Pub Date : 2024-04-08DOI: 10.36347/sjmcr.2024.v12i04.007
Colna Antonio N´fad, Togo Mamadu, Pr. Yassine Er-Rahali, Pr. Ahmed Anass Guerboub
Autoimmune polyendocrinopathy type II (AIEP II) is a more common syndrome that appears mainly in adults. It combines several autoimmune pathologies including Addison's disease and autoimmune thyroid disease (Schmidt syndrome) and/or type 1 diabetes (Carpenter syndrome). We report the case of a 16-year-old patient with notable familial pathological ATCD: Father followed by high blood pressure under antihypertensive treatment and type 2 diabetes under oral anti-diabetes medication. Mother followed for hypothyroidism under hormone replacement treatment with levothyroxine. The patient was followed for hypothyroidism for 2 years, hospitalized in our training for suspicion of adrenal insufficiency. Clinically the patient was asthenic, she had arthralgia and myalgia with anorexia contrasting an appetite for salt with notion of fasting hypoglycemia without melanoderma or vitiligo, the rest of the clinical examination was unremarkable. Weight: 65 kg; Height: 1.69 m; BMI: 23Kg/m²; TT: 70 cm; Pulse: 64 bpm. BP: 110/60 mm Hg in the right arm standing and lying down. Biological exploration found low 08 h plasma cortisol with high ACTH, high TSH and anti-TPO antibodies, and macrocytic normochromic anemia at 8 g/dl with anti-parietal cell antibodies and intrinsic factor have positive. whose explorations were in favor of Biermer's disease. The diagnosis of PEA type 2 was made. The treatment recommended: hormonal replacement of adrenal and thyroid insufficiency as well as vitamin B12 injections with good clinical and biological progress.
自身免疫性多内分泌病 II 型（AIEP II）是一种更常见的综合征，主要出现在成年人身上。它结合了多种自身免疫性病变，包括阿狄森氏病和自身免疫性甲状腺疾病（施密特综合征）和/或 1 型糖尿病（卡彭特综合征）。我们报告了一例 16 岁患者的病例，该患者具有明显的家族病理 ATCD：父亲因高血压接受降压治疗，2 型糖尿病接受口服抗糖尿病药物治疗。母亲因甲状腺功能减退接受左甲状腺素激素替代治疗。患者因甲状腺功能减退症接受了两年的随访，因怀疑肾上腺功能不全而在我院住院治疗。临床上，该患者体质虚弱，有关节痛和肌痛，伴有厌食，食盐量少，有空腹低血糖症状，无黑色素瘤或白癜风，其他临床检查无异常。体重：65 千克；身高：1.69 米；体重指数：23 千克/平方米；TT：70 厘米；脉搏：64 次/分。血压：右臂站立和平卧时均为 110/60 mm Hg。生物学检查发现 08 h 血浆皮质醇偏低，ACTH 偏高，促甲状腺激素（TSH）和抗-TPO 抗体偏高，大红细胞正常色素性贫血（8 g/dl），抗顶叶细胞抗体和内在因子呈阳性。诊断结果为 PEA 2 型。治疗建议：肾上腺和甲状腺功能不全的激素替代以及维生素 B12 注射，临床和生物学进展良好。
{"title":"Autoimmune Polyendocrinopathy Type 2 (PEA Type) Associated with Biermer's Disease: Report of a Case and Review of the Literature","authors":"Colna Antonio N´fad, Togo Mamadu, Pr. Yassine Er-Rahali, Pr. Ahmed Anass Guerboub","doi":"10.36347/sjmcr.2024.v12i04.007","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i04.007","url":null,"abstract":"Autoimmune polyendocrinopathy type II (AIEP II) is a more common syndrome that appears mainly in adults. It combines several autoimmune pathologies including Addison's disease and autoimmune thyroid disease (Schmidt syndrome) and/or type 1 diabetes (Carpenter syndrome). We report the case of a 16-year-old patient with notable familial pathological ATCD: Father followed by high blood pressure under antihypertensive treatment and type 2 diabetes under oral anti-diabetes medication. Mother followed for hypothyroidism under hormone replacement treatment with levothyroxine. The patient was followed for hypothyroidism for 2 years, hospitalized in our training for suspicion of adrenal insufficiency. Clinically the patient was asthenic, she had arthralgia and myalgia with anorexia contrasting an appetite for salt with notion of fasting hypoglycemia without melanoderma or