scholarly journals Crowned Dens Syndrome Occurring after Endoscopic Submucosal Dissection for Early Gastric Cancer

2021 ◽  
pp. 22-27
Author(s):  
Takeshi Okamoto ◽  
Takashi Ikeya ◽  
Katsuyuki Fukuda
Keyword(s):  
Gastric Cancer ◽  
Neck Pain ◽  
Endoscopic Submucosal Dissection ◽  
Odontoid Process ◽  
Calcium Pyrophosphate ◽  
Endoscopic Procedures ◽  
Submucosal Dissection ◽  
Calcium Pyrophosphate Dehydrate ◽  
Crowned Dens Syndrome ◽  
Head Computed Tomography

Crowned dens syndrome (CDS) is a rare form of pseudogout which causes acute neck pain due to calcium pyrophosphate dehydrate deposition surrounding the odontoid process, commonly causing neck pain with rigidity. While invasive procedures such as surgery are known to present a risk of acute pseudogout, reports of occurrence after endoscopic procedures are scarce. We report the case of a 75-year-old man who presented with sudden neck pain after endoscopic submucosal dissection (ESD) for gastric cancer. He could nod but could not rotate his head. Computed tomography showed calcifications surrounding the odontoid process consistent with CDS. Prolonged dietary restrictions and proton pump inhibitor use following the ESD procedure may have caused hypomagnesemia, a precipitating factor for CDS. We prescribed colchicine 1 mg/day and symptoms resolved completely in 3 days. This is the first report of CDS after ESD. CDS should be included in the differential diagnosis of neck pain after endoscopic procedures.

scholarly journals Crowned dens syndrome

2012 ◽  
Author(s):  
Norma Belfiore ◽  
Vito Privitera ◽  
Giampaolo Carmosino ◽  
Giulio Doveri
Keyword(s):  
Neck Pain ◽  
Odontoid Process ◽  
Unknown Origin ◽  
The Elderly ◽  
Calcium Pyrophosphate ◽  
Acute Onset ◽  
Cervical Pain ◽  
Calcium Pyrophosphate Dehydrate ◽  
Crowned Dens Syndrome ◽  
Inflammatory Drugs

Introduction Microcrystalline deposition in peri-odontoid articular structures is mainly responsible for acute or chronic cervical pain and is known as “crowned dens syndrome”.Materials and methods We described two cases of acute cervical pain associated with onset of fever and peripheral acute monoarthritis. Cervical computed tomography (CT) scan showed linear calcification of the retrodens ligament and calcium pyrophosphate dehydrate (CPPD) crystals were found in synovial fluid of inflamed joints. Both patients were treated with anti-inflammatory drugs and colchicine.Discussion Calcium depositions around the odontoid process of the axis can be occasionally detected by radiological studies. They are frequently asymptomatic but sometimes can be associated with severe neurological abnormalities, fever and acute neck pain. CPPD crystals are usually deposited in joints and bursae but occasionally can disrupt these anatomical confines and deposit in periarticular tissues, sometimes forming large masses confused with tumours.Conclusions Acute onset of cervical neck pain associated with elevation of inflammatory indicators and/or signs of cervical myelopathy should suggest CT scans searching for microcrystal depositions in the peryodonthoid tissue. Differential diagnosis of fever of unknown origin (FUO) should include crowned dens syndrome specially in the elderly after exclusion of several endocrine or metabolic disorders, infection diseases (meningitis), arthritis (psoriatic arthritis and ankylosing spondylitis) and tumours (chordoma, meningioma, osteoblastoma).

Síndrome de la apófisis odontoides coronada, una manifestación inusual de dolor cervical. Presentación de un caso

2020 ◽  
Vol 63 (3) ◽  
pp. 23-25
Author(s):  
Pedro Pablo González Rojas ◽  
Jonathan Restrepo Pérez Restrepo ◽  
Juan Felipe Mantilla Hernández
Keyword(s):  
Odontoid Process ◽  
Clinical History ◽  
Calcium Pyrophosphate ◽  
Cervical Pain ◽  
Crystal Deposition ◽  
Crystal Deposition Disease ◽  
Calcium Pyrophosphate Dehydrate ◽  
Deposition Disease ◽  
Crowned Dens Syndrome ◽  
Unnecessary Procedures

