scholarly journals Non-Surgical Management of Bilateral Adrenal Abscess in Neonates: Report of Two Cases

2017 ◽  
Vol 6 (2) ◽  
pp. 31 ◽  
Author(s):  
Ankur Mandelia ◽  
J S Kishore ◽  
Rajnikant Yadav ◽  
Richa Lal
Keyword(s):  
Surgical Management ◽  
Percutaneous Drainage ◽  
Medical Literature ◽  
Fatal Outcome ◽  
Adrenal Hemorrhage ◽  
Ultrasound Guided ◽  
Meconium Aspiration ◽  
Intravenous Antibiotics ◽  
History Of ◽  
Adrenal Abscess

Adrenal hemorrhage is not uncommon in neonates but the development of an adrenal abscess is extremely rare. Bilateral adrenal abscess is even rarer with less than ten cases documented in the medical literature. It may have a fatal outcome if inadequately treated. Here, we present two cases of neonates with history of obstructed labour and meconium aspiration who presented with bilateral adrenal abscesses. The abscesses were successfully treated using ultrasound-guided percutaneous drainage along with administration of appropriate intravenous antibiotics.

scholarly journals Current Controversies in the Management of Diverticulitis: A Review

2018 ◽  
Vol 36 (3) ◽  
pp. 195-205 ◽  
Author(s):  
Deirdre M. Nally ◽  
Dara O. Kavanagh
Keyword(s):  
Surgical Management ◽  
Acute Diverticulitis ◽  
Contemporary Literature ◽  
Management Strategies ◽  
Evidence Based ◽  
Treatment Results ◽  
High Profile ◽  
Intravenous Antibiotics ◽  
History Of ◽  
Symptom Progression

Background: Symptomatic diverticular disease is challenging for patients, clinicians and health services. The prevalence increases with age and BMI and as such, the burden of this disease is set to increase with higher rates of acute presentations already documented. The natural history of recurrent episodes, complications and symptom progression is not fully understood. Furthermore, medical and surgical management strategies are under constant appraisal, debate and evolution. Methods: A review of the contemporary literature was performed to examine the emerging trend towards conservative treatment. Results: Routine use of in-patient, intravenous antibiotics may not be required and outpatient management is possible for certain patients. Universal colonoscopy examination after uncomplicated acute diverticulitis is controversial but is mandatory after complicated episodes. Recent, high-profile, clinical trials suggest that less aggressive surgical management of both acute and chronic presentations may be feasible in some cases. Conclusions: Diverticulitis is a common yet challenging topic that demands clinicians to provide an individualised yet evidence-based approach.

Adenoid Cystic Carcinoma of Lacrimal Gland

JMS SKIMS ◽  
2012 ◽  
Vol 15 (1) ◽  
pp. 76-77
Author(s):  
Mohd Athar ◽  
K S Sodhi ◽  
S Kala ◽  
R K Maurya ◽  
S Chauhan ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Natural History ◽  
Adenoid Cystic Carcinoma ◽  
Salivary Glands ◽  
Hard Palate ◽  
Clinical Course ◽  
Fatal Outcome ◽  
Minor Salivary Glands ◽  
Adenoid Cystic ◽  
History Of

Adenoid cystic carcinoma is a relatively uncommon tumour of salivary, glands and is characterised by a prolonged clinical course and a fatal outcome. It was first described as `cylindroma' by Billroth in 1859. Half of these tumors occur in glandular tissues other than the major salivary glands; principally in the hard palate, but they can also arise in the tongue and minor salivary glands. Unusual locations include the external auditory canal, nasopharynx, lacrimal glands, breast, vulva, esophagus, cervix and Cowper glands. The long natural history of this tumor and its tendency for local recurrence are well known. JMS 2012;15(1):76-77.

Surgical management of choke through oesophagotomy in a buffalo: A case report

2017 ◽  
Vol 12 (3) ◽  
Author(s):  
Devasee Borakhatariya ◽  
A. B. Gadara
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Thoracic Inlet ◽  
Cervical Oesophagus ◽  
Foreign Objects ◽  
History Of ◽  
Oesophageal Obstruction ◽  
Large Animals

Oesophageal disorders are relatively uncommon in large animals. Oesophageal obstruction is the most frequently encountered clinical presentation in bovine and it may be intraluminal or extra luminal (Haven, 1990). Intraluminal obstruction or “choke” is the most common abnormality that usually occurs when foreign objects, large feedstuff, medicated boluses, trichobezoars, or oesophageal granuloma lodge in the lumen of the oesophagus. Oesophageal obstructions in bovine commonly occur at the pharynx, the cranial aspect of the cervical oesophagus, the thoracic inlet, or the base of the heart (Choudhary et al., 2010). Diagnosis of such problem depends on the history of eating particular foodstuff and clinical signs as bloat, tenesmus, retching, and salivation

Occurrence of seromucinous borderline tumours in the peritoneal lesions after bilateral salpingo-oophorectomy

2020 ◽  
Vol 13 (12) ◽  
pp. e234692
Author(s):  
Taihei Yamada ◽  
Satoko Eguchi ◽  
Ikuko Yokoo ◽  
Takahide Arimoto
Keyword(s):  
Malignant Transformation ◽  
Surgical Management ◽  
Previous History ◽  
Cancer Antigen ◽  
History Of

