OpenMed/multicare-articles huggingface dataset:
A case report of septic shock and splenic abscess formation secondary to gastric band erosion: A rare complication of laparoscopic adjustable gastric banding
Authors: Victoria Lu, Harsh Kanhere
Journal: Int J Surg Case Rep (2020)
Keywords: bariatric surgery, gastric band complication, gastric band erosion, laparoscopic adjustable gastric band, splenic abscess
MeSH terms: Case Reports

Introduction:
With the rising burden of obesity, bariatric surgery is becoming more common as a treatment option. Laparoscopic adjustable gastric banding (LAGB) is considered safe and effective and is a popular procedure in Australia. However there are recognised complications to be aware of such as band erosion which can lead to infection and abscess formation.
Presentation of case:
A 59-year-old caucasian female presented with fevers, rigors and feeling generally unwell. She was previously fit and well with her only past medical history being LAGB 14 years prior. Clinically the patient was in septic shock and required intensive care admission for inotropic support. On investigations the CRP was 227 and abdominal computed tomography (CT) revealed a splenic abscess. Follow up upper gastrointestinal endoscopy diagnosed an eroded gastric band in the stomach. The patient proceeded to laparoscopy, a gastrotomy was performed and the band was removed. The splenic abscess was concurrently drained and the patient treated with an extended course of intravenous and oral antibiotics.
Discussion:
Band erosion is a rare but serious complications of LAGB surgery along with band slippage, pouch dilatation and abscess formation. Patients are often asymptomatic making early diagnosis difficult. Upper gastrointestinal endoscopy is used to locate the band and recommended treatment is band removal via laparoscopy or laparotomy.
Conclusion:
Band erosion should be suspected in patients with a history of LAGB presenting with nonspecific symptoms such as abdominal pain or fevers. This case also highlights the importance of appropriate patient follow up post operatively and counselling of operative risks and long-term complications.
Use of Extracorporeal Membrane Oxygenation in Postpartum Management of a Patient with Pulmonary Arterial Hypertension
Authors: Humna Abid Memon, Zeenat Safdar, Ahmad Goodarzi
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Current guidelines do not recommend pregnancy in patients with pulmonary arterial hypertension (PAH). This is due to the associated high mortality, which both dissuades PAH patients from becoming pregnant and encourages termination of pregnancy due to high maternal mortality risk. As a result, there is a lack of data and, consequently, there are only general guidelines available for management of pregnancy in PAH patients. Additionally, novel therapeutic strategies such as extracorporeal membrane oxygenation (ECMO), although used in the management of nonpregnant PAH patients as a bridge to lung transplantation, have not been used to treat cardiopulmonary collapse in pregnant PAH patients. In an attempt to bridge this paucity of data, we report the successful use of ECMO in resuscitation and management of a pregnant PAH patient who experienced cardiopulmonary collapse following a caesarian section.
Intraductal papillary neoplasm of the bile duct presenting with hepatogastric fistula: a case report and literature review
Authors: Wen-Hui Chan, Chien-Ming Chen, Shang-Yu Wang, Ren-Chin Wu, Tse-Ching Chen, Hao-Kang Lee, Cheng-Hui Lin, Chun-Nan Yeh
Journal: Front Oncol (2023)
Keywords: cholangiocarcinoma, gastrectomy, hepatectomy, hepatogastric fistula, intraductal papillary neoplasm of the bile duct
MeSH terms: Case Reports

Intraductal papillary neoplasm of the bile duct (IPNB) is an uncommon entity characterized by papillary growth within the bile duct lumen. IPNB is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm of the pancreas, which sometimes complicates with fistula formation to adjacent organs, mainly due to high-pressure related erosion from mucin-filled ducts. However, fistula formation from IPNB is quite rare. Here we report a case of IPNB complicated with hepatogastric fistula. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed disproportional dilatation of left intrahepatic duct with intraluminal soft tissue nodules and fistulous connections to gastric high body. Endoscopy revealed ulcers with two fistulous orifices at upper gastric body. The patient underwent left hepatectomy with gastric wedge resection. Histopathology examination revealed IPNB with invasive cholangiocarcinoma, directly invading to gastric wall leading to hepatogastric fistula. In summary, we have presented the clinical, imaging and pathological findings, along with a comprehensive review of relevant literature, in order to enhance the understanding of this rare condition.
A Case Report of Cannabis Abuse: A Surprising Etiology of Elevated Troponin
Authors: Nway Nway, Sagar Pandey, Tutul Chowdhury, Malavika Shankar, Kalpana Panigrahi
Journal: Cureus (2023)
MeSH terms: Case Reports

