scholarly journals Hypertriglyceridemia-Induced Pancreatitis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A309-A310
Author(s):  
Sai Man Mung ◽  
Edward Jude
Keyword(s):  
Pain Control ◽  
Alcohol Intake ◽  
Insulin Infusion ◽  
Distress Syndrome ◽  
Patient Controlled Analgesia ◽  
Normal Range ◽  
Computed Tomographic ◽  
Low Fat Diet ◽  
Computed Tomographic Scan ◽  
History Of

Abstract A 31-year-old woman was admitted with abdominal pain. Her blood sample was noted to be lipemic. She was not known to have diabetes, hypothyroidism or family history of hyperlipidaemia and denied alcohol intake. She had no eruptive xanthoma or corneal arcus. On admission, triglycerides were 118mmol/L (normal range < 1.8). Computed tomographic scan demonstrated swollen pancreas, extensive peripancreatic inflammation and fatty liver. A diagnosis of hypertriglyceridemia-induced pancreatitis was made. She was kept nil by mouth and commenced on insulin infusion, fenofibrate and a low-fat diet. Her admission was complicated by acute respiratory distress syndrome and difficult pain control requiring morphine patient-controlled analgesia. Her triglycerides gradually reduced and on day 12 it was 6.6mmol/L. This case illustrates the importance of multidisciplinary input with endocrinologist, intensivist, gastroenterologist and dietician. Other treatments that could have been initiated was plasma apheresis but as she improved this was not required.

scholarly journals Occult Liver Abscess Following Clinically Unsuspected Ingestion of Foreign Bodies

1997 ◽  
Vol 11 (5) ◽  
pp. 445-448 ◽  
Author(s):  
Ban CH Tsui ◽  
J Mossey
Keyword(s):  
Foreign Body ◽  
Preoperative Diagnosis ◽  
Foreign Bodies ◽  
Clinical Presentation ◽  
Computed Tomographic ◽  
Liver Abscesses ◽  
Computed Tomographic Scan ◽  
History Of ◽  
Variable Clinical Presentation

Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gut with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively. This report emphasizes the role of ultrasound and computed tomographic scan in evaluating similar cases. Any patient with known risk factors for ingestion of foreign body should arouse suspicion and be investigated further.

Hypertension as a Risk Factor for Epilepsy after Aneurysmal Subarachnoid Hemorrhage and Surgery

Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 578-581 ◽  
Author(s):  
Juha öhman
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Epileptic Seizures ◽  
Consecutive Series ◽  
Computed Tomographic ◽  
Anticonvulsant Medication ◽  
Computed Tomographic Scan ◽  
History Of ◽  
The Difference ◽  
Lost To Follow Up

Abstract A prospective, consecutive series of 307 patients with aneurysmal subarachnoid hemorrhage ranging from Grades I to V according to the classification of Hunt and Hess on admission were evaluated to determine the incidence of epilepsy 1 to 3 years (mean, 1.4 years) after aneurysmal subarachnoid hemorrhage (SAH) and surgery. Sixty-three patients had died and one patient was lost to follow-up. Twenty-nine patients developed epileptic seizures after the SAH and surgery. The mean time from the SAH to epileptic seizure varied from 0 days (day of the SAH) to 2 years (mean, 6.7 months). The seizures were classified as focal in 9 patients (31%) and as generalized in 20 patients (69%). All patients received anticonvulsant medication after more than one seizure. The risk factors for development of posthemorrhagic/postoperative epilepsy were, in order of importance: a history of hypertension; an infarct on late computed tomographic scan; and the duration of coma after the ictus. Of the 85 patients with histories of hypertension, 17 (20.0%) developed epilepsy. Only 12 (5.4%) of the 222 nonhypertensive patients developed epileptic seizures. The difference between the groups was significant (P =0.0001). Computed tomographic scans were undertaken in 237 patients 1 to 3 years (mean, 1.4 years) after the SAH and surgery. Postoperative epilepsy was significantly associated with infarcts visualized on computed tomographic scan (P = 0.0005).

