OpenMed/multicare-articles huggingface dataset:
Laparoscopic proctectomy for rectal cancer in an automated peritoneal dialysis patient: A case report
Authors: Hao Li, Bin Wang, Linhua Jiang, Yizhou Yao, Xuchao Wang, Diyuan Zhou, Xinguo Zhu
Journal: Int J Surg Case Rep (2020)
Keywords: laparoscopic proctectomy, peritoneal dialysis, rectal cancer
MeSH terms: Case Reports

Introduction:
There is little evidence to support the safety of peritoneal dialysis (PD) in restarting immediately after abdominal surgery. It is also unclear whether early recovery of PD in minimally invasive abdominal surgery reduces the risk of complications. This is the first case report of laparoscopic proctectomy in a patient on PD.
Presentation of case:
A 66-year-old female patient with end-stage renal disease underwent daily automated peritoneal dialysis. Colonoscopy in the patient suggested rectal cancer. After laparoscopic rectum resection, restart PD on post-operative day 2. Two weeks after the operation, the patient's surgical wound healed well and renal function recovered to the same as before, and the original PD plan was maintained without obvious discomfort.
Discussion:
Multiple other case reports have shown that PD has been safely resumed after various operations. However, PD patients undergoing abdominal surgery may cause serious complications. Maybe the peritoneal dialysis restores immediately after surgery should consider some conditions.
Conclusion:
We think that it may be safe for PD patients to continue to maintain PD after laparoscopic rectum resection without the need for temporary hemodialysis transition. More cases will be collected in the future to consolidate this conclusion and provide reference for the diagnosis and treatment of similar cases in the future.
Atypical acute disseminated encephalomyelitis with systemic inflammation after a first dose of AztraZaneca COVID-19 vaccine. A case report
Authors: Laure Bastide, Gaetano Perrotta, Valentina Lolli, Céline Mathey, Ortensa-Irina Vierasu, Serge Goldman, Frédéric Vandergheynst
Journal: Front Neurol (2022)
Keywords: covid-19, acute disseminated encephalomyelitis (adem), fluorodeoxyglucose positron emission tomography with computed tomography (fdg-pet/ct), systemic inflammation, vaccination
MeSH terms: Case Reports

Background:
Only a few cases of acute disseminated encephalomyelitis (ADEM) following coronavirus disease 19 (COVID-19) vaccination have been described since the beginning of the vaccination campaign.
Results:
Here we report the first case of central nervous system (CNS) demyelination with systemic inflammatory findings on whole body 19-fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) following the ChAdOx1 nCoV-19 vaccine.
Conclusions:
Clinicians should stay aware of potential new adverse events after immunization.
Strawberry milk-like blood in a subject with diabetic lipemia: dramatic change to transparent color after insulin therapy
Authors: Atsushi Obata, Shinji Kamei, Seizo Okauchi, Tomohiko Kimura, Hidenori Hirukawa, Akihito Tanabe, Tomoe Kinoshita, Kenji Kohara, Fuminori Tatsumi, Masashi Shimoda, Shuhei Nakanishi, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
Journal: Springerplus (2016)
Keywords: chylomicronemia, diabetic lipemia, hypertriglycemia

Introduction:
It is known that chylomicronemia is caused by several pathologies and is classified as primary and secondary chylomicronemia. Since hypertriglycemia is associated with an increased risk of cardiovascular disease and severe pancreatitis, it is very important to make a proper diagnosis of the cause of hypertriglycemia.
Case description:
We herein present the case of a 40-year-old male who developed severe hypertriglycemia accompanied with acute exacerbation of type 2 diabetes mellitus. On admission, his blood glucose level was 306 mg/dl and HbA1c was 12.5 %. Moreover, serum triglyceride level was elevated up to 5661 mg/dl. When blood was drawn, it presented strawberry milk-like color. After receiving insulin treatment, he obtained good glycemic control and the serum became back to normal transparent color.
Discussion and evaluation:
Insulin resistance reduces triglyceride clearance and also increases triglyceride release from adipocyte. It is known that glucose toxicity and strong insulin resistance induce inactivation of LPL, which results in chylomicronemia.
Conclusion:
This case report suggests that when serum triglyceride level is markedly elevated due to diabetic lipemia, it is extremely important to obtain good glycemic control.
Accessory Renal Artery Stenosis and Secondary Hypertension
Authors: Ariel A Chung, Patricia R Millner
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

