scholarly journals Interesting series of extra abdominal complications in two patients with chronic pancreatitis secondary to chronic alcoholism and pancreatic divisum

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Dhaval Choksi ◽  
Vikas Pandey ◽  
Prateik Poddar ◽  
Alisha Chaubal ◽  
Meghraj Ingle ◽  
...  
Keyword(s):  
Case Report ◽  
Chronic Pancreatitis ◽  
Pleural Effusion ◽  
Rare Complication ◽  
Chronic Alcoholism ◽  
High Index ◽  
Abdominal Complications ◽  
First Case ◽  
Per Se ◽  
High Index Of Suspicion

Pancreaticopleural fistula is an extremely rare complication of chronic pancreatitis. Interestingly it may present without any symptoms of pancreatitis per se. The diagnosis requires a high index of suspicion due to the predominant thoracic symptoms. Cases with massive, rapidly refilling, refractory pleural effusion in the setting of pancreatitis (symptomatic or asymptomatic) should be suspected of having a pancreaticopleural fistula. We report two cases of pancreaticopleural fistula. One of the patient also had pancreatic divisum and to the best of our knowledge this is the first case report of pancreatic divisum with pancreaticopleural fistula in the literature.

scholarly journals Anti-NMDA Encephalitis: A Rare Encephalitis in a Child- A Case Report

2020 ◽  
Vol 19 (2) ◽  
pp. 108-111
Author(s):  
Saurav Khetan ◽  
Nikhil Agrawal ◽  
Prakash Rajoli
Keyword(s):  
Case Report ◽  
Japanese Encephalitis ◽  
Viral Encephalitis ◽  
Psychiatric Symptoms ◽  
Autoimmune Encephalitis ◽  
High Index ◽  
First Case ◽  
High Index Of Suspicion

Anti-NMDA encephalitis is second commonest cause of autoimmune encephalitis among children; however, it is hardly diagnosed and often not considered as one of the differentials when a child presents with encephalitis-related symptoms. In children, it presents mostly with seizures or psychiatric symptoms without prodrome. Here we present a six years old girl who presented with seizures and inappropriate behaviour. We investigated her in the line of viral encephalitis such as Japanese Encephalitis, which is very common in our region. However, results were not suggestive of Japanese Encephalitis and further investigations subsequently lead to diagnosis of anti- NMDA encephalitis. This is probably one of the first case report of this disease in our country. We want to highlight the significance of high index of suspicion for looking out for an organic cause in any child who presents with psychiatric symptoms, along with seizures.

Uretero-Arterial Fistula: A Case Report and Review of the Literature

2020 ◽  
pp. 153857442097673
Author(s):  
Amr I. Al Abbas ◽  
Marc Salhanick ◽  
Melissa L. Kirkwood
Keyword(s):  
Case Report ◽  
Rare Complication ◽  
Laser Lithotripsy ◽  
High Index ◽  
Endovascular Intervention ◽  
Review Of The Literature ◽  
Aortobifemoral Bypass ◽  
Left Ureter ◽  
High Index Of Suspicion

Uretero-arterial fistula (UAF) is a rare complication of either aneurysmal disease primarily or pelvic inflammation secondary to urologic, oncologic, or vascular interventions. Diagnosis can be difficult to confirm and treatment may need to proceed on high index of suspicion alone. We present the case of a 56-year-old woman suffering from intermittent hematuria after laser lithotripsy leading to UAF between her left ureter and left Dacron aortobifemoral bypass limb. The fistula was successfully treated with endovascular intervention.

scholarly journals Pancreaticopleural fistula in a child with chronic pancreatitis harboring compound SPINK1 variants

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teera Kijmassuwan ◽  
Prapun Aanpreung ◽  
Varayu Prachayakul ◽  
Prakarn Tovichien
Keyword(s):  
Chronic Pancreatitis ◽  
Pleural Effusion ◽  
Pancreatic Duct ◽  
Imaging Modality ◽  
Rare Complication ◽  
Clinical Suspicion ◽  
High Index ◽  
Fistula Tract ◽  
Radiological Imaging ◽  
Pancreatic Duct Stent

Abstract Background Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis (CP) that requires a high index of clinical suspicion in the patient who presents with a pleural effusion. Visualizing the fistula tract from the pancreatic duct to the pleural space by radiological imaging provides confirmation of this complication. Case presentation A 9-year-old boy who presented with massive right pleural effusion secondary to PPF, a complication of CP from a genetic mutation involving two mutations of SPINK1. We successfully managed the case with by endoscopic pancreatic duct stent placement after failure of conservative treatment approaches. Conclusions PPF is a rare but serious complication of CP in all ages. The diagnosis of PPF in children requires a high index of clinical suspicion and should be considered in the differential diagnosis of massive pleural effusion where pancreatic pathology is present. A high level of pleural fluid amylase and the results from radiological imaging when the patients have symptoms play essential roles in the diagnosis of PPF. Currently, Magnetic resonance cholangiopancreatigraphy (MRCP) is the imaging modality of choice. Endoscopic therapy and surgery are treatment options for patients who do not respond to conservative therapy.

