OpenMed/multicare-articles huggingface dataset:
Fatigue Acetabular Fracture after Lumbopelvic Instrumented Fusion in Elderly
Authors: Panagiotis Korovessis, Vasileios Tsekouras, Alkis Korovesis
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Purpose:
Only several cases of acetabular "fatigue"/insufficiency fractures have been reported in elderly patients with osteoporosis. However, fatigue acetabular fracture below lumbopelvic fixation has not been published. This review reports on the frequency and mechanisms of acetabular fatigue fractures in elderly individuals, including postmenopausal osteoporosis, and presents a case of an acetabular "fatigue" fracture in association with lumbopelvic fusion.
Methods:
We report on a 71-year-old postmenopausal woman who underwent in our department a L2-pelvis instrumented fusion for failed lumbar decompression and interbody fusion performed in another institution. For at least one year, the patient was receiving antiosteoporotic treatment (Alendronate plus Calcium and Vitamin D) and was fully ambulatory without limping. Eighteen months following our surgery, the patient sought again our department because of increasing pain in her right hip and limping without trauma.
Results:
The physical examination disclosed painful passive motion in her right hip. The roentgenograms and CT-scans disclosed a transverse acetabular fracture with radiolucencies around both iliac screw tips, particularly the right. Additionally, a severe compression fracture of the 12th thoracic vertebral body and upper endplate of the L2 vertebra was disclosed. We recommended open stabilization of the acetabulum and T12 and L2 vertebrae. Immediately before the planned surgeries, the patient had a serious heart infarct, and thus, surgeries were canceled by the patient's cardiologist because of the high perioperative risk. The patient and relatives denied further surgeries because of the heart disease. In the final telephone call and CT and roentgenographic evaluation that went to us after request, there was an acetabular pseudarthrosis in the right hip without however associated complaints. Since surgery was not accepted, the patient was prescribed Denosumab injection therapy plus Vitamin and Calcium supplement.
Conclusion:
This case report emphasizes the significance of follow-up observation of elderly patients with postmenopausal osteoporosis following lumbopelvic fusions, for possible fatigue acetabular and vertebral fractures. The authors speculate that this extremely rare acetabular "fatigue"/insufficiency fracture should be the result of increased repetitive mechanical forces acting around the acetabulum in association with osteoporosis.
Intrathecal daptomycin use in a challenging case of Enterococcus faecium ventriculitis
Authors: Ankush Dhariwal, Rachel Leff, Mike Allen, Benny Cherian
Journal: Access Microbiol (2022)
Keywords: enterococcus faecium, vre, daptomycin, external ventricular drain, intrathecal, ventriculitis
MeSH terms: Case Reports

Treatment of ventriculitis caused by enterococci can be challenging, and antibiotic options are limited. We describe a case of device-related ventriculitis caused by vancomycin-resistant Enterococcus faecium , refractory to initial antibiotics. Our management approach included intrathecal daptomycin. There were no attributable adverse events, and the patient remained infection-free following ventriculo-peritoneal shunt insertion and cessation of antibiotics.
Technical Approach to Laparoscopic Examination of the Small Bowel in Gallstone Ileus
Authors: Sarah Assali, John Mourany, Brendan Jones, Lauren Dudas, Nova Szoka
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Background:
Gallstone ileus is an infrequent cause of small bowel obstructions (SBO), accounting for only 0.1-5% of SBOs and 25% of nonstrangulating causes of SBO in the elderly population. There is scant literature available regarding the use of laparoscopy to treat gallstone ileus. Currently, much of the literature available is limited to case reports only.
Methods:
A complete laparoscopic approach was utilized to manage a 65-year-old woman with morbid obesity who presented with gallstone ileus. With regard to our technical approach, we describe the technical approach that facilitates safe laparoscopic examination of the entire small bowel and can be applied to other acute care surgery cases involving small bowel pathology.
Results:
The patient's postoperative course was complicated by new-onset atrial fibrillation which was treated medically with good response. She was safely discharged on postoperative day 2.
Conclusion:
Laparoscopy is a feasible option for the management of gallstone ileus and can lead to decreased morbidity compared to laparotomy. The technique described allows for laparoscopic examination of the entire small bowel.
The addition of the surgical robot to skin cancer management
Authors: A D MacKenzie Ross, P Kumar, B J Challacombe, P Dasgupta, J L C Geh
Journal: Ann R Coll Surg Engl (2013)
MeSH terms: Carcinoma, Merkel Cell / surgery, Carcinoma, Squamous Cell / surgery, Lymph Node Excision / instrumentation, Melanoma / surgery, Robotics / instrumentation, Skin Neoplasms / surgery, Case Reports, Adult, Aged, Equipment Design, Female, Humans, Laparoscopy / instrumentation, Length of Stay, Middle Aged, Operative Time, Postoperative Complications / etiology, Prospective Studies

