scholarly journals Fatal Outcome of Emphysematous Gastritis due to Sarcina ventriculi Infection

2021 ◽  
pp. 933-938
Author(s):  
Anita Savić Vuković ◽  
Nives Jonjić ◽  
Ana Bosak Veršić ◽  
Dražen Kovač ◽  
Marko Radman
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Incidental Finding ◽  
Ductus Arteriosus ◽  
Fatal Outcome ◽  
Sarcina Ventriculi ◽  
Asymptomatic Patients ◽  
Emphysematous Gastritis ◽  
Life Threatening

<i>Sarcina ventriculi</i> is an increasingly common bacterium with a variable pathogenic role. It is often an incidental finding in asymptomatic patients but can also lead to life-threatening conditions, such as gastric perforation and emphysematous gastritis. We report a case of a 14-year-old boy with fatal emphysematous gastritis caused by <i>S. ventriculi</i>, who presented with abdominal pain and vomiting. His medical history included infantile left hemiparesis and operation of patent ductus arteriosus. Emergency surgery was scheduled due to the extremely dilated stomach and gastric pneumatosis, and a total gastrectomy was performed. On the third postoperative day, he suddenly dies, and the diagnosis was confirmed postmortem. This case is an opportunity to review the clinical presentation of emphysematous gastritis and to point out the role of the histopathological examination for the identification of the bacteria.

scholarly journals An Unusual Histology for a Lung Nodule: A Case Report of Primary Pulmonary Paraganglioma

2021 ◽  
Vol 8 ◽  
Author(s):  
Alessandra Mazzucco ◽  
Eleonora Poirè ◽  
Andrea Leporati ◽  
Matteo Chiari ◽  
Laura Moneghini ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Incidental Finding ◽  
Lung Nodule ◽  
Pulmonary Tissue ◽  
Case Presentation ◽  
X Ray ◽  
Asymptomatic Patients ◽  
Chest X Ray

Introduction: Primary pulmonary paraganglioma is a rare tumor with few cases reported in literature and unspecific clinical presentation.Case Presentation: A 49-year-old woman presented to our department with an incidental finding of a pulmonary mass at chest X-ray and no associated clinical symptom. The CT scan and the FDG-PET showed mild uptake of contrast, but a definitive diagnosis was only possible after surgery through histopathological examination.Conclusion: Paragangliomas originating in the pulmonary tissue are generally non-functioning masses discovered incidentally in otherwise asymptomatic patients. Surgery appears to be the best treatment option, with only radiologic follow-up necessary afterwards.

scholarly journals Postmortem Diagnosis of Gastric Ulcer Perforation and Peritonitis with Sarcina Ventriculi: A Case Report

2019 ◽  
Vol 24 (1) ◽  
pp. 80-82
Author(s):  
Aytül Buğra ◽  
Taner Daş ◽  
Neval Elgörmüş ◽  
Gizem Ayaz
Keyword(s):  
Gastric Ulcer ◽  
Delayed Gastric Emptying ◽  
Gastric Perforation ◽  
Histopathological Examination ◽  
Case Reports ◽  
Postmortem Diagnosis ◽  
Sarcina Ventriculi ◽  
Ulcer Perforation ◽  
Emphysematous Gastritis ◽  
Life Threatening

Sarcina ventriculi is a gram-positive anaerobic coccus with characteristic tetrad morphology. Sarcina ventriculiis identified by light microscopy with features of basophilic staining, cuboidal shape, tetrad morphology, and refractile nature. There have been very few case reports of Sarcina ventriculi reported in the literature. We present a case of a 53-year-old male, with gastric ulcer perforation where peritonitis was incidentally found to harbor Sarcina ventriculi in postmortem histopathological examination. Most of the cases exhibit abdominal pain, nausea, vomiting and delayed gastric emptying. It has also fatal life-threatening complications, such as gastric perforation and emphysematous gastritis. The histopathological examination has a key role for identification of the bacteria. The pathologist must always keep it in mind these bacteria as a cause of gastric ulcer perforation in the differential diagnosis. We want to present a case of a 53-year-old male gastric ulcer perforation who was found dead in his bed.

scholarly journals Emphysematous Gastritis Associated with Sarcina ventriculi

2019 ◽  
Vol 13 (1) ◽  
pp. 207-213 ◽  
Author(s):  
Kevin Singh
Keyword(s):  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Clinical Presentation ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Sarcina Ventriculi ◽  
Emphysematous Gastritis ◽  
Gastrointestinal Emergency

Emphysematous gastritis is a rare and lethal gastrointestinal emergency if not promptly identified and managed. In rare cases, emphysematous gastritis is associated with Sarcina ventriculi infection, usually in patients with delayed gastric emptying. Here we report a lethal case of S. ventriculi-associated emphysematous gastritis in the absence of delayed gastric emptying in which the diagnosis was confirmed postmortem. This case provides an opportunity to review the clinical presentation, pathophysiology, and management of emphysematous gastritis so that the condition can be promptly diagnosed and managed to prevent significant morbidity and mortality.

