OpenMed/multicare-articles huggingface dataset:
Renal-inferior vena cava fistula complicating laparoscopic cholecystectomy causing heart failure repaired endovascularly, a case report and literature review
Authors: Ahmed Almumtin, Mohammed Dahman, Bassam Khalil, Mitham Alabduljabbar, Elaf Almusahel, Samer Koussayer
Journal: Int J Surg Case Rep (2023)
Keywords: arteriovenous fistula, case report, endovascular repair, iatrogenic fistula, laparoscopic cholecystectomy, renal-caval fistula
MeSH terms: Case Reports

Introduction:
Renal-caval Arterio-venous fistulas are rare entity which can be acquired, idiopathic or congenital. Laparoscopic cholecystectomy complicated by arteriovenous fistula formation is extremely rare and often go unnoticed. High output heart failure can occur as a consequence of such high flow fistulas. Repair can be done through open or endovascular approach with the latter being effective and less invasive. Repair can result in resolution of symptoms and improvement of heart function.
Case presentation:
We report a 43-year old female who developed an iatrogenic renal-caval fistula following laparoscopic cholecystectomy, that was complicated by intraoperative bleeding. She presented with worsening high output cardiac failure a year post-operative. Due to past history of Cor-triatriatum surgical repair -a congenital heart disease-, the diagnosis of renal arteriovenous fistula remained insidious. The fistula was diagnosed during cardiac catheterization in an attempt to diagnose her rapidly decompensating heart failure, and repaired successfully by endovascular repair.
Discussion:
To our knowledge, there are only a few reports in literature describing iatrogenic renal artery-caval fistulas in association with laparoscopic cholecystectomy. Such high flow fistulas can result in a significant, potentially life threatening physiologic impairment. The case was managed by endovascular approach resulting in return to baseline cardiac function and resolution of symptoms.
Conclusions:
Renocaval arteriovenous fistulas are extremely rare to complicate laparoscopic cholecystectomy. It might go unnoticed, but may present with decompensated heart failure. It can be reversed by early recognition of symptoms, and diagnosis. High index of suspicion is a key, and endovascular modality is excellent treatment approach.
Case Report: Clinical response to anaplastic lymphoma kinase inhibitor-based targeted therapy in uterine inflammatory myofibroblastic tumor harboring ALK-IGFBP5 fusion
Authors: Ting Zhao, Xiaowei Zhang, Xin Liu, Min Ren, Yufan Cheng, Jian Wang, Zhiguo Luo
Journal: Front Oncol (2023)
Keywords: alk-igfbp5 fusion, crizotinib, inflammatory myofibroblastic tumor, neutrophil-to-lymphocyte ratio (nlr), uterine inflammatory myofibroblastic
MeSH terms: Case Reports

Background:
An inflammatory myofibroblastic tumor (IMT) is a mesenchymal tumor with a prevalence ranging from 0.04% to 0.7% worldwide, in which the lung is the most common predilection site, accounting for 33% of cases, followed by the abdomen, pelvis, mesentery, and uterus. Approximately 50% of uterine IMTs present as anaplastic lymphoma kinase (ALK) positive along with ALK gene fusion, which lays a solid foundation for the development of ALK-based target therapy to optimize treatment strategies.
Case presentation:
Herein we describe a 57-year-old woman who presented with a slow-growing mass in the uterus for over 10 years and then received surgical resection because of significant progressive enlargement of the mass during follow-up. She was diagnosed with uterine leiomyosarcoma (LMS) with no further interventions until recurrence. We revised the diagnosis to uterine IMT based on diffuse ALK expression, ALK-IGFBP5 gene fusion, and the morphologic features of the tumors by pathology consultation. Based on these, we recommended an ALK tyrosine kinase inhibitor (TKI) treatment, crizotinib (250 mg bid), and she achieved a complete response (CR) with at least 18 months of progression-free survival (PFS). We monitored the dynamics of target lesions and peripheral blood cells at regular intervals through CT scans and routine blood tests during the treatment process. We present patient responses to ALK inhibitor-based targeted therapy with uterine IMT harboring ALK-IGFBP5 fusion, and the neutrophil-to-lymphocyte ratio (NLR) may be an effective indicator to predict prognosis.
Rapid Progression of Heterotopic Ossification in Severe Variant of Fibrodysplasia Ossificans Progressiva with p.Arg258Gly in ACVR1: A Case Report and Review of Clinical Phenotypes
Authors: Kosei Hasegawa, Hiroyuki Tanaka, Natsuko Futagawa, Hiroyuki Miyahara, Hirokazu Tsukahara
Journal: Case Rep Genet (2022)
MeSH terms: Case Reports

