Acute pancreatitis with pulmonary embolism: A case report

paythelady.612 shared this article with you from Inoreader Acute pancreatitis with pulmonary embolism: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):904-911. doi: 10.12998/wjcc.v9.i4.904. ABSTRACT BACKGROUND: Acute pancreatitis (AP) is a common critical disease of the digestive system that is often associated with multiple complications. Vascular complications are relatively rare and are one of the causes of death. AP complicated with pulmonary embolism (PE) is even rarer, and there are no reports of AP complicated with PE in elderly patients. CASE SUMMARY: We describe a rare case of AP complicated with PE and review the literature. A 68-year-old woman was diagnosed with AP due to widespread abdominal pain. During the course of treatment, the patient had shortness of breath and progressively worsening dyspnea without chest pain or hemoptysis with a progressive increase in D-dimer and fibrin degradation product. Respiratory failure and right heart failure occurred, and refractory hypoxemia remained after mechanical ventilation. Plain chest c omputed tomography revealed a small amount of left pleural effusion and external pressure atelectasis in the lower lobe of the left lung but no findings that could lead to refractory hypoxemia. Color Doppler ultrasound indicated pulmonary hypertension and extensive venous thrombosis in the lower extremities. Chest computed tomography angiography finally suggested pulmonary thromboembolism. The patient's dyspnea symptoms disappeared after anticoagulation treatment. CONCLUSION: During the diagnosis and treatment of AP, it is necessary to dynamically monitor D-dimer and consider PE. PMID:33585638 | PMC:PMC7852627 | DOI:10.12998/wjcc.v9.i4.904 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reciprocal hematogenous osteomyelitis of the femurs caused by Anaerococcus prevotii: A case report

paythelady.612 shared this article with you from Inoreader Reciprocal hematogenous osteomyelitis of the femurs caused by <em>Anaerococcus prevotii</em>: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):830-837. doi: 10.12998/wjcc.v9.i4.830. ABSTRACT BACKGROUND: Haematogenous osteomyelitis is an extremely rare disease occurring in adults, especially in developed countries. It is clearly a systemic infection, because bacteraemia spreads over proximal and distal long bones or paravertebral plexuses, resulting in acute or chronic bone infection and destruction. CASE SUMMARY: A 46-year-old Caucasian male was complaining of a left thigh pain. It is known from the anamnesis that the patient developed severe pneumonia three months ago before the onset of these symptoms. The patient was diagnosed with haematogenous osteomyelitis, which developed a turbulent course and required complex combination therapy. The primary pathogen is thought to be Anaerococcus prevotii, which caused pneumonia before the onset of signs of osteomyelitis. Unfortunately, due to the complexity of identifying anaerobes an d contributing nosocomial infections, the primary pathogen was not extracted immediately. After the manifestation of this disease, pathological fractures occurred in both femurs, as well as purulent processes in the lungs and molars accompanied. The patient received broad-spectrum antibiotic therapy and countless amounts of orthopaedic and reconstructive surgeries, but no positive effect was observed. The patient underwent osteosynthesis using an Ilizarov's external fixation apparatus, re-fixations, external AO, debridements, intrame-dullary osteosynthesis with a silver-coated intramedullary nail, abscessotomies. The right femur healed completely after the pathological fracture and osteomyelitis did not recur. Left femur could not be saved due to non-healing, knee contracture and bone destruction. After almost three years of struggle, it was decided to amputate the left limb, after which the signs of osteomyelitis no longer appeared. CONCLUSION: To sum it all up, complicated o r chronic osteomyelitis requires surgery to remove the infected tissue and bone. Osteomyelitis surgery prevents the infection from spreading further or getting even worse up to such condition that amputation is the only option left. PMID:33585629 | PMC:PMC7852651 | DOI:10.12998/wjcc.v9.i4.830 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Apert syndrome diagnosed by prenatal ultrasound combined with magnetic resonance imaging and whole exome sequencing: A case report

