International Medical Case Reports Journal最新文献

{"title":"Rapid Glycaemic Control Leading to Painful Neuropathy: A Case of Treatment-Induced Neuropathy of Diabetes in a Young Patient.","authors":"Abubakr Sowilem, Hebatallah Nasser Fadhl, Muhammad Taha Zaman, Shatha Ahmad Alhawawreh, Shehab Hashem Elsoghier, Preeny Treesa Pauly, Mohammed Ali Saghir","doi":"10.2147/IMCRJ.S634216","DOIUrl":"10.2147/IMCRJ.S634216","url":null,"abstract":"<p><strong>Introduction: </strong>Intensive glycaemic control is essential for managing Type 1 Diabetes Mellitus (T1DM), yet rapid metabolic optimization can trigger Treatment-Induced Neuropathy of Diabetes (TIND). This iatrogenic condition, characterized by acute neuropathic pain and autonomic dysfunction, is increasingly relevant with the use of advanced automated insulin delivery (AID) systems.</p><p><strong>Case presentation: </strong>A 19-year-old male with a 10-year history of poorly controlled T1DM (baseline HbA1c 13.7%) was transitioned to an automated hybrid closed-loop system (Medtronic MiniMed 780G). Following a rapid HbA1c reduction of 6.3% over six weeks, the patient developed severe, \"electric shock-like\" neuropathic pain in the lower limbs and upper back without associated autonomic nervous system involvement. Nerve conduction studies confirmed a length-dependent sensorimotor axonal polyneuropathy. The patient's pain was refractory to duloxetine but showed significant improvement with gabapentin alongside clinical recovery observed over 4 weeks. To stabilize glucose levels, the AID system was discontinued in favor of a less intensive multiple daily injection (MDI) regimen.</p><p><strong>Conclusion: </strong>Rapid glycemic correction in patients with high baseline HbA1c carries a significant risk of TIND. Clinicians should consider close monitoring and individualized adjustment of blood glucose descent in high-risk individuals, even when utilizing advanced AID systems, to prevent debilitating neurological complications.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"634216"},"PeriodicalIF":0.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905514","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":"Bicornuate Uterus with Third Trimester Fetal Demise in a Non-Communicating Rudimentary Uterine Horn: A Case Report.","authors":"Bwire Innocent, Fardowso Dahir Warsame, Ayan Hussein Hashi Snr, Fatima Abdallah Noor, Mohamed Abdi Deheyeh, Qabul Isse Omar Snr, Namujju Josephine, Okurut Emmanuel, Baruti Petrus, Theoneste Hakizimana, Adam Abdrahim Suliman Ebaid","doi":"10.2147/IMCRJ.S621351","DOIUrl":"10.2147/IMCRJ.S621351","url":null,"abstract":"<p><strong>Background: </strong>Bicornuate uterus is a rare congenital uterine anomaly that occurs due to incomplete fusion of the mullerian ducts during fetal development, resulting in a single cervix and two uterine horns with partial to complete separation with or without communication between the cavities. Pregnancy in a rudimentary non-communicating uterine horn of a bicornuate uterus is an even rare occurrence, usually due to transperitoneal migration of sperms or zygote, and it is often associated with fetal demise and uterine rupture. We report a case of a bicornuate uterus unicollis with a third-trimester fetal demise in a non-communicating rudimentary uterine horn with focus on diagnosis, investigations and management in a low resource setting.</p><p><strong>Case presentation: </strong>The patient was a 24-year-old Ugandan, gravida 2 para 0+1 at 29 weeks of gestation who presented with abdominal pain for 3 days. She had a history of dyspareunia, dysmenorrhea, and a first-trimester miscarriage four years ago. Laparotomy for an abdominal ectopic pregnancy revealed a bicornuate uterus with a gravid non-communicating rudimentary uterine horn containing a dead fetus. Resection of the right non-communicating uterine horn was done with preservation of the right ovary.</p><p><strong>Conclusion: </strong>Despite the rarity and difficulty in the diagnosis of uterine anomalies in low-resource settings, it is important for clinicians, especially obstetricians and gynecologists, to be aware of a bicornuate uterus with a non-communicating rudimentary horn pregnancy that can lead to fetal demise and uterine rupture. Early antenatal diagnosis by ultrasonography is crucial in prevention of future obstetric complications in low resource settings.