OpenMed/multicare-articles huggingface dataset:
Hand-assisted laparoscopic surgery for Bochdalek hernia in an adult patient with a history of laparotomy: A case report
Authors: Shogo Fukutomi, Shoichirou Arai, Masahiro Fujisaki, Kazuya Naritomi, Masahiro Kawabata, Masae Mano
Journal: Int J Surg Case Rep (2019)
Keywords: abdominal incisional hernia, bochdalek hernia, case report, hand-assisted laparoscopic surgery

Introduction:
Bochdalek hernia (BH) is a congenital diaphragmatic hernia that generally occurs in infants and is rarely seen in adults. Surgical repair of BH is recommended, but the approach for repairing BH should be selected carefully in individual cases. It is well known that hand-assisted laparoscopic surgery (HALS) has the advantage of preserving tactile sensation compared with standard laparoscopic surgery. We describe an adult patient with a history of abdominal incisional hernia who developed BH that was treated safely by HALS.
Presentation of case:
An 87-year-old woman was admitted to our hospital with nausea. She had a history of right hemicolectomy and repair of an abdominal incisional hernia using mesh at 5 years after hemicolectomy. Chest and abdominal computed tomography revealed herniation of the gastric corpus through the left posterior diaphragm. BH was diagnosed and hernia repair by HALS was selected as the approach because dense adhesions were expected in the abdominal cavity. The operation was performed safely and her postoperative course was uneventful.
Conclusion:
HALS was useful, especially when removing adhesions around the hernial orifice. HALS is a feasible approach for BH and should be considered as one of the options in patients with a history of previous abdominal surgery.
Expansion/Facemask Treatment of an Adult Class III Malocclusion
Authors: Gregory W Jackson, Neal D Kravitz
Journal: Case Rep Dent (2014)

The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reported that, although early treatment may be the most effective, face mask therapy can provide a viable option for older children as well. But what about young adults? Can the skeletal and dental changes seen in expansion/facemask therapy in children and adolescents be demonstrated in this age group as well, possibly eliminating the need for orthodontic dental camouflage treatment or orthognathic surgery? A case report is presented of an adult class III malocclusion with a Class III skeletal pattern and maxillary retrusion. Treatment was with nonextraction, comprehensive edgewise mechanics with slow maxillary expansion with a bonded expander and protraction facemask.
Meckel Diverticulum Causing Intestinal Volvulus
Authors: Liviu Musteata, Raouf Fayisall Geraldo, Hugues Ndasu Matendo, Aurélie Reitz, Valériu Krasovski, Valentin Nitu, Thierry Gastaud, Fabrice Cattan
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Intestinal volvulus is rare and responsible for upper bowel obstruction. They occur more frequently in a patient with abdominal surgery history. We report a case of small intestine volvulus on Meckel diverticulum, which occurred in a 21-year-old patient, with no history of laparotomy. The diagnosis confirmation was intraoperative, and the management consisted in a segmental resection of the small intestine with immediate anastomosis. The postoperative follow-up was good. This case underlines the scarcity and the severity of this presentation which therefore requires appropriate care in order to improve the prognosis.
Pneumatized superior turbinate as a cause of headache
Authors: Elias Homsioglou, Dimitrios G Balatsouras, Gregory Alexopoulos, Antonis Kaberos, Michael Katotomichelakis, Vassilios Danielides
Journal: Head Face Med (2007)
MeSH terms: Headache / etiology, Nasal Obstruction / etiology, Turbinates / pathology, Turbinates / surgery, Case Reports, Adult, Diagnosis, Differential, Endoscopy, Female, Humans, Nasal Obstruction / diagnostic imaging, Nasal Obstruction / surgery, Tomography, X-Ray Computed, Turbinates / diagnostic imaging

