OpenMed/multicare-articles huggingface dataset:
Bouveret's syndrome as a rare complication of cholelithiasis: Disputes in current management and report of two cases
Authors: Giuseppe Evola, Sebastiano Caramma, Giovambattista Caruso, Giovanni Dapri, Francesco Roberto Evola, Carlo Reina, Giuseppe Angelo Reina
Journal: Int J Surg Case Rep (2020)
Keywords: bouveret’s syndrome, case report, cholecysto-duodenal fistula, cholelithiasis, gallstone ileus, gastrotomy
MeSH terms: Case Reports

Introduction:
Bouveret's syndrome is a rare complication of cholelithiasis that determines an unusual type of gallstone ileus, secondary to an acquired fistula between the gallbladder and either the duodenum or stomach with impaction of a large gallbladder stone. Preoperative diagnosis is difficult because of its rarity and the absence of typical symptoms. Adequate treatment consists of endoscopic or surgical removal of obstructive stone.
Presentation of cases:
Two old females patients were admitted to the Emergency Department with a history of abdominal pain associated with bilious vomiting. Physical examination revealed abdominal distension with tympanic percussion of the upper quadrants, abdominal pain on deep palpation of all quadrants and in the first patient positive Murphy's sign. Preoperative diagnosis of gallstone impacted in the duodenum was obtained by abdominal computed tomography (CT) scan in the first patient and by esophagogastroduodenoscopy in the second one. Both patients underwent surgery with extraction of the gallstone from the stomach. Postoperative course of two patients was uneventful and they were discharged home.
Discussion:
Bouveret's syndrome usually presents with signs and symptoms of gastric outlet obstruction. Preoperative radiological investigations not always are useful for its diagnosis. Appropriate treatment, endoscopic or surgical, is debated and must be tailored to each patient considering medical condition, age and comorbidities.
Conclusion:
Bouveret's syndrome is a very rare complication of cholelithiasis, difficult to diagnose and suspect, because of lack of pathognomonic symptoms. Nowaday there are no guidelines for the correct management of this pathology. Endoscopic or surgical removal of obstructive stone represents the correct treatment.
Non-tuberculous mycobacterial ocular infection masquerading as choroidal tumour - a diagnostic conundrum
Authors: Khy Ching Yeap, Premala Devi Sivagurunathan, Puspha Raman, Khairul Husnaini Mohd Khalid
Journal: GMS Ophthalmol Cases (2019)
Keywords: mycobacterium fortuitum, atypical, choroidal tumour, non-tuberculous mycobacteria
MeSH terms: Case Reports

Purpose: To report a rare case of non-tuberculous mycobacterial (NTM) choroiditis masquerading as choroidal tumour, where the initial diagnosis was masked by keratitis. Case description: A 57-year-old heroin chaser with a pre-existing left eye blindness due to past blunt trauma presented with diffuse bacterial keratitis on the same side. Systemic examination revealed multiple non-tender cervical lymphadenopathies. B-scan ultrasonography showed a hyperechoic choroidal mass with surrounding exudative retinal detachment, resembling a choroidal tumour. However, computed tomography (CT) and magnetic resonance imaging (MRI) scan findings were suggestive of inflammatory choroidal changes. Inflammatory markers were significantly raised and infective screening was positive for HIV and Hepatitis C. Tuberculosis workup was normal. In view of intractable pain, evisceration was done and his vitreous humour was sent for polymerase chain reaction (PCR). It was reported to be positive for Mycobacterium Fortuitum. Conclusion: NTM ocular infections are rare, challenging to diagnose, and potentially sight threatening. Early recognition and prompt treatment is life and vision saving.
Case report: Outer lamellar macular hole and outer retinal detachment within myopic foveoschisis post-cataract surgery
Authors: Yii Hern Eng, Kah Wei Ong, Meng Hsien Yong, Wan Haslina Wan Abdul Halim, Mae-Lynn Catherine Bastion
Journal: Front Med (Lausanne) (2023)
Keywords: cataract, myopia, myopic foveoschisis, outer lamellar macular hole, outer retinal detachment
MeSH terms: Case Reports