Cannabis is the most commonly used additive drug after alcohol and tobacco. There has been literature proving the relationship between cannabis use and elevated troponin from myocardial infarction, with many mechanisms explaining them. However, limited data are available on elevated troponin due to cannabis-induced high myocardial oxygen demand due to vasospasm. We present a case of a 21-year-old female presenting with chest pain after cannabis abuse. She exhibited a steep rise in troponin with a normal electrocardiogram (EKG). She refused a coronary angiogram, but a bedside echocardiogram showed no wall motion abnormality. Therefore, the dramatic rise of troponin levels with the chest pain and the resolution of the symptoms were most likely explained by demand ischemia via the mechanism of reversible vasospasm.
Case Report: Management of Traumatic Carotid-Cavernous Fistulas in the Acute Setting of Penetrating Brain Injury
Authors: Andrea Loggini, Tareq Kass-Hout, Issam A Awad, Faten El Ammar, Christopher L Kramer, Fernando D Goldenberg, Christos Lazaridis, Ali Mansour
Journal: Front Neurol (2022)
Keywords: endovascular intervention, neurocritical care, penetrating brain injury, traumatic carotid cavernous fistula, traumatic cerebrovascular injury
MeSH terms: Case Reports

Traumatic carotid-cavernous fistulas (tCCFs) after penetrating brain injury (PBI) have been uncommonly described in the literature with little guidance on optimal treatment. In this case series, we present two patients with PBI secondary to gunshot wounds to the head who acutely developed tCCFs, and we review the lead-up to diagnosis in addition to the treatment of this condition. We highlight the importance of early cerebrovascular imaging as the clinical manifestations may be limited by poor neurological status and possibly concomitant injury. Definitive treatment should be attempted as soon as possible with embolization of the fistula, flow diversion via stenting of the fistula site, and, finally, vessel sacrifice as possible therapeutic options.
Pancreas as an Occult Source of Recurrent Salmonella enteritidis Bacteremia in an Immunocompromised Patient
Authors: Don Bambino Geno Tai, Laxmi Upadhyay, Ruchika Jain, Robert Goldstein
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Salmonella infection usually presents as gastroenteritis and enteric fever. Some cases of bacteremia can lead to invasion of different organ systems and become occult sources for recurrence. Almost all organs of the body can be affected and have been reported in the literature. We report a rare case of repeated Salmonella enteritidis infection in a patient with systemic lupus erythematosus. She was treated with intravenous and oral antibiotics but still had recurrence of fevers and bacteremia. After a thorough workup, pancreatic abscesses were identified and drained with abscess culture revealing Salmonella enteritidis. She was then treated with a prolonged course of antibiotics and finally cleared the infection. This case demonstrates that nontyphoid Salmonella can be invasive and cause persistent infection. This is particularly pertinent in immunocompromised patients who are at an increased risk of infection. An aggressive workup and prolonged antibiotic course might be beneficial for this subset of patients.
Future Tense and Economic Decisions: Controlling for Cultural Evolution
Authors: Seán G Roberts, James Winters, Keith Chen
Journal: PLoS One (2015)
MeSH terms: Cultural Evolution, Decision Making, Economics, Language, Research Support, Non-U.S. Gov't, Bias, Geography, Humans, Models, Theoretical, Statistics as Topic

