scholarly journals A Rare Case of Chronic Suppurative Appendicitis in Neonatal Presenting as Intestinal Malrotation

2021 ◽  
Vol 9 (C) ◽  
pp. 158-162
Author(s):  
Putu Pradnyanita Mustika ◽  
Made Sukmawati ◽  
I. Made Darmajaya ◽  
I. G. A. Sri Mahendra Dewi ◽  
I. Wayan Dharma Artana ◽  
...  
Keyword(s):  
Good Condition ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Abdominal Distension ◽  
Bowel Sound ◽  
Proximal Jejunum ◽  
Gas Distribution ◽  
Histopathology Result ◽  
Male Neonate ◽  
Ladd’S Procedure

Neonatal appendicitis (NA) is an extremely rare acute abdomen condition, moreover, if it is a chronic suppurative one. The definite risk factor of NA is barely unknown. The signs and symptoms are often nonspecific and appear after perforation occurs. Most of the cases were found unexpectedly during surgery suspected as other diagnoses. A 7-day-old male neonate presenting lethargic and hypoglycemia since 1 st day of life. Patient drunk breast milk right after since he was born. Meconium was produced <24 h. On the 3 rd day of hospitalization, he experienced bilious vomiting and abdominal distension, so nasogastric tube was installed. Physical examination revealed decreased bowel sound. Investigation showed leucocytosis, slightly increased procalcitonin and abdominal X-ray showed that gas distribution lasted until third part of duodenum followed by minimal gas distribution in the distal part of duodenum. The patient was suspected as distal duodenum stenosis or proximal jejunum. Intraoperatively, it was found that there was second part duodenum malrotation and open Ladd’s procedure was done. During Ladd’s procedure, a perforated appendix was also found. The histopathology result revealed that it was a chronic suppurative appendicitis. Patient was discharged in good condition 20 days after surgery. NA is a rare condition with nonspecific signs and symptoms which was usually found accidentally during surgery suspected as other diagnoses.

CLINICAL CASE OF A MALIGNANT PECOMA OF THE LUNG

2019 ◽  
Vol 65 (5) ◽  
pp. 756-759
Author(s):  
Mikhail Postolov ◽  
Nadezhda Kovalenko ◽  
K. Babina ◽  
Stanislav Panin ◽  
Yelena Levchenko ◽  
...  
Keyword(s):  
Good Condition ◽  
Lung Neoplasm ◽  
Rare Condition ◽  
Epithelioid Cell ◽  
X Ray ◽  
Perivascular Epithelioid Cell ◽  
Mesenchymal Neoplasm ◽  
Preoperative Ct ◽  
Lymph Duct ◽  
The Right

Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both mela-nocytic and smooth muscle markers. Only 10 primary malignant lung PEComas have been reported up to date. We report a 59-year-old male who presented with a lung neoplasm, found during the routine X-ray examination. Preoperative CT-scan revealed the 3,5-cm-sized mass, located at the border of the upper, middle and lower lobes of the right lung. Patient underwent a thoracotomy, resection of the upper, middle and lower lobes of the right lung accompanied with mediastinal lymphadenectomy. After surgery, chylothorax was revealed. Conservative treatment was unsuccessful, so we performed laparoscopic clipping of the thoracic lymph duct. Patient was dismissed from hospital on the 10-th day after the second operation in good condition. In this report, we intend to increase the limited knowledge relating to natural history and optimal treatment of such a rare condition as a primary malignant lung PEComa.

scholarly journals Multiple Brain Abscesses by an Air Gun Shot: A Case Report

2021 ◽  
Author(s):  
Mohammad Jamali ◽  
Iman Ahrari ◽  
Keyvan Eghbal ◽  
Arash Saffarrian ◽  
Abbas Rakhsha ◽  
...  
Keyword(s):  
Brain Injury ◽  
Brain Injuries ◽  
Good Condition ◽  
Signs And Symptoms ◽  
Low Velocity ◽  
Penetrating Brain Injury ◽  
Air Gun ◽  
Gun Shot ◽  
Brain Abscesses ◽  
Air Gun Pellet

