scholarly journals A Five Years Old Child with Failure To Thrive and Vomiting Presenting as a Diagnostic Dilemma: A Case Report

2020 ◽  
Vol 58 (228) ◽  
Author(s):  
Anita Lamichhane ◽  
Rupesh Sharma ◽  
Ramana Rajkarnikar ◽  
Rubee Awale ◽  
Prapti Shrestha ◽  
...  
Keyword(s):  
Failure To Thrive ◽  
Exploratory Laparotomy ◽  
Age Group ◽  
Older Children ◽  
Diagnostic Challenge ◽  
High Resolution Computed Tomography ◽  
Diagnostic Dilemma ◽  
Recurrent Vomiting ◽  
Colicky Pain ◽  
Band Failure

Vomiting with failure to thrive in older children is a diagnostic challenge due to the diversity in the diagnosis. We report a case of a five-years-old girl with failure to thrive, history of recurrent vomiting and intermittent colicky pain abdomen since 45 days of life. Intestinal malrotation with Ladd’s band was diagnosed based on clinical acumen, high- resolution computed tomography, barium follow through and intraoperative findings. Exploratory laparotomy with Ladd’s procedure was performed under general anesthesia which showed malrotation at the duodenojejunal junction with a short route of mesentery with floating caecum with Ladd’s band. Failure to thrive with malrotation of the gut in the older age group is rare in itself. As there are very few cases reported in this age group, so we undertook to report this case to increase the awareness of knowledge concerning the diagnosis and timely management to prevent the comorbidity of this condition.

Gossypiboma - A Diagnostic Dilemma

2021 ◽  
Vol 11 (5) ◽  
pp. 329-332
Author(s):  
Faaizah Shaikh ◽  
Sujoy Mani ◽  
Abhay Gursale
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Exploratory Laparotomy ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Surgical Sponge ◽  
Retained Foreign Body ◽  
History Of ◽  
Gastric Mass ◽  
Vague Abdominal Pain

A surgical sponge is the most common type of retained foreign body (RFB) also known as a gossypiboma (gossypium = cotton, boma = concealment). It is mostly asymptomatic but can lead to a host of symptoms in the patient ranging from pain in the abdomen to anorexia and weight loss. It poses a diagnostic challenge not just for the surgeon but also the radiologist as it can mimic an intraabdominal mass. Here we present a case of a 58 yrs old male who presented with dysphagia and abdominal pain on and off who was radiologically diagnosed as a case of gastric mass and subsequently underwent exploratory laparotomy where it was proven to be a gossypiboma. The case attempts to highlight the importance of keeping gossypiboma as a differential diagnosis for patients with vague abdominal pain and history of a surgery in the past. Key words: gossypiboma, sponge, abdominal pain, computed tomography, foreign body.

scholarly journals A rare acute presentation of intestinal malrotation in the elderly

2020 ◽  
Vol 7 (10) ◽  
pp. 3432
Author(s):  
Abidemi A. Adesuyi ◽  
Oladele O. Situ ◽  
Cephas S. Batta
Keyword(s):  
The Elderly ◽  
Intestinal Malrotation ◽  
Age Group ◽  
Midgut Volvulus ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Acute Presentation ◽  
History Of ◽  
High Index Of Suspicion

Intestinal malrotation, a congenital anomaly of the midgut, typically presents in pediatrics age group with the most feared complication of midgut volvulus and its catastrophic sequelae. Midgut volvulus secondary to intestinal malrotation is a rare presentation in adults more so in the elderly. Its rarity portends a diagnostic dilemma for both the surgeon and radiologist. We report a 65-year-old man admitted following a referral with a 12-hour history of acute abdomen with an initial diagnosis of acute pancreatitis but later had laparotomy with intraoperative findings of a midgut volvulus and gangrenous ileal segment secondary to intestinal malrotation. This case emphasizes the importance of early diagnosis to prevent the disastrous complication of this disease. The rarity of this condition portends a formidable diagnostic challenge in adults hence the awareness of its possibility and a high index of suspicion is crucial in diagnosis.

scholarly journals Dual threat of comorbidity of celiac disease and systemic lupus erythematosus

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Yimin Ma ◽  
Duanming Zhuang ◽  
Zhenguo Qiao
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Celiac Disease ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Severe Malnutrition ◽  
Systemic Lupus ◽  
Electrolyte Disorders ◽  
Diagnostic Challenge ◽  
Immune Mediated

Celiac disease (CD) is a chronic immune-mediated intestinal disease that is characterized by production of autoantibodies directed against the small intestine. The main clinical manifestations of CD are typically defined as those related to indigestion and malabsorption. These manifestations include unexplained diarrhea or constipation, abdominal pain, bloating, weight loss, anemia, failure-to-thrive in children, and decreased bone density. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by heterogeneous clinical manifestations, which may also involve the gastrointestinal tract. Comorbidity of CD and SLE is rare, and the overlapping symptoms and nonspecific clinical presentation may pose a diagnostic challenge to clinicians. We report here a case of SLE with CD, which mainly manifested as recurrent diarrhea, uncorrectable electrolyte disorders, and severe malnutrition. Through review, we hope to further improve our understanding and diagnostic level of this combination of diseases.

