Incarcerated paraoesophageal hernia complicated with distal oesophageal perforation: a combined laparoscopic and endoscopic approach

Paraoesophageal hernias are common, but symptoms are not always present nor pathognomonic of this condition, and patients may be suffering for many years before a diagnosis is made. Incarceration and strangulation are rare, but they are life-threatening complications, warranting an emergent surgical repair. Hiatal hernia incarceration causing distal oesophagus perforation is even rarer. To our knowledge, this is the first case report in adult patients. Despite many advances in care, a high grade of suspicion is needed to diagnose this condition, and the mortality rate for an oesophageal perforation remains high, achieving 50% in some series. We present the surgical management of a case of hiatal hernia incarceration with distal oesophagus perforation by combined laparoscopy and upper endoscopy.

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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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Gastric mixed adenoneuroendocrine carcinoma case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x19828918 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1982891

Author(s):

Miguel Angel Moyón Constante ◽

Fernando Xavier Moyón Constante ◽

Jorge Fernando Tufiño ◽

Andres Cárdenas Patiño ◽

Gabriel Alejandro Molina ◽

...

Keyword(s):

Case Report ◽

World Health ◽

Low Grade ◽

Radical Gastrectomy ◽

Upper Endoscopy ◽

Mixed Adenoneuroendocrine Carcinoma ◽

First Case ◽

The World ◽

Medical Teams ◽

Health Organization

Mixed adenoneuroendocrine carcinomas are rare tumors that contain both an exocrine and an endocrine component. Since the latest classification by the World Health Organization and with the aid of immunostaining, more mixed adenoneuroendocrine carcinomas are now identified and diagnosed. Nonetheless, our knowledge of these tumors is still limited, notably concerning gastric variants, as the cases reported in the literature are very limited. The clinical and surgical treatment, including the chemotherapy schemes, the prognosis, and recurrence still represent challenges for the medical teams. We present the case of a 62-year-old woman. After an upper endoscopy revealed multiple polyps and a low-grade neuroendocrine tumor, a D2 radical gastrectomy was performed. A low output esophageal anastomotic leak was discovered in the postoperative period and successfully managed. Pathology revealed a gastric mixed adenoneuroendocrine carcinoma, the first case of this kind reported in Ecuador. Patient is doing well and under constant surveillance up until her 13th postoperative month.

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Adult Presentation of a Familial-Associated Vein of Galen Aneurysmal Malformation: Case Report

Neurosurgery ◽

10.1227/neu.0b013e3181fa00d8 ◽

2010 ◽

Vol 67 (6) ◽

pp. E1845-E1851 ◽

Cited By ~ 14

Author(s):

David S Xu ◽

Asad A Usman ◽

Michael C Hurley ◽

Christopher S Eddleman ◽

Bernard R Bendok

Keyword(s):

Case Report ◽

Natural History ◽

Vein Of Galen ◽

Review Of The Literature ◽

Time Resolved ◽

Presenting Symptoms ◽

First Case ◽

Life Threatening ◽

History Of ◽

Asymptomatic Adult

Abstract BACKGROUND AND IMPORTANCE: Vein of Galen aneurysmal malformations (VGAMs) arise from persistent arteriovenous shunting from primitive choroidal vessels into the median prosencephalic vein of Markowski, the embryonic precursor of the vein of Galen. VGAMs rarely present past infancy, and their natural history in adults is unknown. We report the first case of a familial-associated VGAM in an asymptomatic adult female patient. The clinical features of this case are presented alongside a systematic review of the literature on adult VGAM cases to assess the natural history, clinical management, and genetic basis of this rare neurovascular lesion. CLINICAL PRESENTATION: A previously healthy 44-year-old woman with a family history of a VGAM in a stillborn presented with an 8-week onset of dizziness and vertigo that spontaneously resolved. Time-resolved magnetic resonance angiography identified a choroidal VGAM. No intervention was undertaken at this time because of the patient's asymptomatic status after 9 months of follow-up. CONCLUSION: Based on our review of the literature, this is the first case report of a familial-associated VGAM in an adult patient and suggests that VGAM development can be genetically linked. Of 15 adult VGAM cases previously reported, all patients were either symptomatic or treated, thus precluding determination of VGAM natural history in adults. Patient outcomes correlated with the severity of presenting symptoms, which ranged from asymptomatic to immediately life-threatening. We hypothesize that self-selection may render VGAMs to be more benign for them to persist past childhood. Further investigation of the molecular biology underlying VGAM development is warranted.

