Pancreatic microcystic serous cystadenoma: a lethal disease? Rare case of a life-threatening haemorrhage

Serous pancreatic cystadenomas are benign tumours and most cases are detected incidentally. Complications are unusual. A patient with a history of a large pancreatic serous cystadenoma (SCA) presented to the emergency department with abdominal pain and haemodynamic shock. After haemodynamic stabilisation, an urgent abdominal CT scan revealed a large hemoperitoneum but the origin of the bleeding was not found. The patient was submitted to an angiography that revealed a bleeding hypervascular pancreatic mass and an embolisation was done successfully. After 3 weeks, the patient underwent a laparotomic left pancreatectomy with en bloc splenectomy. The anatomopathological results were consistent with a microcystic SCA of the pancreas. Despite the high vascularity of pancreatic SCA, haemorrhage is a very rare but life-threatening complication.

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A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

10.31487/j.jscr.2020.01.03 ◽

2020 ◽

pp. 1-3

Author(s):

Jinping Xu ◽

Ruth Wei ◽

Salieha Zaheer

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Femoral Hernia ◽

Rare Case ◽

Hernia Recurrence ◽

High Morbidity ◽

Diagnostic Challenge ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

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A RARE CASE REPORT ON MYXOEDEMA COMA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i3.32401 ◽

2021 ◽

pp. 1-3

Author(s):

SHANTHI B ◽

MARY CHANDRIKA A

Keyword(s):

Case Report ◽

Female Patient ◽

Rare Case ◽

Previous History ◽

Altered Mental Status ◽

Electrolyte Imbalance ◽

Rare Case Report ◽

Life Threatening ◽

History Of ◽

Life Threatening Complication

Myxoedema coma is a sporadic life-threatening complication of severe hypothyroidism with high mortality. Altered mental status and hypothermia are the main symptoms of myxoedema coma. Apart from that, hypoxia, bradycardia, hypotension, anemia, and hyponatremia would be present. Few patients present comatose with severe myxoedema. Presenting coma may mislead the diagnosis of this condition. A female patient presented with fever, breathlessness, and disorientation was admitted. First diagnosed to have electrolyte imbalance and treatment was started accordingly. The patient did not show much of an improvement, and it took a day to identify the presence of severe hypothyroidism. Treating hypothyroidism resulted in an advance in the patient condition. Patients’ previous history of hypothyroidism was not informed during admission. It is always tough to diagnose myxoedema coma when the patients’ previous history of hypothyroidism is unknown. Hence, it is still essential to have hypothyroidism in mind while treating patients with comatose. This case has been reported to alert physicians in diagnosing myxoedema coma patients and to proceed with the treatment at the earliest.

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Haemophagocytic lymphohistiocytosis secondary to brucellosis in a young child

BMJ Case Reports ◽

10.1136/bcr-2020-240759 ◽

2021 ◽

Vol 14 (3) ◽

pp. e240759

Author(s):

Jashan Mittal ◽

Prawin Kumar ◽

Jagdish Prasad Goyal ◽

Abhishek Purohit

Keyword(s):

Haemophagocytic Lymphohistiocytosis ◽

Appetite Loss ◽

Specific Therapy ◽

Adequate Treatment ◽

Underlying Condition ◽

Persistent Fever ◽

Threatening Condition ◽

Life Threatening ◽

History Of ◽

Life Threatening Complication

Brucellosis is a common zoonotic disease worldwide. It has protean clinical manifestation and sometimes may has a life-threatening complication. A 4-year-old boy presented with a history of fever, myalgia and appetite loss for 3 weeks. On examination, he had hepatosplenomegaly. The initial working diagnosis was an infection, autoimmune disease and malignancy. Investigations showed positive Brucella serology, and he was started on rifampicin and cotrimoxazole. He was further investigated because of persistent fever, which revealed evidence of haemophagocytic lymphohistiocytosis (HLH). He continued treatment for brucellosis, except rifampicin which was replaced with doxycyclin due to a worsening liver function. The child showed complete clinical and biochemical improvement after 6 weeks of therapy. HLH is a life-threatening condition and should be suspected in children with brucellosis, who did not respond to appropriate antibiotics treatment. Secondary HLH does not always require specific therapy; it may improve with adequate treatment of the underlying condition.

