A case of hematuria and vomiting in the emergency room: Never forget the emphysematous pyelonephritis

We describe the case of a 68-year-old man with a known history of hypertension and diabetes mellitus presented to our Emergency Department, complaining of hematuria and vomiting in the last 12 hours, stypsis and urinary incontinence in the last week, and worsening hyporexia in the last 6 months. Bedside ultrasound documented a slight right pleural effusion with B lines in the middle and basal right field, gastrectasis, dilated fluid-filled bowel loops, potential signs of gas in the upper right quadrant, grade 3 bilateral hydronephrosis, and bladder globe. Abdominal CT scan confirmed the bilateral hydroureteronephrosis and showed the right kidney with Emphysematous Pyelonephritis (EPN) with extension into the perinephric and muscular planes for 24 cm, and initial EPN in the left kidney. A RT-PCR nasopharyngeal swab for SARS CoV-2 was negative. A diagnosis of ileum paretic, acute renal failure and urosepsis due to EPN was made.

Download Full-text

A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

10.31487/j.jscr.2020.01.03 ◽

2020 ◽

pp. 1-3

Author(s):

Jinping Xu ◽

Ruth Wei ◽

Salieha Zaheer

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Femoral Hernia ◽

Rare Case ◽

Hernia Recurrence ◽

High Morbidity ◽

Diagnostic Challenge ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

Download Full-text

“Old wine in a new bottle” - post COVID-19 infection, central serous chorioretinopathy and the steroids

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-021-00244-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Srinivasan Sanjay ◽

Poornachandra B. Gowda ◽

Bhimasena Rao ◽

Deepashri Mutalik ◽

Padmamalini Mahendradas ◽

...

Keyword(s):

Virus Disease ◽

Anterior Segment ◽

Central Serous Retinopathy ◽

Oral Antibiotics ◽

Rt Pcr ◽

Case Presentation ◽

Ocular Manifestations ◽

Corrected Distance Visual Acuity ◽

History Of ◽

The Right

Abstract Introduction Corona virus disease (COVID-19) pandemic can cause myriad of ocular manifestations. We report a case of unilateral multi focal central serous retinopathy, post COVID-19 infection in an Asian Indian female. Case presentation A 42-year-old female presented to us with unilateral blurring, in the right eye (OD), 12 days after COVID-19 infection. She had fever, chills, shortness of breath and cough with tiredness and was COVID- RT PCR positive. She was administered intravenous and oral antibiotics with injection heparin/remdesivir, during her 7 day stay at the hospital. She was also on steroid inhalers. She had no systemic history of note. On ocular evaluation, her corrected distance visual acuity was 20/40 in OD and 20/20 in left eye (OS). Anterior segment was normal. Anterior vitreous was clear. Fundus examination of the OD showed central serous retinopathy (CSCR) with OS being normal. Conclusion CSCR can occur post COVID-19 due to steroid administration and physicians administering it should be aware of this and refer the patients to an ophthalmologist earlier.

Download Full-text

EMBRYOMA OF KIDNEY (WILMS' TUMOR) IN CHILDREN

PEDIATRICS ◽

10.1542/peds.4.2.197 ◽

1949 ◽

Vol 4 (2) ◽

pp. 197-200

Author(s):

LLOYD B. DICKEY ◽

L. R. CHANDLER

Keyword(s):

Survival Rate ◽

Physical Examination ◽

Wilms Tumor ◽

Left Kidney ◽

Bottle Feeding ◽

Postoperative Radiation ◽

History Of ◽

The Right ◽

Infants And Young Children ◽

Careful Physical Examination

A series of 12 cases of Wilms' tumor, in which the diagnosis was confirmed in all instances by examination of the gross or microscopic tissue, is reported, with a survival rate of 33.3%. Four patients are living and well, 4, 8, 10, and 15 years, respectively, after treatment. All recurrences appeared less than 10 months after treatment. The sex incidence, and the sex survival incidence were exactly equal. Six tumors were in the left kidney, and six in the right. Eight of the patients were under 2 years of age when first diagnosed and treated, and all were under 7 years. The history of breast or bottle feeding was irrelevant. In a large number of these and reported cases, the presence of the tumor was the first symptom, and in a considerable number the only symptom. This fact stresses the importance of careful physical examination of infants and young children, regardless of complaint, or of lack of it. The finding of calcification in the tumor is possibly a good prognostic sign. All three patients in whom calcification was noted in the tumor are living and well. Immediate removal of the tumor by transperitoneal nephrectomy, with postoperative radiation to the area, seems to be the advisable treatment.

