scholarly journals Sigmoid Volvulus in a Neonate with Anorectal Malformation: A Case Report

2020 ◽  
Vol 2 (1) ◽  
pp. 13-15
Author(s):  
Wilms MC ◽  
Lienert M

Background: Sigmoid volvulus in the neonate is an extremely rare condition needing emergency treatment. Sporadic cases of neonatal sigmoid volvulus and some in association with Hirschsprung’s disease have been documented. Sigmoid volvulus has been described only twice in the literature in association with anorectal malformation. However, newborns with anorectal malformations might be especially at risk for sigmoid volvulus due to increased intraluminal intestinal weight caused by bowel obstruction and its existence might be underreported. Case presentation: This is the case report of a full-term neonate with trisomy 21 who was diagnosed with anorectal malformation upon birth. An abdominal X-ray on his second day of life showed typical radiological findings of sigmoid volvulus as described by the radiologist. However, the findings were interpreted as a dilated rectosigmoid sling typical for anorectal malformation by the surgeon and a transverse loop colostomy was placed. On the fourth postoperative day sigmoid perforation occurred and led to meconium peritonitis and septic shock. An emergency laparotomy was performed and a perforation at the distal sigmoid colon was found. Conclusion: There is an urgent need to raise awareness as to the existence of sigmoid volvulus in the neonate with anorectal malformations. The distinct radiological findings of the “coffee bean sign”, the “northern exposure sign” and an empty rectum allow to distinguish the extremely rare sigmoid volvulus from the common finding of a dilated rectosigmoid in patients with anorectal malformations. Detorsion of sigmoid volvulus is vital to preventing sigmoid perforation.

2021 ◽  
pp. 1-6
Author(s):  
Long Jiahuan Xanicia ◽  
Long Jiahuan Xanicia ◽  
Ng Kok Kit

Renal lymphangiectasia (RLM) is a rare condition characterized by dilatation of perirenal, parapelvic or intrarenal lymphatics. We report an unusual case of bilateral RLM in a 20-year-old Malay male who presented with 1 month duration of bilateral flank pain. Bedside ultrasound showed bilateral perinephric collections, which were further confirmed on computer tomography intravenous pyelogram (CT IVP). Other causes of perinephric collections were ruled out based on laboratory and radiological findings, and he was managed conservatively as for RLM with surveillance ultrasound kidneys at 3 to 6 monthly intervals.


2014 ◽  
Vol 15 (1) ◽  
pp. 84-86
Author(s):  
Forhad H Chowdhury ◽  
Khandkar A Kawsar ◽  
Khandkar A Kawsar ◽  
Mohammod R Haque ◽  
Mohammod R Haque ◽  
...  

Sigmoid volvulus in acromegalic patients is very rare. Here we report a case of sigmoid volvulus in an acromegalic patient who refused surgical treatment for pituitary macroadenoma after initial diagnosis five years back. Sigmoid volvulus was managed successfully by emergency laparotomy and sigmoid colectomy followed by primary end to end anastomosis. Six weeks later she underwent endonasal transsphenoidal removal of pituitary tumor. Postoperatively she improved gradaully and Post operative MRI of brain showed no residual tumor but still her serum GH level is high even after 12 months. So we advised her for radiotherapy. She is scheduled for regular follow up with clinical and investigational assessments.DOI: http://dx.doi.org/10.3329/jom.v15i1.19882 J Medicine 2014; 15: 84-86


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Aikaterini Melemeni ◽  
Aliki Tympa Grigoriadou ◽  
Athanasia Tsaroucha

Abstract Background Free air after laparoscopic hysterectomy is a common finding; in rare cases, free air represents gastrointestinal perforation, requiring emergency laparotomy. Ectopic air localizations after pneumoperitoneum have been reported in various laparoscopic surgical techniques. Delayed diagnosis of visceral perforation is associated with high mortality rates. Case presentation We present a white Caucasian female in which dysphonia due to air entrapment in the cervical area, pneumomediastinum and pneumothorax, occured afterlaparoscopic hysterectomy. Conclusions Upon mobilization of the patient, air from sigmoid perforation moved cephalad. Through the same path, pneumoperitoneum, causes subcutaneous emphysema in the neck and face, pneumomediastinum and pneumothorax.


2019 ◽  
Vol 98 (7) ◽  
pp. 291-296

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.


