Pub Date : 2024-12-01DOI: 10.1016/j.hmedic.2024.100141
Tomas Leng , Bowen Song , Benjamin L. Hamel , Matthew Di Giusto , Marc Patterson
Propofol related infusion syndrome is a rare and potentially lethal complication of propofol infusion. The syndrome is clinically characterized by multiorgan failure and brain injury has also been reported. We report the case of symmetric thalami, innominate substance and dentate nuclei involvement with left middle cerebral artery stroke in a five-month-old infant who presented with multiorgan failure concerning for propofol related infusion syndrome.
{"title":"Thalamic and dentate nuclei involvement in an infant with propofol related infusion syndrome: A case report","authors":"Tomas Leng , Bowen Song , Benjamin L. Hamel , Matthew Di Giusto , Marc Patterson","doi":"10.1016/j.hmedic.2024.100141","DOIUrl":"10.1016/j.hmedic.2024.100141","url":null,"abstract":"<div><div>Propofol related infusion syndrome is a rare and potentially lethal complication of propofol infusion. The syndrome is clinically characterized by multiorgan failure and brain injury has also been reported. We report the case of symmetric thalami, innominate substance and dentate nuclei involvement with left middle cerebral artery stroke in a five-month-old infant who presented with multiorgan failure concerning for propofol related infusion syndrome.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-17DOI: 10.1016/j.hmedic.2024.100137
Snehanjan Sarangi , Basudev Mahato , Samir Mandal , Shreya S. Saha
Gorlin-Goltz syndrome (GGS), also known as the basal cell nevus syndrome (BCNS), or nevoid basal cell carcinoma syndrome (NBCCS), is a multisystem autosomal dominant disorder, characterized by the presence of numerous odontogenic keratocysts (OKC), along with variable cutaneous, dental, skeletal, muscular, neurological, sexual and ophthalmologic anomalies. Mostly mutation of the patched 1 (PTCH1) gene is responsible, while in a few instances germline mutation of suppressor of fused homolog (SUFU) gene is evident. Timely diagnosis and proper management of the various systemic abnormalities associated with NBCCS, is of utmost significance, owing to its susceptibility towards malignant transformation to basal cell carcinoma (BCC). Herein, we describe GGS in a 22 years old male patient, with relevant diagnostic aspects.
{"title":"Gorlin-Goltz syndrome – Report of a case with review of literature","authors":"Snehanjan Sarangi , Basudev Mahato , Samir Mandal , Shreya S. Saha","doi":"10.1016/j.hmedic.2024.100137","DOIUrl":"10.1016/j.hmedic.2024.100137","url":null,"abstract":"<div><div>Gorlin-Goltz syndrome (GGS), also known as the basal cell nevus syndrome (BCNS), or nevoid basal cell carcinoma syndrome (NBCCS), is a multisystem autosomal dominant disorder, characterized by the presence of numerous odontogenic keratocysts (OKC), along with variable cutaneous, dental, skeletal, muscular, neurological, sexual and ophthalmologic anomalies. Mostly mutation of the patched 1 (PTCH1) gene is responsible, while in a few instances germline mutation of suppressor of fused homolog (SUFU) gene is evident. Timely diagnosis and proper management of the various systemic abnormalities associated with NBCCS, is of utmost significance, owing to its susceptibility towards malignant transformation to basal cell carcinoma (BCC). Herein, we describe GGS in a 22 years old male patient, with relevant diagnostic aspects.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1016/j.hmedic.2024.100133
Bilawal Abbas , Fiza Shafi , Muhammad Usama bin Shabbir , Sijel Husseini
The medical condition termed as nephrotic syndrome (NS) is defined by excessive excretion of proteins in the urine, called proteinuria, and lack of circulating albumin, called hypoalbuminemia. The value for proteinuria in NS is more than 40 mg/m^2 per hour, and the cut-off value for albumin is less than 30 g/L. A rare form of vasculitis, called microscopic polyangiitis mainly affects the kidneys and lungs. We have an instance of a seventeen-year-old girl with the involvement of the renal and central nervous systems as a manifestation of microscopic polyangiitis on the background of overlap. Renal biopsies and perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) suggested microscopic polyangiitis. After receiving cyclophosphamide and pulse steroids, the patient's symptoms resolved, and the patient was discharged. To help with early disease detection and treatment, this case emphasizes the importance of considering ANCA-associated vasculitis during diagnostic processes and highlights the concept of nephrotic-nephritic overlap.