Duodenal Obstruction in a Patient Previously Treated With EndoVascular Aneurysm Sealing System Repair

2021 ◽  
pp. 153857442110125
Author(s):  
Carlo Biddau ◽  
Carlo Nagliati ◽  
Michele Graziano ◽  
Lorenzo Cereser ◽  
Giovanni Terrosu ◽  
...  
Keyword(s):  
Duodenal Obstruction ◽  
Acute Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Biomedical Literature ◽  
Aortic Aneurysms ◽  
Extensive Search ◽  
Novel Approach ◽  
Abdominal Aortic ◽  
Recurrent Vomiting ◽  
Previously Treated

The Nellix® endovascular aneurysm sealing system (EVAS) is a relatively novel approach for the treatment of abdominal aortic aneurysms (AAAs). We present herein a case of duodenal obstruction (DO) which occurred following an EVAS treatment for the repair of an AAA. A 77-year old man was admitted to our hospital with acute abdominal pain and recurrent vomiting. Computed tomography (CT) revealed a retroperitoneal 66 × 59 × 90 mm (antero-posterior, AP; latero-lateral, LL; cranio-caudal: CC) solid mass located in the epigastrium, corresponding to the infrarenal abdominal aortic aneurysm sac, previously treated by EVAS. An exploratory laparotomy was performed, which revealed a retroperitoneal mass compressing the third and fourth parts of the duodenum. A gastroenteroanastomosis was performed in order to bypass the duodenal obstruction. An extensive search of biomedical literature databases was conducted to identify similar cases. To our knowledge, this is the first reported case of DO following an AAA repair with EVAS.

scholarly journals Benign Osteoblastoma Involving Maxilla: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
K. Bokhari ◽  
M. S. Hameed ◽  
M. Ajmal ◽  
Rafi A. Togoo
Keyword(s):  
Case Report ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Histopathological Diagnosis ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Long Term Follow Up ◽  
Rare Benign Tumor ◽  
Benign Osteoblastoma ◽  
Maxilla And Mandible

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma.Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free.Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion—Benign Osteoblastoma.

scholarly journals Infant Acute Myeloid Leukemia: A Unique Clinical and Biological Entity

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 777
Author(s):  
Charlotte Calvo ◽  
Odile Fenneteau ◽  
Guy Leverger ◽  
Arnaud Petit ◽  
André Baruchel ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Lymphoblastic Leukemia ◽  
Age Groups ◽  
Study Groups ◽  
Biological Entity ◽  
Age Group ◽  
Older Children ◽  
Megakaryoblastic Leukemia ◽  
Acute Myeloid

Infant acute myeloid leukemia (AML) is a rare subgroup of AML of children <2 years of age. It is as frequent as infant acute lymphoblastic leukemia (ALL) but not clearly distinguished by study groups. However, infant AML demonstrates peculiar clinical and biological characteristics, and its prognosis differs from AML in older children. Acute megakaryoblastic leukemia (AMKL) is very frequent in this age group and has raised growing interest. Thus, AMKL is a dominant topic in this review. Recent genomic sequencing has contributed to our understanding of infant AML. These data demonstrated striking features of infant AML: fusion genes are able to induce AML transformation without additional cooperation, and unlike AML in older age groups there is a paucity of associated mutations. Mice modeling of these fusions showed the essential role of ontogeny in the infant leukemia phenotype compared to older children and adults. Understanding leukemogenesis may help in developing new targeted treatments to improve outcomes that are often very poor in this age group. A specific diagnostic and therapeutic approach for this age group should be investigated.

scholarly journals Tubulocystic renal cell carcinoma: Report of a rare case

2015 ◽  
Vol 9 (9-10) ◽  
pp. 654 ◽  
Author(s):  
Aanchal Kakkar ◽  
Mehar C. Sharma ◽  
Manpreet Uppal ◽  
Sunil Chumber
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Histopathological Examination ◽  
Cystic Neoplasm ◽  
Diagnostic Challenge ◽  
Elderly Male ◽  
Diagnostic Dilemma ◽  
Cystic Neoplasms ◽  
Atypical Cells

