International Journal of Case Reports

Gas in the Inferior Mesenteric Vein – successful non operative management of a rare complication of diverticulitis

Case Report of International Journal of Case Reports Gas in the Inferior Mesenteric Vein – successful non operative management of a rare complication of diverticulitis Williams, Ryan1; Chuang,Tzu-Yi1; Choy, Kay Tai2; Ranasinghe, Saranga 1 1Department of General Surgery, Redland Hospital, Cleveland, Queensland, Australia 2Department of General Surgery, Hervey Bay Hospital, Urraween, Queensland, Australia Septic phlebitis (also known as pyelephlebitis) because of diverticulitis is a rare but important complication. Many previous cases have mandated urgent surgical management for fear of further deterioration. This case report details one of the first cases where septic phlebitis was successfully managed conservatively, and details important clinical lessons clinicians should be aware of. Keywords: Septic phlebitis, pyelephlebitis, diverticulitis, inferior mesenteric vein (IMV) gas ...

Efficacy of an oral appliance in an adult Marfan syndrome patient with obstructive sleep apnea

Case Report of International Journal of Case Reports Efficacy of an oral appliance in an adult Marfan syndrome patient with obstructive sleep apnea Akifumi Enomoto*, Yuko Kinoshita, Atsushi-Doksa Lee, Miho Sukedai, Takeshi Shimoide Department of Oral and Maxillofacial Surgery, Kindai University School of Medicine, 377-2, Ohno-higashi, Osaka-Sayama, 589-8511, Japan. Marfan’s syndrome (MFS) is an autosomal dominant disorder that affects the body’s connective tissue, characterized by changes in three major connective tissue systems: the musculoskeletal, ocular, and cardiovascular systems. Individuals with MFS can develop severe cardiovascular complications., and the life expectancy of patients with MFS is markedly reduced as the effects of the disease on the aorta often lead to progressive dilatation, with subsequent dissection and rupture. Obstructive sleep apnea (OSA) is highly prevalent in patients with cardiovascular diseases. There is a high prevalence of OSA in patients with MFS due to craniofacial dysmorphism and increased upper airway collapsibility. A high prevalence of OSA has been reported in patients with MFS. To date, however, there are only a few case reports regarding the treatment of OSA in MFS patients. We present a treatment in an adult MFS patient with OSA using an oral appliance (OA). The patient was a 48-year-old Japanese woman of MFS, diagnosed with moderate OSA (apnea hypopnea index [AHI] = 27.0; lowest oxygen saturation [SaO2] = 78%; maximum apnea time = 114 s]). An OA was selected as the treatment option, and post-treatment sleep study indicated a reduction in AHI to 8.8/h with an improvement in other factors (lowest SaO2 = 84%; maximum apnea time = 66 s). Additionally, the treatment resulted in a reduction in BNP levels (81.3 from 110.2 pg/ml), and the patient’s cardiac function was stable over the period in which the patient received OA treatment. This study provides a basis for the future appropriate understanding and management of OSA of MFS ...

Early effectivity of teduglutide for the treatment of short bowel sydrome – our first clinical experience

Case Report of International Journal of Case Reports Early effectivity of teduglutide for the treatment of short bowel sydrome – our first clinical experience Gombošová Laura1, Krivuš Juraj2, Lazúrová Ivica1, Dedinská Ivana3, Mokáň Marián2 1internal clinic of University hospital L.Pasteur and Faculty of Medicine of P.J. Šafárik University, Košice, Slovakia;2internal clinic of University Hospital of Martin and Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia; 3Transplant center of University Hospital of Martin and Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia Background Short bowel syndrome is an uncommon malabsorptive condition most frequently caused by massive surgical resection of the small intestine. Standard of care is home parenteral nutrition. Teduglutide, glucagon like peptide 2 analog, was approved to treat patients with short bowel syndrome, who are stable following a period of post-surgery intestinal adaptation. Case presentation We report two cases of patients with short bowel syndrome on home parenteral nutrition,  treated with teduglutide, novel advanced therapy. We monitored the effectiveness and tolerance of the new treatment. Conclusion Teduglutide increases intestinal absorption, causes cryptal hyperplasia, villous hypertrophy, angiogenesis, and allows weaning from parenteral nutrition. We confirmed the early onset of treatment effectiveness in the 4th month. Early effectiveness of treatment allowed a reduction in the volume of home parenteral nutrition with an improvement in quality of life. Keywords: short bowel syndrome, teduglutide, glucagon like peptide 2, home parenteral nutrition ...

Therapeutic Plasma Exchange in Postpartum Hemolytic Uremic Syndrome: A Case Report

