Endobronchial Tuberculosis and Bronchostenosis: A Rare Case of Bronchial Occlusion in a Patient With History of Tuberculosis

Duodenal adenocarcinoma constitutes 0.4% of gastrointestinal malignancies. Achalasia incidence rate is 0.5-1.2 per 100000. The combination is rare. This is a report of a 68-year-old male from Nepal with history of five years abdominal pain, dysphasia and weight loss. Duodenoscopy could confirm ulcero-proliferative growth at D1-D2. Barium meal depicted features of achalasia cardia. No similar case report suggests that occurrence of duodenal carcinoma and achalasia cardia is merely co- incidental. Discussion: No similar case report suggests that occurrence of duodenal carcinoma and achalasia cardia is merely co- incidental. Consent: Informed consent was obtained from the patient for publication of this case report .

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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.

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A case of sigmoid volvulus in an unexpected demographic

Surgical Case Reports ◽

10.1186/s40792-020-01105-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Mohammad Saba ◽

Joshua Rosenberg ◽

Gregory Wu ◽

Gudata Hinika

Keyword(s):

Abdominal Pain ◽

Severe Pain ◽

Rare Case ◽

Young Female ◽

Sigmoid Volvulus ◽

Case Presentation ◽

Operative Complications ◽

History Of ◽

Male Sex ◽

Emergent Laparotomy

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.

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Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

The Surgery Journal ◽

10.1055/s-0041-1731443 ◽

2021 ◽

Vol 07 (03) ◽

pp. e124-e126

Author(s):

Mark Portelli ◽

Mark Bugeja ◽

Charles Cini

Keyword(s):

Computed Tomography ◽

Young Adult ◽

Rare Case ◽

Surgical Repair ◽

Bochdalek Hernia ◽

Case Presentation ◽

Atypical Case ◽

Accident And Emergency ◽

History Of ◽

Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

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Recurrent noncirrhotic hyperammonemia causing acute metabolic encephalopathy in a patient with a continent ileocecal pouch: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02842-1 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

T. M. Skipina ◽

S. Macbeth ◽

E. L. Cummer ◽

O. L. Wells ◽

S. Kalathoor

Keyword(s):

Emergency Department ◽

Metabolic Acidosis ◽

Mental Status ◽

Rare Case ◽

Liver Function Tests ◽

Altered Mental Status ◽

Potassium Citrate ◽

Metabolic Encephalopathy ◽

History Of ◽

Normal Urine

Abstract Introduction Acute encephalopathy, while a common presentation in the emergency department, is typically caused by a variety of metabolic, vascular, infectious, structural, or psychiatric etiologies. Among metabolic causes, hyperammonemia is relatively common and typically occurs in the setting of cirrhosis or liver dysfunction. However, noncirrhotic hyperammonemia is a rare occurrence and poses unique challenges for clinicians. Case presentation Here we report a rare case of a 50-year-old Caucasian female with history of bladder cancer status post chemotherapy, radical cystectomy, and ileocecal diversion who presented to the emergency department with severe altered mental status, combativeness, and a 3-day history of decreased urine output. Her laboratory tests were notable for hyperammonemia up to 289 μmol/L, hypokalemia, and hyperchloremic nonanion gap metabolic acidosis; her liver function tests were normal. Urine cultures were positive for Enterococcus faecium. Computed tomography imaging showed an intact ileoceal urinary diversion with chronic ileolithiasis. Upon administration of appropriate antibiotics, lactulose, and potassium citrate, she experienced rapid resolution of her encephalopathy and a significant reduction in hyperammonemia. Her hyperchloremic metabolic acidosis persisted, but her hypokalemia had resolved. Conclusion This case is an example of one of the unique consequences of urinary diversions. Urothelial tissue is typically impermeable to urinary solutes. However, when bowel segments are used, abnormal absorption of solutes occurs, including exchange of urinary chloride for serum bicarbonate, leading to a persistent hyperchloremic nonanion gap metabolic acidosis. In addition, overproduction of ammonia from urea-producing organisms can lead to abnormal absorption into the blood and subsequent oversaturation of hepatic metabolic capacity with consequent hyperammonemic encephalopathy. Although this is a rare case, prompt identification and treatment of these metabolic abnormalities is critical to prevent severe central nervous system complications such as altered mental status, coma, and even death in patients with urinary diversions.

