International Journal of Case Reports

Case Report of International Journal of Case Reports An unusual cause of facial nerve palsy affecting a mum and her child with literature review and analysis for other causes Abdulmohsin Y. Saleem1, Omar Al-Allaf2, Zakariya A. Younus3, Abdul-Wahab Al-Allaf4 1Consultant Otolaryngologist, Early Detection Childhood Disabilities Center in Dohuk, Iraq; 2Walsall Manor Hospital, Moat Road, WS2 9PS, UK; 3Emergency Department, Gaziantep University Hospital, Gaziantep, Turkey; 4Senior Consultant Rheumatologist, Hamad Medical Corporation, Hamad General Hospital, Department of Medicine, Doha Qatar, P.O.Box 3050 Facial nerve palsy is a condition with several implications, particularly when occurring in infancy and childhood. It represents a clinical problem with regard to its etiology, treatment options and its outcome, particularly when occurs in infants and children. There are several causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformation diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, 40-75% of the cases of unilateral facial paralysis remain idiopathic. Unilateral familial congenital facial nerve palsy is an extremely rare condition that is usually syndromic, namely, in Moebius syndrome. The occurrence of isolated familial facial nerve palsy is even rarer, with only a few cases reported in the literature. Here we report a mother and her child both have congenital facial paralysis on the same side. Keywords: Facial paralysis, Seventh cranial nerve, Children, Bell’s palsy ...

Case Report of International Journal of Case Reports Duodenal and inferior vena cava perforation due to a rosemary branch ingestion: a Case Report Simone Gianazza¹, Davide Inversini¹, Lorenzo Latham², Sabrina Garbarino¹, Matteo Zanchetta¹, Marika Morabito¹, Natalia Palamara¹, Giuseppe Ietto¹ and Giulio Carcano¹ 1General, Emergency and Transplant Surgery Department, ASST-Settelaghi, University of Insubria, 21100 Varese, Italy; 2UO Chirurgia Generale, Ospedale SacraFamiglia – Fatebenefratelli, 22036 Erba, Italy Introduction: Foreign  body  (FB)  ingestion  is  frequently  observed  in  surgical  and endoscopic practice. They are often removed from the body cavities without causing any severe complications but occasionally they lead to serious damages. We report a case of a  rosemary  branch  ingestion  causing  a  duodenal  and  Inferior  Vena  Cava (IVC) perforation. Case  Presentation:  A 61 year-old man was admitted in ER with abdominal pain, vomiting  and  with  a  single  episode  of  melaena.  Vital  parameters  were  stable. The abdomen was mildly distended but tender. Computed tomography (CT) scan revealed a foreign body in the second part of duodenum, passing through it, reaching and perforating the Inferior Vena Cava (IVC). An urgent Esophagogastroduodenoscopy (EGDS) confirmed the presence of a rosemary branch passing through the duodenum in correspondence of the lower duodenal knee. An emergency surgery with a median xifopubic laparotomy was performed.  The foreign body removed firstly from the duodenum, then from IVC. No complication were observed in the postoperative period. Discussion: This case peculiarity was the paucisymptomatic presentation related to the severe lesion to the vessels and the bowel. Laparotomic approach was chosen to permit a secure and effective bleeding control.  Probably the lack of symptoms, was due to the presence of an extended fibrotic reaction around the rosemary branch. Conclusion:  Duodenal  perforation  and  large  vessels  lesions  due  to  foreign  body ingestion are rare conditions that can lead to severe complications. Not withstanding the utilization of Computed Tomography ...