We present the introduction of the surgical robot for pelvic lymphadenectomy for skin cancer through a cross-specialty collaboration. In this prospective series, we include the first report of cases undergoing robot-assisted pelvic lymph node dissection for Merkel cell carcinoma and melanoma in the recognised scientific literature.
Reversible right-sided heart failure secondary to carcinoid crisis
Authors: Mariana Soto Herrera, José A Restrepo, Jesús H Díaz, Andrés Ramos, Andrés Felipe Buitrago, Mabel Gómez Mejía
Journal: Case Rep Crit Care (2013)

Carcinoid crisis is an infrequent and little-described complication of neuroendocrine tumors that can be life threatening. It may develop during induction of anesthesia, intraoperatively, during tumor manipulation and arterial embolization, or even spontaneously. The massive release of neuroendocrine substances can lead to potentially fatal complications. Somatostatin analogs inhibit the release of these substances and are the mainstay of treatment. The following case report describes a patient with reversible acute right-sided heart failure posterior to hepatic artery embolization.
The Combination of Cognitive-Behavioural Therapy with Virtual Reality for the Treatment of Postnatal Depression in a Brief Intervention Context: A Single-Case Study Trial
Authors: George Stamou, Azucena Garcia-Palacios, Brendon J Woodford, Carlos Suso-Ribera, Cristina Botella
Journal: J Healthc Eng (2021)
MeSH terms: Cognitive Behavioral Therapy, Depression, Postpartum / therapy, Virtual Reality, Clinical Trial, Crisis Intervention, Female, Humans, Treatment Outcome

Postnatal depression (PND) is a mood disorder with potentially devastating effects to the individual on many levels. It can affect cognitive functioning, motivation, and self-esteem. The person can socially withdraw from their immediate familial or social circle. It can affect bonding and quality time between the mother and baby. There are many effective therapeutic treatments used for the treatment of PND such as cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT). This study using a single-case study trial with 15 participants investigates the clinical usefulness of combining CBT with virtual reality (VR). Results show that the combination of CBT with VR is an effective treatment for PND. In addition, VR can enhance awareness, decision-making, and self-appreciation within the individual and can also have real-life applications. This study also shows that the combination of VR and CBT is feasible, while the use of such a technology is well accepted.
Case report of successful management of intraoperative tracheal rupture during thoracoscopic esophageal resection in patient with esophageal cancer
Authors: Аlexander Khitaryan, Ismail Miziev, Camil Veliev, Olga Voronova, Anastasiya Golovina, Raisa Zavgorodnyaya, Sergey Kovalev, Albert Alibekov, Аlexey Orekhov
Journal: Int J Surg Case Rep (2019)
Keywords: case report, esophageal cancer, intraoperative complications, thoracoscopic esophageal resection, trachea rupture

Introduction:
A rupture of the membranous part of trachea during thoracoscopic and transhiatal resection of esophagus is a rare complication that occurs in 0.4% of cases. This complication often requires thoracotomy and is associated with prolonged pulmonary ventilation, long-term pleural draining due to persistent air leakage and development of a tracheopleural fistula, prolonged hospitalization, and high risk of septic and secondary cardiorespiratory complications.
Presentation of case:
A 52-year-old woman complained of difficulty eating solid food, impaired swallowing, persistent pain behind the sternum, nausea, sickness and weight loss. EGD revealed tumor almost completely obturating the lumen in the middle third of the esophagus. The histopathological examination showed esophageal SCC. CT scan confirmed 33 × 29 × 55 mm tumor. The patient underwent thoracoscopic esophageal resection during which two defects of the tracheobronchial tree with sizes of 15 mm and 30 mm were detected and then successfully sewn using intracorporeal continuous Stratafix 3.0 suture. The patient was diagnosed with cancer of middle third of esophagus pT3N1M0, stage IIIB.
Discussion:
Thorough selection of patients undergoing thoracoscopic esophageal resection together with gentle manipulations with the esophagus in the area adjacent to the trachea can prevent intraoperative tracheobronchial damages. Timely diagnosis of such serious complications makes it possible to successfully manage them using thoracoscopic techniques.
Conclusion:
Intraoperative tracheal and bronchial ruptures can be successfully managed with thoracoscopic intracorporeal suture.
Terminal Complement Pathway Deficiency in an Adult Patient with Meningococcal Sepsis
Authors: F Staels, W Meersseman, P Stordeur, K Willekens, S Van Loo, A Corveleyn, I Meyts, G Meyfroidt, R Schrijvers
Journal: Case Reports Immunol (2022)
MeSH terms: Case Reports

