scholarly journals Ileoileal Intussusception - Rare variety

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Naeem Ahmad Khan ◽  
Asma Abdul Razzaq ◽  
Mirrat Imtiaz ◽  
Khalid Rehman Yousaf, ◽  
Nasir Raza Zaidi
Keyword(s):  
Abdominal Ultrasound ◽  
Acute Onset ◽  
Coil Spring ◽  
Ultrasound Probe ◽  
X Ray ◽  
Normal Limits ◽  
History Of ◽  
Laboratory Investigations ◽  
History Of Pain ◽  
Fluid Levels

A 23 years old man presented in emergency with acute onset of pain in the centre of abdomen. He had a history of pain in abdomen & vomiting off and on for one week only. In emergency he was investigated by plain X-Ray abdomen (erect) and other routine laboratory tests. On plain X-ray abdomen multiple air fluid levels were noted & laboratory investigations were within normal limits. He was advised routine abdominal ultrasound which revealed a gut mass measuring about 8x6.5cm showing multilayered pattern. The mass was mobile while pressing with ultrasound probe. The appearances were suggestive of Ileoileal Intussusception (rare variety of intussusception). Barium follow through was done which revealed typical coil spring appearance indicative of Ileoileal intussusception. Surgery was done which confirmed the ultrasound & Barium study findings. There was another finding on surgery after the reduction of intussusception. A rounded mass was seen at the site of intussusception which was found to be the leading factor for this ileo-ilea/ intussusception. Resection and end to end anastomosis was done. On histopathology this mass was turned out to be Fibroliposarcoma.

scholarly journals Bone Mineral Density in Gravida: Effect of Pregnancies and Breast-Feeding in Women of Differing Ages and Parity

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ehud Lebel ◽  
Yuri Mishukov ◽  
Liana Babchenko ◽  
Arnon Samueloff ◽  
Ari Zimran ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Institutional Review Board ◽  
Mineral Density ◽  
X Ray ◽  
Normal Limits ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
History Of ◽  
Breast Fed

Changes of bone during pregnancy and during lactation evaluated by bone mineral density (BMD) may have implications for risk of osteoporosis and fractures. We studied BMD in women of differing ages, parity, and lactation histories immediately postpartum for BMD,T-scores, andZ-scores. Institutional Review Board approval was received. All women while still in hospital postpartum were asked to participate. BMD was performed by dual-energy X-ray absorptiometry (DXA) machine at femoral neck (FN) and lumbar spine (LS) by a single technician. Of 132 participants, 73 (55.3%) were ≤30 years; 27 (20.5%) were primiparous; 36 (27.3%) were grand multiparous; 35 (26.5%) never breast fed. Mean FNT-scores andZ-scores were higher than respective mean LS scores, but all means were within the normal limits. Mean LST-scores andZ-scores were highest in the grand multiparas. There were only 2 (1.5%) outliers with lowZ-scores. We conclude that, in a large cohort of Israeli women with BMD parameters assessed by DXA within two days postpartum, meanT-scores andZ-scores at both the LS and FN were within normal limits regardless of age (20–46 years), parity (1–13 viable births), and history of either no or prolonged months of lactation (up to 11.25 years).

scholarly journals Bilateral Kienböck’s disease concomitant with gouty arthritis

2020 ◽  
Vol 13 (3) ◽  
pp. e233725
Author(s):  
Deepak Chouhan ◽  
Vivek Shankar ◽  
Mohammed Tahir Ansari
Keyword(s):  
Gouty Arthritis ◽  
Left Wrist ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Daily Life Activities ◽  
History Of ◽  
Laboratory Investigations ◽  
History Of Pain ◽  
The Right ◽  
Kienbock’S Disease

A 38-year-old man presented with a 2-month history of pain and stiffness in the bilateral wrist. The pain in right wrist was disabling and severe enough to restrict the daily life activities. After the evaluation of clinical and radiological features, the patient was diagnosed with Kienböck’s disease Lichtman stage IIIB in the right wrist and stage IIIA in the left wrist. Routine laboratory investigations revealed a serum uric acid 9.27 mg/dL. Lunate excision and scaphocapitate fusion were done in the right wrist after discussing with the patient. The histopathological examinations of tophi in synovial tissue were negatively birefringent under polarised light microscopy. It confirmed the diagnoses of gout. Febuxostat was started postoperatively. The patient returned to work at the end of 5 months. There was no recurrence of symptoms and radiological signs of arthritis at the end of 1 year.