Background:
Secondary hypertension is an uncommon cause of hypertension with extensive workup not recommended in most patients; however, further evaluation is generally recommended in young patients presenting with hypertension. Case Presentation. A 31-year-old female presented with history of elevated blood pressures. Secondary hypertension workup revealed no laboratory abnormalities; however, renal artery ultrasound demonstrated a left superior accessory artery and suspected bilateral renal vein congestion that was further evaluated with renal CT with contrast. Renal CT showed ostial stenosis of the left accessory renal artery. In addition, compression of the left renal vein between aorta and superior mesenteric artery was also noted, consistent with nutcracker syndrome. Hypertension was suspected to be secondary to stenosis of the accessory renal artery. Upon consultation with interventional radiology, pharmacologic treatment was recommended, and blood pressure control was ultimately achieved with a single agent. Discussion. Renovascular etiologies are responsible for 1% of cases of mild hypertension and up to 45% of severe hypertension. Accessory renal arteries are a normal anatomical variant in approximately 30% of the population. Secondary hypertension due to stenosis of an accessory renal artery is rare with very few cases described in case reports.
Conclusion:
Though hypertension secondary to accessory renal artery stenosis is rare and not well published in medical literature, few case reports, including this one, demonstrate that accessory renal artery stenosis can be an underlying etiology of hypertension.
Leiomyoma of the renal vein: a rare tumor presenting as a renal mass
Authors: Cengiz Kocak, Sahin Kabay, Burak Isler
Journal: Case Rep Urol (2015)

Leiomyomas are benign mesenchymal tumors that rarely occur in the kidney. Renal leiomyomas usually occur in the renal cortex or capsule. They are less commonly found in the muscularis propria of the renal pelvis and cortical vascular smooth muscle. In this case report, we present a 41-year-old woman who had right flank pain and detected a mass in the right kidney hilum.
A Case of Primary Signet-Ring Cell Cervical Carcinoma Treated with Chemoradiation, Brachytherapy, and Adjuvant Hysterectomy
Authors: Nicole Salmen, Dominic LaBella, Kenneth Strumpf, Wiley Douglas Bunn, Paul Aridgides
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Primary signet-ring cell carcinoma of the uterine cervix is a rare subtype of cervical mucinous adenocarcinoma. Approximately 20 cases of primary signet-ring cell carcinoma of the cervix have been reported. Pathologic examination shows that adenocarcinomas with mucin accumulation in intracytoplasmic vacuoles displacing the nucleus indicate signet-ring cell carcinoma. A thorough metastatic workup is needed both for staging and to rule out gastrointestinal tract origin. Due to the rarity of the disease, both the true incidence and optimal management are unknown. Herein, the authors present a case of stage 1B3 primary signet-ring cell cervical carcinoma treated with combined chemotherapy and radiation (including external beam radiation and brachytherapy), followed by resection for residual disease. This case is consistent with limited reports where all surviving patients received surgery as well as 1 surviving patient with bulky disease required with chemoradiation and adjuvant hysterectomy.
Coexistent Congenital Diaphragmatic Hernia with Extrapulmonary Sequestration
Authors: Nao Kawamura, Samarjeet Bhandal
Journal: Can Respir J (2016)
MeSH terms: Bronchopulmonary Sequestration / complications, Hernias, Diaphragmatic, Congenital / complications, Case Reports, Bronchopulmonary Sequestration / diagnostic imaging, Female, Hernias, Diaphragmatic, Congenital / diagnostic imaging, Humans, Infant, Newborn

