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Clinical Case Reports

Dimitrios Bobos, Meletios A Kanakis, Sofia Koulouri, Spyridon Rammos, Andreas Karabinis, Nicholas M Giannopoulos
Central venoarterial (VA) placement of extracorporeal membrane oxygenation (ECMO) is performed surgically, and in the majority of cases, the patient remains with an open sternum. Herein, a case of a 3-year-old patient who underwent insertion of a central VA ECMO for heart failure due to acute myocarditis is described. An alternative technique for ECMO placement providing sternal closure and minimizing infection risk for the safe patient transport is described.
May 2017: Clinical Case Reports
Andrew C Chatzis, Joanne Sofianidou, Theofili Kousi, Olga Karapanagiotou, Meletios A Kanakis
Although many variations regarding lobar or segmental bronchial subdivisions have been described, abnormal bronchi originating from the trachea or main bronchi are relatively rare. These abnormalities can remain undetectable as they usually do not present with symptoms; however, they may pose major obstacles during surgery especially when accompanied by bronchial wall abnormalities.
May 2017: Clinical Case Reports
Satoshi Fujisawa, Fumio Otsuka
Osteoarthritis of the manubriosternal joint can be found in patients with inflammatory arthritis. Acromegalic arthropathy is often found in the shoulders, wrists, knees, hips, and spine; however, attention should also be given to sternalgia as a complication of acromegalic involvement of the manubriosternal joint.
May 2017: Clinical Case Reports
Akira Baba, Yumi Okuyama, Takeo Shibui, Hiroya Ojiri
It is important for the dentists to make accurate diagnosis and appropriate treatment of odontogenic cutaneous fistula. Although large facial skin lesions may bring up malignancy on top of the differential list, careful evaluation including physical observation, imaging, and pathology can rule out malignancies.
May 2017: Clinical Case Reports
Suneed Kumar
Inadvertent spillage of gall stones is a rare yet important cause of delayed postcholecystectomy complications. Varied presentations and difficulty in diagnosis are the hallmarks, making it crucial to have a high index of suspicion to detect and intervene appropriately. Peritoneo-cutaneous fistulae from the retained stone can be completely excised in toto.
May 2017: Clinical Case Reports
Kiyoshi Shikino, Takako Masuyama, Tomoko Yamashita, Masatomi Ikusaka
Allergic contact dermatitis (ACD) is one of the common causes of facial swelling. Clinical clues for diagnosing ACD include a rash that spares the area behind the ears, nasolabial folds, and under the chin. Once clinicians suspect ACD, the substances that cause contact dermatitis should be avoided.
May 2017: Clinical Case Reports
Ashwin Subramaniam, Adrian Pick, Ravi Tiruvoipati
Spinal infarction is a rare and devastating complication of open-heart surgery, especially in the context of perioperative hemodynamic instability in patients requiring high dose of inotropes and vasoconstrictors. Our report highlights that spinal infarction can occur in such circumstances following a valve replacement surgery.
May 2017: Clinical Case Reports
Taku Koyama, Yoritaka Otsuka, Masaaki Kawahara, Yuki Imoto, Keita Nakamura, Sunao Kodama, Hiroo Noguchi
We describe a case of atrial fibrillation in which an intracardiac thrombus that could not be prevented with "low-dose" dabigatran treatment was resolved by switching to apixaban treatment. Thrombolysis using direct oral anticoagulants (DOACs) could be a therapeutic option for patients with intracardiac thrombi, although the efficacies of different DOACs seem to differ and need further examination.
May 2017: Clinical Case Reports
Stephen Palmquist, Benji Mathews
A 42-year-old woman presents with abdominal pain after taking her first dose of lisinopril. Visceral angioedema was diagnosed based on clinical suspicion and abdominal computed tomography (CT). Awareness of this rare side effect of a common medication is key to avoid delays in diagnosis and unnecessary procedures.
May 2017: Clinical Case Reports
Tomaz Crochemore, Flavia Nunes Dias Campos, Camila Menezes Souza Pessoa, Leonardo Lima Rocha, Pedro Paulo Zanella do Amaral Campos, Thiago Domingos Corrêa
Approximately 25-50% of septic patients develop disseminated intravascular coagulation. The thromboelastometry evaluates whole blood clot formation and dissolution in real time and has been considered for management of bleeding in diverse clinical conditions. We present a case of thromboelastometry-guided bleeding management of a septic shock patient with overt disseminated intravascular coagulation (DIC).
May 2017: Clinical Case Reports
Toshihiko Matsuo, Osamu Yamasaki
A patient with metastatic cutaneous malignant melanoma developed Vogt-Koyanagi-Harada disease-like posterior uveitis after two nivolumab (anti-PD-1 antibody) injections. Vogt-Koyanagi-Harada disease, with the background of autoimmunity against choroidal melanocytes, suggests nivolumab be working by disintegrating inhibition circuit of T cells against a common epitope shared between melanoma cells and normal melanocytes.