A previous study by Chen demonstrates a correlation between languages that grammatically mark future events and their speakers' propensity to save, even after controlling for numerous economic and demographic factors. The implication is that languages which grammatically distinguish the present and the future may bias their speakers to distinguish them psychologically, leading to less future-oriented decision making. However, Chen's original analysis assumed languages are independent. This neglects the fact that languages are related, causing correlations to appear stronger than is warranted (Galton's problem). In this paper, we test the robustness of Chen's correlations to corrections for the geographic and historical relatedness of languages. While the question seems simple, the answer is complex. In general, the statistical correlation between the two variables is weaker when controlling for relatedness. When applying the strictest tests for relatedness, and when data is not aggregated across individuals, the correlation is not significant. However, the correlation did remain reasonably robust under a number of tests. We argue that any claims of synchronic patterns between cultural variables should be tested for spurious correlations, with the kinds of approaches used in this paper. However, experiments or case-studies would be more fruitful avenues for future research on this specific topic, rather than further large-scale cross-cultural correlational studies.
Twin-Twin Transfusion Syndrome After Radiofrequency Ablation in Dizygotic Monochorionic Triamniotic Triplet Pregnancy With Sex Discordance: A Case Report
Authors: Mingming Tang, Xingbo Tian, Jianglai Luo, Xiaohang Zhang, Suzhen Ran, Jiaojiao Xiong, Yanlin Chen, Gongli Chen
Journal: Front Med (Lausanne) (2022)
Keywords: dizygotic triplet pregnancy, monochorionic triamniotic triplet pregnancy, radiofrequency ablation (rfa), sex discordance, twin-twin transfusion syndrome (ttts)
MeSH terms: Case Reports

Background:
We report a case of dizygotic monochorionic triamniotic triplet pregnancy. Twin-twin transfusion syndrome was subsequently diagnosed combined with sex discordance in the two surviving fetuses after one fetus was reduced, which is extremely rare and has not been previously reported.
Case presentation:
After reducing one fetus by radiofrequency ablation of a monochorionic triamniotic triplet pregnancy, twin-twin transfusion syndrome was subsequently diagnosed combined with sex discordance in the two surviving fetuses. Amniotic fluid for chromosome analysis showed normal karyotype 46, XY/46, XX of the donor and recipient fetus, and short tandem repeat (STR) analysis revealed dizygotic twins.
Conclusions:
Through this is an unusual case, we aim to emphasize the importance of accurate diagnosis of chorionicity and zygosity in sex discordant triplet pregnancy, which is the key to appropriate clinical management.
Hyperfunctioning solid/trabecular follicular carcinoma of the thyroid gland
Authors: Luca Giovanella, Fabrizio Fasolini, Sergio Suriano, Luca Mazzucchelli
Journal: J Oncol (2010)
MeSH terms: Case Reports

A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the (99m)Tc-pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.
Simultaneous occurrence of duane retraction syndrome with marfan syndrome
Authors: Mihir Kothari, Florence Manurung, Bhavesh Mithiya
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

Marfan syndrome (MFS) is an autosomal dominant disorder of connective tissue, while Duane retraction syndrome (DRS) is a congenital cranial dysinnervation disorder (CCDD) which can be transmitted as autosomal dominant disorder in 5-10% of patients. In this paper, we present an 8-year-old girl who presented with left eye DRS and bilateral subluxation of the lens associated with MFS in absence of familial involvement. To our knowledge this is the first case report of DRS with MFS. The occurrence of these syndromes together is very rare and appears to be coincidental.
Uterine Myxoid Tumor: A Case Report on a Mysterious and Unexpected Diagnosis
Authors: Reham A Khubrani, Abdulmohsen Alkushi, Mona M Mahjoub
Journal: Cureus (2023)
Keywords: imt, inflammatory myofibroblastic tumor (imt), uterine fibroid, uterine malignancy, uterine myxoid neoplasm
MeSH terms: Case Reports

Inflammatory myofibroblastic tumors (IMTs) are soft-tissue tumors that are rarely malignant. They can occur throughout the body but are rarely seen in the female genital tract. To our knowledge, the literature reports only a few cases of uterine IMTs. This article describes a 60-year-old female with a uterine IMT presumed to be a fibroid. The correct diagnosis was made based on a combination of gross appearance, microscopic findings from multiple hematoxylin and eosin-stained tumor slides, and immunohistochemical staining. We also provide a literature review and compare our findings to other reported cases.
A Chronic Glottic Foreign Body Diagnosed by Radiograph after 9 Months of Symptoms
Authors: Laura H Swibel Rosenthal, Virginia Smith-Bronstein, Santino Cervantes, James W Schroeder Jr
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