Abstract Introduction Low-velocity penetrating brain injury is not prevalent. In some conditions such as childhood, and with the penetration of a pellet in weak spots of skull, low-velocity penetrating brain injury is expected; however, high-velocity projectiles have also been reported as the cause of severe brain injuries. One of the complications of penetrating brain injury is infection, in which different types of microorganisms play a role. The Streptococcus genus is the leading cause of abscess formation in non-traumatic patients. Multiple brain abscesses are not common. Case Presentation A 10-year-old boy with penetrating brain injury caused by an air gun pellet, who developed signs and symptoms of high intracranial pressure 18 days after the trauma. After the imaging scans and the detection of multiple brain abscesses and severe brain edema, prompt surgical intervention was performed for all three lesions in a single operation. The culture of a pus specimen was positive for Streptococcus species, and, with adequate antibiotic therapy, the patient was discharged from the hospital in good condition. Conclusion Brain injury with air gun shot is not prevalent. The penetration of a low-velocity air gun pellet in weak points of the skull (such as the orbit, the squamous portion of the temporal bone, and the cranial suture), specially in children, can cause significant brain injuries.

THE EFFECT OF SUCKING LOLLIPOPS ON RETURN OF BOWEL FUNCTION AFTER ELECTIVE DISTAL BOWEL SURGERY IN CHILDREN.

2021 ◽  
pp. 5-6
Author(s):  
Saket Jha ◽  
Geeta Kekre ◽  
Abhaya Gupta ◽  
Paras Kothari ◽  
Apoorva Kulkarni ◽  
...  
Keyword(s):  
Paralytic Ileus ◽  
Abdominal Distension ◽  
Bowel Function ◽  
Control Group ◽  
Bowel Sound ◽  
Respiratory Compromise ◽  
Bowel Surgery ◽  
Distal Bowel ◽  
Mean Time ◽  
Experimental Group

BACKGROUND-The phenomenon of cessation of coordinated bowel motility, commonly called as paralytic ileus is well known after certain surgeries. While procedures that involve direct manipulation of gut are almost always associated with post operative paralytic ileus, even orthopaedic surgeries may also cause post operative paralytic ileus. It contributes signicantly in prolonging hospital stay and is associated with abdominal distension, respiratory compromise, nausea and vomiting. Number of pharmacological and non pharmacological agents have been tried to reduce the post operative paralytic ileus. We studied the effect of sucking lollipop on the return of bowel function in children undergoing distal bowel surgery. AIM-To study effect of lollipop sucking on return of bowel function in children undergoing distal bowel surgery in terms of time to return of bowel, passage of stool per anal. MATERIALAND METHODS-Patients undergoing distal bowel stoma closure were assigned to two groups. The experimental group patients were given lollipops 6 hrs postoperatively, time to return of bowel sound and rst passage of stool was noted and analysed. RESULTS-Mean time to return of bowel sounds in the experimental group was 50.25 + 6.016 hrs, while in control group was 65.87 + 8.83 hrs, difference was statistically signicant (P<0.0001).Mean time to passage of stools in experimental group was 72.312 +12.644 hrs , while in control group was 88.25 + 8.38 hrs. difference was statistically signicant(P=0.0002) . CONCLUSION- Sucking lollipop is a safe and effective in reducing duration of post operative paralytic ileus in paediatric patients undergoing elective bowel surgery.

scholarly journals Tympano-Mastoid Cholesterol Granuloma: Case Report and Review of the Literature