Fibrodysplasia ossificans progressiva (FOP) is a rare skeletal disorder characterized by congenital malformation of the great toes and progressive heterotopic ossification. Malformation of the great toes appears at birth, while heterotopic ossification generally occurs during childhood and rarely occurs during infancy. Classical FOP results from the heterozygous p.Arg206His variant of the ACVR1 gene, which encodes Activin A receptor type 1. Recently, some atypical FOP patients with other ACVR1 gene variants and clinical features that are not observed in classical FOP patients have been reported. Herein, we describe a girl with severe FOP and multiple anomalies, including syndactyly of the hands and feet, nail agenesis, mandibular hypoplasia, heterotopic ossification occurring from infancy, and congenital cardiac malformation. In our patient, we identified de novo occurrence of the heterozygous p.Arg258Gly variant of ACVR1, which has previously been reported in only two severe FOP patients. Heterotopic ossification occurred earlier and more frequently compared with classical FOP patients. We present the time-series changes in heterotopic ossification in our patient and compare her clinical features with those of the previously reported patients with p.Arg258Gly. Our report deepens understanding of the clinical features in severe FOP with p.Arg258Gly and of FOP as a systemic disorder.
Salvaged, Staged, and Safer Management of Aortoesophageal Fistula and Mediastinitis After Removing a Pork Bone: A Case Report
Authors: Yan Ge, Ayinuer Tuerdi, Xinming Yang, Jingqun Tang, Quanming Li
Journal: Front Surg (2022)
Keywords: aortoesophageal fistula, esophageal foreign body, mediastinitis, salvaged staged strategy, thoracic endovascular aortic repair, video-assisted thoracoscopic surgery
MeSH terms: Case Reports

Aortoesophageal fistula (AEF) caused by esophageal foreign body (EFB) ingestion is a life-threatening condition with a very low survival rate. However, the optimal management strategy remains undetermined. Here, we describe our successful management of a patient with AEF and mediastinitis. A 36-year-old man developed persistent chest and back pain and vomited fresh blood three days after removal of a pork bone in the esophagus under endoscopy in a local hospital. Computed tomography (CT) confirmed bilateral pulmonary infections, mediastinitis, and fistula of the aortic arch. After a multidiscipline discussion, a comprehensive staged strategy was made including salvaged thoracic endovascular aortic repair (TEVAR) to control fatal bleeding, adequate mediastinal debridement, drainage with cervical incision, and video-assisted thoracoscopic surgery, as well as jejunostomy to prevent nasal or gastrostomy reflux from aggravating the mediastinal infection. Furthermore, systematic personalized nutrition support and antibiotics were provided. The patient recovered well and has survived for 50 months until now. Careful assessment should be made with CT to ascertain the risk of AEF before and after the removal of EFB. A salvaged staged strategy of TEVAR with adequate mediastinal debridement and drainage in a less invasive approach may be a safer alternative for AEF patients with infections caused by EFB.
Extracorporeal membrane oxygenation as a bridge to liver transplantation for acute respiratory distress syndrome-induced life-threatening hypoxaemia aggravated by hepatopulmonary syndrome
Authors: Antoine Monsel, Hervé Mal, Hélène Brisson, Rubin Luo, Daniel Eyraud, Corinne Vézinet, Chung Hi Do, Qin Lu, Jean-Christophe Vaillant, Laurent Hannoun, Pauline Houssel, François Durand, Jean-Jacques Rouby
Journal: Crit Care (2011)
MeSH terms: Extracorporeal Membrane Oxygenation, Hepatopulmonary Syndrome / complications, Hypoxia / etiology, Hypoxia / therapy, Respiratory Distress Syndrome / complications, Case Reports, Research Support, Non-U.S. Gov't, Hepatopulmonary Syndrome / surgery, Humans, Liver Transplantation, Male, Middle Aged, Respiratory Distress Syndrome / surgery, Waiting Lists

