Invagination Intestinale Aiguë De L’adulte: Aspects Diagnostiqsues, Thérapeutiques Et Étiologiques

Introduction: Acute intussusception is a rare clinical entity in adults where it accounts for only 1-2% of intestinal obstructions. The authors wanted to report cases of acute intussusception in adult patients, their diagnostic aspects, their management, and their etiologies. Patients and Methods: This study is a retrospective study of the medical files of patients of both sexes. They include adults over 15 years of age, operated between January 2010 and December 2014, who were diagnosed with obstruction due to acute intestinal intussusception. Results: Six cases of adult intestinal intussusception were collected. The average age was 26.5 years. The sex ratio was 1 and there were so many men as women. Five out of six patients were unstable on admission. The diagnosis was made preoperative in two cases out of six, 33.3%. Ultrasound revealed a target sign in two cases. The ileo-ileal form was the most frequent (5 cases out of 6) or 83.3%. Also, there were two cases of intestinal necrosis out of six. Intestinal resection was performed in five cases or 83.33%. The cause of intussusception was found in four cases out of six or 66.7%. Here, a tumor was the cause in half of the cases. Immediate surgical follow-up was uncomplicated in all patients. Conclusion: Acute intestinal intussusception of the adult is a very rare condition. The preoperative diagnosis of acute intussusception of the adult remains delicate. The ileo-ileal form is more frequent than the ileo-colic form in adults. Treatment is always surgical in adults.

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Interventricular membranous septal aneurysm incidentally diagnosed during computed tomographic angiography in a patient with infrequent supraventricular tachycardia

Clinics and Practice ◽

10.4081/cp.2017.921 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 1

Author(s):

Munish Sharma ◽

Farhad Elmi

Keyword(s):

Congenital Heart Disease ◽

Congenital Heart ◽

Rare Condition ◽

Computed Tomographic Angiography ◽

Rare Clinical Entity ◽

Ventricular Septal Defects ◽

Computed Tomographic ◽

Septal Defects ◽

Tomographic Angiography

Interventricular membranous septal (IVMS) aneurysm is a rare condition with no accurate incidence. It is known to be associated with 0.3 % of congenital heart disease and 19 % of ventricular septal defects. IVMS aneurysm is often asymptomatic but can be complicated with right ventricular obstruction, rupture, thromboembolism, and conduction defects. Clinicians and radiologist should be aware about this rare clinical entity and evaluation of any possible underlying cardiac abnormalities should be performed. Conservative management with close follow up is the mainstay of management in the absence of complication.

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Unexpected bony structure in tonsillar fossa during tonsillectomy

Vojnosanitetski pregled ◽

10.2298/vsp151008193c ◽

2017 ◽

Vol 74 (4) ◽

pp. 371-373

Author(s):

Ljiljana Cvorovic ◽

Milan Jovanovic ◽

Dragoslava Djeric ◽

Nenad Arsovic

Keyword(s):

Computed Tomography ◽

Rare Case ◽

Anatomic Variation ◽

Rare Condition ◽

Styloid Process ◽

Rare Clinical Entity ◽

Tonsillar Fossa ◽

Bony Structure ◽

Elongated Styloid Process

Introduction. The elongated styloid process is a very rare clinical entity. In most cases it is asymptomatic, but also could cause Eagle?s syndrome. We presented a rare case of the anatomic variation of styloid process and its clinical implication. Case report. In the left tonsillar fossa an unexpected bony structure was found during the routine tonsillectomy on a 16-year-old female patient. Computed tomography showed the elongated styloid process. No further treatment was necessary because it was asymptomatic in the follow-up period. Conclusion. The elongated styloid process is a very rare condition, but physicians should be aware of it and keep it in mind in order to make the diagnosis in patients with suggestive symptoms.

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Autoimmune Pancreatitis – Diagnosis, Management and Longterm Follow-up

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.232.sc1 ◽

2014 ◽

Vol 23 (2) ◽

pp. 179-185 ◽

Cited By ~ 7

Author(s):

Suvadip Chatterjee ◽

Kofi W. Oppong ◽

John S. Scott ◽

Dave E. Jones ◽

Richard M. Charnley ◽

...

Keyword(s):

