OpenMed/multicare-articles huggingface dataset:
Abdominal cocoon syndrome (idiopathic sclerosing encapsulating peritonitis): An extremely rare cause of small bowel obstruction-Two case reports and a review of literature
Authors: Humood A Alsadery, Saleh Busbait, Abdulrahman AlBlowi, Morshed Alsawidan, Hassan Mohammed AlBisher, Shadi Alshammary
Journal: Front Med (Lausanne) (2022)
Keywords: abdominal cocoon, idiopathic, intestinal obstruction, peritoneal encapsulation syndrome, primary, sclerosing encapsulation peritonitis
MeSH terms: Case Reports

Introduction:
Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction in which the bowel and internal abdominal organs are wrapped with a fibrocollagenous cocoon-like encapsulating membrane [1,2]. SEP is divided into two entities: abdominal cocoons (AC), also known as idiopathic or primary sclerosing encapsulating peritonitis, which is of extremely rare type, and secondary sclerosing encapsulating peritonitis, which is the more common type.
Case presentation:
Two male patients from India, a 26 year old and a 36 year old, presented to our hospital complaining about abdominal pain associated with nausea and vomiting without any history of previous surgical interventions; the patients' vitals were stable. Preoperative diagnosis of abdominal cocoon was established by abdominal computed tomography. It showed multiple dilated fluid-filled small bowel loops in the center of the abdominal cavity with thin soft tissue, non-enhancing capsules encasing the small bowel loops with mesenteric congestion involving small and large bowel loops. Both patients underwent complete surgical excision of the sac without intraoperative complications. Patients had a smooth postoperative hospital course and were discharged home in good conditions.
Conclusion:
Patients with abdominal cocoons have a non-specific clinical presentation of intestinal obstruction. A high index of clinical suspicion in combination with the appropriate radiological investigation will increase the chance of preoperative detection of the abdominal cocoon. In patients with complete bowel obstruction, complete excision of the peritoneal sac is the standard of care.
Renal Pseudoaneurysms after Flexible Ureteroscopy and Holmium Laser Lithotripsy: A Case Report
Authors: Xin-Xi Deng, Wensheng Zhang, Delai Fu, Bin Fu
Journal: Front Surg (2022)
Keywords: flexible ureteroscopy (furs), holmium laser, pseudoaneurysm (pa), renal calculi, vascular embolization
MeSH terms: Case Reports

Background:
Flexible ureteroscopy (FURS) and holmium laser lithotripsy is considered one of the most minimally invasive and safe surgical methods for the treatment of renal calculi. Renal pseudoaneurysm is a rare complication after FURS holmium laser lithotripsy. We report a case of renal pseudoaneurysm after FURS and holmium laser lithotripsy and review the relevant literature to analyze the possible etiology and summarize the treatment.
Case presentation:
A 29-year-old male with a 2-year history of diabetes was admitted to the hospital because of right back pain for 5 days. A doppler ultrasound demonstrated bilateral renal calculi with bilateral mild hydronephrosis. The patient underwent one-stage right FURS and holmium laser lithotripsy and bilateral ureteral stent implantation. The urine was clear on the second day after the operation, and he was discharged from the hospital. Due to severe gross hematuria, he had to be hospitalized 28 days after the operation. A CT scan showed multiple blood clots in the right renal pelvis and bladder. An emergency blood transfusion and removal of the bladder blood clots and bilateral double J tubes were performed. His urine was clear for one week, and he was discharged from the hospital. He was hospitalized again 47 days after the operation because of fever and hematuria. A CT scan demonstrated blood clots in the bladder and right renal pelvis. Angiography showed a pseudoaneurysm in a small branch of the right renal artery, and hematuria stopped after selective renal artery embolization with microcoils.
Conclusion:
FURS and holmium laser lithotripsy is safe, but we should be aware of the possibility of renal artery pseudoaneurysms (RAP). Through careful operation during the surgery, avoiding kidney injury, reducing intrarenal pressure and controlling the time of operation may prevent the occurrence of this complication. Vascular embolization is the first choice for the treatment of pseudoaneurysms.
Case report: Non-thrombotic iliac vein lesion: an unusual cause of unilateral leg swelling in a patient with endometrial carcinoma
Authors: Jan Zeman, Ritika Kompella, JuYong Lee, Agnes S Kim
Journal: Front Cardiovasc Med (2023)
Keywords: cancer, imaging, intravascular ultrasonography (ivus), peripheral edema, vascular disease
MeSH terms: Case Reports

81-year-old female presented with subacute right lower extremity edema due to iliac vein compression by a markedly enlarged external iliac lymph node later identified as newly relapsed metastatic endometrial carcinoma. The patient underwent a full evaluation of the iliac vein lesion and cancer and had an intravenous stent placed with complete resolution of symptoms post-procedure.
Systemic Amyloidosis and Cardiac Autonomic Neuropathy Associated with Waldenstrom's Macroglobulinemia
Authors: Aasems Jacob, Rishi Raj, Warren Walkow
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

