Sigmoid volvulus in children

2021 ◽  
Vol 14 (5) ◽  
pp. e241869
Author(s):  
Merete Berthu Damkjaer ◽  
Waqas Farooqui ◽  
Inge Ifaoui ◽  
Luit Penninga
Keyword(s):  
Differential Diagnosis ◽  
Ct Scan ◽  
Sigmoid Volvulus ◽  
Abdominal Discomfort ◽  
Paediatric Patients ◽  
Threatening Condition ◽  
Life Threatening ◽  
Abdominal Distress ◽  
Emergency Resection

Sigmoid volvulus in paediatric patients is a rare but potentially life-threatening condition. Since 1940, only 100 cases have been reported. There are no consensual guidelines for juvenile sigmoid volvulus unlike in adults, where the condition and the treatment is well described. We report a case of a 12-year-old patient, who presented with uncharacteristic symptoms of mild abdominal discomfort and lack of passage of stool. A CT-scan showed a sigmoid volvulus and emergency resection was performed with placement of a colostomy. With this case, we want to emphasise juvenile sigmoid volvulus as a probable differential diagnosis when symptoms of abdominal distress and constipation occur.

scholarly journals T-wave inversion in the precordial leads: сardiac and non-cardiac causes

Kardiologiia ◽  
2020 ◽  
Vol 60 (5) ◽  
pp. 136-145
Author(s):  
I. R. Tsoy ◽  
I. P. Kolos
Keyword(s):  
Pulmonary Embolism ◽  
Differential Diagnosis ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Arrhythmogenic Cardiomyopathy ◽  
Cardiac Memory ◽  
T Wave ◽  
Wave Inversion ◽  
Threatening Condition ◽  
Life Threatening

The T-wave inversion (TWI) is a common electrocardiographic finding. Causes for TWI are numerous and sometimes TWI may appear in life-threatening conditions. The aim of this review was to provide an up-to-date analysis of TWI, including i) definition and prevalence; ii) causes, and iii) differential diagnosis in benign TWI, reversible myocardial ischemia of the left ventricular anterior wall; takotsubo cardiomyopathy; subarachnoid hemorrhage; pulmonary embolism; right ventricular arrhythmogenic cardiomyopathy; and “cardiac memory”. The review presents practical electrophysiological criteria, which allow suspecting in time a life-threatening condition to choose an up-to-date treatment.

Methaemoglobinaemia from Vagisil creme in a 50-year-old woman

2021 ◽  
Vol 14 (3) ◽  
pp. e239697
Author(s):  
Sarah Cheyney ◽  
Zachary Field ◽  
Jacqueline Kropf ◽  
Steve Carlan
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Topical Anaesthetic ◽  
Over The Counter ◽  
Perimenopausal Woman ◽  
Threatening Condition ◽  
Life Threatening

Methaemoglobinaemia is a life-threatening condition that results from increased methaemoglobin production. As methaemoglobin is unable to reversibly bind to oxygen potentially lethal hypoxia and functional anaemia can occur. Benzocaine can be used as a topical anaesthetic and can be found in many nonprescription preparations marketed for self-application. It is known to cause methaemoglobinaemia in rare cases but most reports describe the complication occurring during endoscopy procedures. Methaemoglobinaemia occurring after topical benzocaine use on the perineum of a perimenopausal woman is exceedingly rare. A 50-year-old woman with methaemoglobinaemia secondary to the perineal application of over-the counter Vagisil (benzocaine 20% and resorcinol 3%- an antiseptic and disinfectant, respectively) presented to the emergency department. She had been using Vagisil for severe, chronic vaginal itching. While methaemoglobinaemia secondary to excessive use of over-the-counter medications such as Vagisil creme is exceedingly rare, it should be included in the differential diagnosis.

scholarly journals A case of lung injury resembling diffuse pulmonary hemorrhage after the first administration of alemtuzumab in a patient with multiple sclerosis. Role of the HRCT

