scholarly journals Rare localization of angiolipoma in the gastrointestinal tract: a case series

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052093858
Author(s):  
Juan Sun ◽  
Weiming Kang ◽  
Ziyang Zeng ◽  
Zimu Zhang ◽  
Xianze Wang
Keyword(s):  
Gold Standard ◽  
Benign Tumor ◽  
Clinical Manifestations ◽  
Case Series ◽  
Diagnostic Techniques ◽  
Gi Tract ◽  
Elderly Men ◽  
Upper Gi ◽  
Clinical Presentations ◽  
Complete Surgical Resection

Objective Angiolipoma is a benign tumor that rarely occurs in the gastrointestinal (GI) tract. This case series was performed to increase clinicians’ understanding of the diagnosis and management of GI angiolipoma. Methods We evaluated the clinical presentations, diagnoses, and treatments of 3 patients with angiolipoma in the upper GI tract in our hospital and 27 cases reported in the literature. Results Among all 30 cases of GI angiolipoma, 2 originated in the esophagus, 4 in the stomach, 2 in the duodenum, 1 in the jejunum, 7 in the ileum, 1 in the cecum, 9 in the colon, 2 in the rectum, and 2 in both the duodenum and colon. Conclusion Angiolipoma of the GI tract may be more likely to occur in middle-aged and elderly men and be located in the ileum and colon. The clinical manifestations generally involve upper GI hemorrhage and lower GI pain and obstruction. Computed tomography and endoscopy may be effective diagnostic techniques, but postoperative histopathologic examination is still the gold standard. The management of angiolipoma in the GI tract depends on the size and type of lesion. Most cases in the present series were managed by complete surgical resection, after which no recurrence was found.

Scrub Typhus with Varied Clinical Presentations

2017 ◽  
Vol 13 (04) ◽  
pp. 319-322
Author(s):  
Susrita Banerjee ◽  
Satyabrata Roychowdhuri ◽  
Mihir Sarkar
Keyword(s):  
Scrub Typhus ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Case Series ◽  
Dengue Shock Syndrome ◽  
Tertiary Care Center ◽  
Eastern India ◽  
Clinical Presentations ◽  
Diagnostic Difficulties

AbstractWe present four cases of pediatric scrub typhus from a tertiary care center of eastern India, emphasizing on varied unusual clinical manifestations posing diagnostic difficulties. A low index of suspicion is required to prevent under diagnosis. We report a case series of four patients with scrub typhus having uncommon clinical manifestations (two patients with hemophagocytic lymphohistiocytosis, one patient with myocarditis, and one patient presenting with shock reminiscent of dengue shock syndrome). The response to doxycycline was good, with fever subsiding within 48 to 72 hours of starting the treatment. Three out of four cases completely recovered once appropriate medication was given.

scholarly journals Use of i-scan Endoscopic Image Enhancement Technology in Clinical Practice to Assist in Diagnostic and Therapeutic Endoscopy: A Case Series and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Shawn Hancock ◽  
Erik Bowman ◽  
Jyothiprashanth Prabakaran ◽  
Mark Benson ◽  
Rashmi Agni ◽  
...  
Keyword(s):  
Image Enhancement ◽  
Cell Cancer ◽  
Rectal Adenocarcinoma ◽  
Case Series ◽  
Gastric Malt Lymphoma ◽  
Rectal Ulcer ◽  
Tubular Adenoma ◽  
Gi Tract ◽  
Upper Gi ◽  
Upper Gi Tract

Background. i-scan is a software-driven technology that allows modifications of sharpness, hue, and contrast to enhance mucosal imaging. It uses postimage acquisition software with real-time mapping technology embedded in the endoscopic processor. Aims. To review applications of i-scan technology in clinical endoscopic practice. Methods. This is a case series of 20 consecutive patients who underwent endoscopic procedures where i-scan image enhancement algorithms were applied. The main outcome measures were to compare mucosal lesions with high-definition white light endoscopy (HD-WLE) and i-scan image enhancement for the application of diagnostic sampling and therapy. Results. 13 cases involving the upper GI tract and 7 cases of the lower GI tract are included. For upper GI tract pathology i-scan assisted in diagnosis or therapy of Barrett’s esophagus with dysplasia, esophageal adenocarcinoma, HSV esophagitis, gastric MALT lymphoma, gastric antral intestinal metaplasia with dysplasia, duodenal follicular lymphoma, and a flat duodenal adenoma. For lower GI tract pathology i-scan assisted in diagnosis or therapy of right-sided serrated adenomas, flat tubular adenoma, rectal adenocarcinoma, anal squamous cell cancer, solitary rectal ulcer, and radiation proctitis. Conclusions. i-scan imaging provides detailed topography of mucosal surfaces and delineates lesion edges, which can directly impact endoscopic management.