Case Report of International Journal of Case Reports Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) Masquerading as New-Onset Bipolar Disorder in an Elderly Female 1Dawn Radford D.O., 2Manish Karamchandani M.D., 2McKay Hanna M.D., 3Mini Singh M.D. 1Medical University of South Carolina; 2Medical University of South Carolina; 3University of Virginia Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also known as Hashimoto’s Encephalopathy (HE), is an immune-mediated condition that may present with a myriad of neuropsychiatric symptoms, making diagnosis a quandary. We report a case of a 70-year-old female who presented with subacute onset of mania and cognitive decline, diagnosed as bipolar disorder. She was treated with valproic acid for mood stabilization with minimal improvement in symptoms and six months later presented with new-onset seizures. Interestingly, her seizures started four days after discontinuing valproic acid. Following her admission to our hospital, a diagnosis of autoimmune epilepsy was suspected. EEG revealed multiple focal onset seizures with secondary generalization originating from the right frontocentral area and/or right temporal lobe. MRI revealed asymmetric cortical thickening along the paramedian right anterior frontal region thought to be nonspecific. She was empirically treated with pulse dose steroids and intravenous immunoglobulins. She underwent an extensive work up including neuroimaging studies that were unremarkable as well as serological testing for autoimmune etiologies. A high titer of anti-thyroid peroxidase (anti-TPO) antibodies was detected. She was clinically and biochemically euthyroid. A diagnosis of SREAT was rendered and the patient had significant clinical improvement in symptoms following administration of corticosteroids. SREAT is a diagnosis of exclusion but is supported by the presence of elevated anti-TPO and steroid responsiveness. Initial presentation may masquerade as a primary mood disorder, as in this case. Prompt diagnosis and treatment fully reverses neurological and psychiatric dysfunction in most cases. Keywords: neuroimmunology, immunology, neuropsychiatry, geriatric neuropsychiatry, thyroid, SREAT, bipolar disorder, ...

Case Report of International Journal of Case Reports Retrograde Ejaculation after Anterior Lumbar Fusion Resolved with a Plant-Based Diet: Case Report and Discussion Asef Bawahab1, Logan Karlen2, Casey Slattery3, Kushagra Verma4 1General Surgery, Universal Health Services, SoCal MEC [Southern California Medical Education Consortium], Temecula, California, USA. 2University of California, Los Angeles, Los Angeles, California, USA. 3Orthopaedic Surgery, University of New Mexico Hospital, Albuquerque, New Mexico, USA. 4Orthopaedic Spine Surgeon, Long Beach Memorial Medical Center, Long Beach, California, USA. This is an unusual report of a 33-year-old male with retrograde ejaculation as a complication of stand-alone L5-S1 anterior lumbar spinal fusion. This case is discussed in detail, with particular interest directed toward fertility issues and their implications. A plant-based diet was suggested as a treatment option due to the diet’s blood viscosity reduction properties. The patient initially noticed improvement after two months of starting the diet, with complete resolution of his retrograde ejaculation six months after beginning a plant-based diet. He successfully fathered a child a few years afterward. Keywords: Retrograde Ejaculation;  Anterior Lumbar Fusion ...

Case Report of International Journal of Case Reports Abdominal wall abscess secondary to post-cholecystectomy clip migration: A case report Sophia Smith, MD 1,2, Daniel C. Wiener, MD, FACS1,3, Gentian Kristo, MD, MPH, FACS1,3 1Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA, USA; 2Department of Surgery, Boston Medical Center, Boston University Medical School, Boston, MA, USA; 3Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA. Background: The migration of surgical clips after laparoscopic cholecystectomy is rare and can lead to complications such as clip-related biliary stones and intra-abdominal abscesses. In this article, we report a case of a retained dropped metal clip after a laparoscopic cholecystectomy resulting in an abscess that necessitated through the right abdominal wall and into the subcutaneous tissues 13 months later. Summary: Our patient is a 79-year-old male, with multiple comorbidities who underwent a laparoscopic cholecystectomy for acute cholecystitis. The cystic duct and artery were divided in-between 10-mm metallic clips. After 13 months, patient presented with a perihepatic abscess and a retained metallic clip necessitating through the right abdominal wall into the subcutaneous tissues. Patient was taken to the operating room and underwent an incision and drainage of the right abdominal wall abscess and retrieval of the migrating cholecystectomy clip. Conclusion: To avoid complications related to dropped cholecystectomy clips, it is important to use the correct technique for applying clips and attempt to retrieve any noticeably dropped clips intraoperatively. Keywords: retained clip; clip migration; laparoscopic cholecystectomy; intra-abdominal abscess ...