication of Delayed Foreign Body Removal
Authors: Ciel Harris, Lauren Stemboroski, Asim Shuja
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

The majority of foreign bodies ingested pass uneventfully through the gastrointestinal tract without endoscopic intervention. Nevertheless, certain ingested objects pose a greater risk for complications and are more challenging to remove than others. This case report describes a 49-year-old male who swallowed a cigarette lighter causing a gastric ulcer. The lighter was successfully removed by flexible endoscopy using a polypectomy snare. Urgent removal is required due to the shape of the object and its hazardous contents. This is the first case report published in the United States describing cigarette lighter ingestion and management.
Leiomyoma: a case report of a rare benign tumor of the female urethra
Authors: Amine Slaoui, Abdelouahed Lasri, Tarik Karmouni, Khalid Elkhader, Abdelatif Koutani, Ahmed Ibn Attaya
Journal: Pan Afr Med J (2015)
Keywords: leiomyoma, smooth muscle, tumor, urethra
MeSH terms: Leiomyoma / pathology, Urethral Neoplasms / pathology, Case Reports, Dysuria / etiology, Female, Follow-Up Studies, Humans, Leiomyoma / diagnosis, Leiomyoma / surgery, Middle Aged, Urethral Neoplasms / diagnosis, Urethral Neoplasms / surgery, Urinary Tract Infections / etiology

Leiomyoma is a benign smooth muscle tumor which is rarely found in urethra. It often appears in females during their reproductive age (from menarche to menopause); the mean age of their appearance is approximately 41 years. Less than 100 cases were reported in the literature. We hereby report a case of a 52-year-old White woman who presented with complaints of dysuria and urinary tract infection. The mass was completely removed by transvaginal excision with a rim of normal tissue. Histopathological studies confirmed the urethral leiomyoma. The patient remained asymptomatic and there was no evidence of recurrence in the followup.
Benefits of intraoperative endoscopy: case report and review of 300 sleeves gastrectomies
Authors: Ameer Gomberawalla, Rami Lutfi
Journal: Ann Surg Innov Res (2015)
Keywords: bariatric surgery, endoscopy, sleeve gastrectomy
MeSH terms: Case Reports

Background:
The laparoscopic sleeve gastrectomy (LSG) is the fastest rising bariatric procedure being performed in the United States. Some surgeons advocate for an intra-operative endoscopy for their leak test, while others utilize air via a form of an oral gastric tube. We present a case demonstrating the benefits of endoscopy intra-operatively as well as discuss our experience of 200 consecutive sleeve gastrectomies.
Case presentation:
The case is a 37 years old female undergoing LSG for treatment for morbid obesity. As is our practice, we routinely perform an intra-operative endoscopy to help ensure a tight seal on the remnant stomach prior to completion of the procedure. During our endoscopy, a blood clot overlying a portion of the esophagus was noted, evacuated and evaluated and found to have a non-bleeding mucosal tear. This was unusual in our experience. There was no leak found on intra-operative endoscopy. After the patient woke up, she starting to have bouts of hematemesis. The decision was made to go back to the OR and evaluate her endoscopically. rather than attempting a laparoscopy based off of our endoscopic findings. Upon take back, we found a mucosal tear in her distal esophagus that now started bleeding, and her staple line was intact. Hemostasis was successfully achieved with two epinephrine injections. The remaining portion of her postoperative course was uncomplicated.
Discussion and conclusions:
The patient was able to be safely managed with a post-operative EGD. The intra-operative endoscopic findings allowed us to be more confident that this was an esophageal issue rather than a staple line problem, and were able to start with EGD prior to laparoscopy. Additionally, from a visualization perspective, the intra-operative endoscopy allows you to fully visualize the staple line, evaluate for twists or narrowing, and test for leak with confidence. From a residency standpoint, it also increases the confidence of residence to perform endoscopy on intubated patients.
Unilateral Maxillary Sinus Actinomycosis with a Closed Oroantral Fistula
Authors: Jason E Cohn, Mark Lentner, Hui Li, Matthew Nagorsky
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Actinomycosis is a bacterial infection due to Actinomyces israelii, a gram-positive, anaerobic organism that normally affects the cervicofacial region. However, facial injury or trauma (i.e., dental procedures) can allow this bacteria to inhabit other regions. There have been rare reports of actinomycosis of the paranasal sinuses. We present a case of a 50-year-old female who originally presented with a suspected oroantral fistula who subsequently was found to have actinomycosis involving her right maxillary sinus. Additionally, the dental extraction site revealed no connection with the maxillary sinus. We discuss the diagnostic approach and management of this patient as it relates to the limited existing literature.
A complex heterozygous mutation in PADI6 causes early embryo arrest: A case report
Authors: Ting Zhang, Peng Liu, Guanfeng Yao, Xin Zhang, Cuijuan Cao
Journal: Front Genet (2023)
Keywords: padi6 gene, case report, complex heterozygous mutation, early embryo arrest, female infertility
MeSH terms: Case Reports

