Τετάρτη 26 Σεπτεμβρίου 2018

Clinical improvement in a patient with monostotic melorheostosis after treatment with denosumab: a case report

A 20-year-old Danish woman with melorheostosis in her right femoral shaft and disabling pain in the affected area, whose symptoms did not in the long term respond to zoledronic acid, experienced continuous rem...

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Spontaneous asymptomatic rupture of pseudocyst into stomach

Description 

A 27-year-old woman presented with complaints of pain in the epigastric region radiating to back for 20 days. She was treated initially at local hospital and was diagnosed as acute pancreatitis as her amylase and lipase levels were >1000 U/mL. She was managed with analgesics and intravenous fluids and was discharged in 4 days. She then presented to our emergency, with complaints of epigastric pain, awareness of lump in the epigastric region and non-passage of stool or flatus for past 3 days. She also gave history of fever and multiple episodes of bilious vomiting. Patient denied previous history of similar episodes in past and is non-alcoholic. On abdominal examination, a lump of size 20x15 cm was palpable in the epigastric region extending into the umbilical region. On ultrasonogram abdomen, a cystic swelling was seen along with multiple gall stones in the gall bladder. Contrast-enhanced CT (CECT) abdomen was suggestive of a large cystic...



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Primary retroperitoneal filariasis: a common disease of tropics with uncommon presentation and review of literature

Lymphatic filariasis is caused by nematode filariae Wuchereria bancrofti, Brugia malayi or Brugia timori. It is commonly seen in tropical and subtropical regions of the world and affects the lymphatic system of humans, who are the definitive host while mosquito is the intermediate host. The most common manifestation of the disease is hydrocele followed by lower limb lymphoedema and elephantiasis. Although filariasis is much more common entity in north India, its presentation as retroperitoneal cyst is very rare with reported incidence rate of 1/105 000. We present a case of primary retroperitoneal filariasis in a 52-year-old man, without any classic signsandsymptoms, diagnosed postoperatively after surgical resection following diagnostic uncertaintyandfailure of other medical therapies.



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Gossypiboma: a ghastly find

A gossypiboma is a mass within a patient's body comprising a cotton matrix surrounded by a foreign body granuloma. We describe an unusual presentation of a gossypiboma presenting in a 32-year-old man with acute epigastric pain and haematemesis. His surgical history revealed an emergency laparotomy following a road traffic accident 16 years ago. Initial gastroscopy showed extrinsic stomach compression. An abdominal ultrasound scan followed by a CT scan evidenced a large, well-defined, predominantly cystic mass with some solid areas occupying the left hypochondrium. Conservative management with insertion of a percutaneous drain proved to be inefficient. A laparotomy was performed; intraoperatively, the cyst was found to be ruptured and within it, a large surgical gauze was found. This was removed but required a distal pancreatectomy and gastrectomy for complete excision. He was discharged on day 74 of admission with outpatient follow-up.



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Primary renal diffuse large B-Cell lymphoma causing haemodialysis-dependent nephromegaly in a child

A 4-year-old boy presented with fatigue and was found to have severe kidney injury requiring haemodialysis. A renal ultrasound demonstrated bilateral nephromegaly with mild loss of corticomedullary differentiation but preserved echogenicity. He had a persistent isolated monocytosis. Renal biopsy revealed extensive infiltration by primary renal diffuse large B-cell lymphoma. He required haemodialysis for 18 days and received chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisone, rituximab and intrathecal methotrexate. He achieved remission with an estimated glomerular filtration rate of 50 mL/min/1.73 m2, and his kidneys returned to normal size. Nephromegaly due to renal-limited haematolymphoid disease is extremely rare, especially in children.



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Congenital Granular Cell Tumor: Case Report and Review

Congenital granular cell tumors are infrequently occurring masses occurring on a neonate's gingiva/alveolus. These lesions are benign with no noted malignant transformation, and treatment of excision is based on its effect on the neonate's respiratory ability and/or nutritional intake. The purpose of this review is to discuss a case of a congenital granular cell tumor and its treatment and review of the literature including demographics, histopathology, and operative treatment.

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Use of a qualitative case study to learn lessons from severe preeclampsia causing a maternal near-miss: a case report

Maternal mortality is a critical indicator in assessing the quality of services provided by a health care system. Approximately 99% of all maternal deaths occur in developing countries; where a majority of the...

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