2020 ◽  
Vol 13 ◽  
pp. 117954762095872
Author(s):  
Annalisa Pace ◽  
Giannicola Iannella ◽  
Mara Riminucci ◽  
Alessandro Corsi ◽  
Giuseppe Magliulo
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Foreign Body Giant Cell ◽  
Cholesterol Granuloma ◽  
Review Of The Literature ◽  
Cell Reaction ◽  
Cholesterol Crystals ◽  
Specific Sign

Cholesterol granuloma (CG) is a rare condition histological consisting of a foreign body, giant cell reaction to cholesterol crystals and haemosiderin derived from the ruptured of the erythrocytes. A 25-year-old man came to our Department presenting signs and symptoms of tympano-mastoid cholesterol granuloma. He showed all the specific sign and symptoms of the disease. However, considering the lack of literature regarding TMCG, this study was performed with the aim of presenting the main characteristics of tympano-mastoid CG, describing the case report and reviewing the literature.

scholarly journals Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with Plasmodium knowlesi infection from Sabah, Malaysian Borneo

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Mimi Azreen Abdullah ◽  
Saleh Mohammed Abdullah ◽  
Subbiah Vijay Kumar ◽  
Mohammad Zahirul Hoque
Keyword(s):  
Fusion Gene ◽  
Plasmodium Knowlesi ◽  
Previous History ◽  
Bone Marrow Aspiration ◽  
Signs And Symptoms ◽  
Abdominal Distension ◽  
Juvenile Myelomonocytic Leukemia ◽  
Diagnostic Challenge ◽  
Oral Ulcers ◽  
Myelomonocytic Leukemia

A 3-year-old male child was presented with worsening abdominal pain, abdominal distension, lethargy, pallor and hepatosplenomegaly. The patient had multiple outpatient visits in the past and was treated with oral antibiotics, oral anthelmintic agents, albeit with minimal benefit. The patient also had non-neutropenic pyrexia spikes and oral ulcers. The patient was an adopted child; hence details about his biological parents’ previous history were unclear. Differential diagnosis of Chronic Myelomonocytic Leukemia (CMML), Juvenile Myelomonocytic Leukemia (JMML), Gaucher’s disease, Thalassemia and discrete pancreatic pathology was considered. Hemoglobin electrophoresis was indicative of thalassemia. Also, molecular detection method by polymerase chain reaction confirms a concurrent infection with Plasmodium knowlesi malaria. The BCR-ABL fusion gene was found to be negative. Correlating with peripheral monocytosis, bone marrow aspiration and trephine biopsy with blasts only 3-4% and hepatosplenomegaly, a diagnosis of JMML was established. We present a rare phenomenon with an overlap of signs and symptoms between JMML, underlying thalassemia, and Plasmodium knowlesi, posing a diagnostic challenge to physicians.

Self-Healing Congenital Langerhans Cell Histiocytosis Presenting as Neonatal Papulovesicular Eruption

2001 ◽  
Vol 5 (6) ◽  
pp. 486-489 ◽  
Author(s):  
Kelli W. Morgan ◽  
Jeffrey P. Callen
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Male Infant ◽  
Skin Lesions ◽  
Langerhans Cell ◽  
Self Healing ◽  
Systemic Involvement ◽  
S 100 ◽  
Simplex Virus

Background: Congenital self-healing Langerhans cell histiocytosis (CSHLCH) is a rare condition which may present at birth or during the neonatal period. It is usually characterized by the eruption of multiple, disseminated, red-brown papules and nodules which may increase in size and number during the first few weeks of life. Systemic signs are usually absent except for occasional mild hepatomegaly. Objective: We present a 3.5-kg male infant who presented at birth with numerous diffuse, erythematous, crusted erosions. He was presumed to have congenital herpes simplex virus (HSV) and was started on IV acyclovir. Histopathologic examination revealed a mixed inflammatory infiltrate with numerous histiocytes which were S-100 and peanut agglutin positive consistent with CSHLCH. Further workup did not reveal any signs of systemic involvement. Conclusion: CSHLCH has rarely been reported to present as a papulovesicular eruption at birth. In these cases, a viral etiology is commonly entertained in the differential diagnosis. Despite the spontaneous regression of skin lesions in CSHLCH, close followup is required to evaluate for systemic signs and symptoms associated with latent Letterer–Siwe disease.

