scholarly journals An alien in the gallbladder. A rare case of biliary ascariasis in an Italian emergency department

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Enrico Ferri ◽  
Angelo Ianni ◽  
Laura Magrini ◽  
Salvatore Di Somma
Keyword(s):  
Rare Case ◽  
Clinical Manifestations ◽  
Intestinal Lumen ◽  
Emergency Setting ◽  
Abdominal Ultrasonography ◽  
Biliary Ascariasis ◽  
Radiologic Findings ◽  
Perforation Peritonitis ◽  
Sanitary Conditions ◽  
Common Infection

Ascariasis is a common infection in many developing countries. The prevalence of ascariasis is related to poverty, poor hygienic and sanitary conditions. The adult form of <em>Ascaris lumbricoides</em> usually resides in the human intestinal lumen (more frequently in the jejunum and middle ileum) and does not cause symptoms. However, it can occasionally cause severe complications such as intestinal obstruction or perforation peritonitis. Its migration into the biliary tract is not uncommon but gallbladder involvement is very rare. Abdominal ultrasonography is essential to detect the presence of this parasite. In this article, we describe the radiologic findings, clinical manifestations and successful medical treatment of a patient with gallbladder ascariasis diagnosed in an emergency setting.

scholarly journals An uncommon case of late-onset chylothorax in blunt thoracic trauma in the emergency department

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Enrico Ferri ◽  
Angelo Ianni ◽  
Laura Magrini ◽  
Chiara De Dominicis ◽  
Salvatore Di Somma
Keyword(s):  
Thoracic Duct ◽  
Late Onset ◽  
Clinical Manifestations ◽  
Clinical Problem ◽  
Emergency Setting ◽  
Radiologic Findings ◽  
Traumatic Chylothorax ◽  
Post Traumatic ◽  
Uncommon Case ◽  
The Right

Blunt chest trauma is a rare cause of chylothorax because thoracic duct is well protected by the spine posteriorly and mediastinal contents anteriorly. Ribs or vertebral fractures are often associated but isolated chylothorax has been described. Thoracic duct injury may be due to stretching over the spine, or to shearing of the duct by the right crus of the diaphragm. Chylothorax can be associated with high rates of morbidity and mortality and early diagnosis is of paramount importance in order to adequate and prompt therapy. Chilothorax is well distinguishable in CT scan but the diagnosis must be confirmed by analysis of the pleural fluid. The optimal treatment for traumatic chylothorax is unclear and a challenging clinical problem. In this article, we describe the clinical manifestations, radiologic findings, and successful medical treatment of a patient with post traumatic chylothorax diagnosed in an emergency setting.

scholarly journals Upbeat vertical nystagmus after brain stem cavernoma resection: a rare case of nucleus intercalatus/nucleus of roller injury

2020 ◽  
Vol 267 (10) ◽  
pp. 2865-2870
Author(s):  
Torstein R. Meling ◽  
Aria Nouri ◽  
Adrien May ◽  
Nils Guinand ◽  
Maria Isabel Vargas ◽  
...  
Keyword(s):  
Rare Case ◽  
Vascular Malformations ◽  
Clinical Manifestations ◽  
Neurological Injury ◽  
Medial Longitudinal Fasciculus ◽  
Blurred Vision ◽  
Complete Excision ◽  
First Case ◽  
Vertical Nystagmus ◽  
Upbeat Nystagmus

Abstract Introduction CNS cavernomas are a type of raspberry-shaped vascular malformations that are typically asymptomatic, but can result in haemorrhage, neurological injury, and seizures. Here, we present a rare case of a brainstem cavernoma that was surgically resected whereafter an upbeat nystagmus presented postoperatively. Case report A 42-year old man presented with sudden-onset nausea, vomiting, vertigo, blurred vision, marked imbalance and difficulty swallowing. Neurological evaluation showed bilateral ataxia, generalized hyperreflexia with left-sided predominance, predominantly horizontal gaze evoked nystagmus on right and left gaze, slight left labial asymmetry, uvula deviation to the right, and tongue deviation to the left. MRI demonstrated a 13-mm cavernoma with haemorrhage and oedema in the medulla oblongata. Surgery was performed via a minimal-invasive, midline approach. Complete excision was confirmed on postoperative MRI. The patient recovered well and became almost neurologically intact. However, he complained of mainly vertical oscillopsia. The videonystagmography revealed a new-onset spontaneous upbeat nystagmus in all gaze directions, not suppressed by fixation. An injury of the rarely described intercalatus nucleus/nucleus of Roller is thought to be the cause. Conclusion Upbeat nystagmus can be related to several lesions of the brainstem, including the medial longitudinal fasciculus, the pons, and the dorsal medulla. To our knowledge, this is the first case of an iatrogenic lesion of the nucleus intercalatus/nucleus of Roller resulting in an upbeat vertical nystagmus. For neurologists, it is important to be aware of the function of this nucleus for assessment of clinical manifestations due to lesions within this region.

