OpenMed/multicare-articles huggingface dataset:
Strangulated inguinal hernia due to an omental band adhesion within the hernial sac: a case report
Authors: Senthil Nachimuthu, Szabolcs Gergely
Journal: Cases J (2009)

Introduction:
Strangulated Inguinal hernia is one of the most common surgical emergencies dealt with by surgeons worldwide. Usually the narrow internal inguinal ring or the external inguinal ring is the site of constriction of the viscus, which forms the content of the hernia resulting in strangulation. We report a rare case of strangulated inguinal hernia where the constricting element is not the internal or external inguinal ring, but an omental band adhesion causing closed loop small bowel obstruction and gangrene within the hernial sac in the inguinal canal.
Case report:
A 56-year-old Caucasian gentleman presented to us with a 6 hours history of non-reducible tender lump in his right groin. His groin was explored urgently under general anaesthesia and was found to have an omental band adhesion causing closed loop small bowel obstruction with gangrene within the hernial sac in the inguinal canal with a wide internal inguinal ring. Gangrenous small bowel was resected and primary anastomosis was performed through the same inguinal incision.
Conclusion:
Strangulation of the inguinal hernial content is usually due to the tight constriction at the level of internal inguinal ring or at external inguinal ring. Uncommonly strangulation of the contents can occur due to other causes like omental band adhesion. Anyone presenting with clinical features of strangulated inguinal hernia with small bowel obstruction mandates prompt exploration of the inguinal canal. Although it may not change the treatment approach, one should be aware about this special entity. Resection of the gangrenous small bowel and primary anastomosis can be safely performed through the same inguinal incision.
Cortical Blindness and Altered Mental Status following Routine Hemodialysis, a Case of Iatrogenic Cerebral Air Embolism
Authors: Lawrence Lau, Kory London
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

Cerebral air embolism is a known complication from a myriad of iatrogenic causes. This case describes a 60-year-old female presenting from hemodialysis with altered mental status, bilateral homonymous hemianopia, and repetitive speech. A noncontrast head CT revealed air in the vein of Galen and the deep cerebral veins of the left thalamus and occipital sulcus, a complication from air being introduced into the patient via improper flushing of dialysis tubing. The retrograde flow of air bubbles in the upright patient during dialysis was likely responsible for the air embolus lodging in the cerebral vasculature. This patient was transferred to receive hyperbaric therapy, whereupon the patient survived with residual attention and spatial deficits.
Case Report: An unclassified T cell lymphoma subtype with co-expression of TCR αβ and γ chains revealed by single cell sequencing
Authors: Wei Song, Gang Wang, Cheng Wang, Lulu Liu, Liming Zhang, Ruoyu Zhang, Haixi Zhang, Keqian Shi
Journal: Front Immunol (2023)
Keywords: t cell lymphoma, tcr - t cell receptor, single cell, single cell rna seq, single cell tcr sequencing
MeSH terms: Lymphoma, T-Cell / pathology, Lymphoma, T-Cell, Peripheral, Case Reports, Humans, Leukocytes, Mononuclear / pathology, Male, Middle Aged, Positron Emission Tomography Computed Tomography, Receptors, Antigen, T-Cell / genetics, Receptors, Antigen, T-Cell, alpha-beta / genetics, Receptors, Antigen, T-Cell, alpha-beta, Receptors, Antigen, T-Cell

Background:
T cell lymphomas (TCL) are a group of heterogeneous diseases with over 40 subtypes. In this study, we identified a novel TCL subtype which was featured by a unique T cell receptor (TCR) presentation, α, β and γ chains were co-existing in a single malignant T cell.
Case presentation:
A 45-year-old male patient was diagnosed T cell lymphoma after 2-month of abdominal distension and liver enlargement. Combining histology review, PET-CT scanning and immunophenotyes, the patient was not classified to any existing TCL subtypes. To better understand this unclassified TCL case, we performed single cell RNA sequencing paired with TCR sequencing on the patient's PBMC and bone marrow samples. To our surprise, we identified that the malignant T cells had a very rare TCR combination, by expressing two α chains, one β chain and one γ chain simultaneously. We further studied the molecular pathogenesis and tumor cell heterogeneity of this rare TCL subtype. A set of potential therapeutic targets were identified from the transcriptome data, such as CCL5, KLRG1 and CD38.
Conclusions:
We identified the first TCL case co-expressing α, β and γ chains and dissected its molecular pathogenesis, providing valuable information for precision medicine options for this novel TCL subtype.
Subcutaneously Anchored Sutureless Device for Securement of Chest Tubes in Neonates with Pleural Effusion: Three Case Reports
Authors: Carmen Rodriguez Perez, Maria Grazia Romitti, Elena Pezzotti, Vito D'Andrea, Lucilla Pezza, Mauro Pittiruti
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