Background:
This study aimed to report a case of outer lamellar macular hole and outer retinal detachment within myopic foveoschisis (MF) post-cataract surgery.
Case presentation:
An elderly female patient with bilateral high myopia and pre-existing myopic foveoschisis underwent uncomplicated sequential cataract surgeries 2 weeks apart. She was able to achieve a satisfactory visual outcome for her left eye with stable myopic foveoschisis and visual acuity of 6/7.5, near vision N6. However, her right eye vision remained poor postoperatively, with a visual acuity of 6/60. Macular optical coherence tomography (OCT) revealed a new right eye outer lamellar macular hole (OLMH) and outer retinal detachment (ORD) within pre-existing myopic foveoschisis. Her vision remained poor after 3 weeks of conservative management, and she was offered vitreoretinal surgical intervention with pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. However, she refused surgical intervention, and her right vision remained stable at 6/60 over 3 months of follow-up.
Conclusion:
Outer lamellar macular hole and outer retinal detachment within myopic foveoschisis can occur soon after cataract surgery, which may be related to the progression of associated vitreomacular traction, and have a poor visual outcome if left untreated. Patients with high myopia should be informed of these complications as part of pre-operative counseling.
Cardiac osteosarcoma: a case report and literature review
Authors: Dae-Hwan Bae, Sangshin Park, Min Kim, Sangmin Kim, Woong Gil Choi, Jang-Whan Bae, Kyung-Kuk Hwang, Dong-Woon Kim, Myeong-Chan Cho, Ju-Hee Lee
Journal: Front Cardiovasc Med (2023)
Keywords: cardiac osteosarcoma, cardiac tumor, chemotherapy, echocardiography, surgery
MeSH terms: Case Reports

Background:
Primary cardiac tumors are rare, and malignant primary cardiac tumors are even rarer. Cardiac osteosarcoma is a very rare type of malignant primary cardiac tumor with limited reported cases. We present a case report of cardiac osteosarcoma and review its characteristics and the related literature.
Case summary:
A 44-year-old female patient without a specific medical history presented with intermittent dyspnea that started 1 month prior to presentation. A heterogeneous mass was observed in the left atrium on echocardiography and a large mass was observed in the left atrium on computed tomography. Surgery was performed under the suspicion of atypical cardiac myxoma, and the tumor was successfully removed. However, postoperative histopathological examination revealed cardiac osteosarcoma. The patient underwent chemotherapy and has been well maintained without recurrence for 10 years.
Conclusion:
We present a case report of the echocardiographic features and treatment strategies for cardiac osteosarcoma, an extremely rare cardiac tumor. Multimodal imaging can be helpful; however, a histological diagnosis through surgical resection is essential. Appropriate treatment and follow-up based on histological findings are necessary.
Transvaginal Ultrasound Diagnosis of Ovarian Ectopic Pregnancy
Authors: Marcos Sosa, Sophia Brancazio, Audrey Drummey, Thinh Nguyen, Thomas Toussaint
Journal: Cureus (2023)
Keywords: acute pelvic pain, ectopic pregnancy, ovarian cyst, ovarian ectopic pregnancy management, sonography in the diagnosis of ectopic pregnancy, transvaginal sonography
MeSH terms: Case Reports

Primary ovarian pregnancies are rare and comprise less than one percent of all ectopic pregnancies. Diagnosis can be difficult as an ovarian ectopic pregnancy may share similar features on ultrasound with those of a corpus luteal cyst. Findings on transvaginal ultrasound, including a hyperechoic ring, may denote the presence of a gestational sac and therefore an ovarian ectopic pregnancy. Ultrasonographic findings, as well as a strong suspicion of an ovarian ectopic pregnancy, are critical. The report reviews the case of a 23-year-old primigravida with first trimester bleeding, an elevated human chorionic gonadotropin, an ovarian cyst, and no intrauterine pregnancy detected on ultrasound. The evaluation, diagnosis, and surgical management of an ovarian ectopic pregnancy are discussed.
The Treatment of Oesophageal Perforation after Anterior Cervical Spinal Surgery
Authors: Li-Sheng Hu, Zhen-Quan Wu, Li-Min Zou, Yong-Can Huang
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Oesophageal perforation is a rare complication occurring during or after cervical spine surgery, and the risk factors are not well understood. This study presents a case of a 25-year-old man with oesophageal perforation after anterior cervical spine surgery. It is suggested that four factors (anatomical structure, mechanism of trauma, implant dislodgment, and the operation) could induce postoperative oesophageal perforation after cervical spine surgery performed using the anterior surgical approach. A comprehensive understanding and early management of this complication are necessary for successful therapy.
A case of brucellosis presenting with multiple hypodense splenic lesions and bilateral pleural effusions
Authors: Emine Dilek Eruz, Serhat Birengel, Alpay Azap, Gulden Yilmaz Bozkurt
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Brucellosis is a zoonotic infectious disease, which mainly present with lymphoreticular system invovement. However any organ system can be attacked by the microorganism. In this paper we present a 52-year-old female patient who was admitted to the Infectious Diseases Department with complaints of fatigue, arthralgias, fever, and weight loss. In the medical examination and radiological analysis bilateral pleural effusions and hepatosplenomegaly were detected. Serum transaminase levels were two times higher than the upper limits of normal. Abdominal ultrasound revealed sludge in the gallbladder and multiple hypodense splenic lesions (the largest was 1 cm in diameter). Brucella melitensis was isolated from the blood culture of the patient. Rifampicin (600 mg/day) and doxycycline (200 mg/day) therapy was started. Follow-up chest radiography and ultrasonography revealed the absence of pleural effusion. Splenic lesions and hepatosplenomegaly were totally regressed. The patient has been followed for 3 months after 6 week antibiotic regimen without recurrence. Brucellosis was expected to be the cause of all pathological signs.
Spondylodiscitis Caused by Enterobacter agglomerans
Authors: Jayaweera Arachchige Asela Sampath Jayaweera, Mahen Kothalawala, Balachandran Devakanthan, Sinnappoo Arunan, Dinithi Galgamuwa, Manori Rathnayake
Journal: Case Rep Infect Dis (2016)
MeSH terms: Case Reports

