American Journal of Case Reports最新文献

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Tricuspid Valve Infective Endocarditis with Severe Tricuspid Regurgitation.
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-08 DOI: 10.12659/AJCR.948728
Robert Doyle, Mark Wilkinson
{"title":"Tricuspid Valve Infective Endocarditis with Severe Tricuspid Regurgitation.","authors":"Robert Doyle, Mark Wilkinson","doi":"10.12659/AJCR.948728","DOIUrl":"https://doi.org/10.12659/AJCR.948728","url":null,"abstract":"<p><p>BACKGROUND Tricuspid valve infective endocarditis (TVIE) is a serious condition commonly associated with intravenous drug use (IVDU). It frequently leads to complications such as severe tricuspid regurgitation, septic embolization, and vegetation growth requiring surgical intervention. This case highlights the complexities of treating TVIE in an IVDU patient and emphasizes the need for multidisciplinary care strategies. CASE REPORT A man in his early 40s with a history of IVDU and hepatitis C presented with generalized chest pain, productive cough, fevers, and left groin swelling. Blood cultures confirmed methicillin-sensitive Staphylococcus aureus bacteremia, and echocardiography revealed a large (19 mm) vegetation on the tricuspid valve with severe tricuspid regurgitation and evidence of right ventricular overload. Despite an initial course of intravenous antibiotics, the patient exhibited poor adherence to treatment and discharged against medical advice. He returned with worsening symptoms, persistent bacteremia, and progressive vegetation growth, necessitating surgical intervention. However, due to concerns regarding postoperative compliance, compounded by the patient's fear of surgical risks and ongoing substance use, he refused surgery after initially consenting, resulting in loss to follow-up. CONCLUSIONS This case underscores the challenges of managing TVIE in the context of IVDU, particularly regarding treatment adherence and continuity of care. It highlights the importance of early multidisciplinary intervention, including addiction support services, supervised antimicrobial therapy, and patient-centered discharge planning. Future strategies should focus on integrating medical and social interventions to improve patient outcomes and reduce recurrent infections in this high-risk population.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948728"},"PeriodicalIF":0.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Scleral Rupture with Uveal Prolapse Following Trivial Trauma in an Eye Previously Treated with Internal and External Cyclodestructive Procedures: A Case Report. 巩膜破裂伴葡萄膜脱垂的小创伤后的眼睛先前治疗的内部和外部环破坏程序:一个病例报告。
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-07 DOI: 10.12659/AJCR.949442
Raed Alnutaifi, Ibrahim Nasser Asiri, Ahmed Al Habash, Sami Alshahwan, Sulaiman AlTariqi, Halah Bin Helayel
{"title":"Scleral Rupture with Uveal Prolapse Following Trivial Trauma in an Eye Previously Treated with Internal and External Cyclodestructive Procedures: A Case Report.","authors":"Raed Alnutaifi, Ibrahim Nasser Asiri, Ahmed Al Habash, Sami Alshahwan, Sulaiman AlTariqi, Halah Bin Helayel","doi":"10.12659/AJCR.949442","DOIUrl":"https://doi.org/10.12659/AJCR.949442","url":null,"abstract":"<p><p>BACKGROUND Scleral rupture and uveal tissue prolapse after internal and external cyclodestructive procedures are rare complications secondary to trivial trauma. Micropulse cyclophotocoagulation (MP-CPC) and ultrasound cycloplasty (UCP) are effective treatments for controlling intraocular pressure (IOP) and pain in refractory glaucoma, with few complications. This case report documents a case of scleral rupture and uveal tissue prolapse secondary to trivial trauma in an eye with a history internal and external cyclodestructive procedures. CASE REPORT A 28-year-old woman with a history of intermediate uveitis and secondary glaucoma presented to the Emergency Department with significant eye pain and decreased vision following trivial trauma to her right eye. She had undergone multiple ocular surgeries, including MP-CPC and UCP, 17 months earlier. Examination revealed a perilimbal scleral rupture extending from 2 to 5 o'clock, corneal edema, and hyphema. On the same day as the initial presentation, she underwent primary repair of the right eye. Postoperative recovery showed a gradual improvement in IOP and a stable scleral wound without a leak. CONCLUSIONS Following cyclodestructive procedures, structural weakening of the ocular wall may predispose to scleral rupture and uveal tissue prolapse, particularly in eyes with a history of inflammation or prior surgery. Although the rupture in this case was triggered by trauma, it highlights a potential indirect risk associated with such interventions.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949442"},"PeriodicalIF":0.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bezold-Jarisch Reflex-Induced Cardiac Arrest During Colonoscopy Under Sedation: A Case Report.