We report the clinical cases of three neonates, all of them premature, requiring the placement of a chest tube for drainage of a massive pleural effusion. In all three patients, the chest tube was secured using a new subcutaneously anchored sutureless system. This new securement device was easy to insert and to remove, and highly effective in preventing dislodgment. Also, it was not associated to any undesired effect: no sign of pain and/or discomfort and no skin inflammation. The securement device proved to be comfortable and harmless even in fragile patients as neonates, including the frailest ones, the premature. To our best knowledge, this is the first report describing the use of such a device for this purpose.
Tracheobronchopathia Osteochondroplastica-Clinical, Radiological, and Endoscopic Correlation: Case Series and Literature Review
Authors: Carlos Alejandro García, Saveria Sangiovanni, Valeria Zúñiga-Restrepo, Eliana Isabel Morales, Luz Fernanda Sua, Liliana Fernández-Trujillo
Journal: J Investig Med High Impact Case Rep (2020)
Keywords: bronchoscopy, case report, tracheal diseases, tracheobronchopathia osteochondroplastica
MeSH terms: Bronchi / pathology, Osteochondrodysplasias / diagnosis, Trachea / diagnostic imaging, Trachea / pathology, Tracheal Diseases / diagnosis, Case Reports, Review, Aged, Bronchoscopy, Disease Progression, Female, Humans, Male, Middle Aged, Osteochondrodysplasias / diagnostic imaging, Osteochondrodysplasias / pathology, Tomography, X-Ray Computed, Tracheal Diseases / diagnostic imaging, Tracheal Diseases / pathology, Tracheobronchopathia osteoplastica

Tracheobronchopathia osteochondroplastica (TO) is a rare idiopathic and benign disease that is often underdiagnosed. TO is characterized by multiple submucosal cartilaginous and osseous tracheobronchial nodules that spare the posterior wall. It usually affects the elderly, developing when the person is around 60 years old without gender preference and has a reported incidence of 0.11%. TO can be symptomatic and should be considered in patients with chronic cough, dyspnea, and recurrent pulmonary infections. Diagnosis is usually incidental by computed tomography or bronchoscopy, the latter being the gold standard diagnostic test for TO. Many thoracic imagers are not well acquainted with TO; thus, these patients are often underdiagnosed or misdiagnosed. We came across 5 patients in our institution who were incidentally diagnosed with TO, inspiring us to review the available literature on this disease. A total of 33 patients diagnosed with TO between 2009 and 2019 were identified by our retrospective review. Clinical and imaging data were collected on these patients. We also included the clinical, radiological, and endoscopic data of our 5 cases. TO should be considered in patients with chronic cough, dyspnea, and recurrent pulmonary infections. Our experience is that both computed tomography and bronchoscopy can be used to make a reliable diagnosis. It is crucial for physicians, especially radiologists and pulmonologists, to be aware of the existence of TO in order to ensure proper diagnosis.
Acute Vertigo After COVID-19 Vaccination: Case Series and Literature Review
Authors: Paola Di Mauro, Ignazio La Mantia, Salvatore Cocuzza, Pasqua Irene Sciancalepore, Deborak Rasà, Antonino Maniaci, Salvatore Ferlito, Isabella Tundo, Roberta Anzivino
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19, hints examination, acute vertigo, central vertigo, dizziness, peripheral vertigo, tinnitus, vaccine