肾病综合征（NS）是指尿液中蛋白质排泄过多，称为蛋白尿，而循环白蛋白缺乏，称为低白蛋白血症。肾病综合征的蛋白尿值为每小时 40 毫克/米^2 以上，白蛋白的临界值为 30 克/升以下。一种罕见的血管炎称为显微镜下多血管炎，主要累及肾脏和肺部。我们有一个 17 岁女孩的病例，她的肾脏和中枢神经系统均受累，这是显微镜下多血管炎重叠背景下的一种表现。肾活检和核周抗中性粒细胞胞浆抗体（p-ANCA）提示她患有显微镜下多血管炎。在接受环磷酰胺和脉冲类固醇治疗后，患者的症状缓解并出院。为了帮助早期发现和治疗疾病，本病例强调了在诊断过程中考虑 ANCA 相关血管炎的重要性，并突出了肾病-肾炎重叠的概念。
{"title":"Overlap of nephrotic syndrome with nephritic syndrome and its relation to microscopic polyangiitis in a seventeen-year-old young female","authors":"Bilawal Abbas , Fiza Shafi , Muhammad Usama bin Shabbir , Sijel Husseini","doi":"10.1016/j.hmedic.2024.100133","DOIUrl":"10.1016/j.hmedic.2024.100133","url":null,"abstract":"<div><div>The medical condition termed as nephrotic syndrome (NS) is defined by excessive excretion of proteins in the urine, called proteinuria, and lack of circulating albumin, called hypoalbuminemia. The value for proteinuria in NS is more than 40 mg/m^2 per hour, and the cut-off value for albumin is less than 30 g/L. A rare form of vasculitis, called microscopic polyangiitis mainly affects the kidneys and lungs. We have an instance of a seventeen-year-old girl with the involvement of the renal and central nervous systems as a manifestation of microscopic polyangiitis on the background of overlap. Renal biopsies and perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) suggested microscopic polyangiitis. After receiving cyclophosphamide and pulse steroids, the patient's symptoms resolved, and the patient was discharged. To help with early disease detection and treatment, this case emphasizes the importance of considering ANCA-associated vasculitis during diagnostic processes and highlights the concept of nephrotic-nephritic overlap.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100133"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1016/j.hmedic.2024.100138
Antonio Al Hazzouri , Christopher Sleiman , Rose-Mary Daou , Karam Karam , Elias Fiani
Parvovirus B19 is a common virus, typically known for causing erythema infectiosum in children and polyarthritis in adults. In rare cases, parvovirus can cause hepatitis. We present the case of a 40-year-old previously healthy woman who presented with fever, fatigue, arthralgia, and a reticular erythematous rash. Physical examination revealed mild hepatomegaly and right upper quadrant tenderness. Further laboratory analysis was unremarkable except for elevated liver enzymes. Viral serologies for hepatotrophic viruses were negative, but parvovirus B19 IgM and IgG were positive and suggestive of parvovirus B19-induced hepatitis. In the medical literature, parvovirus B19 has been associated with acute and fulminant hepatitis, especially in immunocompromised patients. The outcomes can range from asymptomatic transaminase elevations to liver failure requiring transplantation. Nonetheless, our case highlights the possibility of atypical infection with no hematological abnormalities. It is important to recognize and treat parvovirus B19 as a potential cause of hepatitis, regardless of classic presentations or hematological results.