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"621351"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897379","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":"Pediatric Varicocele as the Presenting Sign of Nutcracker Syndrome: An Ultrasound Case Report.","authors":"Ahmed Abdisalan Warsame, Shamsa Ahmed Mohamed","doi":"10.2147/IMCRJ.S620146","DOIUrl":"10.2147/IMCRJ.S620146","url":null,"abstract":"<p><strong>Background: </strong>Pediatric varicocele is most often recognized during adolescence; presentation at a younger age or with atypical features should prompt consideration of secondary causes. Nutcracker syndrome (NCS) is the symptomatic clinical consequence of left renal vein (LRV) compression and may produce collateral gonadal venous reflux.</p><p><strong>Case presentation: </strong>A 10-year-old boy presented with a 6-month history of painless left scrotal swelling. Examination demonstrated a soft \"bag of worms\" mass that became more prominent with standing and the Valsalva maneuver. Urinalysis showed no hematuria or proteinuria. Scrotal Doppler ultrasonography demonstrated left pampiniform plexus veins measuring up to 3.31 mm with reflux. Because of the patient's young age, abdominal Doppler evaluation was extended to the renal venous circulation and demonstrated focal LRV compression between the aorta and superior mesenteric artery with marked prestenotic dilatation. The aortomesenteric angle was 8.58°, the hilar-to-compressed LRV diameter ratio was approximately 10.9:1 (5.34 mm/0.49 mm), and peak systolic velocity at the compressed segment was approximately 91.2 cm/s. The combined clinical and Doppler findings supported anterior NCS with associated left-sided varicocele.</p><p><strong>Conclusion: </strong>This report does not claim a novel NCS-varicocele association. Its educational value lies in demonstrating a practical Doppler pathway from an apparently isolated scrotal finding to an upstream vascular cause in a young child with normal urinalysis. Morphologic and hemodynamic ultrasound findings should be interpreted together with the clinical presentation.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"620146"},"PeriodicalIF":0.7,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887566","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":"Spinal Mucormycosis Following a Traditional Cupping Procedure in a Diabetic Patient: A Rare Case Report from Somalia.","authors":"Hussein Salad Yusuf, Mohamed Said Adan, Abdirisak Ali Abukar, Raqiib Abdirahman Mubarik, Abdiaziz Siad Mohamed, Zakariye Yusuf Mohamed, Mustaf Abdi Ulusow, Sharmarke Hassan Ali, Liban Ade Huseein, Mohamed Osman Dahir, Ismail Mohamoud Abdullahi","doi":"10.2147/IMCRJ.S604435","DOIUrl":"10.2147/IMCRJ.S604435","url":null,"abstract":"<p><strong>Background: </strong>Spinal mucormycosis is a rare but potentially fatal fungal infection that is often observed in immunocompromised patients, particularly in those with poorly controlled diabetes or other systemic conditions. Early diagnosis and treatment are crucial for improving patient outcomes.</p><p><strong>Case presentation: </strong>A 55-year-old male with poorly controlled diabetes mellitus presented with throat pain, chest tightness, and dyspnea. Over the course of one year, the patient experienced repeated hospitalizations for pneumonia and pleural effusion, and subsequently developed a spinal abscess following a traditional cupping procedure. Imaging revealed severe spinal cord compression and abscess formation, extending from the thoracic spine. Initial treatment with antibiotics did not yield a significant improvement, and further imaging suggested possible tuberculosis. However, histopathological examination after thoracic spinal laminectomy confirmed the presence of mucormycosis.</p><p><strong>Management: </strong>The patient was initially started on empiric intravenous fluconazole, which was discontinued upon confirmation of mucormycosis. Definitive therapy with intravenous liposomal amphotericin B was then initiated, along with broad-spectrum intravenous antibiotics for possible secondary bacterial infection. Thoracic spinal laminectomy was performed; however, despite treatment, no recovery from paraplegia was observed, and the patient was discharged after several months of care.</p><p><strong>Discussion: </strong>Mucormycosis can present insidiously, mimicking bacterial or tuberculous infections, making early diagnosis difficult. In this case, delayed identification and treatment of the fungal infection allowed it to spread, leading to severe complications. The importance of maintaining a high index of suspicion for fungal infections in immunocompromised individuals is emphasized, particularly when standard therapies fail.</p><p><strong>Conclusion: </strong>Spinal mucormycosis is a rare but serious condition that requires prompt diagnosis and aggressive management. This case underscores the need for early recognition and a multidisciplinary approach for managing infections involving both medical and surgical interventions. Timely initiation of antifungal therapy is critical for improving patient outcomes and reduce mortality.