scholarly journals A Case of Neuroleptic Malignant Syndrome in a Profoundly Intellectually Disabled Patient with Successful Reintroduction of Antipsychotic Therapy with Quetiapine

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Kamal Patel ◽  
Brandon Lilly ◽  
Oluwadamilare Ajayi ◽  
Kelly Melvin
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
First Generation ◽  
Early Recognition ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Antipsychotic Agent ◽  
Muscle Rigidity ◽  
Status Change ◽  
Antipsychotic Therapy ◽  
Autonomic Instability

Neuroleptic Malignant Syndrome (NMS) is a rare condition clinically characterized by muscle rigidity, hyperthermia, autonomic instability, and acute mental status change. NMS is most often associated with use of high-potency first-generation antipsychotic medications; though, other neuroleptics have been implicated as well. NMS can be fatal with estimated mortality rates as high as 20%. Patients experiencing certain severe complications, including renal failure, have been associated with mortality as high as 50%, stressing the need for early recognition and treatment. Here we present the case of a 54-year-old male that initially presented with symptoms suspicious for sepsis, but who eventually developed a clinical picture consistent with NMS. We describe the diagnostic and treatment process leading to symptom remission. We then discuss our decision to reintroduce an atypical antipsychotic agent, quetiapine. This case illustrates the importance of early recognition of the signs and symptoms of NMS and the need to initiate treatment promptly in order to prevent complications, including death. This case also highlights the decision to resume antipsychotic pharmacotherapy after adequate resolution of NMS, demonstrating that it can be done so safely if started at low doses coupled with intensive monitoring of the patient.

Intramedullary Endometriosis of the Conus Medullaris

Neurosurgery ◽  
2006 ◽  
Vol 59 (2) ◽  
pp. E428-E428 ◽  
Author(s):  
Amit Agrawal ◽  
Bellore J.P. Shetty ◽  
Jagadeesh H. Makannavar ◽  
Lathika Shetty ◽  
Jayaprakash Shetty ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Back Pain ◽  
Relevant Literature ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Conus Medullaris ◽  
Resonance Imaging ◽  
Acute Hemorrhage ◽  
Neurological Signs ◽  
Lower Back

Abstract OBJECTIVE: Intraspinal endometriosis is an extremely rare condition with characteristic symptoms, including lower back pain that increases in severity during each menstrual cycle. METHODS: Here, we report a case of endometriosis involving the conus cauda region. This patient presented with acute deterioration secondary to hemorrhage. We also review the relevant literature. RESULTS: Magnetic resonance imaging scans of the dorsolumbar region showed a mass lesion within the spinal canal at the L1–L2 level with evidence of acute hemorrhage. The patient underwent an emergency D12–L2 laminectomy and microdecompression of the lesion. The histological and immunohistochemical features were characteristic of intraspinal endometriosis. CONCLUSION: Intraspinal endometriosis must be recognized as a potential cause of periodic neurological signs and symptoms in young and middle-aged women.

scholarly journals Spontaneous Bilateral Sternoclavicular Joint Septic Arthritis and Lumbar Discitis: An Unusual Case in a Healthy Adult

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Georgios Mamarelis ◽  
Mohammad Zain Sohail ◽  
Athanasios Mamarelis ◽  
Hassan Fawi ◽  
Jehangir Mahaluxmivala
Keyword(s):  
Septic Arthritis ◽  
Healthy Adult ◽  
Joint Infection ◽  
Good Condition ◽  
Rare Condition ◽  
Sternoclavicular Joint ◽  
Intravenous Antibiotics ◽  
History Of ◽  
Image Investigation ◽  
Ct And Mri