Introduction:
Combined with massive lung aeration loss resulting from acute respiratory distress syndrome, hepatopulmonary syndrome, a liver-induced vascular lung disorder characterized by diffuse or localized dilated pulmonary capillaries, may induce hypoxaemia and death in patients with end-stage liver disease.
Methods:
The case of such a patient presenting with both disorders and in whom an extracorporeal membrane oxygenation was used is described.
Results:
A 51-year-old man with a five-year history of alcoholic cirrhosis was admitted for acute respiratory failure, platypnoea and severe hypoxaemia requiring emergency tracheal intubation. Following mechanical ventilation, hypoxaemia remained refractory to positive end-expiratory pressure, 100% of inspired oxygen and inhaled nitric oxide. Two-dimensional contrast-enhanced (agitated saline) transthoracic echocardiography disclosed a massive right-to-left extracardiac shunt, without patent foramen ovale. Contrast computed tomography (CT) of the thorax using quantitative analysis and colour encoding system established the diagnosis of acute respiratory distress syndrome aggravated by hepatopulmonary syndrome. According to the severity of the respiratory condition, a veno-venous extracorporeal membrane oxygenation was implemented and the patient was listed for emergency liver transplantation. Orthotopic liver transplantation was performed at Day 13. At the end of the surgical procedure, the improvement in oxygenation allowed removal of extracorporeal membrane oxygenation (Day 5). The patient was discharged from hospital at Day 48. Three months after hospital discharge, the patient recovered a correct physical autonomy status without supplemental O2.
Conclusions:
In a cirrhotic patient, acute respiratory distress syndrome was aggravated by hepatopulmonary syndrome causing life-threatening hypoxaemia not controlled by standard supportive measures. The use of extracorporeal membrane oxygenation, by controlling gas exchange, allowed the performing of a successful liver transplantation and final recovery.
Spontaneous Splenic Rupture and Rituximab-Induced Acute Thrombocytopenia in a Patient with High-Risk Mantle Cell Lymphoma
Authors: Jared Williams, Shingi Chiruka
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Mantle cell lymphoma is a relatively rare type of mature B-cell non-Hodgkin's lymphoma with an incidence of approximately 8 cases per million persons per year. In patients with mantle cell lymphoma, there are rare case reports of the potentially life-threatening consequences of splenic rupture and rituximab-induced acute thrombocytopenia (RIAT) occurring separately, but there are no reports of these occurring in the same patient. Whilst rare, they are important to be aware of as early detection may prevent fatal outcomes.
A Rare Report of Lung Metastasis of the Common Non-Melanotic Skin Cancer
Authors: Mohsen Shafiepour, Arda Kiani, Kimia Taghavi, Sharareh Seifi, Mitra Sadat Rezaie, Seyed Mohammad Reza Hashemian, Atefeh Abedini
Journal: Tanaffos (2018)
Keywords: basal cell carcinoma, lung metastasis, metastatic basal cell carcinoma, pulmonary
MeSH terms: Case Reports

Basal cell carcinoma is a common non-melanotic skin cancer with a prevalence of 74.5%-82.6% in the Iranian population. BCC rarely metastasizes. However, metastasis can cause significant morbidity. The prevalence of metastatic basal cell carcinoma varies between 0.0028% and 0.55% of all cases. We describe a case of lung metastasis of basal cell carcinoma of the scalp.
Adrenal Failure due to Adrenal Metastasis of Lung Cancer: A Case Report
Authors: Gustavo Adolpho Moreira Faulhaber, Flavia Kessler Borges, Aline Maria Ascoli, Renato Seligman, Tania Weber Furlanetto
Journal: Case Rep Oncol Med (2011)
MeSH terms: Case Reports

We report a case of a patient with adrenal failure due to bilateral adrenal metastasis of lung cancer. This is a rare presentation of lung cancer. We review the differential diagnosis of weight loss and how to make diagnosis of adrenal insufficiency.
Bilateral diffuse uveal melanocytic proliferation presenting as small choroidal melanoma
Authors: J N Ulrich, S Garg, G K Escaravage Jr, T M Meredith
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

