Yellowish lesions in the oesophagus

Gut ◽  
2017 ◽  
Vol 68 (1) ◽  
pp. 39-158
Author(s):  
Kenta Hamada ◽  
Yasushi Yamasaki ◽  
Jun-ichi Kubota ◽  
Hiroyuki Okada
Keyword(s):  
Clinical Presentation ◽  
Blood Tests ◽  
Normal Limits ◽  
Surface Figure ◽  
Previous Disease ◽  
Thoracic Oesophagus

Clinical presentationA 51-year-old man, who had no previous disease, underwent a screening oesophagogastroduodenoscopy, which revealed multiple yellowish lesions in the middle thoracic oesophagus. All lesions were ≤3 mm in size and slightly elevated. Each lesion showed one or two white protrusions on the surface (figure 1). We observed that one lesion looked obviously different from the others and showed yellowish granular spots (figure 2). A biopsy was performed on a representative lesion among the slightly elevated yellowish lesions with white protrusions (figure 3). A biopsy was repeated on a lesion showing yellowish granular spots (figure 4). Blood tests which were examined on the same day, including triglyceride and cholesterol, were within normal limits. Figure 1Slightly elevated yellowish lesions with white protrusions in the middle thoracic oesophagus.Figure 2A lesion showing yellowish granular spots in the middle thoracic oesophagus.QuestionWhat is the diagnosis?

scholarly journals Olmesartan-Induced Enteropathy: A Case of Recurrent Diarrhoea

2020 ◽  
Author(s):  
Ana Rita Matos ◽  
Elisabete Coelho ◽  
Sofia Caridade
Keyword(s):  
Clinical Presentation ◽  
Villous Atrophy ◽  
Kidney Injury ◽  
Duodenal Mucosa ◽  
Outpatient Basis ◽  
Antibody Testing ◽  
Blood Tests ◽  
History Of ◽  
Biopsy Examination ◽  
Previous Admission

A 77-year-old man with arterial hypertension and dyslipidaemia, treated with olmesartan/hydrochlorothiazide and simvastatin, was admitted with a 3-week history of anorexia, nausea, vomiting, profuse diarrhoea and weight loss. He was dehydrated and blood tests showed acute kidney injury. The aetiological study was inconclusive. The patient had a favourable clinical evolution during hospitalization and was discharged. However, after about 10 days at home, he was re-admitted to hospital with the same clinical presentation. It was noticed that olmesartan had not been prescribed during the previous admission but had been restarted on an outpatient basis. Biopsy examination showed duodenal mucosa with villous atrophy and polymorphic inflammatory infiltrate. Antibody testing for coeliac disease was negative. Based on these facts, it was hypothesized that the patient had olmesartan-induced enteropathy, which was subsequently confirmed.

scholarly journals COVID-19 in a child with multiple comorbidities

2021 ◽  
Vol 24 (3) ◽  
pp. 153-155
Author(s):  
Elena-Cristina Sandu ◽  
◽  
Geta Vancea ◽  
Nicoleta Voicu-Pârvu ◽  
Dana Ispas ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Female Child ◽  
Febrile Episode ◽  
Rt Pcr ◽  
Blood Tests ◽  
Normal Limits ◽  
Good General Condition ◽  
Neurological Conditions ◽  
And Control ◽  
Inflammatory Syndrome

A female child, 1 year-old and 2 months, diagnosed with multiple neurological conditions, including myelomeningocele and operated hydrocephalus, was diagnosed with SARS-CoV-2 in October 2020 and hospitalized in our clinic. At the time of the onset of the disease, the patient had a febrile episode, laboratory blood tests showed a slightly increased biological inflammatory syndrome, and mixed pneumonia was described radiologically. Thus, antibiotic treatment was initiated, with laboratory tests and control imaging within normal limits after several days of admission. Being an institutionalized child, according to the epidemiological recommendations of that time, she was hospitalized in our clinic during the 14 days of the illness. Thus, on the 15th day of the disease she was discharged, with negative SARS-CoV-2 control RT-PCR, with good general condition, afebrile over 10 days.

scholarly journals Renal Metastasis from Submandibular Gland Adenocarcinoma First Reported Patient in Literature History

2019 ◽  
Vol 2 (3) ◽  
pp. e1-e4
Author(s):  
M D Ahmed ◽  
N Tofazzal ◽  
R Nirula ◽  
J A Thomas ◽  
Ananda Kumar Dhanasekaran
Keyword(s):  
Salivary Gland ◽  
Submandibular Gland ◽  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
History Taking ◽  
Renal Metastasis ◽  
Salivary Gland Tumours ◽  
Literature History ◽  
Previous Disease ◽  
Immunohistochemical Identification

This paper presents a patient of primary submandibular gland adenocarcinoma later presenting with renal metastasis. Renal cancers are known for its predisposition to unusual metastasis to other organs. On the contrary, renal metastasis from salivary gland tumours are extremely rare with none reported from the submandibular gland to date. Hence the significance of adequate history taking, immunohistochemical identification of pathology and multidisciplinary approach in the management of such rare clinical presentation is discussed here. Metastatic disease should always be a differential when evaluating cancer patients regardless of the interval since previous disease or rarity of occurrence.

