OpenMed/multicare-articles huggingface dataset:
Pneumoperitoneum, pneumatosis intestinalis and portal venous gas: Rare gastrostomy complications case report
Authors: Carlos Jose Perez Rivera, Nathaly Alexandra Ramirez, Alejandro Gonzalez-Orozco, Isabella Caicedo, Paulo Cabrera
Journal: Int J Surg Case Rep (2019)
Keywords: case report, gastrostomy, pneumatosis intestinalis, pneumoperitoneum, portal venous gas

Introduction:
The gastrostomy is one of the most common procedures performed in general surgery. Although a simple procedure, it is not exempted from potential complications, specifically portal venous gas and intestinal pneumatosis being some of the ones with higher rates of mortality. The following case report presents a pneumoperitoneum due to extensive pneumatosis from esophageal, gastric, intestinal and portal gas. These rare complications were managed medically without undergoing emergency surgical intervention.
Presentation of case:
A 19-year-old male patient, with previous history of cerebral palsy, chronic malnutrition and severe physical deconditioning, required a nutritional access. Due to co-existing pathologies, an open gastrostomy was chosen as the best intervention, which was performed without complications. On the tenth postoperative day, patient presents abdominal pain and diarrhea; laboratory results were within normal limits, and the abdominal computed tomography scan reported extensive pneumatosis compromising esophagus, stomach, small intestine, part of the colon, pneumoperitoneum and gas in the portal venous system. Medical management was carried out with an adequate recovery.
Discussion:
Intestinal pneumatosis and portal venous gas are rare and potentially lethal complications. Surgical intervention as well as severe malnutrition impairs carbohydrate digestion and promotes bacterial fermentation forming large volumes of gas and dissection of the intestinal mucosal wall, causing the intestinal pneumatosis evidenced in this case report.
Conclusions:
This case report presents a rare open gastrostomy complication, as well as a differential diagnosis to pneumoperitoneum. Additionally, the medical management poses a successful alternative to an emergency surgical intervention.
Pineal Region Glioblastoma, a Case Report and Literature Review
Authors: Hayley Beacher Stowe, C Ryan Miller, Jing Wu, Dina M Randazzo, Andrew Wenhua Ju
Journal: Front Oncol (2017)
Keywords: o-6-methylguanine-dna methyltransferase, bevacizumab, glioblastoma, pineal, radiotherapy, temozolomide
MeSH terms: Case Reports

