Primary abdominal cocoon with cryptorchidism: a case report

Abstract Background We report a rare case of primary abdominal cocoon with bilateral cryptorchidism. Case presentation The patient had a history of laparoscopic surgery for bilateral cryptorchidism 6 years earlier. He was admitted to the hospital again due to intestinal obstruction. Surgery was performed on the patient after the failure of conservative treatment. The patient was diagnosed with primary abdominal cocoon. Instead of the greater omentum, many cocoon-like tissues surrounding the bowel were seen during operation. Abdominal surgery can increase the risk of intestinal adhesion, which is one of the main causes of intestinal obstruction, especially in patients with abdominal cocoon. We hypothesize that the surgery 6 years earlier to address transabdominal bilateral cryptorchidism accelerated the patient’s intestinal obstruction. Conclusion This case implies that it is important for urologists to evaluate whether their patients exhibit abdominal cocoon before cryptorchidism surgery, to choose better surgical methods and reduce the risks of poor prognosis.

Download Full-text

A case of sigmoid volvulus in an unexpected demographic

Surgical Case Reports ◽

10.1186/s40792-020-01105-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Mohammad Saba ◽

Joshua Rosenberg ◽

Gregory Wu ◽

Gudata Hinika

Keyword(s):

Abdominal Pain ◽

Severe Pain ◽

Rare Case ◽

Young Female ◽

Sigmoid Volvulus ◽

Case Presentation ◽

Operative Complications ◽

History Of ◽

Male Sex ◽

Emergent Laparotomy

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.

Download Full-text

Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

The Surgery Journal ◽

10.1055/s-0041-1731443 ◽

2021 ◽

Vol 07 (03) ◽

pp. e124-e126

Author(s):

Mark Portelli ◽

Mark Bugeja ◽

Charles Cini

Keyword(s):

Computed Tomography ◽

Young Adult ◽

Rare Case ◽

Surgical Repair ◽

Bochdalek Hernia ◽

Case Presentation ◽

Atypical Case ◽

Accident And Emergency ◽

History Of ◽

Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

Download Full-text

A Rare Case of Stage IV Adrenocortical Carcinoma with Acute Adrenocortical Dysfunction After Trans-Catheter Arterial Chemo-Embolization (TACE)

10.21203/rs.3.rs-127784/v1 ◽

2020 ◽

Author(s):

Zhilong Wang ◽

Xin Sun ◽

Fengli Zhang ◽

Ting Wang ◽

Ping Li

Keyword(s):

Liver Metastasis ◽

Adrenocortical Carcinoma ◽

Poor Prognosis ◽

Rare Case ◽

Stage Iv ◽

Postoperative Recurrence ◽

Tumor Burden ◽

Case Presentation ◽

Embolization Therapy ◽

New Treatment

Abstract Background: Adrenocortical carcinoma(ACC) is a rare and highly invasive endocrine malignant tumor with poor prognosis and insensitivity tochemotherapy, which don't have effective treatment. Although Surgical resection is considered to be the main treatment for ACC, postoperative recurrence and metastasis have become the most important factors of death. Therefore, local treatments such as trans-catheter arterial chemo-embolization, radiofrequency ablation become be new treatment for ACC. Trans-catheter arterial chemo-embolization therapy for ACC patients with liver metastasis has good efficacy and can effectively reduce the tumor burden of patients, which is considered to be safe and easy for patients. Case presentation: We report a 47-year-old female patient diagnosed with stage Ⅳ ACC with liver metastases, who developed symptoms of acute adrenocortical dysfunctions after hepatic arterial catheter chemo-embolization.Conclusion: Trans-catheter arterial chemo-embolization therapy for ACC patients with liver metastasis is not completely safe, and there is a certain probability that it will lead to secondary adrenal dysfunction. Hydrocortisone supplementation can effectively alleviate the symptoms.

Download Full-text

A Rare Case of HHV-8 Associated Hemophagocytic Lymphohistiocytosis in a Stable HIV Patient

Case Reports in Infectious Diseases ◽

10.1155/2019/3297463 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Nonso Osakwe ◽

Diane Johnson ◽

Natalie Klein ◽

Dalia Abdel Azim

Keyword(s):