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-07 DOI: 10.12659/AJCR.949496
Qian Liu, Shaomao Jia, Haoming Chen, Hui Liu, Liu Xu, Peng Li
{"title":"Bezold-Jarisch Reflex-Induced Cardiac Arrest During Colonoscopy Under Sedation: A Case Report.","authors":"Qian Liu, Shaomao Jia, Haoming Chen, Hui Liu, Liu Xu, Peng Li","doi":"10.12659/AJCR.949496","DOIUrl":"https://doi.org/10.12659/AJCR.949496","url":null,"abstract":"<p><p>BACKGROUND Bezold-Jarisch reflex (BJR) is a physiologic cardioinhibitory reflex, but its occurrence can lead to severe bradycardia and hypotension, or even cardiac arrest. Due to the rarity of its occurrence and the lack of awareness among most anesthesiologists, this clinical presentation may be mistaken for other adverse cardiovascular events, and effective preventive and curative measures may not be taken. CASE REPORT We report a case of cardiac arrest during a routine sedated colonoscopy. Following the arrest, the patient underwent cardiopulmonary resuscitation and received atropine and epinephrine. After 2 minutes of cardiopulmonary resuscitation, the patient's heart rate and blood pressure normalized, and he regained consciousness with no discomfort reported except for fatigue. We excluded organic pathology after a thorough systematic examination, and after discussion with our multidisciplinary team in the context of intraoperative hemodynamic alterations, it was concluded that intraoperative cardiac arrest was caused by BJR in this patient. The patient's clinical course - characterized by initial recurrent bradycardia with hypotension progressing to syncope or cardiac arrest - was more consistent with BJR than with typical vasovagal syncope. Prolonged fasting prior to sedated colonoscopy likely induced hypovolemia, and subsequent sedation further exacerbated peripheral vasodilation, collectively triggering BJR. The patient was discharged on day 5 after cardiac arrest, with no recurrence of syncope noted during a 4-month telephone follow-up. CONCLUSIONS This is the first reported case of BJR-induced cardiac arrest during sedated colonoscopy. It underscores the need for anesthesiologists to consider BJR in the differential diagnosis of recurrent bradycardia and hypotension, and to implement targeted interventions to mitigate the risk of associated severe complications.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949496"},"PeriodicalIF":0.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Hypothermic Cardiac Arrest with Hemoperitoneum from LUCAS Device: A Case Report. LUCAS装置治疗低体温心脏骤停伴腹膜积血1例。
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-06 DOI: 10.12659/AJCR.949607
Wade Hopper, Elena J Danielson, Anthony J Duncan, Abirami Saravanan, Kristin Korderas, Rebekah Devasahayam, Ramzi K Deeik, Khaled Zreik
{"title":"Management of Hypothermic Cardiac Arrest with Hemoperitoneum from LUCAS Device: A Case Report.","authors":"Wade Hopper, Elena J Danielson, Anthony J Duncan, Abirami Saravanan, Kristin Korderas, Rebekah Devasahayam, Ramzi K Deeik, Khaled Zreik","doi":"10.12659/AJCR.949607","DOIUrl":"https://doi.org/10.12659/AJCR.949607","url":null,"abstract":"<p><p>BACKGROUND Witnessed hypothermic cardiac arrest is a rare injury with high mortality, particularly at extreme temperatures. We describe a case of witnessed accidental hypothermia with a profoundly low core temperature of 20°C, resulting in pre-hospital cardiac arrest. The patient was successfully treated with cardiopulmonary bypass rewarming, but the clinical course was further complicated by a liver injury from device-assisted cardiopulmonary resuscitation (CPR), necessitating exploratory laparotomy. CASE REPORT A 30-year-old man was found roadside in -15°C weather and suffered pre-hospital cardiac arrest, witnessed by emergency medical personnel. Rewarming treatment with cardiopulmonary bypass was