Introduction:
Pineal region glioblastoma multiforme (GBM) is a rare disease entity with a generally poor prognosis. We present a case of a patient with an unresectable pineal region GBM treated with chemoradiation with favorable outcome.
Case background:
A 65-year-old patient who was presented with visual symptoms was found to have a pineal region tumor on imaging. A stereotactic biopsy showed a World Health Organization Grade IV GBM, O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylated, isocitrate dehydrogenase 1 and 2 wild type. The patient was treated with radiotherapy with concurrent temozolomide, followed by adjuvant temozolomide. Disease progression occurred at 58 weeks post-biopsy, which prompted the initiation of bevacizumab. The patient was alive and functioning well as of his last follow up, 166 weeks from the initial biopsy.
Discussion:
On our review of the literature, 24 cases of pineal region GBM have been reported. The median reported survival for these previously reported cases was 6 months (range, 2-24 months). This patient has the longest overall survival reported to date for a patient with this diagnosis. This is the first patient in the literature with pineal region GBM who has been reported to have MGMT promoter methylation.
Concluding remarks:
Although pineal region GBM is a rare disease entity with a generally poor prognosis, long-term survival is achievable for select patients. MGMT promoter methylation may potentially have prognostic value. Favorable control of recurrent disease with the use of bevacizumab is possible.
Invasive Carcinoma Ex-Pleomorphic Adenoma of the Lacrimal Gland with a Cystadenocarcinoma Component: A Case Report and Review of the Literature
Authors: Vamsee K Neerukonda, Bryant Carruth, Maria Del Valle Estopinal
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Lacrimal gland neoplasms comprise up to 18% of all orbital masses clinically and histologically. Much of our current core knowledge regarding lacrimal gland tumors stems from prior study of their more common counterparts, the salivary glands. The prognosis for each lacrimal gland tumor is contingent upon proper clinical evaluation and ultimately the histopathologic diagnosis. We describe a case of an invasive carcinoma ex-pleomorphic adenoma (Ca-ex-PA) with a cystadenocarcinoma component arising from the lacrimal gland in the absence of any previously diagnosed pleomorphic adenoma (benign mixed tumor) or prior incisional surgery. This case illustrates the importance of the histopathologic assessment including immunohistochemistry and genetic testing to narrow a differential diagnosis and potentially aid or guide therapy in the future. Our finding suggests that carcinoma of the lacrimal gland may be derived from previously undiagnosed and perhaps even subclinical pleomorphic adenoma.
Dolichocolon Presenting with Bilateral Hydronephrosis in a Neonate
Authors: Laura Gielen, Anke Raaijmakers, Bert De Groote, Eva Ter Haar
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Background:
Dolichocolon is an inborn anatomic variant of the colon with redundancies often causing constipation and/or volvulus presenting in childhood, adolescence, or adulthood. To the best of our knowledge, this is the first case of dolichocolon presenting in infancy with constipation and bilateral hydronephrosis. Case Presentation. A nineteen-day-old neonate presented to the emergency department with severe constipation and discomfort. During his admission, he developed pyelonephritis, and subsequent ultrasound of the kidneys and bladder showed bilateral hydroureteronephrosis. A barium enema was performed and it showed a dolichocolon. Enemas and lactulose were initiated with good effect on both the constipation as well as the hydronephrosis.
Conclusions:
Dolichocolon in a neonate can cause severe constipation which could also lead to an obstructive nephropathy if untreated. Monitoring of urine flow might be indicated when a neonate presents with severe constipation.
Thrombus in Transit through Patent Foramen Ovale
Authors: Hassan Baydoun, Iskander Barakat, Elie Hatem, Michel Chalhoub, Ali Mroueh
Journal: Case Rep Cardiol (2013)

A thrombus in transit through a patent foramen ovale (PFO) with impending paradoxical embolism is an extremely rare event. Due to its transient nature, it is unable to identify the thrombus, and most of the cases have been reported at autopsy. We are reporting a case of thrombus straddling the foramen ovale which was diagnosed by echocardiography and treated surgically. Through this personal case, an exhaustive review of the literature was performed. There were 88 cases reported. We concluded that there is no medical consensus about the best option for treatment. Nevertheless, surgery, which is associated with fewer complications of recurrent embolic events than those of thrombolysis and anticoagulation, appeared to be the best approach in patients who are not at a high surgical risk. Anticoagulant treatment appears to be an acceptable therapeutic alternative to surgery, particularly in patients with comorbidities who are at high surgical risk and for patients with small PFO. Thrombolysis is linked to the highest mortality, which could be explained by the severity of the patient's initial presentation. In conclusion, and after the cumulative effects of these case reports, we propose a diagram consisting of the use of the three therapeutic options in the different clinical scenarios.
Case report: Retrieval of knotted ureteric stent causing obstructive urosepsis
Authors: G N Weeratunga, L Yuan, O Yassaie, P Caswell-Smith
Journal: Urol Case Rep (2023)
MeSH terms: Case Reports

Knotting of ureteric stents is a rare complication, with only 30 cases being described and can be vexing to manage. A few strategies have been described in the literature in a very limited collection of case reports. Currently there are no reports of successful percutaneous removal in the setting of obstructive urosepsis. Herein we discuss our approach to this case, where a ureteric stent was placed for elective ureteric identification for an Abdominal Aortic Aneurysm repair and removed successfully with an antegrade approach without the use of nephroscopy.
Hypertension-Induced Thrombotic Microangiopathy Leading to End-Stage Renal Disease
Authors: Angel Juarez, Lidice Galindo, Maryam Gondal
Journal: Cureus (2023)
Keywords: end-stage renal disease, hypertensive emergency, microangiopathic autoimmune hemolytic anemia, thrombotic microangiopathy, tma
MeSH terms: Case Reports