{"title":"Unmasking parvovirus B19: An atypical case of hepatitis with rash and arthralgia","authors":"Antonio Al Hazzouri , Christopher Sleiman , Rose-Mary Daou , Karam Karam , Elias Fiani","doi":"10.1016/j.hmedic.2024.100138","DOIUrl":"10.1016/j.hmedic.2024.100138","url":null,"abstract":"<div><div>Parvovirus B19 is a common virus, typically known for causing erythema infectiosum in children and polyarthritis in adults. In rare cases, parvovirus can cause hepatitis. We present the case of a 40-year-old previously healthy woman who presented with fever, fatigue, arthralgia, and a reticular erythematous rash. Physical examination revealed mild hepatomegaly and right upper quadrant tenderness. Further laboratory analysis was unremarkable except for elevated liver enzymes. Viral serologies for hepatotrophic viruses were negative, but parvovirus B19 IgM and IgG were positive and suggestive of parvovirus B19-induced hepatitis. In the medical literature, parvovirus B19 has been associated with acute and fulminant hepatitis, especially in immunocompromised patients. The outcomes can range from asymptomatic transaminase elevations to liver failure requiring transplantation. Nonetheless, our case highlights the possibility of atypical infection with no hematological abnormalities. It is important to recognize and treat parvovirus B19 as a potential cause of hepatitis, regardless of classic presentations or hematological results.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100138"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.hmedic.2024.100134
Faiqa Taj , Chitturi Sai Sujana , Jawaria Amin , Babar Naeem
Background
Measles is a highly contagious, vaccine-preventable viral disease characterized by fever, rash, and respiratory symptoms. While measles is generally rare in neonates due to the protective effect of transplacental maternal antibodies, cases in early infancy can occur, raising concerns about the efficacy of maternal immunity.
Case presentation
We report a case of a 15-day-old male neonate who presented with high-grade fever, maculopapular rash, and respiratory distress. Despite the mother’s vaccination history, the infant was diagnosed with measles through serological testing. The disease progressed rapidly, leading to severe respiratory compromise and significant ocular involvement, requiring intensive care management.
Conclusion
This case underscores potential gaps in neonatal protection, even in infants of vaccinated mothers, suggesting that waning maternal immunity may result in insufficient antibody transfer. It highlights the need for re-evaluating vaccination strategies in women of reproductive age and emphasizes the importance of stringent infection control measures in postpartum care settings to prevent neonatal measles.
{"title":"A rare case of neonatal measles: Reevaluating maternal immunity in the vaccination era","authors":"Faiqa Taj , Chitturi Sai Sujana , Jawaria Amin , Babar Naeem","doi":"10.1016/j.hmedic.2024.100134","DOIUrl":"10.1016/j.hmedic.2024.100134","url":null,"abstract":"<div><h3>Background</h3><div>Measles is a highly contagious, vaccine-preventable viral disease characterized by fever, rash, and respiratory symptoms. While measles is generally rare in neonates due to the protective effect of transplacental maternal antibodies, cases in early infancy can occur, raising concerns about the efficacy of maternal immunity.</div></div><div><h3>Case presentation</h3><div>We report a case of a 15-day-old male neonate who presented with high-grade fever, maculopapular rash, and respiratory distress. Despite the mother’s vaccination history, the infant was diagnosed with measles through serological testing. The disease progressed rapidly, leading to severe respiratory compromise and significant ocular involvement, requiring intensive care management.</div></div><div><h3>Conclusion</h3><div>This case underscores potential gaps in neonatal protection, even in infants of vaccinated mothers, suggesting that waning maternal immunity may result in insufficient antibody transfer. It highlights the need for re-evaluating vaccination strategies in women of reproductive age and emphasizes the importance of stringent infection control measures in postpartum care settings to prevent neonatal measles.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100134"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.hmedic.2024.100131
Adam Maestas , Parsa Charkhchi , Farbod Malek
Femoral subtrochanteric (ST) fractures have a bimodal age distribution and often the result of high-energy trauma in young patients and minor trauma in elderly patients. Intramedullary nailing (IMN) has been the mainstay for repair and is favorable over fixed angle plating due to greater stability and decreased complications. Many elderly patients with femoral fractures also suffer from other general bone-related comorbidities such as osteoarthritis (OA). Traditionally, concurrent ST femur fractures and severe hip osteoarthritis have been treated separately, but there is growing evidence supporting the use of total hip arthroplasty (THA) as a viable treatment choice. Here the case of a 71-year-old female with a right femoral ST spiral fracture and advanced hip OA is presented. The patient was treated for her fracture and hip OA simultaneously through a THA with a long stem prosthesis and FiberTape cerclage wires. The patient followed up in good condition and was able to ambulate with the assistance of a walker then transitioned to a cane. It is proposed that patients with ST femur fractures and hip OA would significantly benefit from THA as a single procedure, and its consideration is recommended in future cases with similar presentations.