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"604435"},"PeriodicalIF":0.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880164","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":"Penetrating Cranio-Cerebral Gunshot Injury with Retained Intracranial Bullet Adjacent to the Superior Sagittal Sinus.","authors":"Liban Hussein Ahmed, Tadese Kebede Nadew, Esmail Husein Mohamud, Ifrah Hassan Nur, Abdirafi Said Elmi, Abdullahi Ali Muse, Mohamed Osman Alim","doi":"10.2147/IMCRJ.S633497","DOIUrl":"10.2147/IMCRJ.S633497","url":null,"abstract":"<p><strong>Introduction: </strong>Penetrating gunshot injuries to the head are among the most severe forms of traumatic brain injury and are associated with high morbidity and mortality. This case report describes a 40-year-old female who presented to the emergency department 2 hours after sustaining a penetrating cranio-cerebral gunshot injury. The patient experienced loss of consciousness at the time of injury. On admission, with a Glasgow Coma Scale score of 10/15 and no focal neurological deficits. Vital signs were stable.Non-contrast head CT of the brain revealed a retained bullet in the parietal lobe without evidence of intracranial hemorrhage, mass effect, or midline shift, although image interpretation was limited by metallic artifact. The patient underwent an emergency craniotomy for removal of the retained intracranial bullet. Extreme caution was exercised to preserve the superior sagittal sinus and avoid vascular injury during the procedure. The surgery was completed without complications, and the patient was subsequently monitored in the intensive care unit). Follow-up CT imaging confirmed complete bullet removal and preservation of the superior sagittal sinus. Clinically, the patient showed neurological improvement, with her GCS increasing to 15/15.</p><p><strong>Conclusion: </strong>This case highlights the importance of early clinical stabilization, rapid neuroimaging, and timely neurosurgical intervention in improving outcomes following penetrating cranial gunshot injuries. Favorable neurological recovery can be achieved through surgical planning and timely intervention, even when a retained intracranial bullet is located in close proximity to critical neurovascular structures.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"633497"},"PeriodicalIF":0.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873974","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":"Acute Pediatric Toxic Ingestion of Automotive Grease: Full Remission via Conservative Management.","authors":"Salah Eldin Abdel Hag Abdel Haleem","doi":"10.2147/IMCRJ.S621808","DOIUrl":"10.2147/IMCRJ.S621808","url":null,"abstract":"<p><p>The accidental ingestion of automotive lubrication grease presents a distinct clinical challenge due to its high-viscosity semi-solid matrix and thickener profile. They are chemically complex, characterized by long, open carbon chains, a metallic salt group, and potentially toxic polycyclic aromatic hydrocarbons (PAHs). Given its common domestic availability, automotive grease represents a source of potential accidental poisoning. This report details the case of a 5-year-old girl who ingested automotive lubrication grease and subsequently developed acute gastroenteritis. Her symptoms included abdominal pain, excessive bowel movements, excessive salivation, and belching. At presentation, she was fully conscious but displayed irritability and stress. Initial investigations proved inconclusive, failing to yield a definitive diagnosis. Patient stabilization was successfully achieved through oral water intake for irrigation and intravenous fluid administration. Significant improvement was observed following the administration of ondansetron and prednisolone. A complete remission occurred once the ingested substance was passed in the stools. This is a rare and significant clinical presentation of pediatric ingestion of automotive grease with successful conservative management. The case emphasizes the importance of timely intervention and meticulous follow-up in managing unusual toxic exposures in emergency settings.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"621808"},"PeriodicalIF":0.