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No histology for diminutive duodenal neuroendocrine tumors: Is it safe?

Endoscopy International Open ◽

10.1055/a-0650-4478 ◽

2019 ◽

Vol 07 (02) ◽

pp. E308-E309

Author(s):

Thomas Walter

Keyword(s):

Natural History ◽

Ct Scan ◽

Neuroendocrine Tumors ◽

Surgical Procedures ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

Interesting Approach ◽

History Of ◽

Duodenal Neuroendocrine Tumors

AbstractFor the management of diminutive duodenal neuroendocrine tumors (d-NETs), Harshit et al. have proposed – in the work accompanying this editorial – an interesting approach, the endoscopic banding without resection (BWR) technique. Given the risks associated with classic endoscopic resections and surgical procedures, and the likely favorable natural history of diminutive d-NETs, BWR may be an option for these selected patients with a very low risk of LN + and recurrence. However, a close follow-up (endoscopic, EUS and thoraco-abdominal CT scan) is then required to guarantee the safety of this policy.

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Extramedullary haematopoiesis presenting as a periportal mass

BMJ Case Reports ◽

10.1136/bcr-2020-235064 ◽

2020 ◽

Vol 13 (7) ◽

pp. e235064

Author(s):

Faranak Rafiee ◽

Sara Haseli ◽

Seyed Hamed Jafari ◽

Pooya Iranpour

Keyword(s):

Bone Marrow ◽

Abdominal Pain ◽

Histopathological Examination ◽

Final Diagnosis ◽

Extramedullary Haematopoiesis ◽

Abdominal Ct ◽

Rare Presentation ◽

Abdominal Ct Scan ◽

History Of ◽

Vague Abdominal Pain

Extramedullary haematopoiesis (EMH) is defined as haematopoiesis occurring in organs outside the bone marrow. The liver is one of the rare sites of EMH, and to the best of our knowledge, a few cases of adult EMH of the liver have been reported in the last 20 years. Here, we reported the case of a 68-year-old man with a known history of myelofibrosis presented with vague abdominal pain. An abdominal CT scan showed a hypoattenuating periportal mass encasing the portal vein. The final diagnosis of EMH was made through the histopathological examination. This is a rare presentation of EMH, which may be easily mistaken for other pathologies such as metastases. Familiarity with this type of presentation aids in correctly diagnosing it in an appropriate clinical setting.

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Identification of Persistent Aortocaval Fistula Using Ultrasonography in the Outpatient Setting: A Case Report

Journal for Vascular Ultrasound ◽

10.1177/1544316720933379 ◽

2020 ◽

Vol 44 (3) ◽

pp. 150-153

Author(s):

Richard A. Meena ◽

Melissa N. Warren ◽

Thomas E. Reeve ◽

Olamide Alabi

Keyword(s):

Abdominal Aortic Aneurysm ◽

Case Report ◽

Surgical Repair ◽

Outpatient Setting ◽

Aortocaval Fistula ◽

Abdominal Aortic ◽

Life Threatening ◽

History Of ◽

Life Threatening Complication

Aortocaval fistula (ACF) is a rare and life-threatening complication associated with rupture of an abdominal aortic aneurysm (rAAA). Early detection and management of ACF’s during surgical repair of rAAAs is recommended to reduce the risk of future aneurysm-related complications, including mortality. There is a paucity of current literature on the natural history of ACFs postendovascular exclusion. We present a case study describing the detection of a persistent ACF by duplex ultrasonography (DU) postendovascular aortic repair (EVAR).

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Hereditary Angioedema Type II: First Presentation in Adulthood with Recurrent Severe Abdominal Pain

Case Reports in Immunology ◽

10.1155/2018/7435870 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Mohamed Abuzakouk ◽

Nada AlMahmeed ◽

Esat Memisoglu ◽

Martine McManus ◽

Aydamir Alrakawi

Keyword(s):

Abdominal Pain ◽

Family History ◽

Hereditary Angioedema ◽

Positive Family History ◽

Cleveland Clinic ◽

Severe Abdominal Pain ◽

Type Ii ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

History Of

A 27-year-old Emirate man presented to Cleveland Clinic Abu Dhabi emergency department with a 4 year history of recurrent episodes of severe swellings affecting different parts of his body. He used to get 2 swelling episodes every week affecting either his face, hands, feet or scrotum and severe abdominal pain twice a week. Abdominal CT scan and a colonoscopy showed bowel wall oedema. There was no family history of similar complaint or of hereditary angioedema (HAE). Complement studies confirmed the diagnosis of HAE type II. He was commenced on danazol 100 mg twice daily and his symptoms resolved. This case report highlights the importance of considering HAE in patients with recurrent unexplained abdominal pain even in the absence of positive family history of HAE.