scholarly journals Shigella sonneiBacteremia Presenting with Profound Hepatic Dysfunction

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Oluwaseun Shogbesan ◽  
Andrew Rettew ◽  
Bilal Shaikh ◽  
Abdullateef Abdulkareem ◽  
Anthony Donato
Keyword(s):  
Laboratory Data ◽  
Abdominal Ultrasound ◽  
The United States ◽  
Shigella Sonnei ◽  
Public Health Issue ◽  
Watery Stool ◽  
Normal Limits ◽  
Significant Public Health ◽  
History Of

Worldwide, Shigellosis is a significant public health issue, associated with nearly one million deaths annually. About half a million cases ofShigellainfection are reported annually in the United States.Shigellabacteremia is uncommon and generally seen in children and immunocompromised adults. We present a case of aShigella sonneibacteremia with marked hepatic derangement in a 27-year-old previously healthy homosexual male with history of Roux-en-Y gastric bypass, who presented to the emergency room with a 4-day history of loose watery stool, abdominal cramps, nausea and vomiting, and yellow skin of 2-day duration. He reports similar diarrhea illness in two close contacts in preceding days. On examination, he was fully oriented but dehydrated, icteric, and febrile. Laboratory data revealed WBC of 2200/μL, elevated AST and ALT (201 IU/L, 73 IU/L resp.), normal alkaline phosphatase, elevated total and direct bilirubin of 8.2 mg/dL and 4.4 mg/dL, albumin of 3.2 g/dL, INR of 2.9, prothrombin time of 31.7, and platelet of 96,000/μL. Workup for infectious, autoimmune and medication-induced hepatitis, Wilson’s disease, and hemochromatosis was negative. Abdominal ultrasound and computed tomography of the abdomen showed hepatic steatosis and right-sided colitis. Stool and blood cultures were positive forShigella sonnei. He was treated with ciprofloxacin with improvement in liver function. Follow-up blood test 4 months later was within normal limits.

scholarly journals Hyperphosphatemic tumoral calcinosis: a rare differential of periarticular swelling

2020 ◽  
Vol 8 (5) ◽  
pp. 1874
Author(s):  
Sunil Nanjareddy ◽  
Rajashree Paidipatti ◽  
Vishwanath Muttagaduru Shivalingappa ◽  
Nuthan Jagadeesh
Keyword(s):  
Soft Tissue ◽  
Rare Condition ◽  
The Body ◽  
Tumoral Calcinosis ◽  
Greater Trochanter ◽  
X Ray ◽  
Osseous Involvement ◽  
History Of ◽  
Calcium Deposits ◽  
History Of Pain

Tumour calcinosis is a rare clinical and histopathological syndrome characterised by deposition of calcium deposits in different periarticular soft tissue regions of the body. It mainly manifest in childhood/ adolescence as a painless, firm to hard tumour like mass around the joints. Most common regions involved: Shoulder, elbow and hip. An 18 year old male patient presented to the opd with a history of pain and swelling over his left hip since 2 months. On examination, there was a diffuse tender swelling over the left greater trochanter, skin over the swelling was normal with no discharge, no dilated/ engorged veins. Range of motion of left hip was normal, no limb length discrepancies. X-ray: Showed a well define calcified mass over the greater trochanter with no osseous involvement. MRI revealed an encapsulated hypointense mass present posterior to the greater trochanter, mostly in the muscular plane. Lab findings revealed mild hyperphosphetemia. An aspirate from the swelling showed casseousmaterial. En mass removal was done and sent for biopsy. Biopsy showed features suggestive of tumoral calcinosis. Tumoral calcinosis is a distinct clinico-radiopathological entity characterised by soft tissue periarticular calcinosis which mimics a true neoplasm, associated with elevated levels of serum phosphate. It is an extremely rare condition which is seen in the adolescence and requires more studies regarding the surgical and medical management of the same.

scholarly journals Retrocaval Ureter: Report of Two Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Henry Atawurah ◽  
Patrick Opoku Manu Maison ◽  
Mohammed Owusu-Ansah ◽  
Alvin Asante-Asamani
Keyword(s):  
Congenital Anomaly ◽  
Vena Cava ◽  
Abdominal Ultrasound ◽  
Flank Pain ◽  
Cape Coast ◽  
Rare Congenital Anomaly ◽  
Retrocaval Ureter ◽  
Ct Urogram ◽  
History Of ◽  
Laboratory Investigations