股骨转子下（ST）骨折呈双峰年龄分布，通常是年轻患者高能量创伤和老年患者轻微创伤的结果。髓内钉（IMN）一直是主要的修复方法，与固定角钢板相比，其稳定性更高，并发症更少。许多股骨骨折的老年患者还患有骨关节炎（OA）等其他与骨相关的并发症。传统上，并发 ST 股骨骨折和严重的髋关节骨关节炎是分开治疗的，但越来越多的证据支持将全髋关节置换术（THA）作为一种可行的治疗选择。这里介绍的是一名 71 岁女性的病例，她患有右股骨 ST 螺旋形骨折和晚期髋关节 OA。患者同时接受了骨折和髋关节 OA 的治疗，采用长柄假体和 FiberTape 黏附钢丝进行全髋关节置换术。患者术后情况良好，能够在助行器的帮助下行走，然后过渡到使用拐杖。我们认为，股骨ST段骨折合并髋关节OA的患者可从THA单次手术中显著获益，建议今后在类似病例中考虑采用这种手术。
{"title":"Total hip arthroplasty as a single procedure for subtrochanteric femur fracture with concurrent hip osteoarthritis: A case report","authors":"Adam Maestas , Parsa Charkhchi , Farbod Malek","doi":"10.1016/j.hmedic.2024.100131","DOIUrl":"10.1016/j.hmedic.2024.100131","url":null,"abstract":"<div><div>Femoral subtrochanteric (ST) fractures have a bimodal age distribution and often the result of high-energy trauma in young patients and minor trauma in elderly patients. Intramedullary nailing (IMN) has been the mainstay for repair and is favorable over fixed angle plating due to greater stability and decreased complications. Many elderly patients with femoral fractures also suffer from other general bone-related comorbidities such as osteoarthritis (OA). Traditionally, concurrent ST femur fractures and severe hip osteoarthritis have been treated separately, but there is growing evidence supporting the use of total hip arthroplasty (THA) as a viable treatment choice. Here the case of a 71-year-old female with a right femoral ST spiral fracture and advanced hip OA is presented. The patient was treated for her fracture and hip OA simultaneously through a THA with a long stem prosthesis and FiberTape cerclage wires. The patient followed up in good condition and was able to ambulate with the assistance of a walker then transitioned to a cane. It is proposed that patients with ST femur fractures and hip OA would significantly benefit from THA as a single procedure, and its consideration is recommended in future cases with similar presentations.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100131"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-13DOI: 10.1016/j.hmedic.2024.100135
Karam Karam , Alaa Taha , Melissa Kyriakos Saad , Khaled Soukarieh , Rafca Challita , Joseph Amara , Elias Fiani , Elias Saikaly
Duodenal neuroendocrine tumor is a rare tumor mostly asymptomatic and found incidentally on radiography or endoscopy. Treatment options include endoscopic or surgical resection. The incidence of D-NET is increasing due to advanced detection techniques. The diagnosis of duodenal neuroendocrine tumor is a challenge due to the vague presenting symptoms. Herein, we report a rare case of duodenal neuroendocrine tumor in a middle-aged woman who presented with recurrent episodes of melena and anemia.