All over the globe, the incidence of vertebral infection is rising. Nowadays, compared to tuberculous variety, pyogenic spondylodiscitis incidence is high. The increase in the susceptible population and improved diagnostics summatively contributed to this. In clinical grounds, differentiation of pyogenic and tuberculous spondylodiscitis is well defined. Enterobacter agglomerans is a hospital contaminant and associated with infections in immunocompromised individuals and intravenous lines. It causes a wide array of infections. Enterobacter agglomerans spondylodiscitis is unusual and there are, around the globe, only less than 31 suspected cases that have been previously reported. Enterobacter agglomerans histology mimics tuberculous rather than pyogenic spondylodiscitis. A 65-year-old farming lady, while being in hospital, developed sudden onset spastic paraparesis with hyperreflexia. Later blood culture revealed Enterobacter agglomerans with 41-hour incubation in 99.9% probability from Ramel identification system. Her initial ESR was 120 mm/first hour. Isolate was susceptible to ciprofloxacin and intravenous followed with oral therapy shows a drastic ESR fall and improved clinical response. Differentiation of tuberculous and pyogenic spondylodiscitis is very much important in management point of view. Therefore, blood culture has a role in diagnosis of spondylodiscitis. ESR can be used as important inflammatory marker in monitoring the response to treatment. Retrospectively, ESR would aid in reaching a definitive diagnosis.
How unclogging a sink can be lethal: case report of an accidental methyl bromide poisoning leading to a multiple organ failure
Authors: Sylvain Lecailtel, Céline Broucqsault-Dedrie, Clément Vanbaelinghem, Martine Nyunga, Delphine Colling, Patrick Herbecq
Journal: J Intensive Care (2015)
Keywords: intensive care, methyl bromide, multiple organ failure, poisoning
MeSH terms: Case Reports

Methyl bromide (CH3Br) is a colorless and odorless volatile gas, used as an insecticide, fire extinguisher, fumigant, and refrigerant. Although forbidden since 1987 for domestic use, it is still used in industry, for example, to fumigate agricultural fields which are for importation in the United States. Here is the case of a 74-year-old man who was accidentally exposed to methyl bromide after using an old fire extinguisher. Even though he finally survived, he developed a severe multiple organ failure and spent 2 months in intensive care unit. We present in this report all the difficulties we had to diagnose this unusual poisoning.
Appendiceal Intussusception Mimicking Cecal Mass and Fecal Matter: A Report of Two Rare Cases
Authors: James Haug, A S Katkar, James Covelli
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Intussusception of the appendix is a relatively rare event that is usually asymptomatic but can present similar to other acute and chronic abdominal conditions. We present two separate cases of suspected appendiceal intussusception mimicking cecal masses. The authors also present a cursory review of the limited number of literatures available concerning this entity to help the radiologist avoid misdiagnosis and potentially unnecessary invasive intervention.
Case Report: Combined Cataract Surgery and Minimally Invasive Glaucoma Surgery Provide an Alternative Treatment Approach for Lowe Syndrome
Authors: Chen Wang, Wenzhe Zhang, Leyi Wang, Wenhui Liu, Hui Guo
Journal: Front Med (Lausanne) (2022)
Keywords: lowe syndrome, ocrl, case report, congenital cataract, congenital glaucoma, minimally invasive glaucoma surgery
MeSH terms: Case Reports