Retrocaval ureter (RCU) is a rare congenital anomaly in which the ureter passes posterior to the inferior vena cava (IVC). A little over 200 cases have been reported worldwide since Hochstetter’s first report in 1893. We present two cases of retrocaval ureter which were successfully managed at the Cape Coast Teaching Hospital in Ghana. Case 1. A 55-year-old woman presented with a history of dull right flank pain of 2 years duration. Physical examination and basic laboratory investigations performed on her were normal. Abdominal ultrasound showed right hydronephrosis and a retrograde right ureteropyelogram (RPG) showed right hydroureteronephrosis with an “S” shaped proximal ureter. A diagnosis of retrocaval ureter was made and confirmed at surgery. Case 2. A 25-year-old man presented with dull intermittent right flank pain of 1 year duration. Clinical examination and laboratory investigation were normal. Abdominal ultrasound showed right hydronephrosis and a CT urogram made a diagnosis of retrocaval ureter which was confirmed at surgery. Conclusion. Retrocaval ureter is a rare congenital anomaly that is now increasingly being reported. Surgical treatment of symptomatic cases successfully relieves symptoms.

Teenage boy with bullous rash

2020 ◽  
pp. edpract-2019-317600
Author(s):  
McKenna Elizabeth Boyd ◽  
Shabana Yusuf
Keyword(s):  
Abdominal Ultrasound ◽  
Renal Ultrasound ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
List Type ◽  
High Power Field ◽  
Normal Limits ◽  
History Of ◽  
Left And Right ◽  
Left Image ◽  
Probable Diagnosis

­A 14-year-old boy with recent antibiotic treatment for tonsillitis, presented to the emergency department with 1-week history of worsening rash and haemorrhagic bullae involving the bilateral legs, trunk and hands (figures 1 and 2). Laboratory results were significant for proteinuria (2+protein) and haematuria (1+, 5–10 red blood cells/high power field); 24 hours urinary protein and renal function were within normal limits. The patient had an inconclusive skin biopsy.Figure 1Left and right images show palpable purpura with some overlying bullae and vesiculation coalescing into plaques on both lower extremities.Figure 2Left image shows rash on abdominal wall and right image shows coalesced haemorrhagic bullae on hands.QuestionsWhat is the most probable diagnosis?Bullous Ig A vasculitisMeningococcemiaBullous impetigoEosinophilic granulomatosis with polyangiitisCryoglobulinemiaWhat is the best test which will establish the diagnosis in this patient?Renal ultrasoundRenal biopsyAbdominal ultrasoundCreatinine clearanceWhat is first line of treatment in this patient?AntibioticsSteroidsSurgical debridementMultispecialty consultationImmunosuppressants such as azothioprineWhat other systems can this condition affect besides the skin?LungsKidneysSpleenNervous systemA, B and DAnswers can be found on page 02.

scholarly journals Unprovoked hemothorax : an unusual presentation in Dengue Haemorrhagic Fever

2016 ◽  
Vol 7 (3) ◽  
pp. 121-122
Author(s):  
Robin George Manappallil
Keyword(s):  
Viral Disease ◽  
Acute Onset ◽  
Dengue Haemorrhagic Fever ◽  
Haemorrhagic Fever ◽  
Medical Sciences ◽  
X Ray ◽  
The World ◽  
History Of ◽  
Chest X Ray ◽  
Plasma Leakage

According to WHO, Dengue fever (DF) is the most rapidly spreading mosquito-borne viral disease in the world. Dengue Haemorrhagic fever (DHF) is a severe and more serious form of DF, characterised by fever, bleeding manifestations, plasma leakage and thrombocytopenia. This is a case of a 28 year old male, who presented with history of fever and myalgia and was diagnosed to have DF. He had developed acute onset dyspnoea and his chest X-Ray showed right sided pleural effusion. Pleurocentesis revealed haemorrhagic fluid in the absence of trauma.Unprovoked hemothorax as an initial presentation of DHF has rarely been reported.Asian Journal of Medical Sciences Vol.7(3) 2016 121-122

scholarly journals Appendicitis-Like Picture Induced by Foreign Body in a 2-Year-Old Boy