The complement system is an essential part of our innate immune system. Three enzymatic activation pathways are described, all converging into a common terminal pathway which causes lysis of the target cell. Late complement deficiencies (LCDs) are typically diagnosed in children or adolescents with invasive meningococcal disease (IMD). However, IMD can also be a first manifestation in adulthood and should prompt for the evaluation of the LCD. We report the case of a young adult with IMD who was found to have a LCD, caused by a compound heterozygous mutation in C6. His vaccination status was optimized and prophylactic antibiotic treatment was initiated. By means of this case, we would like to raise awareness of underlying LCD in (young) adults presenting with IMD by N. meningitidis. Screening for complement deficiencies after IMD, followed by genetic testing, can be lifesaving and allows for genetic counselling. In addition, we discuss the diagnosis and treatment of LCD.
A Case Report and Literature Review of Pseudo-TORCH Syndrome Type 2 (PTORCH2)
Authors: Rami A Misk, Lama Qawasme, Fawzy M Abunejma, Bahaa Ibrahim Abu Rahma, Ehab Mohammad Abuawwad, Raja Imad Abu Iram, Abdulrahman Hussein Karaki, Tareq Z Alzughayyar, Jihad Samer Zalloum
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

A pseudo-TORCH syndrome is a rare autosomal recessive disease characterized by intracranial calcification and microcephaly, leading to spasticity and seizures, but the serology of TORCH infection is negative. We present a 4-day-old female patient with jaundice, abnormal movement, and convulsions who was found to be homozygous for the missense USP18 gene mutation that causes pseudo-TORCH syndrome 2 (PTORCH2). The patient was managed with conservative measures.
Transverse colonic volvulus after resection of sigmoid volvulus: Presentation of a case report
Authors: Samaual Eldirdiri, Idriss H Musa, Hawa Y Adam, Afraa G Suliman, Muaz M Ata Elmanan, Sami Eldirdiri, Yasir O M Awadelseed, Majdi O A Bakhiet
Journal: Int J Surg Case Rep (2019)
Keywords: case report, gangrenous, sigmoid volvulus, transverse colonic volvulus

Introduction:
Colonic volvulus is the third leading cause of colonic obstruction in the world following colorectal cancer and complicated sigmoid diverticulitis. Transverse colon is the rarest among other colonic volvulus. Moreover synchronous/metachronous transverse colonic volvulus is extremely rare condition with only few case reported in the literature, we hereby report this case of metachronous transverse colonic volvulus years after sigmoidectomy for sigmoid volvulus CASE PRESENTATION: A case of transverse colon volvulus in elderly male with history of chronic constipation and a previous history of a sigmoid volvulus resection few years ago. He presented as an emergency with typical features of acute large bowel obstruction. He was successfully managed with a good out come DISCUSSION: We discuss the presentation, diagnosis and surgical management with a literature review of this case of a metachronous transverse colonic volvulus.
Conclusion:
Metachronous colonic volvulus is an extremely rare cause of large bowel obstruction and should be considered as a differential diagnosis especially in geographic areas with high rate of volvulus or in those with underlying risk factor.
A Case of Leptospirosis-Associated Severe Pulmonary Hemorrhagic Syndrome Successfully Treated with Venovenous Extracorporeal Membrane Oxygenation
Authors: Nao Umei, Shingo Ichiba
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Background:
In patients with leptospirosis-associated severe pulmonary hemorrhagic syndrome (SPHS), hypoxemia is the most common cause of death despite maximal mechanical ventilation.
Case:
A 50-year-old male sushi chef who had never traveled outside Japan presented with a 2-day history of fever and muscle pain. On admission, the patient had thrombocytopenia, renal insufficiency, and jaundice. His condition continued to deteriorate, with decreasing platelet count, worsening renal function, hyperbilirubinemia, hypotension, and respiratory distress. On day 5 after onset of symptoms, he required intubation and mechanical ventilation. Bronchoscopy showed diffuse endobronchial bleeding. His respiratory status worsened rapidly with a partial pressure of arterial oxygen to fraction of inspired oxygen ratio of 70, necessitating venovenous extracorporeal membrane oxygenation (V-V ECMO) and treatment with an inotrope, renal replacement therapy, and broad-spectrum antibiotics including benzylpenicillin. Anticoagulation was maintained at the minimum level. His condition improved, and he was weaned off ECMO on day 15 and discharged on day 19 after onset of symptoms. The leptospirosis diagnosis was confirmed by leptospiral DNA detection in urine samples by polymerase chain reaction and the results of paired serum antibody titer testing.
Conclusions:
V-V ECMO may prevent mortality in patients with leptospirosis-induced SPHS that does not respond to conventional therapy.
An Immunocompetent Adult Male Presented with a Liver Abscess Caused by the Mycobacterium tuberculosis: A Case Report from India
Authors: Akash Pawar, Sagar Khadanga, Abhishek Singhai
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

