Acute gastric dilatation in a patient with severe anorexia nervosa: a case report

Abstract Background Acute gastric dilatation (AGD) leading to gastric necrosis and perforation has been reported to be a rare but fatal complication in young patients with eating disorders, particularly anorexia nervosa. Case presentation We report a case of a Canadian female patient presenting with mild abdominal pain, with a history of anorexia nervosa, the binge/purge subtype, who was found to have severe acute gastric dilatation on subsequent computed tomography imaging. Her clinical course was uncomplicated after gastric decompression. The cause of her AGD was thought to be secondary to dysmotility disorder caused by her anorexia nervosa. Conclusion Our case report demonstrates the importance of clinical identification of AGD and subsequent diagnosis and management. Because of the urgency to rule out obstruction or perforation through consultation or additional imaging modalities, recognition and correct diagnosis of this condition is necessary for appropriate patient management. In addition, our case report adds to an underreported but important complication of anorexia nervosa.

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Primary breast angiosarcoma: a case report

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00494-1 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Fui Tin Pang ◽

Sze Yuen Lee ◽

Maninderpal Kaur

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Young Patients ◽

Distant Metastases ◽

Vascular Tumor ◽

Left Breast ◽

Vascular Tumors ◽

Case Presentation ◽

History Of ◽

Vascular Structures

Abstract Background Angiosarcomas are rare and fast growing tumors that arise from vascular structures. This case report is significant because it is rare and may cause treatment delay if not considered as a differential diagnosis. Hence, we aim to inform efficient, appropriate, and evidence-based imaging practice to the benefit of patients regionally and worldwide. Case presentation Thirty-five-year-old lady, presented with a large left breast swelling. She had recent history of trauma to the breast which initially caused confusion regarding the possible diagnosis. Ultrasound and MRI raised high suspicion of an angiosarcoma. Patient went through embolectomy prior to mastectomy and axillary clearance. Histopathology confirmed the diagnosis of an angiosarcoma. She had no distant metastases at the time of diagnosis and the patient was treated with chemotherapy and radiotherapy. However, she returned with recurrence within 1-year duration. Conclusion Primary breast angiosarcomas are rare aggressive vascular tumors with generally poor prognosis and no pathognomonic signs on radiological imaging, especially mammogram. Ultrasound and MRI do help in characterizing these tumors and raising the suspicion of a vascular tumor. Ultrasound-guided biopsy is recommended to avoid unnecessary complications. In young patients with rapidly growing, highly vascular breast tumors, a differential diagnosis of primary angiosarcomas should be considered until proven otherwise.

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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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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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Type Va extrahepatic bile duct duplication: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-019-2259-5 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 2

Author(s):

Bharat Mani Banjade ◽

Ashish Rajbhandari ◽

Rabin Koirala ◽

Tuhin Shah ◽

Chitra Lal Bhattachan

Keyword(s):

Case Report ◽

Bile Duct ◽

Extrahepatic Bile Duct ◽

Correct Diagnosis ◽

Diagnostic Techniques ◽

Case Presentation ◽

Double Common Bile Duct ◽

Unusual Variant ◽

Rural Nepal ◽

Calculous Cholecystitis

Abstract Background Extrahepatic bile duct duplication is an extremely rare congenital anomaly in which two common bile ducts exist. There are five different types of this anomaly and we present an unusual variant of duplication of an extrahepatic biliary system of type Va variety. Case presentation This case report describes a 63-year-old women from rural Nepal who presented with type Va of duplicated extrahepatic bile duct, with chronic calculous cholecystitis and choledocholithiasis. She was managed with cholecystectomy with hepatic ductoplasty and hepaticojejunostomy. Conclusion A rare case of double common bile duct (type Va) complicated by choledocholithiasis, cholangitis, and chronic cholecystitis is reported here. Rare cases are sometimes overlooked by modern diagnostic techniques. Correct diagnosis helps appropriate surgical intervention.

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

BMC Surgery ◽

10.1186/s12893-019-0601-x ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Yi Zhao ◽

Zhichao Lai ◽

Xiaojun Song ◽

Rong Zeng ◽

Changwei Liu ◽

...

Keyword(s):

Prostate Cancer ◽

Case Report ◽

Carotid Endarterectomy ◽

Early Stage ◽

Prostatic Hyperplasia ◽

Surgical Patients ◽

Blood Products ◽

Case Presentation ◽

Life Threatening ◽

History Of

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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Unicuspid aortic valve concomitant with aortic insufficiency presenting with infectious endocarditis: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-019-2239-9 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Naoko Yuzawa-Tsukada ◽

Toshikazu D. Tanaka ◽

Satoshi Morimoto ◽

Michihiro Yoshimura

Keyword(s):

Case Report ◽

Aortic Valve ◽

Aortic Insufficiency ◽

Infectious Endocarditis ◽

Cardiac Abnormality ◽

Case Presentation ◽

Old Japanese ◽

History Of ◽

Nonbacterial Thrombotic Endocarditis ◽

High Turbulence

Abstract Background A unicuspid aortic valve is a rare congenital cardiac abnormality. Despite its uncommon finding on an initial presentation, aortic insufficiency is accompanied with unicuspid aortic valve and this might reflect the natural history of progression in the morphology of unicuspid aortic valve. Case presentation We describe a 65-year-old Japanese man who was evaluated for endocarditis and found to have a unicuspid aortic valve concomitant with moderate aortic insufficiency, which was, owing to the lack of evidence of valve membrane destruction, independent of underlying infectious endocarditis. In addition, aortic insufficiency was progressed because of nonbacterial thrombotic endocarditis on the ventricular side, in areas of high turbulence around the heart valve. Conclusions Our case is unusual given the unicuspid aortic valve concomitant with aortic insufficiency, which was presumably independent of underlying infectious endocarditis because of the location of the vegetation and the lack of evidence of valve destruction. Therefore, attention should be paid to a variety of complications in the setting of unicuspid aortic valve.

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Acute gastric dilatation with infarction and perforation: Report of fatal outcome in patient with anorexia nervosa

Gut ◽

10.1136/gut.22.11.978 ◽

1981 ◽

Vol 22 (11) ◽

pp. 978-983 ◽

Cited By ~ 66

Author(s):

S H Saul ◽

A Dekker ◽

C G Watson

Keyword(s):

Anorexia Nervosa ◽

Fatal Outcome ◽

Gastric Dilatation ◽

Acute Gastric Dilatation

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Unusual case of classic testicular seminoma in a 90-year-old patient: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02517-3 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Ahmad Al-Mousa ◽

Mohammad Nour Shashaa ◽

Mohamad Shadi Alkarrash ◽

Mohamad Alkhamis ◽

Lina Ghabreau ◽

...

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Elderly Patients ◽

Unusual Case ◽

Medical Literature ◽

Testicular Tumor ◽

Testicular Seminoma ◽

Case Presentation ◽

History Of ◽

Pure Seminoma

Abstract Background Seminoma is the most common subtype of testicular cancer and occurs most commonly in patients aged 30–49 years, but decreases to a very low level in men in their 60s or older. Case presentation A 90-year-old Syrian man with a 6-year history of an increase in size of his right scrotum, presented to the urological clinic and, on clinical examination, the findings suggested testicular tumor. After orchiectomy and histology results based on microscopic and immunohistochemical examinations, a pure seminoma was diagnosed, so we describe in this case report the second-oldest patient with classical seminoma in the medical literature. Conclusion This case report has been written to focus on the probability of any type of testicular tumor occurring at any age or decade; urologists should consider seminoma as a differential diagnosis with any testicular swelling even in elderly patients.

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