Bronchopulmonary foregut malformations are a heterogeneous but interrelated group of abnormalities that may contain more than one histologic feature. It is helpful to be familiar with the presentation and imaging features of bronchopulmonary foregut malformations presenting as a congenital mass or mass-like lesion, as imaging plays a central role in the evaluation of these lesions since, when symptomatic, clinical features are usually nonspecific. With imaging, the presence of other associated lesions can be determined, facilitating appropriate management to prevent the potential complications. We report a case of coexisting extralobar pulmonary sequestration and ipsilateral diaphragmatic hernia in a term neonate.
Medical Treatment of Postendoscopic Submucosal Dissection Phlegmonous Gastritis in an Elderly Diabetic Woman with Myelodysplastic Syndrome
Authors: Ko Matsuura, Shinsuke Hiramatsu, Rika Taketani, Kohei Ishibashi, Masanao Uraoka, Shinichi Baba, Akihiro Nakamura, Hiroshi Takihara, Chie Ueda, Taro Inoue
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Phlegmonous gastritis is a rare, suppurative disease characterized by full-thickness exudative changes, infiltration of inflammatory cells, and edema primarily in the submucosal layer. A 76-year-old woman with type 2 diabetes and myelodysplastic syndrome underwent endoscopic submucosal dissection (ESD) for early gastric cancer. Postoperatively, she developed persistent fever and computed tomography displayed full-circumference thickening of the gastric wall and increased levels of fat stranding. Endoscopy showed post-ESD ulcer floor expansion, formation of a false lumen between the ulcer floor and surrounding folds, and adhesion of purulent matter. Klebsiella pneumoniae, Pseudomonas aeruginosa, and Candida albicans were detected from pus culture and Klebsiella pneumoniae from blood culture, leading to a diagnosis of phlegmonous gastritis. Contrast examination showed no leakage outside the gastric wall; therefore, the patient fasted and was given antibiotics. She was successfully treated with medical therapy, as demonstrated by repeat endoscopy. Based on our experience, we recommend antibiotics before and after ESD in patients thought to be at high risk of infection, as well as careful postoperative management including postoperative endoscopy.
Management of methylmalonic acidemia (MMA) with N-carbamylglutamate: A case report from Italy
Authors: Flavia Tubili, Francesca Pochiero, Maria Rosaria Curcio, Elena Procopio
Journal: Mol Genet Genomic Med (2023)
Keywords: carglumic acid, italy, n-carbamylglutamate, methylmalonic acidemia
MeSH terms: Amino Acid Metabolism, Inborn Errors / drug therapy, Hyperammonemia, Case Reports, Child, Female, Humans, Italy, N-carbamylglutamate, Methylmalonic acidemia

Background:
Methylmalonic acidemia (MMA) is an inborn error of metabolism whose optimal management, especially in the long-term remains to be established.
Methods:
We describe the case of a child with MMA mut0 who was in a cycle of episodes of decompensation and hospitalization when we started to use carglumic acid (CA), a well-known adjunctive therapy to standard care for the treatment of acute hyperammonemia due to MMA.
Results:
Using the lowest effective therapeutic dose of CA and adjusting the patient's diet with caloric and protein intake adequate for her age and pathology, we managed to keep ammonium levels within the normal range, and to ensure a normal growth pattern.
Conclusion:
The present case adds further confirmation of the long-term management of MMA using CA, focusing on the long duration of follow up and on the use of a lower dose of CA in real life settings.
Endovascular stenting with a drug-eluting stent of transplanted renal artery stenosis in a dual kidney transplanted patient
Authors: Rajesh Vijayvergiya, Navjyot Kaur, Ganesh Kasinadhuni, Ashish Sharma, Anupam Lal, Ashwani Sood
Journal: J Vasc Bras (2021)
Keywords: double kidney transplant, drug-eluting stent, end-stage renal disease, expanded criteria donor, percutaneous transluminal renal angioplasty, transplant renal artery stenosis
MeSH terms: Case Reports

Renal transplant remains the preferred therapy for end-stage renal disease (ESRD). Given the shortage of suitable donor kidneys, use of an expanded criteria donor (ECD) allows marginal kidneys to be transplanted; albeit at risk of increased graft failure due to lower nephron mass. To reduce the risk of graft failure, double kidney transplant (DKT) is advocated, with favorable outcomes. Transplant renal artery stenosis (TRAS) is one of the most common vascular complications following renal transplant. Unlike single kidney transplants, where TRAS usually presents with fluid overload, uncontrolled hypertension, and worsening kidney functions; it may be clinically silent in DKT patients since they have two functional transplanted kidneys. We hereby report a case of TRAS in a DKT patient who had 2 years of favorable clinical outcomes following successful endovascular stenting. He however recently died of COVID-19 associated pneumonitis.
Liposome bupivacaine for postsurgical pain in an obese woman with chronic pain undergoing laparoscopic gastrectomy: a case report
Authors: Peter M Bertin
Journal: J Med Case Rep (2014)

