OpenMed/multicare-articles huggingface dataset:
A predictive model of bowel resection for incarcerated inguinal hernia based on the systemic immune-inflammation index
Authors: Lei Chen, Ying-Ying Wang, Li-Xiang Zhang, Xiao-Gang Xia
Journal: Front Surg (2022)
Keywords: bowel resection, incarcerated inguinal hernia, nomogram, strangulated inguinal hernia, systemic immune-inflammation index(sii)

Background and purpose:
An inguinal hernia is a common surgical disease. Once incarcerated or strangulated, it may endanger the life of the patient. Therefore, it is essential to study the risk factors of incarcerated inguinal hernia (IIH) and strangulated inguinal hernia (SIH). One of the serious complications of IIH and SIH is intestinal necrosis, which occurs owing to blood supply disorder. The study explores the risk factors of intestinal resection and establishes a simple model to assess the incidence of intestinal resection to provide significant assistance and limited guidance for clinical work.
Patients and methods:
Our research team collected and retrospectively analysed the clinical data of 338 patients with IIH who were hospitalized in the First Affiliated Hospital of Wenzhou Medical University between September 2008 and December 2016. According to the surgical plan, we divided the included cases into two groups, non-intestinal and intestinal resection groups, and the clinical case characteristics of these groups were statistically analysed.
Results:
Based on multivariable logistic regression analysis, we found that increased risk of bowel resection was highly correlated among the elderly (≥70 years), and for people with high temperature (≥37.3°C), high systemic immune-inflammation index(SII) values (≥1230.13), presence of bowel obstruction, and signs of peritonitis. Further, we processed the five independent risk factors using special software to obtain a simple model called a nomogram. To verify the nomogram's accuracy and predictive ability, we calculate the C-index: 0.806 and use the calibration curve to evaluate its stability and predictive performance. We constructed the ROC curve nomogram and other sub-variables, and calculated the area under the curve (AUC) corresponding to the nomogram (AUC = 0.808, 95% CI = 0.762 to 0.848), SII (AUC = 0.752, 95% CI = 0.703 to 0.797), age (AUC = 0.641, 95% CI = 0.587 to 0.692), temperature (AUC = 0.579, 95% CI = 0.524 to 0.632), bowel obstruction (AUC = 0.685, 95% CI = 0.633 to 0.734), and signs of peritonitis (AUC = 0.580, 95% CI = 0.525 to 0.633).
Conclusion:
It can be said that we found for the first time that clinical variables such as SII are independent risk factors for enterectomy for IIH. The nomogram based on SII and other variables can accurately and easily predict the probability of IIH requiring bowel resection.
Excision of rare carotid body tumour without preembolisation: Case report and literature review
Authors: S Shahi, Anupam Raj Upadhyay, Anuj Devkota, Tridip Pantha, Dipendra Gautam, Dhundi Raj Paudel
Journal: Int J Surg Case Rep (2018)
Keywords: carotid body, case report, excision, paraganglioma, preembolisation

Introduction:
Carotid body tumors also known as parganglioma or chemodactomas are one of the rare tumors of head and neck which present as slow growing masses in the neck region. We present a case of 40 years female with painless slow growing mass over left side of her neck for 6 months. Diagnosis was made on basis of clinical history, examination and radiological findings. Tumor was graded as Shamblin grade II. She was managed with excision of the tumor without preoperative embolisation. Intraoperative and postoperative periods were uneventful.
Case presentation:
A forty years female presented with left sided painless neck swelling∼5 × 4 cm2 over left anterior triangle for 6 months with no history of dysphagia, odynophagia, change in voice, shortness of breath, palpitations, tremors or syncopal attacks. She underwent USG neck and CT angiogram. Based upon the radiological and clinical findings, she was diagnosed asCarotid body tumor. She was managed with excision of the tumor without preembolisation. Her diagnosis was confirmed with histopathology.
Conclusion:
Carotid body tumours are rare entities of head and neck region. They are mostly benign in nature. Though mostly bening, increasing size might result in grave complications. Thus, the recommended treatment for carotid body tumors is early excision with or without pre-embolisation. In our case preembolisation was not performed. Though some studies have suggested the use of preoperative embolisation in large sized tumors, more studies are yet required to justify the choice of preembolisation despite the dreaded complications.
Synchronous hepatocellular carcinoma and cholangiocarcinoma in a patient transplanted for cryptogenic cirrhosis
Authors: B Geramizadeh, R Gity, A Bahraini, S A Malek-Hosseini
Journal: Int J Organ Transplant Med (2014)
MeSH terms: Case Reports