Background: The PADI6 gene is a component of the subcortical maternal effect complex (SCMC). Mutations in the PADI6 gene, which was the first gene discovered to impact the activation process of the human embryonic genome, have been shown to induce early embryo arrest. Case: A 29-year-old lady with primary infertility underwent in vitro fertilization embryo transfer (IVF-ET) for tubal reasons, who had normal hormone levels and ovarian reserve. A Progestin-Primed Ovarian Stimulation (PPOS) protocol of Ovarian stimulation with IVF was performed. The total of Gonadotropin (Gn) stimulation with u-FSH was 2100 IU, which lasted for 10 days. When three follicles measuring less than 18 mm in diameter were seen, r-hCG 250 ug and triptorelin acetate 0.2 mg were injected to trigger oocyte maturation. Nineteen oocytes (including thirteen MII oocytes) were picked up 37 h after the trigger, and seven of these were normal fertilized. Unfortunately, these many embryos were stopped at the 1- or 2-cell stage, hence this infertile patient's IVF treatment won't result in an embryo transfer. Using whole-exome sequencing, a complex heterozygous mutation in PADI6 was discovered: c. 1247T>C [p.Ile416Thr] in exon 12 of PADI6, and c. 2009_2010del [p.Glu670GlyfsTer48] in exon 17 of PADI6. Conclusion: We found a complex heterozygous mutation in the PADI6 gene (c. 1247T>C; c. 2009_2010del) that caused embryos were arrested at the 1- or 2- cell stage. The discovery in this patient adds to the evidence showing the PADI6 gene mutation causes early embryo arrest in humans.
Case Report: A Case of a Child With Facial Foreign Body Abscess and Facial Artery Pseudoaneurysm
Authors: Rong Kuang, Jing Zhou, Jiaqi Deng, Tian Xia, Mingxing Li
Journal: Front Pediatr (2022)
Keywords: abscess, aneurysm, face, foreign body, glass, traumatic
MeSH terms: Case Reports

Facial artery pseudoaneurysms are rare and mostly a result of blunt injury. Since the facial arteries are well protected by facial soft tissue and the lumen of the facial artery is thin and small in diameter, a sharp injury usually leads to complete transection rather than partial laceration of the blood vessel. As a non-invasive method, ultrasound does not involve radiation and sedation. Diagnosis of facial artery pseudoaneurysms is most commonly made with ultrasound, and Doppler ultrasound is essential. On grayscale imaging, facial artery pseudoaneurysms often appearanced of a fluid collection, Color Doppler imaging often show a well-defined swirl pattern named "yin and yang sign," the Spectral Doppler showed a diagnostic "to and fro" two-phase bidirectional arterial blood flow spectrum. It's particularly for the examination of facial artery pseudoaneurysms in children. Here, we report a case of facial foreign body abscess and facial artery pseudoaneurysm in a 19-month-old child 1 week after a sharpness injury that was diagnosed by ultrasound.
Single-incision laparoscopic bariatric surgery
Authors: Chih-Kun Huang
Journal: J Minim Access Surg (2011)
Keywords: sils, single-incision laparoscopic surgery, bariatric surgery, single-incision transumbilical laparoscopic surgery

Background:
Bariatric surgery has been established as the best option of treatment for morbid obesity. In recent years single-incision laparoscopic surgery (SILS) has emerged as another modality of carrying out the bariatric procedures. While SILS represents an advance, its application in morbid obesity at present is limited. In this article, we review the technique and results of SILS in bariatric surgery.
Methods:
The PubMed database was searched and totally 11 series reporting SILS in bariatric surgery were identified and analyzed. The case reports were excluded. Since 2008, 114 morbidly obese patients receiving SILS bariatric surgeries were reported.
Results:
The procedures performed included SILS gastric banding, sleeve gastrectomy and gastric bypass. No mortality was reported in the literatures. Sixteen patients (14.05%) needed an additional incision for a liver retractor, a trocar or for conversion. Only one complication of wound infection was reported in these series. All the surgeons reported that the patients were highly satisfied with the scar.
Conclusion:
Because of abundant visceral and subcutaneous fat and multiple comorbidities in morbid obesity, it is more challenging for surgeons to perform the procedures with SILS. It is clear that extensive development of new instruments and technical aspects of these procedures as well as randomized studies to compare them with traditional laparoscopy are essential before these procedures can be utilized in day-to-day clinical practice.
Coinfection by Aspergillus and zygomycetes species in a case of acute rhinosinusitis
Authors: Dhara Vaidya, Parul Shah
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

Invasive mycotic infections can be effectively treated if rapid identification of fungus is obtained. We reported a case of coinfection by Aspergillus and Rhizopus sp. involving nose, paranasal sinuses, orbit, and brain in a 68-year-old known hypertensive male. He was presented to ENT OPD with history of fever and intermittent headache since fifteen days along with history of right-sided nasal obstruction and proptosis since seven days. CT scan of brain and paranasal sinuses showed findings of pansinusitis with cellulitic changes in right orbit. MRI confirmed the same along with features of intracranial extension with focal meningitis in right frontotemporal region. Laboratory parameters did not conclude much except for leucocytosis and hyponatremia. Patient was taken for endoscopic debridement from nose and paranasal sinuses, and tissue was sent for microbiological and histopathological examination. Minced tissue was processed, and after 48 hrs of incubation two types of growth were identified, one was yellowish, granular, and powdery consistent with Aspergillus sp., and another was cottony and woolly consistent with Rhizopus sp. LCB mount confirmed presence of Aspergillus flavus and Rhizopus arrhizus. Patient responded to therapy with IV amphotericin B and surgical debridement. On discharge patient's condition was good.
Chronic progressive disseminated histoplasmosis in a Mexican cockfighter
Authors: René Agustín Flores-Franco, Antonio Gómez-Díaz, Antonio de Jesús Fernández-Alonso
Journal: Am J Trop Med Hyg (2015)
MeSH terms: Histoplasmosis / diagnosis, Occupational Exposure, Case Reports, Antifungal Agents / therapeutic use, Chronic Disease, Histoplasmosis / etiology, Humans, Itraconazole / therapeutic use, Male, Mexico, Middle Aged, Antifungal Agents, Itraconazole

We present illustrative images from a Mexican 58-year-old man who had the occupation of cockfighting from childhood and presented with chronic progressive disseminated histoplasmosis with primarily cutaneous manifestations.