Thrombotic microangiopathy (TMA) is a term used for a group of rare and life-threatening hematological conditions. Usually, these disease processes are characterized by microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and microthrombi leading to tissue or organ injury. We present a case of a 41-year-old male with TMA induced by uncontrolled hypertension leading to end-stage renal disease requiring hemodialysis. Our goal is to highlight the importance of distinguishing hypertension-induced thrombotic microangiopathy from other etiologies of TMA, particularly thrombotic thrombocytopenic purpura (TTP), and its effect on renal function despite treatment focused on blood pressure control. Thus, it is a challenging diagnosis for clinicians to determine whether to initiate plasmapheresis for prompt treatment of suspected TTP in the setting of severe hypertension with thrombocytopenia.
Detection of complex deletions in chromosomes 13 and 21 in a fetus by noninvasive prenatal testing
Authors: Ting Wang, Chengying Duan, Cong Shen, Jingjing Xiang, Quanze He, Jie Ding, Ping Wen, Qin Zhang, Wei Wang, Minjuan Liu, Hong Li, Haibo Li, Lili Zhang
Journal: Mol Cytogenet (2016)
Keywords: array-based comparative genomic hybridization, karyotype analysis, noninvasive prenatal testing, subchromosomal abnormalities
MeSH terms: Case Reports

Background:
To detect complex fetal subchromosomal abnormalities by noninvasive prenatal testing (NIPT).
Case presentation:
After routine prenatal serum screening, the plasma of high-risk pregnant women were tested via NIPT, and the NIPT results were further validated by fetal karyotype analysis and array-based comparative genomic hybridization (aCGH) through amniocentesis. In addition, the chromosome karyotypes of the parents were also analyzed. NIPT results indicated subchromosomal abnormalities in chromosomes 13 and 21; aCGH results showed 22 Mb and 16 Mb deletions in 13 q31.3 - q34 and 21q11.1 - q21.3, respectively; and the fetal karyotype was 45,XX, der(13),-21. The maternal karyotype 46,XX,inv(9)(p12q13),t(13;21)(q31.3;q21.3) was abnormal, while the paternal karyotype showed no obvious abnormality.
Conclusion:
In this study, we successfully detected complex deletions in chromosomes 13 and 21 in a fetus using NIPT, and NIPT can provide effective genetic information for the detection of fetal subchromosomal abnormalities.
Case Report: Isolated Epileptic Seizures Associated With Anti-LGI1 Antibodies in a 7-Year-Old Girl With Literature Review
Authors: Ying Wang, Wei-Hua Zhang, Yuan Wang
Journal: Front Pediatr (2022)
Keywords: lgi1 antibodies, autoimmune encephalitis, children, immunotherapy, isolated seizures
MeSH terms: Case Reports

We describe the case of a 7-year-old girl with anti-leucine-rich glioma-inactivated 1 (anti-LGI1) antibodies (Abs) who presented with isolated epileptic seizures. Her refractory focal seizures did not respond to anti-seizure medicines but responded rapidly to immunotherapy. She remained seizure-free at 2 years follow-up. Reviewing the literature, isolated epileptic seizures have not been reported as the phenotype of anti-LGI1 autoimmunity in children. Our study indicated that screening for anti-LGI1 Abs is necessary for children with severe and/or drug-resistant new-onset focal epileptic seizures.
A Case of Severe Seronegative Inflammatory Arthritis due to Nivolumab and Review of the Literature
Authors: Bicky Thapa, Asad Ali, Raunak Nair, Rishik Vashisht, Cassandra Calabrese
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Immune-checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer, yet therapy is often hampered by immune-related adverse events (irAEs) which range from mild to severe life-threatening events. Musculoskeletal (MSK) irAEs leading to discontinuation of ICIs are uncommon but increasingly recognized. We report a challenging case of severe immune-related seronegative inflammatory arthritis due to nivolumab in a patient with stage IV metastatic adenocarcinoma.
Giant Parathyroid Tumor: Parathyroid Adenoma versus Parathyroid Carcinoma
Authors: Farid Gossili, Allan Carlé, Trine B Andersen, Helle D Zacho
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

