A case report of delayed lower intestinal bleeding after organophosphate poisoning

Abstract Background Organophosphate poisoning is a serious issue and it results in significant casualties in developing countries. Since agriculture remains an important and necessary sector of human society and organophosphate are commonly used in agriculture, it is difficult to prevent organophosphate poisoning. Gastrointestinal bleeding is not a common but life threatening symptom of organophosphate poisoning. We report a rare case of gastrointestine bleeding due to organophosphate poisoning. Case presentation A 78-year-old woman presented to our hospital approximately 12 h after ingesting a mouthful of organophosphate and benzodiazepines in a suicide attempt. Six weeks after successful medical treatment for respiratory failure, she developed recurring melena. Colonoscopy and esophagogastroduodenoscopy findings were negative for ulcers or bleeding. Enteroscopy revealed severe circumferential ulcers with luminal narrowing 10 cm proximal to the ileocecal valve. The patient underwent a 100-cm ileum resection after failed medical treatment and recovered uneventfully. The resected terminal ileum demonstrated severe inflammation and a sharp transitional zone between the healthy and injured mucosa approximately 50 cm proximal to the ileocecal valve. Pathological examination revealed an injured mucosa with inflammatory cell infiltration and structural damage. This case highlights a rare event of OP poisoning with late-onset lower gastrointestinal bleeding, which prolonged the patient’s recovery course and parenteral alimentation period. Conclusion We report a rare case of a patient with organophosphate poisoning, with late-onset lower GI tract bleeding, which raised clinical awareness regarding the organophosphate poisoning that induce intestinal symptoms.

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An extremely rare case of a gastric accessory spleen: case report and review of the literature

BMC Gastroenterology ◽

10.1186/s12876-021-01852-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Guiqin Chen ◽

Lei Nie ◽

Tijiang Zhang

Keyword(s):

Rare Case ◽

Accessory Spleen ◽

Gastric Fundus ◽

Pathological Examination ◽

Review Of The Literature ◽

Gastric Bleeding ◽

Computed Tomographic ◽

Normal Spleen ◽

Elevated Lesion ◽

Lesser Curvature

Abstract Background The accessory spleen has no anatomical or vascular relationship with the normal spleen, The tissue structure and physiological function of the accessory spleen are the same as those of the normal spleen, which usually locate in the splenic hilum and the tail of the pancreas. The aims of this manuscript are to present a rare case of the gastric accessory spleen and a review of the literature. Case presentation A 19-year-old male patient was sent to the emergency department with stomach bleeding after drinking alcohol. The computed tomographic scan showed a 1.2 cm × 1.7 cm mass at the lesser curvature of the gastric fundus. Gastrointestinal endoscopy displayed a submucosal elevated lesion on the gastric fundus, and gastrectomy was performed. Postoperative pathological examination proved an accessory spleen in the stomach. The postoperative course was uneventful, and the patient was discharged on the 6th day after the surgery. Conclusions The accessory spleen at the fundus of stomach is extremely rare, especially in this case, which is accompanied by acute gastric bleeding, and it is difficult to diagnosis before operation. Many literatures reported that it was misdiagnosis as tumor, so it is necessary to diagnose accessory spleen correctly.

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Challenge in diagnosis of late onset necrotizing enterocolitis in a term infant: a case report

BMC Pediatrics ◽

10.1186/s12887-021-02626-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Gunadi ◽

Dian Nirmala Sirait ◽

Aditya Rifqi Fauzi ◽

Ninditya Nugroho ◽

Fadil Fahri ◽

...

Keyword(s):

Ct Scan ◽

Necrotizing Enterocolitis ◽

Intestinal Inflammation ◽

Late Onset ◽

Gastrointestinal Disease ◽

Early Recognition ◽

Ileocecal Valve ◽

Abdominal Distention ◽

Clinical Deterioration ◽

Wall Thickening

Abstract Background Necrotizing enterocolitis (NEC) is a common devastating inflammatory gastrointestinal disease and frequently occurs in premature infants. Here, we reported a case of late-onset NEC in a term neonate with good outcome after surgery for long-term follow-up. Case presentation Ten-week-old male came to emergency unit due to prolonged diarrhea and abdominal distention. He was born at gestational age of 40 weeks with birth weight and Apgar score of 2800 g and 7/8, respectively. He had no history of formula feeding. Two weeks before admitted to the hospital, the patient had frequent diarrhea with fever. He was found lethargic with abdominal distention, absence of bowel sounds and abdominal tenderness. Plain abdominal x-ray and CT scan showed gastric and intestinal dilatation and gasless colon, suggesting a small bowel obstruction, and bowel wall thickening indicating peritonitis, without any free subdiaphragmatic air (pneumoperitoneum). Moreover, the patient did not have a congenital heart disease. While in intensive medical treatment, he showed a continuous clinical deterioration. All findings were suggestive of intestinal inflammation with clinical deterioration, and we decided to perform an emergency exploratory laparotomy and found an ischemia along the jejunoileal with a perforation at 25 cm above the ileocecal valve. Subsequently, we performed a double-barrel ileostomy through a separate incision from the laparotomy. Histopathological findings confirmed the diagnosis of NEC. We closed the stoma at postoperative day 43. The patient was discharged uneventfully a month after stoma closure. Conclusion Abdominal CT scan might be useful to establish an early recognition of late-onset NEC; thus, immediate surgical intervention might be performed to decrease its morbidity and mortality. Moreover, late-onset NEC in term neonates might occur without any risk factors or significant co-morbidities.