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Pheochromocytoma in a Twelve-Year-Old Girl with SDHB-Related Hereditary Paraganglioma-Pheochromocytoma Syndrome

Case Reports in Genetics ◽

10.1155/2014/273423 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7

Author(s):

Daryl Graham ◽

Megan Gooch ◽

Zhan Ye ◽

Edward Richer ◽

Aftab Chishti ◽

...

Keyword(s):

Blood Pressure ◽

Ct Scan ◽

Medical Management ◽

Elevated Blood Pressure ◽

Clinical Implications ◽

Elevated Blood ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

History Of ◽

Sdhb Gene

A twelve-year-old girl presented with a history of several weeks of worsening headaches accompanied by flushing and diaphoresis. The discovery of markedly elevated blood pressure and tachycardia led the child’s pediatrician to consider the diagnosis of a catecholamine-secreting tumor, and an abdominal CT scan confirmed the presence of a pheochromocytoma. The patient was found to have a mutation in the succinyl dehydrogenase B (SDHB) gene, which is causative for SDHB-related hereditary paraganglioma-pheochromocytoma syndrome. Herein, we describe her presentation and medical management and discuss the clinical implications of SDHB deficiency.

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Risperidone-Induced Neuroleptic Malignant Syndrome: A Case Report and Review

The Canadian Journal of Psychiatry ◽

10.1177/070674379604100112 ◽

1996 ◽

Vol 41 (1) ◽

pp. 52-54 ◽

Cited By ~ 21

Author(s):

Gb Meterissian

Keyword(s):

Case Report ◽

Side Effects ◽

Neuroleptic Malignant Syndrome ◽

Clinical Features ◽

Prior History ◽

Extrapyramidal Side Effects ◽

Life Threatening ◽

History Of ◽

Life Threatening Complication ◽

The One

Objectives: 1. To report the case of a 53-year-old patient who developed neuroleptic malignant syndrome (NMS) — a rare but potentially life-threatening complication of neuroleptic therapy — 4 days after treatment with risperidone was initiated. 2. To review previously reported cases of NMS associated with risperidone. Methods: A computerized search of several databases, including MEDLINE, was conducted to find all previously reported cases of NMS with risperidone. Results: Five reported cases of risperidone-induced NMS were found in the literature. All cases including the one reported here displayed typical clinical features of NMS and all 6 patients had a prior history of extrapyramidal side effects and/or NMS. Age and duration of exposure to risperidone did not seem to be of significance. Conclusions: These cases illustrate that clinicians should be on the lookout for risperidone-induced NMS.

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Traditional medicine: a rare cause of lead poisoning in Western countries

F1000Research ◽

10.12688/f1000research.2-250.v1 ◽

2013 ◽

Vol 2 ◽

pp. 250 ◽

Cited By ~ 3

Author(s):

Halima Muller ◽

Simon Regard ◽

Nicole Petriccioli ◽

Omar Kherad

Keyword(s):

Laboratory Tests ◽

Lead In Blood ◽

Rapid Improvement ◽

Abdominal Ct ◽

Heavy Metal Poisoning ◽

Traditional Medicines ◽

Metal Poisoning ◽

Abdominal Ct Scan ◽

History Of ◽

High Level

A 42-year-old man from Bhutan was admitted to the emergency department with a 5-day history of abdominal pain, nausea and vomiting. Enhanced abdominal CT scan was found negative, however laboratory tests showed hemolytic anemia and basophilic stippling which are often seen in lead and heavy metal poisoning. Additional tests revealed a high level of lead in blood and urine. The patient was administered a chelator treatment with rapid improvement of the symptoms. A detailed interview revealed that the patient had been taking daily Bhutanese traditional medicines to treat a Bell’s palsy from which he had been suffering for a few months. The analysis of these medicines confirmed the presence of a high level of lead.

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