GIST of the stomach masquerading as recurrent falls in an older adult: a case report and review

Abstract Background Gastric tumors become increasingly prevalent with advanced age but can be challenging to diagnose in older adults who may present with non-specific symptoms. Here, we report a rare case of an occult gastric tumor associated with mesenteric panniculitis that presented with recurrent falls precipitated by vertigo. Case presentation We describe a diagnostically challenging case of cryptogenic gastric tumor associated with mesenteric panniculitis in a 74-year-old female who presented with abdominal bloating and recurrent falls precipitated by vertigo, dehydration, acute kidney injury and electrolyte deficiencies, but had no alarm symptoms. Her symptoms resolved after laparoscopic wedge resection of the gastric tumor. Conclusions Our case highlights that while alarm symptoms such as dysphagia, weight loss, gastrointestinal bleeding and vomiting are considered indications for endoscopy, clinicians should also maintain a high index of suspicion for gastric tumors in older patients who may present with atypical symptoms.

Download Full-text

Gastric schwannoma: a case report and literature review

Journal of International Medical Research ◽

10.1177/0300060520957828 ◽

2020 ◽

Vol 48 (9) ◽

pp. 030006052095782

Author(s):

Changsheng Pu ◽

Keming Zhang

Keyword(s):

Wedge Resection ◽

Postoperative Recovery ◽

Postoperative Treatment ◽

Laparoscopic Wedge Resection ◽

Case Presentation ◽

Gastric Tumors ◽

Gastric Schwannoma ◽

History Of ◽

Upper Abdominal

Background Gastric schwannoma is a rarely seen gastric tumor accounting for only 0.2% of all gastric tumors. It is difficult to distinguish a gastric schwannoma from other gastric tumors preoperatively. Case presentation: A 30-year-old man with no significant medical history or physical examination findings presented with a 1-month history of right upper abdominal discomfort. The preoperative diagnosis was a gastrointestinal stromal tumor, but the postoperative pathologic and immunohistochemical examinations confirmed a gastric schwannoma. The patient underwent laparoscopic wedge resection of the stomach without additional postoperative treatment, and his postoperative recovery was uneventful. No recurrence or metastasis was found at the 2-year follow-up examination. Conclusion Although gastric schwannomas are usually not malignant, they are difficult to distinguish from other malignant stromal tumors preoperatively. Surgical resection should be recommended when a schwannoma is malignant or considered to be at risk of becoming malignant.

Download Full-text

Laparoscopic wedge resection will be the optimal treatment for nonepithelial, submucosal gastric tumors

Surgical Endoscopy ◽

10.1007/s00464-010-1448-5 ◽

2010 ◽

Vol 25 (6) ◽

pp. 2054-2054

Author(s):

Chong-wei Ke

Keyword(s):

Wedge Resection ◽

Optimal Treatment ◽

Laparoscopic Wedge Resection ◽

Gastric Tumors

Download Full-text

Nonepithelial, submucosal gastric tumors: is laparoscopic wedge resection the optimal treatment?

Surgical Endoscopy ◽

10.1007/s00464-010-1447-6 ◽

2010 ◽

Vol 25 (6) ◽

pp. 2052-2053

Author(s):

Odysseas Zoras ◽

John Spiliotis

Keyword(s):

Wedge Resection ◽

Optimal Treatment ◽

Laparoscopic Wedge Resection ◽

Gastric Tumors

Download Full-text

Laparoscopic wedge resection for benign gastric tumors

Surgical Endoscopy ◽

10.1007/s004640000273 ◽

2001 ◽

Vol 15 (8) ◽

pp. 893-895 ◽

Cited By ~ 25

Author(s):

M. Röthlin ◽

O. Schöb

Keyword(s):

Wedge Resection ◽

Laparoscopic Wedge Resection ◽

Gastric Tumors

Download Full-text

Bone marrow necrosis and fat embolism syndrome: a near fatal complication in previously undiagnosed sickle beta + thalassaemia

BMJ Case Reports ◽

10.1136/bcr-2020-238317 ◽

2021 ◽

Vol 14 (1) ◽

pp. e238317

Author(s):

Nibash Budhathoki ◽

Sunita Timilsina ◽

Bebu Ram ◽

Douglas Marks

Keyword(s):

Bone Marrow ◽

Multiorgan Failure ◽

Rare Condition ◽

Altered Mental Status ◽

Fat Embolism ◽

Bone Marrow Necrosis ◽

Embolism Syndrome ◽

Hb S ◽

High Index Of Suspicion ◽

Specific Symptoms

Prevalence of haemoglobin sickle-β+ thalassaemia (Hb S/β+thal) is variable with geography ranging from 0.2% to 10% among sickle cell patients. Clinical presentation of Hb S/β+thal patients depends on HbA level, with milder disease often going undiagnosed. However, rarely these patients can present with a fulminant vaso-occlusive crisis (VOC). Given VOC can present with non-specific symptoms, the diagnosis and treatment is often delayed. Here, we present a patient who initially developed altered mental status, pancytopenia and multiorgan failure due a critical VOC resulting in bone marrow necrosis and fat embolism. Subsequent workup confirmed that our patient had Sickle-β+ thalassaemia, which had gone undiagnosed, despite subclinical evidence of haemolysis on routine lab work for years. Following diagnosis and initiation of RBC exchange, he improved significantly and was discharged home. High index of suspicion and bone marrow biopsy is vital for early diagnosis and management of this rare condition.