We describe the case of a 4-month-old boy who presented with bilateral congenital cataract and high intraocular pressure (IOP) in the left eye, followed by mental retardation and delayed motor development. Genetic investigation revealed the boy had a splicing variant (c.940-11G>A) of the oculocerebrorenal syndrome of Lowe (OCRL) gene. The boy underwent a lensectomy for congenital cataract in his right eye, and lensectomy combined with a 360° suture trabeculotomy to remove the clouded lens and to control IOP of the left eye. During postoperative one-and-a-half-year follow-up, the boy exhibited an improved visual acuity and a well-controlled IOP without the use of topical IOP-lowering medications. Lowe syndrome is a rare multisystemic disorder that is diagnosed through clinical manifestation and genetic testing. The possibility of Lowe syndrome should be considered in patients presenting with typical triad, and genetic analysis should be performed in time to confirm the diagnosis. We recommend combined cataract surgery and minimally invasive glaucoma surgery (MIGS) as a safe, feasible, and efficient method to treat congenital cataract and glaucoma in Lowe syndrome patients.
Case Report: PD-L1-negative advanced bladder cancer effectively treated with anlotinib and tislelizumab: A report of two cases
Authors: Teng Li, Wuyun Hu, Lan Jin, Xianghua Yin, Dongxu Kang, Longzhen Piao
Journal: Front Oncol (2023)
Keywords: pd-l1, anlotinib, fibroblast growth factor receptor (fgfr), tislelizumab, urothelial cancer (uc)
MeSH terms: Case Reports

Second-line treatment for metastatic or locally advanced urothelial cancer (UC) is limited. Immunotherapy is approved as a second-line treatment for metastatic UC. Its use as a first-line agent is limited to patients who are ineligible for cisplatin-based treatments. The fibroblast growth factor receptor (FGFR) inhibitor, erdafitinib, can be applied as a third-line approach after the failure of these prior treatments in eligible patients. Therefore, it is especially important to combine limited drugs for second-line treatment of advanced or metastatic UC. Anlotinib is a multiple tyrosine kinase inhibitor agent with both anti-angiogenic and FGFR inhibitory effects. For two patients with advanced and metastatic UC, we combined anlotinib and tislelizumab therapy even though there is no indication of its use. We describe two patients with programmed death ligand-1 (PD-L1)-negative advanced bladder cancer, one with FGFR3 mutation and another with FGFR3 wild type. Both patients had progressed after first-line chemotherapy with gemcitabine and cisplatin. We selected anlotinib in combination with tislelizumab, a programmed death-1 (PD-1) immune checkpoint inhibitor, for second-line treatment. Responses were evaluated as partial remission in both cases, who achieved up to 12 months of progression-free survival with no significant adverse events. Two patients with PD-L1-negative UC underwent second-line therapy using tislelizumab in combination with anlotinib, and the efficacy was better than that of tislelizumab alone. These results suggest that anlotinib may act synergistically with tislelizumab in the treatment of UC.
Venetoclax and Decitabine for T/Myeloid Mixed-Phenotype Acute Leukemia Not Otherwise Specified (MPAL NOS)
Authors: Heather Klocke, Zhao Ming Dong, Craig O'Brien, Nicholas Burwick, Robert E Richard, Daniel Y Wu, Thomas R Chauncey, Solomon A Graf
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

T/myeloid mixed-phenotype acute leukemia not otherwise specified (MPAL NOS) is an uncommon and aggressive leukemia without well-established treatment guidelines, particularly when relapsed. Venetoclax plus a hypomethylating agent offers a promising option in this situation since studies support its use in both acute myeloid and, albeit with fewer data to date, acute T-cell-lymphoblastic leukemias. We report the successful eradication of T/myeloid MPAL NOS relapsed after allogeneic stem cell transplant with venetoclax plus decitabine. A consolidative allogeneic stem cell transplant from a second donor was subsequently performed, and the patient remained without evidence of disease more than one year later. Further investigation is indicated to evaluate venetoclax combined with hypomethylating agents and/or other therapies for the management of T/myeloid MPAL NOS.
Atypical Central Neurocytoma with Recurrent Spinal Dissemination over a Period of 20 Years: A Case Report and Review of the Literature
Authors: Tareq A Juratli, Kathrin Geiger, Mario Leimert, Gabriele Schackert, Matthias Kirsch
Journal: Case Rep Neurol Med (2013)