A 73-year-old male with long-standing Waldenstrom's macroglobulinemia complicated with systemic amyloidosis presented with a witnessed syncopal episode. He had complaints of orthostatic dizziness and palpitations for few months. Orthostatic hypotension and peripheral neuropathy were demonstrated on physical examination. EKG, 24-hour Holter monitoring, and 2D echocardiogram were unremarkable. MRI of the brain ruled out stroke. Patients with amyloidosis can develop cardiovascular disease through amyloid cardiomyopathy, small vessel disease, conduction defects, pericardial effusion, or autonomic denervation. After ruling out other life-threatening causes, Ewing's battery of tests was done to rule out cardiac autonomic neuropathy. Two heart rate tests and one blood pressure test were abnormal which indicated severe cardiac autonomic neuropathy. Cardiac autonomic neuropathy can mask symptoms of acute coronary syndrome and hence early diagnosis using the simple bedside maneuver is beneficial. The test is also important for prognostication. Absence of augmentation of cardiac output from inadequate autonomic stimulation will lead to postural hypotension, exercise intolerance, and tachycardia. There may be no change in heart rate with Valsalva or deep breathing both of which increase parasympathetic tone. As the condition progresses, it may result in cardiac denervation which can result in silent myocardial infarction, syncope, and sudden death.
The surgical management of a hypogastric dermatofibrosarcoma protuberans
Authors: Leila Essid, Selim Sassi, Khaled Khelil, Mohamed Ali Sbai, Riadh Maalla
Journal: Pan Afr Med J (2019)
Keywords: dermatofibrosarcoma, flap, plastic surgery, skin defect
MeSH terms: Dermatofibrosarcoma / surgery, Skin Neoplasms / surgery, Surgical Flaps, Case Reports, Dermatofibrosarcoma / pathology, Humans, Male, Middle Aged, Skin Neoplasms / pathology

Dermatofibrosarcoma protuberans (DFSP) is an uncommon skin tumor with intermediate grade of malignancy. Wide surgical resection with disease-free margin offers an excellent probability of cure. These large excisions cause large skin defect that can be difficult to cover. Through this case report we describe a surgically treated DFSP that was covered by a Mc Gregor flap; which despite its seniority is still relevant and continues to serve plastic surgery.
An unusual presentation of ovarian teratoma: a case report
Authors: Seema Khanna, Vivek Srivastava, Sanjai Saroj, Shashi Prakash Mishra, S K Gupta
Journal: Case Rep Emerg Med (2012)
MeSH terms: Case Reports

Mature cystic teratomas account for 10-20% of all ovarian neoplasms and are the most common neoplasm in younger patients. Spontaneous rupture of the teratoma is rare and has been occasionally reported. Here we present an unusual case of left ovarian teratoma rupturing into sigmoid colon.
Sturge-weber syndrome: a case report with persistent headache
Authors: Ece Balkuv, Nihal Isik, Ilknur Aydin Canturk, Nejat Isik, Recep Basaran
Journal: Pan Afr Med J (2014)
Keywords: sturge-weber syndrome, angioma, congenital disorder, vascular nevus
MeSH terms: Sturge-Weber Syndrome / complications, Tension-Type Headache / etiology, Case Reports, Female, Humans, Young Adult