Background:
A pneumatized superior turbinate is a rare cause of headache. Nasal endoscopy alone, does not provide us with adequate information for this inaccessible area of the superior nasal cavity. A coronal computed tomography (CT) must be obtained to confirm the diagnosis.
Case presentation:
We present a 40-year-old female with migraine-type headache and nasal obstruction. Nasal endoscopy revealed a mild septal deviation, a right middle concha bullosa and a paradoxically curved middle turbinate on the left side. Coronal CT-scan showed also the presence of a superior concha bullosa on the left, which was in close contact with the nasal septum. The patient underwent septoplasty and bilateral endoscopic sinus surgery, including partial removal of both the pneumatized middle turbinates in conjunction with gentle lateralization and resection of the lower half of the left superior turbinate. Prompt relief from headache and nasal symptoms was obtained.
Conclusion:
Pneumatized superior concha causing migrainous headache is a rare finding. Endoscopic surgery may provide permanent relief of symptoms.
ArterioVenous Malformation within Jejunal Diverticulum: an unusual cause of massive gastrointestinal bleeding
Authors: Jeffrey K Lee, John M Carethers, Pradipta Ghosh
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

Massive gastrointestinal (GI) bleeding can occur with multiple jejunal diverticulosis. However, significant bleeding in the setting of few diverticulae is very unusual and rare. We report a case of massive gastrointestinal bleeding from an arteriovenous malformation (AVM) within a jejunal diverticulum to underscore the significance of such coexisting pathologies. Mesenteric angiogram was chosen to help identify the source of bleeding and to offer an intervention. Despite endovascular coiling, emergent intestinal resection of the bleeding jejunal segment was warranted to ensure definitive treatment. However several reports have shown jejunal diverticulosis as a rare cause of massive GI bleeding. The coexistence of jejunal diverticulum and AVM is rare and massive bleeding from an acquired Dieulafoy-like AVM within a diverticulum has never previously been described. Awareness of Dieulafoy-like AVM within jejunoileal diverticulosis is useful in preventing delay in treatment.
Oligodontia and Facial Phenotype Associated with a Rare Syndrome
Authors: Fatima Ezzahra Zidane, Mustapha El Alloussi
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Introduction:
Oligodontia is a dental abnormality in which the patient is missing teeth. It is a hereditary disorder characterized by agenesis of more than six primary or permanent teeth, excluding the wisdom teeth. Oligodontia is often related with an abnormal size of teeth, conical shape, taurodontism, frequent enamel abnormalities, and delayed eruption. Oligodontia may be clinically isolated or associated with ectodermal dysplasia, a large group of rare diseases, and other syndromes. Patient Information. Dental characteristics of a six-and-a-half-year-old Moroccan boy with oligodontia and in apparent good health were described. Clinical Findings. Three syndromes associated with oligodontia have been discussed. Above all, based on the facial phenotype, Dubowitz syndrome has been retained as the most likely diagnostic hypothesis. This case could be the first reported case described in Morocco, but a thorough examination with genetic analysis must be carried out.
Conclusion:
Oligodontia could clinically be isolated or associated with ectodermal dysplasia, a large group of rare diseases, and other syndromes.
Surgical outcomes of primary carcinosarcoma of the gallbladder after curative resection: A rare case series
Authors: Mohammed Yousef Aldossary, Abdullah Saleh AlQattan, Yasmeen Megad Alghamdi, Amal A Alayed, Fatimah Alquraish, Omar Abdulaziz AlAnzi, Nawaf Alabdulrahim, Abdulaziz Alateeq, Mohammed Saad Alqahtani
Journal: Int J Surg Case Rep (2019)
Keywords: carcinosarcoma, gallbladder, prognosis, surgical outcome, survival rate

Introduction:
Primary carcinosarcoma is a rare neoplasm of the gallbladder, and is characterized by collision elements of the adenocarcinomatous and sarcomatous components. The tumours comprise both malignant epithelial and mesenchymal elements, and are usually very aggressive, conferring poor prognosis. Adenocarcinomas are the most common neoplasms of the gall bladder, while carcinosarcoma are extremely rare, with a global prevalence rate of less than 1%. The low incidence of carcinosarcoma greatly hinders the understanding of its aetiology.
Presentation of case:
Here, we report the surgical outcome of 3 rare cases of gallbladder carcinosarcomas, two of which had a IVB stage disease and in one case the staging was II. Following surgery, the survival in the former was less than 1 year, while in the latter, it extended up to 7 years (86 months), and the patient is alive till date. This study aimed to elucidate the surgical outcomes and prognosis after curable resection for carcinosarcomas of the gallbladder.
Discussion:
The findings suggest that carcinosarcomas are associated with a poor prognosis and short survival, particularly in those with tumours of >5 cm. In the absence of effective adjuvant treatment, surgery remains the mainstay of treatment.
Conclusion:
Complete surgical resection may improve prognosis and extend survival in patients with this rare and aggressive form of gallbladder cancer.
Cardiac tamponade complicating thoracocentesis: a case for image-guided procedure
Authors: Anthony Adeseye Adeniran, Omolade Oluwafadekemi Adegoke, Akinwumi Oluwole Komolafe
Journal: Pan Afr Med J (2018)
MeSH terms: Cardiac Tamponade / etiology, Thoracentesis / adverse effects, Case Reports, Adult, Autopsy, Fatal Outcome, Female, Humans, Thoracentesis / methods

