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Presentation Invasive Mole After Normal Pregnancy: A Very Rare Case Report 正常妊娠后出现的浸润性痣:非常罕见的病例报告
Pub Date : 2023-12-31 DOI: 10.18502/crcp.v8i4.14575
A. Tehranian, Akram Ghahghaei-nezamabadi, M. V. Dastjerdi, Sophia Esalatmanesh, Akram Seifollahi
Gestational trophoblastic neoplasia (GTN) is a rare neoplasm and is a spectrum of proliferative disorders of placenta. Invasive mole is a subtype of GTN that almost always arises after molar pregnancy. This report presents a 35-year-old woman with an atypical presentation of invasive mole after a normal pregnancy. The patient presented with a complaint of vaginal bleeding after normal vaginal delivery. Invasive mole was diagnosed based on findings of imaging and elevated beta human chorionic gonadotropin (ß-hCG) levels. Hysterectomy was finally decided upon due to severe vaginal bleeding and the patient’s request. Although GTN occurs after normal delivery, the patient recovered without receiving chemotherapy. It is important to consider all subtypes of GTN as a differential diagnosis of patients with abnormal postpartum bleeding and elevated ß-hCG levels even after a normal pregnancy.
妊娠滋养细胞肿瘤(GTN)是一种罕见的肿瘤,是胎盘增生性疾病的一种。侵袭性痣是 GTN 的一种亚型,几乎总是在臼齿妊娠后出现。本报告介绍了一名 35 岁女性在正常妊娠后出现的非典型侵袭性痣。患者主诉正常阴道分娩后出现阴道出血。根据影像学检查结果和升高的β-人绒毛膜促性腺激素(ß-hCG)水平,诊断为浸润性黑痣。由于严重的阴道出血和患者的要求,最终决定切除子宫。虽然 GTN 发生在正常分娩之后,但患者在没有接受化疗的情况下恢复了健康。对于产后异常出血和ß-hCG水平升高的患者,即使是正常妊娠,也必须将所有亚型的GTN作为鉴别诊断。
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引用次数: 0
A Colorectal Adenocarcinoma With Obstruction in a 26-Year-Old Man: A Case Report in an Unlikely Age Group 一名 26 岁男子的结直肠腺癌伴梗阻:一个不寻常年龄组的病例报告
Pub Date : 2023-12-31 DOI: 10.18502/crcp.v8i4.14576
Faraz Mahdizadeh, Mir Mehdi Chinifroush-Asl, Farzad Heidary
Colorectal cancer affects the rectum or large bowel, including the appendix. This type of cancer develops from the colorectal mucosa, with adenocarcinoma being the most common form, accounting for over 95% of cases. It typically affects individuals aged 50 years or older. However, this report highlights a case of colorectal adenocarcinoma that occurred at a young age, despite no family history. Unfortunately, the cancer was initially missed during check-ups because of the unlikely age group, resulting in a delayed diagnosis. The patient, who presented with an obstruction, underwent surgical interventions. Upon further examination, the histopathological tests revealed that the patient had well-differentiated type I colorectal adenocarcinoma.