Autoimmune Pancreatitis ◽

Rare Condition ◽

Team Approach ◽

Diagnostic Challenge ◽

Multisystem Disorder ◽

North East ◽

The North ◽

Work Up ◽

Igg4 Level

Background & Aims: Autoimmune pancreatitis (AIP) is a fibroinflammatory condition affecting the pancreas and could present as a multisystem disorder. Diagnosis and management can pose a diagnostic challenge in certain groups of patients. We report our experience of managing this condition in a tertiary pancreaticobiliary centre in the North East of England.Methods: Patients were identified from a prospectively maintained database of patients diagnosed with AIP between 2005 and 2013. Diagnosis of definite/probable AIP was based on the revised HISORt criteria. When indicated, patients were treated with steroids and relapses were treated with azathioprine. All patients have been followed up to date.Results: Twenty-two patients were diagnosed with AIP during this period. All patients had pancreatic protocol CT performed while some patients had either MR or EUS as part of the work up. Fourteen out of 22 (64%) had an elevated IgG4 level (mean: 10.9 g/L; range 3.4 - 31 g/L). Four (18%) patients underwent surgery. Extrapancreatic involvement was seen in 15 (68%) patients, with biliary involvement being the commonest. Nineteen (86%) were treated with steroids and five (23%) required further immunosuppression for treatment of relapses. The mean follow up period was 36.94 months (range 7 - 94).Conclusion: Autoimmune pancreatitis is being increasingly recognized in the British population. Extrapancreatic involvement, particularly extrahepatic biliary involvement seems to be a frequent feature.Diagnosis should be based on accepted criteria as this significantly reduces the chances of overlooking malignancy. Awareness of this relatively rare condition and a multi-disciplinary team approach will help us to diagnose and treat this condition more efiectively thereby reducing unnecessary interventions.

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Surgical Treatment of Diffuse Idiopathic Skeletal Hyperostosis (DISH) Involving the Cervical Spine: Technical Nuances and Outcome of a Multicenter Experience

Global Spine Journal ◽

10.1177/2192568220988272 ◽

2021 ◽

pp. 219256822098827

Author(s):

Giorgio Lofrese ◽

Alba Scerrati ◽

Massimo Balsano ◽

Roberto Bassani ◽

Michele Cappuccio ◽

...

Keyword(s):

Cervical Spine ◽

Clinical Outcome ◽

Waiting Times ◽

Diffuse Idiopathic Skeletal Hyperostosis ◽

Surgical Techniques ◽

Rare Condition ◽

Surgical Strategies ◽

Bone Removal ◽

Mild Dysphagia

Study Design: Retrospective multicenter. Objectives: diffuse idiopathic skeletal hyperostosis (DISH) involving the cervical spine is a rare condition determining disabling aero-digestive symptoms. We analyzed impact of preoperative settings and intraoperative techniques on outcome of patients undergoing surgery for DISH. Methods: Patients with DISH needing for anterior cervical osteophytectomy were collected. Swallow studies and endoscopy supported imaging in targeting bone decompression. Patients characteristics, clinico-radiological presentation, outcome and surgical strategies were recorded. Impact on clinical outcome of duration and time to surgery and different surgical techniques was evaluated through ANOVA. Results: 24 patients underwent surgery. No correlation was noted between specific spinal levels affected by DISH and severity of pre-operative dysphagia. A trend toward a full clinical improvement was noted preferring the chisel ( P = 0.12) to the burr ( P = 0.65), and whenever C2-C3 was decompressed, whether hyperostosis included that level ( P = 0.15). Use of curved chisel reduced the surgical times ( P = 0.02) and, together with the nasogastric tube, the risk of complications, while bone removal involving 3 levels or more ( P = 0.04) and shorter waiting times for surgery ( P < 0.001) positively influenced a complete swallowing recovery. Early decompressions were preferred, resulting in 66.6% of patients reporting disappearance of symptoms within 7 days. One and two recurrences respectively at clinical and radiological follow-up were registered 18-30 months after surgery. Conclusion: The “age of DISH” counts more than patients’ age with timeliness of decompression being crucial in determining clinical outcome even with a preoperative mild dysphagia. Targeted bone resections could be reasonable in elderly patients, while in younger ones more extended decompressions should be preferred.

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Rare Etiology of Odynophagia in a Female Adolescent

Case Reports in Gastroenterology ◽

10.1159/000513801 ◽

2021 ◽

pp. 352-358

Author(s):

Anastasios Koutsoumourakis ◽

Asterios Gagalis ◽

Maria Fotoulaki ◽

Maria Stafylidou

Keyword(s):

Antiviral Treatment ◽

Healing Process ◽

Rare Condition ◽

Female Adolescent ◽

Mucosal Barrier ◽

Esophageal Mucosa ◽

Intact Immune System ◽

History Of ◽

Orolabial Herpes

Herpes esophagitis (HE) is a rare condition in immunocompetent adolescents. However, it commonly occurs as a primary infection in younger individuals. Herein, we report a 16-year-old female patient who had a history of fever for 5 days, odynophagia, and orolabial herpes infection for 7 days. Clusters of painful vesicles on an erythematous base on the lips, gingiva, and palate were observed on physical examination. Further, esophagogastroduodenoscopy revealed diffuse linear ulcerations in the distal esophagus. The patient then received the following treatment: intravenous (I.V.) acyclovir 5 mg/kg three times a day, I.V. omeprazole 40 mg two times a day, and acyclovir 5% cream four times a day. After 8 days of admission, the patient was discharged. A follow-up esophagogastroduodenoscopy was performed 7 weeks after discharge, and the results revealed that the esophageal mucosa had a normal appearance. The effect of antiviral treatment against HE remains unknown in these patients. Nevertheless, it is believed to accelerate the healing process in individuals with esophageal mucosal barrier damage. To the best of our knowledge, this case of a female adolescent with an intact immune system is the sixth case of herpes simplex esophagitis to be reported in the literature.

