scholarly journals Inverted Proximal Ileal Loop Prolapse with Ileal Rupture through a Patent Omphalomesenteric Duct: A Rare Case

2019 ◽  
Vol 7 (5) ◽  
pp. 797-800
Author(s):  
Handayani Handayani ◽  
Yamoguna Zega ◽  
Tati Ziliwu ◽  
Faldi Yaputra ◽  
Nora Minori

BACKGROUND: Prolapse of the small intestine through the umbilicus is indeed a rare presentation and is the most significant complication of the patent omphalomesenteric duct which requires pediatric surgical emergency due to its significant increase of mortality. To date, it is less than twenty cases of this presentation have been reported in medical literature. We are reporting a case of the same in an infant presenting with it on 1st week after he was delivered, but was followed by ileal rupture as well. CASE PRESENTATION: We present a case of a patent omphalomesenteric duct with ileal prolapse and ileal rupture as its complication. It is a case of a 1-year-old infant with a history of unusual bleed-on-touch mass emerging from the anterior abdominal wall with absent umbilicus. Once his condition is stabilised, he underwent a reduction of the prolapsed bowel along with complete excision of the omphalomesenteric duct and restoration of the ileal continuity. Post-operatively he regained normal bowel function and resumed breastfeeding 5 days after surgery. CONCLUSION: This case is an important addition to the literature about patent omphalomesenteric duct with complications of inverted proximal ileal loop prolapse and ileal rupture.

2018 ◽  
Vol 31 (5) ◽  
pp. 585-588 ◽  
Author(s):  
Rohan K. Henry ◽  
Monika Chaudhari

Abstract Background: Amiodarone-induced thyrotoxicosis (AIT) type 2, characterized as a destructive thyroiditis, is well described in the medical literature; however, iodine-induced thyrotoxicosis (IIT) is not, though the latter has similar features and can be managed similarly. Case presentation: We present a 17-year-old female who presented with a history of an intermittent goiter with thyroid function tests (TFTs): thyroid-stimulating hormone (TSH)<0.015 (0.4–4 μU/mL), free thyroxine (T4)≥6 (0.7–2.1 ng/dL) and total triiodothyronine (T3) 651 (50–200 mg/dL). Thyroid antibodies were all negative. Despite methimazole therapy for 6 weeks, hyperthyroidism proved refractory to medical management. 123I scan uptake was suppressed. With hyperthyroidism being recalcitrant to therapy, a nutritional history revealed consumption of an iodine supplement containing at least 7 times the recommended daily allowance (RDA) for 5 years, contributing to the Jod-Basedow phenomenon. Urinary spot and 24-hour urinary iodine were both elevated. Though a surgical consult was obtained, surgery was cancelled once TFTs improved and then normalized with steroid therapy. The TFTs and urinary iodine levels remained normal post steroid therapy. Conclusions: We suggest that in addition to the need for a thorough nutritional history, a trial of corticosteroids should be utilized in the management of IIT which can present with findings similar to AIT type 2 which is recalcitrant to thionamide therapy. If successful, corticosteroids may delay or prevent surgical management thus avoiding possible complications with the latter approach.


2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.


2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Jay Lodhia ◽  
Ayesiga Herman ◽  
Rune Philemon ◽  
Adnan Sadiq ◽  
Deborah Mchaile ◽  
...  

Introduction. Hydatidosis is a parasitic manifestation caused by Echinococcus granulosus. It is characterized by cystic lesions in the liver and lungs. Diagnosis is based on typical history and radiological measures. Case presentation. A four-year-old boy presented with a one-year history of dry cough and difficulty in breathing which was of gradual progression. Computed tomography of the chest revealed a large 11.7 cm×8.6 cm×11.0 cm cyst in the right hemithorax. The patient underwent thoracotomy and recovered well post procedure. Conclusion. This case report highlights that large hydatid cysts can be surgically removed with good outcome and the importance of realizing that the disease is a burden to the public health and is much neglected.


2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Ahmad Al-Mousa ◽  
Mohammad Nour Shashaa ◽  
Mohamad Shadi Alkarrash ◽  
Mohamad Alkhamis ◽  
Lina Ghabreau ◽  
...  

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.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jingwen Hui ◽  
Yun Zhao ◽  
Lei Zhang ◽  
Jinyong Lin ◽  
Hong Zhao

Abstract Background Extraskeletal osteosarcoma is a malignant tumour composed of an osteoid and/or cartilaginous matrix; it arises in soft tissues without connection to the skeleton, and to our knowledge, this type of tumour is extremely rare. Case presentation The present study reports a 57-year-old man with primary orbital extraskeletal osteosarcoma who presented with a history of painful swelling in the left orbit that had occurred for 11 months. Imaging of the orbit showed an atypical, well-defined heterogeneous mass attached to the posterior globe of the left orbit. The patient underwent an anterior orbitotomy and complete excision of the tumour. The mass was originated from neither the globe nor the bony orbital wall but from the soft tissue. Histopathology demonstrated an extraskeletal osteosarcoma. After 13 months of follow-up, there was apparent recurrence of the tumour. The medical history showed no complaints of previous trauma or radiotherapy. Conclusions ESOS is a highly malignant tumour. Immunosuppression, trauma and adjuvant radiotherapy are possible predisposing factors in the development of this tumour. Prompt recognition and thorough treatment are essential for preventing orbital lesions and presence of metastasis from other organs.