May 2017: Clinical Case Reports
Shun Yamaguchi, Kengo Kanetaka, Shinichiro Kobayashi, Yasuhiro Nagata, Naoe Kinosita, Junya Fukuoka, Shunsuke Murakami, Fumihiko Fujita, Mitsuhisa Takatsuki, Susumu Eguchi
There are very few reports of esophageal carcinoma producing granulocyte colony-stimulating factor (G-CSF). G-CSF-producing esophageal squamous cell carcinoma is an extremely aggressive carcinoma. Leukocyte counts, neutrophil counts, and serum C-reactive protein levels may be markers of its progression.
May 2017: Clinical Case Reports
Mina Fukai, Tetsu Hirosawa, Hideo Nakatani, Tomoko Muramatsu, Mitsuru Kikuchi, Yoshio Minabe
Ammonium acid urate urolithiasis is a quite rare condition. Our literature review of ammonium acid urate urolithiasis suggests that ammonium acid urate urolithiasis should be regarded as a general medical complication related to anorexia nervosa, and purging by laxative abuse might be a crucially important risk.
May 2017: Clinical Case Reports
Patric Blomstedt, Matilda Naesström, Owe Bodlund
Deep brain stimulation (DBS) may be considered in severe cases of therapy-refractory major depressive disorder (MDD). However, DBS for MDD is still an experimental therapy. Therefore, it should only be administered in clinical studies driven by multidisciplinary teams, including surgeons with substantial experience of DBS in the treatment of other conditions.
May 2017: Clinical Case Reports
John Zade, Abdulhadi Jfri, Adam Nabatian, Abdullah Alajaji, Lauren Geller, Hooman Khorasani
Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare eccrine hamartoma, with treatment generally being unsatisfactory. The unique features of PEODDN presented include bilateral and facial lesions, and extensive body involvement. Management with CO2 laser was successful, and follow-up will be necessary to monitor for recurrent lesions.
May 2017: Clinical Case Reports
Abdul S Parwani, Anna I Schröder, Daniela Blaschke, Florian Blaschke, Martin Huemer, Philipp Attanasio, Burkert Pieske, Leif-Hendrik Boldt, Wilhelm Haverkamp
A patient developed a transient first-degree AV block during a radiofrequency ablation of an atrioventricular nodal reentrant tachycardia. Three days later the patient presented with a third-degree AV block. It resolved within 24 h under antiphlogistic therapy. Patient was asymptomatic without necessity for pacemaker implantation at 12 months follow-up.
May 2017: Clinical Case Reports
Eva Jennes, Dorothee Guggenberger, Rainer Zotz, Lora Thompson, Tim H Brümmendorf, Steffen Koschmieder, Edgar Jost
Acquired von Willebrand syndrome may be related to plasma cell dyscrasia and can cause severe bleeding complications. Treatment, for example, with intravenous immunoglobulins may be indicated in selected cases. Physicians treating plasma cell dyscrasia have to be aware of bleeding complications in these patients, and clarification is necessary.
May 2017: Clinical Case Reports
Alexandre Hinzpeter, Marie-Pierre Reboul, Isabelle Callebaut, Cécile Zordan, Bruno Costes, Julie Guichoux, Albert Iron, Didier Lacombe, Natacha Martin, Benoit Arveiler, Pascale Fanen, Patricia Fergelot, Emmanuelle Girodon
In vitro functional tests aimed to investigate CFTR dysfunction appear critical to help elucidate the functional impact of new variants of uncertain clinical significance and solve inconclusive cases, especially in early deceased newborns.
May 2017: Clinical Case Reports
Takashi Shirobe, Hideyuki Kawakami, Sadanori Abe, Tomoki Yokochi
Retroperitoneal perforation of duodenal diverticula around the papilla of Vater is relatively rare. In this report, we describe retroperitoneal abscess, which was successfully treated by endoscopic drainage. Thus, endoscopic approach for retroperitoneal perforation caused by diverticulum is one of the treatment options in addition to surgery.
May 2017: Clinical Case Reports
Aya Furuya, Masahiro Kawahara, Mina Kumode, Yasuyuki Ohira, Asako Usui, Shiho Nagai, Sakura Hosoba, Hitoshi Minamiguchi, Katsuyuki Kito, Akira Andoh
Central nervous system (CNS) involvement of acute promyelocytic leukemia (APL) causes poor prognosis. Our three cases show that CNS can be involved at the first hematological recurrence, but predicting this is difficult. Triple intrathecal treatment and craniospinal irradiation were effective, while arsenic oxide failed to prevent and improve CNS involvement.
May 2017: Clinical Case Reports
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