SURGICAL MANAGEMENT OF A PARACLINOID ANEURYSM CONTAINING A DISPLACED NEUROFORM MICROSTENT

Neurosurgery ◽  
2008 ◽  
Vol 63 (4) ◽  
pp. E817-E817 ◽  
Author(s):  
J. Alex Thomas ◽  
Vance E. Watson ◽  
Kevin M. McGrail
Keyword(s):  
Internal Carotid ◽  
Clinical Presentation ◽  
Aneurysm Neck ◽  
Computed Tomographic ◽  
Proximal Half ◽  
Paraclinoid Aneurysm ◽  
First Case ◽  
Computed Tomographic Scan ◽  
History Of ◽  
The Ideal

ABSTRACT OBJECTIVE We report the first case of clip obliteration of a cerebral aneurysm containing a displaced microstent. CLINICAL PRESENTATION A 63-year-old woman presented with a 6-month history of headaches. She had no other neurological symptoms, and her examination was normal. A computed tomographic scan showed no evidence of hemorrhage. Angiography confirmed the presence of a large left paraclinoid aneurysm. INTERVENTION The patient initially underwent attempted endovascular repair of the aneurysm. A Neuroform microstent (Boston Scientific, Natick, MA), which was placed across the aneurysm neck, migrated into the aneurysm upon passing through it with the microcatheter to be used to place coils. This left the proximal half of the stent in the aneurysm and the distal half in the internal carotid artery. Attempts to remove the stent and to place a second stent across the neck of the aneurysm failed, and any plans to place coils were aborted. Three months after the failed endovascular procedure, the patient consented to a craniotomy. The aneurysm was successfully obliterated by placing several clips directly across the neck of the aneurysm and leaving the stent in place. CONCLUSION The patient experienced an excellent clinical and angiographic outcome. Although not the ideal treatment strategy, this report illustrates that clip obliteration of aneurysms containing displaced microstents can be performed successfully for this complication of endovascular treatment.

Sarcomatoid Carcinoma of the Gallbladder With a Rhabdoid Tumor Component

2003 ◽  
Vol 127 (10) ◽  
pp. e406-e408 ◽  
Author(s):  
Mi-Jung Kim ◽  
Eunsil Yu ◽  
Jae Y. Ro
Keyword(s):  
Sarcomatoid Carcinoma ◽  
Electron Microscopic Examination ◽  
Rhabdoid Tumor ◽  
Electron Microscopic ◽  
Mucin Production ◽  
Computed Tomographic ◽  
Rhabdoid Cells ◽  
Computed Tomographic Scan ◽  
History Of

Abstract We report the case of a sarcomatoid carcinoma with a rhabdoid tumor component originating in the gallbladder, along with immunohistochemical and electron microscopic findings. A 61-year-old woman presented with a 5-month history of right upper quadrant pain. Ultrasonography and a computed tomographic scan indicated gallbladder cancer. She underwent a cholecystectomy and a common bile duct resection. A firm mass (4.5 cm in greatest dimension) was present in the neck portion of the gallbladder. The mass was firm, solid, yellowish gray, and granular with areas of necrosis. Microscopically, the tumor was a biphasic sarcomatoid carcinoma and consisted of diffusely arranged pleomorphic cells, focally showing rhabdoid features and neoplastic glands with focal mucin production. Heterologous components such as osteoid, chondroid, and rhabdomyoblastic elements were not identified. By immunohistochemical staining, we demonstrated that the rhabdoid cells coexpressed cytokeratin and vimentin. On electron microscopic examination, the rhabdoid tumor cells showed cytoplasmic whorls of intermediate filaments in the cytoplasm and eccentric nuclei. Two months postoperatively, the follow-up computed tomographic scan showed multiple intrahepatic metastases and omental seedings.

Can the Tomographic Aspect Characteristics of Patients Presenting with Acute Respiratory Distress Syndrome Predict Improvement in Oxygenation-related Response to the Prone Position?