Synchronous development of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) in a liver is an extremely rare event. Very few cases have so far been reported in the literature with such condition. Herein, we report on the first case of incidental diagnosis of synchronous HCC and CC in a patient with cryptogenic cirrhosis who underwent liver transplantation. The diagnosis was made after careful examination of the explanted liver.
Chyle Leak following Open Donor Nephrectomy: A Rare Complication-A Case Report
Authors: Sandeep Harkar, Dharam Vir Singh, Sanjay Kumar Gupta, Raghav Talwar, Yajvender Pratap Singh Rana
Journal: Case Rep Transplant (2012)

Introduction. Donor workup in renal transplantation is extensive. Despite this, chyle leakage following donor nephrectomy, a rare complication, has been reported in the literature. We encountered two cases of chyle leak in kidney donors in our series of open donor nephrectomies. Summary of Cases. After complete workup, standard open retroperitoneal donor nephrectomy with drain placement was performed in 684 living renal donors. We encountered chyle leak in two cases. The first case was a 33-year-old female who underwent an otherwise uneventful left donor nephrectomy but continued to have high drain output (upto 300-400 mL/24 hrs) in the postoperative period. The drain fluid was milky, raising the suspicion of chyle which was confirmed on biochemical analysis. The second case was a 42-year-old female with a similar case history. Both were managed conservatively with low-fat diet. The leak subsided spontaneously in three weeks and one week in the first and second patients, respectively. The drain was removed, and the patients remained symptom-free on followup. Conclusions. Both of our cases of chyle leak following open donor nephrectomy were managed successfully with conservative management. The management options and the experience of other centers are reviewed and discussed.
Chronic Avulsion Lesion at the Brachialis Muscle Insertion
Authors: Dima Al Jahed, Filip Vanhoenacker
Journal: J Belg Soc Radiol (2021)
Keywords: humeral splints, brachialis muscle, computed tomography, magnetic resonance imaging
MeSH terms: Case Reports

Teaching Point: Humeral splints or brachialis insertion avulsion syndrome is a distinct type of stress injury at the insertion of the brachialis muscle on the lateral surface of the humeral diaphysis.
Pediatric multiple sclerosis-a challenging demyelinating disease: case report and brief review of the literature
Authors: Regina Célia Ajeje Pires de Albuquerque, Raquel Siqueira Leonel de Paula, Manuelina Mariana Capellari Macruz Brito, José Roberto Lopes Ferraz Filho, Lucas Crociati Meguins
Journal: Case Rep Pediatr (2012)

Multiple sclerosis (MS) is an inflammatory, demyelinating, neurodegenerative disorder of the central nervous system (CNS) of unknown etiology. The peak onset is between age 20 and 40 years and usually affects more women than men. Although much knowledge has been achieved on the diagnosis and treatment of adult patients with MS, it remains a matter of debate and controversy in childhood. We present a case of MS in 9-year-old girl, review the current state of the knowledge on pediatric MS, and discuss the available tools for the diagnosis and treatment.
A "Near-Miss Lethal Accident Case" in MR Suit of a Tertiary Care Hospital
Authors: Samina Mufti, Mushtaq A Sheikh, Abdul Hakim, Showkat A Mufti, Farooq Jan
Journal: Case Rep Radiol (2011)
MeSH terms: Case Reports

A "near miss" is an unpleasant event that did not result in injury, illness, or damage but had the potential to do so, but for a fortunate break in the chain of events. We present a near-miss case which occurred in the MR suite of a tertiary care hospital. Although the MR is considered a very safe procedure, if MR safety guidelines are not adhered to, adverse and catastrophic events to the extent of patient deaths are known to have occurred. It is hoped that this incident will prompt hospitals to document and follow MR safety protocols for patient and staff safety. Although MRI is an extremely safe procedure rarely MR adverse incidents have resulted in serious physical injury or even death. The incident is an eye opener regarding potential adverse events lurking in the relatively safe MR environment and provides an opportunity to rectify the inadequacies in MR safety.
Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease
Authors: Adelaide Moutinho, Rita Gamboa Cunha, Sheila Koch Jamal, Marta Meleiro Lisboa, Sandra Tavares
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