scholarly journals 1632. Comparing the epidemiology and clinical characteristics of childhood tuberculosis through active and passive case finding

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S807-S808
Author(s):  
Saki Ikeda ◽  
Andrea T Cruz ◽  
Jeffrey R Starke
Keyword(s):  
Clinical Manifestations ◽  
Central Nervous System Disease ◽  
Data Safety Monitoring Board ◽  
Case Finding ◽  
Childhood Tuberculosis ◽  
Contact Tracing ◽  
System Disease ◽  
Radiologic Findings ◽  
Mediastinal Adenopathy ◽  
Epidemiological Characteristics

Abstract Background Childhood tuberculosis can be found via passive case finding (PCF), diagnosing a symptomatic child, and active case finding (ACF), discovering a child through contact tracing. Most high prevalence areas perform PCF, but as ACF is introduced, the clinical and radiologic findings may differ. We compare clinical, radiographic, microbiologic and epidemiological characteristics of children diagnosed through PCF and ACF. Methods A retrospective cohort study of all patients diagnosed with TB from 01/01/2012-12/31/2019 at Texas Children’s Hospital. ACF is TB in a child who had not previously sought care before identified via contact tracing, immigration screening, or screening for incarceration. Severity of disease was based on location of illness, imaging and bacteriology/histopathology. Associations between PCF/ACF and demographics, disease severity, and microbiology were analyzed. Results Of 178 patients, 80 (45%) were diagnosed via ACF. ACF patients were more likely to be US-born (OR: 2.29, [95% Confidence interval (CI): 1.12-4.67]) and younger (mean 6.18 vs 8.84 years, p= 0.016). Only 2.5% of ACF patients had extrapulmonary disease, compared to 45% of the PCF group (p&lt; 0.0001). All 14 severe extrathoracic cases were in the PCF group (10 central nervous system disease, 3 ocular disease, 1 spondylitis). Fewer patients in the ACF group had severe intrathoracic findings (11% vs 39%, p&lt; 0.001): miliary disease (0% vs 10%, p=0.006), cavity (1% vs 9%, p=0.04), and multilobar involvement (7.5% vs 22.4%, p=0.006). ACF patients had more hilar/mediastinal adenopathy (OR: 2.51, [CI: 1.34-3.72], p=0.004). ACF patients were less often cultured (38% vs 89%, p&lt; 0.0001) and had less microbiological confirmation by cultures or PCR (21% vs 52%, p=&lt; 0.0001). Conclusion Patients in the ACF group were younger, had less severe clinical manifestations, and had almost no extrathoracic disease. Clinicians need to be aware that the common clinical and radiographic presentations in children differ between PCF and ACF. Disclosures Jeffrey R. Starke, MD, Otsuka Pharmaceuticals (Other Financial or Material Support, Member, Data Safety Monitoring Board)

scholarly journals Non-tuberculous Mycobacterium Disease: Radiologic Manifestation in an Infant presenting with Respiratory Distress

2017 ◽  
Vol 5 (1-2) ◽  
pp. 13-20
Author(s):  
Rupesh Gautam ◽  
Maria Isabel Atienza ◽  
Maika Noda ◽  
Mariaem Andres
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Pulmonary Infection ◽  
Clinical Manifestations ◽  
Distinct Group ◽  
Middle Lobe ◽  
Air Trapping ◽  
Pulmonary Tb ◽  
Radiologic Findings ◽  
The Common ◽  
Common Manifestation

Non-tuberculous mycobacterium (NTM) comprises distinct group of organisms with lymphadenitis and pulmonary infection as the common manifestation. The diagnosis of pulmonary disease is based on clinical manifestations, radiologic findings and microbiologic culture. The classic NTM infection may be indistinguishable from pulmonary TB. Non-classic infection has predilection to the middle lobe and lingula unlike tuberculosis which is commonly seen in the upper lobes. The disease may also present as hypersensitivity pneumonitis with ground glass like opacities, centrilobular nodules and air trapping on imaging. The knowledge of imaging manifestations of NTM will aid in timely diagnosis and treatment of the disease.Nepal Journal of Radiology Vol.5(1-2) 2015: 13-20

Trismus and TMJ disorders as first clinical manifestations in an intracranial acquired cholesteatoma

2021 ◽  
Vol 14 (5) ◽  
pp. e242460
Author(s):  
Chiara Copelli ◽  
Domenico Catapano ◽  
Alfonso Manfuso ◽  
Aurelio d’Ecclesia
Keyword(s):  
Hearing Loss ◽  
Temporomandibular Joint ◽  
Otitis Media ◽  
Rare Case ◽  
Clinical Manifestations ◽  
Chronic Otitis Media ◽  
Temporomandibular Joint Disorders ◽  
Intracranial Extension ◽  
Rare Occurrence ◽  
Acquired Cholesteatoma

Intracranial extension of acquired cholesteatoma is a rare occurrence that can develop secondary to trauma, chronic otitis media or acquired aural cholesteatoma. The most commonly observed symptoms are headache and hearing loss. The authors report on a rare case of intracranial cholesteatoma presenting with atypic symptoms: swelling and temporomandibular joint disorders.

