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BMJ Case Reports

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https://www.readbyqxmd.com/read/28647717/a-large-choledochocystolithiasis-mimicking-mirizzi-syndrome
#1
Mustafa Belal Hafeez Chaudhry, Muhammad Azeemuddin, Muhammad Rizwan Khan, Om Parkash
An 18-year-old man presented with spontaneous severe epigastric pain, progressing and radiating to back since 3 days. It was associated with epigastric tenderness, bilious vomiting and jaundice. He had been intermittently experiencing these symptoms for the last 1 year. No known comorbid. Ultrasound showed a poorly visualised heterogeneous focus at porta hepatis; considering poor visualisation, this might represent an enlarged calcified lymph node or cystic duct calculus causing extrinsic compression or a large sludge ball within the common bile duct (CBD), leading to dilatation of common hepatic duct and intrahepatic biliary system...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647716/bilateral-recurrent-pyosalpinx-in-a-sexually-inactive-12-year-old-girl-secondary-to-rare-variant-of-mullerian-duct-anomaly
#2
Tareq Maraqa, Mohamed Mohamed, Daniel Coffey, Gul R Sachwani-Daswani, Crystal Alvarez, Leo Mercer
Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.(1 2) Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.(3) We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647713/microcephaly-in-infantile-sandhoff-s-disease
#3
Kaushik Maulik, Santhosh Kumar, Paramjeet Singh, Arushi Gahlot Saini
No abstract text is available yet for this article.
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647712/disseminated-histoplasmosis-in-a-patient-with-hiv-diagnosed-by-simple-bedside-investigations
#4
Pongsakorn Buraphat, Wannarat Pongpirul, Patama Suttha
No abstract text is available yet for this article.
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647711/down-syndrome-and-moyamoya-disease-unusual-cause-of-stroke
#5
Carlos Tavares Bello, Catarina Barreiros, Inês Gil, Carlos Vasconcelos
Down syndrome is a frequent clinical entity, being considered one of the most frequent chromosomal aberrations. It is characterised by a typical clinical phenotype and is associated with a heterogeneous group of organ and system-specific abnormalities. The cardiovascular system is commonly affected and if so, it may be associated with an increased morbidity and mortality. Cerebrovascular events in patients with Down syndrome are multifactorial, being possibly related to congenital heart disease, vascular malformations and traditional cardiovascular risk factors...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647710/perforated-duodenal-diverticulum-a-rare-complication-in-a-common-condition
#6
Cláudio Branco, Teresa Carneiro, Dina Luis, António Gomes
The authors present a rare case of perforated duodenal diverticulum diagnosed in an 80-year-old Caucasian woman with vomiting and abdominal pain localised to the epigastrium. CT scan showed thickening of the second portion of the duodenum with retroperitoneal fat stranding and perihepatic free fluid, with a presumptive diagnosis of a duodenal perforation. A laparotomy was performed which showed a perforated diverticulum in the second portion of the duodenum. A diverticulectomy with single-layer closure was performed, without complications...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645906/an-umbilical-bleeding-nodule
#7
Hemal Shah, Salvador Diaz-Cano, Lucia Pozo-Garcia
No abstract text is available yet for this article.
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645905/obesity-related-hypogonadism-a-reversible-condition
#8
Stamatios Zouras, Jeffrey W Stephens, David Price
Obesity is associated with hypogonadism. While this association is widely accepted, the underlying mechanisms remain unclear. Furthermore, obesity is a risk factor for hypogonadism and conversely hypogonadism may be a risk factor for obesity. We present the case of a morbidly obese man aged 30 years with hypogonadotrophic hypogonadism that underwent a Roux-en-Y gastric bypass operation. Following the surgical treatment of his obesity, the testosterone level returned to normal with improvements in hypogonadal symptoms, which allowed discontinuation of exogenous testosterone therapy...
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645904/intra-articular-lipoma-of-the-hip
#9
Anthony J Mells, G Max Gosey, Michael P Muldoon
Intra-articular lipoma of the hip is a rare entity, with only two reports published in the English-language literature. We present a case of successful arthroscopic resection of an intra-articular peripheral compartment lipoma in a 69-year-old woman with a coincident labral tear. This woman presented with left hip pain that developed gradually over 2 years and increased over 2 months. MRI showed a fat-intense mass in the anterior aspect of the hip joint, convincing for intra-articular lipoma. Physical examination in the operating room reproduced decreased range of motion and evidence of impingement but with a soft endpoint...
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645903/an-unusual-case-of-abdominal-pains
#10
Muhammad Hassan Tahir, Mohammad Y Ibrahim, Naresh Kumar, Vinuta Mohan
No abstract text is available yet for this article.
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645902/the-cause-of-the-stroke-a-diagnostic-uncertainty
#11
Abhishek Dattani, Ava Jackson
A 39-year-old man with a history of sickle cell disease (SCD) presented with left leg weakness. He had a normal CT head and CT angiogram, but MRI head showed multiple acute bilateral cortical infarcts including in the right precentral gyrus. The MRI findings were more in keeping with an embolic source rather than stroke related to SCD, although it could not be ruled out. He also had an echocardiogram which revealed a patent foramen ovale. He was treated with antiplatelet therapy and also had red blood cell exchange transfusion...