Castleman disease is a rare lymphoproliferative disorder presenting with localized or disseminated lymphadenopathy and systemic symptoms. It can be categorized clinically as unicentric or multicentric, histopathologically as hyaline vascular, plasma cell, or mixed variant, and etiologically, considering the subtypes based on causative viral agents and associated syndromes. The multicentric type can mimic other haematological malignancies, ranging from asymptomatic to multiple organ involvement. Although its pathophysiology is not well known, the current approved treatments are directed towards interleukin-6, CD-20, and viral agents. The authors present an 82-year-old leucodermic man presented with a 2-week history of constitutional symptoms. Examination revealed pallor, hepatosplenomegaly, and palpable left axillary lymphadenopathy. Investigation showed anaemia, thrombocytopenia, polyclonal hypergammaglobulinemia, hypoalbuminemia, and high acute phase reactants, with image study revealing multiple axillary, mediastinal, inguinal, and pelvic lymphadenopathies. The lymph node biopsy was consistent with hyaline vascular-type Castleman disease without human herpersvirus-8 markers. He started prednisolone with initial improvement evolved poorly on a short term. Castleman disease has a broad spectrum of clinical manifestations, associations, and complications that bring a diagnostic challenge, requiring a multidisciplinary approach. Clinicians should be familiar with its features because proper diagnosis and aggressive targeted treatment are the pillars of proper management of these patients.
Geminated Maxillary Lateral Incisor with Two Root Canals
Authors: Nayara Romano, Luis Eduardo Souza-Flamini, Isabela Lima Mendonça, Ricardo Gariba Silva, Antonio Miranda Cruz-Filho
Journal: Case Rep Dent (2016)
MeSH terms: Case Reports

This paper reports a case of gemination in a maxillary lateral incisor with two root canals and crown-root dilaceration. A 16-year-old male patient was referred for endodontic treatment of the maxillary left lateral incisor and evaluation of esthetic and functional complaints in the anterior region. The patient reported trauma to the anterior primary teeth. There was no spontaneous pain, but the tooth responded positively to the vertical percussion test and negatively to the pulp vitality test. Clinical examination showed esthetic and functional alterations and normal periodontal tissues. CBCT imaging confirmed the suspicion of gemination and crown-root dilaceration and also revealed the presence of two root canals and periapical bone rarefaction. The root canals were instrumented with Reciproc R40 and 1% NaOCl irrigation and were filled by lateral condensation of gutta-percha and AH Plus sealer. The tooth was definitely restored with composite resin to recover esthetics. Continued follow-up over 6 months has shown absence of pain or clinical alterations as well as radiographic image suggestive of apical repair.
Generalized Dystonia Due to a Pathogenic THAP1 Variant Showing Sustained Response to Globus Pallidus Deep Brain Stimulation
Authors: Shakya Bhattacharjee, Monty A Silverdale, Michael Bonello, Julian Evans, Christopher Kobylecki
Journal: Tremor Other Hyperkinet Mov (N Y) (2023)
Keywords: thap1, deep brain stimulation, dystonia, mutation, novel
MeSH terms: Botulinum Toxins, Deep Brain Stimulation, Dystonic Disorders / genetics, Dystonic Disorders / therapy, Torticollis, Case Reports, Research Support, Non-U.S. Gov't, Adult, Apoptosis Regulatory Proteins, Child, DNA-Binding Proteins, Female, Globus Pallidus, Humans, Young Adult, Botulinum Toxins, THAP1 protein, human, DNA-Binding Proteins, Apoptosis Regulatory Proteins