We present a case of cardiac tamponade that was precipitated by thoracocentesis and discovered at autopsy.
Primary closure of superior partial sternal cleft in a 2-month-old girl: case report
Authors: Halil Ibrahim Tanriverdi, Fulya Doğaneroğlu, Abdülkadir Genç, Ömer Yılmaz
Journal: Ann Pediatr Surg (2021)
Keywords: hemangioma, primary closure, sternal cleft

Background:
Sternal cleft is a quite rare malformation. It is seen 1 out of 100,000 live births and makes up less than 1% of all chest wall deformities, seen more often among females. The deformity can be partial or complete. Partial deformities can be superior or inferior. It is generally diagnosed at birth when paradoxical respiratory movements are seen. Patients are often asymptomatic when they are born and generally other abnormalities accompany. As sternal clefts can be repaired primarily at early ages, they are repaired using autologous or synthetic grafts in the following years. We present a 2-month-old girl with superior partial sternal cleft repaired primary and accompanying hemangiomas in this case report.
Case presentation:
A girl who was born in another center and had a sternal cleft, who did not have any problems in the early period, was admitted to our hospital with respiratory distress at the age of 43 days. The patient was monitored with mechanical ventilator support, and there were hemangiomas around his left ear and lips. There were paradoxical respiratory movements in front of the heart, in the upper midline of the chest. Three-dimensional computed tomography showed that the upper part of the sternum did not develop, and there were hypoplasic sternal bars on both sides. It was evaluated as superior partial sternal cleft, and surgery was planned. In the operation, the sternal bars were released from the pericardium and pleura. The periosteum in the medial of both sternal bars was then released and connected in the midline, in front of the pericardium.
Conclusion:
Although neonates with a sternal cleft are asymptomatic at birth, respiratory symptoms may develop in later periods. In addition, because the structures are more flexible in the neonatal period, the primary repair of the cleft is easier and the risk of cardiac compression is lower. In our case, sternal bars could be approached primary, and no chondral grafts, patches, or steel wires were required.
Periprosthetic pathologic fracture following tibial Echinoccocosis: A case report
Authors: Germano Nascimento, Carmen Silva, Raquel Marques, Carlos Silva, João Francisco Oliveira, Jorge Santos, João Leiria
Journal: Int J Surg Case Rep (2018)
Keywords: echinoccocosis, hydatid cyst, pathologic fracture, total knee replacement

Introduction:
Hydatid disease in humans caused by the parasitic tapeworm Echinococcus granulosus has an osseous involvement of about 0.5%-2.5% of all cases in humans. The location of hydatid cysts in the tibia is seldom described in the medical literature, and its diagnosis and treatment is challenging.
Case report:
This paper presents a patient, with a long term, well tolerated, bilateral total knee arthroplasty (TKA), treated at our clinic, with a recent history of pain and oedema in her left upper leg. After achieving a, radiologically and histhopathologically, well documented, diagnosis of Echinoccocosis lesion in her left proximal tibia, a surgical intervention was planed, a wide resection of the cyst performed, and a specific anti-helmintic therapy was instituted. Four years later, she returns to our observation complaining of pain and unable to bear weight on her left knee, from which a pathologic fracture, adjacent to the tibial component, was diagnosed. After surgical debridement of the newly advanced hydatid cyst growth, the TKA was revised, and due to the tibial component failure and the femoral implant loosening, a semi-constrained total knee revision arthroplasty was executed. Functional outcome was excellent.
Conclusion:
Although challenges in treatment of musculoskeletal hydatid cysts (HC) lesions have been documented, data regarding the musculoskeletal HC lesions resembling tumor is scarce, and those resulting in a prosthetic failure have not been published. The authors intend to add data concerning the therapeutic approach to this entity.
Ulcerated breast cancer with single brain metastasis: A combined surgical approach. Clinical presentation at one year follow up - A case report
Authors: Francesca Santori, Gianluca Vanni, Oreste Claudio Buonomo, Adriano De Majo, Maurizio Rho, Alessandra Vittoria Granai, Marco Pellicciaro, Maria Cotesta, Massimo Assogna, Rolando Maria D'Angelillo, Marco Materazzo
Journal: Int J Surg Case Rep (2020)
Keywords: brain metastasis, breast cancer, breast reconstruction, case report, metastasectomy
MeSH terms: Case Reports

