OpenMed/multicare-articles huggingface dataset:
Colopancreatic Fistula: An Uncommon Complication of Recurrent Acute Pancreatitis
Authors: Mouhanna Abu Ghanimeh, Omar Abughanimeh, Khalil Abuamr, Osama Yousef, Esmat Sadeddin
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Colonic complications, including colopancreatic fistulas (CPFs), are uncommon after acute and chronic pancreatitis. However, they have been reported and are serious. CPFs are less likely to close spontaneously and are associated with a higher risk of complications. Therefore, more definitive treatment is required that includes surgical and endoscopic options. We present a case of a 62-year-old male patient with a history of heavy alcohol intake and recurrent acute pancreatitis who presented with a 6-month history of watery diarrhea and abdominal pain. His abdominal imaging showed a possible connection between the colon and the pancreas. A further multidisciplinary workup by the gastroenterology and surgery teams, including endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, and colonoscopy, resulted in a diagnosis of CPF. A distal pancreatectomy and left hemicolectomy were performed, and the diagnosis of CPF was confirmed intraoperatively. The patient showed improvement afterward.
Concentrated Growth Factor: A Novel Platelet Concentrate for Revascularization of Immature Permanent Teeth-A Report of Two Cases
Authors: M S Nivedhitha, Benoy Jacob, Aishwarya Ranganath
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

This article elucidates the utilization of a novel platelet concentrate-concentrated growth factor (CGF) for rapid and successful healing outcome in regenerative endodontics. This case report focusses on two cases: 23-year-old and 21-year-old patients with incomplete root formation and periapical lesion. Case 1 and case 2 are classified as stage IV and stage II, respectively, in accordance with Cvek's classification of open apex and had varied outcomes. The extent of open apex, root dentin thickness, and lesion were assessed using periapical radiograph and CBCT. Revascularization procedure was carried out after obtaining patient consent. Following bleeding induction, CGF was prepared, placed, and condensed using pluggers in the root canal space, followed by the placement of mineral trioxide aggregate (MTA) up to the level of CEJ. At 1-year follow-up, apical closure with increased root dentin thickness and reduced periapical radiolucency was evident.
Blastoid mantle cell lymphoma presenting as acute leukemia: a case report
Authors: Amol Dongre, Niraj Kanchankar, Mahesh Deshmukh, Dilip Wasnik, Trupti Dongre
Journal: Pan Afr Med J (2021)
Keywords: blastoid variant, case report, leukemia, mantle cell lymphoma
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / administration & dosage, Lymphoma, Mantle-Cell / diagnosis, Stem Cell Transplantation / methods, Case Reports, Combined Modality Therapy, Cyclophosphamide / administration & dosage, Doxorubicin / administration & dosage, Female, Humans, Leukemia / diagnosis, Lymphoma, Mantle-Cell / therapy, Middle Aged, Prednisone / administration & dosage, Rituximab / administration & dosage, Transplantation, Autologous, Treatment Outcome, Vincristine / administration & dosage, R-CHOP protocol, Rituximab, Vincristine, Doxorubicin, Cyclophosphamide, Prednisone