A 65-year-old woman with a previous history of bilateral salpingo-oophorectomy had peritoneal cysts, increasing in size over 15 years and an increasing cancer antigen 19–9 (CA 19–9) level. The size of the cysts eventually reached 86 mm and 70 mm. As malignant transformation of endometriosis was suspected, we performed peritoneal cystectomy and hysterectomy. Histopathology revealed seromucinous borderline tumours (SMBTs) derived from endometriosis. One month after surgery, her CA 19-9 level had decreased. It is rare for SMBT to occur after bilateral salpingo-oophorectomy; surgical management is the best treatment at present.

scholarly journals Scopolamine fatal outcome in an inmate after buscopan® smoking

2021 ◽  
Author(s):  
Sabina Strano-Rossi ◽  
Serena Mestria ◽  
Giorgio Bolino ◽  
Matteo Polacco ◽  
Simone Grassi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Drug Abuse ◽  
Muscarinic Receptors ◽  
Histopathological Examination ◽  
Fatal Outcome ◽  
Post Mortem ◽  
Butyl Bromide ◽  
Cannabis Abuse ◽  
Toxic Concentration ◽  
History Of

AbstractScopolamine is an alkaloid which acts as competitive antagonists to acetylcholine at central and peripheral muscarinic receptors. We report the case of a 41-year-old male convict with a 27-year history of cannabis abuse who suddenly died in the bed of his cell after having smoked buscopan® tablets. Since both abuse of substances and recent physical assaults had been reported, we opted for a comprehensive approach (post-mortem computed tomography CT (PMCT), full forensic autopsy, and toxicology testing) to determine which was the cause of the death. Virtopsy found significant cerebral edema and lungs edema that were confirmed at the autopsy and at the histopathological examination. Scopolamine was detected in peripheral blood at the toxic concentration of 14 ng/mL in blood and at 263 ng/mL in urine, and scopolamine butyl bromide at 17 ng/mL in blood and 90 ng/mL in urine. Quetiapine, mirtazapine, lorazepam, diazepam, and metabolites and valproate were also detected (at therapeutic concentrations). Inmates, especially when they have a history of drug abuse, are at risk to use any substance they can find for recreational purposes. In prisons, active surveillance on the management and assumption of prescribed drugs could avoid fatal acute intoxication.

scholarly journals Similar Efficacies of Endoscopic Ultrasound–guided Transmural and Percutaneous Drainage for Malignant Distal Biliary Obstruction

2016 ◽  
Vol 14 (7) ◽  
pp. 1011-1019.e3 ◽  
Author(s):  
Tae Hoon Lee ◽  
Jun-Ho Choi ◽  
Do Hyun Park ◽  
Tae Jun Song ◽  
Dong Uk Kim ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Percutaneous Drainage ◽  
Biliary Obstruction ◽  
Ultrasound Guided

scholarly journals AB0444 THROMBOTIC MICROANGIOPATHY AND SJÖGREN SYNDROME, AN UNUSUAL ASSOCIATION. PRESENTATION OF CLINICAL CASE AND SYSTEMATIC REVIEW OF THE LITERATURE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1521.2-1521
Author(s):  
Y. Santamaria ◽  
M. Galvis ◽  
A. Vanegas
Keyword(s):  
Hospital Admission ◽  
Plasma Exchange ◽  
Thrombotic Microangiopathy ◽  
Clinical Case ◽  
Medical Literature ◽  
Sjogren Syndrome ◽  
Plasma Exchange Therapy ◽  
History Of ◽  
The Mean ◽  
Intravenous Steroids