2002 ◽  
Vol 97 (3) ◽  
pp. 599-607 ◽  
Author(s):  
Laurent Papazian ◽  
Marie-Héléne Paladini ◽  
Fabienne Bregeon ◽  
Xavier Thirion ◽  
Olivier Durieux ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Prone Position ◽  
Supine Position ◽  
Distress Syndrome ◽  
Arterial Oxygen ◽  
Computed Tomographic ◽  
Computed Tomographic Scan ◽  
A Prospective Study

Background In some patients with acute respiratory distress syndrome, the prone position is able to improve oxygenation, whereas in others it is not. It could be hypothesized that the more opacities that are present in dependent regions of the lung when the patient is in the supine position, the better the improvement in oxygenation is observed when the patients are turned prone. Therefore, we conducted a prospective study to identify computed tomographic scan aspects that could accurately predict who will respond to the prone position. Methods We included 46 patients with acute respiratory distress syndrome (31 responders and 15 nonresponders). Computed tomographic scan was performed in the 6-h period preceding prone position. Blood gas analyses were performed before and at the end of the first 6-h period of prone position. Results Arterial oxygen partial pressure/fraction of inspired oxygen increased from 117 +/- 42 (mean +/- SD) in the supine position to 200 +/- 76 mmHg in the prone position (P < 0.001). There were 31 responders and 15 nonresponders. There was a vertebral predominance of the opacities (P < 0.0001). However, there was no difference between responders and nonresponders. When only the amount of consolidated lung located under the heart was evaluated, there was more consolidated tissue under the heart relative to total lung area in nonresponders than in responders (P = 0.01). Conclusions There are no distinctive morphologic features in the pattern of lung disease measured by computed tomographic scanning performed with the patient in the supine position that can predict response to the prone position.

Colloid Cyst of the Fourth Ventricle: Diagnostic Problems and Pathogenic Considerations

Neurosurgery ◽  
1989 ◽  
Vol 24 (6) ◽  
pp. 939-942 ◽  
Author(s):  
Michel Jan ◽  
Vincent Ba Zeze ◽  
Stéphane Velut
Keyword(s):  
Case History ◽  
Fourth Ventricle ◽  
Clinical History ◽  
Colloid Cyst ◽  
Computed Tomographic ◽  
3Rd Ventricle ◽  
Computed Tomographic Scan ◽  
History Of ◽  
Colloid Cysts ◽  
4Th Ventricle

ABSTRACT The authors report the case history of a patient with a colloid cyst of the 4th ventricle. The clinical history of slow intracranial hypertension, homogeneous hyperdensity with contrast enhancement on computed tomographic, scan, and the gelatinous aspect of the cyst at surgery are characteristic of colloid cysts. The diagnosis was made, however, only at the time of histological examination. A common neuroepithelial origin with 3rd ventricle cysts would be explained by similar embryological developments of the prosencephalic and the rhombencephalic roofs.

Chylothorax Associated With a Congenital Peritoneopericardial Diaphragmatic Hernia in a Dog

2009 ◽  
Vol 45 (3) ◽  
pp. 134-137 ◽  
Author(s):  
Chad Weber Schmiedt ◽  
Kate F. Washabaugh ◽  
Deepa B. Rao ◽  
Rebecca L. Stepien
Keyword(s):  
Pleural Effusion ◽  
Diaphragmatic Hernia ◽  
Chest Radiographs ◽  
Diagnostic Evaluation ◽  
Respiratory Effort ◽  
Computed Tomographic ◽  
Cisterna Chyli ◽  
Computed Tomographic Scan ◽  
History Of ◽  
Peritoneopericardial Diaphragmatic Hernia

A 2-year-old dog was presented with a 3-month history of increasing respiratory effort and rate, inappetence, and lethargy. Chest radiographs demonstrated significant pleural effusion, which was consistent with chyle on biochemical and cytological evaluations. Further diagnostic evaluation, including a thoracic computed tomographic scan, revealed a peritoneopericardial diaphragmatic hernia (PPDH) resulting in a large, fat-attenuating mass within the pericardium. The dog was taken to surgery for repair of the PPDH, pericardectomy, and cisterna chyli ablation. Rapid and permanent resolution of the chylothorax occurred postoperatively. This is the first reported case of chylothorax secondary to PPDH.