Blastoid variant of mantle cell lymphoma (MCL) is an aggressive and incurable form of B-cell lymphoma. Various chemo-immunotherapy regimens have been used with a limited success. Autologous stem cell transplant (ASCT) is being increasingly recommended in first remission for patients with blastoid variant MCL. Here, we describe the case of a 45-year-old lady suffering from blastoid variant of MCL. Patient was administered R-CHOP and underwent autologous stem cell transplant (ASCT). Currently, patient is disease-free and is on a regular follow up for 26 months now. This is an extremely rare case documented in the Indian literature with a long survival post-transplant.
Central Venous Line Insertion Revealing Partial Anomalous Pulmonary Venous Return: Diagnosis and Management
Authors: Bashar Alzghoul, Ayoub Innabi, Aditya Chada, Ahmad R Tarawneh, Krishna Kakkera, Khaled Khasawneh
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Central venous line malposition is a well-known complication of line insertion. Rarely, it can be mal-positioned in an anomalous pulmonary vein. We present an unusual case of a 56-year-old woman that was found to have partial anomalous pulmonary venous return on central venous line insertion. In this report, we describe a systematic approach to diagnosis and management of this unusual situation.
A Case of Sudden Death: Subarachnoid Hemorrhage, Pheochromocytoma, Berry Aneurysm
Authors: Ana B Arevalo, Jacxelyn Moran, Stephen Zink, Binny Khandakar
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Subarachnoid hemorrhage is a medical emergency. Berry aneurysm rupture is the second most common cause following trauma. Diagnosis is often challenging. Neurogenic heart syndrome often complicates subarachnoid hemorrhage. A concomitant pheochromocytoma can be deadly causing sudden cardiac arrhythmia. Here, we describe a case of subarachnoid hemorrhage with concomitant incidental pheochromocytoma in a relatively young female who died suddenly, diagnosed during autopsy. A 57-year-old Hispanic woman with past medical history of asthma, prediabetes, and uncontrolled hypertension collapsed unexpectedly. She initially had ventricular tachycardia, followed by pulseless electrical activity and finally asystole without response to resuscitation. In the emergency department she was on epinephrine, calcium, naloxone, and tPA with suspected thrombotic stroke. Despite measures, she was pronounced dead. Autopsy revealed subarachnoid hemorrhage due to a ruptured berry aneurysm. Additionally, pheochromocytoma was detected in the right adrenal gland. Subarachnoid hemorrhage has a grave prognosis by itself. This case describes the uncommon detection of pheochromocytoma in the setting of subarachnoid hemorrhage.
A case study of a strategic initiative in pediatric rehabilitation transition services: An insiders' perspective on team principles and practices
Authors: Gillian King, Laura R Bowman, C J Curran, Anna Oh, Laura Thompson, Carolyn McDougall, Dolly Menna-Dack, Laura Howson-Strong
Journal: Front Rehabil Sci (2022)
Keywords: co-design, humanism, parallel principles, relational practice, shared leadership, solution-focused communication, teamwork

Aims:
The aim was to describe an innovative initiative that took place in a pediatric rehabilitation hospital. The goal of this organization-wide strategic initiative, called the Transition Strategy, was to improve service delivery to children/youth with disabilities and their families at times of life transition. The research question was: What are the key elements that have contributed to the success of the Strategy, from the perspective of team members? The objectives were to describe: (a) the guiding principles underlying team functioning and team practices, (b) key enablers of positive team functioning, (c) the nature of effective team practices, and (d) lessons learned.
Methods:
A holistic descriptive case study was conducted, utilizing historical documents, tracked outcome data, and the experiences and insights of multidisciplinary team members (the authors). Reflecting an insiders' perspective, the impressions of team members were key sources of data. The perspectives of team members were used to generate key teamwork principles, enablers of team functioning, team practices, and key learnings.
Findings and discussion:
Team members identified four guiding humanistic principles (respect, support, partnership, and open communication). These principles underpinned three novel practices that contributed to team effectiveness in the eyes of team members: supportive relational practices, human-centered co-design, and solution-focused communication. Key enablers were the relational style of leadership, and a team climate of innovation, autonomy, and trust, supported by the organizational vision. This team climate fostered a sense of psychological safety, thereby encouraging both experimentation and learning from failure.
Conclusions:
This article provides information for other healthcare organizations interested in understanding the Strategy's value and its implementation. It provides a practical example of how to adopt a humanistic approach to health care, leading to both innovative service development and thriving among team members.
Carotid Endarterectomy in a Patient with Severe Internal Carotid Artery Stenosis with Persistent Trigeminal Artery and Ischemia of the Anterior and Posterior Circulation
Authors: Melanie R F Greenway, Hussam A Yacoub, Shweta Varade, Yevgeniy Isayev
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Occurrence of cerebral ischemia in the posterior circulation as a result of severe internal carotid artery disease and persistent trigeminal artery is rare. An 81-year-old man with medical history of hypertension and ischemic stroke presented with dizziness, nausea, and mild dysarthria. Magnetic resonance imaging of the brain revealed acute infarcts in the left internal carotid artery territory. CT angiogram revealed a persistent trigeminal artery (PTA) and severe atherosclerosis. The patient developed new neurological symptoms and repeat imaging revealed new acute infarcts in the PTA distribution. After undergoing a left carotid endarterectomy with no complications, the patient was discharged to a skilled nursing facility with no recurrence of ischemic stroke. This case adds a rare complication of an infrequent vascular anomaly to the limited body of the literature.
Buccal mucosal graft onlay repair for a ureteric ischemic injury following a pyeloplasty
Authors: Vipul Agrawal, Vimal Dassi, Mukund G Andankar
Journal: Indian J Urol (2010)
Keywords: omentum pedicle, onlay buccal mucosa patch graft, ureteric strictures
MeSH terms: Case Reports