Hemophagocytic Lymphohistiocytosis ◽

Rare Case ◽

Viral Infections ◽

Rare Condition ◽

Lymph Node Biopsy ◽

Castleman Disease ◽

Human Herpes Virus 8 ◽

Case Presentation ◽

Multicentric Castleman Disease ◽

History Of

Background. Hemophagocytic lymphohistiocytosis (HLH) is a rare condition associated with viral infections including HIV. Cases have been reported mainly in advanced HIV/AIDS. This is a rare case that reports HLH associated with human herpes virus-8 (HHV-8) associated multicentric Castleman disease in a stable HIV patient. Case Presentation. A 70-year-old Asian male patient with history of stable HIV on medications with CD 4 cell count above 200 presented with cough and fever and was initially treated for pneumonia as an outpatient. Persisting symptoms prompted presentation to the hospital. The patient was found to have anemia which persisted despite repeated transfusion of packed red cells. A bone marrow biopsy to investigate anemia revealed hemophagocytosis. A CT scan revealed multiple enlarged lymph nodes and hepatosplenomegaly. An excisional lymph node biopsy revealed HHV-8 associated multicentric Castleman disease. The patient deteriorated despite initiation of treatment. Conclusion. HLH can occur at any stage of HIV, rapid diagnosis to identify possible underlying reactive infectious etiology and prompt initiation of treatment is crucial to survival.

Download Full-text

Osteochondritis Dissecans of the Capitellum: A Case Report of Successful Arthroscopic Treatment

Case Reports in Orthopedics ◽

10.1155/2017/5086542 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

J. Ribeiras Cabral ◽

R. Henriques ◽

J. Arvela Matoso ◽

S. Martins ◽

M. Sarmento

Keyword(s):

Osteochondritis Dissecans ◽

Early Identification ◽

Rare Case ◽

White Male ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Successful Result ◽

Case Presentation ◽

History Of ◽

Prompt Diagnosis

Introduction.Osteochondritis dissecans (OCD) of the capitellum is a localized disorder of the subchondral bone, in a region with limited healing capacity. Although its aetiology is still unknown, it has been associated with repetitive microtrauma. The natural history of this disease involves the evolution for degenerative joint disease in approximately half of the patients, with early identification and treatment being critical to optimizing the outcome.Case Presentation.We present a rare case in our practice, illustrating a capitellar OCD in a fifteen-year-old White male without an identified cause of repetitive microtrauma.Conclusion.In this case prompt diagnosis and arthroscopic-assisted treatment led to a successful result.

Download Full-text

A Complex Renal Cyst: It Is Time to Call the Oncologist?

International Journal of Nephrology ◽

10.4061/2011/893985 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Antonio Granata ◽

Antonio Basile ◽

Giuseppe Alessandro Bruno ◽

Alberto Saita ◽

Mario Falsaperla ◽

...

Keyword(s):

Hydatid Cyst ◽

Hydatid Disease ◽

Rare Case ◽

Renal Cyst ◽

Renal Involvement ◽

Case Presentation ◽

Magnetic Resonance Scan ◽

History Of ◽

The Right ◽

Vague Abdominal Pain

Introduction. Hydatid disease is a cyclozoonotic parasitic infestation caused by the cestodeEchinococcus granulosus. The cysts mainly arise in the liver (50 to 70%) or lung (20 to 30%), but any other organ can be involved, in abdominal and pelvic locations, as well as in other less common sites, which may make both diagnosis and treatment more complex. Isolated renal involvement is extremely rare.Case Presentation. We report a rare case of isolated renal hydatid disease in a 71-year-old man with a history of vague abdominal pain, anemia, fever, and microhematuria. Ultrasonographic examination revealed a complex cyst in the right kidney, including multiple smaller cysts with internal echoes. A magnetic resonance scan of the abdomen confirmed the findings, and hydatid cyst disease was diagnosed. Right nephrectomy was performed, and microscopic examination confirmed the diagnosis of hydatid cyst. Albendazole, 10 mg/kg per day, was given for 4 weeks (2 weeks preoperatively and 2 weeks postoperatively).Conclusion. Isolated primary hydatidosis of the kidney should always be considered in the differential diagnosis of any cystic renal mass, even in the absence of accompanying involvement of liver or other visceral organs.

Download Full-text

Diagnostic difficulties in obturator hernia: a rare case presentation and review of literature

BMJ Case Reports ◽

10.1136/bcr-2020-235644 ◽

2020 ◽

Vol 13 (9) ◽

pp. e235644

Author(s):

Tharun Ganapathy Chitrambalam ◽

Pradeep Joshua Christopher ◽

Jeyakumar Sundaraj ◽

Sundeep Selvamuthukumaran

Keyword(s):

Inguinal Hernia ◽

Intestinal Obstruction ◽

Rare Case ◽

Diagnostic Laparoscopy ◽

Obturator Hernia ◽

High Morbidity ◽

Radiological Imaging ◽

Review Of Literature ◽

Case Presentation ◽

Diagnostic Difficulties

Hernia arising from obturator canal is rare and it contributes to about less than 1% of incidence of all hernias. Diagnosing an obturator hernia clinically is a challenging one and nearly impossible. These hernias usually present as an intestinal obstruction as more than 50% of obturator hernias goes in for strangulation. Here, we report an unusual presentation of an obturator hernia in a 70-year-old woman who presented to emergency room with acute abdomen and uncomplicated reducible inguinal hernia. Radiological imaging showed obstructed inguinal hernia while on diagnostic laparoscopy, a strangulated and perforated obturator hernia of Richter’s type was seen in addition to an uncomplicated inguinal hernia. Obturator hernia, although very rare, is associated with high morbidity and mortality as it is often underdiagnosed as in our case. Laparoscopy bailed us out from missing out a perforation from an occult obturator hernia.