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sadi A. Abukhalaf ◽  
Rami A. Misk ◽  
Hussam I. Alzeerelhouseini ◽  
Ismaeel M. Irziqat ◽  
Abdulrahman H. Asaferah ◽  
...  
Keyword(s):  
Foreign Body ◽  
Perforated Appendicitis ◽  
Abdominal Ultrasound ◽  
Case Presentation ◽  
X Ray ◽  
Delay In Diagnosis ◽  
High Clinical Suspicion ◽  
Cecal Perforation ◽  
History Of ◽  
Inflammatory Changes

Background and Aim. Appendicitis is unusual in toddlers and foreign body- (FB-) induced appendicitis is rare. We present a FB-induced appendicitis in a toddler with no suggestive history of FB ingestion. Case Presentation. A 2-year-old healthy boy presented to the emergency department with irritability for 3 days duration associated with fever of 39°C, nausea, anorexia, and vomiting. There was no history of foreign body ingestion. The abdomen was distended and diffusely tender. An abdominal ultrasound (US) was suggestive of perforated appendicitis with appendicular mass formation. An abdominal X-ray showed a pin-like foreign body in the abdomen. An emergent appendectomy was performed. Intraoperatively, a sealed small cecal perforation was noticed. A 5 cm pin-like metallic foreign body was found to obstruct the appendicular lumen. The appendix was grossly normal without inflammatory changes. Conclusion. FB-induced perforations or appendicitis albeit in patients with no history of FB ingestion or infants and toddlers need a high clinical suspicion to prevent the delay in diagnosis and the subsequent complications.

scholarly journals Dengue and scrub typhus co-infection causing septic shock

2021 ◽  
Vol 2021 (11) ◽  
Author(s):  
Prakriti Subedi ◽  
Manoj Ghimire ◽  
Karun Shrestha ◽  
Kalpana Ghimire ◽  
Sudeep Adhikari ◽  
...  
Keyword(s):  
Septic Shock ◽  
Clinical Improvement ◽  
Scrub Typhus ◽  
Intravenous Fluids ◽  
High Grade Fever ◽  
X Ray ◽  
Chest Auscultation ◽  
History Of ◽  
Chest X Ray ◽  
Laboratory Investigations

ABSTRACT A 33-year-old female presented with a history of high-grade fever, cough, dyspnea, joint pain and myalgia. On examination, the patient was febrile with tachycardia, hypotension and decreased oxygen saturation. Chest auscultation revealed bilateral decreased air entry with crepitation supported by bilateral pulmonary infiltrates on chest X-ray. The laboratory investigations showed leukocytosis, thrombocytopenia, transaminitis and renal impairment. The patient was treated with intravenous fluids, ceftriaxone and levofloxacin; however, there was no clinical improvement till 48 h. She was then diagnosed with scrub typhus and dengue co-infection via serologies. Doxycycline was started following which the patient improved in 24 h. Scrub typhus can present with septic shock but does not respond to the usual antibiotics and the addition of doxycycline will result in rapid clinical improvement. Co-infection with other tropical diseases such as dengue is also common, hence it is important to test based on local endemicity.

scholarly journals An Unusual Pulmonary Condition Presenting following Trauma

2006 ◽  
Vol 13 (7) ◽  
pp. 384-386
Author(s):  
John RA Turkington ◽  
Eamon McAteer ◽  
Rory P Convery
Keyword(s):  
Left Lung ◽  
Pleuritic Chest Pain ◽  
Radiographic Appearance ◽  
X Ray ◽  
System A ◽  
Difficulty Breathing ◽  
History Of ◽  
Chest X Ray ◽  
Fluid Levels ◽  
Lung Base

An 18-year-old man presented to the emergency department following an assault. He complained of left-sided pleuritic chest pain and difficulty breathing. Clinical examination revealed reduced air entry and coarse crepitations at the left lung base. A chest x-ray showed a large opacity at the left lung base that contained multiple cystic areas with air-fluid levels. Due to the history of trauma, a provisional diagnosis of a ruptured hemidiaphragm with small bowel herniation was made. Further imaging, including ultrasound, spiral computed tomography and magnetic resonance angiography, showed an aberrant vessel supplying the opacity and drainage into the pulmonary venous system. A diagnosis of a bronchopulmonary sequestration (intralobar type) was made. The differential diagnosis of the radiographic appearance is also discussed.

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