Case Report of International Journal of Case Reports Therapeutic Plasma Exchange in Postpartum Hemolytic Uremic Syndrome: A Case Report SIRAT KAUR Department of ImmunoHematology and Blood Transfusion Dayanand Medical College and Hospital BACKGROUND AND AIM: Adult, non-infective, haemolytic-uremic syndrome (HUS) although a rare disease in itself, has a high likelihood of occurrence in pregnancy and immediate post partum period. It is an important differential diagnosis in the evaluation of thrombotic microangiopathies. Patients with post-partum HUS display a classical triad of microangiopathic haemolytic anaemia, acute nephropathy and thrombocytopenia. I hereby present a case of post partum HUS treated with therapeutic plasma exchange (TPE) MATERIAL AND METHODS: A total of six sessions of TPE were performed daily, three sessions for consecutive days and remaining three sessions were performed on alternate days. All the procedures were carried out with Haemonetics MCS+ exchanging one plasma volume using fresh frozen plasma and saline as replacement fluid. Haemodialysis was started and four sessions were carried out on alternate days. RESULT: A 37 year old, 85 kg female, G2 P1, underwent emergency LSCS because of foetal distress at 38 weeks of pregnancy. Post surgery she developed decreasing urine output, anuria ensued. Emergency therapeutic plasma exchange was carried out within 24 hours of diagnosis. It could be found that with TPE, patient had improvement in renal function, decrease in LDH levels and increase in platelet count. Patient had sustained remission and discontinuation of haemodialysis. CONCLUSION: HUS is a disorder with high mortality and long term morbidity, if prompt treatment is not instituted. The decision to intervene with plasma exchange should be based upon the severity of thrombocytopenia, microangiopathic haemolytic anaemia and neurological abnormalities, even if the diagnosis and nomenclature is uncertain. Improved survival after this disorder has been attributed to aggressive treatment with plasma exchange therapy. Keywords: Therapeutic Plasma ...

Acute cholecystitis with intraluminal gallbladder bleeding: Case report and literature review

Case Report of International Journal of Case Reports Acute cholecystitis with intraluminal gallbladder bleeding: Case report and literature review Jerica Novak, MD, PhD, Aleksander Göntér, MD, Jurij Janež, MD, PhD Department of Abdominal Surgery, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia, University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia. Background: Hemorrhagic cholecystitis is an infrequent complication of acute cholecystitis associated with high mortality rate. Recognition of this acute abdominal condition is often challenging. Authors present a case of acute intraluminal gallbladder bleeding with a consequential gallbladder wall perforation and hematoperitoneum requiring emergency surgery in a patient on anticoagulant therapy. Case Presentation: An 80-year old woman with atrial fibrillation on warfarin was presented to abdominal surgeon due to acute abdominal pain with hemodynamic instability and active intraluminal gallbladder bleeding on CT-scan. An emergency laparotomy with cholecystectomy was performed. Despite intensive treatment patient died on the third postoperative day. Conclusions: Hemorrhagic cholecystitis is a potentially life-threatening condition. Patients on anticoagulant therapy with clinical signs of acute cholecystitis are more prone to develop bleeding into the gallbladder. Contrast-enhanced CT of the abdomen is the diagnostic modality of choice and cholecystectomy definitive therapy in patients with hemorrhagic cholecystitis. Keywords: hemorrhagic cholecystitis, anticoagulant therapy, hematoperitoneum, abdominal CT, emergency surgery ...

Dr. Xiaoning Luo
Professor, Department of Otorhinolarygology-Head and Neck Surgery, Guangdong General Hospital, Guangzhou, China

Professor & Head, Dept.of Medicine, Govt. Medical College, Amritsar, India

Dr. Jitesh K. Kar
Clinical assistant professor, Department of Internal Medicine – Neurology, University of Alabama at Birmingham, Huntsville Regional Campus

Dr. Nisar Haider Zaidi
MBBS, MS, MRCS (Glasgow), FICS, FACS. Department of surgery, King Abdulaziz University Hospital , POBox-80215 Jeddah 21589 , Saudi Arabia

Dr. Giuseppe Lanza
Consultant Neurologist and Clinical Researcher, Department of Neurology IC of the “Oasi” Institute for Research on Mental Retardation and Brain Aging

Dr. Yousif Mohamed Y. Abdallah
Professor (Assistant), Radiological Science and Medical Imaging Department, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia

Dr. Karol Szyluk
District Hospital of Orthopedics and Trauma Surgery

Dr. Mohd Normani Zakaria
Chairman / Head of Hospital Unit / Assistant Professor / Consultant Audiologist, Audiology and Speech Pathology Programme, School of Health Sciences,, Universiti Sains Malaysia 

Dr. Dennis J. Mazur
Senior Scholar, Center for Ethics in Health Care, and Professor of Medicine, Oregon Health and Science University, Portland, Oregon USA

Dr. Marcos Roberto Tovani Palone
Department of Pathology and Legal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

Dr. Begum Sertyesilisik
Assoc. Prof. at the Istanbul Technical University

Dr. Jamunarani Veeraraghavan
Baylor College of Medicine, One Baylor Plaza, Houston, Texas 

Dr. Rajinder Pal Singh Bajwa
Niagara Falls Mem Med Center, Division of Infectious Diseases, 621 Tenth Street, Niagara Falls, NY

Adiyaman University School Of Medicine, Department Of Neurosurgery, Adiyaman

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1. Avinaba Mukherjee, Sourav Sikdar, Anisur Rahman Khuda-Bukhsh. Evaluation of ameliorative potential of isolated flavonol fractions from Thuja occidentalis in lung cancer cells and in Benzo(a) pyrene induced lung toxicity in mice. International Journal of Traditional and Complementary Medicine, 2016; 1(1): 0001-0013. 
2. Vikas Gupta, Parveen Bansal, Junaid Niazi, Kamlesh Kohli, Pankaj Ghaiye. Anti-anxiety Activity of Citrus paradisi var. duncan Extracts in Swiss Albino Mice-A Preclinical Study. Journal of Herbal Medicine Research, 2016; 1(1): 0001-0006.

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International Journal of Case Reports (ISSN:2572-8776; DOI:10.28933/IJCR) is a peer reviewed open access journal publishing case reports in all kinds of diseases of all medical fields. Our aim is to provide a platform for authors from all countries to encourages publication of most recent case reports in all specialties. 

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Scope: (Case reports from all medical fields.)

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