A six-year-old girl presented to an emergency room after describing choking on a rubber band. She was in no distress and was discharged. Over the course of the next 9 months, she had numerous outpatient and emergency room visits due to intermittent stridor, difficulty breathing, and hoarseness. Eventually, dedicated airway films revealed a laryngeal foreign body. During rigid bronchoscopy, a two-centimeter rubber band was discovered in the larynx. It extended from the supraglottis, through the glottis, and into the subglottis. It was successfully removed. The patient was asymptomatic 24 hours later. This case highlights the appropriate evaluation and management of a child with stridor.
A rare fungal infiltration of lungs in a healthy young girl
Authors: Rajesh Gupta, Nidhi Goel, Anupama Gupta, K B Gupta, Uma Chaudhary, Sushma Sood
Journal: Case Rep Pulmonol (2011)
MeSH terms: Case Reports

Cunninghamella bertholletiae is an opportunistic fungal organism found in soil and is a rare cause of human disease. The few reported cases of C. bertholletiae have involved immune compromised hosts. We report a case of C. bertholletiae in an otherwise healthy patient presenting with persistent high-grade fever and pulmonary infiltration resistant to antibiotics. The organism is isolated through bronchoscopy and responded to broad spectrum antifungal. This is the first case of C. bertholletiae reported in the literature in an immune competent individual.
Antiepileptic Effects of a Novel Non-invasive Neuromodulation Treatment in a Subject With Early-Onset Epileptic Encephalopathy: Case Report With 20 Sessions of HD-tDCS Intervention
Authors: Oded Meiron, Rena Gale, Julia Namestnic, Odeya Bennet-Back, Nigel Gebodh, Zeinab Esmaeilpour, Vladislav Mandzhiyev, Marom Bikson
Journal: Front Neurosci (2019)
Keywords: electroencephalography (eeg), high-definition transcranial direct current stimulation (hd-tdcs), interictal epileptic discharges (ieds), neonatal epileptic encephalopathy, seizure