paythelady.612 shared this article with you from Inoreader Apert syndrome diagnosed by prenatal ultrasound combined with magnetic resonance imaging and whole exome sequencing: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):912-918. doi: 10.12998/wjcc.v9.i4.912. ABSTRACT BACKGROUND: Most cases of Apert syndrome (AS) are found after birth. Cases of AS diagnosed by ultrasound combined with magnetic resonance imaging (MRI) and whole exome sequencing (WES) during pregnancy are rare. CASE SUMMARY: We present the case of a 34-year old female patient (gravida 2, para 1) whose fetus was diagnosed with AS during pregnancy. Fetal ultrasound performed at 30, 2/7 wk of pregnancy showed abnormalities. MRI and three-dimensional ultrasound performed at 31, 1/7 wk of pregnancy showed the possibility of AS. Chromosome examination and core family WES were conducted at 31, 5/7 wk of pregnancy. The results showed that FGFR2 in the fetus had a c.755C>G missense mutation in its nucleotide, and AS was confirmed. CONCLUSION: This case highlights the importance of imaging examinations. Prenatal ultrasound combined with MRI can identify fetal morphological abnormalities accurately, which can be confirmed by WES. PMID:33585639 | PMC:PMC7852645 | DOI:10.12998/wjcc.v9.i4.912 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Altemeier perineal rectosigmoidectomy with indocyanine green fluorescence imaging for a female adolescent with complete rectal prolapse: A case report

paythelady.612 shared this article with you from Inoreader Altemeier perineal rectosigmoidectomy with indocyanine green fluorescence imaging for a female adolescent with complete rectal prolapse: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):847-853. doi: 10.12998/wjcc.v9.i4.847. ABSTRACT BACKGROUND: Rectal prolapse in young women is rare. Although laparoscopic ventral mesh rectopexy is the standard procedure because of its lower recurrence rate, postoperative infertility is a concern. Perineal rectosigmoidectomy (Altemeier procedure) is useful for these patients. However, the risk of anastomotic leakage should be considered. Recently, the usefulness of fluorescence imaging with indocyanine green (ICG) to prevent anastomotic leakage was reported. We report a case of an adolescent woman with complete rectal prolapse who underwent ICG fluorescence imaging-assisted Altemeier rectosigmoidectomy. CASE SUMMARY: A 17-year-old woman who had a mental disorder was admitted to our hospital for treatment for water intoxication. The patient also suffered from rectal prolapse, approximately 3 mo before admission. She was referred to our surgical department because recurrent rectal prolapse could worsen her psychiatric disorder. Approximately 10 cm of complete rectal prolapse was observed. However, the mean maximum anal resting and constriction pressures were within normal limits on anorectal manometry. Because she had the desire to bear children in the future, she underwent Altemeier perineal rectosigmoidectomy to prevent surgery-related infertility. We performed ICG fluorescence imaging at the same time as surgery to reduce the risk of anastomotic leakage. Her postoperative course was uneventful, and the rectal prolapse was completely resolved. She continued to do well 18 mo after surgery, without recurrence of the rectal prolapse. CONCLUSION: ICG fluorescence imaging-assisted Altemeier perineal rectosigmoidectomy is useful in preventing postoperative anastomotic leakage in young as well as elderly patients. PMID:33585631 | PMC:PMC7852635 | DOI:10.12998/wjcc.v9.i4.847 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Application of neoadjuvant chemotherapy combined with anlotinib in occult breast cancer: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Application of neoadjuvant chemotherapy combined with anlotinib in occult breast cancer: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):919-926. doi: 10.12998/wjcc.v9.i4.919. ABSTRACT BACKGROUND: Occult breast cancer (OBC) is a special type of breast cancer presenting as axillary lymph node metastasis with undetectable primary lesions in the breast. Due to its low incidence and unique clinical manifestations, there is a lack of consensus on the diagnosis and treatment of OBC. We report a case of OBC treated with neoadjuvant chemotherapy combined with anlotinib. The treatment was well tolerated, and the patient achieved a pathologic complete response. CASE SUMMARY: A 53-year-old woman presented with a lump in her right axillary area with no primary lesions in the breast. Pathological biopsy confirmed right axillary metastatic carcinoma. Immunohistochemical staining results were positive for progesterone receptor, cytokeratin 7, specific breast markers GATA3 and gross cystic disease fluid protein-15. Tumor cells were negative for estrogen receptor, human epidermal growth factor receptor-2, cytokeratin 5/6, cytokeratin 20, and villin. The patient was diagnosed with OBC, and she underwent neoadjuvant chemotherapy combined with anlotinib. Mastectomy plus axillary lymph node dissection was performed. The patient achieved pathologic complete response with no residual invasive tumor cells in the breast or axillary lymph nodes. Postoperatively, she received adjuvant radiotherapy and endocrine therapy. CONCLUSION: Neoadjuvant chemotherapy and anlotinib had good efficacy and safety in the treatment of OBC and may be a new therapeutic option. PMID:33585640 | PMC:PMC7852641 | DOI:10.12998/wjcc.v9.i4.919 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent medullary thyroid carcinoma treated with percutaneous ultrasound-guided radiofrequency ablation: A case report