大肠癌影响直肠或大肠,包括阑尾。这种癌症从大肠粘膜发展而来,腺癌是最常见的形式,占病例的 95% 以上。它通常影响 50 岁或以上的人。然而,本报告重点介绍了一例年轻时就患上的结直肠腺癌,尽管没有家族史。不幸的是,由于年龄不大,该癌症最初在体检时被漏诊,导致诊断延误。患者出现梗阻,接受了手术治疗。经进一步检查,组织病理学检测显示患者患有分化良好的 I 型大肠腺癌。
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引用次数: 0
Adult Presentation of Meckel’s Diverticulum: A Case Report 梅克尔憩室的成人表现:病例报告
Pub Date : 2023-12-31 DOI: 10.18502/crcp.v8i4.14574
Queeneth Uwandu, Ogheneyoma Akpoviroro
Meckel’s diverticulum (MD) is a congenital outpouching or bulge in the lower part of the small intestine. It is the most common congenital defect of the gastrointestinal tract. MD is usually asymptomatic but when symptomatic, typically presents in childhood. A case is presented of a 33-year-old Caucasian man who presented with multiple episodes of bright red blood per rectum prior to hospital admission, with associated weakness and nausea. The patient denied abdominal discomfort, fevers, or vomiting. Eventually, it was found that the patient had a Meckel’s diverticulum with an associated focus of active extravasation from a dilated mesenteric vein. The feeding artery was successfully embolized with cessation of flow to the draining vein. Colonoscopy and computed tomography (CT) scan were inconclusive, and the patient ultimately underwent diagnostic laparoscopy and small bowel resection of the Meckel’s diverticulum to prevent further bleeding by removing aberrant tissue
梅克尔憩室(MD)是小肠下部的一种先天性外翻或隆起。它是胃肠道最常见的先天性缺陷。MD通常无症状,但如果有症状,通常会在儿童时期出现。本病例涉及一名 33 岁的白种男子,入院前曾多次出现直肠鲜红色血迹,并伴有乏力和恶心。患者否认腹部不适、发烧或呕吐。最终,医生发现患者患有梅克尔憩室,并伴有肠系膜静脉扩张引起的活动性外渗灶。栓塞供血动脉后,引流静脉血流停止。结肠镜检查和计算机断层扫描(CT)均未得出结论,患者最终接受了诊断性腹腔镜检查和梅克尔憩室小肠切除术,通过切除异常组织防止进一步出血。
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引用次数: 0
Rapunzel Syndrome in A 13-Year-Old Girl with Abdominal Pain Presenting to The Pediatric Emergency Department: A Case Report 一名 13 岁女孩因腹痛到儿科急诊就诊时患上了长发公主综合征:病例报告
Pub Date : 2023-12-31 DOI: 10.18502/crcp.v8i4.14578
Majid Aflatoonian, Rohoollah Edalatkhah, Hojatollah Raji, Amir Pasha Amel Shahbaz
Trichobezoar is a rare form of bezoar characterized by the accumulation of swallowed hair in the stomach. An unusual form of bezoar, in which the bezoar spreads from the stomach to the small intestine or beyond, is called Rapunzel syndrome. This syndrome is mainly seen in females and is often associated with psychiatric disorders. Trichobezoar usually presents with abdominal pain, early satiety, and nausea. However, it may also present as an asymptomatic abdominal mass or obstruction and pe rforation of the gastrointestinal tract. This diagnosis should be considered in young women with abdominal pain, an epigastric mass, and malnutrition, especially in patients with a history of trichophagy or psychiatric disorder. The case of a 13-year-old girl with Rapunzel syndrome is described. She presented to the emergency ward with a history of abdominal pain, non-bilious vomiting after meal and fluid intake, halitosis, decreased appetite, and weight loss. The patient was treated successfully by laparotomy.
三叶盲蝽是一种罕见的盲蝽,其特征是吞下的毛发堆积在胃部。一种不寻常的虾尾病称为长发公主综合征,它是指虾尾从胃部扩散到小肠或更远的地方。这种综合征主要见于女性,通常伴有精神障碍。三叶虫症通常表现为腹痛、早饱和恶心。然而,它也可能表现为无症状的腹部肿块或胃肠道梗阻和穿孔。对于伴有腹痛、上腹肿块和营养不良的年轻女性,尤其是伴有吞咽困难或精神障碍病史的患者,应考虑这一诊断。本病例描述了一名患有长发公主综合征的 13 岁女孩。她因腹痛、进食和进水后出现非淤性呕吐、口臭、食欲下降和体重减轻而来到急诊病房。患者通过开腹手术得到了成功治疗。
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引用次数: 0
Adhesion Band Small Bowel Obstruction in Virgin Abdomen: A Case Report 处女腹部粘连带状小肠梗阻:病例报告
Pub Date : 2023-12-31 DOI: 10.18502/crcp.v8i4.14577
Hadi Fardis
Small bowel obstruction (SBO) is a common surgical emergency, accounting for almost 50% of all emergency laparotomies with significant in-hospital morbidity. History of previous intra-abdominal surgery is very common in SBO patients, which can include up to 80% of these patients. However, there are cases of SBO with no prior abdominal surgery caused by omental bands, which are very rare and have a high probability of misdiagnosis, referred to as a virgin abdomen. In this article, a rare case of adhesion band small bowel obstruction in a virgin abdomen is presented. Although the factors related to SBO in a virgin abdomen and its underlying causes are not yet fully understood. In this case, the most possible explanation is considering the patient’s age and congenital condition because of the absence of previous abdominal surgeries or inflammation history.