vitiligo, the rest of the clinical examination was unremarkable. Weight: 65 kg; Height: 1.69 m; BMI: 23Kg/m²; TT: 70 cm; Pulse: 64 bpm. BP: 110/60 mm Hg in the right arm standing and lying down. Biological exploration found low 08 h plasma cortisol with high ACTH, high TSH and anti-TPO antibodies, and macrocytic normochromic anemia at 8 g/dl with anti-parietal cell antibodies and intrinsic factor have positive. whose explorations were in favor of Biermer's disease. The diagnosis of PEA type 2 was made. The treatment recommended: hormonal replacement of adrenal and thyroid insufficiency as well as vitamin B12 injections with good clinical and biological progress.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731454","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}
Pub Date : 2024-04-05DOI: 10.36347/sjmcr.2024.v12i04.005
I. Traoré, S. Boudhas, M. Idrissi, N. Mamouni, S. Errarhay, C. Bouchikhi, A. Banani
Angiomyofibroblastoma is a rare benign mesenchymal tumor. Angiomyofibroblastism is a generally painless tumor, most patients consult for the genes caused the tumor in cases where they are large. We report a case of vaginal location of 3 cm in a 67 years old patient discovered during investigation of abnormal uterine bleeding. The patient benefited complete excision of the tumor, surgical hysteroscopy and hysterectomy by surgical laparoscopy. Angiomyofibroblastoma can be associated with a uterine pathology whose intake in charge cannot be dissociated from it.
{"title":"Vaginal Angiomyofibroblastoma Associated with Uterine Pathology about a Case","authors":"I. Traoré, S. Boudhas, M. Idrissi, N. Mamouni, S. Errarhay, C. Bouchikhi, A. Banani","doi":"10.36347/sjmcr.2024.v12i04.005","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i04.005","url":null,"abstract":"Angiomyofibroblastoma is a rare benign mesenchymal tumor. Angiomyofibroblastism is a generally painless tumor, most patients consult for the genes caused the tumor in cases where they are large. We report a case of vaginal location of 3 cm in a 67 years old patient discovered during investigation of abnormal uterine bleeding. The patient benefited complete excision of the tumor, surgical hysteroscopy and hysterectomy by surgical laparoscopy. Angiomyofibroblastoma can be associated with a uterine pathology whose intake in charge cannot be dissociated from it.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140738954","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}
Pub Date : 2024-04-05DOI: 10.36347/sjmcr.2024.v12i04.004
Bounouar Ibtissam, ElManjra Chama, N. Oussama, Lairani Fatima Ezzahra, AitErrami Adil, Oubaha Sophia, Samlani Zouhour, K. Khadija
Chylous ascites, an infrequent manifestation of ascites characterized by a triglyceride-rich milky fluid, is associated with lymphatic system disruption resulting from obstruction or post-traumatic injury. It is an unusual complication of lymphomas, which nonetheless represent the primary cause in adults in developed countries, often due to abdominal lymphatic obstruction. We present the case of a 71-year-old woman who presented with abdominal distension attributed to chylous ascites, ultimately revealing non-Hodgkin lymphoma. Palpable peripheral lymph nodes and enlarged lombo-aortic lymph nodes on abdominal CT scans indicated the diagnosis of stage IV centrofollicular non-Hodgkin lymphoma (Ann Arbor classification). The chylous ascites resolved with chemotherapy treatment.