Parathyroid adenoma is the most common cause of primary hyperparathyroidism (PHPT). We present the preoperative detection of a giant parathyroid adenoma (GPA) using (99mTc)-sestamibi parathyroid scintigraphy in a patient presenting with severely elevated parathyroid hormone, hypercalcemia, hypophosphatemia, and vitamin D insufficiency. The patient complained of cerebral symptoms and intermittent abdominal discomfort without constipation. After surgical removal of the hyperactive parathyroid gland and D vitamin supplementation, all blood tests were normalized. The clinical and paraclinical characteristics of GPA may raise the suspicion of parathyroid carcinoma, but not absolutely in this case.
Malignant Pleural Mesothelioma with Marked Lymphatic Involvement: A Report of Two Autopsy Cases
Authors: Reiko Ideguchi, Kazuto Ashizawa, Saori Akashi, Michiko Shindo, Kazunori Minami, Toshio Fukuda, Junji Irie, Minoru Fukuda, Masataka Uetani
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy. CT also showed a consolidative mass with bronchovascular bundle and septal thickening in the lungs suggesting pulmonary parenchymal involvement and the lymphangitic spread of the tumor. These CT findings mimicked lung cancer with pleuritis and lymphangitic carcinomatosis. Autopsy was performed in both cases. Macroscopically, the tumor cells infiltrated the lung with the marked lymphatic spread of the tumor. Microscopy also revealed that the tumor had invaded the pulmonary parenchyma with the marked lymphatic spread of the tumor. Although this growth pattern is unusual, malignant pleural mesothelioma should be considered as the differential diagnosis, especially in patients with pleural lesions.
Relapse of Acute Myeloid Leukemia with t(16;21)(p11;q22) Mimicking Autoimmune Pancreatitis after Second Allogeneic Bone Marrow Transplantation
Authors: Yuhei Kamada, Kazumi Suzukawa, Kenichi Taoka, Yasushi Okoshi, Yuichi Hasegawa, Shigeru Chiba
Journal: ISRN Hematol (2011)
MeSH terms: Case Reports

We report the case of a 37-year-old woman who had a relapse of acute myeloid leukemia (AML) during treatment for chronic graft versus host disease (cGVHD) after allogeneic bone marrow transplantation. She was originally suspected of having autoimmune pancreatitis. Relapse of AML often occurs at extramedullary sites. Whereas the pancreas is rare as an organ of AML relapse, physicians should be aware that enlargement of the pancreas could be a sign of relapsed AML when excluding autoimmune pancreatitis, particularly during active cGVHD after allogeneic stem cell transplantation.
Case Report: Trochlear Wedge Sulcoplasty, Tibial Tuberosity Transposition, and Lateral Imbrication for Correction of a Traumatic Patellar Luxation in a Miniature Companion Pig: A Case Report and Visual Description
Authors: Jennifer Høy-Petersen, Joe S Smith, Paul T Merkatoris, Kelley E Black, Cosette M Faivre, Kristina G Miles, Dane M Tatarniuk, Karl H Kraus
Journal: Front Vet Sci (2021)
Keywords: medial patellar luxation, miniature pig, patellar luxation, sulcoplasty, tibial tuberosity transposition
MeSH terms: Case Reports