scholarly journals Kartagener’s syndrome: review of a case series

2015 ◽  
Vol 10 ◽  
Author(s):  
Nicola Ciancio ◽  
Maria Margherita De Santi ◽  
Raffaele Campisi ◽  
Laura Amato ◽  
Giuseppina Di Martino ◽  
...  
Keyword(s):  
Cross Sections ◽  
Genetic Disorder ◽  
Clinical Manifestations ◽  
Case Series ◽  
Central Position ◽  
Specialized Center ◽  
Clinical Presentations ◽  
Pathological Differentiation ◽  
Dynein Arms

Background: Kartagener Syndrome (KS) is a rare autosomal recessive genetic disorder, resulting in a group of clinical manifestations, including bronchiectasis, chronic pansinusitis and situs inversus. Methods: We hereby reviewed eight cases of this rare entity selected from patients attending our outpatients Respiratory Unit since 2006. Samples of respiratory epithelium were obtained with the method of nasal brushing and sent to a specialized center in order to be studied with electron microscopy. At least 50 cross sections of different cilia from different cells were observed in each specimen to study the axonemal structure. Electron micrographs were taken at a magnification of X 50,000 to determine the orientation of the cilia and at a magnification of X 110,000 to study the axonemal pattern. The incidence of abnormal cilia was expressed as a percentage. Results: We observed different ultrastructural defects in our KS patients, including absence of outer dynein arms, absence of outer and inner dynein arms, and absence of the central pair with transposition of a peripheral doublet into the central position. Patient’s follow up lasted till 2014, however two patients with more severe clinical behavior died before. Conclusions: This is a review of a case series, yet our data has shown that nasal brushing with ultrastructural pathological differentiation may be useful to identify patients with high risk and to develop more complex clinical presentations.

Management of Corrosive Injuries of Upper GI Tract: Case Series

2015 ◽  
Vol 13 (7) ◽  
pp. e97-e98
Author(s):  
Anusha Alluri ◽  
V. Krishnam Raju
Keyword(s):  
Case Series ◽  
Gi Tract ◽  
Upper Gi ◽  
Upper Gi Tract

scholarly journals Middle Fossa Encephaloceles Treated via the Transmastoid Approach: A Case Series and Review of the Literature

2021 ◽  
Author(s):  
Tyler Scullen ◽  
Zane Freeman ◽  
Mansour Mathkour ◽  
Joseph Lockwood ◽  
Rizwan Aslam ◽  
...  
Keyword(s):  
Average Length ◽  
Clinical Manifestations ◽  
Case Series ◽  
Cerebrospinal Fluid Leak ◽  
Middle Fossa ◽  
Short Term ◽  
Clinical Presentations ◽  
Tegmen Tympani ◽  
Transmastoid Approach

Abstract BACKGROUND Middle fossa (MF) encephaloceles are rare lesions resulting from herniation through defects in the tegmen tympani or mastoideum. Underlying etiologies and clinical presentations are variable. Surgical goals include fistula obliteration, resection of nonfunctioning parenchyma, and dehiscence repair. The middle cranial fossa approach (MCFA), transmastoid approach (TMA), and combined (MCFA + TMA) approaches have been described. The minimally invasive TMA provides excellent exposure of the pathology and allows for ample working room to repair the defect. OBJECTIVE We present short-term follow-up results in patients treated via the TM repair at our institution. METHODS A retrospective review of patients with symptomatic encephaloceles treated via the TMA by our multidisciplinary team. Patient demographics, clinical presentations, intraoperative findings, repair technique, and outcomes were highlighted. RESULTS A total of 16 encephaloceles in 13 patients were treated. Defect etiologies included spontaneous (50.0%), secondary to chronic infection (25.0%), or cholesteatoma (18.8%). Defects were most often within the tegmen mastoideum (68.8%). Average length of surgery was 3.3 h (95% CI: 2.86-3.67) and length of stay 3.9 d (95% CI: 3.09-4.79). On short-term follow-up (average 11.5 mo), no patients experienced postoperative cerebrospinal fluid leak or recurrence. The majority of patients (83.3%) experienced confirmed improvement or stabilization of hearing. CONCLUSION MF encephaloceles present with various clinical manifestations and result from multiple underlying etiologies. The TMA is an alternative to craniotomy and our short-term results suggest that this approach may be utilized effectively in appropriately selected cases.