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865027","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 Virginity Matters: Transabdominal Cervical Polypectomy in an Adolescent Girl, a Case Report.","authors":"Maram Balouli, Modar Doyya, Basel Ahmad, Aya Ahmad, Dema Adwan","doi":"10.2147/IMCRJ.S631439","DOIUrl":"10.2147/IMCRJ.S631439","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical polyps are common benign lesions, typically found in women of reproductive age. While often asymptomatic, they may lead to abnormal uterine bleeding and secondary complications such as anemia. Diagnosis is usually confirmed through transvaginal ultrasound or hysteroscopy; however, these methods pose challenges in virgin women, necessitating alternative diagnostic and therapeutic approaches. This case underscores several clinically relevant considerations. First, cervical polyps, though uncommon in young nulliparous women, should be considered in cases of refractory abnormal bleeding. Second, in settings where hysteroscopic resection is unavailable, transabdominal polypectomy offers a safe and effective solution for preserving anatomical integrity. The patient's presentation with severe metrorrhagia and anemia was particularly notable, as cervical polyps in this demographic typically manifest with milder symptoms.</p><p><strong>Case presentation: </strong>We report the case of a 22-year-old virgin Syrian woman with a six-year history of heavy menstrual bleeding and intermenstrual bleeding, unresponsive to medical management. Upon admission, she presented with severe anemia (hemoglobin: 7.5 g/dL), requiring blood transfusion. Pelvic magnetic resonance imaging (MRI) identified a large cervical polyp, later confirmed as a benign adenomatous lesion on histopathology. Given the patient's virginity and restricted vaginal access, an abdominal polypectomy was performed leading to complete resolution of symptoms.</p><p><strong>Conclusion: </strong>Cervical polyps, though rare in adolescents and young nulliparous women, warrant consideration in cases of unexplained gynecologic bleeding. A thorough diagnostic workup, including advanced imaging when necessary, is essential for accurate identification. While vaginal polypectomy remains the standard treatment, transabdominal resection represents a viable alternative for patients where vaginal access is limited. This case highlights the importance of individualized management in optimizing patient outcomes.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"631439"},"PeriodicalIF":0.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865058","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":"Pleomorphic Adenoma of a Minor Salivary Gland of the Hard Palate Complicated by Surgical Site Infection: A Case Report.","authors":"Alpha Muhindo Kavuyiro, Bienfait Mumbere Vahwere, Mihret Adane Woldemicheal, Charles Malisaba Posite, Eluzai Ndiwelubula, Jonas Makatsi, Franck Katembo Sikakulya, Yanurkis Duranones Rosales, Brian Agaba, Elizabeth Vargas Escalante","doi":"10.2147/IMCRJ.S627369","DOIUrl":"10.2147/IMCRJ.S627369","url":null,"abstract":"<p><strong>Background: </strong>Pleomorphic adenoma is the most common benign salivary gland tumor of the head and neck, predominantly affecting the parotid gland. Although minor salivary gland tumors are less common, the palate is a notable site, while involvement of the hard palate remains relatively rare. Complete surgical excision is the mainstay of treatment, with postoperative wound care or reconstruction tailored to the resulting defect. Although postoperative infection following oral surgery is uncommon, the risk increases with extensive tissue manipulation, flap elevation, bone exposure, or use of foreign materials and surgical packing. Infection associated with intraoral packing after excision of a palatal pleomorphic adenoma is exceptionally rare and may present challenges in postoperative management, highlighting the need for early recognition and a structured, evidence-informed approach to treatment.</p><p><strong>Case presentation: </strong>We describe a case of a 29-year-old Ankole male who presented with a painless swelling in the oral cavity that had slowly increased in size over three years. Clinical and radiological evaluations suggested a benign tumor arising from the palatal salivary glands. Surgical excision was performed, and absorbable intraoral packing was placed in the surgical wound. The histopathological examination provided the diagnosis of pleomorphic adenoma. On the fifth day after surgery, the patient developed clinical signs of surgical site infection. The packing was removed, wound care was continued, and antimicrobial treatment was administered. His condition improved progressively, and complete wound healing was achieved after three weeks of daily dressing.</p><p><strong>Conclusion: </strong>This report presents an uncommon postoperative complication following excision of pleomorphic adenoma of a minor salivary gland of the hard palate. Infection of intraoral packing complicated the early postoperative course, but removal of the infected material, antibiotics, and regular local wound care led to satisfactory recovery. The case underlines the importance of close postoperative follow-up.