scholarly journals Peritoneal-Pleural Leaks Demonstrated by CT Peritoneography

2015 ◽  
Vol 5 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Tian Xu ◽  
Jingyuan Xie ◽  
Weiming Wang ◽  
Hong Ren ◽  
Nan Chen
Keyword(s):  
Pleural Effusion ◽  
Ct Scan ◽  
Case Reports ◽  
Noninvasive Treatment ◽  
Case Presentation ◽  
Ct Value ◽  
Satisfactory Outcome ◽  
Ionic Contrast ◽  
Life Threatening ◽  
Ionic Contrast Medium

Introduction: Acute hydrothorax is an uncommon complication of peritoneal dialysis (PD). Currently, there is no specific diagnostic method. Although it is not a life-threatening complication, hydrothorax often requires interrupting or quitting PD. Misdiagnosis often leads to more serious consequences. Case Presentation: A 49-year-old woman (height 163 cm, weight 58 kg, BMI 21.82), who started PD 3 months previously, suddenly presented with acute dyspnea and a right pleural effusion. Blood routine examination, serum albumin and a series of laboratory tests were immediately performed. Except for the serum creatinine, all of the other tests were within normal range. Thoracentesis was performed to obtain pleural fluid specimens; there was also no evidence of a tumor or inflammation. Congestive heart failure, infection and hypoalbuminemia were excluded as well. Because PD-associated pleural leakage was suspected, computerized tomography (CT) peritoneography was performed next. The first CT scan showed that the CT value of pleural effusion was 6 Hounsfield units (HU). On the evening of the same day, 100 ml ionic contrast medium was mixed with 2 l dialysate and infused into the peritoneal cavity. The next morning, a CT scan was performed again. The CT value of pleural effusion at the same site increased to 40 HU. At the end, pleural leakage was clearly diagnosed. Subsequently, she received temporary hemodialysis and a small dose of automated PD. After 3 months, she successfully returned to PD without any recurrence of hydrothorax. Conclusion: Although similar case reports are not rare, this report provided a simple and effective method for diagnosing pleural leakage. Furthermore, noninvasive treatment of pleural effusion will also get a satisfactory outcome.

scholarly journals Gastrointestinal symptoms as first remarkable signs of ANCA-associated granulomatosis with polyangiitis: a case report and reviews

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nóra Ledó ◽  
Ákos Géza Pethő
Keyword(s):  
Gastrointestinal Bleeding ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Case Reports ◽  
Gastrointestinal Symptoms ◽  
Case Presentation ◽  
Life Threatening ◽  
Proper Diagnosis ◽  
Duodenal Bleeding ◽  
Inflammatory Bowel

Abstract Background Systemic vasculitis associated with antineutrophil cytoplasmic autoantibodies (ANCA) have an extremely wide variety of symptoms, therefore the fast and proper diagnosis is difficult to establish even for experienced physicians. Gastrointestinal manifestations in ANCA-associated granulomatosis with polyangiitis (GPA) may be present, however, severe, life-threatening complications (such as perforations) are rare. Case presentation A case of an 18-year-old male patient is presented, where gastrointestinal symptoms (abdominal pain, vomiting, diarrhoea) were the first remarkable signs of GPA. The initial diagnosis of inflammatory bowel disease delayed the administration of proper immunosuppressive therapy, which might have contributed to the rare and life-threatening complication of arterial duodenal bleeding with perforation. Our systematic review of the literature found only a few case reports where gastrointestinal symptoms were the first signs of GPA, however, this entity might be more frequent if physicians would think of this possibility more often. Conclusions Gastrointestinal bleeding is a rare but potential lethal complication of vasculitis. Consequently, we recommend investigating the patients diagnosed with GPA for gastrointestinal bleeding during the treatment.

scholarly journals Acetazolamide-Triggered Acute Flaccid Paralysis and Toxic-Metabolic Encephalopathy in a Toddler with Gastroenteritis: A Case Report

2020 ◽  
Vol 10 (01) ◽  
pp. e159-e162
Author(s):  
Jack Green ◽  
Pooja Nawathe
Keyword(s):  
Acute Flaccid Paralysis ◽  
Case Reports ◽  
Flaccid Paralysis ◽  
Medication History ◽  
Metabolic Derangement ◽  
Metabolic Encephalopathy ◽  
Case Presentation ◽  
Adult Disease ◽  
Neurologic Sequelae ◽  
Life Threatening