乳糜腹水是一种不常见的腹水表现，以富含甘油三酯的乳白色液体为特征，与淋巴系统阻塞或创伤后导致的淋巴系统破坏有关。腹水是淋巴瘤的一种罕见并发症，但在发达国家，淋巴瘤是成人腹水的主要原因，通常是由于腹腔淋巴管阻塞所致。我们介绍了一例 71 岁女性的病例，她因乳糜腹水导致腹胀，最终发现患有非霍奇金淋巴瘤。腹部 CT 扫描显示可触及周围淋巴结和肿大的主动脉淋巴结，诊断为 IV 期中心叶状非霍奇金淋巴瘤（Ann Arbor 分类）。化疗后，乳糜腹水消退。
{"title":"Unusual Unveiling: Hodgkin's Lymphoma Manifesting as Chylous Ascites","authors":"Bounouar Ibtissam, ElManjra Chama, N. Oussama, Lairani Fatima Ezzahra, AitErrami Adil, Oubaha Sophia, Samlani Zouhour, K. Khadija","doi":"10.36347/sjmcr.2024.v12i04.004","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i04.004","url":null,"abstract":"Chylous ascites, an infrequent manifestation of ascites characterized by a triglyceride-rich milky fluid, is associated with lymphatic system disruption resulting from obstruction or post-traumatic injury. It is an unusual complication of lymphomas, which nonetheless represent the primary cause in adults in developed countries, often due to abdominal lymphatic obstruction. We present the case of a 71-year-old woman who presented with abdominal distension attributed to chylous ascites, ultimately revealing non-Hodgkin lymphoma. Palpable peripheral lymph nodes and enlarged lombo-aortic lymph nodes on abdominal CT scans indicated the diagnosis of stage IV centrofollicular non-Hodgkin lymphoma (Ann Arbor classification). The chylous ascites resolved with chemotherapy treatment.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140738551","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}
Pub Date : 2024-04-05DOI: 10.36347/sjmcr.2024.v12i04.006
Y. Amchich, H. ouzzani, A. Rhorfi, A. Abid
We present an extremely rare case of a old man 52 answith hydatid pulmonary embolism caused by a direct invasion of the pulmonary artery by a hydatid cyst. Even if it is a benign parasitic disease, it can lead to serious complications such as arterial, systemic, or multivisceral dissemination or being responsible for an anaphylactic shock. Because of the clinical polymorphism, the diagnosis can be delayed. Therefore, A chest CT angiography is the gold standard for the positive diagnosis.
{"title":"Pulmonary Hydatidosis and Hydatid Pulmonary Embolism","authors":"Y. Amchich, H. ouzzani, A. Rhorfi, A. Abid","doi":"10.36347/sjmcr.2024.v12i04.006","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i04.006","url":null,"abstract":"We present an extremely rare case of a old man 52 answith hydatid pulmonary embolism caused by a direct invasion of the pulmonary artery by a hydatid cyst. Even if it is a benign parasitic disease, it can lead to serious complications such as arterial, systemic, or multivisceral dissemination or being responsible for an anaphylactic shock. Because of the clinical polymorphism, the diagnosis can be delayed. Therefore, A chest CT angiography is the gold standard for the positive diagnosis.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739100","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}
Pub Date : 2024-04-02DOI: 10.36347/sjmcr.2024.v12i04.003
O. Hadadia, M. Haida, F. Lairani, O. Nacir, A. Errami, S. Oubaha, Z. Samlani, K. Krati
Ogilvie’s Syndrome is a rare entity in which the colon becomes massively dilated without apparent mechanical obstruction. Patients on antidepressant drugs commonly complain of dryness of the mouth, tremors, blurring of vision and constipation, which are attributed to the anticholinergic action of the drugs. We report a case of a 39-year-old female case of gastrointestinal complication (pseudo-intestinal obstruction), which are considered rare according to a review of the literature.