2019 ◽  
pp. 199-206
Author(s):  
О. З. Скакун ◽  
С. В. Федоров ◽  
О. С. Вербовська ◽  
І. З. Твердохліб

Distinctive atrioventricular type I heart block is diagnosed when the PQ interval is 0.30 s. or more. Prolongation of the PQ interval more than 0.50 s. is a very rare condition. Usually it is associated with a pseudo-pacemaker syndrome. The last one manifests itself with dizziness, syncope, general weakness, shortness of breath upon physical exertion, cough, seizures, cold sweat, a feeling of pulsation in the head, neck and abdomen, a headache, paroxysmal nocturnal dyspnea, swelling of the lower extremities, tachypnea and jugular venous pulsation. The P wave appears immediately after the previous QRS complex. Atrial contraction occurs at the moment when the ventricles don’t relax after the previous contraction; due to the fact that pressure in the ventricles at this moment is higher than in the atria, the tricuspid and mitral valves remains closed. During the atrial contraction, most of the blood is ejected not into the ventricles, but backward into the pulmonary veins from the left atrium and into the venae cavae from the right atrium. Also, an atrial kick is absent which results in a less ventricular filling. There is increased pressure in the atria leading to their distension and excessive secretion of the atrial natriuretic peptide. A case report of the distinctive atrioventricular type I heart block associated with the pseudo-pacemaker syndrome is described. The patient suffered from a pre-syncope, short-term dizziness during the previous two days, tinnitus, general weakness, feeling of pulsation in the abdomen, neck, head, which interfered with his sleep. He developed these complaints after an infectious disease, which manifested as a runny nose and sore throat. In this patient, an extremely prolonged PQ interval up to 0.70 s. was observed. Also, episodes of Mobitz I and Mobitz type II atrioventricular block were detected. During the monitoring of patient state, the interval PQ was gradually shortening, and in 1 month it reached the normаl duration. It can be assumed that in the case of distinctive atrioventricular type I heart block, a significant prolongation of the refractory period in the rapid pathways of the AV-node plays a key role in the pathogenesis of this condition. According to the recommendations of the ACC/AHA (1998), for patients with distinctive atrioventricular type I heart block accompanied by the pseudo-pacemaker syndrome and documented alleviation of symptoms with temporary AV pacing, the pacemaker implantation should be considered (IIaB). The implantation of dual chamber pacemaker may reduce symptoms and lead to an improvement in the functional state of patients, in whom shortening of the interval between atrial and ventricular contractions improves hemodynamics. For asymptomatic patients with the PQ interval of ≥ 0.30 s, pacemaker is not recommended. The distinctive atrioventricular type I heart block in patients with pseudo-pacemaker syndrome is a rare condition and often remains undiagnosed. But it may have a benign course with a gradual normalization of the PQ interval. Indications for permanent pacemaker implantation should be reviewed as this block may be completely reversible. A permanent pacemaker may be used in the case of absence of positive dynamics in a shortening of the PQ interval.    


2020 ◽  
Vol 12 (3) ◽  
pp. 231-235
Author(s):  
Carl Maximilian Thielmann ◽  
Wiebke Sondermann

Erythromelanosis follicularis faciei et colli, a rare condition of unknown etiology, was first described by Kitamura et al. from Japan in 1960. It is characterized by a triad consisting of well-demarcated erythema, hyperpigmentation, and follicular papules. We report the case of a 50-year-old Caucasian male, who had asymptomatic symmetrical facial lesions since the age of 42. His family history was unremarkable. Published erythromelanosis follicularis faciei et colli cases of the last 10 years are summarized in this report to demonstrate the variability and differences in the clinical presentation of this uncommon diagnosis.


2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199223
Author(s):  
Xiaolin Zhang ◽  
Hongmei Jiao ◽  
Xinmin Liu

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.


2021 ◽  
pp. 29-32
Author(s):  
Elsiddig E. Mahmoud

Congenital bilateral humeroradial synostosis (HRS) is a rare condition. It is generally divided into 2 categories. In the first group, which is mainly sporadic, additional upper limb hypoplasia typically coexists. In the second group, which is classically familial, HRS is commonly an isolated upper extremity anomaly. HRS can lead to variable degrees of functional disability. The clinical case reported here illustrates a possibly avoidable presentation of this uncommon condition. In this case report, we present a 6-week-old male who presented with bilateral radius fractures. Radiography revealed congenital HRS at both elbows. No other associated congenital abnormalities were detected, and there was no family history of similar conditions in any first-degree relatives. In cases of congenital HRS, movement at the elbow joint is not possible. Parents who are unaware of this information might try to straighten their infant’s elbows, which in turn may result in fractures of the proximal radius. Hence, early diagnosis and proper parental education could prevent fractures as a sequela of HRS.


2020 ◽  
Vol 11 (1) ◽  
pp. 21
Author(s):  
Claudia Brogna ◽  
Valentina Milano ◽  
Barbara Brogna ◽  
Lara Cristiano ◽  
Giuseppe Rovere ◽  
...  

The partial trisomy 13q encompasses an extensive variability of phenotypic and radiological findings including leukoencephalopathy and brain malformations such as holoprosencephaly, callosal dysgenesis, hippocampal hypoplasia, olfactory hypoplasia, and vermian hypoplasia. We report for the first time a case of a 23-year-old patient affected by de novo partial 13q22.1q34 trisomy (41.7 Mb, 72,365,975-114,077,122x3) presenting with hemiparesis related to both ischemic and haemorrhagic cerebral lesions compatible with cerebral vasculitis due to a possible combination of genetic and immunological interaction.


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