小肠梗阻(SBO)是一种常见的外科急症,几乎占所有急诊开腹手术的 50%,院内发病率很高。在 SBO 患者中,既往腹腔内手术史非常常见,占这些患者的 80%。然而,也有一些病例是由网膜带引起的、既往未进行过腹部手术的 SBO,这种病例非常罕见,误诊几率很高,被称为处女腹。本文介绍了一例罕见的处女腹腔粘连带小肠梗阻病例。虽然与处女腹腔 SBO 相关的因素及其根本原因尚未完全明了。在本病例中,最可能的解释是考虑到患者的年龄和先天条件,因为既往没有腹部手术史或炎症史。
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引用次数: 0
Occult Pheochromocytoma and Acute Ischaemic Stroke in Young Adult: Cause or Association 青少年隐匿性嗜铬细胞瘤与急性缺血性中风:原因或关联
Pub Date : 2023-12-31 DOI: 10.18502/crcp.v8i4.14580
Zeba Siddiqi, Mateen Saboor, Shivesh Singhi, Haneen Shah
Pheochromocytoma is a rare catecholamine-secreting tumours of chromaffin tissues that cause a constellation of symptoms. It is closely associated with endocrine hypertension that can be masked, sustained or paroxysmal leading to hypertensive crisis, resulting in vascular and non-vascular complications and rarely cerebral ischaemia and stroke. A healthy 22 year old male reported with acute Right upper limb(RUL) monoplegia and Motor aphasia for five days with raised blood pressure levels. hypertonia was present, deep tendon reflexes were exaggerated in RUL and Right Plantar was extensor. General and systemic findings were nonsignificant . Routine investigations showed thrombocytosis and M.R.I. Brain was suggestive of acute infarction of Left Parieto-Temporal region. Renal doppler, Carotid Intima Media Thickness, Cerebral Angiogram, 2D-E.C.H.O. and Fundoscopy were normal. AntinuclearAntibody was negative. Contrast CT of abdomen revealed right adrenal mass suggestive of isolated Pheochromocytoma. Vanyl-Mandelic Acid was positive. Patient was stabilised and managed conservatively for 4 weeks followed by adrenalectomy and appropriate medical therapy. Patient is on regular followup and does not seem to require any antihypertensives or any other intervention. Pheochromocytoma is a notorious tumor and a great masquerader specially in young adults. A keen eye, routine checkups and evaluation is the key to detecting and preventing its associated morbidity and mortality.