Introduction:
Breast cancer is the most common malignancy in woman. Approximately 5-10% of breast cancer occurs as de novo stage IV and some studies have shown that from 10% to 30% of those patients presents Brain Metastasis.
Presentation of case:
In this study, we report a case of solitary brain metastasis of breast cancer in a 63-year-old Italian Caucasian woman with neurological symptoms as first clinical presentation. After the correct diagnosis and multidisciplinary meeting it was decided to simultaneously perform a metastasectomy surgery plus right mastectomy, right axillary dissection and immediate breast reconstruction. In our clinical practice we report a successful combined surgical approach in a stage IV de novo breast cancer patient with single site brain metastasis at one year follow-up.
Discussion:
Metastasectomy plus mastectomy provided neurological control of acute complication of metastatic disease and complete breast cancer local control. One-time operation could be the best option when diagnosis of breast cancer is made thanks to the onset of oncological emergency like intracranial hypertension due to single brain metastasis.
Conclusion:
Combined surgical approach offers the opportunity to treat two different oncological urgencies, reducing the unnecessary repeated surgical and anesthesiologic trauma.
Ileocecal intussusception with histomorphological features of inflammatory neuropathy in adenovirus infection
Authors: Elke Kaemmerer, Jens J W Tischendorf, Gerd Steinau, Norbert Wagner, Nikolaus Gassler
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

The pathophysiological mechanisms for ileocecal intussusception in children with adenovirus infection are not well characterized. Here we demonstrate coincidence of adenovirus infection and inflammatory neuropathy of myenteric plexus in two children with ileocecal intussusception. Inflammatory neuropathy, an unspecific morphological feature which is found in peristalsis disorders, was morphologically characterized by the influx of CD3 positive lymphocytes in nervous plexus. To our knowledge, this is the first report suggesting peristalsis disorders from inflammatory neuropathy as additional mechanism in the pathophysiological concept of adenovirus-associated ileocecal intussusception.
Case report: Medical treatment for limbal epithelial stem cell deficiency in patients treated for glaucoma
Authors: Shunsuke Nakakura, Sachiko Maruoka, Taiichiro Chikama, Yuki Nagata, Etsuko Terao, Kanae Ueda, Saki Dote, Satomi Oogi
Journal: Front Med (Lausanne) (2023)
Keywords: anti-glaucoma, cornea, glaucoma, limbal epithelial stem cell deficiency, topical
MeSH terms: Case Reports

Limbal epithelial stem cell deficiency (LSCD) is an abnormal corneal epithelial lesion with several causes. The patient was diagnosed using fluorescein staining. Bullous keratopathy, multiple surgeries, and drug-related damage can cause LSCD in glaucoma patients. We evaluated the medical treatment course for LSCD in patients with glaucoma. We retrospectively reviewed the electronic medical records of patients diagnosed with LSCD and investigated their background, course of treatment, and classification stages of LSCD before and after treatment. The global consensus classification system (stages IA-C, IIA-B, and III) proposed by Deng et al. (Cornea 2020) was used. Seven patients (two males) and eight eyes were studied. The median age of the patients was 82 years, and the mean duration of glaucoma treatment was 8 years. The patients had open-angle glaucoma (four eyes), exfoliation glaucoma (one eye), neovascular glaucoma (one eye), normal tension glaucoma (one eye), and uveitic glaucoma (one eye). Stage classifications at diagnosis were stage IA in four eyes and stages IC, IIA, IIB, and III in one eye each. All treatments were carried out with dry eye drops, steroid eye drops, and antibiotics. The mean duration of treatment was 1.4 years. The classifications at the time of the final visit were normal corneal epithelium (three eyes), stage IA (two eyes), IIA (one eye), and III (two eyes). Three eyes (37%) improved by more than one stage and one eye deteriorated by more than one stage. LSCD is long-lasting and difficult to treat in a short period; thus, it requires careful medical attention.
Rationale use of Thalidomide in erythema nodosum leprosum - A non-systematic critical analysis of published case reports
Authors: Pugazhenthan Thangaraju, Sajitha Venkatesan, Meenalotchini Gurunthalingam, Shoban Babu, Tamilselvan T
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: Erythema Nodosum, Leprosy, Lepromatous, Leprosy, Multibacillary, Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Infant, Leprostatic Agents, Male, Middle Aged, Thalidomide, Young Adult, Leprostatic Agents, Thalidomide