scholarly journals Diverse clinical presentations of Moyamoya disease: a case series

2021 ◽  
Author(s):  
Hendrick Henrique Fernandes Gramasco ◽  
Mateus Felipe dos Santos ◽  
Yasmim Nadime José Frigo ◽  
Guilherme Drumond Jardini Anastácio ◽  
Stella de Angelis Trivellato ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Moyamoya Disease ◽  
Internal Carotid ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Case Series ◽  
Point Of View ◽  
Cerebrovascular Events ◽  
Clinical Presentations ◽  
Proximal Occlusion

Context: Moyamoya disease or chronic occlusive cerebrovascular disease is characterized by proximal occlusion of the internal carotid artery and its branches bilaterally, generating an angiographic “smoke” pattern (moyamoya, from Japanese “something hazy”) and by diverse ischemic manifestations. Case report: The sample consists of three female patients, aged between 13 and 46 years, followed in our service due to the diagnosis of Moyamoya Disease. Among the clinical manifestations presented, ischemic cerebrovascular events with neurological deficit predominated, and one of the patients presented two episodes compatible with stroke and one episode compatible with transient ischemic accident. The youngest patient presented with a choreic picture initially interpreted as Sydenham’s chorea. Although the gold standard for the diagnosis of chronic occlusive cerebrovascular disease is cerebral arterial angiography, it was possible to observe a pattern compatible with the disease in other modalities of examination, such as cerebral arterial angiotomography and cerebral arterial angioresonance. From the therapeutic point of view, one of the patients underwent surgical intervention (encephaloduromyosinangiosis), with improvement of symptoms after treatment. Conclusions: In this paper, we emphasize the importance of complementary imaging tests in the evaluation of patients with cerebrovascular syndromes and the diversity of clinical presentation of Moyamoya disease.

scholarly journals Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far?

2021 ◽  
Vol 28 (4) ◽  
pp. 2317-2325
Author(s):  
Luigi Bennardo ◽  
Francesco Bennardo ◽  
Amerigo Giudice ◽  
Maria Passante ◽  
Stefano Dastoli ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Gold Standard ◽  
Systemic Chemotherapy ◽  
Standard Treatment ◽  
Case Reports ◽  
Case Series ◽  
Surgical Removal ◽  
Local Chemotherapy

Background: Squamous cell carcinoma (SCC) is one of the most common cancers involving skin and oral mucosa. Although this condition’s gold-standard treatment is the surgical removal of the lesions, the physician must propose alternative treatments in some cases due to the patient’s ineligibility for surgery. Among the available alternative therapies, local chemotherapy may represent an initial treatment in combination with radiotherapy or systemic chemotherapy due to the low frequency of side-effects and the lack of necessity for expensive devices. Methods: In this paper, we review all available literature in various databases (PubMed, Scopus-Embase, Web of Science), proposing local chemotherapy as a treatment for cutaneous and oral SCC. Exclusion criteria included ocular lesions (where topical treatments are common), non-English language, and non-human studies. Results: We included 14 studies in this review. The majority were case reports and case series describing the treatment of non-resectable localized SCC with either imiquimod or 5-fluorouracil. We also analyzed small studies proposing combination treatments. Almost all studies reported an excellent clinical outcome, with a low risk of relapses in time. Conclusions: Resection of the lesion remains the gold-standard treatment for SCC. When this approach is not feasible, local chemotherapy may represent a treatment alternative, and it may also be associated with radiotherapy or systemic chemotherapy.

