Cases journal最新文献

Right atrioventricular thrombus was diagnosed by echocardiography in a 14-year-old boy. Thrombus was reached through the right ventricle to the pulmonary artery and it was caused to tricuspit valve insufficiency. Surgical thrombectomy was performed and, he was treated with oral anticoagulation in postoperative period.

Epididymitis and epididymo-orchitis are an uncommon causes of acute testicular pain in neonatal boys, epididymo-orchitis is infection or inflammation of epididymis and testis it's may be associated with urinary tract infections or reflux of urine predisposed by an underlying vasal anomaly. Pediatricians should examine the testicles meticulously after a baby is born.We report a 7 day-old boy with urinary malformations (ureteral duplication, ureterocel and right hydro-ureteronephrosis) who presented with acute scrotum. The ultrasonography exploration of the testis showed findings consistent with epididymo-orchitis, confirmed by the needle scrotal aspiration of the pus. Further radiological investigations of urinary tract showed the multiples malformations. Epididymo-orchitis should be suspected initially with abnormal physical signs and laboratory findings. Prompt prescription of antibiotics is mandatory, and appropriate therapeutic measures (antibiotics) should be undertaken to prevent recurrences and sequelae.

Intranodal palisaded myofibroblastoma is a rare benign soft tissue tumor, almost always arising from inguinal lymph nodes. It usually presents as a painless, slow-growing inguinal mass. We report herein a case of an intranodal palisaded myofibroblastoma occurring in a 36-year-old man. The salient clinicopathologic features of this unusual tumor are presented and the literature is briefly reviewed.

Background: Arteriovenous malformation of the vein of Galen with partial anomalous pulmonary venous return can lead to a critically challenging condition associated with a high morbidity and mortality.

Case report: We report a case of a full term infant born with a vein of Gallen arteriovenous malformation complicated by partial anomalous pulmonary venous return and congestive heart failure where B-type natriuretic peptide was used as a vital tool in clinical assessment and treatment management.

Conclusions: Rapid diagnosis and treatment in infants with complex conditions such as this are imperative to expedite appropriate treatments, preventing long term negative outcome.

Rectal bleeding following any form of rectal surgery is a well recognised complication 1, 2, 3 & 4. However retro-rectal bleeding and tracking which then presents as rectal bleeding has not been reported in the literature. We describe a novel way of dealing with this technically difficult post-operative complication.We present two cases of significant rectal bleeding (one following STARR procedure and other after Delormes procedure). Both patients had to be taken back to theatre due to continuing, significant bleeding. Examination under anaesthesia on both occasions revealed a posterior boggy swelling, with an opening which admitted a finger. In both cases clots were evacuated and a corrugated drain was inserted in to the retro rectal space.The authors believe that following any form of rectal surgery, retro-rectal bleeding with tracking can present as rectal bleeding. Treatment in the form of EUA and insertion of corrugated helped to resolve the problem.We present both cases and literature review of the complications of stapled haemorrhoidopexy.

Adenosquamous carcinoma of the pancreas is a rare variant of pancreatic exocrine carcinoma. We report a case of 70 year old man who came to our hospital with abdominal pain, anorexia and jaundice. Imaging of the abdomen showed a mass in the region of the head of the pancreas. Histological evaluation of the pancreatic tumor showed an adenosquamous carcinoma which was extensively infiltrative with perineural invasion, involvement of peripancreatic lymph nodes and all the thickness of the duodenum wall. The tumor exhibited a biphasic malignant growth identified as well to moderate differentiated adenocarcinoma and well to poorly differentiated squamous cell carcinoma.

A 53 year-old Caucasian man with no previous history of gastrointestinal bleeding presented with sudden, massive hematochezia and abdominal pain; his hemoglobin dropped from 12 to 8.3. Colonoscopy revealed coagulated blood in a diverticulum, but bleeding recurred after cautery of the lesion.Repeated upper and lower gastrointestinal (GI) endoscopy, visceral selective angiogram, bleeding scan, and Meckel diverticulum scan did not locate the source of bleeding. Further investigation with capsule endoscopy demonstrated two arteriovenous malformations in the small bowel.Wireless capsule endoscopy is a sensitive and specific test for overt obscure gastrointestinal bleeding. Clinicians need not hesitate to employ this procedure when other diagnostic modalities fail.

The common causes of orbital masses in pediatric age group include pseudotumour, lymphomas, hemangioma and dermoid cyst. Orbital tuberculosis is rare especially in children. We report a case of 5 year old child who presented with proptosis and gross diminution of vision due to orbital tuberculoma. Ocular examination of the left eye revealed proptosis with the eyeball displaced downwards and forwards. Vision was counting finger close to face. CT Scan showed an extraconal soft tissue mass along posteromedial side of left orbit with lateral displacement of medial rectus muscle. On antitubercular treatment, proptosis regressed and visual recovery was observed over a period of six month vision, in the left eye at the last followup was 20/30.

Background: Microscopic examination of all surgical specimens is controversial.

Case presentation: We report two cases where examination has revealed unexpected results that have changed patient management and treatment.

Conclusions: Histopathological examination of all tissue should be considered. The benefits and disadvantages of routine examination of tissue are discussed.

Body piercing, a growing trend especially in young people, is often complicated by severe infections. We present a case of acute bacterial endocarditis by Staphylococcus aureus complicated by multiple cerebral, kidney, spleen embolisms in a young girl, with no known previous cardiac abnormalities, following the piercing of nasal septum. This case highlights the importance of education of patients with and without structural heart disease to the potential dangerous and even life threatening infectious complications of piercing, and stimulate further discussion on the possibility of antibiotic prophylaxis of such procedures.