Neonatal airway lesions: our experience and a review of the literature

2012 ◽  
Vol 127 (1) ◽  
pp. 80-83 ◽  
Author(s):  
V Rangachari ◽  
R Aggarwal ◽  
A Jain ◽  
M C Kapoor
Keyword(s):  
Case Report ◽  
Multidisciplinary Team ◽  
Congenital Anomalies ◽  
Case Reports ◽  
High Index ◽  
Institutional Setting ◽  
Review Of The Literature ◽  
First Case ◽  
High Index Of Suspicion

AbstractObjectives:This paper reports on two rare cases of neonatal airway lesions with differing aetiology that were successfully managed by surgery, and provides a review of the literature on neonatal stridor and airway lesions.Case reports:In the first case report, a newborn presented with a nasopharyngeal teratoma. In the second case report, a newborn presented with a congenital laryngeal saccular cyst. Difficulties in the diagnosis of these lesions, and surgical and anaesthetic challenges in their management are discussed.Conclusion:Every case of neonatal airway distress must be evaluated and the cause of stridor needs to be established. It is important that rare lesions such as teratomas and laryngeal cysts are not overlooked; a high index of suspicion for these congenital anomalies is necessary. These airway lesions should be managed in an institutional setting by a multidisciplinary team.

scholarly journals Bilateral Charcot hip Arthropathy Due to Tabes Dorsalis: A Case Report

2018 ◽  
Vol 25 (1) ◽  
pp. 21-23
Author(s):  
Ip Hoi Yeung ◽  
Yeung Yip Kan ◽  
Luk Kristine Shik ◽  
Lam Polly Wy ◽  
Wong Kwok Ho
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Clinical Course ◽  
High Index ◽  
Tabes Dorsalis ◽  
High Index Of Suspicion

This article illustrates the clinical course of a patient diagnosed to have bilateral Charcot hip arthropathy secondary to tabes dorsalis from delayed untreated syphilitic infection. This differential diagnosis of rapid bilateral hip destruction was a near-extinct entity, and a high index of suspicion is needed to prevent untoward sequelae.

scholarly journals Massive Spontaneous Hemothorax as a Complication of Apixaban Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
M. Abu Hishmeh ◽  
P. Srivastava ◽  
Q. Lougheide ◽  
M. Srinivasan ◽  
S. Murthy
Keyword(s):  
Pleural Effusion ◽  
Health Care Providers ◽  
Rare Complication ◽  
Pigtail Catheter ◽  
Care Providers ◽  
Nonvalvular Atrial Fibrillation ◽  
Vein Thrombosis ◽  
Spontaneous Hemothorax ◽  
First Case ◽  
Iatrogenic Trauma

Introduction. Hemothorax is usually related to chest or iatrogenic trauma from procedures such as central lines and thoracentesis. Spontaneous hemothorax is defined as pleural fluid hematocrit greater than 50% of serum hematocrit in absence of natural or iatrogenic trauma affecting the lung or pleural space. Coagulopathy secondary to anticoagulant use has been associated with spontaneous hemothorax. We present a case of spontaneous hemothorax in a patient taking apixaban for venous thromboembolism disease. To our knowledge, this is the first case report of apixaban as a cause of spontaneous hemothorax. Case Presentation. A 56-year-old woman with end-stage renal disease (ESRD) was diagnosed with upper extremity deep vein thrombosis (DVT) one month prior to presentation and was started on apixaban presented with dyspnea and left-sided pleuritic chest pain for two weeks. She was found to have left-sided large pleural effusion which was diagnosed as hemothorax. Other etiologies for spontaneous hemothorax were excluded and drainage by 12-French pigtail catheter achieved total resolution of hemothorax in three days. Discussion. Apixaban is a DOAC used to prevent stroke or thromboembolic events in patients with nonvalvular atrial fibrillation and to prevent recurrent venous thromboembolic disease. Events such as gastrointestinal, intracranial, and soft tissue bleeding have been well-documented. However, bleeding manifestation as hemothorax is seldom reported. Our patient presented with isolated left-sided large pleural effusion which was diagnosed as spontaneous hemothorax. 12-Fr pigtail catheter drainage was effective in the management of our patient and provided total resolution in three days. Conclusion. Spontaneous hemothorax is a rare complication of anticoagulant therapy and might not exhibit the usual radiological signs of traumatic hemothorax. Health care providers should have high index of suspicion for spontaneous hemothorax when evaluating new pleural effusion in patients receiving DOACs therapy. Drainage by small bore pigtail catheter might be as effective as larger chest tubes.

scholarly journals Hypomelanosis of Ito: Case report of a rare neurocutaneous syndrome in a neonate and review of the literature.

