Continuous infusion of lipo-prostaglandin E1 for Takayasu’s arteritis with heart failure in an 11-month-old baby: a case report

Takayasu's arteritis is extremely rare in children aged below 6 years. At the onset of Takayasu's arteritis in children, symptoms are varied but differ from those in adults. Corticosteroids are the mainstay of...

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Pediatric lung adenocarcinoma presenting with brain metastasis: a case report

Diagnosis and treatment of primary lung adenocarcinoma in children remains challenging given its rarity. Here we highlight the clinical history, pathological evaluation, genomic findings, and management of a v...

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Rare association of tetralogy of Fallot with absent pulmonary valve syndrome with anomalous origin of right pulmonary artery from ascending aorta

Description 

A 2-month-old boy presented to the paediatric cardiology department with cyanosis and feeding difficulties. Chest radiograph revealed cardiomegaly, right-sided aortic knuckle and dilated pulmonary artery segment along with mild indentation on the lower trachea and diffusely narrowed left main bronchus (figure 1A). A diagnosis of tetralogy of Fallot (TOF) with absent pulmonary valve syndrome was made on transthoracic echocardiogram; however, origin of right pulmonary artery (RPA) was not well visualised. The patient further underwent CT angiography (CTA) to delineate the cardiac as well as any extracardiac abnormalities.

Figure 1

Frontal chest radiograph (A) reveals cardiomegaly, right-sided aortic knuckle and dilated pulmonary artery segment along with mild indentation on the lower trachea and diffusely narrowed left main bronchus. Sagittal oblique maximum intensity projection (B) shows presence of features of tetralogy of Fallot, that is, right ventricular hypertrophy, perimembranous ventricular septal defect and pulmonary annular stenosis....

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Non-operative management, supported by self-monitoring using web-based patient reported outcome measures (PROMs), in knee osteoarthritis

Despite being straightforward to collect and key to providing patient-centred, individualised care, the routine use of patient reported outcome measures (PROMs) remains limited in the National Health Service. Herein is described the case of a 69-year-old woman who presented to secondary care with osteoarthritis. Web-based PROMs were used to track the patient's symptoms and function. Lifestyle changes were recommended to manage the osteoarthritis. Monitoring enabled the patient to take control of her disease management. Two years later, she continues to manage her knee symptoms conservatively, recording progress by using a web-based system. This case illustrates how web-based PROMs can be used to support conservative management of knee osteoarthritis by both empowering patients and minimising the burden on secondary care outpatient services.

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New endoscopic technique for retrieval of large colonic foreign bodies and an endoscopy-oriented review of the literature

Colorectal foreign bodies (FB) are challenging issues for the endoscopist especially if the mostly used methods (polypectomy snare, biopsy forceps or wire-guided 40 mm dilation balloon) failed. We report a case of a 31-year-old man who was admitted in the emergency department for the impaction of a 60 cm long and large-size FB in the sigmoid colon. We failed to remove the FB using several different standard technique because of the rigidity, the smoothness and the size of the object. After all these attempts, we built up a 'home-made' device inserting a 0.035 inch non-hydrophilic guidewire (Metro WireGuide, Cook Medical) doubled into an 8.5 Fr stent-pusher-catheter (Cook Medical) serving as an outer sheet in order to create a noose and we finally succeeded in the endoscopic extraction of the device. We suggest this new technique as a valid option to remove large FBs from the colon and rectum when standard endoscopic methods for FB's extraction fail.

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Acute regrowth and dissemination of a mature spinal cord teratoma after partial resection

A 23-year-old man presented with difficulty walking and leg pain and numbness. MRI revealed a cystic mass at Th11–12 and a pineal-region tumour. The patient underwent surgery to resect the thoracic-level mass. The tumour adhered strongly to the neural tissue and could only be partially resected. On pathological examination, the resected tumour was diagnosed as a mature teratoma. The tumour regrew and disseminated within 3 months after resection. Both the spinal cord tumour and the tumour in the pineal region shrank significantly after chemotherapy and radiotherapy. Although the tumour was pathologically diagnosed as a mature teratoma, we suspect that the residual tumour contained an immature or malignant component. Thus, careful follow-up observation is mandatory after partial resection of a mature teratoma. In addition, because teratomas can disseminate in the central nervous system, the presence of teratoma should prompt an examination of both the spinal cord and brain.

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Correction: Spontaneous ovarian heterotopic pregnancy

Stanley R, Nair A, Fiallo F. Spontaneous ovarian heterotopic pregnancy. BMJ Case Rep 2018.doi: 10.1136/bcr-2018-225619 [Epub ahead of print 9 Aug 2018].

This article contains an error in the authors list. The correct order of authors is:

Russell Stanley, Francisco Fiallo, and Anjana Nair.

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