Objective: The aim of this study was to present some cases of acute vertigo potentially related to the coronavirus disease 2019 (COVID-19) vaccine and review the available literature about cochleovestibular dysfunction after the COVID-19 vaccination. Methods: In the period from May to July 2021, we evaluated 33 patients (mean age 54.3 ± 14.1) with "acute vertigo" post COVID-19 vaccination. A detailed medical history was taken on comorbidities, types of vaccines received, and symptoms associated. All patients underwent otoneurological evaluation, such as head impulse test, nystagmus evaluation, test of skew (HINTS) examination. Head shaking test-induced nystagmus, hyperventilation-induced nystagmus, and parossistic positional nystagmus were studied to search for vestibular impairment. Results: Symptoms included 16 patients (48.5%) with objective vertigo, 14 patients (42.4%) with subjective vertigo, and 3 patients (9.1%) with dizziness. Of the associated ear, nose, and throat (ENT) symptoms, the most expressed was tinnitus (18.2%). Bedside examination showed absent nystagmus in 7 patients (21.2%), 9 patients (27.3%) had horizontal or rotatory nystagmus, 17 patients (51.5%) had a vertical or oblique nystagmus, negative HST, or "central HINTS." Discussion and Conclusions: The 9 patients had an evoked nystagmus pathognomonic for benign paroxysmal positional vertigo; in the remaining 17 cases, peripheral vestibular dysfunction could be excluded and central disorder may be suggested. Due to the prevalence of nystagmus of non-peripheral origin, a central nervous system involvement could not be excluded. However, due to the small sample size, a definite cause-effect relationship between vaccination and vertigo cannot be inferred. In light of expected third dose, large-scale and well-designed studies are needed to better define possible adverse reactions of the COVID-19 vaccine.
Should prophylactic thrombolysis be routine in clinical practice? Evidence from an autopsy case of septicemia
Authors: Kunihiro Inai, Sakon Noriki, Hiromichi Iwasaki
Journal: BMC Clin Pathol (2014)
MeSH terms: Case Reports

Background:
Central venous catheters provide easy access for intravenous infusion and nutrition, but they can bring about complications such as catheter-related infections. Infected central venous catheters often cause nosocomial bloodstream infections with high morbidity and mortality. However, most of the morphological data that have been published are derived from in vitro and in vivo studies and few reports of direct evidence obtained from patient-derived samples have been described. Here we present visual evidence of catheter-related candidemia. To our knowledge, this is the first reported conventional histopathological evidence of a Candida-infected intraluminal thrombus in a patient's central venous catheter.
Case presentation:
A 62-year-old Japanese female with obstructive jaundice, gastrointestinal bleeding, and liver metastasis from pancreatic head cancer was given an implantable subcutaneous central venous port for nutrition and chemotherapy administration. High fever ensued on day 16 after the central venous port insertion and blood cultures revealed Candida albicans. Although the patient was given 300 mg/day of fosfluconazole according to the suggestion of the infection control team, she died from respiratory failure. Postmortem computed tomography revealed findings consistent with acute respiratory distress syndrome, suggesting that the patient's course was complicated by catheter-related sepsis. Autopsy revealed a subcutaneous abscess around the port, from which C. albicans was cultured. However, no catheter-adherent thrombus, thrombosis of the great central veins, or endocardial vegetations were detected in the patient. Histological analysis revealed scattered abscesses in several organs including lungs and kidneys. Hyaline membrane formation and Candida colonies were found in the lungs. The central venous port tube, together with the part of the subclavian vein into which it had been inserted, was involved in an intraluminal fibrin thrombus containing neutrophils and macrophages, indicating that the thrombus existed while the patient was alive. Histopathological examination following use of the periodic acid-Schiff reagent and the Grocott stain revealed scattered Candida in the thrombus.
Conclusions:
Prophylactic thrombolysis should be encouraged to prevent central venous catheter-related candidiasis in clinical practice.
Stone removal by percutaneous papillary balloon dilatation for cystic duct and bile duct stones after cholecystectomy and distal gastrectomy with Roux-en-Y gastrojejunostomy
Authors: Fumio Chikamori, Koji Ueta, Kazuhisa Onishi, Mitsuteru Yoshida, Nobuyuki Tanida, Hiromichi Yamai, Hisashi Matsuoka, Norihiro Hokimoto, Jun Iwabu, Ryo Yamada, Kai Mizobuchi, Shigeto Shimizu, Niranjan Sharma
Journal: Radiol Case Rep (2022)
Keywords: cobra-shaped sheath, cystic duct stone, ehl, electrohydraulic lithotripsy, mrcp, magnetic resonance cholangiopancreatography, mri, magnetic resonance imaging, ppbd, percutaneous papillary balloon dilatation, ptbd, percutaneous transhepatic biliary drainage, percutaneous papillary balloon dilatation, percutaneous stone removal, roux-en-y gastrojejunostomy
MeSH terms: Case Reports