A 38-year-old female presented with long stricture in the left upper ureter following a pyeloplasty causing persistent flank pain. A left PCNL with an antegrade endopyelotomy was attempted in view of a concomitant left renal 1.5 cm calculus in the lower calyx but it failed. Subsequently, a buccal mucosal onlay graft was applied on the strictured ureter. Follow-up at 3 months showed good uptake of the graft with patent passage for urine drainage.
Spontaneous Splenic Rupture due to Metastatic Pancreatic Cancer
Authors: D Politis, D Myoteri, M Bourou, C Nastos, I Papaconstantinou, D Dellaportas
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Introduction. Nontraumatic splenic rupture is a rare event. On the other hand, splenic metastasis is also rare and usually found in the context of disseminated disease. Spontaneous splenic rupture caused by a metastatic deposit has been reported only as case reports. To the best of our knowledge, pancreatic cancer being the primary site has been reported in only a handful of cases. Case Presentation. A case of spontaneous splenic rupture in a 68-year-old male presenting with acute onset left shoulder pain, caused by metastatic pancreatic cancer to the spleen, is presented herein. During the investigation, the patient developed hypovolemic shock due to intra-abdominal hemorrhage, necessitating emergency splenectomy. The patient recovered well and was discharged from the hospital on the 8th postoperative day. Discussion. This study underlines the fact that the spleen is a rare site of metastasis, remaining mostly asymptomatic. However, it can nevertheless prove to be a life-threatening condition. The exact pathophysiological mechanism of splenic rupture due to metastasis still remains unknown, requiring further research. Emergency splenectomy remains the standard of care, and this clinical condition should be considered in the differential diagnosis of cases with acute abdomen and malignant neoplasm history.
Hematologic malignancies following immune checkpoint inhibition for solid tumors
Authors: Mick J M van Eijs, Lotte E van der Wagen, Rogier Mous, Roos J Leguit, Lisette van de Corput, Anne S R van Lindert, Britt B M Suelmann, Anna M Kamphuis, Stefan Nierkens, Karijn P M Suijkerbuijk
Journal: Cancer Immunol Immunother (2023)
Keywords: case series, immune checkpoint inhibitor, leukemia, myeloid neoplasms, second primary cancer
MeSH terms: Hematologic Neoplasms / drug therapy, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Leukemia, Myeloid, Acute, Myelodysplastic Syndromes / drug therapy, Myelodysplastic Syndromes / genetics, Humans, Immune Checkpoint Inhibitors / therapeutic use, Immune Checkpoint Inhibitors

Immune checkpoint inhibition (ICI) can induce durable responses in patients with advanced malignancies. Three cases of hematological neoplasia following ICI for solid tumors have been reported to date. We present five patients treated at our tertiary referral center between 2017 and 2021 who developed chronic myeloid leukemia (two patients), acute myeloid leukemia, myelodysplastic syndrome and chronic eosinophilic leukemia during or after anti-PD-1-based treatment. Molecular analyses were performed on pre-ICI samples to identify baseline variants in myeloid genes. We hypothesize that PD-1 blockade might accelerate progression to overt myeloid malignancies and discuss potential underlying mechanisms.
Large cystic-based gastrointestinal stromal tumor: A case report
Authors: Xinqi Chen, Huizeng Lv, Wenhai Zhang, Jie Cao
Journal: Oncol Lett (2014)
Keywords: c-kit, exophytic tumor, extensive cystic change, gastrointestinal stromal tumor