A 21-year-old woman of south Asian origin presented with cervical dystonia which had progressed over the previous three years. Her symptoms started as writer's cramp since the age of seven years. She did not respond to medications and needed botulinum toxin injection for generalised dystonia. Subsequent whole genome sequencing revealed a likely pathogenic c.98G>A p.(Cys33Tyr) heterozygous variant in the THAP1 gene. She underwent bilateral posteroventral globus pallidus interna (GPi) deep brain stimulation (Medtronic Activa PC) implantation at the age of thirty-one years. She responded well to the deep brain stimulation even after more than 8 years post-surgery though she needs botulinum toxin injection for her cervical dystonia.
Synovial Cyst of the Atlantoaxial Joint Removed through a Posterior Intradural Approach
Authors: Atsuhiko Toyoshima, Kiminori Sakurai, Nobuhiro Sasaki, Miyuki Fukuda, Shigeo Ueda, Minoru Houshimaru, Hiroaki Manabe
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Introduction. Synovial cysts rarely develop in the atlantoaxial joint. We report a case of posterior C1-2 laminectomy for a synovial cyst of the atlantoaxial joint which passed through the dorsal dura and put pressure on the cervical spinal cord. Case Presentation. A 62-year-old man with rapid progression of pain and weakness in the left upper extremity presented to our hospital. A cervical spine X-ray showed left C5-6 and C6-7 stenoses. A cervical magnetic resonance imaging showed an intradural extramedullary cystic lesion on the right side of the ventral cervical spinal cord at the C1-2 level and severe compression of the cervical spinal cord. Because a cyst was partially enhancing, a tumor lesion was not identifiable. Due to severe spinal cord compression, we performed intradural cyst removal via a posterior intradural approach with C1-2 laminectomy and left-sided C5-6 and C6-7 foraminotomies. One year after surgery, the cyst did not recur, and atlantoaxial instability did not appear. Discussion. A compressive lesion on the cervical spinal cord was not identified preoperatively as a synovial cyst. However, intraoperative and pathological findings suggested that the compressive lesion can be a synovial cyst which passed through the dorsal dura. The surgical treatment strategy for a synovial cyst of the atlantoaxial joint is controversial due to factors, such as the presence of atlantoaxial instability, level of cyst causing compression of the cervical spinal cord, severity of myelopathy, and cyst location. In the present study, the cervical spinal cord was highly compressed and the cyst was located on the right side of the cervical spinal cord; we chose cyst removal through a posterior intradural approach with C1-2 laminectomy.
Staged open reduction and internal fixation with double-locking plates to treat bilateral distal femur periprosthetic fractures after total knee arthroplasty: A case report
Authors: Jiangpeng Wu, Zheng Li, Jiang Huang, Xufeng Jiao, Guanglei Cao
Journal: Front Surg (2023)
Keywords: case report, delayed union, distal femur periprosthetic fracture, double-locking plate, total knee arthroplasty
MeSH terms: Case Reports

Background:
The incidence of periprosthetic fractures after total knee arthroplasty (TKA) increases in parallel with the number of procedures. Comminuted fractures along the primary fracture line extending to the edge of the prosthesis are challenging, and bilateral fractures are rarely reported, especially with open injuries.
Case presentation:
A 65-year-old female had undergone bilateral TKA in our hospital 5 years before admission. She was admitted with a traumatic bilateral Rorabeck type II B distal femur periprosthetic fracture (closed right, open left, Gustilo II) and was treated with bilateral staged open reduction and internal fixation (ORIF) with double-locking plates. The patient experienced a prolonged delayed fracture union and finally healed around 21 months postoperatively. The function was satisfactory after 4 years of follow-up.
Conclusion:
ORIF with double-locking plates can be used to treat Rorabeck II B periprosthetic fracture where the primary fracture line extends beyond the edge of the prosthesis; however, there may be delayed healing or nonunion. Patients need to undergo long-term rehabilitation and endure long disability times and require good rehabilitation nursing care. Once they achieve bone healing, the treatment achieves bone preservation and substantial prosthesis survival.
Case report: A preterm infant with rubinstein-taybi syndrome and Marmorata telangiectatica harboring a frameshift mutation in the CREBBP gene
Authors: Yang Yang, Jing Xiao, Yuanyuan Ye, Jianwen Xiang, Zhu Wang, Jia Chen
Journal: Front Pediatr (2023)
Keywords: crebbp, case report, cutis marmorata telangiectatica congenita, preterm, rubinstein-taybi syndrome
MeSH terms: Case Reports

Rubinstein-Taybi syndrome (RSTS) is a rare autosomal dominantly inherited disease characterized by slow mental and physical growth, skeletal abnormalities (broad thumbs and big toes), and dysmorphic facial features. RSTS is associated with de novo variants of the epigenetic-associated gene CREBBP. RSTS is primarily diagnosed based on clinical manifestations and genetic testing. Cutis marmorata telangiectatica congenita (CMTC) is a rare, congenital, and typically benign vascular anomaly of unknown etiology; it is described as persistent reticulated marbled erythema. The diagnosis of CMTC is largely based on clinical features, and GNA11 mutations are associated with CMTC. In this case report, we describe the case of a preterm infant (boy) with RSTS and CMTC who had a novel frameshift mutation leading to a premature stop codon in the CREBBP gene. This study adds the novel mutation c.5837dupC to the known molecular spectrum of disease-causing CREBBP gene mutations.
Bicycle handlebar injury in a child resulting in complex liver laceration with massive bleeding and bile leakage: A case report
Authors: Jan Grosek, Žan Čebron, Jurij Janež, Aleš Tomažič
Journal: Int J Surg Case Rep (2020)
Keywords: bicycle accidents, case report, handlebar injury, liver laceration, pediatric trauma
MeSH terms: Case Reports