A liver abscess is a collection of purulent fluid in the liver parenchyma caused by a variety of etiological organisms such as bacteria, protozoa, and in rare occasions fungi. Mycobacterium tuberculosis (MTB) is a frequent and widespread infection in underdeveloped nations such as India, which can manifest in many ways. Tuberculosis mostly affects the lungs, although it can also affect any organ in the body. We are reporting a case of liver abscess caused by MTB infection in order to raise general awareness among physicians about the importance of suspecting and ruling out tuberculosis as a cause of liver abscess. To the best of our knowledge, there have been very few such cases reported from India/the rest of the world.
Total Colonic Expulsion with Part of Small Bowel per Vaginum due to Low-Flow Phenomenon and NOMI: A Case Report
Authors: Suha Deen, Martin Powell
Journal: Diagn Ther Endosc (2011)
MeSH terms: Case Reports

Introduction. Intestinal ischaemia is a devastating disease process that could lead to bowel gangrene and death if either not diagnosed early or left untreated; death is usually caused by irreversible shock, intestinal necrosis, or septicaemia. It is usually seen in elderly patients with atherosclerotic disease. The course of bowel ischaemia may affect variable lengths of the intestine and it is not unusual for the condition to be followed by uneventful recovery. Case presentation. We are reporting an unusually rare case where an elderly patient passed an extraordinarily long segment of bowel, including rectum, the whole of the large bowel, and part of the small bowel, through anus following an episode of nonobstructive mesenteric ischaemia (NOMI) complicating myocardial infarction. To our knowledge, there are only eight cases reported in the literature where the condition was diagnosed upon the passage of short segments of the large bowel particularly of the rectosigmoid segment through the anus. Conclusion. Physician should keep a high level of suspicion in order to prevent it or at least recognise it early on and offer adequate management and hence reducing morbidity and mortality.
Parkinsonism following Bee Sting: A Case Report
Authors: Ruchika Mittal, Sanjay Munjal, Dheeraj Khurana, Ashok Gupta
Journal: Case Rep Neurol Med (2012)

We are reporting here a rare case of Parkinsonism (Hypokinetic dysarthria) caused after a bee stung, a member of the hymenoptera order. The main aim of this report is to orient the clinicians with the possibility of extrapyramidal syndromes because of hymenoptera stings.
Unilateral Cysticercosis of the Parotid Gland: Case Report, Diagnosis, and Clinical Management
Authors: Zachary Elwell, Shethal Bearelly, Khalid Aboul-Nasr, Jonathan Lara
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