A 60-year-old male with increasing abdominal distension was admitted to The Fifth Affiliated Hospital of Guangzhou Medical University (Guangzhou, China). The abdominal sonogram exhibited a huge abdominal cystic-based mass with solid components in the left upper quadrant. A contrast-enhanced computed tomography scan of the abdomen revealed a large heterogeneous cystic solid tumor, but the source of the tumor could not be determined. The laparotomy demonstrated a huge cystic-based tumor with an integrated cystic wall, arising from the posterior wall of the gastric body. Multiple septa and ~3,500 ml of yellowish fluid were found in the cystic cavity. Pathological analysis showed that the tumor contained a mixture of polygonal and spindle cells. Immunohistochemical study indicated that the tumor cells were positive for CD117 and CD34. The final diagnosis was gastric gastrointestinal stromal tumor. The patient recovered well and no recurrence or metastasis was identified following a 12-month follow-up.
Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan
Authors: Tariq Ahmad, Nasrum Minallah, Nida Khaliq, Hania Rashid, Misbah Syed, Moath Ahmad Abdullah Almuradi
Journal: Front Pediatr (2023)
Keywords: pcnl, infants, minimally invasive, nephrolithiasis, percutaneous nephrolithotomy

Objective:
To assess the efficacy and safety of mini-percutaneous nephrolithotomy (PCNL) for small renal stones 1-2 cm in size in infants less than one year.
Material and methods:
This descriptive case series was conducted in the department of pediatric urology Institute of Kidney Diseases Peshawar, Pakistan, from March 2019 to March 2022. All the patients underwent mini-PCNL in prone position under GA with 14 Fr access sheath and 10 Fr nephroscope. Stone clearance was assessed by non-contrast CT KUB at 30th postoperative day. Patients with no residual fragments on the non-contrast CT KUB were defined as stone-free. Patients with residual fragments of any size were defined as procedure failure. Safety was determined in terms of intra and postoperative complications.
Results:
A total of 51 infants were included in the study. The mean age of patients was 9.6 + 1.8 (5-12 month). The mean stone size was 15.8 + 2.7 (10-21) mm in length and 12.3 + 2.2 (8-17) mm in width. PCNL mean operative time was 51.6 ± 7.1 (40-70) minutes. Complete stone clearance at one month was observed in 46 (90.2%) patients. Residual fragments were seen in 5(9.8%) patients with a mean size of 1.6 + 0.4 (0.9-2.0) mm. None of the patients required any additional procedure for clearance of stones. In 7 (13.7%) patients, some post-operative complications were observe, all were grade I complications, including fever in 5(9.8%) and transient hematuria in 2(3.9%) patients.
Conclusion:
Mini-PCNL is a safe and effective treatment for renal stones in infants measuring 1-2 cm with high SFR and an acceptable complication rate.
Rapidly enlarging axillary cystic hygroma in a 6-year-old male patient: A case report and literature review
Authors: Layth Al-Karaja, Mohammad G Ibdah, Salem M Tos, Narmeen Giacaman, Ahmadullah Musleh Abu Yousef, Rafiq Salhab
Journal: Int J Surg Case Rep (2023)
Keywords: axillary mass, case report, cystic swelling, hygroma
MeSH terms: Case Reports

Introduction:
Cystic hygromas are relatively uncommon tumors of lymphatic origin, it appears most of the time, approximately 90 % before age of 2 years, and it is caused by abnormal development of lymphatic vessels.
Case presentation:
Here we report a case of axillary cystic hygroma in a 6-year-old healthy boy, which presented with the rapid development of a right axillary mass during 3 days, without any predisposing factor.
Discussion:
Cystic hygromas occur due to complete or partial obstruction of lymphatic vessels, which leads to lack of communication with the venous system, this results in the accumulation of lymphatic fluid and swelling, it occurs in the cervicofacial region most of the time 75 %, but it can arise anywhere in the body, it classically presents as painless, soft mass, diagnosis can be done using ultrasound, CT, MRI, each of which has its advantages, surgical treatment is routinely favored, but other options are also available.
Conclusion:
Axillary cystic hygromas are quite rare, few cases have been reported in fetuses and adults, but only one case in the pediatric age group, thus, in light of these cases, cystic hygromas should be considered in the differential diagnosis of any cystic axillary swelling.
Clinico-haematological profile of acute megakaryoblastic leukaemia: report of five cases
Authors: Sunita Sharma, Anita Nangia, Sonal Jain Malhotra, Shashi Narayan, Aparna Harbhajanka, Sarika Singh
Journal: Adv Hematol (2009)
MeSH terms: Case Reports