嗜铬细胞瘤是一种罕见的儿茶酚胺分泌性绒毛组织肿瘤,可引起一系列症状。嗜铬细胞瘤与内分泌性高血压密切相关,这种高血压可为隐性、持续性或阵发性,导致高血压危象,引起血管性和非血管性并发症,很少发生脑缺血和中风。一名 22 岁的健康男性报告急性右上肢(RUL)单瘫和运动性失语五天,血压升高。全身检查结果无异常。常规检查显示血小板增多,脑部M.R.I.提示左侧颞旁区急性梗死。肾脏多普勒、颈动脉内膜厚度、脑血管造影、2D-E.C.H.O.和眼底镜检查均正常。抗核抗体呈阴性。腹部对比 CT 显示右肾上腺肿块,提示为孤立的嗜铬细胞瘤。乙酰扁桃酸呈阳性。患者病情稳定,保守治疗 4 周后进行了肾上腺切除术,并接受了适当的药物治疗。目前患者正在接受定期随访,似乎不需要任何降压药或其他干预措施。嗜铬细胞瘤是一种声名狼藉的肿瘤,特别是在年轻人中很容易伪装。敏锐的洞察力、常规检查和评估是发现和预防其相关发病率和死亡率的关键。
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引用次数: 0
Anterior Wall of Maxillary Sinus as a New Autogenic Graft Source: A Case Report 上颌窦前壁作为一种新的自体移植来源:病例报告
Pub Date : 2023-12-28 DOI: 10.18502/crcp.v8i4.14569
Arash Tahmasebi, Seyed Hadi Hoseini, Donya Maleki
This study introduces the anterior wall of the maxillary sinus as a viable and accessible graft site for small to moderate bone defects in the maxilla that pose challenges for implantation. A healthy 40-year-old woman was referred by a prosthodontist due to malpositioned implants. Following a comprehensive assessment, the decision was made to remove the implants. Upon executing this treatment plan, a medium-sized defect was revealed. The flap was elevated to expose the anterior wall of the maxillary antrum, from which an osseous graft was obtained. This graft was then fixed as a buccal wall of the defect and supported by a membrane. After a healing period of 6 months, two implants were successfully inserted. The anterior wall of the maxillary sinus can serve as a beneficial graft source. However, more extensive studies with appropriate design are required to reach a definitive conclusion.
本研究介绍了上颌窦前壁作为一个可行的、可触及的移植部位,用于治疗上颌骨小到中度的骨缺损,这些缺损给种植带来了挑战。一名 40 岁的健康女性因种植体位置不正而由一名修复科医生转诊。经过全面评估后,医生决定移除种植体。在执行该治疗方案时,发现了一个中等大小的缺损。皮瓣被抬起,暴露出上颌窦的前壁,从中获得了骨性移植体。然后将其固定为缺损的颊侧壁,并用薄膜支撑。经过 6 个月的愈合期后,成功植入了两颗种植体。上颌窦前壁可以作为一种有益的移植物来源。不过,要得出确切的结论,还需要进行更广泛的研究和适当的设计。
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引用次数: 0
Better Inset in Nipple Reconstruction by Modification in Skate Flap: A Case Study 通过修改鳐鱼皮瓣实现更好的乳头内陷重建:病例研究
Pub Date : 2023-12-28 DOI: 10.18502/crcp.v8i4.14570
J. Rahmati, Shahriar Haddady-Abianeh, Hosseinali Abdolrazagh, Iraj Pourahmadian, H. Molaei
NAC reconstruction represents the final stage of breast reconstruction. This can be accomplished thr ough non-surgical and surgical procedures, each with its own set of advantages and disadvantages. The majority of surgeons employ the Skate flap. The following is a de monstration of a modific ation to this flap. A woman, 56 years of age, who had previously undergone breast reconstruction using a TRAM flap, was admitted for nipple reconstruction. During the design of the star flap, a modification was executed, which involved reciprocally changing the orientation of the lateral flaps. Both flaps were properly positioned in their prepared locations during the flap inset and skin closure. The final outcome was satisfactory and aesthetically pleasing. The modification in the design of the Skate flap alters the orientation of the transferred flaps, making the final inse t feasible with less dis figurement.