{"title":"A hidden duodenal neuroendocrine tumor: A case report","authors":"Karam Karam , Alaa Taha , Melissa Kyriakos Saad , Khaled Soukarieh , Rafca Challita , Joseph Amara , Elias Fiani , Elias Saikaly","doi":"10.1016/j.hmedic.2024.100135","DOIUrl":"10.1016/j.hmedic.2024.100135","url":null,"abstract":"<div><div>Duodenal neuroendocrine tumor is a rare tumor mostly asymptomatic and found incidentally on radiography or endoscopy. Treatment options include endoscopic or surgical resection. The incidence of D-NET is increasing due to advanced detection techniques. The diagnosis of duodenal neuroendocrine tumor is a challenge due to the vague presenting symptoms. Herein, we report a rare case of duodenal neuroendocrine tumor in a middle-aged woman who presented with recurrent episodes of melena and anemia.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100135"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-13DOI: 10.1016/j.hmedic.2024.100136
Anna Soldevila , Marina García , Halima Berrada Zizzi , Francisco Ruíz Tolosa
Introduction
Hemorrhagic Descemet’s membrane (DM) detachment is a rare complication after glaucoma surgery. Related to nonpenetrating deep sclerectomy (NPDS), it is postulated to be caused due to blood reflux from the Schlemm’s canal or from a hemorrhage originated under the scleral flap. Different therapeutic approaches are described: from observation to Nd:YAG laser, ab interno membranotomy or evacuation through corneal incision. This condition might compromise the patient’s visual acuity so the treatment must be done early.
Case report
A 69-year-old black male underwent a phacoemulsification and a NPDS without incidents. In the early postoperative period, an hemorrhagic pre- Descemet detachment associated to an hemorrhagic bleb and an uncontrolled intraocular pressure (IOP) were observed. A Nd:YAG laser endothelial puncture and a suturolysis were performed without an optimal IOP control. After 10 days, an anterior chamber lavage combined with a needling achieved a complete transparent cornea and a controlled IOP without topical treatment.
Discussion
The pathophysiology of the presented case could be explained by an hemorrhage originated from vessels under the scleral flap due to an elevated intrableb pressure that favored the dissection of the weakest connected site, the DM. A Nd:YAG laser puncture was capital to avoid corneal staining and to lower the pressure from the filtration bleb (FB). Nevertheless, IOP was not controlled because of hypema and fibrosis of the trabeculo-descemetic membrane. After anterior chamber lavage and a needling with piercing of the TDM the IOP normalized and the FB was functional again.
The treatment in a hemorrhagic pre-Descemet detachment is personalized and it is very important to understand the pathophysiology to approach it properly.
{"title":"Hemorrhagic pre-Descemet’s membrane detachment after nonpenetrating deep sclerectomy","authors":"Anna Soldevila , Marina García , Halima Berrada Zizzi , Francisco Ruíz Tolosa","doi":"10.1016/j.hmedic.2024.100136","DOIUrl":"10.1016/j.hmedic.2024.100136","url":null,"abstract":"<div><h3>Introduction</h3><div>Hemorrhagic Descemet’s membrane (DM) detachment is a rare complication after glaucoma surgery. Related to nonpenetrating deep sclerectomy (NPDS), it is postulated to be caused due to blood reflux from the Schlemm’s canal or from a hemorrhage originated under the scleral flap. Different therapeutic approaches are described: from observation to Nd:YAG laser, ab interno membranotomy or evacuation through corneal incision. This condition might compromise the patient’s visual acuity so the treatment must be done early.</div></div><div><h3>Case report</h3><div>A 69-year-old black male underwent a phacoemulsification and a NPDS without incidents. In the early postoperative period, an hemorrhagic pre- Descemet detachment associated to an hemorrhagic bleb and an uncontrolled intraocular pressure (IOP) were observed. A Nd:YAG laser endothelial puncture and a suturolysis were performed without an optimal IOP control. After 10 days, an anterior chamber lavage combined with a needling achieved a complete transparent cornea and a controlled IOP without topical treatment.</div></div><div><h3>Discussion</h3><div>The pathophysiology of the presented case could be explained by an hemorrhage originated from vessels under the scleral flap due to an elevated intrableb pressure that favored the dissection of the weakest connected site, the DM. A Nd:YAG laser puncture was capital to avoid corneal staining and to lower the pressure from the filtration bleb (FB). Nevertheless, IOP was not controlled because of hypema and fibrosis of the trabeculo-descemetic membrane. After anterior chamber lavage and a needling with piercing of the TDM the IOP normalized and the FB was functional again.