The objective of this case report was to describe successful surgical and post-operative management of a medial patellar luxation in a Vietnamese Potbellied Pig. A two-year old, castrated, Vietnamese Potbellied Pig presented to a veterinary teaching hospital for right pelvic limb lameness of 2 weeks duration. Upon physical examination a grade 3 patellar luxation was diagnosed on the right pelvic limb. Surgical repair included a trochlear wedge sulcoplasty, tibial tuberosity transposition, and lateral imbrication as described for canine patellar luxation. The pig was managed post-operatively with meloxicam and a physical therapy regimen of seven weeks duration. At recheck examination the pig was sound, no complications were observed, and the owners were satisfied with the outcome. As miniature companion pigs, such as Vietnamese Potbellied Pigs are currently increasing in popularity as pets, this case demonstrated that comparative techniques from other veterinary species should be considered when considering a treatment plan for a pig with a medial patellar luxation.
Hereditary Hemorrhagic Telangiectasia in a Sudanese Patient
Authors: Omer Ali Mohamed Ahmed Elawad, Ahmed Abdalazim Dafallah Albashir, Mohammed Mahgoub Mirghani Ahmed, Ahmed Ali Mohamed Ahmed Elawad, Osman Eltieb Elbasheer Mohamed
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Background:
Hereditary hemorrhagic telangiectasia (HHT) also known as Osler-Weber-Rendu syndrome is a rare autosomal dominant disorder, which results in vascular dysplasia affecting mainly visceral and mucocutaneous organs. Case Presentation. A 65-year-old woman with a 12-year history of recurrent spontaneous epistaxis presented with shortness of breath, easy fatigability, and bilateral lower limb edema. Her family history was significant for definite hereditary hemorrhagic telangiectasia in first-degree relatives. During the previous 15 days, she has experienced three episodes of recurrent nasal bleeding. She has a background of chronic mitral regurgitation. Physical examination revealed telangiectases in her tongue, lower lip, and hand in addition to signs of congestive heart failure. The patient met 3\4 Curacao criteria and had a definite HHT. Her laboratory workup revealed a hemoglobin count of 5.4 g/dl. Echocardiography revealed a left systolic ejection fraction of 51% with left atrial dilatation and severe mitral regurgitation. Chest X-ray showed features of cardiomegaly and pulmonary edema. The abdominal ultrasonography showed enlarged liver size with homogenous texture and congested hepatic veins without features of hepatic AVMs. She was treated with intravenous frusemide, iron supplement, tranexamic acid, blood transfusion, and nasal packing.
Conclusions:
HTT usually passes unnoticed in Sudan. The rarity of HHT, difficulties in affording diagnostic imaging studies, and low clinical suspicion among doctors are important contributing factors. Anemia resulting from recurrent epistaxis might have an influential role in precipitating acute heart failure in those with chronic rheumatic valvular disease.
Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male
Authors: Jason D Heiner, Katisha D Eng, Todd A Bialowas, Diane Devita
Journal: Case Rep Emerg Med (2012)
MeSH terms: Case Reports

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening.
Adrenocortical carcinoma presenting with signs of acute abdomen
Authors: Dimitrios Symeonidis, Ioannis Chatzinikolaou, Georgios Koukoulis, Ioannis Mamaloudis, Konstantinos Tepetes
Journal: Case Rep Surg (2013)

Background. Adrenocortical carcinomas represent rare malignancies. In cases of hormone-secreting tumors, the hormone in excess determines the nearly diagnostic clinical presentation. Biologically inert tumors are diagnosed either due to the mass effect or incidentally. The purpose of the present study was to present an extremely rare presentation pattern of adrenocortical carcinoma. Case Presentation. We present the case of a 35-year-old female patient that underwent emergency laparotomy due to signs of acute abdomen and concomitant cardiovascular collapse caused by a spontaneously ruptured large adrenocortical carcinoma. Conclusion. Spontaneous rupture of an adrenocortical carcinoma presenting with signs of acute abdomen is an extremely rare clinical scenario. Increased level of suspicion is essential in order to diagnose and treat timely this life-threatening complication.
Supplementation of High Velocity Nasal Insufflation with a Nonrebreather Mask for Severe Hypoxemic Respiratory Failure in Adult Patients with COVID-19
Authors: Jessica S Whittle, Jigme Sethi, Leonithas I Volakis, Jeremy Greenberg
Journal: Case Rep Crit Care (2022)
MeSH terms: Case Reports

The unique clinical features of COVID-19-related acute hypoxemic respiratory failure, as well as the widespread impact leading to resource strain, have led to reconsiderations of classic approaches to respiratory support. HFNO includes high flow nasal cannula (HFNC) and high velocity nasal insufflation (HVNI). There are currently no widely accepted criteria for HFNO failure. We report a series of three patients who experienced COVID-19-related acute severe hypoxemic respiratory failure. Each patient was initially managed with HVNI and had a ROX index < 3.85, suggesting HFNO failure was likely. They were subsequently managed with a nonrebreather mask (NRM) overlying and in combination with HVNI at maximal settings and were able to be managed without the need for invasive mechanical ventilation.
Successful Removal of a Posterior Cardiac Lipoma by Transection of the Ascending Aorta and Main Pulmonary Artery
Authors: Saeki Watanabe, Yuki Ichihara, Kozo Morita, Satoshi Saito, Hiroshi Niinami
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Primary cardiac tumors are unusual, whereas lipomas are particularly rare. We successfully removed a very large posterior cardiac lipoma by transecting the ascending aorta and main pulmonary artery. Transecting both the ascending aorta and the main pulmonary artery facilitated surgical exposure and complete removal of the posterior cardiac lipoma.