performed at our level-1 trauma center after the patient presented with a core temperature of 20°C and underwent 195 minutes of CPR. Intraoperatively, he was noted to have constant loss of volume on bypass as well as a tense, distended abdomen. Exploratory laparotomy was performed showing hemoperitoneum from a liver laceration secondary to CPR with a Lund University Cardiopulmonary Assist System (LUCAS) device. Delayed sternal and abdominal closure was performed with definitive closure occurring on hospital day 3. The patient experienced full neurologic recovery and was discharged home on hospital day 23. CONCLUSIONS Extracorporeal rewarming is a definitive treatment for cardiac arrest from accidental severe hypothermia and can be accomplished with cardiopulmonary bypass. Providers should have heightened clinical suspicion for solid organ injury when CPR is facilitated by a LUCAS device rather than manual compressions. Disproportionately low return volumes on the cardiopulmonary bypass circuit should prompt consideration of a differential diagnosis which in post-resuscitation patients can include traumatic hemoperitoneum.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949607"},"PeriodicalIF":0.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eosinophilic Esophagitis After Radiofrequency Ablation of Barrett's Esophagus in a 41-Year-Old Man. 一例41岁男性Barrett食管射频消融术后嗜酸性食管炎。
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-06 DOI: 10.12659/AJCR.949169
Anna Mokrowiecka, Agata Wróbel, Adam Fabisiak, Jakub Czerwiński, Marcin Braun, Ewa Małecka-Wojciesko
{"title":"Eosinophilic Esophagitis After Radiofrequency Ablation of Barrett's Esophagus in a 41-Year-Old Man.","authors":"Anna Mokrowiecka, Agata Wróbel, Adam Fabisiak, Jakub Czerwiński, Marcin Braun, Ewa Małecka-Wojciesko","doi":"10.12659/AJCR.949169","DOIUrl":"https://doi.org/10.12659/AJCR.949169","url":null,"abstract":"<p><p>BACKGROUND Gastroesophageal reflux disease (GERD) and Barrett's esophagus (BE) can contribute to the development of esophageal eosinophilia, specifically after radiofrequency ablation (RFA). Eosinophilic esophagitis (EoE) after treatment for BE is much rarer. EoE is a chronic, immune-mediated disease of the esophagus, commonly presenting with symptoms such as dysphagia and heartburn. Diagnosis is established based on histological evaluation of esophageal biopsies. This report describes a 41-year-old man with chronic GERD and BE with symptomatic EoE, following RFA. CASE REPORT A 41-year-old male patient with a history of GERD spanning over a decade and BE treated with RFA in 2013 was admitted to the Department of Gastroenterology in April 2024 for routine upper endoscopy with biopsy sampling. Esophagogastroduodenoscopy (EGD) revealed significant abnormalities throughout the esophagus, including pronounced trachealization, longitudinal furrows, mucosal exudates, and edema. Histopathological analysis of multiple biopsy samples revealed over 15 eosinophils per high-power field (hpf) in the proximal squamous mucosa, with no signs of dysplasia. CONCLUSIONS We report a case of EoE development after successful RFA treatment of Barrett's esophagus. This case highlights the importance of long-term endoscopic surveillance in patients with a history of esophageal conditions, even after seemingly successful therapeutic interventions. Clinicians should remain vigilant for atypical presentations of EoE, especially in patients with prior esophageal disease or interventions.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949169"},"PeriodicalIF":0.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing Detection and Management of Spontaneous Bilateral Ectopic Pregnancies: Insights From a Rare Case. 加强自发性双侧异位妊娠的发现和处理:来自一个罕见病例的见解。
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-05 DOI: 10.12659/AJCR.949468