Download Full-text

A Rare Case of Acute Renal Failure Secondary to Rhabdomyolysis Probably Induced by Donepezil

Case Reports in Nephrology ◽

10.1155/2014/214359 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Osman Zikrullah Sahin ◽

Teslime Ayaz ◽

Suleyman Yuce ◽

Fatih Sumer ◽

Serap Baydur Sahin

Keyword(s):

Emergency Department ◽

Renal Failure ◽

Creatine Kinase ◽

Acute Renal Failure ◽

Rare Case ◽

Laboratory Studies ◽

Case Presentation ◽

History Of ◽

One Year ◽

Renal Function Tests

Introduction. Acute renal failure (ARF) develops in 33% of the patients with rhabdomyolysis. The main etiologic factors are alcoholism, trauma, exercise overexertion, and drugs. In this report we present a rare case of ARF secondary to probably donepezil-induced rhabdomyolysis.Case Presentation. An 84-year-old male patient was admitted to the emergency department with a complaint of generalized weakness and reduced consciousness for two days. He had a history of Alzheimer’s disease for one year and he had taken donepezil 5 mg daily for two months. The patient’s physical examination revealed apathy, loss of cooperation, and decreased muscle strength. Laboratory studies revealed the following: urea: 128 mg/dL; Creatinine 6.06 mg/dL; creatine kinase: 3613 mg/dL. Donepezil was discontinued and the patient’s renal function tests improved gradually.Conclusion. Rhabdomyolysis-induced acute renal failure may develop secondary to donepezil therapy.

Download Full-text

Multiple Abdominal Cocoons: An Unusual Presentation of Intestinal Obstruction and a Diagnostic Dilemma

Case Reports in Surgery ◽

10.1155/2015/282368 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Mohammad Zain Sohail ◽

Shumaila Hasan ◽

Benan Dala-Ali ◽

Shahanoor Ali ◽

M. A. Hashmi

Keyword(s):

Intestinal Obstruction ◽

Abdominal Cavity ◽

Fibrous Membrane ◽

Unknown Aetiology ◽

Abdominal Cocoon ◽

Diagnostic Dilemma ◽

Previous Abdominal Surgery ◽

History Of ◽

Subacute Intestinal Obstruction ◽

Encapsulating Peritonitis

Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare acquired condition with an unknown aetiology. It is characterized by encapsulation of the small bowel by a fibrous membrane and can lead to intestinal obstruction. We present the case of a 42-year-old gentleman with a history of hepatitis C, tuberculosis, and previous abdominal surgery, who presented with subacute intestinal obstruction. Surgical exploration of the abdomen revealed that the entire contents were enclosed into three distinct sacs by a dense fibrous membrane. Excision of the sacs was performed followed by adhesiolysis. This is believed to be the first reported case of multiple cocoons within the abdominal cavity. The case is discussed with reference to the literature.

Download Full-text

Case Report: Migrainous Infarct without Aura

Case Reports in Neurology ◽

10.1159/000481281 ◽

2017 ◽

Vol 9 (3) ◽

pp. 241-251

Author(s):

Kamesh Gupta ◽

Anurag Rohatgi ◽

Shivani Handa

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Case Report ◽

Rare Case ◽

Case Presentation ◽

The Past ◽

Need To Evaluate ◽

History Of ◽

Complicated Migraine ◽

Full Investigation

Background: Stroke in a migraine with aura has been documented in several cases, even deserving the merit of a classification as complicated migraine. Herein, we present a rare case of migrainous infarct without aura. The diagnosis was challenging due to lack of risk factors. The patient was unique in not having any other comorbidities. Case Presentation: The case is of a 21-year-old female presenting with right-sided hemiplegia and facial drooping. She had had an index presentation of throbbing headaches for the past 2 years, typical of a migraine but not preceded by any aura symptoms. However, in the current episode, the pain became excessively severe and accompanied by right-sided hemiplegia and facial drooping. A full investigation workup using MRI revealed evidence of infarct in the left temporoparietal and basal ganglion region. Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.

Download Full-text