Cystic neoplasms of the kidney are rare, and present a unique diagnostic challenge. We report the case of an elderly male who presented with a large cystic neoplasm, which was a diagnostic dilemma clinically and radiologically. Histopathological examination showed a tumour composed of variably sized tubules lined by atypical cells having large round nuclei with prominent nucleoli. Hobnailing was seen at places. Tumour cells were immunopositive for pancytokeratin, vimentin, CD10, CK19 and AMACR, confirming a diagnosis of tubulocystic renal cell carcinoma (TC-RCC).

scholarly journals Uterine Epithelioid Trophoblastic Tumor in a 44-Year-Old Woman: A Diagnostic Dilemma

2021 ◽  
Vol 11 (3) ◽  
pp. 631-639
Author(s):  
Maria-Gabriela Aniţei ◽  
Diana-Elena Lazăr ◽  
Raluca Alina Pleşca ◽  
Cristina Terinte ◽  
Radu Iulian ◽  
...  
Keyword(s):  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Natural Childbirth ◽  
Trophoblastic Tumor ◽  
Epithelioid Trophoblastic Tumor ◽  
Uterine Curettage ◽  
Normal Human ◽  
Poorly Differentiated ◽  
Β Hcg

Background: Epithelioid trophoblastic tumor (ETT) is a rare and newly defined disease, which most commonly occurs in women of reproductive age and can be a sequela of any gestational event. ETT can be present in both intrauterine and extrauterine sites. Case report: A woman of reproductive age, without specific comorbidities and with a single pregnancy and natural childbirth eight years ago, was diagnosed initially with poorly differentiated pleomorphic leiomyosarcoma on the hemostatic uterine curettage. Conclusion: Our case highlights that ETT presents a diagnostic challenge due to its rarity and histologic resemblance to other pathologies. Misdiagnosis delays effective treatment and affects survival. To date, only 8 cases of ETT of the uterus without previous gestational event and normal human chorionic gonadotropin (β-HCG) levels in a 60-year literature survey have been reported.

scholarly journals A Diagnostic Dilemma of Cryptogenic Organising Pneumonia

2012 ◽  
Vol 52 (188) ◽  
Author(s):  
K Gurung
Keyword(s):  
Steroid Therapy ◽  
Lung Biopsy ◽  
Early Recognition ◽  
Steroid Treatment ◽  
Age Group ◽  
Shortness Of Breath ◽  
Diagnostic Dilemma ◽  
Good Outcome ◽  
Lung Condition

Cryptogenic Organising Pneumonia is a rare lung condition, which has incidence of 6-9 cases per 1000,000 people with onset at age group between 50-60. The pathogenesis of this condition remains unknown. It mimics like pneumonia but has a good outcome with steroid treatment. Early recognition is very important and treatment with steroid therapy can save lives. This case highlights the unusual cause of shortness of breath due to COP and co existing incidental severe AS where we faced a diagnostic dilemma till lung biopsy was performed. Keywords: Cryptogenic organising pneumonia; Pneumonia.

scholarly journals Coexistent Tuberculosis of Spine and Chronic Myeloid Leukemia: Resolving the Diagnostic Dilemma and Management

2015 ◽  
Vol 49 (2) ◽  
pp. 85-87
Author(s):  
Arvind Jayaswal ◽  
Sanjay Yadav ◽  
Ankur Goswami ◽  
G Vijayraghavan
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Management Strategies ◽  
Poor Response ◽  
Diagnostic Methods ◽  
Current Standard ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Ct Guided ◽  
Tuberculosis Of Spine

ABSTRACT Tuberculosis (TB) and association with hematological malignancy is well described in literature. Lymphoid malignancies like non-Hodgkin lymphoma and chronic lymphocytic lymphoma (CLL) are documented but chronic myeloid leukemia (CML) is uncommon. The association of TB and malignancy can be sequential, concurrent or masquerading. We encountered a case posing diagnostic challenge between CML and tuberculosis. The objective to report such a clinical situation is to be aware of such rare possibilities, to analyze the diagnostic methods and subsequent management strategies. Though tuberculosis is usually the first differential diagnosis in endemic areas, it can be overstressed upon and other concurrent pathologies may be missed. Such possibilities should be kept in consideration in cases with poor response or clinical deterioration on antitubercular treatment (ATT). The importance of tissue diagnosis by CT-guided core biopsy as current standard of care is reiterated even in prevalent regions. Multidisciplinary approach is must for optimum outcome. How to cite this article Yadav S, Jayaswal A, Vijayraghavan G, Goswami A. Coexistent Tuberculosis of Spine and Chronic Myeloid Leukemia: Resolving the Diagnostic Dilemma and Management. J Postgrad Med Edu Res 2015;49(2):85-87.

Sign in / Sign up

Export Citation Format

Share Document