An unusual cause of delayed hematoma after carotid endarterectomy: a case report

Abstract Background Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively. Case presentation We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed. Conclusions This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

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Pemphigus Vulgaris- A Case Report

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i43a32493 ◽

2021 ◽

pp. 324-328

Author(s):

Mayur B. Wanjari ◽

Deeplata Mendhe ◽

Pratibha Wankhede ◽

Sagar Alwadkar

Keyword(s):

Case Report ◽

Pemphigus Vulgaris ◽

Entire Body ◽

Case Presentation ◽

Transmembrane Glycoprotein ◽

Mouth Ulcer ◽

Life Threatening ◽

History Of ◽

Epithelial Lesions ◽

Intraepithelial Lesions

Introduction: Pemphigus is a rare and life-threatening autoimmune disease characterized by blisters and erosion of the skin and mucous membranes throughout the entire body. It mostly affects the mouth, eye, nose, throat as well as genitals. Pemphigus vulgaris is most common type of pemphigus. The epithelial lesions are caused by autoantibodies reacting with desmosomal glycoproteins found on the keratinocyte's cell surface. The binding of immunoglobulin G autoantibodies to desmoglein 3, a transmembrane glycoprotein adhesion molecule found on desmosomes, is the underlying process that causes intraepithelial lesions. Case Presentation: A 40-year-old male patient came to the hospital with a complaint of a mouth ulcer and a genital lesion that had been since 15 years. He is having a history of oral ulcer in oral mucosa and involvement of genital area in glans penis with a history of pain, bleeding, difficulty in swallowing. Intervention: The patient was admitted to the hospital on 29/07/2021 and taken Inj. Rituximab 1gm in 500Ml Normal Saline in infusion pumps in over 6 Hours. Conclusion: In this case report, we mainly focus on expert dermatological management and excellent nursing care in managing the rare complicated case nicely. Early diagnosis and treatment of pemphigus Vulgaris help determine the course of the disease of the patient and is done by a dermatologist.

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Autoimmune Haemolysis After Operation of Gastric Cancer Complicated With Drug-refractory Idiopathic Thrombocytopenic Purpura: a Case Report and Review of the Literature

10.21203/rs.3.rs-537900/v1 ◽

2021 ◽

Author(s):

Xiao Pang ◽

Wei-Kang Guan ◽

Yu-Lin Pan ◽

Yi-Chao Zhang ◽

Li-Ya Xu ◽

...

Keyword(s):

Gastric Cancer ◽

Case Report ◽

Idiopathic Thrombocytopenic Purpura ◽

Perioperative Management ◽

Early Stage ◽

Abdominal Ct ◽

Thrombocytopenic Purpura ◽

Case Presentation ◽

Anastomotic Bleeding ◽

History Of

Abstract Background: To the best of our knowledge, few reports are available at home and abroad on autoimmune haemolysis occurring after operation of gastric cancer complicated with drug-refractory idiopathic thrombocytopenic purpura (ITP)(Table 1). The treatment process in this case is usually risky, and multidisciplinary collaboration is often required. Therefore, the case report aims to improve the awareness of the perioperative management of this type of patients.Case presentation: A 69-year-old male admitted to the hospital for "anaemia" was diagnosed with gastric adenocarcinoma after gastroscopy and biopsy. This diagnosis was confirmed to be an early stage by abdominal CT imaging. However, the patient had an extremely low platelet level and a history of hormone therapy. Moreover, administration of thrombopoietin and immunoglobulin was ineffective for treatment. After transfusion of aphaeretic platelets, laparoscopic total gastrectomy with D2 lymphadenectomy and splenectomy were performed. Anastomotic bleeding and autoimmune haemolysis occurred after the operation. Haemolytic symptoms were spontaneously relieved after a period of hospitalisation.Conclusion: This case involved many disciplines, and revealed the interaction and mutual promotion of gastric cancer, ITP and autoimmune haemolysis, but further relationships need to be further investigated.

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An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

10.31487/j.gscr.2020.01.03 ◽

2020 ◽

pp. 1-5

Author(s):

Anton Stift ◽

Kerstin Wimmer ◽

Felix Harpain ◽

Katharina Wöran ◽

Thomas Mang ◽

...

Keyword(s):

Case Report ◽

Sigmoid Colon ◽

Immunohistochemical Staining ◽

Late Onset ◽

Hirschsprung Disease ◽

Endoscopic Examination ◽

Case Presentation ◽

Idiopathic Megacolon ◽

History Of ◽

Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

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Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

Open Life Sciences ◽

10.1515/biol-2019-0062 ◽

2019 ◽

Vol 14 (1) ◽

pp. 564-567

Author(s):

Qiancheng Xu ◽

Yingya Cao ◽

Hongzhen Yin ◽

Rongrong Wu ◽

Tao Yu ◽

...

