scholarly journals Systemic Amyloidosis: A Rare Presentation of Mesenteric Angina

2002 ◽  
Vol 16 (10) ◽  
pp. 683-685 ◽  
Author(s):  
Christopher N Andrews ◽  
Jack N Amar ◽  
Malcolm MM Hayes ◽  
Robert A Enns
Keyword(s):  
Computed Tomography ◽  
Weight Loss ◽  
Cardiac Arrest ◽  
Epigastric Pain ◽  
Systemic Amyloidosis ◽  
Rare Presentation ◽  
Arterial Involvement ◽  
Rare Manifestation ◽  
History Of ◽  
Ischemic Enteritis

A 64-year-old man presented with an eight-month history of increasing postprandial epigastric pain and a 15 kg weight loss. Computed tomography of the abdomen, panendoscopy and mesenteric angiography failed to explain the cause of the patient's mesenteric angina. Systemic amyloidosis involving intestinal small vasculature without larger arterial involvement was diagnosed at autopsy after the patient died of an asystolic cardiac arrest. Mesenteric angina without evidence of ischemic enteritis or pseudo-obstruction is a rare manifestation of amyloidosis.

scholarly journals Splenic Involvement in Hereditary Hemorrhagic Telangiectasia

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Susumu Takamatsu ◽  
Kota Sato ◽  
Shunsuke Kato ◽  
Hiroto Nagano ◽  
Shunro Ohtsukasa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Epigastric Pain ◽  
Liver Parenchyma ◽  
Pathological Examination ◽  
Resected Specimen ◽  
Recurrent Epistaxis ◽  
Rare Manifestation ◽  
Splenic Involvement ◽  
History Of

A 33-year-old man who presented with prolonged epigastric pain was referred to our hospital. He had experienced recurrent epistaxis and had a family history of hereditary hemorrhagic telangiectasia. Computed tomography and magnetic resonance imaging revealed splenomegaly and a 9 cm hypervascular mass in his spleen. Computed tomography also showed a pulmonary arteriovenous malformation and heterogeneous enhancement of the liver parenchyma, suggesting the presence of arteriosystemic shunts and telangiectases. Based on these findings, the patient was definitely diagnosed with hereditary hemorrhagic telangiectasia according to Curaçao criteria. He underwent splenectomy, and his symptoms disappeared after surgery. Pathological examination of the resected specimen revealed that the hypervascular lesion of the spleen was not a tumor but was composed of abnormal vessels associated with hereditary hemorrhagic telangiectasia. Symptomatic splenic involvement may be a rare manifestation of hereditary hemorrhagic telangiectasia but can be revealed by imaging modalities.

scholarly journals Delayed diaphragmatic rupture presenting with acute gastric volvulus

2014 ◽  
Vol 96 (7) ◽  
pp. e17-e19 ◽  
Author(s):  
JML Williamson ◽  
R Macleod ◽  
A Hollowood
Keyword(s):  
Computed Tomography ◽  
Cardiac Arrest ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Gastric Volvulus ◽  
Diaphragmatic Rupture ◽  
Motorcycle Accident ◽  
Thoracic Computed Tomography ◽  
Acute Gastric Volvulus ◽  
Hospital Cardiac Arrest

Gastric volvulus is a rare complication of diaphragmatic rupture. We report the case of an 82-year-old man who presented following an out-of-hospital cardiac arrest. Chest radiography and thoracic computed tomography revealed an acute gastric volvulus and a chronic diaphragmatic hernia containing transverse colon and abdominal viscera. He had complained of retching and associated epigastric pain prior to collapse, and had sustained a motorcycle accident approximately 60 years earlier. Insertion of a nasogastric tube was unsuccessful (completing Borchardt’s diagnostic triad) and his condition prevented both operative and endoscopic reduction of his volvulus. He died soon afterwards.

scholarly journals Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract managed conservatively with corticosteroids

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Tyler McKechnie ◽  
Haroon Yousuf ◽  
Stephen Somerton
Keyword(s):  
Computed Tomography ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
T Cell ◽  
Complete Resolution ◽  
Lymphoproliferative Disorder ◽  
Duodenal Biopsy ◽  
High Dose ◽  
History Of

An 82-year-old female presented with a 4-week history of abdominal pain, weight loss, diarrhea, and nausea. A complete infectious workup was negative. Her computed tomography (CT) scan showed no pathologic changes and her esophagogastroduodenoscopy (EGD) showed erosive damage in the duodenum. Her duodenal biopsy showed inflammation with a marked increase in intra-epithelial lymphocytes and her immunohistochemistry was consistent with indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. She was started on high dose steroids three months after the onset of her symptoms. She gradually improved with complete resolution of erosive changes on her repeat EGD.

