Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

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Hirschsprung’s Disease: A Rare Adult Diagnosis

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.6.46492 ◽

2020 ◽

Vol 4 (3) ◽

pp. 480-481

Author(s):

Kaitlyn Schmutz ◽

Gaea McGaig ◽

B. Jason Theiling

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Young Adult ◽

Chronic Constipation ◽

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Failure To Thrive ◽

Case Presentation ◽

Gut Colonization ◽

History Of

Case Presentation: Approximately 94% of patients with Hirschsprung’s disease (HD) are diagnosed before the age of five. In our case, a young adult with years of constipation presented to the emergency department with significant abdominal distention. He was ultimately diagnosed with HD, which was identified using computed tomography (CT). Discussion: In HD, we find defects in gastric motility due to improper gut colonization. Without childhood recognition, HD often leads to chronic constipation and failure to thrive in adulthood. CT is a key step in identifying this rare adult diagnosis that should be considered in all patients with a history of chronic constipation.

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Faecopneumothorax due to missing diaphragmatic hernia: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02606-3 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Resul Nusretoğlu ◽

Yunus Dönder

Keyword(s):

Computed Tomography ◽

Diaphragmatic Hernia ◽

Colon Resection ◽

Emergency Laparotomy ◽

Hernia Sac ◽

Case Presentation ◽

Abdominal Tenderness ◽

History Of ◽

Diaphragmatic Hernias ◽

Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

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A case of sigmoid volvulus in an unexpected demographic

Surgical Case Reports ◽

10.1186/s40792-020-01105-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Mohammad Saba ◽

Joshua Rosenberg ◽

Gregory Wu ◽

Gudata Hinika

Keyword(s):

Abdominal Pain ◽

Severe Pain ◽

Rare Case ◽

Young Female ◽

Sigmoid Volvulus ◽

Case Presentation ◽

Operative Complications ◽

History Of ◽

Male Sex ◽

Emergent Laparotomy

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.

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Successful treatment of hepatic lymphorrhea by percutaneous transhepatic lymphangiography followed by sclerotherapy using OK-432

Surgical Case Reports ◽

10.1186/s40792-019-0761-z ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Masayuki Kojima ◽

Masanori Inoue ◽

Seiichiro Yamamoto ◽

Toshio Kanai ◽

Seishi Nakatsuka ◽

...

Keyword(s):

Computed Tomography ◽

Rare Case ◽

Intraperitoneal Administration ◽

Lymphatic Vessels ◽

Hepatoduodenal Ligament ◽

Massive Ascites ◽

Case Presentation ◽

Successful Case ◽

Leakage Site ◽

And Control

Abstract Background Conventional lymphangiography cannot detect leakage sites of hepatic lymphatic vessels. Percutaneous transhepatic lymphangiography can be used to visualize leakage sites, and once the leakage site has been confirmed, effective sclerotherapy can be performed. Case presentation A rare case of intractable hepatic lymphorrhea due to injury of the hepatoduodenal ligament following pancreaticoduodenectomy is reported. Drainage of massive ascites from the drainage tube continued after surgery. Percutaneous transhepatic lymphangiography visualized the intrahepatic lymphatic vessels and the leakage site at the hepatic hilum. An 8-Fr drainage catheter was inserted adjacent to the leakage point under fluoroscopic computed tomography guidance. Repeated sclerotherapy using intraperitoneal administration of OK-432 (picibanil) through the catheter was performed, which exposed the leakage site, and control of the ascites was finally achieved. Conclusions To the best of our knowledge, this is the first successful case of detection of a leakage site using intrahepatic lymphangiography, followed by sclerotherapy using OK-432.