Keyword(s):

Blood Pressure ◽

Case Report ◽

Respiratory Failure ◽

Pressure Drop ◽

Thoracic Cavity ◽

Severe Hypotension ◽

Life Threatening ◽

History Of ◽

Posterior Mediastinal ◽

Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

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Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01441-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Zai-Qiang Zhang ◽

Jia-Wang Ding

Keyword(s):

Case Report ◽

Atrial Septal Defect ◽

Septal Defect ◽

Emergency Operation ◽

Atrial Wall ◽

Aortic Sinus ◽

Case Presentation ◽

Lethal Complications ◽

Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

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The spontaneous resolution of a vortex vein varix: case report

BMC Ophthalmology ◽

10.1186/s12886-021-01861-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara L Weidmayer ◽

Hakan Demirci

Keyword(s):

Case Report ◽

Natural History ◽

Extended Period ◽

Spontaneous Resolution ◽

Case Presentation ◽

Clinical Resolution ◽

History Of ◽

Vortex Vein ◽

Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

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Ondine’s curse, a fatal infarction diagnosed by polysomnography and saved by ventilation: a case report

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00326-z ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Hany Aref ◽

Tamer Roushdy ◽

Amr Zaki ◽

Nevine El Nahas

Keyword(s):

Case Report ◽

Diagnostic Procedure ◽

Cardiac Pacemaker ◽

Brainstem Infarction ◽

Case Presentation ◽

Ondine’S Curse ◽

Lateral Medullary Syndrome ◽

Life Threatening ◽

Ondine's Curse

Abstract Background Lateral medullary syndrome causing Ondine’s curse is a rare yet fatal brainstem infarction. Any patient presenting with lateral medulla infarction ought to be well observed and a polysomnography must be ordered for him. Case presentation A patient presenting with Ondine’s curse is dealt with through polysomnography as a diagnostic procedure that was followed by tracheostomy with portable ventilator and cardiac pacemaker as a therapeutic maneuver which ultimately preserved his life. Conclusion Lateral medullary syndrome infarct could be a life-threatening stroke if not diagnosed and managed properly.

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Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

The Journal of Critical Care Medicine ◽

10.1515/jccm-2017-0013 ◽

2017 ◽

Vol 3 (2) ◽

pp. 84-88

Author(s):

Thomas-Michael Schneider ◽

Friederike Klenner ◽

Franz Brettner

Keyword(s):

Case Report ◽

Extracorporeal Membrane Oxygenation ◽

Therapeutic Option ◽

High Dose ◽

Great Success ◽

Case Presentation ◽

Computed Tomographic ◽

Rehabilitation Hospital ◽

Membrane Oxygenation ◽

History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

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Arterial Thrombosis and Gangrene Secondary to Arachnidism

Vascular ◽

10.2310/6670.2009.00022 ◽

2009 ◽

Vol 17 (4) ◽

pp. 239-242

Author(s):

Jan M. Eckermann ◽

Theodore H. Teruya ◽

Christian Bianchi ◽

Ahmed M. Abou-Zamzam

Keyword(s):

Case Report ◽

Lower Extremity ◽

Vascular Disease ◽

Tissue Damage ◽

Arterial Thrombosis ◽

Progressive Necrosis ◽

Life Threatening ◽

History Of ◽

Spider Bites ◽

Spider Bite

Spider bites can cause local tissue damage as well as life-threatening complications. This is a case report of a female with no history of lower extremity vascular disease who presented with a spider bite on the dorsum of her foot. She developed progressive necrosis and eventually suffered limb loss despite attempts at revascularization.

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Case Report: Poor oral hygiene leading to an emergency condition: A case report of Ludwig’s angina

F1000Research ◽

10.12688/f1000research.74692.1 ◽

2021 ◽

Vol 10 ◽

pp. 1219

Author(s):

Prashant Pant ◽

Oshan Shrestha ◽

Pawan Budhathoki ◽

Nebula Devkota ◽

Prabin Kumar Giri ◽

...

Keyword(s):

Case Report ◽

Oral Hygiene ◽

Common Source ◽

Poor Oral Hygiene ◽

Presenting Symptoms ◽

Dental Procedures ◽

Life Threatening ◽

History Of ◽

Ludwig’S Angina ◽

Ludwig's Angina

Ludwig’s angina (LA) is a rapidly spreading and potentially life-threatening infection having an odontogenic infection as the most common source. It involves the floor of the mouth and neck. Modernization in medical care has made this entity rare and of low mortality at the present but it is still feared as a lethal entity due to rapidly progressive airway obstruction that follows. Here we report a case of a 15-year-old male who suffered from LA. Presenting symptoms and findings of the examination helped in the clinical diagnosis. Immediate intubation, use of broad-spectrum antibiotics, and treatment of complications aided the patient’s recovery. LA should be considered for differential diagnosis in the case of neck swelling especially in those having a history of poor oral hygiene and recent dental procedures. Management of LA and its complications should always involve doctors from multiple disciplines.

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