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Abacavir Hypersensitivity Reaction: The First Case Report in Thailand and Literature Review

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.01.11569 ◽

2021 ◽

Vol 104 (1) ◽

pp. 159-163

Keyword(s):

Developing Countries ◽

Case Report ◽

Hypersensitivity Reaction ◽

Screening Test ◽

Blood Test ◽

Clinical Presentation ◽

Health Security ◽

First Case ◽

Threatening Condition ◽

Life Threatening

Abacavir-related hypersensitivity reaction (ABC-HSR) is a life-threatening condition. The incidence is low since it could have been prevented by screening with blood test for HLA-B*5701, which is strongly associated with this reaction. However, the affordability for the HLA-B*5701 screening test is still a challenging issue in many developing countries. Thai National Health Security Office (NHSO) recommends either using HLA-B*5701 as a screening test or monitoring clinical presentation for ABC-HSR after using it. Therefore, the clinical presentation of ABC-HSR should be acknowledged for the diagnosis of this condition and death prevention. This was the first reported case and literature reviewed of ABC-HSR associated with the presence of the HLA-B*5701 allele in Thailand. Keywords: Abacavir, Hypersensitivity reaction, HLA-B*5701, Clinical presentation, Thailand

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Doxycycline-Induced Gastric Perforation

The American Surgeon ◽

10.1177/00031348211047494 ◽

2021 ◽

pp. 000313482110474

Author(s):

Yeahwa Hong ◽

Christopher Staniorski ◽

Dean Pollack ◽

Steven Evans

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Chest Pain ◽

Adverse Effects ◽

Diagnostic Criteria ◽

Gastric Perforation ◽

Mucosal Injury ◽

First Case ◽

Life Threatening

Esophageal and gastric mucosal injuries are well-documented adverse effects of doxycycline leading to odynophagia, chest pain, and abdominal pain. There are no clear diagnostic criteria for such adverse effects; hence, the diagnosis depends heavily on thorough history. There is a paucity of literature describing life-threatening complications from doxycycline-induced mucosal injury, such as hemorrhage and perforation. We present the first case report describing a gastric perforation from doxycycline use.

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Hemospray for Life-Threatening Gastrointestinal Bleeding Secondary to Ulcer Disease: First Case Report in the United States Presidential Poster

The American Journal of Gastroenterology ◽

10.14309/00000434-201210001-01319 ◽

2012 ◽

Vol 107 ◽

pp. S522-S523

Author(s):

Peter Sargon ◽

Timothy Laurie

Keyword(s):

United States ◽

Case Report ◽

Gastrointestinal Bleeding ◽

The United States ◽

Ulcer Disease ◽

First Case ◽

Life Threatening

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Idarucizumab to revert the anticoagulant effect of dabigatran in traumatic acute subdural haematoma: a case report of first use in Latin America

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytz098 ◽

2019 ◽

Vol 3 (2) ◽

Cited By ~ 1

Author(s):

Raúl Izaguirre Ávila ◽

José Eduardo Bahena López ◽

Evelyn Cortina de la Rosa ◽

Miguel Ángel Hernández Márquez

Keyword(s):