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Impacted urethral stone presenting as urinary retention in a child

BMJ Case Reports ◽

10.1136/bcr-2020-235022 ◽

2021 ◽

Vol 14 (1) ◽

pp. e235022

Author(s):

Kelly Storm Hoffmann ◽

Alok Godse

Keyword(s):

Urinary Retention ◽

Urethral Catheter ◽

Calcium Oxalate Stone ◽

Accident And Emergency ◽

Urethral Catheterisation ◽

History Of ◽

Accident And Emergency Department ◽

Urethral Stone ◽

Definitive Management

A seven-year-old boy was referred to our Accident and Emergency department with a history of urinary retention secondary to urinary tract infection and an inability to pass a urethral catheter. He had been treated a month before for suspected pyelonephritis by the referring hospital. Attempts at urethral catheterisation failed, and he was taken to theatre for cystourethroscopy and catheter placement. At this time, an impacted urethral stone was discovered. Because it could not be dislodged, a suprapubic catheter was placed, and the child was brought back at a later date for definitive management. Investigations revealed a pure calcium oxalate stone that was secondary in origin. There has been no recurrence during a follow-up period of 6 months.This illustrates that while rare, urethral stones do occur in children and should be considered in children presenting with urinary retention, haematuria and/or abdominal pain.

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A Rare Case of Coexistence of Pituitary Stalk Interruption Syndrome and Mayer-Rokitansky-Küster-Hauser Syndrome

10.21203/rs.3.rs-91618/v1 ◽

2020 ◽

Author(s):

Wanlu Ma ◽

Xi Wang ◽

jiangfeng mao ◽

Min Nie ◽

Xueyan Wu

Keyword(s):

Computed Tomography ◽

Differential Diagnosis ◽

Rare Case ◽

Hypogonadotropic Hypogonadism ◽

Pituitary Stalk ◽

Primary Amenorrhea ◽

Case Presentation ◽

Mrkh Syndrome ◽

Breech Delivery ◽

Prepubertal Girls

Abstract Background Pituitary stalk interruption syndrome (PSIS) is a rare congenital pituitary anatomical disorder. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is characterized by congenital absence of the uterus, cervix, and part of the vagina in phenotypically normal 46, XX females. Case presentation A young woman was initially diagnosed as MRKH syndrome based on primary amenorrhea, 46, XX karyotype, and absence of uterus or vagina. Further investigation revealed breech delivery, short stature, hypogonadotropic hypogonadism, interrupted pituitary stalk on pituitary MRI, which led to the diagnosis of PSIS. After a 12-month treatment with estradiol, no signs of uterus or vagina were found on pelvic computed tomography.Conclusions We highlight the importance of considering PSIS in the differential diagnosis of suspected MRKH syndrome in prepubertal girls or girls with delayed or absent puberty, when no uterus is visualized on imaging.

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A Rare Case of HHV-8 Associated Hemophagocytic Lymphohistiocytosis in a Stable HIV Patient

Case Reports in Infectious Diseases ◽

10.1155/2019/3297463 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Nonso Osakwe ◽

Diane Johnson ◽

Natalie Klein ◽

Dalia Abdel Azim

Keyword(s):

Hemophagocytic Lymphohistiocytosis ◽

Rare Case ◽

Viral Infections ◽

Rare Condition ◽

Lymph Node Biopsy ◽

Castleman Disease ◽

Human Herpes Virus 8 ◽

Case Presentation ◽

Multicentric Castleman Disease ◽

History Of

Background. Hemophagocytic lymphohistiocytosis (HLH) is a rare condition associated with viral infections including HIV. Cases have been reported mainly in advanced HIV/AIDS. This is a rare case that reports HLH associated with human herpes virus-8 (HHV-8) associated multicentric Castleman disease in a stable HIV patient. Case Presentation. A 70-year-old Asian male patient with history of stable HIV on medications with CD 4 cell count above 200 presented with cough and fever and was initially treated for pneumonia as an outpatient. Persisting symptoms prompted presentation to the hospital. The patient was found to have anemia which persisted despite repeated transfusion of packed red cells. A bone marrow biopsy to investigate anemia revealed hemophagocytosis. A CT scan revealed multiple enlarged lymph nodes and hepatosplenomegaly. An excisional lymph node biopsy revealed HHV-8 associated multicentric Castleman disease. The patient deteriorated despite initiation of treatment. Conclusion. HLH can occur at any stage of HIV, rapid diagnosis to identify possible underlying reactive infectious etiology and prompt initiation of treatment is crucial to survival.

