Rare Complication
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Hamed H. Alnouri ◽  
Khalifa Alyatama

AbstractSump syndrome is a rare complication of a side to side choledochoduodenostomy (CDD). After the introduction of endoscopic retrograde cholangiopancreatography (ERCP) in 1968 Kozarek (Gastroenterol Hepatol (N Y) 13(10):620-622, 2017), choledochoduodenostomy and its complications are seldom seen. The diagnosis of sump syndrome is further befogged by the lack of characteristic clinical or laboratory findings, the inability of the patient to provide medical records of their CDD, and the fact that sump syndrome only presents decades after a CDD. In this article, we will present a case of a 39-year-old female patient who presented as a case of ascending cholangitis with an initially unknown past surgical history. A detailed medical history was thoroughly taken, and her previous medical reports were presented after which an ERCP was done with extraction of debris was preformed. In a time where choledochoduodenostomy is rarely being chosen as a choice of treatment and its complications are infrequently encountered, this case serves as a reminder that even in the ERCP era, complications of choledochoduodenostomy should still be well understood.

2021 ◽  
pp. 000313482110610
Yasong Yu ◽  
Justin T. Sambol ◽  
Huzaifa A. Shakir

Tracheal perforation is a rare complication of intubation and is associated with high mortality. Here we describe a case of large, full-thickness tracheal perforation from traumatic intubation after an elective procedure. The injury was managed with prolonged intubation that bypassed the site of injury, and the patient was successfully extubated after 11 days. Conservative management of tracheal perforation after traumatic intubation is an option in select patients that avoids need for surgery.

Jayati Joshipura ◽  
Vani H.N. ◽  
Nabanita Kora

Tumour-induced hypoglycaemia is a rare complication/condition mainly seen in adults. It is caused due to increased production of insulin or insulin-like growth factor (IGF) 2 tumour cells. We present a 3-year-old paediatric patient with non-islet cell tumour induced hypoglycaemia (NICTH) secondary to rhabdomyosarcoma. She presented with abdominal mass and refractory hypoglycaemia, requiring high glucose infusion and steroids. Critical sample analysis during hypoglycaemia showed suppression of insulin, IGF-1, C-peptide, growth hormone, and ketones, with a high cortisol level. CT scan of abdomen and pelvis showed a huge retroperitoneal mass, later diagnosed as rhabdomyosarcoma. In a resource-limited setting, where IGF-2 is not possible, low serum insulin and IGF-1 levels during hypoglycaemia aids in diagnosis of NICTH. This is one of the first few reported paediatric cases with NICTH from India, and we believe that reporting this case would add more information to the existing literature. Thus, NICTH should be suspected in all malignancies presenting with intractable hypoglycaemia irrespective of their age.

2021 ◽  
Vol 96 (12) ◽  
pp. 3178-3179
Marine Bordet ◽  
Anne Long ◽  
Philippe Tresson

DEN Open ◽  
2021 ◽  
Vol 2 (1) ◽  
Kazunaga Ishigaki ◽  
Yousuke Nakai ◽  
Akiyuki Inokuma ◽  
Yukari Suzuki ◽  
Kensaku Noguchi ◽  

2021 ◽  
Vol 21 (1) ◽  
Reza Abbasi ◽  
Farnaz Sadat Javanmardi ◽  
Ahmad Mokhtari ◽  
Parisa Hosseinpour ◽  
Reza Shahriarirad ◽  

Abstract Background With the ongoing coronavirus disease (COVID-19) pandemic, along with the development of new mutations of the virus and an increase in the number of cases among pediatrics, physicians should be aware and alerted on the atypical presentations of the disease, especially in less expected individuals. Case presentation Here we present a 12-year-old obese boy (BMI = 37.5 kg/m2) who presented with empyema, which was following SARS-CoV-2 infection. The patient had no history of fever. Due to the onset of dyspnea, a chest tube was inserted for him which was later altered to a pleural drainage needle catheter. Conclusion Our case is the first report of COVID-19 presenting as empyema among pediatrics. Pleural empyema should be considered as a rare complication of COVID-19. Since there is still no guideline in the management of empyema in the context of COVID-19, delay in diagnosis and intervention may cause morbidity and mortality in children.

Mariana Leal ◽  
Carolina Amado ◽  
Bárbara Paracana ◽  
Diana Aguiar ◽  
Mariana Sousa

The iliopsoas muscle abscess is rare condition, with increasing recognition, that can be either primary, by hematological or lymphatic dissemination, or secondary to infections in the gastrointestinal, genitourinary tract or musculoskeletal system. Its early identification is highlighted, for an adequate therapeutic orientation, contributing to a good prognosis.

Ambati Bhavani ◽  
Palanki Satya Dattatreya ◽  
Vinukonda Shyamala

Imatinib is an FDA approved first-line treatment for Philadelphia-positive CML. It is a selective tyrosine kinase inhibitor specifically targeting BCR-ABL, c-KIT, PDGFRA. It has been reported with low incidence of adverse effects and high tolerability, with haemorrhagic events being a rare complication. We report here a case of 51-year-old female patient with chronic myeloid leukemia who was on high dose imatinib experienced recurrent sub-dural haemorrhage. This case report emphasizes on the need to consider Sub dural haemorrhage as an unusual cause of headache associated with vomiting in a patient taking high dose of imatinib.

Edgar Salvador Salas Ochoa ◽  
Maria Eugenia Dominguez Gutierrez ◽  
Alfredo Lopez Rocha ◽  
Edilia Naraleth Arce Sanchez ◽  
Karla Itzel Altamirano Moreno ◽  

Gallbladder disease affects more than 20 million people in the United States. Acute cholecystitis is a clinic entity characterized by the inflammation of the vesicular wall that is usually manipulated by abdominal pain, right hypochondrial sensitivity and fever. The technique of choice for the diagnosis of cholecystitis is abdominal ultrasound; gallbladder perforation is a rare complication of acute cholecystitis (2%-11%). The presence of perivesicular abscesses is infrequent, its prevalence varies between 2.1% and 19.5%. Clinical record was reviewed of a 73 years old woman who attended a second level public care unit, with a clinical picture of acute chronic lithiasis cholecystitis, who underwent surgery consisting of open converted laparoscopic cholecystectomy with a finding of vesicular perforation with liver abscess, it was initiated with laparoscopic approach, it was not possible to identify anatomical structures, so it was decided to convert to open surgery. Cholecystectomy and abdominal lavage are usually sufficient in the treatment of gallbladder perforation.

Tiago Corvelo Pavão ◽  
Rosa Simão ◽  
Mário Nora ◽  
Carlos Casimiro

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