European journal of case reports in internal medicine最新文献

{"title":"Splenic Infarctions in Acute Epstein-Barr Virus Infection: A Rare but Possibly Underdiagnosed Complication in Adults.","authors":"Carlos Tarrazo, Alba Barragán Mateos","doi":"10.12890/2025_005497","DOIUrl":"10.12890/2025_005497","url":null,"abstract":"<p><strong>Background: </strong>Although splenomegaly is a common finding in Epstein-Barr virus (EBV) infection, splenic infarction is rarely reported and may be under-recognised, especially in adults. Neurological complications such as aseptic meningitis are also uncommon but documented. The simultaneous occurrence of both complications in the context of primary EBV infection is exceptional.</p><p><strong>Case description: </strong>We describe the case of a 56-year-old previously healthy man who presented with fever and abdominal pain. Abdominal computed tomography (CT) revealed splenomegaly and multiple wedge-shaped splenic infarcts. During admission, the patient developed transient disorientation, and cerebrospinal fluid analysis was consistent with aseptic meningitis. Serological and molecular testing confirmed acute EBV infection in blood, pharyngeal swab and cerebrospinal fluid. No underlying prothrombotic condition was identified. The patient recovered completely with supportive care, without the need for antiviral treatment or anticoagulation.</p><p><strong>Conclusions: </strong>Splenic infarction is a rare but possibly underestimated complication of primary EBV infection, particularly in adults. Awareness of this association can help avoid unnecessary investigations or treatments. In selected patients, conservative management without anticoagulation may be appropriate.</p><p><strong>Learning points: </strong>Splenic infarctions are a rare but potentially severe complication of primary Epstein-Barr virus infection.EBV-related mononucleosis in adults may present with atypical features, including neurological involvement such as aseptic meningitis.Awareness of these complications may facilitate earlier diagnosis and appropriate supportive management.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005497"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Thrombocytopenia as the Initial and Sole Manifestation of Bone Marrow B-Cell Lymphoma in an Elderly Female.","authors":"Muhammad Mohsin Zahoor, Hira Gul, Abdul Mannan, Brian Casserly","doi":"10.12890/2025_005740","DOIUrl":"10.12890/2025_005740","url":null,"abstract":"<p><p>B-cell lymphomas are highly aggressive forms of lymphoma that commonly present with lymphadenopathy, systemic \"B\" symptoms, or organ involvement making them easy to recognize; however, a small percentage of B-cell lymphomas can present without any typical symptoms or evidence of lymphadenopathy, resulting in delayed recognition and management. Isolated thrombocytopenia without anaemia or leukopenia is an unusual presentation of B cell lymphomas and may be misdiagnosed as immune thrombocytopenia (ITP). Given the rarity of this presentation, we wish to report a case of a 76-year-old female who presented with palpitations, shortness of breath, and recurrent chest infections. She was found to have isolated thrombocytopenia (platelet count 57 ×10⁹/l) with otherwise normal laboratory findings. Initial treatment for presumed ITP was unsuccessful, which lead to more invasive investigations. Bone marrow biopsy revealed infiltration with atypical lymphoid nodules consistent with B-cell non-Hodgkin lymphoma. Following chemotherapy, her platelet counts normalized. This case highlights the importance of bone marrow evaluation in elderly patients with unexplained thrombocytopenia, even in the absence of typical lymphoma features.</p><p><strong>Learning points: </strong>This case demonstrates absence of lymphadenopathy or systemic symptoms does not exclude bone marrow infiltration by lymphoma.Early recognition and accurate diagnosis of atypical lymphoma presentations are essential to avoid treatment delays and improve patient outcomes.Bone marrow biopsy plays a crucial role in diagnosing occult B-cell lymphoma in cases lacking systemic symptoms or lymphadenopathy.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005740"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Janus Kinase Inhibitors as A Breakthrough Treatment for Refractory Dissecting Cellulitis of the Scalp.","authors":"Ali Al-Mamoori, Sajjad Ghanim Al-Badri, Sabry Babiker H Sayed, Wael Al-Daraji","doi":"10.12890/2025_005743","DOIUrl":"10.12890/2025_005743","url":null,"abstract":"<p><strong>Background: </strong>Dissecting cellulitis of the scalp (DCS) is a rare, chronic neutrophilic dermatosis that is often refractory to conventional therapies.