Nutcracker syndrome and phenomenon

2015 ◽  
Author(s):  
John Neary ◽  
Neil Turner
Keyword(s):  
Renal Vein ◽  
Incidental Finding ◽  
Left Renal Vein ◽  
Stent Migration ◽  
Nutcracker Syndrome ◽  
Pain Syndromes ◽  
Asymptomatic Patients ◽  
Weak Evidence ◽  
Life Threatening ◽  
Postural Proteinuria

Nutcracker syndrome describes symptomatology associated with obstruction to the left renal vein caused by pressure from the overlying superior mesenteric artery. Modern imaging methods show that some degree of left renal vein obstruction may be a common incidental finding in asymptomatic patients so it is better described as ‘nutcracker phenomenon’, NCP. The association of NCP with symptoms and signs is often speculative. NCP may be seen at any age but most patients with symptoms attributed to it are teenagers or young adults. The strongest evidence is for association with episodic macroscopic haematuria. There is weak evidence that it may in some circumstances account for orthostatic (postural) proteinuria, microscopic haematuria, or pain syndromes. Apart from rare examples of extreme haemorrhage the syndrome has not been associated with life-threatening features other than through complications of treatment. Various interventions have been employed, recently most commonly endovascular or extravascular approaches to stenting the vein, but serious adverse consequences from stent migration and thrombosis have been described.

scholarly journals Gastric Pneumatosis: Emphysematous Gastritis versus Gastric Emphysema

2019 ◽  
Vol 02 (02) ◽  
pp. 151-154
Author(s):  
Amit Kumar Paliwal ◽  
Sachin Girdhar ◽  
Somali Pattanayak ◽  
Brajesh Kumar
Keyword(s):  
Abdominal Surgery ◽  
Diabetic Patient ◽  
Clinical Presentation ◽  
Favorable Outcome ◽  
Radiological Findings ◽  
Benign Condition ◽  
Emphysematous Gastritis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Gastric Emphysema

AbstractPresence of air in the wall of the stomach is known as gastric pneumatosis. It may be associated with a benign condition like gastric emphysema (GE) to life threatening condition emphysematous gastritis (EG). Differentiation between two entities based on clinical presentation, predisposing factors, and radiological findings is important as EG has more complications and higher rates of mortality. The treatment in GE is conservative while treatment in EG is evolving. We present a case of a diabetic patient who developed EG following abdominal surgery and managed conservatively with favorable outcome.

scholarly journals Clinicopathological Study of Cholecystectomy Specimens

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2366-2370
Author(s):  
Sujata R Kanetkar ◽  
Anand Gudur ◽  
Rohit S Kadam ◽  
Atul B Hulwan ◽  
Pawar S J
Keyword(s):  
Odds Ratio ◽  
Biochemical Parameters ◽  
Blood Sugar Level ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Chronic Cholecystitis ◽  
Diabetic Patients ◽  
Significant Odds Ratio ◽  
Treatment Prognosis

In this study, there are possible causes of two years from June 2015 to May of 2017. During study includes 130 cases of cholecystectomy specimens from January 2013 to June 2017. The objective/purpose of the study is to correlate histopathological findings with various biochemical parameters viz. fasting blood sugar level, lipid profile, etc. Amongst the four cases of adenocarcinoma, 3 (75 %) cases showed serosal infiltration and liver infiltration. Out of a total of 130 cases, 69 (53%) were female, and 61 (47%) were male. Out of 4 patients of adenocarcinoma 2 (50%) patients expired during the postoperative period, while 2 (50%) patients improved. Diabetic patients constitute 13.84% of total cholecystectomy patients, so diabetes proved to be a risk factor for the development of gallbladder diseases with statistically significant Odds Ratio (2.66). Results from this study show that a variety of gallbladder lesions are observed in cholecystectomy specimens. The most common lesion observed was chronic cholecystitis with cholelithiasis 99 cases (76.1%), followed by acute cholecystitis 12 cases (9.2%). The present study was undertaken to emphasize the role of histopathological examination in cholecystectomy specimens and its correlation with clinical presentation. Histopathological examination many time reveals an unusual diagnosis bearing significant implications on the treatment, prognosis and outcome of the patient. Hence, the study was undertaken to emphasize the role of histopathological examination in cholecystectomy specimens and its correlation with clinical presentation.

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.