Haneen AlJalodi, Farah AlMughrbi, Kat Pavlidi, Penny Robshaw
{"title":"Enhancing Detection and Management of Spontaneous Bilateral Ectopic Pregnancies: Insights From a Rare Case.","authors":"Haneen AlJalodi, Farah AlMughrbi, Kat Pavlidi, Penny Robshaw","doi":"10.12659/AJCR.949468","DOIUrl":"https://doi.org/10.12659/AJCR.949468","url":null,"abstract":"<p><p>BACKGROUND Ectopic pregnancy is a common gynecological emergency occurring when fertilization implants outside the uterine cavity. Bilateral tubal ectopic pregnancy (BTP), in which there are simultaneous pregnancies in both fallopian tubes, is exceedingly rare. BTP diagnosis is challenging as symptoms mimic unilateral cases, and imaging often fails to identify both sites. No standardized follow-up protocols exist, leading to potential clinical oversight and delayed management. While BTP is more commonly associated with assisted reproductive technologies, spontaneous cases are even rarer. CASE REPORT We present a case of spontaneous BTP in a 28-year-old woman initially treated for unilateral ectopic pregnancy. Transvaginal ultrasonography suggested a right tubal ectopic pregnancy, but laparoscopy revealed a left ectopic pregnancy, requiring salpingectomy. Despite the discrepancy between imaging and surgical findings, no additional follow-up was arranged. The patient re-presented 17 days post-surgery with persistent abdominal pain and shoulder tip pain. Initially diagnosed as postoperative infection, subsequent ultrasound revealed a live ectopic pregnancy in the right tube. Emergency surgery confirmed a ruptured right tubal pregnancy necessitating a second salpingectomy. CONCLUSIONS This rare case highlights the diagnostic challenges of bilateral ectopic pregnancies and emphasizes the need for thorough examination of both fallopian tubes during assessment and surgery. When discrepancies exist between imaging and intraoperative findings, clinicians should maintain vigilance for BTP. This case demonstrates the need for comprehensive postoperative monitoring when imaging-surgical discrepancies occur. Clinicians should consider bilateral ectopic pregnancy when patients present with persistent symptoms following treatment for unilateral ectopic pregnancy. Improved awareness and standardized protocols could enhance early detection and preserve fertility in these rare cases.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949468"},"PeriodicalIF":0.7,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiotoxicity Secondary to Accidental Tilmicosin (Micotil®300) Ingestion in a Young Shepherd: A Case Report. 年轻牧羊犬意外摄入替尔米科星(Micotil®300)继发的心脏毒性:一例报告。
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-05 DOI: 10.12659/AJCR.948094
Zein B Sheikh, Bayan S Alalawi, Fadyah M Alradaddi, Ahlam Y Elbadri
{"title":"Cardiotoxicity Secondary to Accidental Tilmicosin (Micotil®300) Ingestion in a Young Shepherd: A Case Report.","authors":"Zein B Sheikh, Bayan S Alalawi, Fadyah M Alradaddi, Ahlam Y Elbadri","doi":"10.12659/AJCR.948094","DOIUrl":"https://doi.org/10.12659/AJCR.948094","url":null,"abstract":"<p><p>BACKGROUND Tilmicosin (Micotil®300) is a veterinary macrolide antibiotic used in the management of respiratory diseases in cattle and sheep. Human handling can lead to accidental exposures, which has been associated with severe adverse reactions, especially cardiovascular toxicity, and even death. This report describes a case of a 29-year-old male shepherd with cardiac manifestations following accidental ingestion of Tilmicosin. CASE REPORT A young man with no prior history of cardiac disease presented to the Emergency Department with syncope and severe chest pain following accidental oral ingestion of approximately 1 ml of Tilmicosin. Electrocardiography revealed ST elevation in leads V3 and V4 with sinus arrhythmia. Cardiac enzymes remained normal, and imaging studies