2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Gaia Cipolla ◽  
Rosalba Relo ◽  
Elisa Pasciuta ◽  
Domenica Catalano ◽  
Federica Lo Bello ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Ct Scan ◽  
Pulmonary Hemorrhage ◽  
Diffuse Alveolar Hemorrhage ◽  
Ground Glass ◽  
Threatening Condition ◽  
Life Threatening ◽  
Variable Combination ◽  
Total Disappearance

Diffuse alveolar hemorrhage (DAH) is an acute often life-threatening condition characterized by a variable combination of hemoptysis, dyspnoea, diffuse and bilateral ground glass pulmonary opacities, anemia and hypoxemia, that can be induced by different causes, including several drugs. We report here the case of a 25-year-old woman who has been admitted to our pulmonary clinic for the onset of chest pain, cough and haemoptysis, started one week after her first treatment with alemtuzumab for multiple sclerosis. Computed tomography (CT) scan of the chest at the admission showed diffuse and bilateral ground glass pulmonary opacities. Her symptoms resolved completely without any treatment, after the interruption of alemtuzumab, and CT scan of the chest performed one month later showed total disappearance of the pulmonary opacities.

scholarly journals Sudden cardiac arrest associated with myxedema coma due to undiagnosed hypothyroidism: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asami Yoshinaka ◽  
Masayuki Akatsuka ◽  
Shuji Yamamoto ◽  
Michiaki Yamakage
Keyword(s):  
Cardiac Arrest ◽  
Differential Diagnosis ◽  
Physical Examination ◽  
Sudden Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Clinical Findings ◽  
Neurological Dysfunction ◽  
Myxedema Coma ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background Myxedema coma, which occurs due to hypothyroidism, is a rare and life-threatening condition. Some patients have hemodynamic dysfunction, which consequently leads to cardiac arrest. The rarity of this condition makes it difficult to determine the cause of cardiac arrest. It is important to diagnose myxedema coma based on clinical findings, including physical examination and laboratory parameters. We present a case of undiagnosed and untreated hypothyroidism that initially caused myxedema coma and then led to cardiac arrest. Case presentation A 56-year-old woman who had no medical history was transferred to our hospital for the management of return of spontaneous circulation due to sudden cardiac arrest. Findings of laboratory tests revealed that she had hypothyroidism. On physical examination, she was found to have a puffy face, thin eyebrows, and severe systemic non-pitting edema. Therefore, the patient was clinically diagnosed with myxedema coma, which was the cause of cardiac arrest. She was treated with thyroid hormone and hydrocortisone, resulting in improvement in her general condition, except for the neurological dysfunction. Conclusions This case suggests that myxedema coma is caused by undiagnosed and untreated hypothyroidism, leading to sudden cardiac arrest. Our findings are useful in the differential diagnosis of hypothyroidism based on characteristic physical examination findings. Clinicians should be aware of the differential diagnosis of myxedema coma based on findings from physical examination and laboratory testing of thyroid function, and the treatment should be started immediately.

scholarly journals Differential Diagnosis of HyperCKemia

2018 ◽  
Vol 02 (01) ◽  
pp. E72-E83 ◽  
Author(s):  
Rudolf Kley ◽  
Tobias Schmidt-Wilcke ◽  
Matthias Vorgerd
Keyword(s):  
Differential Diagnosis ◽  
Incidental Finding ◽  
Elevated Serum ◽  
Asymptomatic Patients ◽  
Upper Limits ◽  
Electrophysiological Studies ◽  
Threatening Condition ◽  
Life Threatening ◽  
Muscle Disorder ◽  
The Individual