Acute megakaryoblastic leukemia (AMKL) is a rare subtype of acute myeloid leukemia. Although known as a distinct entity for a very long time, because of lack of distinct clinical features and morphological criteria, it is difficult to diagnose this variant correctly. We herein present the clinical, morphological, cytochemical, and immunocytochemical features of five cases of AMKL. Certain morphological features such as presence of abnormal platelet count, giant platelets, and cytoplasmic blebbing in blasts were found to be important pointers towards the diagnosis. However, none of the features were found to be consistent and thus morphological diagnosis has to be confirmed by cytochemistry and immunocytochemistry.
Hepatic Portal Venous Gas with Pneumatosis Intestinalis
Authors: Nayan M Patel
Journal: Gastroenterology Res (2009)
Keywords: esenteric ischemia, hepatic portal venous gas, pneumatosis intestinalis
MeSH terms: Case Reports

Hepatic portal venous gas with pneumatosis intestinalis are radiological clues of intestinal ischemia. Prompt evaluation and a high index of clinical suspicion for the diagnosis of acute mesenteric ischemia are necessary given the high mortality of this condition. We present a case of mesenteric ischemia, radiological clues to diagnosis, and associated mechanisms.
The Use of Virtual Reality to Facilitate Mindfulness Skills Training in Dialectical Behavioral Therapy for Borderline Personality Disorder: A Case Study
Authors: Maria V Nararro-Haro, Hunter G Hoffman, Azucena Garcia-Palacios, Mariana Sampaio, Wadee Alhalabi, Karyn Hall, Marsha Linehan
Journal: Front Psychol (2016)
Keywords: borderline personality, dialectical behavioral therapy, emotion regulation, mindfulness, virtual reality
MeSH terms: Case Reports

Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Virtual Reality technology (VR) is becoming widely available to mainstream consumers. This case study explored the feasibility/clinical potential of using immersive virtual reality technology to enhance DBT® mindfulness skills training of a 32 year old female diagnosed with BPD. Prior to using VR, the patient experienced difficulty practicing DBT® mindfulness due to her emotional reactivity, and difficulty concentrating. To help the patient focus her attention, and to facilitate DBT® mindfulness skills learning, the patient looked into virtual reality goggles, and had the illusion of slowly "floating down" a 3D computer-generated river while listening to DBT® mindfulness training audios. Urges to commit suicide, urges to self harm, urges to quit therapy, urges to use substances, and negative emotions were all reduced after each VR mindfulness session and VR mindfulness was well accepted/liked by the patient. Although case studies are scientifically inconclusive by nature, results from this feasibility study were encouraging. Future controlled studies are needed to quantify whether VR-enhanced mindfulness training has long term benefits e.g., increasing patient acceptance and/or improving therapeutic outcome. Computerizing some of the DBT® skills treatment modules would reduce cost and increase dissemination.
Associating liver partition and portal vein ligation for staged hepatectomy in Qatar: Initial experience with two case series and review of the literature
Authors: Ibnouf Sulieman, Walid Elmoghazy, Mohammed Said Ghali, Ahmed Mahfouz, Ahmed Elaffandi, Hatem Khalaf
Journal: Int J Surg Case Rep (2019)
Keywords: alpps, associating liver partition and portal vein ligation for staged hepatectomy, liver, resection, surgery

Introduction:
Associating Liver Partition and Portal Vein Ligation for Staged -hepatectomy (ALPPS) is an evolving procedure that allows rapid hypertrophy of the future liver remnant (FLR). We describe the first two cases performed in Qatar.
Case presentations:
Case 1: A 53 -year old male with sarcoma metastases to the liver 8 years after resection of an abdominal wall tumor, requiring an extended right hepatectomy but with in an inadequate FLR. ALPPS was done and he achieved 147% increase in the volume of the FLR within 6 days (from 15.9%-34.2%). The second stage was completed successfully on day 7. Case 2: A 59-year old male patient had colorectal liver metastases that required an extended right liver resection and had inadequate FLR of 19.8%. Seven days after the first stage, the FLR hypertrophied to 37.7% (90.2% increase in volume) and the second stage was completed successfully on day 8. Both patients had uneventful recovery and no recurrence or complications on follow up.
Discussion:
ALPPS allows large liver resections while circumventing the long delay in the conventional two staged hepatectomy and portal vein ligation/embolization. The reported morbidity and mortality in earlier series was high, but recent selection criteria and technique refinements reduce this morbidity. Many variations are still being reported.
Conclusion:
ALPPS is an evolving technique that adds to the armamentarium of the liver surgeon to allow larger liver resections in a timely manner. It is feasible and safe to be performed with careful selection.