</p><p><strong>Case report: </strong>We present a 29-year-old male with treatment-resistant DCS who achieved rapid and sustained remission following off-label use of tofacitinib, a Janus kinase (JAK) inhibitor. Previous therapies, including antibiotics, corticosteroids, and isotretinoin, had failed. After 9 weeks of tofacitinib 10 mg daily, the patient showed marked improvement and maintained remission for 6 months without side effects.</p><p><strong>Conclusion: </strong>This case supports JAK inhibitors as a promising therapeutic strategy in refractory DCS, highlighting their potential role in managing challenging inflammatory dermatoses.</p><p><strong>Learning points: </strong><b>Novel therapeutic breakthrough</b> This is one of the first documented cases demonstrating successful monotherapy with tofacitinib in refractory dissecting cellulitis of the scalp (DCS), achieving rapid and sustained remission where all standard treatments had failed.<b>Translational value for internists</b> Given the overlap between DCS and other autoimmune/inflammatory disorders commonly encountered by internists (e.g., rheumatoid arthritis, ulcerative colitis), this case supports considering Janus kinase (JAK) inhibitors for complex inflammatory dermatoses beyond current indications.<b>Clinical impact in practice</b> The case highlights the practical, off-label use of JAK inhibitors in dermatology, providing internists and multidisciplinary teams with a viable option for patients suffering from severe, treatment-resistant conditions.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005743"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lineage Switch of Adult B-Cell Acute Lymphoblastic Leukaemia to Acute Myeloid Leukaemia Following B-Cell-Directed Therapy.","authors":"Oscar F Borja-Montes, Darrel D Horton, Alejandro Toro-Pedroza, Tomas Escobar-Gil, Daniel Babu, Charles Foucar, Ala Ebaid","doi":"10.12890/2025_005724","DOIUrl":"10.12890/2025_005724","url":null,"abstract":"<p><strong>Background: </strong>Blinatumomab and inotuzumab ozogamicin (InO) are B-cell targeted agents used in the frontline and relapsed/refractory treatment of B-cell acute lymphoblastic leukaemia (B-ALL). Blinatumomab, a bispecific T-cell engager that targets CD19 and CD3, and InO, an antibody-drug conjugate targeting CD22, have both shown efficacy. However, recent reports have noted lineage conversion as a complication when these agents are used individually or sequentially. We present a rare case of this phenomenon in a 79-year-old male patient.</p><p><strong>Case description: </strong>A 79-year-old male with refractory B-ALL underwent a lineage switch to acute myeloid leukaemia following treatment with blinatumomab and InO. The patient initially achieved remission after initial therapy but relapsed and was subsequently treated with blinatumomab. Due to adverse effects, the treatment was discontinued. He was then treated with InO but again relapsed. A subsequent bone marrow biopsy revealed morphologic evidence of residual B-ALL, but with the presence of acute monocytic leukaemia. Fluorescence in situ hybridisation (FISH) analysis demonstrated an additional copy of KMT2A in a large percentage of cells which was a feature present since the initial diagnosis. Unfortunately, the patient's condition deteriorated, and he died.</p><p><strong>Conclusion: </strong>This case underscores potential complication of lineage switch following treatment with B-cell directed therapies. Although such therapies have improved outcomes in B-cell malignancies, clinicians should remain aware of rare risks such as lineage transformation. Timely recognition is essential to guide appropriate clinical management.</p><p><strong>Learning points: </strong>Lineage switch is a rare complication observed after B-cell targeted therapies; however, evidence remains limited.Specific genetic alterations, such as KMT2A abnormalities, may predispose leukemic clones to lineage plasticity.Close monitoring for immunophenotypic evolution is essential for timely recognition and clinical management of lineage switch.