The current clinical investigation examined high-definition transcranial direct current stimulation (HD-tDCS) as a focal, non-invasive, anti-epileptic treatment in a child with early-onset epileptic encephalopathy. We investigated the clinical impact of repetitive (20 daily sessions) cathode-centered 4 × 1 HD-tDCS (1 mA, 20 min, 4 mm ring radius) over the dominant seizure-generating cortical zone in a 40-month-old child suffering from a severe neonatal epileptic syndrome known as Ohtahara syndrome (OS). Seizures and epileptiform activity were monitored and quantified using video-EEG over multiple days of baseline, intervention, and post-intervention periods. Primary outcome measures were changes in seizure frequency and duration on the last day of intervention versus the last baseline day, preceding the intervention. In particular, we examined changes in tonic spasms, tonic-myoclonic seizures (TM-S), and myoclonic seizures from baseline to post-intervention. A trend in TM-S frequency was observed indicating a reduction of 73% in TM-S frequency, which was non-significant [t(4) = 2.05, p = 0.1], and denoted a clinically significant change. Myoclonic seizure (M-S) frequency was significantly reduced [t(4) = 3.83, p = 0.019] by 68.42%, compared to baseline, and indicated a significant clinical change as well. A 73% decrease in interictal epileptic discharges (IEDs) frequency was also observed immediately after the intervention period, compared to IED frequency at 3 days prior to intervention. Post-intervention seizure-related peak delta desynchronization was reduced by 57%. Our findings represent a case-specific significant clinical response, reduction in IED, and change in seizure-related delta activity following the application of HD-tDCS. The clinical outcomes, as noted in the current study, encourage the further investigation of this focal, non-invasive neuromodulation procedure in other severe electroclinical syndromes (e.g., West syndrome) and in larger pediatric populations diagnosed with early-onset epileptic encephalopathy. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02960347, protocol ID: Meiron 2013-4.
Oncogenic Potential and Clinical Implications of Giant Endometrial Polyps: A Case Report and Literature Review
Authors: Brittany van Staalduinen, Andrew Stahler, Catherine Abied, Rita Shats, Nisha A Lakhi
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Endometrial polyps exceeding 4 centimeters in length are exceedingly rare and are termed "giant polyps." We describe two patients that presented to our hospital with giant endometrial polyps. Clinical implications and oncologic potential of giant endometrial polyps are discussed. Risk factors of oncologic transformation include advanced age, menopausal status, obesity, diabetes, arterial hypertension, use of tamoxifen, and size greater than 1.0 centimeter. A literature review of all documented cases of giant endometrial polyps is presented and management strategies for counseling and polypectomy are reviewed.
Acute Hypoxic and Refractory Respiratory Failure Induced by an Underlying PFO: An Unusual Case of Platypnea Orthodeoxia and Transient Complication after Transcatheter Closure
Authors: Carlos Salazar, Romeo A Majano
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Platypnea orthodeoxia (PO) is an infrequent condition of dyspnea with hypoxemia, increased by adopting an upright position and is relieved in decubitus. This condition may occur in patients with hidden intracardiac shunts, usually across a persistent foramen ovale (PFO). The incidence of PFO in general population is quite common, around 27%; however, the concurrent presentation with PO, especially in acute refractory respiratory failure, is extremely rare. PFO closure in this setting is still the treatment of choice with significant improvement or complete resolution of symptoms after closure with an overall periprocedural complication in the first 24 hours of approximately less than 5%. A transient ST-segment elevation in the inferior leads is present in extremely rare occasions and most likely is induced by either an air embolism or a mechanically provoked spasm of coronary arteries. We report a case of an 83-year-old woman in acute hypoxic and refractory respiratory failure in whom PO was identified, most likely induced by a hidden PFO. The patient underwent percutaneous transcatheter closure and developed immediate chest pain, transient hemodynamic instability, and ST-segment elevation in the inferior leads; nevertheless, our patient recovered completely with rapid resolution of respiratory failure with no adverse clinical sequelae.
Primary gastric actinomycosis: report of a case diagnosed in a gastroscopic biopsy
Authors: Khaleel Al-Obaidy, Fatimah Alruwaii, Areej Al Nemer, Raed Alsulaiman, Zainab Alruwaii, Mohamed A Shawarby
Journal: BMC Clin Pathol (2015)
Keywords: actinomycosis, gastric, gram, grocott’s, pas
MeSH terms: Case Reports

Background:
Primary gastric actinomycosis is extremely rare, the appendix and ileocecal region being the most commonly involved sites in abdominopelvic actinomycosis. Herein, we report a case of primary gastric actinomycosis. The diagnosis was made on microscopic evaluation of gastroscopic biopsy specimens. To the best of our knowledge, this is the third case to be reported in the literature, in which the diagnosis was made in a gastroscopic biopsy rather than a resection specimen.
Case presentation:
An 87-year-old Saudi male on medication for cardiomyopathy, premature ventricular contractions, renal impairment, hypertension, and dyslipidemia, presented to the emergency department with acute diffuse abdominal pain, abdominal distension, constipation and vomiting for two days, with no history of fever, abdominal surgery or trauma. The patient was admitted to the hospital with an impression of gastric outlet obstruction. Based on radiologic and gastroscopic findings, a non-infectious etiology was suspected, possibly adenocarcinoma or lymphoma. Gastroscopic biopsies showed an actively inflamed, focally ulcerated atrophic fundic mucosa along with fragments of a fibrinopurulent exudate containing brownish, iron negative pigment and abundant filamentous bacteria, morphologically consistent with Actinomyces.
Conclusion:
Althuogh extremely rare, primary gastric actinomycosis should be considered in the differential diagnosis of radiologic and gastroscopic diffuse gastric wall thickening and submucosal tumor-like or infiltrative lesions, particularly in patients with history of abdominal surgery or trauma, or those receiving extensive medication. A high level of suspicion is required by the pathologist to achieve diagnosis in gastroscopic biopsies. Subtle changes such as the presence of a pigmented inflammatory exudate should alert the pathologist to perform appropriate special stains to reveal the causative organism.