scholarly journals Postobstructive pulmonary edema: A fatal complication in suicidal near-hanging

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092271
Author(s):  
Mohamed Amin Mesrati ◽  
Oussama Jaoued ◽  
Yosra Mahjoub ◽  
Marwa Boussaid ◽  
Med Fkih Hassen ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Pulmonary Edema ◽  
Fatal Case ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Computed Tomographic ◽  
Computed Tomographic Scan ◽  
Life Threatening ◽  
History Of ◽  
Respiratory State

Postobstructive pulmonary edema is a life-threatening complication that occurs after the removal of severe upper airway obstruction. Development of postobstructive pulmonary edema has been described after several cases of upper airway obstruction. However, postobstructive pulmonary edema developing after non-lethal hanging has not been reported widely in the literature. Herein, we describe a fatal case of postobstructive pulmonary edema in a 10-year-old girl, which was brought to the hospital with history of attempted suicide by hanging. At presentation, the girl was breathing laboriously. The oxygen saturation was of 82% and pulmonary auscultation revealed bilateral and diffuse crepitations. The chest computed tomographic scan showed bilateral diffuse infiltrates consistent with pulmonary edema. After 3 days of hospitalization, the respiratory state of the girl worsened leading to death despite intensive care. An autopsy was conducted and confirmed the diffuse pulmonary edema. Hence, this case confirms that delayed death in near hanging may occur. Pulmonary edema which develops subsequently in such patients is an uncommon mechanism of death that physicians should consider in emergency room.

The Growth of Cerebral Cavernous Angiomas

Neurosurgery ◽  
1989 ◽  
Vol 25 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Eugenio Pozzati ◽  
Giuliano Giuliani ◽  
Giacomo Nuzzo ◽  
Massimo Poppi
Keyword(s):  
Natural History ◽  
The Other ◽  
Capsule Formation ◽  
Cavernous Angiomas ◽  
Computed Tomographic ◽  
Large Size ◽  
Computed Tomographic Scan ◽  
History Of

Abstract The natural history of cavernous angiomas is poorly understood, and their growth has rarely been documented. We report three cases of cavernous angiomas that grew to large size in 6 years, 2 years, and 2 months, respectively. An initial computed tomographic scan disclosed no abnormalities in one patient and demonstrated two “minimal” lesions in the other two. The mechanisms of growth of these lesions are discussed; subsequent hemorrhages and capsule formation played a major role in their enlargement.

Idiopathic External Hydrocephalus: Natural History and Relationship to Benign Familial Macrocephaly

PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 901-907
Author(s):  
Luis A. Alvarez ◽  
Joseph Maytal ◽  
Shlomo Shinnar
Keyword(s):  
Motor Development ◽  
Normal Development ◽  
External Hydrocephalus ◽  
Computed Tomographic ◽  
Gross Motor Development ◽  
Computed Tomographic Scan ◽  
History Of ◽  
Study Population ◽  
Interhemispheric Fissure ◽  
Characteristic Picture

External hydrocephalus was identified in 63 infants. The 36 infants in whom external hydrocephalus was idiopathic constitute the study population. The group was homogeneous. Although not all were macrocephalic at birth, the head circumference exceeded the 95th percentile in all cases by 1 year of age, and subsequent head growth was parallel to the 95th percentile. The head computed tomographic scan showed a characteristic picture of a prominent interhemispheric fissure, a collection of subarachnoid fluid over the frontal convexities, and prominent basal cisternae. Mild ventriculomegaly was present in ten cases. These abnormalities resolved after 18 to 24 months of age. No infant required therapy for the condition. Development was normal in 32 infants, suspect in three, and clearly abnormal in only one of the 36 infants. However, of the 32 infants with normal development, 14 were found to be delayed in gross motor development and five in language development at a prior time. There was a family history of macrocephaly in 88% of cases. Several families had a mixture of members with external hydrocephalus and benign familial macrocephaly throughout several generations. These findings suggest that idiopathic external hydrocephalus is a relatively benign, self-limited condition that resolves without treatment and is closely related to benign familial macroceophaly.

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