Purpose. To describe a patient with Bilateral Diffuse Uveal Proliferation who presented initially with a clinical picture consistent with choroidal melanoma. Methods. Presentation of a clinical case with fundus photos, fluorescein angiography, and optical coherence tomography. Results. A 70-year-old Caucasian male with history of esophageal cancer presented with an asymptomatic pigmented choroidal lesion in his left eye initially diagnosed as choroidal nevus. This lesion enlarged over the course of a year and developed orange pigment and increased thickness. A metastatic workup was negative, and a radioactive iodine plaque was placed on the left eye. Over the next six months, the visual acuity in his left eye decreased. His clinical picture was consistent with unilateral Diffuse Uveal Proliferation. A recurrence of his esophageal carcinoma with metastasis was discovered and palliative chemotherapy was initiated. Although his visual acuity improved in the left eye, similar pigmentary changes developed in the right fundus. His visual acuity in both eyes gradually decreased to 20/200 until his death a year later. Conclusion. BDUMP should always be considered in the differential diagnosis of patients with pigmented fundus lesions and a history of nonocular tumors.
Chronic ileocolic intussusception due to transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy: a case report
Authors: Ryuta Saka, Takashi Sasaki, Ikuo Matsuda, Satoko Nose, Masafumi Onishi, Tetsurou Fujino, Hideki Shimomura, Yoshitoshi Otsuka, Noriko Kajimoto, Seiichi Hirota, Takaharu Oue
Journal: Springerplus (2015)
Keywords: chronic intussusception, lymphoma

Chronic intussusception, defined as intussusception continuing over 14 days, is rare in children. We herein report a case of chronic ileocolic intussusception caused by the transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy. The patient had been suffering from anorexia and intermittent abdominal pain for 5 weeks, during which his body weight decreased by around 7 kg. Upon admission to our hospital, ultrasonography and enhanced computed tomography (CT) of the abdomen showed ileocolic intussusception. A retrospective examination of abdominal CT led us to suspect that the intussusception had initially appeared 5 weeks before admission, presumably coinciding with the beginning of the patient's abdominal symptoms. Since hydrostatic reduction was unsuccessful, laparotomy was performed, which showed unreducible ileocolic intussusception with a marked edematous ileum and mesentery. Ileocecal resection without lymph node dissection was carried out, and a histological examination of the resected specimen revealed the transmural infiltration of diffuse large B-cell lymphoma of the terminal ileum. The patient's postoperative course was uneventful, and adjuvant chemotherapy was administered. This case illustrates the diagnostic challenges of confirming 'chronic' intussusception in older children.
Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use
Authors: Tirtza N Spiegel Strauss, Sarah L Pachtman, Burton Rochelson
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Spontaneous spinal epidural abscess (SEA) is a rare infection of the central nervous system. We report a case of a 25-year-old G3 P0020 at 36 weeks of gestational age with history of intravenous drug abuse presenting with acute-onset and severe back pain. Despite antibiotic therapy, pain worsened and she developed lower extremity weakness. Magnetic resonance imaging (MRI) revealed an SEA, and cesarean delivery was performed secondary to increasing weakness, followed by laminectomy (T9-12) and decompression of epidural abscess. Postoperative course was complicated by a psoas muscle abscess and persistent SEA refractory to antibiotic therapy, requiring surgical reexploration and extended treatment with antibiotics. She was discharged home in stable condition and neonate did well with no resulting sequelae. Spinal epidural and psoas abscesses are rare and diagnosis is often delayed. Prompt recognition and treatment are necessary to prevent catastrophic neurologic consequences, and the diagnosis should be considered in pregnant patients presenting with back pain, especially in those with risk factors.
Direct Anterior Approach for One-Stage Bilateral Total Hip Arthroplasty in an ASA 3 Wheelchair-Dependent Woman
Authors: B Britt Barvelink, J T Arjan Hooghof, R B G Roy Brokelman
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