Introduction:
Thalidomide is an anti- tumor necrosis factor alpha (TNF-a) drug used mainly in the management of moderate to severe form of Erythema Nodosum Leprosum (ENL). Because of its teratogenic potential it has to be used under proper supervision. Our critical analysis tries to look into the rationale with which it has been used by means of case reports on lepra reaction.
Methods:
We looked for the case reports between December 2005 to June 2019 in databases like Pubmed, Embase and other relevant resources. We used search words like "erythema nodosum leprosum(ENL)", "thalidomide", "case report" in different combinations to get relevant reports that focus on thalidomide usage atleast once at any time point during management. The information extracted were indication of thalidomide use, dose, response, outcome, complication if any, along with all the demographic details and geographical distribution.
Results:
We found 41 case reports eligible for analysis.The information was critically evaluated. From the analysis it was found that 7 of the case report mentioned the exact indication, 4 case report showed irrational use of thalidomide in the case of neuritis without use of steroids, 7 showed proper use of Clofazimine prior to thalidomide initiation, 26 case report showed case report of rationale dose range and in 4 case reports clofazimine was used prior to thalidomide along with the rational dose of thalidomide.
Conclusions:
This analysis helps to guide the rationale use of thalidomide focussing on few important points that anyone should keep in mind while managing a case of ENL.
Postanoxia-Induced Chorea Treated with Intravenous Fentanyl
Authors: Ashley Audi, Brittany Cunningham, Christopher Newey
Journal: Case Rep Neurol Med (2023)
MeSH terms: Case Reports

The case presented is that of a young male with postanoxic brain injury secondary to cocaine overdose who began to exhibit choreiform movements of the left upper extremity. Traditional treatment options for chorea were unsuccessful, leading to the administration of fentanyl, which rapidly resolved the patient's choreiform movements. There is a limited research involving the treatment of chorea in anoxic brain injury as well as fentanyl's role in the movement pathway. We hypothesize that chorea can be caused or exacerbated by opioid withdrawal in a patient with chronic opioid use through modulation of dopamine transmission.
Case report: Severe, refractory hypoglycemia in a 9-year-old Brittany Spaniel with renal nephroblastoma
Authors: Paula Simons, Bridget Lyons, Adrienne Bentley, Elisa Mazzaferro, Lindsay Thalheim, Riccardo Finotello, Lorenzo Ressel
Journal: Front Vet Sci (2023)
Keywords: glucagon, hypoglycemia, nephrectomy, nephroblastoma, non-islet cell tumor-induced hypoglycemia (nicth), oncology
MeSH terms: Case Reports

A 9-year-old female spayed Brittany Spaniel presented for weakness and stumbling, and was diagnosed with severe hypoglycemia. An insulin to glucose ratio was not consistent with insulinoma as a cause for hypoglycemia. Diagnostic imaging (abdominal ultrasound and computed tomography) revealed a large left renal mass and a possible metastatic lesion in the right kidney. Glucagon therapy was initiated, but hypoglycemia was refractory to therapy. A left nephrectomy was performed and hypoglycemia subsequently resolved. Histopathology of the mass was consistent with nephroblastoma and immunohistochemistry for anti-insulin-like Growth Factor-2 (IGF-2) antibody revealed immunoreactivity in over 50% of the neoplastic cells. Chemotherapeutic treatment was initiated with a combined protocol of vincristine and doxorubicin. To the authors' knowledge, this is the first case report documenting the treatment of severe, refractory non-islet cell tumor-induced hypoglycemia in a dog, suspected to be secondary to an IGF-2 secreting nephroblastoma.