Background:Thrombotic microangiopathy (TMA) is a clinicopathologic diagnosis defined as microangiopathic hemolytic anemia (MAHA) with associated features of thrombocytopenia and end-organ ischemia. Systemic lupus erythematosus, antiphospholipid antibody syndrome, and scleroderma, are within the autoimmune diseases, the more commonly associated with TMA. It has been considered that the association with Sjögren Syndrome (SS) is rare.Objectives:To describe one patient with TMA and SS, and to review all cases reported in the literature.Methods:We notified a clinical case of a patient with Sjögren’s syndrome and TMA. Then, we searched the medical literature finding a total of 17 cases reported with this association until 2019. Before the data obtained were tabulated by trained staff and descriptive, comparing groups and bivariate analysis was performed. The outcome of interest was the death of the patient. Stata 12.0 software was used.Results:A 26-years-old Colombian female presented with a 6-week history of petechiae in lower limbs, gingivorrhagia, menorrhagia and jaundice; and previous history of arthritis and xerostomia. On admission, in the context of severe thrombocytopenia and MAHA, MAT diagnosis was made. During hospitalization we confirm the diagnosis of SS with ANA, antiRo and salivary gland biopsy. The patient was treated with steroids (methylprednisolone 500 mg/day, 3 days), plasma exchange therapy (PLEX) and Cyclophosphamide (750 mg), with recovery of hemoglobin and platelet levels; however, the patient died due to a complication of the PLEX catheter removal procedure.A total of 18 patients diagnosed with de novo or prevalent Sjögren’s syndrome who had hospital admission with a diagnosis of TMA were included. The mean age was 54.55 years (Standard deviation (SD): 12.45) and 83.33% of the patients corresponded to the female gender.At admission, the mean of hemoglobin was 8.45 g/dL (SD: 2.55) and median platelets of 27250/mm3 (interquartile range (IQR) 10500 - 102000) were found. The most frequent clinical manifestations were central nervous system alterations (50%), followed by bleeding in the skin and renal failure (44.44%) and fever (27.78%). The most frequent antibodies found were anti-Ro (100%), anti-nuclear antibodies (80%) and anti-La (75%). The most frequently prescribed treatment was plasma exchange therapy (83.33%), intravenous steroids (61.11%), oral steroids (61.11%) and cyclophosphamide (27.78%). Of the total patients, 38.89% died and 27.7% had some relapse of TMA.In the group comparison analysis, differences were found in intravenous steroid (81.82% in those who lived vs. 28.57% in those who died p=0.039), use of PLEX (100% in those who survived vs. 57.14% in those who died p = 0.043), fever (9.09% in those who survived and 57.14% in those who died, p = 0.047), admission hemoglobin (7.65 g/dL in those who lived vs. 10.22 g/dL in those who died, p = 0.05), final platelets (148,000 in which who lived and 39,000 in those who died p = 0.02). Then, in the logistic regression analysis, an association was found between mortality and use of intravenous steroids (OR: 0.08, 95% CI 0.009 - 0.83, p = 0.35) and fever at admission (OR: 13.33 95% CI: 1.04 - 169.55, p = 0.046).Conclusion:While the association between TMA and SS is uncommon, so far 18 cases have been reported in the world medical literature. It is typically a condition of women age close to 50 years. The most frequent manifestations are neurological. Among the variables evaluated, only the use of endovenous steroids was associated with a decrease in the probability of mortality; on the contrary, the presence of fever at hospital admission increased the probability of death. The results should be evaluated with caution, since, due to the limited availability of information, they may not be generalizable to clinical practice. More information on this should be obtained in the future.Disclosure of Interests:None declared

Fatal outcome of pylephlebitis treated with transhepatic percutaneous drainage

2009 ◽  
Vol 70 (1) ◽  
pp. e15-e18
Author(s):  
Anis Askri ◽  
Leila Ben Farhat ◽  
Mohamed Jarraya ◽  
Ali Rebah ◽  
Nadida Dali ◽  
...  
Keyword(s):  
Percutaneous Drainage ◽  
Fatal Outcome

Carotid artery web with fetal posterior cerebral artery variant masquerading as recurrent ipsilateral cryptogenic ischaemic strokes

2021 ◽  
Vol 14 (12) ◽  
pp. e246421
Author(s):  
Rohit Mehra ◽  
Vikram Patra ◽  
Rishi Dhillan
Keyword(s):  
Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Medical Literature ◽  
Posterior Cerebral Artery ◽  
Surgical Excision ◽  
Patch Angioplasty ◽  
History Of ◽  
Carotid Artery Endarterectomy ◽  
Multidisciplinary Teamwork

A 31-year-old woman was referred to vascular surgeons with the history of recurrent ischaemic strokes in two cerebral artery territories over a span of 1 year. On investigation, she was found to have a right internal carotid artery web, with thrombus and a fetal right posterior cerebral artery (PCA), which explained the ischaemic strokes in right middle cerebral and PCA territory. The rare association of these two infrequent entities makes the case a singular one in the medical literature. Successful surgical excision was done after multidisciplinary teamwork. The carotid web was excised as part of carotid artery endarterectomy and repaired with great saphenous vein patch angioplasty. The patient made a good recovery.

scholarly journals Neuroleptic malignant syndrome

2011 ◽  
Vol 69 (5) ◽  
pp. 751-755 ◽  
Author(s):  
Mariana Moscovich ◽  
Felipe T.M. Nóvak ◽  
Artur F. Fernandes ◽  
Tatiana Bruch ◽  
Tabita Tomelin ◽  
...  
Keyword(s):  
Adverse Event ◽  
Neuroleptic Malignant Syndrome ◽  
Fatal Outcome ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Past Medical History ◽  
History Of ◽  
High Doses ◽  
Symptoms And Signs ◽  
Gathering Data

Neuroleptic malignant syndrome (NMS) is a potentially fatal adverse event associated with the use of antipsychotics (AP). The objective of this study was to investigate the profile of cases of NMS and to compare our findings with those published in similar settings. A series of 18 consecutive patients with an established diagnosis of NMS was analyzed, gathering data on demography, symptoms and signs. Two thirds of all cases involved woman with a past medical history of psychiatric disorder receiving relatively high doses of AP. The signs and symptoms of NMS episodes were similar to those reported in other series and only one case had a fatal outcome, the remaining presenting complete recovery. As expected, more than two thirds of our cases were using classic AP (68%), however the clinical profile of these in comparison with those taking newer agent was similar. Newer AP also carry the potential for NMS.

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