Download Full-text

SARS-CoV-2 infection in an infant with non-respiratory manifestations: a case report

Egyptian Pediatric Association Gazette ◽

10.1186/s43054-020-00047-7 ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Muhammad Adel ◽

Ahmed Magdy

Keyword(s):

Computed Tomography ◽

Aplastic Anemia ◽

Rt Pcr ◽

Positive Real ◽

Case Presentation ◽

Chest Computed Tomography ◽

High Incidence ◽

Laboratory Investigations ◽

High Index Of Suspicion ◽

Specific Symptoms

Abstract Background Coronavirus disease (COVID-19) presents in children usually with less severe manifestations than in adults. Although fever and cough were reported as the most common symptoms, children can have non-specific symptoms. We describe an infant with aplastic anemia as the main manifestation. Case presentation We describe a case of SARS-CoV-2 infection in an infant without any respiratory symptoms or signs while manifesting principally with pallor and purpura. Pancytopenia with reticulocytopenia was the predominant feature in the initial laboratory investigations, pointing to aplastic anemia. Chest computed tomography surprisingly showed typical findings suggestive of SARS-CoV-2 infection. Infection was later confirmed by positive real-time reverse transcription polymerase chain reaction assay (RT-PCR) for SARS-CoV-2. Conclusions Infants with COVID-19 can have non-specific manifestations and a high index of suspicion should be kept in mind especially in regions with a high incidence of the disease. Chest computed tomography (CT) and testing for SARS-CoV-2 infection by RT-PCR may be considered even in the absence of respiratory manifestations.

Download Full-text

Diagnosing gastric volvulus in chest X-ray: report of three cases

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa229 ◽

2020 ◽

Vol 2020 (7) ◽

Author(s):

Narendra Pandit ◽

Abhijeet Kumar ◽

Tek Narayan Yadav ◽

Qamar Alam Irfan ◽

Sujan Gautam ◽

...

Keyword(s):

Computed Tomography ◽

Acute Abdomen ◽

Gastric Volvulus ◽

X Ray ◽

Pain Abdomen ◽

Life Threatening ◽

Chest X Ray ◽

High Index Of Suspicion ◽

Specific Symptoms ◽

Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

Download Full-text

A Case of Benign Schwannoma of the Ascending Colon Treated With Laparoscopic-Assisted Wedge Resection

International Surgery ◽

10.9738/intsurg-d-13-00015.1 ◽

2013 ◽

Vol 98 (4) ◽

pp. 315-318 ◽

Cited By ~ 7

Author(s):

Se-Jin Baek ◽

Won Hwangbo ◽

Jin Kim ◽

In-Sun Kim

Keyword(s):

Submucosal Tumor ◽

Wedge Resection ◽

Ascending Colon ◽

Mesenchymal Tumors ◽

Benign Schwannoma ◽

S 100 ◽

Colon And Rectum ◽

Laparoscopic Assisted ◽

Specific Symptoms ◽

Diffuse Positivity

Abstract Isolated colonic schwannomas are rare gastrointestinal mesenchymal tumors. Only a small number of cases have been reported. Occurrence of these tumors is more common in the stomach than in the large intestine. These spindle cell lesions are distinct from leiomyoma, leiomyosarcoma, and gastrointestinal stromal tumors because the tumor cells have a distinct immunophenotype, with strong diffuse positivity for S-100 and vimentin, as well as corroborative negative staining of CD117 and smooth muscle markers. We present a case of colonic schwannoma in a 70-year-old woman who had no specific symptoms. The patient was diagnosed with a submucosal tumor in the ascending colon on colonoscopy and abdominal computed tomography. Laparoscopic-assisted wedge resection of colon was performed. The very rare pathologic diagnosis of ascending schwannoma was made postoperatively. This case is interesting because schwannomas of the colon and rectum are extremely rare and are treated by laparoscopic-assisted wedge resection.

Download Full-text

Unusual Nasogastric Tube Position Leading to Delay in Diagnosis of Tracheoesophageal Fistula

Journal of Neonatology ◽

10.1177/09732179211036778 ◽

2021 ◽

pp. 097321792110367

Author(s):

Monika Kaushal ◽

Saima Asghar ◽

Ayush Kaushal

Keyword(s):

Early Diagnosis ◽

Nasogastric Tube ◽

Common Type ◽

X Ray ◽

Delay In Diagnosis ◽

Atypical Symptoms ◽

Tube Position ◽

Esophageal Pouch ◽

High Index Of Suspicion ◽

Surgical Unit

Aim: This case highlights the importance of high index of suspicion for early diagnosis and thorough clinical examination of a newborn with tracheoesophageal atresia and fistula. Case Report: We report a case of most common type of tracheoesophageal atresia with fistula where diagnosis was missed due to unusual gastric position of nasogastric tube. Nasogastric tube reached stomach in esophageal atresia with fistula, delaying the diagnosis and management of condition. After accidental removal of tube and failure to pass again raised suspicion and was confirmed with coiled tube in esophageal pouch in X-Ray chest. Baby shifted to surgical unit for treatment, fortunately baby recovered and discharged home after surgical correction. Conclusion: Tracheoesophageal atresia with fistula can present with atypical symptoms and unusual events, challenging the early diagnosis and treatment of common types of conditions. Other association like VACTERL should be looked for, in patients.

Download Full-text