</div><div>The treatment in a hemorrhagic pre-Descemet detachment is personalized and it is very important to understand the pathophysiology to approach it properly.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100136"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case report presents a 39-year-old woman with a history of abdominal discomfort, gastroesophageal reflux disease, and previous biliary colic. Radiological investigations suggested a suspicious infundibular lesion in the gallbladder, prompting further examinations including magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and PET/CT scan. Despite inconclusive findings, the patient underwent robot-assisted cholecystectomy, revealing a fistula between the gallbladder infundibulum, and the common bile duct. Histological examination revealed a complex conglomerate of non-neoplastic processes, including gastric heterotopia, pseudo-pyloric glandular proliferation, and traumatic neuroma-like neural proliferation within the gallbladder wall. Discussion highlights the developmental anomalies and reactive mechanisms potentially underlying these findings, suggesting a connection between gastric heterotopia, glandular proliferation, and neural proliferation. The presence of three different 'pathological entities' in the same case represents the uniqueness of our case report, and the type of growth that sometimes appears to simulate an infiltration is an important element to consider as its misdiagnosis could lead to erroneous considerations and incorrect treatment.
{"title":"Gallbladder glandular proliferation mimicking an adenocarcinoma – A case report","authors":"Tiziana Salviato , Stefania Caramaschi , Giuseppe Esposito , Volkan Adsay","doi":"10.1016/j.hmedic.2024.100132","DOIUrl":"10.1016/j.hmedic.2024.100132","url":null,"abstract":"<div><div>This case report presents a 39-year-old woman with a history of abdominal discomfort, gastroesophageal reflux disease, and previous biliary colic. Radiological investigations suggested a suspicious infundibular lesion in the gallbladder, prompting further examinations including magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and PET/CT scan. Despite inconclusive findings, the patient underwent robot-assisted cholecystectomy, revealing a fistula between the gallbladder infundibulum, and the common bile duct. Histological examination revealed a complex conglomerate of non-neoplastic processes, including gastric heterotopia, pseudo-pyloric glandular proliferation, and traumatic neuroma-like neural proliferation within the gallbladder wall. Discussion highlights the developmental anomalies and reactive mechanisms potentially underlying these findings, suggesting a connection between gastric heterotopia, glandular proliferation, and neural proliferation. The presence of three different 'pathological entities' in the same case represents the uniqueness of our case report, and the type of growth that sometimes appears to simulate an infiltration is an important element to consider as its misdiagnosis could lead to erroneous considerations and incorrect treatment.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100132"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-04DOI: 10.1016/j.hmedic.2024.100128
Matthew Batliner , Rebecca Frost , Marnie Welch , Julia Knight
The management of bipolar disorder during pregnancy and in the post-partum period can often be a challenge for psychiatrists. Psychiatrists and patients must consider both the elevated risks of break-through mood episodes during pregnancy and the post-partum period as well as the potential side effects associated with ongoing pharmacotherapy. Electroconvulsive therapy (ECT) may offer an alternative to pharmacotherapy during pregnancy, though there is very limited information on the use of ECT as a monotherapy or maintenance treatment during pregnancy and in the post-partum period. We present a case of 32 year old woman with bipolar disorder who received maintenance ECT without adjunctive mood stabilizing medications throughout her pregnancy, per patient preference. ECT was found to provide adequate mood stabilization with no adverse effects noted throughout the pregnancy. During the post-partum period which coincided with a brief hiatus of ECTs, the patient experienced a manic episode which resulted in hospitalization, an acute ECT course, and re-initiation of mood stabilizing medications. This case provides a framework for considering the role of ECT as a maintenance option for pregnant patients and emphasizes the need for further information on protocols for ECT treatment in the post-partum period.
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