The calcium pyrophosphate dehydrate (CPPD) or hydroxyapatite (HA) crystal deposition disease can appear in any joint and the accumulation fo crystals in the cervical spine may be painful. Crowned dens syndrome is a rare clinical condition that involves crown-like calcification of the ligaments around the odontoid process. A 70-year-old man presented cervical pain, fever and a headache for over a week, therefore, a neurological condition was suspected. A CT scan revealed lentiform calcifications of the transverse ligament of the atlas. Steroid treatment and a non-steroidal anti-inflammatory diminished the symptoms. A proper clinical history and imaging studies avoid unnecessary procedures and makes it possible to include this entity as a differential diagnosis in acute cervical pain. Key words: Crystal deposition disease; acute cervical pain; crowned dens syndrome; Odontoid process

scholarly journals Crowned dens syndrome presenting as pyrexia of unknown origin (PUO)

2019 ◽  
Vol 57 (3) ◽  
pp. 266-269
Author(s):  
Agam Bansal ◽  
Mohit Gupta
Keyword(s):  
Elderly Patient ◽  
Neck Pain ◽  
Clinical Presentation ◽  
Odontoid Process ◽  
Unknown Origin ◽  
Calcium Pyrophosphate ◽  
X Ray ◽  
Recent Onset ◽  
Pyrexia Of Unknown Origin ◽  
Crowned Dens Syndrome

Abstract Background. Deposition of calcium pyrophosphate crystals in the cervical spine around the odontoid process may lead to neck pain and fever. This condition is called crowned dens syndrome (CDS). Case report. An 89-year-old female presented with complaints of fever for one-month duration and recent onset neck pain. During her admission, she developed right knee pain with evidence of chondrocalcinosis on X-ray. Considering her clinical presentation in setting of pseudogout, she had a CT scan of her neck that revealed erosion of the dens and hyperdense soft tissue surrounding the odontoid process. Based on her clinical and radiologic presentation, she was diagnosed with crowned dens syndrome and started on NSAIDs. Unfortunately, she did not respond to NSAIDs and was switched to Colchicine, which resulted in immediate improvement in her symptoms. Conclusions. We present this case to stress the importance of keeping crowned dens syndrome as one of the differentials in an elderly patient presenting with fever and neck pain.

scholarly journals Pilot Study of Acupuncture’s Antispasmodic Effect on Upper Gastrointestinal Tract during Endoscopic Submucosal Dissection for Early Gastric Cancer: Controlled Clinical Trial

2021 ◽  
Vol 10 (14) ◽  
pp. 3050
Author(s):  
Masao Suzuki ◽  
Naoto Ishizaki ◽  
Takumi Kayo ◽  
Taiga Furuta ◽  
Ryo Igarashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastrointestinal Tract ◽  
Endoscopic Submucosal Dissection ◽  
Controlled Trial ◽  
Upper Gastrointestinal Tract ◽  
Controlled Clinical Trial ◽  
Whitney Test ◽  
Submucosal Dissection ◽  
Mann Whitney Test ◽  
Upper Gastrointestinal

A prospective study was conducted in patients with early-stage gastric cancer to determine the efficacy and safety of acupuncture stimulation as an antispasmodic compared with conventional medication during the procedure of endoscopic submucosal dissection (ESD) of the upper gastrointestinal tract. This study was a prospective single blinded quasi-randomized controlled trial. Seventy-three patients who were scheduled to undergo ESD for gastric cancer at Aizu Medical Center between 19 February 2016 and 30 June 2016 were assessed for eligibility for the study. Sixty out of 73 patients were included in the study and assigned into two intervention groups: medication group (MG) and acupuncture group (AG). Ease of the procedure was evaluated using modified NIWA classification (MNC) by endoscopist considering the frequency and amplitude of the upper gastrointestinal peristalsis. For the statistical analysis, Mann–Whitney test was used to compare the differences of MNC values (baseline and end of procedure) between two groups. The difference of MNC found in the AG (−2.00 (−3.0 to −2.0)) was significantly greater than that in the MG (−1.00 (−2.0 to −1.0), p < 0.0001, Mann–Whitney test). We consider that acupuncture to the abdomen could be an alternative antispasmodic method during upper gastrointestinal endoscopic procedure.

Rebleeding in patients with delayed bleeding after endoscopic submucosal dissection for early gastric cancer

2021 ◽  
Author(s):  
Minami Hashimoto ◽  
Waku Hatta ◽  
Yosuke Tsuji ◽  
Toshiyuki Yoshio ◽  
Yohei Yabuuchi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Delayed Bleeding ◽  
Submucosal Dissection

Recurrence of gastric cancer caused by implantation of tumor cells after curative endoscopic submucosal dissection

2021 ◽  
Author(s):  
Michiko Nakaoka ◽  
Tetsuo Nemoto ◽  
Hideyuki Chiba ◽  
Naoya Okada ◽  
Jun Tachikawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Tumor Cells ◽  
Submucosal Dissection
Sign in / Sign up

Export Citation Format

Share Document