Cardiac myxomas: clinical presentation, diagnosis and management

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319479
Author(s):  
Andres G Griborio-Guzman ◽  
Olexiy I Aseyev ◽  
Hyder Shah ◽  
Masoud Sadreddini
Keyword(s):  
Surgical Resection ◽  
Clinical Presentation ◽  
Survival Rates ◽  
Cardiac Tumours ◽  
Cardiac Symptoms ◽  
Asymptomatic Patients ◽  
Life Threatening ◽  
Line Imaging ◽  
Cardiac Myxomas ◽  
Work Up

Cardiac myxomas (CM) are the most common type of primary cardiac tumours in adults, which have an approximate incidence of up to 0.2% in some autopsy series. The purpose of this review is to summarise the literature on CM, including clinical presentation, differential diagnosis, work-up including imaging modalities and histopathology, management, and prognosis. CM are benign neoplasms developed from multipotent mesenchyme and usually present as an undifferentiated atrial mass. They are typically pedunculated and attached at the fossa ovalis, on the left side of the atrial septum. Potentially life-threatening, the presence of CM calls for prompt diagnosis and surgical resection. Infrequently asymptomatic, patients with CM exhibit various manifestations, ranging from influenza-like symptoms, heart failure and stroke, to sudden death. Although non-specific, a classic triad for CM involves constitutional, embolic, and obstructive or cardiac symptoms. CM may be purposefully characterised or incidentally diagnosed on an echocardiogram, CT scan or cardiac MRI, all of which can help to differentiate CM from other differentials. Echocardiogram is the first-line imaging technique; however, it is fallible, potentially resulting in uncommonly situated CM being overlooked. The diagnosis of CM can often be established based on clinical, imaging and histopathology features. Definitive diagnosis requires macroscopic and histopathological assessment, including positivity for endothelial cell markers such as CD31 and CD34. Their prognosis is excellent when treated with prompt surgical resection, with postsurgical survival rates analogous to overall survival in the age-matched general population.

scholarly journals Sarcina ventriculi: A Rare Case of Life-Threatening Perforated Gastric Ulcer and Review of Literature

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Qing Wei ◽  
Sixto Leal ◽  
Morad Qarmali ◽  
Charles Mel Wilcox ◽  
Chirag Patel ◽  
...  
Keyword(s):  
Gastric Perforation ◽  
Gastrointestinal Surgery ◽  
Outlet Obstruction ◽  
Gastric Surgery ◽  
Gastric Ulcers ◽  
Resected Stomach ◽  
Sarcina Ventriculi ◽  
Emphysematous Gastritis ◽  
Life Threatening ◽  
History Of

Sarcina ventriculi is a gram-positive anaerobic bacterium reported rarely in patients with a history of gastrointestinal surgery and delayed gastric emptying. Sarcina has been implicated in the development of gastric ulcers, emphysematous gastritis, and gastric perforation. So far, less than 30 cases of Sarcina isolated from gastric specimens have been reported, including 3 cases associated with life-threatening illness: emphysematous gastritis and gastric perforation. Herein, we report a case of a 58-yearold woman with history of gastric surgery who presented for evaluation of persistent gastric pain and incurable ulcer. She underwent total gastrectomy, and the resected stomach demonstrated a perforated ulcer with the presence of Sarcina microorganisms. We also report a second case of a 56-year-old woman with history of NSAID use who presented with gastric outlet obstruction. The gastric biopsy identifi ed concurrent Helicobacter pylori and Sarcina. Given Sarcina‘s association with emphysematous gastritis and gastric perforation, its identifi cation on gastric biopsies should be clearly stated in pathology reports and, depending on the clinical scenario, prompt clinicians to add adjunctive antimicrobials to anti-ulcer therapeutic regimens.

scholarly journals The role of apraclonidine in Horner’s syndrome: A case report

2016 ◽  
Vol 144 (5-6) ◽  
pp. 312-314
Author(s):  
Jelena Karadzic ◽  
Igor Kovacevic ◽  
Jelena Ljikar
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Diagnostic Value ◽  
Surgical Removal ◽  
Imaging Studies ◽  
Life Threatening ◽  
History Of ◽  
Previous Medical History ◽  
Sympathetic Pathway

Introduction. Horner?s syndrome is an interruption of the sympathetic nervous system at any point along its course between the hypothalamus and the orbit. Horner?s syndrome is classically presented as an ipsilateral miosis, subtle ptosis, and facial anhidrosis. Pharmacologic testing is very useful in the diagnosis of Horner?s syndrome as it could help to localize the lesioned neuron in the sympathetic pathway, suggesting an etiology. Case Outline. We present a case report of a 41-year-old woman who reported right eyelid drooping immediately after operation of sympathetic chain schwannoma. We performed apraclonidine test for the diagnosis of Horner?s syndrome, which produced mydriasis on the affected eye, while there was no significant change of the normal eye. Based on the clinical presentation of anisocoria and one-sided ptosis, and previous medical history of surgical removal of the mediastinal tumor, the patient was diagnosed with a right-sided, partial Horner?s syndrome. Conclusion. Timely recognition, exact localization of the lesioned neuron, and referral for urgent imaging studies are important for ophthalmologists in order to prevent and treat life-threatening conditions. Besides its diagnostic value in Horner?s syndrome, topical apraclonidine could correct ptosis for the sake of esthetics or when ptosis reduces the superior visual field.

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