A 71-year-old woman was referred to our department for abdominal pain. She was diagnosed with acute obstructive cholangitis due to cystic duct and bile duct stones after cholecystectomy and Roux-en-Y gastrojejunostomy. Two years ago, the patient underwent endoscopic and laparoscopic treatment for cystic duct and bile duct stones, however, the stones remained. This time, she was treated with stone removal using percutaneous papillary balloon dilatation (PPBD). Large stones in the common hepatic and bile ducts were crushed by electrohydraulic lithotripsy and then pushed out into the duodenum through the dilated papilla of Vater using a balloon catheter covered with the sheath and cholangioscopy. Stone in the cystic duct was pulled to the common bile duct and pushed to the duodenum. Stone removal using PPBD is an excellent alternative for patients with cystic duct and bile duct stones unable to be treated with endoscopic or laparoscopic stone removal.
Langerhans cell histiocytosis of the cranial base: is low-dose radiotherapy effective?
Authors: Andreas Meyer, Michael Stark, Johann H Karstens, Hans Christiansen, Frank Bruns
Journal: Case Rep Oncol Med (2012)

Introduction. Langerhans cell histiocytosis (LCH) is a rare disease of unknown etiology with different clinical features. A standardised treatment has not been established so far. Case Report. We report a case of a 28-year-old patient who initially presented with hypesthesia of the fifth cranial nerve and pain of the left ear. Diagnosis showed a tumour localised in the cranial base with a maximum diameter of 4.1 cm. The diagnosis of LCH was confirmed histologically by biopsy. Diagnostic workup verified the cranial lesion as the sole manifestation of LCH. A total dose of 9 Gy (single dose 1.8 Gy) was delivered. The symptoms dissolved completely within 6 months after radiation; repeated CT and MRI scans revealed a reduction in size of the lesion and a remineralisation of the bone. After a followup of 13 years the patient remains free of symptoms without relapse or any side effects from therapy. Discussion. Due to the indolent course of the disease with a high rate of spontaneous remissions the choice of treatment strongly depends on the individual clinical situation. In the presented case low-dose radiotherapy was sufficient to obtain long-term local control in a region with critical structures and tissues.
Enchondroma protuberans of ulnar bone: a case report and review of literature
Authors: Afshin Mohammadi, Abbas Hedayati Asl, Mohammad Ghasemi-Rad, Farahnaz Noroozinia
Journal: Case Rep Radiol (2012)

Introduction. Enchondroma protuberans is an extremely rare benign cartilaginous bone tumor. We report the first case report of enchondroma protuberans in the forearm. Presentation of Case. We report a case of enchondroma protuberans originating in the left ulnar bone of a young woman. A 20-year-old female referred to our hospital complaining of progressive sustained left forearm pain with a radiation to fourth and fifth finger. Conventional radiography revealed a well-defined eccentric osteolytic lesion in the distal diaphysis of ulna with expansion of overlying cortex (without calcification). Magnetic resonance imaging showed a well-defined ovoid intramedullary lesion, which was exophytically protruding from medial surface of left ulnar bone. Histopathology confirmed the diagnosis. Discussion. Enchondroma protuberans typically present as a well-defined intramedullary osteolytic lesion that may be accompanied by a fine matricidal calcification. The connection between the intramedullary portion and the exophytic protrusion can be seen well by magnetic resonance imaging. Conclusion. Enchondroma protuberans should be considered in the differential diagnosis of osteochondroma, enchondroma, and periosteal chondroid tumors.
Capnocytophaga canimorsus Mycotic Aortic Aneurysm After a Dog Bite
Authors: Robert H A Berndsen, Pim B J E Hulshof, Maurits P A van Meer, Ben R Saleem, Vincent P W Scholtes, René M The, Vincent Jongkind, Kak Khee Yeung
Journal: EJVES Vasc Forum (2022)
Keywords: biological graft, is-pro, mycotic aortic aneurysm, open repair
MeSH terms: Case Reports