We present an unusual case of a late recurrent central neurocytoma that was rediagnosed as an ependymoma and neurocytoma in accordance with changes in histological classifications. Case Description. A 56-year-old male teacher presented with incomplete transverse syndrome due to several intradural extramedullary tumors at the level of lumbar vertebrae 1-3. The histological diagnosis at the time was atypical ependymoma. One year later, two additional tumors were removed at the L5-S1 vertebral level. For 12 years, the patient remained tumor free on followup. Fourteen years after the initial diagnosis, the patient presented with thoracic paresthesias due to two new extramedullary tumors in the C7-T1 and the T8-T9 vertebral levels. After complete removal of the tumors, a radiological survey revealed an intracranial lesion in the third ventricle. Five months later, an additional lesion recurrence was removed surgically. The most recent histological diagnosis revealed an atypical central neurocytoma. In retrospect, the previous tumors were reclassified as neurocytoma according to the additional immunohistochemistry evidence. Discussion. There is no standard adjuvant treatment regimen for atypical neurocytoma; therefore, the patient is currently under close followup. Modern histopathological diagnosis is essential in these cases. Potential routes for dissemination of the tumor should be considered upon first recurrence.
A congenital anterior urethrocutaneous fistula in a boy whose mother was exposed to ionizing radiations: case report and literature review
Authors: C Spinelli, V Pucci, C Menchini, I Buti, L Fregoli, R Spisni, A Mogorovich
Journal: Case Rep Urol (2013)

Anterior congenital urethrocutaneous fistula is a rare anomaly that may present in an isolated fashion or in association with other anomalies of the genital urinary tract or anorectal malformations. A case of congenital anterior urethrocutaneous fistula nonassociated with other congenital anomalies in a 3-year-old male whose mother has been exposed to Chernobyl's nuclear fallout is described. The patient was successfully operated with no recurrence. We report a review of the literature about etiology and surgical strategy including the role of ionizing radiations. The congenital anterior urethrocutaneous fistula represents a rare malformation. The etiopathogenesis is unknown.
Successful Prolonged Mechanical CPR in a Severely Poisoned Hypothermic Patient: A Case Report
Authors: Alberto Piacentini, Maurizio Volonte', Marcello Rigamonti, Elisa Guastella, Mario Landriscina
Journal: Case Rep Emerg Med (2012)

Mechanical cardiopulmonary resuscitation (m-CPR) devices are an alternative to manual CPR, but their efficacy has been subject to debate. We present a case of a patient with full-neurologic recovery after prolonged m-CPR. The patient presented with severe hypothermia (internal temperature 24°C) and poisoning (sedatives/hypnotics). Hepatic perfusion and metabolism are considered keys to restore spontaneous circulation. During this period no problems related to the device or patient positioning were encountered. Delivery of high-quality CPR and prolonged resuscitation were achieved. We confirm that ventilations asynchronous with chest compressions can be a problem. Reduction in chest measurements can hamper lung ventilation. A synchronous mode of manual ventilation (30 : 2) seems to be the best solution. The patient had an initial period of manual CPR. No damage to any organ or structure was noted. This case is of further interest because our EMS helicopters can fly 24 hours a day and m-CPR devices could play an important role as a "bridge" in patients when active rewarming by cardiopulmonary bypass is indicated (CPB).
A Rare Case of Pure Primary Large Cell Neuroendocrine Carcinoma of the Gallbladder
Authors: Rodney E Shackelford, Ekin Ozluk, Jehan Abdulsattar, Terry C Lairmore, Quyen Chu, Eric X Wei
Journal: Case Rep Oncol Med (2022)
MeSH terms: Case Reports

Primary large cell neuroendocrine carcinoma (LCNEC) of the gallbladder is a rare malignancy which is often associated with non-LCNEC histologic components. Histologically "pure" LCNECs of the gallbladder are exceedingly rare with only 15 cases reported in the medical literature. Clinically, LCNECs present with abdominal pain and jaundice and follow an aggressive course with patients surviving a median of 15 months following initial diagnosis. To our knowledge, we present the 16th case of a histologically pure LCNEC in a 62-year-old African American male who was successfully treated surgically. After discharge, he was subsequently lost to follow-up. Due to the extreme rarity of such disease entity, accurate diagnosis and proper management are essential for the best clinical outcome.