{"title":"Ogilvie Syndrome Induced by Antidepressant: A Case Report","authors":"O. Hadadia, M. Haida, F. Lairani, O. Nacir, A. Errami, S. Oubaha, Z. Samlani, K. Krati","doi":"10.36347/sjmcr.2024.v12i04.003","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i04.003","url":null,"abstract":"Ogilvie’s Syndrome is a rare entity in which the colon becomes massively dilated without apparent mechanical obstruction. Patients on antidepressant drugs commonly complain of dryness of the mouth, tremors, blurring of vision and constipation, which are attributed to the anticholinergic action of the drugs. We report a case of a 39-year-old female case of gastrointestinal complication (pseudo-intestinal obstruction), which are considered rare according to a review of the literature.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754910","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}
Pub Date : 2024-04-01DOI: 10.36347/sjmcr.2024.v12i04.001
D. Rajih, H. E. Marmouk, F. Lairani, O. Nacir, A. Errami, S. Oubaha, Z. Samlani, K. Krati
Crohn's disease, Behçet's disease, and ankylosing spondylodiscitis are inflammatory conditions that can pose therapeutic challenges when they occur together. Treatment decisions should be guided by the clinical presentation of each condition, its level of activity, and severity. Several points regarding this combined management need to be addressed. We report the case of a 37-year-old man diagnosed with Crohn's disease, Behçet's disease, and ankylosing spondylodiscitis, aiming to present the diagnostic approach and therapeutic specificities of this association.
{"title":"Unusual Clinical Synergy: Crohn's Disease, Behçet's Disease, and Ankylosing Spondylodiscitis – A Comprehensive Look at Interactions","authors":"D. Rajih, H. E. Marmouk, F. Lairani, O. Nacir, A. Errami, S. Oubaha, Z. Samlani, K. Krati","doi":"10.36347/sjmcr.2024.v12i04.001","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i04.001","url":null,"abstract":"Crohn's disease, Behçet's disease, and ankylosing spondylodiscitis are inflammatory conditions that can pose therapeutic challenges when they occur together. Treatment decisions should be guided by the clinical presentation of each condition, its level of activity, and severity. Several points regarding this combined management need to be addressed. We report the case of a 37-year-old man diagnosed with Crohn's disease, Behçet's disease, and ankylosing spondylodiscitis, aiming to present the diagnostic approach and therapeutic specificities of this association.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791746","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}
Pub Date : 2024-04-01DOI: 10.36347/sjmcr.2024.v12i04.002
Mehedra Anass, Babty Mouftah, Fouimtizi Jaafar, Slaoui Amine, Karmouni Tarik, E. Khalid, Koutani Abdellatif Iben Attya, Andaloussi Ahmed
This clinical case involves a 52-year-old married patient with two children who presented initially with left-sided pelvic pain, leading to the discovery of a tumor on a cryptorchid testicle. Further evaluation revealed a suspicious lesion, indicating degeneration of a testicle in an aberrant position. Surgical intervention via laparoscopic orchidectomy confirmed a seminoma, emphasizing the association between cryptorchidism and testicular germ cell tumors. This case underscores the importance of early diagnosis and management of cryptorchidism to mitigate the risk of testicular malignancies, highlighting the necessity for timely surgical intervention and careful monitoring of patients with undescended testicles.