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Late onset penile abscess after 4 years from hyaluronic acid injection. A rare case report

Urology Case Reports ◽

10.1016/j.eucr.2021.101632 ◽

2021 ◽

pp. 101632

Author(s):

Abdullatif K. Al-Maghlouth ◽

Saad Alwesali ◽

Abdulbari bin ajjaj ◽

Anas Faqeeh

Keyword(s):

Hyaluronic Acid ◽

Case Report ◽

Rare Case ◽

Late Onset ◽

Hyaluronic Acid Injection ◽

Acid Injection ◽

Rare Case Report

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Simultaneous massive low gastrointestinal bleeding and hemoperitoneum caused by a capillary hemangioma in ileocecal valve

International Journal of Colorectal Disease ◽

10.1007/s00384-011-1142-7 ◽

2011 ◽

Vol 26 (10) ◽

pp. 1363-1364 ◽

Cited By ~ 4

Author(s):

Jair Santos ◽

Jaime Ruiz-Tovar ◽

Alberto López ◽

Antonio Arroyo ◽

Rafael Calpena

Keyword(s):

Gastrointestinal Bleeding ◽

Ileocecal Valve ◽

Capillary Hemangioma

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A case with massive hemobilia long-term after internal drainage surgery for congenital biliary dilation

Surgical Case Reports ◽

10.1186/s40792-021-01242-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Shunryo Minezaki ◽

Takeyuki Misawa ◽

Makoto Watanabe ◽

Hideki Takahashi ◽

Takashi Koenuma ◽

...

Keyword(s):

Bile Duct ◽

Gastrointestinal Bleeding ◽

Pathological Condition ◽

Extrahepatic Bile Duct ◽

Pathological Examination ◽

Emergency Setting ◽

Internal Drainage ◽

Bile Duct Resection ◽

Extrahepatic Bile Duct Resection ◽

Life Threatening

Abstract Background Currently, there is an unwavering consensus that the standard surgery for congenital biliary dilation (CBD) is extrahepatic bile duct resection and choledochojejunostomy. However, decades prior, choledochocyst–gastrointestinal anastomosis without extrahepatic bile duct resection (internal drainage surgery, IDS) was preferred for CBD because of its simplicity. Currently, there is almost no chance of a surgeon encountering a patient who has undergone old-fashioned IDS, which has been completely obsolete due to the risk of carcinogenesis from the remaining bile duct. Moreover, the pathological condition long after IDS is unclear. Herein, we report a case of life-threatening bile duct bleeding as well as carcinoma of the bile duct 62 years after IDS in a patient with CBD. Case presentation An 82-year-old Japanese woman with hemorrhagic shock due to gastrointestinal bleeding was transferred to our hospital. She had a medical history of unspecified surgery for CBD at the age of 20. Based on imaging findings and an understanding of the historical transition of the surgical procedure for CBD, the cause of gastrointestinal bleeding was determined to be rupture of the pseudoaneurysm of the dilated bile duct that remained after IDS. Hemostasis was successfully performed by transcatheter arterial embolization (TAE) in an emergency setting. Then, elective surgery for extrahepatic bile duct resection and choledochojejunostomy was performed to prevent rebleeding. Pathological examination revealed severely and chronically inflamed mucosa of the bile duct. Additionally, cholangiocarcinoma (Tis, N0, M0, pStage 0) was incidentally revealed. Conclusion It has been indicated that not only carcinogenesis, but also a risk of life-threatening bleeding exists due to long-lasting chronic inflammation to the remnant bile duct after IDS for CBD. Additionally, both knowledge of which CBD operation was performed, and an accurate clinical history are important for the diagnosis of hemobilia.

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HIT BY HEPARIN: A Rare Case of Late Onset Heparin Induced Thrombocytopenia

American Journal of Medical Case Reports ◽

10.12691/ajmcr-3-6-7 ◽

2015 ◽

Vol 3 (6) ◽

pp. 174-176

Author(s):

HAMZA HASHMI MD ◽

UMAYR AZIMI MD

Keyword(s):

Rare Case ◽

Late Onset ◽

Heparin Induced Thrombocytopenia

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A rare case of Organophosphate poisoning with toxic encephalopathy

Journal of Integrated Health Sciences ◽

10.4103/2347-6486.240205 ◽

2016 ◽

Vol 4 (2) ◽

pp. 57

Author(s):

JV Solanki ◽

SK Tilara ◽

PA Bhatt

Keyword(s):

Rare Case ◽

Toxic Encephalopathy ◽

Organophosphate Poisoning

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An unusual case of acute lower gastrointestinal bleeding due to fungal infection

Journal of International Medical Research ◽

10.1177/0300060520967820 ◽

2020 ◽

Vol 48 (11) ◽

pp. 030006052096782

Author(s):

Jianchun Xiao ◽

Ruopeng Zhang ◽

Wanqi Chen ◽

Beizhan Niu

Keyword(s):

Gastrointestinal Bleeding ◽

Fungal Infection ◽

Lupus Erythematosus ◽

Unusual Case ◽

Exploratory Laparotomy ◽

Lower Gastrointestinal Bleeding ◽

Pathological Examination ◽

Disorder Of Consciousness ◽

Glucocorticoid Treatment ◽

History Of

A 63-year-old woman was admitted to our hospital with herpes zoster viral infection and intermittent disorder of consciousness. On day 13 of hospitalization for glucocorticoid treatment, the patient experienced seven episodes of hematochezia. She had a 2-year history of systemic lupus erythematosus and had undergone splenectomy at 40 years of age. Computed tomography and electronic endoscopy revealed bleeding and contrast agent leakage into the splenic flexure of the colon. The patient underwent an emergency exploratory laparotomy and left hemicolectomy for suspected active hemorrhaging into the digestive tract. Pathological examination revealed that the bleeding had been caused by a fungal infection. No further hemorrhaging occurred after the surgery, suggesting that intestinal fungal infection might be a potential differential diagnosis for gastrointestinal bleeding in compromised hosts.

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