Cysticercosis is a systemic parasitic infection caused by the establishment of the larval form of the parasitic cestode, Taenia solium. Cysticercosis is acquired via the fecal-oral route and is prevalent in low- and middle-income countries (LMICs). Patients typically manifest with skeletal muscle, subcutaneous, or central nervous system involvement. Though there are reports of oral mucosa involvement, solitary involvement of the parotid gland is rare. This is a rare case of a 57-year-old man diagnosed with parotid cysticercosis by imaging and FNA. He was successfully treated by anthelminthic therapy and needle aspiration. The patient has been seen back several times. The cyst is not palpable, and he is satisfied. Parotid cysticercosis should be considered in the differential of a parotid mass in patients who have traveled to endemic regions. Though prior reports have indicated the importance of surgical excision, this patient was treated medically.
Evaluation and treatment of an unusual urachal mass: a case report
Authors: John L Cooper, Nikolai A Sopko, Trinity J Bivalacqua
Journal: Springerplus (2015)
Keywords: cystectomy, diabetes, fistula, urachal abscess, urachal adenocarcinoma, urachal mass

Abnormalities of the urachus, the vestigial remnant of the allantois, result when the embryonic lumen fails to completely obliterate during fetal development. In adults, urachal abnormalities are most commonly masses, with urachal adenocarcinoma representing the most frequent etiology. Due to the low incidence of urachal masses, guidelines for diagnostic workup and treatment are based off of a limited body of evidence comprised primarily of case reports and retrospective series. We present the case of a fifty-two-year-old woman with a urachal mass. Full radiologic workup consisting of computed tomography, cystoscopy and ultrasonography is included, and the risk factors, treatment and prognosis are discussed.
Paraneoplastic cerebellar degeneration as initial presentation of renal cell carcinoma
Authors: Sara M Souza, Barbara O Santos, Isadora C A Sodré, Ana Luiza P Oliveira, Diogo Terrana, Mariana Spitz
Journal: Cerebellum Ataxias (2019)
Keywords: ataxia, cerebellar degeneration, paraneoplastic
MeSH terms: Case Reports

Background:
Paraneoplastic cerebellar degeneration is usually associated with gynecological and breast cancer, lung cancer, and Hodgkin's lymphoma. Renal cell carcinoma has rarely been described as an underlying malignancy in these cases.
Case presentation:
We report the case of a 75 year-old woman who develop cerebellar ataxia following a respiratory viral infection. During investigation, around 1 year afterward, she noticed constitutional symptoms suggestive of malignancy. Renal carcinoma was found and the hypothesis of paraneoplastic cerebellar degeneration was considered.
Conclusions:
As no specific antineuronal antibodies have been described in the setting of renal cell carcinoma, paraneoplastic cerebellar degeneration should be considered when the tumor is detected and other causes are excluded. Immunotherapy should be prescribed as soon as possible.
Juvenile Dysplasia Epiphysealis Hemimelica with Multiple Ankle Free Body
Authors: Shinsuke Sato, Song Ho Chang, Taro Kasai, Yuji Maenohara, Sho Yamazawa, Sakae Tanaka, Takumi Matsumoto
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Dysplasia epiphysealis hemimelica (DEH), also known as Trevor's disease, is a rare overgrowth of cartilage that commonly arises in the epiphyseal bone of children. We report a rare case of DEH originating from a talus accompanied by multiple intra-articular free bodies in a 7-year-old patient with ankle instability. After the primary surgery for free body removal and microfracture technique for the cartilage defects in the ankle joint, the free body recurred. Secondary surgery of arthroscopic free body removal with lateral ankle ligament repair succeeded in treating the patient, without further recurrence of the free body.
Joubert syndrome; misleading presentation of two cases as pseudo-tumor cerebri and literature review
Authors: Farrokh Seylanian Toosi, Samineh Boloursaz, Bita Abbasi, Reza Hekmat, Reihaneh Mortazavi Ardestani, Mina Mohajerzadeh
Journal: J Renal Inj Prev (2016)
Keywords: joubert syndrome, renal transplantation, retinitis pigmentosa
MeSH terms: Case Reports

Joubert syndrome is a rare autosomal recessive disorder that may have different clinical presentation such as ataxia, hyperpnea, sleep apnea, nystagmus, hypotonia, seizure and retinitis pigmentosa. We present a 22-year-old girl and her older sibling, labeled as cerebral palsy. She had renal transplant years ago without the true diagnosis of the disorder. Brain imaging revealed the classic "molar tooth sign" appearance, and clinical evaluation established the diagnosis for both of the siblings. Imaging should be done to evaluate the neuroradiological findings of Joubert syndrome. With a neonate with Joubert syndrome in a family, antenatal diagnosis by ultrasound is crucial for future siblings.