Urachal fistula in a 22 year male: a case report

A patent urachus is one of the spectrums of congenital urachal anomalies. It has been termed as "urachal fistula" when the lumen of intra-embryonic portion of allantois persist abnormally. Persisting urachal fistula is a rare condition mostly diagnosed during childhood or in autopsies. Here we report a very rare case of urachal fistula of a young male. We present a case of 22 years male with intermittent periumbilical pain and sero-purulent discharge from umbilicus since birth. On examination sero-purulent discharging umbilical sinus with granuloma was present. Surgical excision of whole of the urachal fistulous tract was done with repair of bladder. Patient did well during post-operative period. Persisting urachal fistula in adult is rare entity and difficult to diagnose because of low incidence and non-specific symptoms. So a high index of suspicion is required in order to make the early diagnosis of urachal anomalies.

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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.

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Primary Ewing's Sarcoma of the Spine: Four Case Report

KYAMC Journal ◽

10.3329/kyamcj.v10i3.44423 ◽

2019 ◽

Vol 10 (3) ◽

pp. 164-167

Author(s):

Md Mofazzal Sharif ◽

Khaleda Parvin ◽

Umme Iffat Siddiqua ◽

A.Q. Mehedi Hassan ◽

Jabed Hossain ◽

...

Keyword(s):

Soft Tissues ◽

Ewing’S Sarcoma ◽

Ewing's Sarcoma ◽

Correct Diagnosis ◽

Surgical Excision ◽

Cord Compression ◽

Acute Paraplegia ◽

Low Incidence ◽

Specific Symptoms ◽

Common Malignancy

Ewing's sarcoma is a common malignancy of the bone and soft tissues in pediatric patients. It mostly affects the long bones and pelvis, and less commonly the flat bones and vertebrae. Primary Ewing's sarcoma affecting the spine is very rare. The patient has non-specific symptoms for a prolonged period of time before the correct diagnosis is given. Patients can present with acute paraplegia due to spinal cord compression, which needs prompt surgical intervention. Early diagnosis and treatment are important for neurological recovery. The definitive management includes three main modalities: surgery, radiotherapy and combination chemotherapy. Adequate surgical excision may not be feasible because of anatomical limitations and local control is mainly achieved by radiotherapy. Because of the low incidence of these tumors, a multitude of therapeutic strategies have been employed with varying success. Currently there are no clinical guidelines outlining optimal management KYAMC Journal Vol. 10, No.-3, October 2019, Page 164-167

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Kimura’s Disease: A Rare Cause of Unilateral Tonsillar Enlargement

Case Reports in Otolaryngology ◽

10.1155/2021/8815317 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Prakash Khanal ◽

Agya Shrestha

Keyword(s):

Histopathological Examination ◽

Cervical Lymphadenopathy ◽

Neck Region ◽

Rare Condition ◽

Surgical Excision ◽

Kimura’S Disease ◽

Inflammatory Disorder ◽

Serum Ige ◽

History Of ◽

High Index Of Suspicion

Introduction. Kimura’s disease is a rare inflammatory disorder of unknown cause, commonly seen in young Asian males. Case Report. A 61-year-old male patient presented with a history of right tonsillar mass and cervical lymphadenopathy. The patient underwent hematological investigation and imaging followed by resection of tonsillar mass. Based on histopathological and subsequent immunohistochemistry reports, the case was diagnosed as Kimura’s disease of the tonsil. Discussion. Kimura’s disease commonly presents as painless subcutaneous masses in the head and neck region or cervical lymphadenopathy. Kimura’s disease presenting as a tonsillar mass is a very rare condition. Patients usually have peripheral eosinophilia and elevated levels of serum IgE. The diagnosis is based on the clinical and histopathologic findings in a biopsy of the mass and/or lymph node along with elevated peripheral eosinophil and serum IgE level. Conclusion. The clinical presentation of Kimura’s disease is highly variable. Kimura’s disease should be considered as a differential diagnosis in patients presenting with a tonsillar mass. A high index of suspicion along with histopathological examination helps in the early diagnosis and management. Surgical excision is the treatment of choice.

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Sudden Death Due to Spontaneous Rupture of the Urinary Bladder following Acute Alcohol Inebriation- A Case report and Review of Literature

International Journal of Global Health ◽

10.14302/issn.2693-1176.ijgh-20-3612 ◽

2020 ◽

Vol 1 (3) ◽

pp. 1-6

Author(s):

Bikash Sah ◽

Shivendra Jha ◽

Dikshant Pokharel

Keyword(s):

Urinary Bladder ◽

Spontaneous Rupture ◽

Alcohol Intoxication ◽

Young Male ◽

Rare Condition ◽

Pelvic Cavity ◽

Acute Alcohol Intoxication ◽

Blood Clots ◽

High Index Of Suspicion ◽

External Injury

Spontaneous rupture of the urinary bladder (SRUB) is a rare clinical condition. Prompt diagnosis is often difficult both clinically and radiologically and necessitates a high index of suspicion as the patients present with non-specific abdominal pain and may not offer a clear history. The depressant effect of alcohol further complicates the diagnosis. We report a case of a young male who was unable to seek medical support and was found dead within 12 hours of the onset of abdominal discomfort following acute alcohol intoxication. At autopsy, rupture of the urinary bladder with blood and blood clots was found in the pelvic cavity with no any corresponding external injury. Spontaneous rupture of the urinary bladder is a rare cause of death in acute alcohol intoxication. In order to further understand this rare condition, the review of related literature has been done.