scholarly journals Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Thanisorn Sukakul ◽  
Supenya Varothai
Keyword(s):  
Autoimmune Disease ◽  
Rare Variant ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Direct Immunofluorescence ◽  
Unusual Manifestation ◽  
Blood Tests ◽  
Immunofluorescence Studies ◽  
Elisa Technique ◽  
Pemphigus Vegetans

Pemphigus vegetans is a rare variant of deep acantholytic pemphigus which usually presents with vesiculobullous rash and vegetative plaques on the folds. We report a case of pemphigus vegetans patient who presented with rashes on tips of fingers and toes resembling paronychia and onychomadesis that misled the diagnosis for months. The final diagnosis of Hallopeau-type pemphigus vegetans was made based on histopathology and direct immunofluorescence studies. Interestingly, not only the clinical presentation was atypical, but blood tests for anti-desmoglein 1 and 3 antibodies by ELISA technique were also negative. Thus, the rare unusual manifestation of pemphigus vegetans in this patient may associate with different autoantibodies to desmosomal proteins compared with those of classic pemphigus patients.

Bilateral Complete Congenital Choanal Atresia in an 18-month-old Female Child with Rare Clinical Presentation: Transnasal Endoscopic Repair with Stent

2016 ◽  
Vol 9 (3) ◽  
pp. 153-154
Author(s):  
Satyawati Mohindra
Keyword(s):  
Cleft Lip ◽  
Clinical Presentation ◽  
Choanal Atresia ◽  
Female Child ◽  
Nasal Discharge ◽  
Delayed Presentation ◽  
Endoscopic Repair ◽  
Normal Limits ◽  
Transnasal Endoscopic Repair ◽  
Threatening Situation

ABSTRACT Congenital choanal atresia (CCA) is the developmental failure of the nasal cavity to communicate with the nasopharynx. Surgical repair is recommended in the first weeks of life in bilateral congenital choanal atresia (BCCA), because this is a life-threatening situation in newborns as they are obligate nose breathers. This article reports on an 18-month-old female child, with delayed presentation of bilateral choanal atresia, treated successfully endoscopically and stent placement postoperatively. Case report The patient is an 18-month-old female child, born full term, by cesarean section (for cephalopelvic disproportion) with birth weight 3,750 gm to a 30-year-old primigravida. There were no immediate prenatal or postnatal medical or surgical problems in the mother. The child cried immediately after birth, there was no postnatal respiratory distress, cyanosis, or any major hospital admission. On examination, microcephaly (head circumference 46 cm below 2 standard deviation of the mean), hypertelorism, ani-Mongolian slanted eyes, left side cleft lip with high arched palate with malocclusion were observed. She presented late with c/o nasal discharge and mild breathing difficulty on breastfeeding. The catheter test revealed the diagnosis of BCCA. Noncontrast computed tomography (CT) scan nose was done, which showed nonposterior choana blocked with bony plates on both the sides (Fig. 1). The paranasal sinuses, orbit, and anterior nasal cavities were within normal limits. Transnasal endoscopic repair was done under general anesthesia. Endoscopy revealed a bony atresia (Fig. 2), which was drilled out keeping the direction medially and inferiorly. Feeding tubes were fashioned as stents and placed for a period of 6 weeks. There were no postoperative complications. The patient was referred to pediatric surgery for other problems. Endoscopy confirmed bilateral patency at 12 weeks postoperatively. How to cite this article Mohindra S, Gupta AK. Bilateral Complete Congenital Choanal Atresia in an 18-month-old Female Child with Rare Clinical Presentation: Transnasal Endoscopic Repair with Stent. Clin Rhinol An Int J 2016;9(3):153-154.

scholarly journals Infarto de omento mayor. Presentación de dos casos con un tratamiento conservador

2020 ◽  
Vol 50 (3) ◽  
Author(s):  
Nolberto Adrián Medina-Gallardo ◽  
Yuhamy Curbelo-Peña ◽  
Júlia Gardenyes-Martínez ◽  
Tomás Stickar ◽  
Javier De Castro-Gutiérrez ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Conservative Treatment ◽  
Emergency Service ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Ct Diagnosis ◽  
Abdominal Ct ◽  
Omental Infarction ◽  
Blood Tests ◽  
The Right

Omental infarction is a rare cause of acute abdominal pain. Cases. The report is based on two cases who attended to emergency, complaining of abdominal pain with CT diagnosis of omental infarction. We present a case of a 42 years old man who consulted to the emergency service for a pain in the right hemiabdomen, with elevated inflammatory markers in blood tests. Radiological examination by abdominal CT showed an omental torsion infarction. The patient evolved favourably with conservative treatment. The second case is a 85 years old man appendectomized who consulted for a pain in the left iliac foza with physical examination and complementary and radiological, it is concluded that it is an omental infarction, with a good evolution due to the treatment. Discussion. Clinical diagnosis remains a challenge, due to its rarity and clinical presentation mimicking acute appendicitis or cholecystitis. Hence in the absence of imaging test, intraoperative diagnosis takes place. It can occur due to two main pathogenic mechanisms: Secondary to vascular pedicle torsion (primary or secondary to another abdominal pathology) or situations that predispose to thrombosis. Conclusion. Omental infarction should be considered in the differential diagnosis of acute abdominal pain. Once confirmed by CT abdominal scan, conservative treatment could be considered, avoiding unnecessary surgery.

