American Journal of Case Reports最新文献

Sustained Immunotherapy Response in Metastatic Brain Melanoma Through 2 Pregnancies.

IF 1

American Journal of Case Reports Pub Date : 2025-03-14 DOI: 10.12659/AJCR.945533

Marcin Rajczykowski, Magdalena Olbryt, Katarzyna Galwas, Adam Idasiak, Ewa Stobiecka, Rafał Suwiński

{"title":"Sustained Immunotherapy Response in Metastatic Brain Melanoma Through 2 Pregnancies.","authors":"Marcin Rajczykowski, Magdalena Olbryt, Katarzyna Galwas, Adam Idasiak, Ewa Stobiecka, Rafał Suwiński","doi":"10.12659/AJCR.945533","DOIUrl":"https://doi.org/10.12659/AJCR.945533","url":null,"abstract":"BACKGROUND Metastatic brain melanoma is a deadly form of cancer with a high mortality rate and short overall survival. Immunotherapy with immune checkpoint inhibitors is the first treatment option for BRAF wild-type patients. Pregnancy is the exclusion criterion for immunotherapy and may promote the progression of melanoma. This report shows the long-lasting response of a patient with metastasis in multiple locations, including the brain, to immunotherapy and radiotherapy, who delivered 2 healthy boys during the disease. CASE REPORT A 39-year-old woman was diagnosed with BRAF(-)/NRAS(+) skin melanoma, pT2bN2aM0 (IIIB). Due to pregnancy, she did not receive adjuvant therapy. Upon delivery, the disease manifested with multiple extracranial and symptomatic brain metastasis. She was treated with whole-brain radiation and immunotherapy with ipilimumab and nivolumab followed by nivolumab. A partial response of the brain metastases and an extracranial complete response were observed. During the immunotherapy, she became pregnant and the therapy was discontinued. She was under regular medical surveillance, during which she delivered a healthy boy. The last CT scan and magnetic resonance brain examination showed a maintenance response for 43 months after initiation of immunotherapy and 31 months after therapy completion. CONCLUSIONS A long-lasting response to radiotherapy and interrupted immunotherapy is possible in the case of symptomatic metastatic brain melanoma developing during pregnancy, and healthy deliveries are possible despite the mother's progressive melanoma or exposure of the fetus to nivolumab (first trimester).","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945533"},"PeriodicalIF":1.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626385","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

Dextromethorphan Overdose with Refractory Status Epilepticus and Reversible Cranial Nerve Reflex Loss: A Case Report.

IF 1

American Journal of Case Reports Pub Date : 2025-03-13 DOI: 10.12659/AJCR.946447

Akifumi Okamoto, Naoki Yonezawa, Kazuhiro Yoshizawa, Reiki Kumashiro, Shinya Suzuki

{"title":"Dextromethorphan Overdose with Refractory Status Epilepticus and Reversible Cranial Nerve Reflex Loss: A Case Report.","authors":"Akifumi Okamoto, Naoki Yonezawa, Kazuhiro Yoshizawa, Reiki Kumashiro, Shinya Suzuki","doi":"10.12659/AJCR.946447","DOIUrl":"https://doi.org/10.12659/AJCR.946447","url":null,"abstract":"BACKGROUND Dextromethorphan is a widely used over-the-counter antitussive medication. Generally safe within the recommended dosages, its misuse can lead to severe adverse effects, particularly in large amounts. However, comprehensive descriptions of severe overdose cases - including pharmacokinetic data of dextromethorphan and its active metabolite (dextrorphan) - are scarce. CASE REPORT A 21-year-old woman with schizophrenia ingested 20 280 mg of dextromethorphan along with other prescribed medications during a suicide attempt. She was discovered semiconscious and experienced a generalized seizure en route to the hospital. Despite intensive treatments - including endotracheal intubation and administration of propofol and midazolam - she continued to experience refractory status epilepticus. Subsequent neurological examination revealed cranial nerve reflex loss. The serum concentration of dextromethorphan was 5.8 mg/L on admission and decreased to 2.2 mg/L by day 1 and 1.1 mg/L by day 2, contrasting with that of dextrorphan, which remained within the therapeutic limits. By day 4, her condition stabilized; she became alert, responsive to commands, and was successfully extubated. She was discharged on day 9 without any sequelae. CONCLUSIONS This report describes the case of a patient who survived a massive dextromethorphan overdose, who presented with refractory status epilepticus followed by reversible suppression of cranial nerve reflexes. The pharmacokinetic profiles suggested that dextromethorphan, rather than dextrorphan, was responsible for the symptoms. High-dose dextromethorphan ingestion can lead to varied and potentially fatal outcomes, especially when compounded by metabolism-altering factors such as CYP2D6 inhibition, genetic variability, or co-ingested medications. This case underscores the importance of prompt, intensive supportive care in managing severe dextromethorphan toxicity.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946447"},"PeriodicalIF":1.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617543","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

Thymoma-Induced Severe Biventricular Failure without Myasthenia Gravis: Investigating Tachycardia-Induced Cardiomyopathy.