scholarly journals Bradyarrhythmic Cardiac Arrest—A Rare Manifestation of Fexofenadine Cardiotoxicity

2021 ◽  
pp. 263246362110436
Author(s):  
Tapan Ghose ◽  
Ranjan Kachru ◽  
Jaideep Dey
Keyword(s):  
Cardiac Arrest ◽  
Electrophysiological Study ◽  
Previous History ◽  
Ventilatory Support ◽  
Mechanical Ventilatory Support ◽  
Successful Resuscitation ◽  
Av Conduction ◽  
Rare Manifestation ◽  
History Of

A 66-year-old diabetic, hypertensive, and hypothyroid female presented in the emergency department with cardiac arrest, for which cardiopulmonary resuscitation was immediately initiated. She had been on oral fexofenadine for 36 h prior to the event. Post successful resuscitation, her cardiac rhythm showed high-grade atrioventricular block. Patient was treated with mechanical ventilatory support and temporary transvenous pacing. No treatable cause could be identified, and she recovered completely following fexofenadine discontinuation, without need for a permanent pacemaker. She has remained asymptomatic during 1 year of follow-up with no documented arrhythmias. An electrophysiological study at 6 months revealed prolonged HV interval (70 ms) with 1:1 AV conduction and no inducible arrhythmias. This is probably the first reported case of fexofenadine-induced cardiac arrest in a patient without previous history of heart disease.

scholarly journals Duodenal metastasis of breast invasive carcinoma of no special type: a rare presentation

2021 ◽  
Vol 84 (2) ◽  
pp. 379-380
Author(s):  
M Mascarenhas Saraiva ◽  
T Ribeiro ◽  
A.R. Coelho ◽  
R Silva ◽  
A.C. Real ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Epigastric Pain ◽  
Growth Factor Receptor ◽  
Progesterone Receptors ◽  
Ca 125 ◽  
Her2 Positive ◽  
Rare Presentation ◽  
History Of ◽  
Lobular Breast Carcinoma ◽  
Epidermal Growth

The authors read with attention the case report by Vande Berg and coworkers, published on a previous issue of this journal, describing a rare diagnosis of rectal metastases of an incognito invasive lobular breast carcinoma (ILC), for which immunohistochemistry was decisive (1). Likewise, we share a similarly rare case of gastrointestinal metastases of breast carcinoma (BC), in which immunohistochemistry played a pivotal role.A 55-year-old woman was diagnosed in June 2015 with an Invasive Breast Carcinoma of no-special-type (IBCNST) grade III, human epidermal growth factor receptor 2 (HER2) positive, estrogen and progesterone receptors (ER/PR) negative. Biopsy revealed vascular permeation. Neoadjuvant chemotherapy and trastuzumab preceded surgery, performed in December 2015, followed by radiotherapy and trastuzumab. The patient remained free of disease until 2017, when a right cerebellar lesion was diagnosed as BC metastasis and was treated with stereotactic radiosurgery. In January 2020, the patient presented with a 1-month history of post-prandial vomiting, epigastric pain, anorexia, fatigue, and a 10 kg weight loss. Lab tests were unremarkable, except for small increase in CA-125 and CA-15.3.

scholarly journals Sentinel bruising as a presentation of metastatic melanoma

2019 ◽  
Vol 12 (2) ◽  
pp. e228114 ◽  
Author(s):  
Lloyd Steele ◽  
Chit Cheng Yeoh
Keyword(s):  
Weight Loss ◽  
Skin Lesions ◽  
Lymph Node Biopsy ◽  
Cutaneous Malignant Melanoma ◽  
Subcutaneous Nodule ◽  
Rare Presentation ◽  
Subcutaneous Nodules ◽  
Node Biopsy ◽  
Melanoma Metastases ◽  
History Of

A 46-year-old man presented with a 4-week history of bruising with subcutaneous nodules and weight loss. He also had a 2-week history of progressive back and hip pain. He had been diagnosed with stage Ib cutaneous melanoma 30 months previously, which had been fully excised. A sentinel lymph node biopsy was negative. On examination, there were five skin lesions at different stages. Each had spontaneously appeared as a bruise with a central subcutaneous nodule, and the bruising then faded to leave a persistent subcutaneous nodule. Excision of one of the nodules demonstrated a 4.5 mm diameter partly necrotic melanoma deposit in the dermis. CT scan of the head, chest, abdomen and pelvis showed widespread metastases. This rare presentation of cutaneous malignant melanoma metastases has been termed ‘sentinel bruising’. There are fewer than 10 cases reported in the literature.