Introduction:
Mycotic aortic aneurysm is defined as dilatation of the aortic wall due to infection caused by a variety of microorganisms and is associated with high mortality rates. This case report describes a patient with a rapid growing mycotic infrarenal aneurysm caused by Capnocytophaga canimorsus following a dog bite.
Report:
A 61 year old male professional dog handler presented with a history of progressive abdominal pain and constitutional symptoms. He had been bitten by a Pit Bull Terrier dog that was attacking a young girl three weeks prior to the onset of complaints. Investigations revealed a mycotic infrarenal aortic aneurysm that grew 0.5 cm in only three days. Open surgical repair consisting of an infrarenal aorto-aortic bypass with a 21 mm × 15 cm bovine bioprosthesis was performed successfully. All cultures and biopsies were negative and the subsequent 16S-23S rRNA intergenic spacer region based polymerase chain reaction (IS-pro) technique revealed C. canimorsus, a Gram negative bacterial pathogen that lives as a commensal in the gingival flora of dogs and cats that can cause a variety of severe infections, as the causative agent. Identification made it possible to treat the patient with eight weeks of intravenous followed by four weeks of oral antibiotics. At the last follow up over a year after surgery, the patient was symptom free, without infection and on ultrasound examination there were no signs of complications or aneurysm formation.
Discussion:
This case highlights C. canimorsus as a rare cause of a rapid growing mycotic aortic aneurysm following a dog bite. 16S-23S rRNA profiling (IS-pro) led to the identification of the bacterial pathogen. The use of biological grafts should be considered in the management of mycotic aortic aneurysms.
Successful erlotinib treatment for a patient with gefitinib-related hepatotoxicity and lung adenocarcinoma refractory to intermittently administered gefitinib
Authors: Tatsuya Nagano, Yoshikazu Kotani, Kazuyuki Kobayashi, Masahiro Katsurada, Yukihisa Hatakeyama, Suya Hori, Daisuke Tamura, Daisuke Kasai, Yasuhiro Funada, Yoshihiro Nishimura
Journal: Case Rep Pulmonol (2011)
MeSH terms: Case Reports

A 73-year-old Japanese man was histologically diagnosed with lung adenocarcinoma harboring an exon 19 deletion in the epidermal growth factor receptor. The patient was treated with gefitinib for 6 weeks until he developed substantially elevated hepatic enzyme levels that resulted in the discontinuation of gefitinib. Gefitinib was reintroduced with an intermittent treatment schedule after the transaminase levels normalized, but the patient's enzyme levels rose again, and the cancer progressed. Gefitinib was eventually replaced with erlotinib. There was stable disease for 7 weeks without any signs of liver toxicity. Thus, erlotinib may be a beneficial and well-tolerated treatment option for patients with gefitinib-related hepatotoxicity.
Are All Mutations the Same? A Rare Case Report of Coexisting Mutually Exclusive KRAS and BRAF Mutations in a Patient with Metastatic Colon Adenocarcinoma
Authors: Anusha Vittal, Akshay Middinti, Anup Kasi Loknath Kumar
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

29-year-old Hispanic woman presented to the clinic with complaints of abdominal pain, nausea, fatigue, and constipation. Laboratory tests indicated the presence of iron deficiency anemia and transaminitis. Imaging evaluation revealed marked hepatomegaly with multiple hepatic metastases and pelvic lymphadenopathy. Biopsy of the hepatic lesions showed adenocarcinoma positive for pan-cytokeratin, CMA5.2, villin, and CDX2. She was positive for tumor markers CA 19-9, CA-125, and CEA. Upon further evaluation, she was found to have colorectal cancer positive for KRAS and BRAF mutations. Unfortunately, her disease progressed rapidly and she expired within 3 months from the time of her first diagnosis. KRAS and BRAF mutations are rare enough to be considered virtually mutually exclusive but coexistent mutations appear to be a distinct molecular and clinical subset with aggressive course of illness, which is in dire need of new treatment strategies. Panitumumab and Cetuximab are approved for patients with wild type KRAS CRC. Vemurafenib is a potent inhibitor of the kinase domain in mutant BRAF and its use in BRAF mutated colon cancer remains to be well established. Our report highlights the need to obtain tissue samples from these patients for analysis and to evaluate the benefit of Vemurafenib in colorectal cancers.