AbstractElevated serum creatine kinase (CK) activity is usually an indicator of muscle damage. HyperCKemia is often an incidental finding and should be controlled after refraining from physical activity for some days, especially in asymptomatic patients. Furthermore, data from recent studies indicate that the upper limits of normal (ULN) need to be revised upward. This review includes an algorithm for the differential diagnosis of CK elevation in patients without muscular symptoms. In the field of neurology, in particular myopathies and neuropathies with affection of the lower motor neuron can cause symptomatic hyperCKemia, with CK values >1000 U/l (16,7 µkat/l) being indicative of a primary muscle disorder. Diseases with very high CK values include subtypes of muscular dystrophies, idiopathic inflammatory myopathies and metabolic myopathies. However, a normal or only slightly elevated CK value does not exclude the presence of a myopathy. The individual diagnostic procedure (e. g., muscle imaging, special laboratory studies, muscle biopsy and genetic testing) depends on the clinical phenotype and the results of electrophysiological studies. HyperCKemia can also be an adverse effect of several drugs including statins. In asymptomatic patients, statin-associated CK elevations <5 times the ULN can be tolerated. In patients with higher CK values and/or muscle symptoms, LDL-cholesterol lowering therapy should be changed. Rhabdomyolysis is a potentially life-threatening condition and is accompanied by highly elevated CK values. Acute phase treatment includes preserving renal function and restoring metabolic derangements.

Serotonin toxicity

2011 ◽  
Vol 28 (2) ◽  
pp. i-iv ◽  
Author(s):  
Sobia Nasim ◽  
Faraz Jabbar ◽  
Asfar Afridi ◽  
Brendan D Kelly
Keyword(s):  
Differential Diagnosis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Causal Agent ◽  
Vital Functions ◽  
Threatening Condition ◽  
Life Threatening ◽  
Clinical Signs And Symptoms ◽  
High Index Of Suspicion ◽  
Serotonin Toxicity

Serotonin toxicity is a potentially life-threatening condition associated with a range of psychotropic medications, co-administration of specific combinations of agents and overdose of certain drugs. It is associated with a wide diversity of clinical signs and symptoms, including cognitive, autonomic and somatic effects, as well as serious complications, including possible death. Diagnosis is often challenging and requires a high index of suspicion. Differential diagnosis includes syndromes such as neuroleptic malignant syndrome. Management depends on the causal agent and urgency of clinical presentation. Treatment may involve discontinuing the causal agent and providing supportive measures, or emergency intervention to preserve vital functions (airway, breathing, circulation), amongst other measures. Further research is needed to clarify the incidence of serotonin toxicity, issues related to differential diagnosis, optimal management of the condition, and treatment of mood problems following serotonin toxicity.

scholarly journals Diagnostic uncertainty in a case of neuroleptic malignant syndrome

CJEM ◽  
2005 ◽  
Vol 7 (04) ◽  
pp. 266-272 ◽  
Author(s):  
Dallas P. Seitz
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Criteria ◽  
Neuroleptic Malignant Syndrome ◽  
Muscle Rigidity ◽  
Atypical Presentation ◽  
Diagnostic Uncertainty ◽  
Threatening Condition ◽  
Life Threatening ◽  
Psychiatric Conditions ◽  
Delays In Diagnosis

ABSTRACTNeuroleptic malignant syndrome (NMS) is a potentially life-threatening condition that has been associated with antipsychotic use. Most diagnostic criteria include fever and muscle rigidity, although NMS may present without either. Diagnostic uncertainty in such cases may result in delays in diagnosis and management, leading to adverse consequences for these patients. The differential diagnosis of NMS is broad and includes a number of neurological, medical and psychiatric conditions as well as substance and medication-induced disorders. A case is described that illustrates an atypical presentation of NMS and demonstrates some of the challenges in its diagnosis. Limitations of current NMS criteria are also examined, and suggestions for future criteria are presented.

scholarly journals Prenatal Diagnosis and Pathology of Laryngeal Atresia in Congenital High Airway Obstruction Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Piya Chaemsaithong ◽  
Tharintorn Chansoon ◽  
Boonsri Chanrachakul ◽  
Suchin Worawichawong ◽  
Sansanee Wongwaisayawan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Prenatal Diagnosis ◽  
Airway Obstruction ◽  
Pathological Examination ◽  
Congenital Cystic Adenomatoid Malformation ◽  
External Compression ◽  
Laryngeal Atresia ◽  
Threatening Condition ◽  
Life Threatening ◽  
Elective Termination