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A rare case of isolated myoclonus in an elderly male without a history of epilepsy

Clinical Neurophysiology Practice ◽

10.1016/j.cnp.2017.11.002 ◽

2018 ◽

Vol 3 ◽

pp. 96-98

Author(s):

Aniruddh Kapoor ◽

Laurence Kinsella

Keyword(s):

Rare Case ◽

Elderly Male ◽

History Of ◽

History Of Epilepsy

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Primary B-cell lymphoma presenting as bilateral ear lobule swelling

The Journal of Laryngology & Otology ◽

10.1017/s0022215107000709 ◽

2007 ◽

Vol 121 (12) ◽

pp. 1207-1209 ◽

Cited By ~ 3

Author(s):

A K Sharma ◽

S Chatterjee ◽

V L Sharma

Keyword(s):

B Cell ◽

Rare Case ◽

Cell Lymphoma ◽

English Literature ◽

B Cell Lymphoma ◽

Excision Biopsy ◽

History Of ◽

One Year

AbstractWe report a rare case of primary B-cell lymphoma presenting as bilateral ear lobule swelling. A 56-year-old white man presented with a one-year history of painless swelling of both ear lobules. An excision biopsy confirmed B-cell lymphoma. Detailed systemic investigation confirmed the primary nature of the tumour. This tumour is rare in the ear lobule. A review of the English literature revealed no previously reported case of bilateral primary ear lobule involvement. Clinicians should be aware that this tumour can present as a primary in the ear lobules.

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Recurrent transient loss of airway secondary to regurgitated pedunculated hypopharyngeal liposarcoma

BMJ Case Reports ◽

10.1136/bcr-2020-240503 ◽

2021 ◽

Vol 14 (5) ◽

pp. e240503

Author(s):

Craig John Hickson ◽

Omar Ahmed ◽

Juliet Laycock ◽

Robert Hone

Keyword(s):

Airway Obstruction ◽

Multidisciplinary Team ◽

Rare Case ◽

Atypical Presentation ◽

Team Meetings ◽

Acute Airway Obstruction ◽

History Of ◽

Transient Loss ◽

Multidisciplinary Team Meetings

We describe a rare case of hypopharyngeal liposarcoma with an atypical presentation. The patient presented with a 3-month history of intermittent, transient acute airway obstruction. In between episodes, he was asymptomatic. A pedunculated tumour originating in the postcricoid region was seen to be suspended into the oesophagus and intermittently regurgitated into the larynx to cause airway obstruction. The lesion was endoscopically removed and examined histologically to confirm the diagnosis. On-going management of rare lesions such as this should be through multidisciplinary team meetings at a tertiary sarcoma centre.

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A rare case of spontaneous haemothorax in patient with haemophilia A

BMJ Case Reports ◽

10.1136/bcr-2021-242412 ◽

2021 ◽

Vol 14 (4) ◽

pp. e242412

Author(s):

Suthaphong Tripoppoom ◽

Nophol Leelayuwatanakul

Keyword(s):

Chest Pain ◽

Rare Case ◽

Rare Event ◽

Haemophilia A ◽

Minor Trauma ◽

Conservative Approach ◽

Pleuritic Chest Pain ◽

Good Clinical Outcome ◽

History Of

Haemorrhage in patients with haemophilia is common after minor trauma but may occur spontaneously. Despite the diversity of bleeding sites, spontaneous haemothorax, on a non-traumatic basis, is an exceedingly rare event and only a few cases had been reported. We present a case of a 43-year-old man with a history of haemophilia A who had pleuritic chest pain for 1 day without significant history of trauma. Diagnostic thoracentesis showed bloody pleural fluid in which neither abnormal cell nor organism was found. He was treated by cryoprecipitate replacement and therapeutic thoracentesis for releasing haemothorax. After discharge, the patient returned for follow-up with complete radiological resolution. Regarding the consequences of retained haemothorax from conservative approach and the procedure-related bleeding of given therapeutic intervention in haemothorax making its management in patients with haemophilia to be more challenging. Our case illustrates a conservative treatment of spontaneous haemothorax in patient with haemophilia resulting in a good clinical outcome.

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