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005724"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Hypoalbuminaemia after Roux-En-Y Gastric Bypass: A Diagnosis of Exclusion.","authors":"Catarina Santos Reis, Ana Filipa Lopes, Francisco Santos Dias, Marta Soares Carreira, Jorge Almeida","doi":"10.12890/2025_005741","DOIUrl":"10.12890/2025_005741","url":null,"abstract":"<p><p>Bariatric surgery has emerged as a highly effective treatment option for individuals with obesity. Severe hypoalbuminaemia is a feared complication after a Roux-en-Y gastric bypass. It is characterised by a low serum albumin level of <25 g/l, neither explained by renal losses, protein-losing enteropathy nor by liver disfunction, and is associated with high morbidity and mortality. Prompt workup leading to the diagnosis and aggressive treatment are recommended to prevent rapid clinical worsening; however, evidence-based recommendations and specific treatment approach are lacking. Most cases can be managed with dietary counselling and protein-enhanced oral supplements. We report a case of a female patient in her 50s with class II obesity, who underwent a Roux-en-Y gastric bypass eight months earlier, who presented to the Emergency Department with new onset of asthenia and lower limb oedema. Her biochemistry panel revealed severe serum hypoalbuminaemia, with a level of 18.4 g/l. After a thorough examination, complete laboratory tests and imaging that excluded renal and gastrointestinal losses and hepatic disfunction, she was presumed to have developed severe hypoalbuminemia after bariatric intervention. She managed to increase her oral intake of protein-enhanced products, according to nutritional counselling. At a six-month follow-up visit the patient regained 1% of the weight and had a slow and progressive increase in the serum albumin level. Our report highlights the importance of continuous nutritional monitoring and a multidisciplinary approach in the post-operative period of bariatric surgery to improve long-term outcomes.</p><p><strong>Learning points: </strong>Severe hypoalbuminaemia caused by bariatric surgery requires exclusion of alternative aetiologies.Surgical reversal can often be avoided by appropriate dietary interventions.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005741"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Skin Reactions Interrupt Bone Therapy: Severe Cutaneous Adverse Reaction to Romosozumab Leading to Treatment Discontinuation.","authors":"Luis Antonio Rodriguez Arrieta, Paola Andrea Rueda Galvis, Miryam Vanessa Rueda Galvis, Samir Alexander Pantoja Meneses, José Manuel Yépes Rodriguez, Francisco Javier Suarez Contreras","doi":"10.12890/2025_05719","DOIUrl":"10.12890/2025_05719","url":null,"abstract":"<p><strong>Background: </strong>Romosozumab is a sclerostin-inhibiting monoclonal antibody that is effective and safe for anabolic treatment in patients with osteoporosis. Its main adverse effects are local; the severity of these injection-site reactions in clinical trials was generally mild.</p><p><strong>Case report: </strong>We present a case of a 71-year-old Colombian woman with osteoporosis at very high risk of fractures with no relevant history of drug allergies. Bone-forming management was indicated for 12 months with romosozumab after ruling out contraindications and alterations in bone mineral metabolism that would prevent its use. After the first dose of romosozumab 210 mg subcutaneously in the abdomen, she presented a severe local cutaneous adverse reaction, she developed two asymmetric erythematous-oedematous circinate plaques with regular and well-defined borders with a perilesional whitish halo associated with local heat in the umbilical region, which forced the discontinuation of this medication after a joint evaluation with endocrinology, dermatology and allergology. Management was rotated to teriparatide with good tolerance. During follow-up, complete improvement was achieved slowly and progressively, 20 days after the application of romosozumab, without any other related adverse reactions.</p><p><strong>Conclusion: </strong>This case documents a severe cutaneous reaction at the romosozumab application site, with an atypical presentation due to its extent and intensity, which led to treatment discontinuation. Although these reactions are usually mild, their early recognition is crucial to ensure proper management and avoid complications that could compromise treatment continuity.