scholarly journals Oral ingestion of lidocaine for suicide: A case report

2020 ◽  
Vol 7 (2) ◽  
pp. 135-136
Author(s):  
Maryam Adimolmasali ◽  
Ali Teimouri ◽  
Hamid Reza Mokhtari ◽  
Mahdi Foroughian ◽  
Parvin Zohoorian Sadr ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Lipid Emulsion ◽  
Suicide Attempts ◽  
Medical Science ◽  
General Ward ◽  
Oral Ingestion ◽  
Case Presentation ◽  
Topical Anesthetics ◽  
History Of

Objective: Systemic toxemia with topical anesthetics could be fatal due to the use of anesthetics in various ways (oral, intravenous, intramuscular, or subcutaneous). Nowadays, topical anesthetics are used in inpatient and outpatient treatments. Despite its widespread usage, many physicians are not fully aware of the deadly side effects of lidocaine poisoning and its treatment. The objective of this case report is to highlight the diagnosis and treatment of lidocaine toxicity. Case Presentation: A 21-year-old woman with a history of multiple suicide attempts ingested approximately three 10% w/w lidocaine sprays. The patient was brought to the emergency department of Imam Reza hospital of Mashhad University of Medical Science with cardiac arrest and respiratory failure. After successful cardiopulmonary resuscitation (CPR), she was admitted to the intensive care unit (ICU). She stayed in ICU for 2 days and we administered dobutamine drip and intravenous lipid emulsion for her then she was transferred to the general ward. We discharged her after 8 days. Conclusion: Using BCLS and ACLS in case of cardiac arrest and administration of Lipid Emulsion with proper dosage are recommended treatments for lidocaine toxicity.

An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  
Keyword(s):  
Case Report ◽  
Sigmoid Colon ◽  
Immunohistochemical Staining ◽  
Late Onset ◽  
Hirschsprung Disease ◽  
Endoscopic Examination ◽  
Case Presentation ◽  
Idiopathic Megacolon ◽  
History Of ◽  
Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

scholarly journals The spontaneous resolution of a vortex vein varix: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci
Keyword(s):  
Case Report ◽  
Natural History ◽  
Extended Period ◽  
Spontaneous Resolution ◽  
Case Presentation ◽  
Clinical Resolution ◽  
History Of ◽  
Vortex Vein ◽  
Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

scholarly journals Acute Iodine Toxicity from a Suspected Oral Methamphetamine Ingestion

2014 ◽  
Vol 7 ◽  
pp. CCRep.S20086 ◽  
Author(s):  
Marilyn N. Bulloch
Keyword(s):  
Case Report ◽  
Gastrointestinal Symptoms ◽  
Liver Function Tests ◽  
Oral Ingestion ◽  
Methamphetamine Abuse ◽  
Normal Limits ◽  
Naturally Occurring ◽  
History Of ◽  
Systemic Symptoms ◽  
Iodine Toxicity

Background Iodine is a naturally occurring element commercially available alone or in a multitude of products. Iodine crystals and iodine tincture are used in the production of methamphetamine. Although rarely fatal, iodine toxicity from oral ingestion can produce distressing gastrointestinal symptoms and systemic symptoms, such as hypotension and tachycardia, from subsequent hypovolemia. Objective The objective of this case report is to describe a case of iodine toxicity from suspected oral methamphetamine ingestion. Case Report A male in his early 20′s presented with gastrointestinal symptoms, chills, fever, tachycardia, and tachypnea after orally ingesting a substance suspected to be methamphetamine. The patient had elevated levels of serum creatinine, liver function tests, and bands on arrival, which returned to within normal limits by day 4 of admission. Based on the patient's narrow anion gap, halogen levels were ordered on day 3 and indicated iodine toxicity. This is thought to be the first documented case of iodine toxicity secondary to suspected oral methamphetamine abuse. Conclusion Considering that the incidence of methamphetamine abuse is expected to continue to rise, clinicians should be aware of potential iodine toxicity in a patient with a history of methamphetamine abuse.

scholarly journals Case report: 2 cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endonasal transsphenoidal endoscopic pituitary surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Wang ◽  
Hongwei Cai ◽  
Huiping Ding ◽  
Xiaoping Xu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Arrest ◽  
Case Report ◽  
Nasal Cavity ◽  
Pituitary Surgery ◽  
Case Presentation ◽  
Clinical Anesthesia ◽  
Vagus Reflex

Abstract Background Trigeminal-cardiac reflex (TCR) is a brainstem vagus reflex that occurs when any center or peripheral branch of the trigeminal nerve was stimulated or operated on. The typical clinical manifestation is sudden bradycardia with or without blood pressure decline. The rhino-cardiac reflex which is one type of TCR is rare in clinical practice. As the rhino-cardiac reflex caused by disinfection of the nasal cavity is very rare, we report these two cases to remind other anesthesiologists to be vigilant to this situation. Case presentation This case report describes two cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endoscopic transsphenoidal removal of pituitary adenomas. Their heart rate all dropped suddenly at the very moment of nasal stimulation and recovered quickly after stimulation was stopped and the administration of drugs or cardiac support. Conclusion Although the occurrence of rhino-cardiac reflex is rare, we should pay attention to it in clinical anesthesia. It is necessary to know the risk factors for preventing it. Once it occurs, we should take active and effective rescue measures to avoid serious complications.

scholarly journals Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

2017 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
Thomas-Michael Schneider ◽  
Friederike Klenner ◽  
Franz Brettner
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Therapeutic Option ◽  
High Dose ◽  
Great Success ◽  
Case Presentation ◽  
Computed Tomographic ◽  
Rehabilitation Hospital ◽  
Membrane Oxygenation ◽  
History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

scholarly journals An unusual cause of delayed hematoma after carotid endarterectomy: a case report