scholarly journals Clinical presentations and long term prognosis of childhood onset polyarteritis nodosa in single centre of Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Seon Lee ◽  
Joong-Gon Kim ◽  
Soyoung Lee
Keyword(s):  
Polyarteritis Nodosa ◽  
Clinical Manifestations ◽  
Long Term Outcomes ◽  
Childhood Onset ◽  
Laboratory Findings ◽  
Clinical Presentations ◽  
Long Term Prognosis ◽  
Digital Amputation

AbstractChildhood-onset polyarteritis nodosa (PAN) is a rare and systemic necrotising vasculitis in children affecting small- to medium-sized arteries. To date, there have been only a few reports because of its rarity. Thus, we aimed to investigate the clinical manifestations, laboratory findings, treatment, and long-term outcomes in patients with childhood-onset PAN and to evaluate the usefulness of the paediatric vasculitis activity score (PVAS). We retrospectively analysed the data of nine patients with childhood-onset PAN from March 2003 to February 2020. The median ages at symptom onset, diagnosis, and follow-up duration were 7.6 (3–17.5), 7.7 (3.5–17.6), and 7.0 (1.6–16.3) years, respectively. All patients had constitutional symptoms and skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. The median PVAS at diagnosis was 7 (range: 2–32). Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived, but three patients with high PVAS at diagnosis experienced irreversible sequelae, including intracranial haemorrhage and digital amputation. In conclusion, early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. This study suggests that high PVAS score at diagnosis may be associated with poor prognosis.

scholarly journals Autoimmune encephalitis in a South Asian population

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nilanka Wickramasinghe ◽  
Dhanushka Dasanayake ◽  
Neelika Malavige ◽  
Rajiva de Silva ◽  
Thashi Chang
Keyword(s):  
Sri Lanka ◽  
Psychiatric Symptoms ◽  
South Asians ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Autoimmune Encephalitis ◽  
Asian Population ◽  
South Asian Population ◽  
Clinical Presentations

Abstract Background Autoimmune encephalitis (AE) is now considered a main, potentially curable cause of encephalitis, but remains conspicuously underreported from South Asia. We studied the clinical characteristics in relation to their antibody status and outcomes of patients presenting with AE in Sri Lanka. Methods Patients admitting to government hospitals who were clinically suspected of AE by an on-site neurologist were prospectively recruited over a period of 12 months. Sera and cerebrospinal fluid were tested for NMDAR, AMPAR1, AMPAR2, LGI1, CASPR2, GABARB1/B2 antibodies (Ab) using commercial cell-based assays. Demographic, clinical and laboratory data were compiled into an investigator-administered proforma. Patients were reviewed at 1 year follow up either in person or via telephone. Results One-hundred and forty-two patients from 21 of 25 districts in Sri Lanka (median age = 20.5 years; range 1–86 years; females = 61.3%) were recruited. Of them, 65 (45.8%; median age = 19 years; range 1–86 years; females = 64.6%) fulfilled diagnostic criteria for probable NMDAR-antibody encephalitis (NMDARE) and 6 (4.2%; median age = 44 years; range 28–71 years; females = 83.3%) limbic encephalitis (LE). Abnormal behaviour (95.3%), seizures (81.5%) and movement disorders (69.2%) were the most frequent clinical manifestations of probable NMDARE. NMDAR-antibodies were detectable in 29 (44.6%) and not detectable in 36 in CSF of probable-NMDARE patients. Abnormal EEG was more frequent (p = 0.003) while a worse outcome (OR = 2.78; 95% CI = 0.88–9.09) and deaths (OR = 2.38; 95% CI = 0.67–8.33) were more likely in antibody-negative than antibody-positive probable-NMDARE. Most patients with LE had amnesia (50%) and/or confusion (100%) with agitation (83.3%) and seizures (100%) but none had detectable antibodies to any of the antigens tested. Conclusions NMDARE is the commonest type of AE among South Asians as is the case worldwide. Clinical presentations of NMDARAb-positive and NMDARAb-negative AE patients do not significantly differ but EEG may be a useful marker of an autoimmune basis for psychiatric symptoms.

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