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880 Rare Benign Chondromyxoid Fibroma of Rib, A Case Report; Is It Really Benign?

British Journal of Surgery ◽

10.1093/bjs/znab259.333 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

B Basak ◽

A Haragan ◽

M Shackcloth ◽

J Thekkudan

Keyword(s):

Benign Tumor ◽

Young Male ◽

Rare Condition ◽

Benign Tumors ◽

High Recurrence Rate ◽

Chondromyxoid Fibroma ◽

Movement Restriction ◽

Adequate Treatment ◽

High Index Of Suspicion

Abstract Chondromyxoid Fibroma is a benign chondrogenic lesion accounting for less than one percent of the bone tumor; hence, likely to be misdiagnosed. Its presentation can vary from asymptomatic to pain, swelling, and movement restriction. The typical presentation includes a young male with a lesion commonly around the knee joint. However, we detail here an unusual presentation of this benign tumor in a 61-year male referred with chest pain and swelling. Histopathology can be very helpful in diagnosing this rare condition showing the characteristic patterns. Besides, as the tumor is locally aggressive, it can often be misinterpreted and treated as sarcoma. Moreover, it has a high recurrence rate. These characteristics make this rare tumor standout from the other benign tumors. Therefore, these cases need to be viewed thoroughly with a high index of suspicion pre-diagnosis and ensure adequate treatment and follow-up for successful management.

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A large parathyroid adenoma presenting with pathological fractures in a young male

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20150907 ◽

2015 ◽

Vol 1 (2) ◽

pp. 88 ◽

Cited By ~ 1

Author(s):

P. K. Sahu ◽

J. R. Galagali ◽

I. D. Singh ◽

Satish Kumar

Keyword(s):

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Young Male ◽

Surgical Excision ◽

Resected Specimen ◽

Pathological Fractures ◽

Present Case Report ◽

Common Cause ◽

The Common ◽

High Index Of Suspicion

Parathyroid adenoma is the common cause of primary hyperparathyroidism and usually presents with features of hypercalcaemia. In the present case report, we describe a case of a large adenoma of the parathyroid gland presenting with pathological fractures. A 42 year old Male presented with bony pains and fracture of the left humerus after a trivial trauma. A detailed clinical examination and laboratory studies revealed hypercalcaemia secondary to hyperparathyroidism. The patient underwent targeted parathyroidectomy of the involved gland after appropriate preoperative localization. Histopathology of the resected specimen was consistent with parathyroid adenoma. Conclusion is a common cause of primary hyperparathyroidism is a common endocrine disorder occurring as a result of Parathyroid adenoma in 80-85% cases. Patients usually present with symptoms related to hypercalcaemia. A high index of suspicion, careful preoperative workup, localization of the affected gland(s) and surgical excision ensures a successful cure.

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Rheology of right ventricular outflow tract obstruction: sub-pulmonary membrane developing months after primary intervention to treat pulmonary atresia with intact interventricular septum

Cardiology in the Young ◽

10.1017/s1047951121001591 ◽

2021 ◽

pp. 1-4

Author(s):

Baher M. Hanna ◽

Wesam E. El-Mozy ◽

Sonia A. El-Saiedi

Keyword(s):

Right Ventricular ◽

Interventricular Septum ◽

Pulmonary Atresia ◽

Right Ventricular Outflow Tract ◽

Rare Condition ◽

Surgical Excision ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Ventricular Outflow Tract Obstruction ◽

The Right

Abstract Isolated sub-pulmonary membrane is a rare condition, the origin of which has been debatable. Transcatheter treatment of pulmonary valve atresia with intact interventricular septum by radiofrequency perforation and balloon dilatation to restore biventricular circulation is gaining more popularity, with improving results over time. We report in our experience of 79 cases in 10 years the development of a sub-pulmonary membrane in 4 cases: causing significant obstruction requiring surgical excision in one case that revealed a fibrous membrane on pathology; causing mild right ventricular outflow tract obstruction in another and not yet causing obstruction in 2. On cardiac MRI, the right ventricular outflow tract and the right ventricular outflow tract/pulmonary atresia angle showed no morphological abnormalities.

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Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽

10.1177/27325016211005062 ◽

2021 ◽

pp. 273250162110050

Author(s):

Samuel Ruiz ◽

Rizal Lim

Keyword(s):

Pediatric Population ◽

Rare Complication ◽

Disease Process ◽

Rare Condition ◽

External Drainage ◽

Direct Extension ◽

Life Threatening ◽

History Of ◽

High Index Of Suspicion ◽

Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

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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.

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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.

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