Genital Herpes in Human Immunodeficiency Virus Infected Patients

2021 ◽  
Vol 5 (8) ◽  
pp. 758-772
Author(s):  
Stella Sunur ◽  
Izazi Hari Purwoko ◽  
Yulia Farida Yahya ◽  
Raden Pamudji
Keyword(s):  
Genital Herpes ◽  
Clinical Manifestations ◽  
Symptomatic Treatment ◽  
Transmitted Infection ◽  
Sexual Transmitted Infection ◽  
Immunodeficiency Virus ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Common Infection

Genital herpes is a recurrent, lifelong sexual transmitted infection caused by HSV, especially type 2. Genital herpes is the most common infection in HIV patient. HSV-2 can increase the risk of HIV acquisition 2 to 3 times. Clinical manifestations of genital herpes can be different between HIV- infected and non-HIV patients. HIV-infected patients have a high risk of developing chronic and severe genital ulcers with atypical manifestation, prolonged healing, and resistant to treatment, depends on CD4 count. Genital herpes can be diagnosed based on history, clinical manifestation, laboratory and histopathologic examination. Management of genital herpes includes education and counseling patients and sexual partners, systemic antiviral, and symptomatic treatment.

scholarly journals Giant Gastroduodenal Trichobezoar: An Endoscopic Surprise

2018 ◽  
Vol 09 (03) ◽  
pp. 131-133
Author(s):  
Ashish Kumar Jha ◽  
Manish Kumar Mishra ◽  
Rakesh Kumar ◽  
Madhur Chaudhary ◽  
Shubham Purkayastha ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Rare Case ◽  
Outlet Obstruction ◽  
Rare Condition ◽  
Current Status ◽  
Gastric Bleeding ◽  
Teenage Girls ◽  
Abdominal Symptoms ◽  
Perforation Peritonitis ◽  
Laparoscopic Assisted

A trichobezoar is a rare condition, mostly seen in teenage girls with abnormal psychiatric behavior of eating hairs and nails (trichophagia). Trichobezoar may rarely present with nonspecific abdominal symptoms without obvious trichotillomania and trichophagia. Trichobezoar can be complicated with potentially serious conditions such as gastric outlet obstruction, gastric bleeding, intussusceptions, and perforation peritonitis. Conventional laparotomy is method of choice for the removal of trichobezoar. We describe a rare case of giant trichobezoar treated by laparoscopic‑assisted gastrostomy and removal of bezoar. We also reviewed the literature on the current status of endoscopic treatment of trichobezoar.

The Thyroid Gland: Physiology and Pathophysiology

2000 ◽  
Vol 19 (8) ◽  
pp. 11-26 ◽  
Author(s):  
Denise Kirsten
Keyword(s):  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Laboratory Tests ◽  
Clinical Manifestations ◽  
Thyroid Stimulating Hormone ◽  
The Body ◽  
Premature Delivery ◽  
Follicular Cells ◽  
Metabolic Hormones ◽  
Radiologic Findings

The thyroid gland contains many follicular cells that store the thyroid hormones within the thyroglobulin molecule until they are needed by the body. The thyroid hormones, often referred to as the major metabolic hormones, affect virtually every cell in the body. Synthesis and secretion of the thyroid hormones depend on the presence of iodine and tyrosine as well as maturation of the hypothalamic-pituitary-thyroid system. Interruption of this development, as occurs with premature delivery, results in inadequate production of thyroid-stimulating hormone and thyroxine, leading to a variety of physiologic conditions. Pathologic conditions occur in the presence of insufficient thyroid production or a defect in the thyroid gland. Laboratory tests are important in diagnosing conditions of the thyroid gland. A thorough history in combination with clinical manifestations and radiologic findings are also useful in diagnosing specific thyroid conditions. Nurses play an important role in identifying and managing thyroid disorders and in providing supportive care to infants and their families.

Clinical Manifestations and Radiologic Findings in Craniopharyngiomas in Adults

1982 ◽  
Vol 94 (2) ◽  
pp. 220-228 ◽  
Author(s):  
Timothy B. Crane ◽  
Robert D. Yee ◽  
Robert S. Hepler ◽  
John M. Hallinan
Keyword(s):  
Clinical Manifestations ◽  
Radiologic Findings
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