showed no structural heart abnormalities. He was treated with supportive care alone with no adverse outcomes observed during hospitalization. CONCLUSIONS Tilmicosin has been associated with life-threatening adverse effects in humans, with this report demonstrating that even minimal non-parenteral exposure can lead to severe cardiac toxicity. This highlights the importance of raising awareness among both the public and professionals regarding safe handling practices, and the prompt initiation of medical evaluation following potential exposure. Tilmicosin should be administered by qualified professionals using standardized techniques to minimize accidental self-injuries. Further research into specific therapies for Tilmicosin toxicity is warranted to improve outcomes.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948094"},"PeriodicalIF":0.7,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel Use of Robotic Surgery in a Rare Case of Canal of Nuck Cyst: A Case Report and Literature Review. 机器人手术治疗罕见的椎管囊肿1例报告及文献复习。
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-04 DOI: 10.12659/AJCR.949239
Winnie Long, Jamie Han, Luca Milone
{"title":"Novel Use of Robotic Surgery in a Rare Case of Canal of Nuck Cyst: A Case Report and Literature Review.","authors":"Winnie Long, Jamie Han, Luca Milone","doi":"10.12659/AJCR.949239","DOIUrl":"https://doi.org/10.12659/AJCR.949239","url":null,"abstract":"<p><p>BACKGROUND A cyst within the canal of Nuck is an uncommon groin mass found in female patients. Embryologically, this is equivalent to a patent processus vaginalis in males. This cyst presents as a nonspecific bulge and is often mistaken for or presents concurrently with an inguinal hernia. Preoperative imaging assists in delineating anatomy and ruling out other differential diagnoses. Surgical management involves excision with inguinal hernia repair and has varied from open techniques to laparoscopic techniques. In this case, we describe a robot-assisted approach to cyst excision with concurrent inguinal hernia repair in an adult female patient. CASE REPORT A 42-year-old woman presented with a nonspecific mass in the left inguinal area, which was identified on magnetic resonance imaging as a fluid collection within the left inguinal canal, consistent with a canal of Nuck hydrocele. The patient underwent robot-assisted laparoscopic excision of cyst and inguinal hernia repair with mesh placement. Surgical pathology confirmed the diagnosis. CONCLUSIONS To the best of our knowledge, this is the first report of the utilization of the DaVinci robot in excision of a cyst of the canal of Nuck. Overall, the surgical approach should be determined by location of the cyst and surgeon preference. A subcutaneous cyst is easily reached via an open anterior approach. In contrast, cysts within the inguinal canal have increasingly been approached via the laparoscopic approach or a combined laparoscopic and open approach for larger cysts. We demonstrate the utility of a robotic-assisted approach to facilitate dissection, reduction, and removal of the cyst.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949239"},"PeriodicalIF":0.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perforated Meckel Diverticulum Caused by Vegetal Food Entrapment: A Rare Case Report and Literature Review. 植物性食物夹带致梅克尔憩室穿孔:一例罕见病例报告及文献复习。
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-04 DOI: 10.12659/AJCR.948592
Odile Sorg, Xenofon Papazarkadas, Michaël Racine, Christian Toso, Stefan Mönig