{"title":"Testicular cancer in undescended testicle: A Review of Literature and Case Report","authors":"Mehedra Anass, Babty Mouftah, Fouimtizi Jaafar, Slaoui Amine, Karmouni Tarik, E. Khalid, Koutani Abdellatif Iben Attya, Andaloussi Ahmed","doi":"10.36347/sjmcr.2024.v12i04.002","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i04.002","url":null,"abstract":"This clinical case involves a 52-year-old married patient with two children who presented initially with left-sided pelvic pain, leading to the discovery of a tumor on a cryptorchid testicle. Further evaluation revealed a suspicious lesion, indicating degeneration of a testicle in an aberrant position. Surgical intervention via laparoscopic orchidectomy confirmed a seminoma, emphasizing the association between cryptorchidism and testicular germ cell tumors. This case underscores the importance of early diagnosis and management of cryptorchidism to mitigate the risk of testicular malignancies, highlighting the necessity for timely surgical intervention and careful monitoring of patients with undescended testicles.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774126","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}
Pub Date : 2024-02-15DOI: 10.36347/sjmcr.2024.v12i02.013
Ageng Beta Prawatya, Dheo Aliffanandy P. N, Naura Salsabila, Oxa Aqilla Putri S, Ulayya Azzah Nadiroh, Iwan Setiawan Adji
Background: Deep neck abscess is a collection of pus (pus) in the potential space between the fascia of the deep neck due to spread from various sources of infection, such as teeth, mouth, throat, paranasal sinuses, ears and neck. Various spaces can be a place for deep neck abscesses including the submandibular, peritonsillar, parapharyngeal, retropharyngeal, submental, parotid, anterior visceral, carotid, and masseter spaces. Inflammation or damage to chronic problem teeth can lead to complications of deep neck abscesses. The main complaint that causes sufferers to come to the hospital is dysphagia, which is difficulty swallowing due to the pain felt by the patient. These complaints can also be accompanied by trismus, stridor caused by tracheal compression, to airway obstruction. Purpose: To determine the progressivity of deep neck abscess so that it can provide medical management until operative incision and drainage. Case report: We report 5 cases of deep neck abscess with management according to the progress of each case. Conclusion: The most common cause or etiology that can lead to deep neck abscess is toothache. Management of deep neck abscess, starting with the administration of empirical antibiotics which is the first step to reduce the infection of bacteria that produce beta lactamase. In deep neck abscess, medical therapy can be given in the form of an antibiotic combination of ceftriaxone with metronidazole, or meropenem with metronidazole as well as surgery in the form of incision and drainage. Treatment can be chosen based on the presence or absence of warning signs and signs of complications. Incision and drainage is performed when complaints do not improve after administration of antibiotics, multiple abscesses and airway obstruction that threatens the patient's life.
{"title":"Deep Neck Infection: A Case Series","authors":"Ageng Beta Prawatya, Dheo Aliffanandy P. N, Naura Salsabila, Oxa Aqilla Putri S, Ulayya Azzah Nadiroh, Iwan Setiawan Adji","doi":"10.36347/sjmcr.2024.v12i02.013","DOIUrl":"https://doi.org/10.36347/sjmcr.2024.v12i02.013","url":null,"abstract":"Background: Deep neck abscess is a collection of pus (pus) in the potential space between the fascia of the deep neck due to spread from various sources of infection, such as teeth, mouth, throat, paranasal sinuses, ears and neck. Various spaces can be a place for deep neck abscesses including the submandibular, peritonsillar, parapharyngeal, retropharyngeal, submental, parotid, anterior visceral, carotid, and masseter spaces. Inflammation or damage to chronic problem teeth can lead to complications of deep neck abscesses. The main complaint that causes sufferers to come to the