AbstractAcetazolamide is an infrequently prescribed medication in the outpatient pediatric setting, as one of its major indications is for the treatment of glaucoma, which is a largely adult disease. Though incredibly rare, serious neurologic side effects such as stroke, flaccid paralysis, and coma can occur after its administration. This case presentation of acute flaccid paralysis with metabolic derangement underscores the unusual, yet possible, toxic-metabolic and neurologic sequelae that can occur in an already acidotic host (in this case, caused by gastroenteritis) with acetazolamide ingestion. Life-threatening conditions must always be ruled out in patients who present with encephalopathy, but a medication history was crucial in clinching this case's unifying diagnosis. While there are case reports highlighting the rare central nervous system toxicities associated with acetazolamide ingestion, to our knowledge, none exist in the pediatric literature.

scholarly journals The Insidious Cardiac Tumor: A Primary Left Atrium Intimal Cardiac Sarcoma in a Young Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Chika-Nwosuh Ogechukwu ◽  
Nnaoma Christopher ◽  
Sossou Christoph ◽  
Okundaye Etinosasere ◽  
Bustillo Jose
Keyword(s):  
Benign Tumor ◽  
Case Reports ◽  
Pulmonary Angiography ◽  
Pulmonary Emboli ◽  
Transesophageal Echocardiogram ◽  
Computed Tomography Pulmonary Angiography ◽  
Case Presentation ◽  
Mitral Orifice ◽  
Life Threatening ◽  
The Right

This case presentation discusses a rare cardiac malignancy initially thought to be a benign tumor. A 36-year-old presented with syncope, dyspnea, Computed Tomography Pulmonary angiography study obtained was negative for pulmonary emboli but revealed a left atrial mass. A transesophageal echocardiogram (TEE) confirmed a mass with multiple lobes and a broad base attached to the septum, encroaching into the right atrium, aortic root wall, base of the anterior mitral leaflet flowing to the mitral orifice in diastole also obstructing the right pulmonary vein. Despite a quick diagnosis and plan to begin treatment, the patient rapidly declined owing to the extent and aggressive nature of this cardiac malignancy. This case reports the insidious nature of these tumors as well as how challenging and life threatening they are at the time of their clinical manifestation.

scholarly journals Vancomycin induced cardiac arrest: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Sharad Khakurel ◽  
Sangam Rawal
Keyword(s):  
Cardiac Arrest ◽  
Adverse Effects ◽  
Case Reports ◽  
Limb Salvage Surgery ◽  
Rapid Infusion ◽  
Case Presentation ◽  
Comprehensive Knowledge ◽  
Life Saving ◽  
Red Man Syndrome ◽  
Life Threatening

Abstract Background Rapid intravenous administration of vancomycin may manifest with histaminergic responses with clinical features ranging from mild rashes, pruritus and even shock. This case reports of a child, who was accidentally given intravenous vancomycin within minutes and had a cardiac arrest. Case presentation A 9-year-old Asian girl who was scheduled for a limb salvage surgery, received vancomycin preoperatively. As a result of rapid infusion of the drug, the patient developed flushing, pruritus and had respiratory distress with hypotension leading to asystole. However, prompt detection and immediate cardiopulmonary resuscitation revived the patient in time following which sound recovery ensued. We recognised inadvertent brisk infusion of vancomycin as the culprit with strong suspicion of Red Man Syndrome. Conclusion Red Man Syndrome, though rarely encountered, can always be life threatening. With a surge in the use of vancomycin, adverse effects associated with its use also rises. So a comprehensive knowledge regarding its rationale use, adverse effects and its prompt management in personnel prescribing it, can be life saving.