This case report involves a 79-year-old wheelchair-dependent woman with bilateral destructive coxarthrosis, requiring total hip arthroplasty (THA). Mobilization and transfers were unbearable due to the bilateral involvement of her hips. Performing unilateral THA would not be sufficient due to the coexisting pain from the contralateral side. Therefore, the decision was made to perform bilateral THA in one stage using the direct anterior approach (DAA). One-stage bilateral THA (1-SBTHA) using the DAA in ASA 3 patients is not previously described in the literature. The procedure was completed as planned, without any major perioperative complications. Eight weeks postoperatively, the patient was able to mobilize unaccompanied using a walker. She regained her mobility and independence. This outcome suggests that 1-SBTHA using DAA can be considered for disabling coxarthrosis in carefully selected ASA 3 patients. DAA is the superior approach for 1-SBTHA, due to decreased muscle damage leading to early mobilization with improved gait. Another benefit of DAA is that both hips can be draped simultaneously without repositioning the patient during the procedure.
Megacolon due to Chronic Schistosomiasis: A Case Report and Review of Literature
Authors: Amer R Alzahrani, Homoud Alawfi, Sara Almeman, Thamer Altayeb, Hasan M Al-Dorzi
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Although Schistosoma infection in humans commonly involves the intestines, megacolon is a rare finding. We report a 47-year-old patient who was found to have chronic megacolon. After failing conservative management, he underwent extended hemicolectomy with colorectal anastomosis. The colon pathology revealed chronic schistosomiasis and Schistosoma serology was positive.
Catatonia in patients with dementia: a case report
Authors: Samira Younes, Sabria Khouadja, Samia Younes, Lazhar Zarrouk
Journal: Pan Afr Med J (2019)
Keywords: catatonia, dementia, lorazepam
MeSH terms: Anti-Anxiety Agents / administration & dosage, Catatonia / drug therapy, Dementia / diagnosis, Lorazepam / administration & dosage, Case Reports, Catatonia / etiology, Dementia / complications, Humans, Male, Middle Aged, Prognosis, Treatment Outcome, Anti-Anxiety Agents, Lorazepam

Catatonia occurring as part of a clinical picture of dementia has been reported with almost all types of dementia. It remains under-diagnosed in older adults and those with dementia. We review a case of a young patient admitted in our psychiatric department for catatonia and after efficient treatment with Lorazepam, assessment revealed a dementia. Catatonia is a severe neuropsychiatric syndrome with an excellent prognosis if recognized and treated without delay.
Hemadsorption with Adult CytoSorb® in a Low Weight Pediatric Case
Authors: Catalin Gabriel Cirstoveanu, Ileana Barascu, Samantha Mc Kenzie Stancu
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb. HDF was safe and effective from the first day for urea removal, but the patient's bilirubin levels kept increasing gradually, culminating on the 9th day with a maximum value of 54 mg/dL of total bilirubin and 31.67 mg/dL of direct bilirubin when we performed hemadsorption with CytoSorb. Over the 49-hour period of hemadsorption, the total bilirubin value decreased from 54 to 14 mg/dL, and the patient's general status improved considerably accompanied by a rapid drop of aminotransferases. Hemodynamic status has been improved as well and inotropes dropped rapidly. The patient's ventilation settings improved during CytoSorb treatment permitting weaning the patient from mechanical ventilation after five days of hemadsorption. The patient was discharged home after 34 days of hospitalization, in a good general status.
Case Report: Symptomatic Chronic Granulomatous Disease in the Newborn
Authors: Milica Miladinovic, Boris Wittekindt, Sebastian Fischer, Elise Gradhand, Steffen Kunzmann, Stefanie Y Zimmermann, Shahrzad Bakhtiar, Thomas Klingebiel, Rolf Schlösser, Thomas Lehrnbecher
Journal: Front Immunol (2021)
Keywords: chronic granulomatous disease, early onset, neonate, outcome, symptoms
MeSH terms: Granulomatous Disease, Chronic / diagnosis, Case Reports, Review, Age of Onset, Biomarkers, Biopsy, Diagnosis, Differential, Granulomatous Disease, Chronic / complications, Humans, Immunohistochemistry, Infant, Newborn, Lymphadenopathy / diagnosis, Lymphadenopathy / etiology, Skin Diseases / diagnosis, Skin Diseases / etiology, Tomography, X-Ray Computed, Biomarkers

Chronic granulomatous disease (CGD) is a primary immunodeficiency, which is diagnosed in most patients between one and three years of age. Here we report on a boy who presented at birth with extensive skin lesions and lymphadenopathy which were caused by CGD. An analysis of the literature revealed 24 patients with CGD who became symptomatic during the first six weeks of life. Although pulmonary complications and skin lesions due to infection were the leading symptoms, clinical features were extremely heterogenous. As follow-up was not well specified in most patients, the long-term prognosis of children with very early onset of CGD remains unknown.