We present a case of obstructive jaundice without biliary stones. This was due to a sclerotrophic gallbladder causing compression (Mirizzi’s syndrome) or adhesions to the extrahepatic biliary tree, pain and recurrent cholecystitis. The jaundice resolved following cholecystectomy. Mirizzi’s syndrome should be suspected in a patient with cholecystitis and obstructive jaundiice.
The objective of this case report is to describe the operation and use of awake ECMO without anticoagulation in a patient with a nearly completely obstructive squamous cell carcinoma of the trachea. A retrospective chart and literature review was performed in a private hospital in a large municipal area.
We describe the anaesthetic management of a 4-day-old premature infant presenting for urgent resection of a massive posterior intrapericardial teratoma. Anaesthetic challenges include anticipating cardiopulmonary collapse upon induction and hemodynamic instability associated with blood loss or tumor manipulation. Premature infants present unique challenges due to patient-to-tumor size discrepancy.
We present a rare case of ectopic pregnancy in a woman using IUD. IUD leads to mild inflammation of uterus, nearby fallopian tube and obstruction in conveyance of ovum. Suspicion of ovarian pregnancy should be considered in a woman using IUD with abdominal pain, vaginal bleeding, positive pregnancy test.
Three COVID-19 patients who were received lopinavir/ritonavir plus favipiravir got to improved without any severe adverse events. Two patients harboring high fever, severe pneumonia and respiratory failure obtained dramatic improvement. The combination therapy might be a treatment option; earlier therapy onset may have needed to avoid lung sequela.
Crecutzfeldt-Jakob disease (CJD) is a rare, fatal, and devastating neurodegenerative disease，It is not well recognized and increasingly underdiagnosed due to its variant clinical presentations. Here we report a case of probable sporadic CJD in a woman with dizziness as initial symptom and misdiagnosed as acute cerebral infarction.
Three patients with COVID-19 pneumonia received treatment with hydroxychloroquine combined with lopinavir plus ritonavir and favipiravir. Two patients early diagnosed with COVID-19 pneumonia received tocilizumab at severe pneumonia diagnosed and survived. The third patient was late diagnosed and received tocilizumab when the disease progressed to ARDS, and passed away.
Olfactory and gustatory dysfunctions are common presentations in COVID-19 patients. We present three patients who received smell and taste tests after recovery. The smell test suspected persistent impairment of olfactory function in these patients. The report proposes continued evaluation of olfactory function by a smell test in COVID-19 patients.
A giant granuloma obstructing the upper airway in a 21-year-old male is described. It arose after an extreme psychological stress. The patient underwent microlaryngoscopic removal of the granuloma, with no recurrence. This case confirms the role of psychological stress in the pathogenesis of laryngeal granulomas, that can reach huge dimensions.
Regular treatment of DKA patients includes rapid and large amount of fluids supply, which is not feasible in DKA patients associated with Uremia because of being urineless and prone to heart failure of these patinets. Our results indicated that continuous renal replacement therapy (CRRT) is a better alternative.
A 26-year-old female developed bilateral blindness after a complete remission for ALK-positive ALCL. Initial workup showed neurolymphomatosis involving the bilateral optic nerves. She underwent hematopoietic cell transplantation and she remained in complete remission after 1 year; however her vision never improved. ALCL likely led to destruction of the optic pathway.
Total anomalous pulmonary venous connection is an anomaly where the pulmonary veins are directly connected to one of the systemic veins or to the right atrium. The most common classification of this condition is by Craig, Darling and Rothney, which is based on the anatomic site of abnormal connection
Rhombencephalitis refers to inflammatory diseases of the rhombencephalon. The encephalitic processes located to the rhombencephalon are frequently associated with Listeria monocytogenes and enterovirus infections. We report a case of community-acquired Klebsiella Pneumoniae systemic infection with CNS involvement in an adult patient without significant comorbidities.
A patient with Birt-Hogg-Dubé Syndrome (BHDS) developed metastatic follicular thyroid cancer, which until now has never been described in someone with BHDS. Thyroid cancer is not currently recommended for screening with BHDS. This case presents implications for future guidelines and planning for renal transplant in patients with this condition.
A 70-year-old diabetic woman was admitted to our hospital with a complaint of high fever accompanying shaking chills for three days. The patient had no abdominal symptoms and no history of eating raw food. The patient’s body temperature was increased to 39 oC, and blood analysis showed elevations of leukocytes (17,400 /µL) and C-reactive protein (16.5 mg/dL). Computed tomography revealed air density spots in the aortic wall (Fig A ), and Salmonella enteritidis serotype O9 was detected by blood culture. Under a tentative diagnosis of Salmonella-induced infective aortic aneurysm, the patient underwent antibiotic treatment with ampicillin/sulbactam. On day 11, the air had disappeared and the aortic wall showed a varicose deformity, leading to a differential diagnosis of infective aortic aneurysm (Fig B ). The patient recovered completely with 8-week antibiotic therapy without any operation.Cases of infective aortic aneurysms account for only about 1% to 3% of total cases of aortic aneurysm. However, the case fatality has been reported to be as high as 18 percent in two years1, and an early diagnosis is essential. Salmonella species are known as a common pathogen of the crucial infection2, and so clinicians should pay attention to the development of the disease.