Introduction:
To reduce incidence and severity of postsurgical pain and minimize the effect of its clinical and economic correlates, multimodal therapy for surgical patients is recommended. In this report, we discuss the use of liposome bupivacaine, a novel multivesicular formulation of bupivacaine indicated for single-dose infiltration into the surgical site to produce postsurgical analgesia, as part of a multimodal analgesic regimen in a patient with a history of chronic pain scheduled to undergo laparoscopic sleeve gastrectomy. To the best of our knowledge, this is the first published report of liposome bupivacaine in the setting of laparoscopic sleeve gastrectomy.
Case presentation:
A 35-year-old white woman with morbid obesity was admitted for laparoscopic sleeve gastrectomy to lose weight prior to hip replacement surgery. Because of a complicated medical history that included rheumatoid arthritis, fibromyalgia, diabetes mellitus, hypertension, and chronic pain, for which she was receiving high doses of opioid analgesics, postsurgical pain management was a concern and she was considered a candidate for multimodal analgesia. At initiation of surgery, 50mL of lidocaine and epinephrine was infiltrated around the port sites. At the conclusion, 25mL of normal sterile saline was added to a 20mL vial of liposome bupivacaine (266mg) and injected around the port sites and at the site of liver retraction. Laparoscopic sleeve gastrectomy was successfully completed. Our patient was discharged to the postanesthesia care unit for approximately four hours before discharge to the surgical floor with a pain score of 5 (11-point scale; 0 = no pain, 10 = worst possible pain). Her postoperative course was uneventful; no adverse events were recorded during surgery or during the remainder of her hospital stay. Our patient was discharged on the same opioid regimen used previously for control of her preexisting chronic pain.
Conclusions:
Liposome bupivacaine use in this morbidly obese patient undergoing laparoscopic sleeve gastrectomy provided analgesic efficacy and limited postsurgical opioids to a level comparable with her baseline opioid regimen for chronic pain. Given her complex medical history and previous issues with acute and chronic pain, we consider these results highly successful and continue to use liposome bupivacaine as part of a multimodal analgesic regimen in an effort to optimize postsurgical pain management.
Ureteroarterial Fistulas After Robotic and Open Radical Cystectomy
Authors: Ricardo Palmerola, Mary E Westerman, Mathew Fakhoury, Stephen A Boorjian, Lee Richstone
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Ureteroarterial fistulas (UAFs) are defined as an abnormal communication between one of the major arteries and the ureter. Urologists most frequently encounter iatrogenic fistulas occurring in patients with a history of pelvic extirpative surgery, chronic ureteral catheterization, and history of pelvic radiation. We present two cases of UAFs in patients with no history of prior radiation, who underwent open radical cystectomy and robot-assisted radical cystectomy with intracorporeal ileal conduit. Both patients developed postoperative ureteroileal anastomotic leaks that were managed with indwelling ureteral catheters. Furthermore, both patients were having left-sided UAF after presenting with nonlife threatening gross hematuria, which became brisk and pulsatile during ureteral stent exchange. Endovascular stenting was performed in both patients with resolution of hemorrhage and full recovery. In one patient, nephrostomy tubes were placed and ureteral catheters were removed; the second patient was managed with continued ureteral catheterization without further episodes of hematuria.
Brain and Optic Chiasm Herniation into Sella after Pituitary Tumor Apoplexy
Authors: Maria M Pineyro, Patricia Furtenbach, Ramiro Lima, Saul Wajskopf, Nicolas Sgarbi, Raul Pisabarro
Journal: Front Endocrinol (Lausanne) (2017)
Keywords: brain herniation, empty sella, optic chiasm herniation, pituitary apoplexy, prolactinoma
MeSH terms: Case Reports