scholarly journals Case Report: Aortitis associated with rheumatoid arthritis: A challenging rheumatoid vasculitis presentation

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1370
Author(s):  
Zeineb Teyeb ◽  
Mohamed Ben Salah ◽  
Lobna Kharrat ◽  
Imen Abdellali ◽  
Taieb Jomni ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Chest Pain ◽  
Clinical Presentation ◽  
Rare Complication ◽  
Rheumatoid Vasculitis ◽  
Rare Presentation ◽  
Blood Tests ◽  
High Doses ◽  
Inflammatory Syndrome

Rheumatoid vasculitis (RV) is a rare but serious extra-articular manifestation of rheumatoid arthritis (RA). Its varied clinical presentation makes it hard to diagnose and treat. Hereby we describe a case of an aortitis revealing RV, which is a rare presentation of a rare complication of RA. A 56-year-old man with rheumatoid arthritis treated with methotrexate presented with fever, chest pain and arthritis. Blood tests revealed inflammatory syndrome associated with cholestasis. The diagnosis of pericarditis associated with aortitis was retained. Cholestasis was mostly due to methotrexate. The patient was treated with cyclophosphamide pulses and high doses of prednisolone. The patient was in complete remission of articular and extra-articular manifestations after two months of treatment.

scholarly journals Complex Etiology in a Case of Pulmonary Hypertension

2019 ◽  
Vol 16 (4) ◽  
pp. 47-55
Author(s):  
Andrei Georgian Florescu ◽  
Andrei Cristian Dan Gheorghe ◽  
Cristina Elena Georgescu ◽  
Alina Ștefania Luiceanu ◽  
Ioan Tiberiu Nanea ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Liver Disease ◽  
Clinical Presentation ◽  
Right Heart Failure ◽  
Review Of The Literature ◽  
Right Heart ◽  
Blood Tests ◽  
Wide Range ◽  
Rule Out

AbstractPorto-pulmonary hypertension (PPH) is the association between portal hypertension (PoH) due to liver disease or extra hepatic etiology and pulmonary hypertension (PH). It’s prevalence ranges between 2 and 16 % (1,2)and it’s diagnosis requires the exclusion of alternative causes of PH which can be sometimes challenging, especially in the context of a wide range of comorbidities that a patient with chronic liver disease can present with. We describe a 72 years-old man with a clinical presentation of right heart failure and signs of severe PH shown by the echocardiography. The blood tests were positive for anti-HCV antibodies and CT-imaging showed signs of cirrhosis and PoH. Complementary exams and review of the literature allowed use to rule out other potential causes constituting the differential diagnosis of the PH in this patient.

Diagnosis of Silica Induced Granulomatous Hypersensitivity

1982 ◽  
Vol 40 ◽  
pp. 336-337
Author(s):  
C. W. Mehard ◽  
W. L. Epstein
Keyword(s):  
Electron Microscope ◽  
White Female ◽  
X Rays ◽  
Blood Tests ◽  
Analytical Electron ◽  
Analytical Electron Microscope

The underlying cause of a disease may not he readily apparent but may have a long history in development. We report one such case which was diagnosed with the aid of the analytical electron microscope.The patient, a 48 yr. old white female, developed a tender nodule on the sole of her foot in December, 1981. Subsequently additional lesions developed on the same foot resulting in deep pain and tenderness. Superficial lesions also extended up to the knee on both legs. No abnormalities were revealed in blood tests or chest X-rays.

Jansky-Bielschowsky syndrome, a lysosomal disease: First diagnosed cash in Oman

1992 ◽  
Vol 50 (1) ◽  
pp. 632-633
Author(s):  
Line Buhl ◽  
David Muirhead
Keyword(s):  
Mental Retardation ◽  
Clinical Picture ◽  
Neurological Disorder ◽  
Clinical Presentation ◽  
Neuronal Ceroid Lipofuscinosis ◽  
Infantile Form ◽  
Lysosomal Disease ◽  
Juvenile Form ◽  
Progressive Encephalopathy ◽  
Lysosomal Diseases

There are four lysosomal diseases of which the neuronal ceroid lipofuscinosis is the rarest. The clinical presentation and their characteric abnormal ultrastructure subdivide them into four types. These are known as the Infantile form (Santavuori-Haltia), Late infantile form (Jansky-Bielschowsky), Juvenile form (Batten-Spielmeyer-Voght) and the Adult form (Kuph's).An 8 year old Omani girl presented wth myclonic jerks since the age of 4 years, with progressive encephalopathy, mental retardation, ataxia and loss of vision. An ophthalmoscopy was performed followed by rectal suction biopsies (fig. 1). A previous sibling had died of an undiagnosed neurological disorder with a similar clinical picture.

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