paythelady.612 shared this article with you from Inoreader Recurrent medullary thyroid carcinoma treated with percutaneous ultrasound-guided radiofrequency ablation: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):864-870. doi: 10.12998/wjcc.v9.i4.864. ABSTRACT BACKGROUND: Treatment for neck lymph node metastases after adequate initial surgery in medullary thyroid carcinoma (MTC) has been controversial. Ultrasound (US)-guided radiofrequency ablation (RFA) has been widely used in recurrent well-differentiated thyroid carcinoma. Here, we report for the first time the use of RFA in a patient with recurrent MTC. CASE SUMMARY: We report the case of a 56-year-old woman with cervical lymph node metastases of MTC. Four years previously, she had undergone a total thyroidectomy and neck lymph node dissection. A neck US revealed many enlarged nodes during the follow-up period. Moreover, the serum calcitonin jumped to 198.17 pg/mL, which strongly indicated the recurrence of MTC. Subsequently, two metastatic lymph nodes were confirmed by US-guided fine-needle aspiration-cytology and fine-needle aspiration-calcitonin, and then the patient was treated with RFA. Four months later, the neck US and a contrast-enhanced US showed obvious shrinkage in the ablation zones, and the serum calcitonin dropped to 11.80 pg/mL. CONCLUSION: This case suggests that RFA may be an effective and safe treatment for local recurrent MTC. PMID:33585633 | PMC:PMC7852637 | DOI:10.12998/wjcc.v9.i4.864 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Atypical presentation of shoulder brucellosis misdiagnosed as subacromial bursitis: A case report

paythelady.612 shared this article with you from Inoreader Atypical presentation of shoulder brucellosis misdiagnosed as subacromial bursitis: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):927-934. doi: 10.12998/wjcc.v9.i4.927. ABSTRACT BACKGROUND: Brucella infections in the shoulder joint are uncommon, and few have been reported in the literature. CASE SUMMARY: A 26-year-old male was admitted to our hospital with complaint of recurrent pain and limited movement of the right shoulder. The patient reported the pain to have first occurred as an isolated event 6 mo previously and to have reoccurred 5 mo later, when it was accompanied by limited movement of the shoulder. Findings from physical examination and magnetic resonance imaging (referred to as MRI) suggested the diagnosis of subacromial bursitis, and diagnostic paracentesis and arthroscopic debridement were performed. Surprisingly, synovial fluid culture detected brucella, and the finding was confirmed by mass spectrometry of a colony sample. The diagnosis was corrected to brucellosis of the shoulder joint, and antibiotic dru g treatment (oral rifampicin and doxycycline) was administrated for 6 wk. The 4-mo postoperative follow-up examination (MRI) yielded normal findings. The 2-year follow-up showed no signs of recurrence. CONCLUSION: This rare case of brucellosis infection in shoulder highlights the importance of increasing awareness to help avoid misdiagnosis. PMID:33585641 | PMC:PMC7852647 | DOI:10.12998/wjcc.v9.i4.927 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.