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yi Zhao ◽  
Zhichao Lai ◽  
Xiaojun Song ◽  
Rong Zeng ◽  
Changwei Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Carotid Endarterectomy ◽  
Early Stage ◽  
Prostatic Hyperplasia ◽  
Surgical Patients ◽  
Blood Products ◽  
Case Presentation ◽  
Life Threatening ◽  
History Of

Abstract Background Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively. Case presentation We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed. Conclusions This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

scholarly journals Unicuspid aortic valve concomitant with aortic insufficiency presenting with infectious endocarditis: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Naoko Yuzawa-Tsukada ◽  
Toshikazu D. Tanaka ◽  
Satoshi Morimoto ◽  
Michihiro Yoshimura
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Insufficiency ◽  
Infectious Endocarditis ◽  
Cardiac Abnormality ◽  
Case Presentation ◽  
Old Japanese ◽  
History Of ◽  
Nonbacterial Thrombotic Endocarditis ◽  
High Turbulence

Abstract Background A unicuspid aortic valve is a rare congenital cardiac abnormality. Despite its uncommon finding on an initial presentation, aortic insufficiency is accompanied with unicuspid aortic valve and this might reflect the natural history of progression in the morphology of unicuspid aortic valve. Case presentation We describe a 65-year-old Japanese man who was evaluated for endocarditis and found to have a unicuspid aortic valve concomitant with moderate aortic insufficiency, which was, owing to the lack of evidence of valve membrane destruction, independent of underlying infectious endocarditis. In addition, aortic insufficiency was progressed because of nonbacterial thrombotic endocarditis on the ventricular side, in areas of high turbulence around the heart valve. Conclusions Our case is unusual given the unicuspid aortic valve concomitant with aortic insufficiency, which was presumably independent of underlying infectious endocarditis because of the location of the vegetation and the lack of evidence of valve destruction. Therefore, attention should be paid to a variety of complications in the setting of unicuspid aortic valve.

scholarly journals Unusual case of classic testicular seminoma in a 90-year-old patient: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Ahmad Al-Mousa ◽  
Mohammad Nour Shashaa ◽  
Mohamad Shadi Alkarrash ◽  
Mohamad Alkhamis ◽  
Lina Ghabreau ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Elderly Patients ◽  
Unusual Case ◽  
Medical Literature ◽  
Testicular Tumor ◽  
Testicular Seminoma ◽  
Case Presentation ◽  
History Of ◽  
Pure Seminoma

Abstract Background Seminoma is the most common subtype of testicular cancer and occurs most commonly in patients aged 30–49 years, but decreases to a very low level in men in their 60s or older. Case presentation A 90-year-old Syrian man with a 6-year history of an increase in size of his right scrotum, presented to the urological clinic and, on clinical examination, the findings suggested testicular tumor. After orchiectomy and histology results based on microscopic and immunohistochemical examinations, a pure seminoma was diagnosed, so we describe in this case report the second-oldest patient with classical seminoma in the medical literature. Conclusion This case report has been written to focus on the probability of any type of testicular tumor occurring at any age or decade; urologists should consider seminoma as a differential diagnosis with any testicular swelling even in elderly patients.

scholarly journals Rescue-Thrombolysis in Cardiac Arrest: The ‘Provider’ of Last Resort

2020 ◽  
Vol 19 (2) ◽  
pp. 319-321
Author(s):  
Lim Khai Yen ◽  
Shahira Ismail ◽  
Shukri Saad ◽  
Mohd Hashairi Fauzi ◽  
Nik Hisamuddin Nik Ab Rahman
Keyword(s):  
Adverse Effect ◽  
Cardiac Arrest ◽  
Risk Factor ◽  
Heart Disease ◽  
Case Report ◽  
Thrombolytic Therapy ◽  
Cause Of Death ◽  
Medical Science ◽  
Cardiac Arrest Patient ◽  
Major Risk Factor

Cardiac arrest is the leading cause of death globally, and heart disease is known to be a major risk factor for cardiac arrest. In practice, an arrest is presumed to be of cardiac origin unless it is known or likely due to non-cardiac causes. The prognosis of the patient following cardiac arrest is generally poor. Although thrombolytic therapy is well known to be the treatment for myocardial thrombosis, it is not routinely recommended in cardiac arrest due to its potential bleeding adverse effect. We described a case report of successful thrombolytic therapy in cardiac arrest patient Bangladesh Journal of Medical Science Vol.19(2) 2020 p.319-321

scholarly journals Case Report: Migrainous Infarct without Aura

2017 ◽  
Vol 9 (3) ◽  
pp. 241-251
Author(s):  
Kamesh Gupta ◽  
Anurag  Rohatgi ◽  
Shivani Handa
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Case Presentation ◽  
The Past ◽  
Need To Evaluate ◽  
History Of ◽  
Complicated Migraine ◽  
Full Investigation

Background: Stroke in a migraine with aura has been documented in several cases, even deserving the merit of a classification as complicated migraine. Herein, we present a rare case of migrainous infarct without aura. The diagnosis was challenging due to lack of risk factors. The patient was unique in not having any other comorbidities. Case Presentation: The case is of a 21-year-old female presenting with right-sided hemiplegia and facial drooping. She had had an index presentation of throbbing headaches for the past 2 years, typical of a migraine but not preceded by any aura symptoms. However, in the current episode, the pain became excessively severe and accompanied by right-sided hemiplegia and facial drooping. A full investigation workup using MRI revealed evidence of infarct in the left temporoparietal and basal ganglion region. Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.

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