hospital is dysphagia, which is difficulty swallowing due to the pain felt by the patient. These complaints can also be accompanied by trismus, stridor caused by tracheal compression, to airway obstruction. Purpose: To determine the progressivity of deep neck abscess so that it can provide medical management until operative incision and drainage. Case report: We report 5 cases of deep neck abscess with management according to the progress of each case. Conclusion: The most common cause or etiology that can lead to deep neck abscess is toothache. Management of deep neck abscess, starting with the administration of empirical antibiotics which is the first step to reduce the infection of bacteria that produce beta lactamase. In deep neck abscess, medical therapy can be given in the form of an antibiotic combination of ceftriaxone with metronidazole, or meropenem with metronidazole as well as surgery in the form of incision and drainage. Treatment can be chosen based on the presence or absence of warning signs and signs of complications. Incision and drainage is performed when complaints do not improve after administration of antibiotics, multiple abscesses and airway obstruction that threatens the patient's life.","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139962920","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}
Pub Date : 2024-02-12DOI: 10.36347/sjmcr.2024.v12i02.012
I. Koti, A. Benhamdane, S. Mrabti, R. Chaibi, S. Hdiye, I. Mouslim, T. Addajou, F. Rouibaa, H. Seddik
Background: Intracystic hemorrhage is an extremely rare complication of simple hepatic cysts. Clinical symptomatology is non-specific, and imaging frequently mimics a biliary cystadenoma or cystadenocarcinoma, which makes it challenging from a diagnostic point of view to an appropriate therapeutic approach. In this report, we present a case of a simple hemorrhagic hepatic cyst mimicking a cystic neoplasm. Case Report: 48-year-old men was referred to our hospital for periumbilical abdominal pain with asthenia and 11 kg weight loss. His physical examination and laboratory findings were unremarkable. Carcinoembryonic antigen concentration was three times higher than normal. Abdominal ultrasonography demonstrated an impure cystic mass measuring 120 x 96 x 108 mm on hepatic segments VI and VII. Abdominal CT showed a cystic mass at the liver possibly related to a cystadenocarcinoma. Abdominal MRI revealed a cystic mass with lobulated contours, located in segments VII, VIII and part of VI, measuring 11.8 x11.4 cm long axis, heterogeneous signal with intense fluid towards the top in T1 and T2 and intense fluid towards the decline in T2 and T1, with the appearance of a small inferior septum slightly enhanced after injection. These findings did not exclude the possibility of malignant cystic tumor, such as biliary cystadenocarcinoma. Therefore, endoscopic ultrasound showed a cystic lesion developing in the liver, with a thickened wall in places, mainly adjacent to an intracystic nodule of 25 mm, this nodule continued with the wall. Biopsy performed using a 22G ultrasound. Aspiration of liquid: string test negative. Pathological examination confirmed a hemorrhagic biliary cyst and there was no tumor tissue. We observed a significant improvement in symptoms and reduction in cyst size after needle aspiration and we decided to adopt a conservative approach. The patient was followed and one year later, the patient remained in good condition without any complaints. ................
背景：囊内出血是单纯性肝囊肿极为罕见的并发症。临床症状无特异性，影像学表现常模仿胆囊腺瘤或胆囊腺癌，这使得从诊断角度到适当的治疗方法都具有挑战性。在本报告中，我们介绍了一例模仿囊性肿瘤的单纯出血性肝囊肿病例。病例报告：48 岁的男性因脐周腹痛、气喘和体重下降 11 公斤而被转诊至我院。他的体格检查和实验室检查结果均无异常。癌胚抗原浓度是正常值的三倍。腹部超声波检查显示，肝脏 VI 和 VII 段有一个 120 x 96 x 108 毫米的不纯囊性肿块。腹部 CT 显示肝脏处有一个囊性肿块，可能与囊腺癌有关。腹部核磁共振成像显示，位于肝脏第VII、VIII节段和第VI节段部分的囊性肿块呈分叶轮廓，长轴尺寸为11.8 x 11.4厘米，T1和T2呈异质信号，顶部有较强的液体，T2和T1呈较弱的液体，注射后出现小的下隔膜，略有增强。这些发现并不排除恶性囊性肿瘤的可能性，如胆囊腺癌。因此，内镜超声检查显示肝脏内出现囊性病变，局部囊壁增厚，主要与一个 25 毫米的囊内结节相邻，该结节与囊壁相连。使用 22G 超声波进行了活检。抽取液体：串联试验阴性。病理检查证实为出血性胆道囊肿，没有肿瘤组织。我们观察到针吸术后症状明显改善，囊肿缩小，因此决定采取保守治疗。我们对患者进行了随访，一年后，患者情况依然良好，没有任何不适。................