Brain and optic chiasm herniation has been rarely reported following dopamine agonist treatment for large prolactinomas. We report a case of brain and optical chiasm herniation, secondary to an empty sella due to apoplexy of a prolactinoma, and we focus on the specific presentation of this case. A 32-year-old female presented to a neurologist complaining of headaches. Her past medical history was significant for acute vision loss in both eyes accompanied by right third nerve palsy when she was 16 years old. She does not recall any endocrine or imaging evaluation at that time and she had spontaneous partial recovery of left eye vision within 3 months, with permanent blindness of right eye. She did not return to any follow-up until her neurologist consultation. Brain magnetic resonance imaging (MRI) revealed herniation of frontal lobe and optic chiasm into the pituitary sella, as well as a pituitary hypointense lesion measuring 5 mm × 5 mm after gadolinium injection. Prolactin levels were 206 ng/ml (4.79-23.3 ng/ml). Repeated prolactin was 258 ng/ml (4.79-23.3 ng/ml). She was started on bromocriptine 2.5 mg/day. Prolactin levels and menstrual cycles normalized. A repeat brain MRI performed 5 months later showed disappearance of pituitary mass, with no changes in brain and chiasmal herniation. To our knowledge, this is the first reported case of brain associated with chiasm herniation secondary to pituitary apoplexy of a prolactinoma. In conclusion, this case highlights that frontal lobe herniation in combination with optic chiasm herniation can be a complication of pituitary tumor apoplexy. Long-term surveillance of patients with pituitary apoplexy is warranted to detect delayed complications.
Haemophagocytic lymphohistiocytosis in patients with human immunodeficiency virus infection: to treat or not to treat
Authors: Farhan Fazal, Nitin Gupta, Shivabalan Kathavarayan Ramu, Aditya Nayan, Naval Kishore Vikram, Animesh Ray
Journal: Pan Afr Med J (2019)
Keywords: malignancy, hospital acquired pneumonia, steroids
MeSH terms: HIV Infections / complications, Immunosuppressive Agents / adverse effects, Lymphohistiocytosis, Hemophagocytic / drug therapy, Case Reports, Adult, Dexamethasone / administration & dosage, Dexamethasone / adverse effects, Female, HIV Infections / immunology, Humans, Immunosuppressive Agents / administration & dosage, Lymphohistiocytosis, Hemophagocytic / etiology, Male, Middle Aged, Immunosuppressive Agents, Dexamethasone

Haemophagocytic lymphohistiocytosis (HLH) in Human Immunodeficiency Virus (HIV) infected individuals can either be due to the disease itself or due to associated infections/malignancies. The treatment for HLH requires immunosuppressive therapy but administering immunosuppressive therapy to an already immunosuppressed patient (HIV infection) is complex. We present two such cases of HLH in patients infected with HIV. In the first case, no alternate cause for HLH was found even after extensive investigations and it was attributed to the uncontrolled HIV replication. Patient was started on dexamethasone for the same but succumbed to hospital acquired pneumonia. The second patient was diagnosed with Hodgkin's lymphoma but he succumbed to his illness before initiating immunosuppressive therapy for HLH. We report these cases to highlight the dilemma and a need for further research in this direction.
Ellis van Creveld syndrome with unusual association of essential infantile esotropia
Authors: D Das, G Das, T K S Mahapatra, J Biswas
Journal: Oman J Ophthalmol (2010)
Keywords: postaxial polydactyly, disproportionate dwarfism, essential infantile esotropia, hypoplastic nails
MeSH terms: Case Reports

Ellis-van Creveld syndrome is a rare short-limbed disproportionate dwarfism characterized by postaxial polydactyly, several skeletal, oral mucosal and dental anomalies, nail dysplasia and in 50-60% cases of congenital cardiac defects. It is an autosomal recessive disorder with mutations of the EVC1 and EVC2 genes located on chromosome 4p16. Patients with this syndrome usually have a high mortality in early life due to cardiorespiratory problems. We present the case of a six- month-old female infant with Ellis-van Creveld syndrome - essential infantile esotropia, which has been infrequently documented in the literature.
Successful emergency management for aortic arch rupture in pregnancy at first trimesters: A case report
Authors: Tien Quyet Tran
Journal: Int J Surg Case Rep (2019)
Keywords: aortic arch rupture, emergency management, first trimester, pregnancy

Background:
The aortic dissection and rupture in pregnancy are uncommon clinical situation, but they are emergency condition with high mortality for both mother and fetus. Here, we report a successful emergency management for pregnancy at first trimesters with aortic arch rupture in Vietnam.
Case presentation:
A young pregnant woman (20-year-old) at 12-week's gestation was transferred to our hospital due to chest pain (last 7 days on treatment) in severe medical condition: conscious responses to stimuli, oxygen 2 l/min directly through endotracheal tube, and hypertension (170/90 mmHg). The chest computed tomography scanner showed aortic arch aneurysm with the image of rupture. An urgent surgery for total aortic arch replacement with cardiopulmonary bypass (185 min) including heart arrest period (cross clamp time 80 min), and general hypothermia (25 °C) performed. She was discharged after 20 days with a normal pregnancy development.
Discussion:
Aortic arch dissection occurring during 1st trimester was very rare. The mortality of aortic dissection without any treatments increased up to 70% at one week after presentation. The aortic arch replacement surgery was successful recuse her, and fortunately, the fetus was safe.
Conclusion:
An emergency surgery for aortic arch replacement was safety for both mother and fetus at 12-week's gestation.