Latin America ◽

Case Report ◽

Emergency Surgery ◽

Subdural Haematoma ◽

Vitamin K Antagonists ◽

Attractive Alternative ◽

Venous Disease ◽

First Case ◽

Increased Risk ◽

Life Threatening

Abstract Background Direct oral anticoagulants (DOAC) are an attractive alternative over vitamin K antagonists. They have several advantages in primary and secondary prevention of thromboembolisms due to atrial fibrillation, as well as in prevention and treatment of thromboembolic venous disease. They have fast onset action, do not need laboratory controls in patients with normal renal function, and they have practically no interference with the patient’s diet or medications. The strongest objection to their use was the lack of reversal agents that could be used in case of life-threatening haemorrhage or the need for emergency surgery. Dabigatran was the first DOAC to have its own specific reversal agent: idarucizumab, a monoclonal antibody. Case summary We report here the case of a patient undergoing treatment with dabigatran that suffered an expansive subdural haematoma secondary to a cranial injury. The condition was life-threatening and required emergency surgery. Anticoagulation was successfully reversed with idarucizumab. Discussion Emergency surgery in patients in treatment with DOAC is associated with an increased risk of bleeding. With the use of a specific antidote to block the action of the anticoagulant, as in the case of idarucizumab with dabigatran, the risk of complications during and after emergency surgery is reduced. This is the first case report with which the successful use of idarucizumab in Latin America is documented.

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Idiopathic aplastic anemia: a rare case report in Jammu and Kashmir region, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20192468 ◽

2019 ◽

Vol 8 (6) ◽

pp. 2559

Author(s):

Smriti Sharma ◽

Upma . ◽

Deep Mani

Keyword(s):

Case Report ◽

Aplastic Anemia ◽

Rare Case ◽

Immunosuppressive Agents ◽

Unknown Origin ◽

Normal Incidence ◽

Jammu And Kashmir ◽

First Case ◽

Rare Case Report ◽

Life Threatening

Idiopathic aplastic anemia is a pancytopenia disorder that is a rare but life threatening for both mother and fetus during pregnancy. Association of aplastic anemia with pregnancy is unclear but considered to be interrelated. Bone marrow transplantation is the most effective treatment for adult aplastic anemia but is inadvisable to perform during pregnancy because of the teratogenic effect of immunosuppressive agents or radiation therapy to the growing fetus. Supportive care, withdrawal from offending drugs and involving erythrocytes and platelets transfusion is a promising way to save the life. Here author present a case report of 36-year-old lady with idiopathy aplastic anemia. In this case medical investigation revealed severe anemia of unknown origin. The patient was treated with hematinics, blood transfusion and glucocorticoids. A healthy baby was delivered without evidence of hemolysis at her eight month and one week of pregnancy, the patient recovered and discharged with normal incidence. Being a rare case, it becomes a necessity to report such life-threatening disorder and management. Moreover, to our knowledge this is the first case reported of its kind from Jammu and Kashmir Division of India.

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Life-threatening digoxin toxicity due to drug–drug interactions in an HIV-positive man

International Journal of STD & AIDS ◽

10.1177/0956462416661437 ◽

2016 ◽

Vol 28 (3) ◽

pp. 297-301 ◽

Cited By ~ 6

Author(s):

Kathir Yoganathan ◽

Beth Roberts ◽

Martyn K Heatley

Keyword(s):

Drug Interaction ◽

Case Report ◽

Drug Interactions ◽

Digoxin Toxicity ◽

Hiv Positive ◽

Hiv Patients ◽

First Case ◽

Life Threatening ◽

Drug Drug Interaction ◽

Positive Population

Drug–drug interactions with corticosteroids, causing Cushing’s syndrome with secondary adrenal suppression, are well known in HIV patients. Corticosteroids are widely prescribed in the HIV-positive population. However, digoxin is rarely used in HIV patients; hence, digoxin toxicity due to drug–drug interaction is not widely recognised. Nevertheless, this practice might change in the future as HIV cohorts of patients are ageing, due to the successful treatment of HIV infection with combination antiretroviral therapy. We report a case of digoxin toxicity in an HIV-positive 51-year-old man, due to a combination of drug–drug interaction and renal impairment. The first case report of digoxin toxicity due to drug–drug interaction with ritonavir in an HIV-positive woman was published in 2003. To the best of our knowledge, no similar case report has since been published in the literature. This case alerts the profession to the importance of drug–drug interaction and highlights the clinical features of digoxin toxicity.

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