Introduction:
Bicycle accidents are a significant cause of traumatic morbidity in the paediatric population. The handlebar injuries are usually isolated and remain a major source of bicycle related morbidity. We present a case of severe liver laceration with left hepatic duct transection caused by handlebar trauma in a 13-year-old boy.
Case presentation:
An otherwise healthy 13-year-old Caucasian male patient was rushed to the hospital following a blunt abdominal trauma from a bicycle handlebar. An ultrasound revealed extensive free intraperitoneal fluid with accompanying features of hemodynamic instability. Operative findings included massive haemoperitoneum, a deep laceration almost separating left and right liver lobes, and a near-complete interruption of the left hepatic duct. Interestingly, the vascular anatomy of the left liver lobe was preserved. After haemostasis was established a duct-to-duct anastomosis of the ruptured left hepatic duct was performed. A T-tube biliary drainage was inserted, and intraoperative cholangiography showed no extraluminal spillage of contrast. During the recovery phase, cholangiography was performed several times revealing leakage from left hepatic duct. The leakage was managed conservatively and finally stopped.
Discussion:
Management of blunt hepatic injuries has remarkably changed from mandatory operation to mostly nonoperative interventions with selective operative management. Hemodynamic instability remains the main reason for exploratory laparotomy. Near-isolated laceration of main hepatic ducts is an extremely rare finding, and immediate reconstruction is the best option if an experienced surgeon is available.
Conclusion:
Due to limited evidence, we recommend consultation with an experienced HPB surgeon on a case-by-case basis for every paediatric biliary injury.
Delayed Diagnosis and Treatment of Traumatic Testicular Dislocation: A Case Report and Literature Review
Authors: Qihua Wang, Rami W A Alshayyah, Hang Lv, Yang Yu, Xinyu Liu, Bo Yang
Journal: Front Surg (2021)
Keywords: case report, delayed diagnosis, testicular dislocation, testicular trauma, urethral injury
MeSH terms: Case Reports

Traumatic testicular dislocation is a rare complication secondary to different kinds of accidents. A 61-year-old man, who was injured by wall collapse and was diagnosed as pelvic fracture and posterior urethral rupture 5 months ago, came to the urologic department to seek urethral reconstruction. However, thorough physical examination and imaging examination confirmed a round mass in the right inguinal region and an empty right scrotum, which support diagnosis of testicular dislocation. The patient did not take the initiative to complain about that because he thought the right testis had been destroyed by the accident already. So the patient underwent fiber cystourethroscopy, urethral reconstruction, and orchiopexy. No testicular atrophy was confirmed at follow-up. We reviewed previous reports about traumatic testicular dislocation and analyzed the cause of delayed diagnosis.
Rare Contents of an Internal Hernia through a Defect of the Broad Ligament of the Uterus
Authors: Masafumi Takahashi, Masanori Yoshimitsu, Takuya Yano, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Herniation through a defect of the uterine broad ligament is a rare internal hernia that is difficult to diagnose definitively. Common hernia contents contain ileal loops. Herein, we report a rare case of internal herniation of both the ileum and fallopian tube through a defect of the broad ligament. A 52-year-old woman presented to our hospital with suprapubic pain and vomiting. She had a history of bowel obstruction following cesarean section. On abdominopelvic computed tomography, we suspected a closed-loop obstruction associated with bowel herniation in the right broad ligament. However, we could not identify an area of poor enhancement adjacent to distended small intestines. Emergency laparoscopic exploration revealed a viable ileal loop and incarcerated organ. Therefore, we switched to laparotomy that revealed the right fallopian tube as the ischemic organ. We reduced the hernia, resected necrotic right fallopian tube, and closed the defect of the broad ligament. The patient had an uneventful postoperative course. Rare hernia contents might complicate preoperative clinical diagnosis. Laparoscopy is useful for establishing a definitive diagnosis and treating broad ligament hernias.