NAC 重建是乳房重建的最后阶段。这可以通过非手术和手术方法来完成,每种方法都有各自的优缺点。大多数外科医生采用 Skate 皮瓣。下面是对这种皮瓣进行改良的示例。一位 56 岁的女性曾使用 TRAM 乳瓣进行乳房再造,现入院进行乳头再造。在设计星形皮瓣时,对其进行了修改,即相互改变侧皮瓣的方向。在皮瓣植入和皮肤闭合过程中,两个皮瓣都正确地放置在准备好的位置上。最终结果令人满意,且美观大方。对 Skate 皮瓣设计的修改改变了转移皮瓣的方向,使最终的皮瓣植入变得可行,同时减少了损伤。
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引用次数: 0
PCNL Surgery Following Laparoscopic Hellström Pyeloplasty in a Patient with UPJO and Concurrent Renal Stones 为一名合并肾结石的 UPJO 患者实施腹腔镜 Hellström 肾盂成形术后的 PCNL 手术
Pub Date : 2023-12-28 DOI: 10.18502/crcp.v8i4.14572
Hormoz Karami, O. Aminirad
The prevalence of renal stones with concomitant UPJO is about 20-30%. Its treatment method is controversial. In this study, a 29-year-old man with UPJO and simultaneous ipsilateral renal stone is presented, who was treated with PCNL following Hellström laparoscopic pyeloplasty.
肾结石并发 UPJO 的发病率约为 20-30%。其治疗方法尚存争议。本研究介绍了一名患有UPJO并同时伴有同侧肾结石的29岁男性,他在接受Hellström腹腔镜肾盂成形术后接受了PCNL治疗。
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引用次数: 0
Immune Thrombocytopenic Purpura (ITP) as a Complication of COVID-19: A Case Report 作为 COVID-19 并发症的免疫性血小板减少性紫癜 (ITP):病例报告
Pub Date : 2023-12-28 DOI: 10.18502/crcp.v8i4.14571
Shaghayegh Ashraf Talesh, A. Hadadi
Immune thrombocytopenic purpura (ITP) is a condition that can occur either spontaneously or as a secondary complication of preexisting disorders, often associated with viral infections. In the context of COVID-19, hematological manifestations, including thrombocytopenia, have been observed and linked to increased mortality rates among severely infected patients. Presented here is a case study of a 70-year-old man who recovered from COVID-19 but subsequently developed ITP. The severity of his thrombocytopenia exceeded what is typically observed during COVID-19 infections, leading to a diagnosis of ITP. Treatment with steroids and intravenous immunoglobulin (IVIG) was initiated based on specialist recommendations, resulting in an adequate response.
免疫性血小板减少性紫癜(ITP)既可自发发生,也可作为原有疾病的继发并发症,通常与病毒感染有关。在 COVID-19 的背景下,已观察到包括血小板减少在内的血液学表现,并与严重感染患者的死亡率增加有关。本文介绍的病例是一名 70 岁的男性,他从 COVID-19 中康复,但随后又患上了 ITP。他血小板减少的严重程度超过了 COVID-19 感染期间通常观察到的程度,因此被诊断为 ITP。根据专家建议,他接受了类固醇和静脉注射免疫球蛋白(IVIG)治疗,并取得了良好的疗效。
{"title":"Immune Thrombocytopenic Purpura (ITP) as a Complication of COVID-19: A Case Report","authors":"Shaghayegh Ashraf Talesh, A. Hadadi","doi":"10.18502/crcp.v8i4.14571","DOIUrl":"https://doi.org/10.18502/crcp.v8i4.14571","url":null,"abstract":"Immune thrombocytopenic purpura (ITP) is a condition that can occur either spontaneously or as a secondary complication of preexisting disorders, often associated with viral infections. In the context of COVID-19, hematological manifestations, including thrombocytopenia, have been observed and linked to increased mortality rates among severely infected patients. Presented here is a case study of a 70-year-old man who recovered from COVID-19 but subsequently developed ITP. The severity of his thrombocytopenia exceeded what is typically observed during COVID-19 infections, leading to a diagnosis of ITP. Treatment with steroids and intravenous immunoglobulin (IVIG) was initiated based on specialist recommendations, resulting in an adequate response.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":"313 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139152412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Case Reports in Clinical Practice
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