{"title":"Perforated Meckel Diverticulum Caused by Vegetal Food Entrapment: A Rare Case Report and Literature Review.","authors":"Odile Sorg, Xenofon Papazarkadas, Michaël Racine, Christian Toso, Stefan Mönig","doi":"10.12659/AJCR.948592","DOIUrl":"https://doi.org/10.12659/AJCR.948592","url":null,"abstract":"<p><p>BACKGROUND Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract. It results from incomplete obliteration of the vitelline duct, leading to the formation of a true diverticulum of the small intestine, and is often clinically silent. However, complications can occur, including gastrointestinal bleeding, bowel obstruction, Meckel's diverticulitis, or perforation. CASE REPORT We present the case of a 62-year-old male patient in good health, with no prior history of surgery, who presented with abdominal pain in the right iliac fossa and elevated C-reactive protein levels. An abdominal ultrasound showed signs of acute appendicitis. During surgical laparoscopic exploration, which was converted to a median laparotomy, an inflamed perforated Meckel diverticulum caused by a foreign body was discovered. Due to the inflammation, a segmental small bowel resection with an ileo-ileal latero-lateral anastomosis was performed. CONCLUSIONS The surgical management of Meckel diverticulum depends on several factors, including the presence of inflammation, perforation, infection, and the size of the diverticulum. Diverticulectomy, which can be easily performed laparoscopically, typically has a lower complication rate. Nevertheless, in cases of bleeding or severe inflammation, a small bowel resection may be needed to ensure that all heterotopic mucosa is removed. This report highlights a rare case of perforation caused by a foreign body of vegetal origin.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948592"},"PeriodicalIF":0.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Rare Case of Waldenström Macroglobulinemia Presenting as Bilateral Bloody Pleural Effusion and Pancytopenia. 一例罕见的Waldenström巨球蛋白血症表现为双侧血性胸腔积液和全血细胞减少症。
IF 0.7
American Journal of Case Reports Pub Date : 2025-10-03 DOI: 10.12659/AJCR.948815
Yue Qing Chen, Hua Wang, Qiong Feng
{"title":"A Rare Case of Waldenström Macroglobulinemia Presenting as Bilateral Bloody Pleural Effusion and Pancytopenia.","authors":"Yue Qing Chen, Hua Wang, Qiong Feng","doi":"10.12659/AJCR.948815","DOIUrl":"https://doi.org/10.12659/AJCR.948815","url":null,"abstract":"<p><p>BACKGROUND Waldenström macroglobulinemia (WM) is an uncommon, indolent mature B-cell lymphoma with various clinical manifestations. Bilateral bloody pleural effusion is rare, while chylothorax is even more infrequent. Furthermore, pancytopenia holds significant clinical relevance in WM, highlighting clinicians' need to exercise substantial vigilance. CASE REPORT We report the case of a 71-year-old man who was admitted for chest tightness, dyspnea, and fatigue. Initial laboratory tests revealed pancytopenia, and a computed tomography (CT) scan showed bilateral pleural effusion. The diagnostic workup included a lymph node biopsy that confirmed CD20+ B-cell lymphoma. Bone marrow molecular studies identified somatic mutations in MYD88 (L252P, c.755T>C) and CXCR4 (R322Sfs*16, c. 966-982del). The bone marrow biopsy indicated lymphoplasmacytic lymphoma. A serum immunofixation test revealed monoclonal bands of IgM and kappa. Based on the patient's symptoms and examination results, a thorough analysis led to the final diagnosis of Waldenström macroglobulinemia. The patient underwent therapeutic thoracentesis, followed by 4 cycles of rituximab (375 mg/m² on Day 1) and bendamustine (70 mg/m² on Days 2-3). Post-treatment evaluation revealed hematologic recovery and complete resolution of pleural effusions on thoracic ultrasound. CONCLUSIONS This case report elaborates on Waldenström macroglobulinemia's diagnosis and treatment process to enhance clinicians' awareness and ability to manage the complications associated with this rare disease.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948815"},"PeriodicalIF":0.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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