2019 ◽  
Vol 2 (1-3) ◽  
pp. 47-53
Author(s):  
Kewal Gangrade ◽  
Girish Yeotikar ◽  
Arjun Wadhwani ◽  
Vinod Naneria

Calcific myonecrosis is characterized by central liquefaction and peripheral calcification involving the entire muscle mass and is considered to be a late sequel of compartment syndrome. Being a rare presentation, considering differential diagnosis is important. Diagnosis is based on history of trauma and typical radiological features. Symptomatic patients require complete excision of the mass while asymptomatic patients can be treated nonoperatively.


2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Ida Bagus Oka Widya Putra ◽  
Irfan Wahyudi ◽  
Arry Rodjani

Objective: To present a case of penile paraffinoma reconstructed with scrotal flap. Case presentation: We report a case of 33-year-old male patient with penile paraffinoma. The patient had a history of injecting liquid paraffin into his penis two times – at 6 months and 2 months prior to his admission to the hospital. His IIEF-5 was 10 (moderate erectile dysfunction). The penile shaft was circumferentially enlarged. There was ulceration on the ventral aspect with signs of inflammation on the surrounding skin. Discussion: We perform a complete excision of paraffinoma. The raw surface was repaired with a one-stage scrotal flap. At six-month follow up, the wound was good, and the patient was able to micturate normally. He was able to achieve painless erection, and IIEF-5 score was improved. Conclusion: A one-stage scrotal flap may offer a good choice in defect closure in penile paraffinoma reconstruction.


Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 128-133
Author(s):  
Tsung-Hsin Chang ◽  
Jen-Shu Tseng

Abstract Case presentation In the current study, we report a 69-year-old female patient who was initially diagnosed with xanthogranulomatous pyelonephritis (XGPN) with nephrolithiasis and a peri-renal abscess. She presented to our department with right flank pain. Physical examination revealed right costovertebral angle knocking pain and computed tomography revealed dilated calyces and one staghorn stone over right kidney, with multiple abscess accumulations over the right peri-renal region. Right radical nephrectomy was performed using a transperitoneal flank approach, and pathology revealed squamous cell carcinoma (SCC) with concurrent XGPN. The patient was alive at 4 months post-operative follow-up. To the best of our knowledge, this is only the fifth case of renal SCC with concurrent XGPN reported in the English medical literature. Conclusion Renal SCC with coexisting XGPN is an extremely rare presentation and only four cases have been previously reported in the English medical literature. A positive diagnosis for this rare combination of diseases was established, based on pathological and immunohistochemical examinations after radical nephrectomy. Poor prognosis has been reported in such cases. Malignancies should be considered in patients with a long-standing history of urolithiasis.


2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Shania Niromi Gunasekera ◽  
Chirath Madurapperuma ◽  
Nilusha Weerasooriya ◽  
Harindra Karunathilake ◽  
Ananda Jayanaga

Abstract Background Takayasu’s arteritis (TA) is a granulomatous, large vessel vasculitis with a preponderance for young women. The inflammation results in disruption of the arterial endothelium causing stenosis, endoluminal thrombosis and aneurismal dilatation. Early disease presentation is with nonspecific general symptoms, and in such instances, the diagnosis can be missed. Unilateral clubbing is a manifestation of myriad of diseases, but is not a common sign of TA. In medical literature, only three such cases have been reported. Case presentation We present a 24-year-old female who presented with multiple constitutional symptoms such as arthralgia, malaise, poor appetite and two episodes of syncope over 3 months’ duration. On examination, unilateral finger clubbing was observed in the right hand, with very low volume radial, ulnar and brachial artery pulses on the ipsilateral side. Her blood pressure measured on the unaffected arm, was normal. Inflammatory markers were elevated and magnetic resonance angiogram (MRA) confirmed TA. Conclusion Although rare, unilateral clubbing may be a manifestation of TA. Therefore, detection of unilateral clubbing should raise a strong clinical suspicion of TA and prompt early diagnosis and initiation of treatment.


2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Ian Gassiep ◽  
Paul Matthew Griffin

Introduction. Delusional infestation is a rare monosymptomatic hypochondriacal psychosis according to The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). It can be a primary disorder or associated with an underlying psychological or physical disorder. It commonly presents as delusional parasitosis, and less than 1% may be fungi related. We present this case as it is a rare presentation of a rare condition.Case Presentation. Our patient is a 60-year-old Caucasian man who presented with a 7-year history of delusional infestation manifested as a disseminated fungal infection. He had previously been reviewed by multiple physicians for the same with no systemic illness diagnosed. After multiple reviews and thorough investigation we diagnosed him with a likely delusional disorder. As is common with this patient cohort he refused psychiatric review or antipsychotic medication.Conclusion. A delusion of a disseminated fungal infestation is a rare condition. It is exceedingly difficult to treat as these patients often refuse to believe the investigation results and diagnosis. Furthermore, they either refuse or are noncompliant with treatment. Multidisciplinary outpatient evaluation may be the best way to allay patient fears and improve treatment compliance.


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