Download Full-text

Pulmonary abscess as a complication of COVID-19 associated pneumonia: a clinical case

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2021-99-12-7-12 ◽

2022 ◽

Vol 99 (12) ◽

pp. 7-12

Author(s):

T. I. Kalenchits ◽

S. L. Kabak ◽

S. V. Primak ◽

N. M. Shirinaliev

Keyword(s):

Clinical Laboratory ◽

Lower Lobe ◽

Pleural Empyema ◽

Lung Abscess ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Pulmonary Abscess ◽

Causative Factors ◽

The Right ◽

Test Result

The article describes a case of polysegmental destructive viral-bacterial pneumonia complicated with acute pulmonary abscess, pleural empyema, and pneumopleurofibrosis in a 50-year-old female patient infected with the SARS-CoV-2 virus. The first clinical, laboratory and radiological signs of purulent-necrotic inflammation appeared only 20 days after receiving a positive RT-PCR test result with a nasopharyngeal swab. A month later, an emerging abscess in the lower lobe of the right lung was diagnosed. Subsequently, it spontaneously drained into the pleural cavity.Coagulopathy with the formation of microthrombi in small pulmonary vessels is one of the causative factors of lung abscess in patients infected with the SARS-CoV-2 virus.

Download Full-text

Obstructed descending colon mass pretended with Bockdalek hernia: a case report

10.21203/rs.3.rs-369079/v1 ◽

2021 ◽

Author(s):

mohammad eslamian ◽

Mohsen kolahdouzan

Keyword(s):

Diaphragmatic Hernia ◽

Abdominal Pressure ◽

Right Colon ◽

Abdominal Ct ◽

Midline Laparotomy ◽

Abdominal Ct Scan ◽

Descending Colon ◽

The Right ◽

Thoracic And Abdominal ◽

Diaphragmatic Hernias

Abstract Introduction: Adult Bochdalek hernia is one of the right-sided diaphragmatic hernias that less than 30 cases reported until now.Case: I herein report a 64-year-old female patient who had dyspnea, abdominal pain, and nausea. Primary imaging (thoracic and abdominal CT scan) showed a right-sided diaphragmatic hernia that was contained the liver and right colon. The patient underwent right posterior thoracotomy at first, so the 5*5 cm diaphragmatic defect was repaired. Due to peritonitis that happened after two days, a midline laparotomy was performed. Finally, it was cleared that the main problem was the obstructed and perforated descending colon mass that was presented with Bockdalek hernia. Unfortunately, she died.Conclusion It is important to determine the reason for the presentation of the symptomatic diaphragmatic hernia in adult patients. It should be considered that an increase of intra-abdominal pressure like the presence of obstructed colon mass can cause it.

Download Full-text

No histology for diminutive duodenal neuroendocrine tumors: Is it safe?

Endoscopy International Open ◽

10.1055/a-0650-4478 ◽

2019 ◽

Vol 07 (02) ◽

pp. E308-E309

Author(s):

Thomas Walter

Keyword(s):

Natural History ◽

Ct Scan ◽

Neuroendocrine Tumors ◽

Surgical Procedures ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

Interesting Approach ◽

History Of ◽

Duodenal Neuroendocrine Tumors

AbstractFor the management of diminutive duodenal neuroendocrine tumors (d-NETs), Harshit et al. have proposed – in the work accompanying this editorial – an interesting approach, the endoscopic banding without resection (BWR) technique. Given the risks associated with classic endoscopic resections and surgical procedures, and the likely favorable natural history of diminutive d-NETs, BWR may be an option for these selected patients with a very low risk of LN + and recurrence. However, a close follow-up (endoscopic, EUS and thoraco-abdominal CT scan) is then required to guarantee the safety of this policy.

Download Full-text

Extramedullary haematopoiesis presenting as a periportal mass

BMJ Case Reports ◽

10.1136/bcr-2020-235064 ◽

2020 ◽

Vol 13 (7) ◽

pp. e235064

Author(s):

Faranak Rafiee ◽

Sara Haseli ◽

Seyed Hamed Jafari ◽

Pooya Iranpour

Keyword(s):

Bone Marrow ◽

Abdominal Pain ◽

Histopathological Examination ◽

Final Diagnosis ◽

Extramedullary Haematopoiesis ◽

Abdominal Ct ◽

Rare Presentation ◽

Abdominal Ct Scan ◽

History Of ◽

Vague Abdominal Pain

Extramedullary haematopoiesis (EMH) is defined as haematopoiesis occurring in organs outside the bone marrow. The liver is one of the rare sites of EMH, and to the best of our knowledge, a few cases of adult EMH of the liver have been reported in the last 20 years. Here, we reported the case of a 68-year-old man with a known history of myelofibrosis presented with vague abdominal pain. An abdominal CT scan showed a hypoattenuating periportal mass encasing the portal vein. The final diagnosis of EMH was made through the histopathological examination. This is a rare presentation of EMH, which may be easily mistaken for other pathologies such as metastases. Familiarity with this type of presentation aids in correctly diagnosing it in an appropriate clinical setting.