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A Rare Case of Osteomyelitis Caused by Haemophilus Parainfluenzae

Journal of Bone and Joint Infection ◽

10.7150/jbji.17387 ◽

2017 ◽

Vol 2 (2) ◽

pp. 104-106 ◽

Cited By ~ 2

Author(s):

Fernando Cobo ◽

Gemma Jiménez ◽

Javier Rodríguez-Granger ◽

Antonio Sampedro ◽

Luis Aliaga-Martínez

Keyword(s):

Computed Tomography ◽

Rare Case ◽

Surrounding Tissue ◽

Surgical Drainage ◽

Joint Infections ◽

Computed Tomography Images ◽

Haemophilus Parainfluenzae ◽

Bone Biopsies ◽

History Of ◽

History Of Pain

Abstract. Haemophilus parainfluenzae is a rare cause of bone and joint infections. We report a case of calcaneal osteomyelitis due to this microorganism with a review of all published. A 23-year-old woman presented with a 1-month history of pain and inflammation in the calcaneus area. Osteomyelitis was suspected at this location based on computed tomography images. Culture of six bone biopsies and surrounding tissue resulted in the isolation of H. parainfluenzae. Surgical drainage and debridement was performed, and antibiotic treatment was prescribed, resolving the infection.

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Osteochondritis Dissecans of the Capitellum: A Case Report of Successful Arthroscopic Treatment

Case Reports in Orthopedics ◽

10.1155/2017/5086542 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

J. Ribeiras Cabral ◽

R. Henriques ◽

J. Arvela Matoso ◽

S. Martins ◽

M. Sarmento

Keyword(s):

Osteochondritis Dissecans ◽

Early Identification ◽

Rare Case ◽

White Male ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Successful Result ◽

Case Presentation ◽

History Of ◽

Prompt Diagnosis

Introduction.Osteochondritis dissecans (OCD) of the capitellum is a localized disorder of the subchondral bone, in a region with limited healing capacity. Although its aetiology is still unknown, it has been associated with repetitive microtrauma. The natural history of this disease involves the evolution for degenerative joint disease in approximately half of the patients, with early identification and treatment being critical to optimizing the outcome.Case Presentation.We present a rare case in our practice, illustrating a capitellar OCD in a fifteen-year-old White male without an identified cause of repetitive microtrauma.Conclusion.In this case prompt diagnosis and arthroscopic-assisted treatment led to a successful result.

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A Complex Renal Cyst: It Is Time to Call the Oncologist?

International Journal of Nephrology ◽

10.4061/2011/893985 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Antonio Granata ◽

Antonio Basile ◽

Giuseppe Alessandro Bruno ◽

Alberto Saita ◽

Mario Falsaperla ◽

...

Keyword(s):

Hydatid Cyst ◽

Hydatid Disease ◽

Rare Case ◽

Renal Cyst ◽

Renal Involvement ◽

Case Presentation ◽

Magnetic Resonance Scan ◽

History Of ◽

The Right ◽

Vague Abdominal Pain

Introduction. Hydatid disease is a cyclozoonotic parasitic infestation caused by the cestodeEchinococcus granulosus. The cysts mainly arise in the liver (50 to 70%) or lung (20 to 30%), but any other organ can be involved, in abdominal and pelvic locations, as well as in other less common sites, which may make both diagnosis and treatment more complex. Isolated renal involvement is extremely rare.Case Presentation. We report a rare case of isolated renal hydatid disease in a 71-year-old man with a history of vague abdominal pain, anemia, fever, and microhematuria. Ultrasonographic examination revealed a complex cyst in the right kidney, including multiple smaller cysts with internal echoes. A magnetic resonance scan of the abdomen confirmed the findings, and hydatid cyst disease was diagnosed. Right nephrectomy was performed, and microscopic examination confirmed the diagnosis of hydatid cyst. Albendazole, 10 mg/kg per day, was given for 4 weeks (2 weeks preoperatively and 2 weeks postoperatively).Conclusion. Isolated primary hydatidosis of the kidney should always be considered in the differential diagnosis of any cystic renal mass, even in the absence of accompanying involvement of liver or other visceral organs.

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