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645901/antenatal-thoracoamniotic-shunting-in-congenital-cystic-adenomatoid-malformation
#12
Terry Cullen, Clare Tower, Kristin Tanney
No abstract text is available yet for this article.
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645926/nasopharyngeal-glial-heterotopia-with-delayed-postoperative-meningitis
#13
Kenichi Maeda, Kenji Furuno, Pin Fee Chong, Takato Morioka
A male infant, who underwent radical resection of a large glial heterotopia at the nasopharynx at 8 days, developed delayed postoperative bacterial meningitis at 9 months. Neuroradiological examination clearly demonstrated that meningitis had occurred because of the intracranial and extracranial connections, which were scarcely seen in the perioperative period. A transsphenoidal extension of hypothalamic hamartoma is possible because the connection started from the right optic nerve, running through the transsphenoidal canal in the sphenoid bone and terminating at the recurrent mass in the nasopharyngeal region...
June 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645925/strangulated-gastric-prolapse-through-a-gastrostomy-site-requiring-emergent-partial-gastrectomy
#14
Shepard Peir Johnson, Benjamin Roose, Mary-Margaret Brandt, Harry Linne Anderson
Strangulated gastric prolapse through a percutaneous endoscopic gastrostomy tract is a rare and potentially life-threatening complication that requires surgical intervention. We describe a case of a 74-year-old woman who was debilitated and ventilator-dependent and who presented with acute gastric prolapse with resultant ischaemic necrosis. The patient underwent an emergent exploratory laparotomy, partial gastrectomy, repair of gastrostomy defect and placement of a gastrojejunostomy feeding tube remote to the previous location...
June 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645924/anterior-abdominal-wall-extraosseous-osteosarcoma-occurring-40-years-after-para-aortic-irradiation
#15
Muhammad Furrukh, Asim Qureshi, Nadira Mamoon, Menahil Fatima
Extraskeletal osteosarcomas (OSs) are highly malignant soft tissue tumours associated with a poor prognosis. Only a few records of these rare aggressive neoplasms have been reported in the literature.We describe the case of a 49-year-old man, who presented to our tertiary care centre with a painful isolated lump around the umbilicus. After surgical biopsy, imaging and subsequent pathological analysis, the swelling was diagnosed to be a localised extraskeletal OS. He received previous radiation as treatment for testicular seminoma 40 years ago, which has been in remission ever since...
June 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645923/the-connection-between-acute-otitis-media-and-the-acute-abdomen
#16
Imran Masood, Tami Hendriksz
A female aged 9 years with a recent episode of acute otitis media (AOM) presented to her primary care physician with complaints of severe abdominal pain with right lower quadrant rebound tenderness, suggestive of an acute surgical abdomen. Neurological examination was normal on presentation. She was transferred to the local children's hospital for workup of appendicitis, during which she began exhibiting ataxia and slurred speech. Further evaluation revealed mastoiditis, venous sinus thrombosis and subdural empyema...
June 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645922/management-of-high-grade-dysplasia-of-the-cystic-duct-after-cholecystectomy
#17
Maitham A Moslim, Andrew Tang, Gareth Morris-Stiff
High-grade dysplasia (HGD) of the cystic duct margin without evidence of concurrent malignancy is a rare occurrence. We present a case of a 36-year-old woman who developed gallstone pancreatitis and subsequently underwent a laparoscopic cholecystectomy. On histopathology, she was found to have HGD at the cystic duct margin. Following evaluation, she underwent excision of the cystic duct remnant with no malignancy being present on final pathology. We present this case to discuss the management of cystic duct dysplasia in the absence of gallbladder malignancy...
June 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28637785/surgical-emergency-rupture-of-infected-brachial-artery-pseudoaneurysm
#18
Derek Lim, David Parizh, Vadim Meytes, Anthony Kopatsis
No abstract text is available yet for this article.
June 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28637846/superior-mesenteric-artery-syndrome-in-a-healthy-adolescent
#19
Kentaro Kogawa, Yoshiki Kusama
No abstract text is available yet for this article.
June 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28637845/successful-conservative-management-of-a-permanent-pacemaker-pocket-infection-a-less-invasive-approach
#20
Alexander James Keeley, Daniel Hammersley, Madhava Dissanayake
We present a successful conservative management strategy for a frail elderly patient with a cardiac resynchronisation pacemaker who presented with evidence of an Enterobacter cloacae pacemaker pocket infection. A device washout and debridement procedure was performed, with reburial of the device in a new prepectoral pocket and creation of a closed-loop continuous antibiotic infusion into the infected pacemaker pocket. This was followed by a 6-week course of ambulatory intravenous antibiotic therapy. This conservative management strategy avoided the need for a more invasive and high-risk full device extraction, which the patient clearly stated he did not wish to have...
June 20, 2017: BMJ Case Reports
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