Download Full-text

Hereditary Angioedema Type II: First Presentation in Adulthood with Recurrent Severe Abdominal Pain

Case Reports in Immunology ◽

10.1155/2018/7435870 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Mohamed Abuzakouk ◽

Nada AlMahmeed ◽

Esat Memisoglu ◽

Martine McManus ◽

Aydamir Alrakawi

Keyword(s):

Abdominal Pain ◽

Family History ◽

Hereditary Angioedema ◽

Positive Family History ◽

Cleveland Clinic ◽

Severe Abdominal Pain ◽

Type Ii ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

History Of

A 27-year-old Emirate man presented to Cleveland Clinic Abu Dhabi emergency department with a 4 year history of recurrent episodes of severe swellings affecting different parts of his body. He used to get 2 swelling episodes every week affecting either his face, hands, feet or scrotum and severe abdominal pain twice a week. Abdominal CT scan and a colonoscopy showed bowel wall oedema. There was no family history of similar complaint or of hereditary angioedema (HAE). Complement studies confirmed the diagnosis of HAE type II. He was commenced on danazol 100 mg twice daily and his symptoms resolved. This case report highlights the importance of considering HAE in patients with recurrent unexplained abdominal pain even in the absence of positive family history of HAE.

Download Full-text

A Fatal Case of COVID-19 in an Infant with Severe Acute Malnutrition Admitted to a Paediatric Ward in Niger

Case Reports in Pediatrics ◽

10.1155/2020/8847415 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Alido Soumana ◽

Aboubacar Samaila ◽

Lamine Mahaman Moustapha ◽

Moumouni Kamaye ◽

Balkissa Daouda ◽

...

Keyword(s):

Nasal Swab ◽

Severe Acute Malnutrition ◽

Fatal Case ◽

Acute Malnutrition ◽

Rt Pcr ◽

X Ray ◽

Laboratory Confirmation ◽

History Of ◽

Chest X Ray ◽

The Right

While there have been very few fatal cases, SARS-CoV-2 has been reported in paediatric patients. This study aims to describe a fatal case of COVID-19 in a child with severe acute malnutrition. The eight-month-old child presented with fever, diarrhoea, and difficulty in breathing. The mother of the child had fever and shortness of breath four weeks before she died. Physical examination revealed lethargy, dehydration, and severe weight loss with a weight of 5 kg at a height of 78 cm tall. The weight-for-height index was less than three Z-scores, which corresponds to severe acute malnutrition. The pulmonary examination revealed moderate respiratory distress, and the chest X-ray presented features suggestive of pneumonia in the right lung area. In the context of the COVID-19 outbreak in Niger and the circumstances of the mother’s death, a nasal swab was taken for laboratory confirmation. Treatment provided to the child included intranasal oxygen, antibiotics, and a dietary program with therapeutic milk. The child died 48 hours after his admission. The history of contact with a SARS-CoV-2 suspect or positive patient should lead to screening for infection by using RT-PCR. It is important to investigate malnutrition as a potential risk factor for severe SARS-CoV-2 infection and resultant mortality.

Download Full-text

Pheochromocytoma in a Twelve-Year-Old Girl with SDHB-Related Hereditary Paraganglioma-Pheochromocytoma Syndrome

Case Reports in Genetics ◽

10.1155/2014/273423 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7

Author(s):

Daryl Graham ◽

Megan Gooch ◽

Zhan Ye ◽

Edward Richer ◽

Aftab Chishti ◽

...

Keyword(s):

Blood Pressure ◽

Ct Scan ◽

Medical Management ◽

Elevated Blood Pressure ◽

Clinical Implications ◽

Elevated Blood ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

History Of ◽

Sdhb Gene

A twelve-year-old girl presented with a history of several weeks of worsening headaches accompanied by flushing and diaphoresis. The discovery of markedly elevated blood pressure and tachycardia led the child’s pediatrician to consider the diagnosis of a catecholamine-secreting tumor, and an abdominal CT scan confirmed the presence of a pheochromocytoma. The patient was found to have a mutation in the succinyl dehydrogenase B (SDHB) gene, which is causative for SDHB-related hereditary paraganglioma-pheochromocytoma syndrome. Herein, we describe her presentation and medical management and discuss the clinical implications of SDHB deficiency.

Download Full-text