Prenatal and postnatal imaging of an intrapericardial teratoma

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Abdullah Alnoman ◽  
Efrat Spiegel ◽  
Pierre-Luc Bernier ◽  
Richard Brown
Keyword(s):  
Prenatal Diagnosis ◽  
Pleural Effusion ◽  
Pericardial Effusion ◽  
Ventricular Dysfunction ◽  
Case Presentation ◽  
Large Pericardial Effusion ◽  
Fetal Movements ◽  
Life Threatening ◽  
Postnatal Surgery

AbstractBackgroundIntrapericardial teratomas are rare tumors arising from all three germinal layers. They are mostly benign but can lead to life-threatening complications.Case presentationA 38-year-old woman with an in vitro fertilization (IVF) conception had a normal fetal anatomical survey at 20 weeks of gestation. At 32 weeks, during evaluation for decreased fetal movements and gestational diabetes, the fetus was found to have a unilateral right pleural effusion, a large pericardial effusion with an 18 × 16 × 17 mm-sized cystic intrapericardial mass and ventricular dysfunction with associated, significant, polyhydramnios. Echocardiography was suggestive of a teratoma which was confirmed by pathology after postnatal surgery.ConclusionEarly prenatal diagnosis and appropriate monitoring during pregnancy are important to optimize outcome, however, even though antenatal intervention may improve the outcome in cases with hydrops, in utero mortality remains high.

scholarly journals New HIV diagnoses in patients with COVID-19: two case reports and a brief literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiu-Cong Zhang ◽  
Xiao-Hui Yu ◽  
Xiao-Han Ding ◽  
Hao-Yu Ma ◽  
Xiao-Qing Cai ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Hiv Infections ◽  
Newly Diagnosed ◽  
Case Presentation ◽  
Multiple Organs ◽  
Life Threatening ◽  
Co Detection ◽  
Atypical Presentations

Abstract Background COVID-19 is novel infectious disease with an evolving understanding of its epidemiology and clinical manifestations. Severe cases developed life-threatening complications, such as respiratory failure, shock, and multiple organs dysfunction. Immunocompromised patients often present atypical presentations of viral infected diseases. Case presentation We report newly diagnosed HIV infections in two patients with COVID-19 in China. In our two cases, both patients with elevated IL-6 received Tocilizumab treatment, but did not present obvious therapeutic effect. Conclusions These cases highlight possible co-detection of known immunocompromised diseases such as HIV. The two cases we reported stressed the risk of misdiagnosis, especially during the pandemic of an infectious disease and the importance of extended testing even if in immune-compromised condition the immune state may be ignored.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan
Keyword(s):  
Case Reports ◽  
Case Presentation ◽  
Open Adrenalectomy ◽  
Large Size ◽  
History Of ◽  
Loin Pain ◽  
Benign Tumours ◽  
Spontaneous Haemorrhage ◽  
Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

scholarly journals Long-term outcomes after penile prosthesis placement for the Management of Erectile Dysfunction: a single-Centre experience

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Valentine Frydman ◽  
Ugo Pinar ◽  
Maher Abdessater ◽  
William Akakpo ◽  
Pietro Grande ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Erectile Dysfunction ◽  
Penile Prosthesis ◽  
Perioperative Outcomes ◽  
Single Centre ◽  
Satisfactory Outcome ◽  
Single Centre Experience ◽  
Life Threatening ◽  
Few Data

Abstract Background Penile prothesis (PP) is the gold-standard treatment of drug-refractory erectile dysfunction (ED). While postoperative outcomes have been widely described in the literature, there are few data about patient satisfaction and intraoperative events. We aimed to assess long-term patient satisfaction and perioperative outcomes after PP implantation in a single-centre cohort of unselected patients using validated scales. Results A total of 130 patients received a PP (median age: 62.5 years [IQR: 58–69]; median International Index of Erectile Function (IEEF-5) score: 6 [IQR: 5–7]). Median follow-up was 6.3 years [IQR: 4–9.4]. Thirty-two (24.6%) patients underwent surgical revision, of which 20 were PP removals (15.4%). Global PP survival rate was 84.6% and previous PP placement was a risk factor for PP removal (p = 0.02). There were six (4.6%) non-life-threatening intraoperative events including two which resulted in non-placement of a PP (1.5%). EAUiaic grade was 0 for 124 procedures (95.4%), 1 for four procedures (3.1%) and 2 for two procedures (1.5%). Of patients who still had their PP at the end of the study, 91 (80.5%) expressed satisfaction. Conclusions PP implantation is a last-resort treatment for ED with a satisfactory outcome. PPs are well accepted by patients.

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