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Brain Abscess Caused by Nocardia: Case Report and Literature Review

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0040-1719124 ◽

2020 ◽

Author(s):

Guilherme Finger ◽

Maria Eduarda Conte Gripa ◽

Tiago Paczko Bozko Cecchini ◽

Tobias Ludwig do Nascimento

Keyword(s):

Case Report ◽

Antibiotic Therapy ◽

Brain Abscess ◽

Clinical Signs ◽

Occipital Lobe ◽

High Morbidity ◽

Rare Clinical Entity ◽

Brain Abscesses

AbstractNocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and a mortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a long-term antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.

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Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00123-8 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Kaoutar Cherrabi ◽

Hind Cherrabi

Keyword(s):

Septic Arthritis ◽

Temporomandibular Joint ◽

Nutritional Assessment ◽

Acute Otitis Media ◽

Clinical Signs ◽

Rare Condition ◽

Pediatric Emergency ◽

Ear Infections ◽

The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

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Persistent Multispecies Actinomyces Mastitis Treated With Repeated Aspiration and Long-Term Oral Antibiotics

The American Surgeon ◽

10.1177/00031348211025748 ◽

2021 ◽

pp. 000313482110257

Author(s):

Colin Jenkins ◽

Anand Ganapathy ◽

Crystal Fancher ◽

Kazuhide Matsushima

Keyword(s):

Antibiotic Therapy ◽

Rare Condition ◽

Breast Abscess ◽

Amoxicillin Clavulanic Acid ◽

Recurrent Breast ◽

Causative Bacterium ◽

Repeated Aspiration ◽

Prolonged Antibiotic Therapy

Actinomycosis is an infection characterized by abscess formation, draining sinuses, and tissue fibrosis. The causative bacterium is a Gram-positive facultative anaerobe from the genus Actinomyces. Infections classically affect the cervicofacial, thoracic, or pelvic region and often require prolonged antibiotic therapy. Actinomycosis of the breast is a rare condition that may present as a recurrent breast abscess. We present a 33-year-old female with a recurrent breast abscess which grew A. radingae and A. israeli on aspirated fluid cultures. Treatment with surgical aspiration and a 6-week course of oral amoxicillin/clavulanic acid 875 mg twice daily resulted in clinical improvement. Our case demonstrates how recurrent breast abscesses caused by Actinomyces can be difficult to manage. Long-term antibiotic therapy with surgical aspiration and regular follow-up offer the best chance of clinical resolution.

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THREE CASES OF BOWEL OBSTRUCTION BY BROAD LIGAMENT HERNIA

British Journal of Surgery ◽

10.1093/bjs/znab160.017 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

M Soto Dopazo ◽

E Pérez Prudencio ◽

A Arango Bravo ◽

C Nuño Iglesias ◽

C Mateos Palacios ◽

...

Keyword(s):

Small Bowel ◽

Bowel Obstruction ◽

Broad Ligament ◽

Intestinal Resection ◽

Laparoscopic Approach ◽

Exploratory Laparotomy ◽

X Rays ◽

Intestinal Necrosis ◽

Urgent Surgery ◽

Internal Hernias

Abstract INTRODUCTION Internal hernias caused by broad ligament defects are an infrequent cause of bowel obstruction. These defects may be congenital or acquired mainly by gynecological antecedents. Small bowel is the most common affected and the diagnosis is difficult due to nonspecific symptoms and absences of characteristic radiological signs. MATERIAL AND METHODS We report the cases of three women aged from 43 to 56 years old, who came to the emergency with abdominal pain, vomiting and bloating of hours duration. One patient has a history of laparoscopic appendectomy, the rest of them with no surgical history. In all of the cases, x-rays showed dilatation of small bowel loops and air-fluid levels and the abdominal TC revealed a generalized distention of bowel loops with transition point in the terminal ileum with no identifiable cause compatible with small bowel obstruction. RESULTS We decided to perform an urgent surgery with an exploratory laparotomy in one case and the rest by laparoscopic approach, finding an internal hernia occasioned by incarceration of small bowel through a broad ligament defect. In all cases, the hernia content was liberated without evidence of ischemia with no need for intestinal resection, and the defect was closed. All patients had a favourable postoperative course without complications. DISCUSSION Broad ligament defects are a rare cause of internal hernias. These are difficult to diagnose clinically as well as radiologically for an absence of characteristic signs. A high level of clinical suspicion allows early diagnosis and the treatment should be performed as soon as possible to reduce the chances of intestinal necrosis.

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Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

Journal of International Medical Research ◽

10.1177/0300060521992234 ◽

2021 ◽

Vol 49 (2) ◽

pp. 030006052199223

Author(s):

Xiaolin Zhang ◽

Hongmei Jiao ◽

Xinmin Liu

Keyword(s):

Case Report ◽

Literature Review ◽

Respiratory Infections ◽

Relevant Literature ◽

Rare Condition ◽

Clinical Entity ◽

Rare Clinical Entity ◽

Esophageal Diverticulum ◽

Bronchoesophageal Fistula ◽

Fatal Complications

Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.

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