scholarly journals Extramedullary haematopoiesis: An uncommon posterior mediastinal mass

2013 ◽  
Vol 17 (3) ◽  
pp. 114-115
Author(s):  
Edson Marchiori ◽  
Miriam Menna Barreto ◽  
Bruno Hochhegger ◽  
Gláucia Zanetti
Keyword(s):  
Computed Tomography ◽  
Weight Loss ◽  
Mediastinal Mass ◽  
Severe Anaemia ◽  
Ct Scans ◽  
Extramedullary Haematopoiesis ◽  
Posterior Mediastinal Mass ◽  
History Of ◽  
Posterior Mediastinal ◽  
Ct Features

A 59-year-old man presented with anaemia and complaints of abdominal pain, weight loss, fatigue and dizziness. Computed tomography (CT) scans of the chest revealed bilateral paravertebral masses. The CT features were typical of extramedullary haematopoiesis (EMH). EMH should be strongly considered in a patient with bilateral, well-marginated, paravertebral thoracic masses and a history of chronic, severe anaemia.

scholarly journals Splenic Infarct: A Rare Presentation in a Pediatric Patient

2014 ◽  
Vol 52 (196) ◽  
pp. 1017-1019 ◽  
Author(s):  
Palla Bhattarai ◽  
Louidson Pierr ◽  
Adebayo Adeyinka ◽  
Swayam Sadanandan
Keyword(s):  
Infectious Mononucleosis ◽  
Rare Case ◽  
Epigastric Pain ◽  
Antibody Test ◽  
Adolescent Male ◽  
Costal Margin ◽  
Rare Presentation ◽  
Splenic Infarct ◽  
Hypochondriac Region ◽  
History Of

A previously healthy 16-year-old male presented with a two day history of persistent epigastric pain. His physical examination was significant for tenderness in the left hypochondriac region with a palpable spleen 2cm below the left sub-costal margin. A CT scan of the abdomen showed a splenic infarct. Heterophile and EBV VCA IgM antibody test were positive. This is a rare case of infectious mononucleosis presenting with splenic infarct in an adolescent male without comorbidities.  Keywords: infectious mononucleosis; splenic infarct.

scholarly journals Intraoperative Endoscopy in Transient Adult Jejunojejunal Intussusception

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Takeshi Okamoto ◽  
Hidekazu Suzuki ◽  
Katsuyuki Fukuda
Keyword(s):  
Computed Tomography ◽  
Bowel Resection ◽  
Epigastric Pain ◽  
Adult Intussusception ◽  
Lead Point ◽  
Intraoperative Endoscopy ◽  
Spontaneous Reduction ◽  
History Of ◽  
Exploratory Laparoscopy

Despite improvements in imaging modalities, causative lead points in adult intussusception may be difficult to diagnose. Such lead points can be malignant, causing recurrence or metastases if left unresected. We describe a case of transient adult jejunojejunal intussusception, in which intraoperative endoscopy was used to confirm the absence of a lead point. A 39-year-old woman with a history of laparoscopic oophorectomy presented with epigastric pain, nausea, and vomiting. Contrast computed tomography revealed jejunojejunal intussusception, with no visible lead point. Spontaneous reduction was confirmed during exploratory laparoscopy. After lysis of adhesions, intraoperative peroral jejunoscopy was performed with the surgeons’ assistance. Endoscopy confirmed the absence of tumor, and bowel resection was avoided. No recurrence has been observed during 24 months of follow-up. Intraoperative endoscopy may provide additional reassurance for the absence of a lead point in cases where preoperative enteroscopy cannot be performed and no lead points can be identified on imaging.

scholarly journals Rapunzel Syndrome: A Rare Presentation with Giant Gastric Ulcer

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Antonios Athanasiou ◽  
Adamantios Michalinos ◽  
Demetrios Moris ◽  
Eleftherios Spartalis ◽  
Nikolaos Dimitrokallis ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Ulcer ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Young Female ◽  
Rare Form ◽  
Rare Presentation ◽  
Rapunzel Syndrome ◽  
History Of ◽  
Small Intestines

The Rapunzel syndrome refers to an uncommon and rare form of trichobezoar that extends past the stomach into the small intestines. The Rapunzel syndrome is usually found in young female patients with a history of psychiatric disorders, mainly trichotillomania and trichophagia. We describe a case of Rapunzel syndrome in a 15-year-old girl who presented with abdominal pain, vomiting, and weight loss. We performed a surgical laparotomy and successfully removed a huge trichobezoar extending into the small intestine.

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