</p><p><strong>Learning points: </strong>Severe inflammatory skin reactions can occur at the romosozumab injection site, even in patients without a relevant allergic history.The detection of moderate or severe local inflammatory reactions allows for an adequate assessment of the risk-benefit balance of romosozumab treatment, which is essential for deciding whether to discontinue treatment and redirect bone-forming therapy.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"05719"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Metastatic Growth of A Pancreatic Signet Ring Cell Carcinoma within 6 weeks of A Negative CT.","authors":"Toni Habib, Micaela Prisco, Peter Mouanes, Chloe Lahoud, Saif Yasin, Ali Sohail, Hassan Al Moussawi","doi":"10.12890/2025_005662","DOIUrl":"10.12890/2025_005662","url":null,"abstract":"<p><p>Pancreatic signet ring cell carcinoma (PSRCC) is a rare and aggressive subtype of pancreatic cancer with a dismal prognosis. We present the case of a 50-year-old male who, within six weeks, developed a pancreatic mass with liver metastases. Endoscopic ultrasound-guided biopsy confirmed PSRCC. The presentation of this tumour with distant metastasis after a negative computed tomography (CT) of the abdomen and pelvis six weeks prior underscores the highly aggressive nature of PSRCC and the crucial need for heightened clinical suspicion, especially in cases with persistent or atypical abdominal pain. This case highlights the limitations of current diagnostic modalities and emphasises the urgent need for further research into improved early detection methods, molecular characterisation and effective treatment strategies for this rare and lethal subtype of pancreatic cancer.</p><p><strong>Learning points: </strong>Aggressive malignancy can become metastatic within six weeks of a negative CT scan.A CT scan may not detect a small pancreatic lesion <2 cm.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005662"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Balance Between Autoimmunity and Infection: A Case Report of Concomitant Pathology of Pulmonary Nocardia and Granulomatosis with Polyangiitis at Initial Presentation.","authors":"Abdulrahman Abdullah Alhumaidi, Eid Mohammed Aljohani, Wajd Ahmed Althakafi, Ohud Mohammed Alkinani, Faisal Abdullah Albalawi","doi":"10.12890/2025_005756","DOIUrl":"10.12890/2025_005756","url":null,"abstract":"<p><p>Concurrent presentation of pulmonary nocardiosis and granulomatosis with polyangiitis (GPA) is exceptionally rare and diagnostically challenging, given the overlapping clinical and radiological features. We report a 54-year-old female with fever, cough, weight loss, and arthralgia. Chest imaging showed multiple pulmonary nodules; serology revealed positive anti-neutrophil cytoplasmic antibodies -proteinase 3, and lung biopsy demonstrated necrotizing granulomatous inflammation with Nocardia species. This led to a dual diagnosis of pulmonary nocardiosis and limited form GPA. The patient improved with co-trimoxazole however methotrexate is set to be initiated concomitantly with close monitoring as the manifestations of limited form GPA were still present. This case highlights the importance of considering infectious mimics during initial evaluation of suspected vasculitis, the possibility of dual pathology of both entities, and the emphasis of the staged approach of treating such cases in the background of controlling infection followed by initiating immunosuppressive therapy.</p><p><strong>Learning points: </strong>Pulmonary nocardiosis may clinically and radiologically mimic granulomatosis with polyangiitis, and both conditions can rarely present simultaneously.Histopathological examination is crucial to distinguish infectious mimics from vasculitis in anti-neutrophil cytoplasmic antibodies-positive patients.A stepwise treatment strategy in which controlling infection before initiating immunosuppression can reduce the risk of complications in dual pathology.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005756"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapidly Progressive Primary Central Nervous System Vasculitis: A Rare Case with Multifocal Small and Medium Vessel Involvement.","authors":"Sara Bashier, Syed Samiullah, Maitha Al Haj, Ishma Aijazi","doi":"10.12890/2025_005384","DOIUrl":"10.12890/2025_005384","url":null,"abstract":"<p><strong>Introduction: </strong>Primary central nervous system vasculitis (primary CNS vasculitis) is a rare inflammatory disorder that affects small-to-medium-sized cerebral vessels, often leading to recurrent strokes. Diagnosis is vague due to non-specific neurological symptoms. Imaging findings, cerebrospinal fluid (CSF) analysis and exclusion of systemic vasculitis are essential for diagnosis. Early immunosuppressive therapy is crucial, but the prognosis remains unpredictable.