Sturge-Weber syndrome (SWS) is a rare congenital disorder characterized by a facial vascular nevus associated with an ipsilateral leptomeningeal angioma. Headache is a rare component of SWS and when it occurs it usually occurs as a migraine-like headache. We aimed to present a SWS patient with episodic tension type headache and to draw attention in different types of headaches that can be seen in SWS. A 21 year old female patient with the diagnosis of SWS was suffering from severe headaches. At her physical examination a facial nevus -occurred due to choroid angioma- was observed. On her neurological examination a mild asymmetry of upper extremities was visible. She had a 2 year history of frequent non-pulsating headaches. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral and pressing in quality. SWS are a very rare and challenging disease for both the patients and their families. Usually migraine type headache is seen in SWS but it should not be forgotten that more generalized headaches like tension type may also be seen.
Lanthanum-Induced Radiopaque Intestinal Precipitates: A Potential Cause of Intestinal Foreign Bodies
Authors: Jason Galo, Bianca Madrid, Warren Kupin
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Lanthanum carbonate is a commonly prescribed oral phosphate binder for use in patients with acute or chronic kidney disease. The elemental form of lanthanum is a soft metal, which will appear radiopaque on a standard X-ray radiograph. This case report illustrates the potential for Lanthanum to masquerade as multiple radiopaque intestinal foreign bodies, leading to the extensive mobilization of medical resources and consultations including serial X-ray monitoring, multiple consultants including acute care and colorectal surgery. Given the few published reports describing this finding in the literature, it is essential to consider Lanthanum precipitates in the differential diagnosis of radiopaque intestinal foreign bodies in patients with chronic kidney disease to avoid unnecessary utilization of medical resources for this predominantly benign condition.
Hypokalemic Periodic Paralysis Precipitated by Thyrotoxicosis and Renal Tubular Acidosis
Authors: Ian Jackson, Yazan Addasi, Moeed Ahmed, Bashar Ramadan, Karson Kalian, Noor Addasi, Ali Nayfeh, Jocelyn Taylor, Khalid Bashir, Bryan Krajicek
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Background:
Hypokalemic periodic paralysis is a rare neuromuscular disorder characterized by transient episodes of flaccid paralysis due to a defect in muscle ion channels. Most cases are hereditary, but it can be acquired. We present a case of acquired hypokalemic periodic paralysis associated with hyperthyroidism and renal tubular acidosis. Clinical Case. A 38-year-old female with a history of Graves' disease presented to the emergency department with generalized weakness and associated nausea, vomiting, and weight loss. Examination was significant for diffuse weakness in all extremities. Labs showed hypokalemia, hyperthyroidism, and nonanion gap metabolic acidosis with a positive urine anion gap. She was treated for hypokalemic periodic paralysis and renal tubular acidosis. Potassium replacement, propranolol, methimazole, and sodium bicarbonate were initiated. Her potassium gradually corrected with resolution of her symptoms. Further investigation revealed a history of dry eyes, dry mouth, and recurrent dental carries. She had positive ANA, SS-A, and SS-B antibodies. She was diagnosed with Sjögren's syndrome, which may have been associated with her Graves' disease and thus contributed to both her RTA and hyperthyroidism.
Conclusion:
Early recognition and treatment of thyrotoxic periodic paralysis are important to prevent cardiac complications. Management includes potassium replacement with careful monitoring to prevent rebound hyperkalemia. The definitive treatment is to achieve euthyroid status.
Lupus Antibody Mimicking Reduced Plasmatic Coagulation in a Patient With Atrial Fibrillation and Ischemic Stroke
Authors: Aydin Huseynov, Verena Haselmann, Maximillian Kittel, Thomas Bertsch, Angelika Alonso, Michael Neumaier, Martin Borggrefe, Ursula Hoffmann
Journal: Front Neurol (2020)
Keywords: anticoagulation, coagulation factor deficiency, ischemic stroke, lupus anticoagulant, thromboplastin
MeSH terms: Case Reports

Background: Lupus anticoagulant (LA) owns procoagulant properties in vivo and prolongs phospholipid-dependent clotting times in vitro. The prolonged in vitro clotting time can be misinterpreted as a bleeding disorder. In some cases, it is necessary to differentiate LA-associated in vitro changes from in vivo coagulation factor deficiency. In this case, we used different laboratory testing in a patient with ischemic stroke and reduced prothrombin time (PT) to identify an in-vitro effect of LA excluding an in-vivo bleeding disorder. Methods: The activity of various coagulation factors was evaluated both with recombinant thromboplastin Innovin (Siemens Healthcare) and reagent tissue extracted thromboplastin Thromborel® (Siemens Healthcare). Moreover, a 1:1 plasma mixing test with standard plasma was performed. In order to exclude the interaction of tromboplastin and LA thromboplastin, an independent global coagulation test, thromboelastography, was used. Diluted-Russel-Viper-Venom (dRVVT) assay was applied to detect the presence of LA detection. Results: The activity of several coagulation factors measured with recombinant thromboplastin Innovin (Siemens Healthcare) showed a reduced activity of the following coagulation factors: Factor V (20.9%), Factor VII (23.8%), Factor X (19.7%) and international normalized ratio (INR) of 2.33. Re-assessment of the factor's activity with another reagent tissue extracted thromboplastin Thromborel® (Siemens Healthcare) showed a normalization of INR and factor's activity in comparison to thromboplastin reagent Innovin®: Factor V (77%), Factor VII (45.4%), Factor X (64.2%), and INR of 1.28. A plasma mixing study with 1:1 standard plasma revealed reduced (<50%) normalization of INR as well as coagulation factor's activity confirming a LA-inhibitor in the patient plasma. Diagnostic LA testing was also performed with dRVVT assay showing a significantly prolonged (112.8 s) test time. Thromboelastography revealed no abnormalities. Conclusions: Different thromboplastin reagents and plasma mixing tests as well as thromboplastin independent coagulation tests may be helpful to differentiate LA and in vitro changes from in vivo factor deficiency in patients with LA.
COVID-19 Pneumonia in Children: From Etiology to Management
Authors: Giuseppe Fabio Parisi, Cristiana Indolfi, Fabio Decimo, Salvatore Leonardi, Michele Miraglia Del Giudice
Journal: Front Pediatr (2020)
Keywords: covid-19, sars-cov2, children, pneumonia, treatment
MeSH terms: Review

COVID-19 is less serious in children than in adults. However, respiratory management dominates the clinical picture of hospitalized COVID-19 even in children. In some case series, deterioration of the clinical picture wherein dyspnea, cyanosis, and the onset of acute respiratory distress syndrome (ARDS) emerged ~8-10 days after the onset of SARS-CoV-2 infection, which could rapidly progress to multiple organ failure and death. This review aimed to evaluate the characteristics of COVID-19 pneumonia in pediatric populations, beginning from its etiology and pathological mechanisms and closing with its clinical management.