Congenital high airway obstruction syndrome is a rare but life-threatening condition. Therefore, prenatal diagnosis is important. The obstruction can be due to laryngeal/tracheal atresia or external compression. While a differential diagnosis with congenital cystic adenomatoid malformation (CCAM) type III may be difficult, it is still possible with ultrasonography. In this study, we report a case of bilateral echogenic lungs with hydrops fetalis. After the prenatal diagnosis of laryngeal atresia, the couple opted to have an elective termination of pregnancy performed at 20 weeks of gestation. The diagnosis was confirmed by a complete pathological examination.

scholarly journals Cerebellar Infarct Accompanied by Acute Hydrocephalus: A Case Report of 1-Year Follow-up in Rural Neurosurgical Practice

2021 ◽  
Vol 9 (C) ◽  
pp. 280-285
Author(s):  
Reza Akbar Bastian ◽  
Rachmat Andi Hartanto ◽  
Rohmania Setiarini
Keyword(s):  
Ct Scan ◽  
Rural Areas ◽  
Signs And Symptoms ◽  
Acute Hydrocephalus ◽  
Standard Management ◽  
Threatening Condition ◽  
Life Threatening ◽  
Contrast Ct ◽  
Cerebellar Infarct

Cerebellar infarctions account for about 2-3% of all ischemic strokes, and acute hydrocephalus due to brainstem compression or compression of the cerebrospinal fluid (CSF) flows is a rare manifestation from a stroke of the posterior circulation. The condition is considered one of the most life-threatening complications in cerebellar infarct due to the possibility of transforaminal and upward transtentorial herniation. The management of patients with cerebellar infarct is challenging, because the patient usually presents with non-specific signs and symptoms until the patient loses consciousness. Standard management should be provided by a stroke unit team or neuro-intensive care unit. The precision timing of treatment and evaluation with close observation is crucial, even when there is no life-threatening condition at initial presentation, but sometimes it is difficult to fulfill in rural areas due to the substandard facilities and lack of resources. Here we report a case of cerebellar infarct with massive edema in association with acute hydrocephalus with the progressive deterioration that happened in a rural area. A 59-year-old male patient complained about an episode of sudden headache which was followed by dizziness, vomiting, and loss of balance. A head non-contrast CT scan in the emergency room (ER) is performed 4 hours after ictus, showed a slightly hypodense lesion in the left cerebellum, without accompanying edema and hydrocephalus. The patient was then managed conservatively in the ward. In the next 36 hours, his consciousness level was reduced and a head CT scan evaluation showed the development of massive edema of cerebellar infarct with acute hydrocephalus. The patient underwent an emergency surgical procedure with suboccipital decompressive craniectomy (SDC) with strokectomy, expanded duraplasty, and ventricular drainage (ventriculoperitoneal shunt). Satisfactory results with rapid resolution of GCS was seen at daily follow-up after surgery. A 1-year follow-up also showed remarkable outcomes.

scholarly journals A Rare Case of Primary Aortoduodenal Fistula

2020 ◽  
Vol 20 (2) ◽  
pp. 164-166
Author(s):  
Hyun Jin Bae ◽  
Byung-Wook Kim ◽  
Joon Sung Kim
Keyword(s):  
Differential Diagnosis ◽  
Mortality Rate ◽  
Blood Loss ◽  
Gastrointestinal Bleeding ◽  
Rare Case ◽  
Aortoduodenal Fistula ◽  
Gastrointestinal Blood Loss ◽  
Threatening Condition ◽  
Life Threatening

Aortoduodenal fistula is a rare but life-threatening condition that can cause gastrointestinal bleeding. Due to its rarity, it is often overlooked as a cause of gastrointestinal blood loss. Notably, the mortality rate of aortoduodenal fistula is nearly 100% in undiagnosed and untreated cases. We report a case of aortoduodenal fistula, which resulted in the patient’s death. This report highlights the importance of considering even extremely rare causes of gastrointestinal bleeding in the differential diagnosis in patients with such a presentation.

Sign in / Sign up

Export Citation Format

Share Document