</p><p><strong>Case description: </strong>A 45-year-old female with diabetes, hypertension and multiple ischaemic strokes presented with altered consciousness due to hypoglycaemia. Initial workup at a different hospital suggested cerebral vasculitis based on the findings of cerebral angiography. She had negative systemic vasculitis markers and was treated with corticosteroids and rituximab and discharged. On admission to our facility, an MRI of the brain revealed multiple infarcts of varying ages, and a CTA showed arterial beading, suggestive of primary CNS vasculitis. CSF analysis demonstrated elevated protein and IgG without pleocytosis. Despite high-dose corticosteroids and rituximab, she developed progressive neurological deterioration with new infarcts in the vertebrobasilar territory, leading to brainstem dysfunction and brain death.</p><p><strong>Conclusion: </strong>Primary CNS vasculitis remains a diagnostic and therapeutic challenge because of its diverse presentation and similarities with other vascular conditions. This case emphasises the importance of early recognition, comprehensive diagnostic evaluation and aggressive treatment to prevent irreversible neurological decline. Disease progression can be rapid even with treatment, highlighting the need for further research to enhance early detection and optimise management strategies.</p><p><strong>Learning points: </strong>Physicians should be alert in diagnosing primary CNS vasculitis in a young patient with recurrent strokes affecting multiple vascular territories, particularly when systemic vasculitis markers are negative.Imaging studies, such as MRI and computed tomography angiography (CTA), play an essential role in diagnosing primary CNS vasculitis, with findings such as arterial beading and a multi-infarct pattern helping differentiate it from atherosclerotic diseases.Early recognition and aggressive high-dose corticosteroid and immunosuppressive (rituximab) therapy are essential in primary CNS vasculitis, as delayed treatment can result in rapid neurological deterioration, as seen in this case.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005384"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Vascular Perforation Bleeding Complications Post-Coronary Intervention Using Coils.","authors":"Nguyen Cong Ha, Nguyen Dinh Phuc, Hoang Van, Nguyen Sinh Hien","doi":"10.12890/2025_005592","DOIUrl":"10.12890/2025_005592","url":null,"abstract":"<p><strong>Background: </strong>Perforation of artery causing bleeding is a rare but serious complication of percutaneous coronary intervention (PCI), with potentially life-threatening consequences. Prompt recognition and management are crucial, particularly in high-risk patients or complex procedures. Coils are essential tools for sealing perforated or ruptured vessels, preventing further haemorrhage and stabilising the patient.</p><p><strong>Case description: </strong>This report highlights three cases of perforated artery managed with coil embolization. The first case involved perforation of a small branch of the internal mammary artery, the second a ruptured aneurysm in the superior mesenteric artery and the third a distal branch perforation of the diagonal artery. All patients presented with significant haemorrhage, requiring urgent intervention. Coil embolization was successfully performed in all cases, achieving haemostasis and preventing further complications.</p><p><strong>Conclusion: </strong>Coil embolization is a lifesaving technique for managing perforated artery or ruptured aneurysm, emphasising the importance of timely diagnosis, technical expertise and the availability of advanced interventional tools.</p><p><strong>Learning points: </strong>Perforation of artery causing bleeding is a rare but life-threatening complication of percutaneous coronary intervention.Coil embolization is a lifesaving technique for distal vessel perforations and aneurysmal ruptures.High-risk interventions demand careful planning, expertise and ready access to advanced tools such as coils.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 9","pages":"005592"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}