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"627369"},"PeriodicalIF":0.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864998","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":"Novel Nerve-Selective Treatment for Managing Knee Pain from Symptomatic Osteoarthritis: A Preliminary Case Series.","authors":"Murray Taverner, Mary Reynolds, Surabhi Gupta, Michael Fishman","doi":"10.2147/IMCRJ.S628297","DOIUrl":"10.2147/IMCRJ.S628297","url":null,"abstract":"<p><strong>Introduction: </strong>Between conservative treatments and total knee arthroplasty, adequate interventional pain management options for osteoarthritis of the knee (OAK) are limited. BXT-786 is a novel nerve-selective biomaterial intended to provide prolonged analgesia when delivered around the nerve branches that innervate the knee joint for use in patients with symptomatic OAK.</p><p><strong>Methods: </strong>We conducted a nonrandomized, single-cohort, open-label pilot feasibility study at a single site in Australia (ANZCTR.org ID: ACTRN12624000250538p) between April and December 2024. The primary objective of the current study was to evaluate the safety and tolerability of BXT-786 version 3.0 in four patients with symptomatic OAK. The secondary objective was to evaluate the preliminary analgesic performance of BXT-786 in managing knee pain associated with OAK.</p><p><strong>Results: </strong>BXT-786 treatment showed a reduction in knee pain that was observed approximately 4 to 9 days post-procedure. Compared to the baseline, the subjects saw a 79.7% decrease in average numerical rating scale pain scores at 6 months. Anecdotal information indicated that most subjects experienced pain relief, which enabled increased mobility, improved use of the affected knee, and greater engagement in daily life activities. BXT-786 treatment did not affect motor functions or result in device-related serious adverse events.</p><p><strong>Conclusion: </strong>This study demonstrates feasibility of BXT-786 version 3.0 in four patients with symptomatic OAK. The observed preliminary clinical benefit of nerve-selective treatment also supports further investigation as a potential non-systemic, non-pharmacologic, and minimally invasive intervention option for long-term pain relief.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"628297"},"PeriodicalIF":0.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857205","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":"Suspected Acute Stanford Type A Aortic Dissection: A Case Report.","authors":"Chigozie Ukachukwu Chukwuocha, James Nelson Okema, Clinton Nwanaga Uche, Chigozie Charles Ekengwu, Jovita Egharevba Eghe, Esther Oniagba Ebunoluwa, Grace Acomo, Ronald Obal, Ivaan Pitua, Felix Bongomin","doi":"10.2147/IMCRJ.S626171","DOIUrl":"10.2147/IMCRJ.S626171","url":null,"abstract":"<p><strong>Background: </strong>Acute Stanford type A aortic dissection carries 1-2% hourly mortality if medically managed. Misdiagnosis as hypertensive emergency delays surgery. In African settings without immediate computed tomography angiography (CTA) access, bedside echocardiography guides triage.</p><p><strong>Case presentation: </strong>A 58-year-old man with uncontrolled hypertension presented to the emergency department of the Federal Teaching Hospital, Owerri, Nigeria, with sudden tearing chest and back pain, diaphoresis, and dyspnea. Blood pressure was asymmetric at 210/115 mmHg in the right arm versus 180/100 mmHg in the left arm, with a new grade 2/6 early diastolic murmur of aortic regurgitation. Electrocardiography showed nonspecific ST-T changes. Chest radiography revealed cardiomegaly (cardiothoracic ratio 0.65) and mediastinal widening exceeding 8 cm. Serial troponin I remained negative at presentation and at 3 hours. Transthoracic echocardiography demonstrated aortic root dilatation to 5.4 cm, ascending aorta dilatation to 6.3 cm with intimal flap visualization, severe aortic regurgitation (vena contracta 0.70 cm), and mild pericardial effusion findings highly suggestive of suspected Stanford type A aortic dissection. Intravenous labetalol reduced heart rate to 55-60 beats per minute, followed by nicardipine titrated to systolic blood pressure 120-130 mmHg, stabilizing the patient for surgical referral.</p><p><strong>Conclusion: </strong>Blood pressure asymmetry, aortic regurgitation murmur, chest radiographic widening, and echocardiographic intimal flap enable recognition of suspected type A aortic dissection without CTA, preventing misclassification as hypertensive emergency.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"626171"},"PeriodicalIF":0.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864977","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}