Introduction. Septic arthritis of the sternoclavicular (SC) joint is a rare condition. Typically, it presents in patients with risk of infection and is usually unilateral. In this report, we describe a case of spontaneous bilateral sternoclavicular joint infection of an otherwise healthy adult. Case Presentation. A 67-year-old man presented in our hospital complaining of 2-week history of neck and chest pain which was radiating to his shoulders bilaterally. Clinical examination revealed erythema and swelling of the sternoclavicular area. Inflammatory markers were raised. Image investigation with CT and MRI was undertaken and verified the presence of bilateral sternoclavicular joint infection. The patient received prolonged course of intravenous antibiotics since his admission. The patient was discharged in a good condition and followed up in clinic. Conclusion. High index of clinical suspicion of SC joint infection is important for early diagnosis to avoid further complications.

scholarly journals Gastric peroral myotomy (G-POEM) in patients with delayed emptying function of the stomach

2021 ◽  
Vol 24 (6) ◽  
pp. 397-402
Author(s):  
Y. A. Kozlov ◽  
A. A. Smirnov ◽  
A. B. Kargabaeva ◽  
N. V. Konkina ◽  
A. A. Rasputin ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Clinical Symptoms ◽  
Intraoperative Complications ◽  
Good Condition ◽  
Hypertrophic Pyloric Stenosis ◽  
Outlet Obstruction ◽  
Abdominal Distension ◽  
Muscle Layer ◽  
Normal Function ◽  
Submucosal Tunnel

Introduction. Disorders in the gastric evacuation function are met in patients with gastroesophageal reflux. In most cases, simultaneous laparoscopic pyloroplasty can solve the problem. As an alternative to surgical pyloroplasty to treat gastroparesis, a new technique has been proposed – peroral submucosal pyloromyotomy or gastric peroral endoscopic myotomy (G-POEM). Recently, this endoscopic surgery has been implemented in adults and in newborns with congenital hypertrophic pyloric stenosis to treat gastric paresis. In the present work, the authors describe this technique and short-term results after G-POEM in a child who had previously been operated on for gastroesophageal reflux.Material and methods. Peroral submucosal pyloromyotomy was performed in a girl of 5 y.o. with impaired motor-evacuation function of the stomach after surgical treatment of gastroesophageal reflux disease at the age of two . For 3 years, the child had therapy which included antiemetics and H2-receptor blockers. However, clinical symptoms constantly recurred, and it was decided to make a thorough examination of the patient. At the contrast examination of upper gastrointestinal tract, stomach enlargement and slow transit of the contrast preparation into the duodenum were seen. Fibrogastroduodenoscopy confirmed the normal function of the fundoplication cuff and found a cause of impaired gastric emptying. A contracted gastric outlet as a spasmodic pylorus was found to be an obstacle for normal stomach evacuation function. A narrow hole in the pylorus was found. A 5.4 mm gastroscope could pass through it. The patient had a complete peroral endoscopic submucosal pyloromyotomy. The technique of this surgery consisted in creating a submucosal tunnel at 4 cm before the pylorus and in dissecting the hypertrophied muscle layer by Ramstedt incision using an electrocoagulation knife. After the end of surgery, the incision on the mucous layer was closed with special clamps.Results. Surgical time lasted for 45 minutes. There were no intraoperative complications: bleedings and mucosal perforation . The patient began to eat in 6 hours after the surgery. The transition to full enteral feeding lasted for 24 hours. The child was discharged from the hospital next day in good condition. At the follow-up examination 6 months after surgery, the girl had weight and height typical for her age. There were no signs of dysphagia, abdominal distension, nausea and vomiting any more . There were no post-operative scarring on the child’s abdominal wall.Conclusion. Peroral submucosal pyloromyotomy is technically implementable, safe and effective for treating disorders of stomach evacuation function in children. Further research is needed to find the place of this technique in the treatment of gastric outlet obstruction. 

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