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Pub Date : 2024-02-12DOI: 10.36347/sjmcr.2024.v12i02.012
I. Koti, A. Benhamdane, S. Mrabti, R. Chaibi, S. Hdiye, I. Mouslim, T. Addajou, F. Rouibaa, H. Seddik
Background: Intracystic hemorrhage is an extremely rare complication of simple hepatic cysts. Clinical symptomatology is non-specific, and imaging frequently mimics a biliary cystadenoma or cystadenocarcinoma, which makes it challenging from a diagnostic point of view to an appropriate therapeutic approach. In this report, we present a case of a simple hemorrhagic hepatic cyst mimicking a cystic neoplasm. Case Report: 48-year-old men was referred to our hospital for periumbilical abdominal pain with asthenia and 11 kg weight loss. His physical examination and laboratory findings were unremarkable. Carcinoembryonic antigen concentration was three times higher than normal. Abdominal ultrasonography demonstrated an impure cystic mass measuring 120 x 96 x 108 mm on hepatic segments VI and VII. Abdominal CT showed a cystic mass at the liver possibly related to a cystadenocarcinoma. Abdominal MRI revealed a cystic mass with lobulated contours, located in segments VII, VIII and part of VI, measuring 11.8 x11.4 cm long axis, heterogeneous signal with intense fluid towards the top in T1 and T2 and intense fluid towards the decline in T2 and T1, with the appearance of a small inferior septum slightly enhanced after injection. These findings did not exclude the possibility of malignant cystic tumor, such as biliary cystadenocarcinoma. Therefore, endoscopic ultrasound showed a cystic lesion developing in the liver, with a thickened wall in places, mainly adjacent to an intracystic nodule of 25 mm, this nodule continued with the wall. Biopsy performed using a 22G ultrasound. Aspiration of liquid: string test negative. Pathological examination confirmed a hemorrhagic biliary cyst and there was no tumor tissue. We observed a significant improvement in symptoms and reduction in cyst size after needle aspiration and we decided to adopt a conservative approach. The patient was followed and one year later, the patient remained in good condition without any complaints. ................
背景：囊内出血是单纯性肝囊肿极为罕见的并发症。临床症状无特异性，影像学表现常模仿胆囊腺瘤或胆囊腺癌，这使得从诊断角度到适当的治疗方法都具有挑战性。在本报告中，我们介绍了一例模仿囊性肿瘤的单纯出血性肝囊肿病例。病例报告：48 岁的男性因脐周腹痛、气喘和体重下降 11 公斤而被转诊至我院。他的体格检查和实验室检查结果均无异常。癌胚抗原浓度是正常值的三倍。腹部超声波检查显示，肝脏 VI 和 VII 段有一个 120 x 96 x 108 毫米的不纯囊性肿块。腹部 CT 显示肝脏处有一个囊性肿块，可能与囊腺癌有关。腹部核磁共振成像显示，位于肝脏第VII、VIII节段和第VI节段部分的囊性肿块呈分叶轮廓，长轴尺寸为11.8 x 11.4厘米，T1和T2呈异质信号，顶部有较强的液体，T2和T1呈较弱的液体，注射后出现小的下隔膜，略有增强。这些发现并不排除恶性囊性肿瘤的可能性，如胆囊腺癌。因此，内镜超声检查显示肝脏内出现囊性病变，局部囊壁增厚，主要与一个 25 毫米的囊内结节相邻，该结节与囊壁相连。使用 22G 超声波进行了活检。抽取液体：串联试验阴性。病理检查证实为出血性胆道囊肿，没有肿瘤组织。我们观察到针吸术后症状明显改善，囊肿缩小，因此决定采取保守治疗。我们对患者进行了随访，一年后，患者情况依然良好，没有任何不适。................
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