1970 ◽  
Vol 42 (3) ◽  
pp. 231-233
Author(s):  
M Mukhtar-yola ◽  
LI Audu ◽  
AT Otuneye ◽  
AB Mairami ◽  
EC Otubelu ◽  
...  
Keyword(s):  
Case Report ◽  
High Index ◽  
Review Of The Literature ◽  
Cutaneous Lesions ◽  
Hypomelanosis Of Ito ◽  
The Third ◽  
Neurocutaneous Syndrome ◽  
Paediatric Practice ◽  
High Index Of Suspicion

Hypomelanosis of Ito (HI) though said to be the third most common neurocutaneus disorder, is rarely reported in paediatric practice in Africa. A high index of suspicion must be maintained in children with cutaneous lesions as a seizure may be the first symptom that may bring the child to attention. A case of HI in a neonate is hereby reported to sensitize clinicians about this relatively uncommon disorder

scholarly journals Cyclical hematuria-ureteral endometriosis: a case report

2018 ◽  
Vol 7 (4) ◽  
pp. 1648
Author(s):  
Sindura Ganga Ravula ◽  
Harish Shetty ◽  
Aparna Rajesh
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Early Diagnosis ◽  
Renal Involvement ◽  
High Index ◽  
True Incidence ◽  
Ureteral Endometriosis ◽  
High Index Of Suspicion ◽  
Specific Symptoms

Little attention has been paid for the renal involvement in endometriosis, a rare and silent disorder which ultimately lead to renal failure. Involvement most commonly may be limited to single ureter (left one) and it is usually involvement extrinsically. Although cases have been reported in the literature, true incidence of ureteral involvement is still not known. The diagnosis is difficult as the disease has non-specific symptoms. Only high index of suspicion with radiological support would be helpful in early diagnosis. Early cases may be benefited with progestin or Anti-aromatase therapy, most cases need surgery, either laparoscopically or laparotomy.

A Case of Eosinophilic Pleural Effusion Complicating Multiple Myeloma

1988 ◽  
Vol 33 (3) ◽  
pp. 278-278 ◽  
Author(s):  
B.J. Lipworth ◽  
D.P. Dhillon
Keyword(s):  
Multiple Myeloma ◽  
Pleural Effusion ◽  
Light Chain ◽  
Recent Literature ◽  
Rare Complication ◽  
Light Chain Type ◽  
First Case ◽  
Eosinophilic Pleural Effusion ◽  
Chain Type

Pleural effusion is a rare complication of multiple myeloma. We report the first case of eosinophilic effusion due to light chain type disease and review the recent literature.

scholarly journals Genitourinary tuberculosis in North America: A rare clinical entity

2015 ◽  
Vol 9 (7-8) ◽  
pp. 484 ◽  
Author(s):  
Michael W Sourial ◽  
Fadi Brimo ◽  
Ruth Horn ◽  
Sero Andonian
Keyword(s):  
North America ◽  
Percutaneous Nephrolithotomy ◽  
Left Kidney ◽  
Granulomatous Inflammation ◽  
Renal Stones ◽  
High Index ◽  
Canadian Woman ◽  
Radiologic Findings ◽  
First Case ◽  
High Index Of Suspicion

Introduction: Although tuberculosis (TB) is the most common cause of mortality from infectious diseases worldwide, genitourinary TB in North America is rare. We review 3 cases of genitourinary TB diagnosed within the last 5 years.Cases: The first case is that of a 76-year-old African-Canadian woman who was referred for percutaneous nephrolithotomy of right lower pole renal stones. Although renal TB was suspected, her initial urinary TB culture was negative. On follow-up imaging, she developed bilateral ureteral thickening and ureteroscopic biopsy confirmed necrotizing granulomata. Repeat urine cultures were positive for M. tuberculosis. The second case is a 73-yearold Italian-Canadian woman who was referred for ureteroscopic biopsy of left thickened ureter to rule out urothelial carcinoma. Initial urine TB cultures were negative, despite biopsies confirming granulomatous inflammation. She was closely followed with urine cytologies and TB cultures. Repeat urine culture was positive for M. tuberculosis. Both patients were treated with a course of anti-tuberculous agents and indwelling ureteral stents to relieve ureteral obstruction. The third case is a 70-year-old Cree woman who was referred for percutaneous nephrolithotomy of a left “staghorn stone” in an atrophic left kidney. Thirty years earlier she had been treated for pulmonary TB in addition to ileocystoplasty for a “thimble” bladder. A computed tomography scan showed autonephrectomized left kidney. Her urine TB cultures were negative. She was placed on prophylactic antibiotics for her recurrent bacterial urinary tract infections.Conclusion: Genitourinary TB may present in various subtle ways, and the astute clinician must have a high index of suspicion for this disease in patients with atypical clinical and radiologic findings. In addition, TB urine cultures should be repeated when there is high index of suspicion.

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