IF 1

American Journal of Case Reports Pub Date : 2025-03-12 DOI: 10.12659/AJCR.945796

Roscoe Lim, Stephanie Wiltshire, Megan Barnet, Julia P Low, Samuel Bolitho, Alisa Kane, Andrew Jabbour, Eugene Kotlyar, Christopher Hayward

{"title":"Thymoma-Induced Severe Biventricular Failure without Myasthenia Gravis: Investigating Tachycardia-Induced Cardiomyopathy.","authors":"Roscoe Lim, Stephanie Wiltshire, Megan Barnet, Julia P Low, Samuel Bolitho, Alisa Kane, Andrew Jabbour, Eugene Kotlyar, Christopher Hayward","doi":"10.12659/AJCR.945796","DOIUrl":"https://doi.org/10.12659/AJCR.945796","url":null,"abstract":"BACKGROUND Cardiomyopathy associated with thymoma is thought to be a cardiac manifestations of myasthenia gravis (MG). However, there are case reports of newly diagnosed thymoma presenting with cardiomyopathy without MG, and the mechanism remains unclear. The purpose of this report is to explore tachycardia-induced cardiomyopathy (TIC) as a potential mechanism for cardiomyopathy in thymoma without features of MG. CASE REPORT A 31-year-old man presented with atrial flutter with right bundle branch block and severe biventricular heart failure. Echocardiogram revealed severe left ventricle ejection fraction (LVEF) of 15% with biventricular dilation with impaired systolic function. Computer tomography coronary angiography demonstrated normal coronary artery disease. Cardiac magnetic resonance imaging showed normal T1 and T2 mapping, without inflammation or edema. A large anterior mediastinal mass was found on computer tomography chest. Mediastinal mass biopsy identified type B3 thymoma (WHO classification) with dual population of large, uniform epithelial thymic cells and immature T cell phenotype. Acetylcholine receptor antibody was positive without clinical features of MG and hypogammaglobulinemia indicating Good syndrome. He was treated with antiarrhythmic and heart failure pharmacotherapy, carboplatin and paclitaxel, and intravenous immunoglobulin. He demonstrated reversible heart failure following abolishment of tachyarrhythmia, consistent with tachycardia-induced cardiomyopathy. CONCLUSIONS We report a rare case of a newly diagnosed thymoma and Good syndrome without clinical features of MG presenting with tachyarrhythmia and severe biventricular failure. The reversibility of the cardiomyopathy following abortion of tachyarrhythmia with treatment highlights TIC as a potential cause.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945796"},"PeriodicalIF":1.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606606","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

Hermansky-Pudlak Syndrome Type 1 Presenting with Interstitial Lung Disease: A Report of a Rare Case from Saudi Arabia.

IF 1

American Journal of Case Reports Pub Date : 2025-03-11 DOI: 10.12659/AJCR.945175

Lama Abdullah Alhomayin, Abdullah Rashed Alharbi, Ahmed Rufai Nadama, Joseph Hope Cal, Muthurajan Paramasivam

{"title":"Hermansky-Pudlak Syndrome Type 1 Presenting with Interstitial Lung Disease: A Report of a Rare Case from Saudi Arabia.","authors":"Lama Abdullah Alhomayin, Abdullah Rashed Alharbi, Ahmed Rufai Nadama, Joseph Hope Cal, Muthurajan Paramasivam","doi":"10.12659/AJCR.945175","DOIUrl":"https://doi.org/10.12659/AJCR.945175","url":null,"abstract":"BACKGROUND Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder characterized by oculocutaneous albinism, bleeding diathesis, and potential multi-organ involvement such as pulmonary fibrosis and granulomatous colitis. While its incidence is globally low, it may be under-reported, particularly in regions with high rates of consanguinity, such as the Middle East. By reporting this case, we aim to increase awareness of this condition as well as its association with ILD. CASE REPORT Herein, we present the case of a 48-year-old Saudi man of Arab descent with a 2-year history of progressive exertional dyspnea that recently worsened over the last 6 months, resulting in a Modified Medical Research Council (MMRC) dyspnea scale score increase from 2 to 3. Examination revealed signs consistent with albinism, accompanied by bibasilar end-inspiratory crackles on chest auscultation. Further evaluations revealed CT imaging consistent with non-specific interstitial lung pneumonia pattern (NSIP) with associated precapillary pulmonary hypertension. Notably, the patient exhibited oculocutaneous albinism, prompting consideration of Hermansky-Pudlak syndrome. Genetic testing confirmed an autosomal recessive HPS type 1 variant, a rarity in the Middle East. CONCLUSIONS HPS1 with ILD is rare in Saudi Arabia. This report describes such a case, offering important insight into its clinical presentation. Clinical management entails a multidisciplinary approach, including supportive care, preventive measures, and consideration of lung transplantation for severe cases. Consanguinity and endogamy, which are quite prevalent in the Middle East, probably means there is more prevalence of HPS and HPS-associated ILD than is recognized. Heightened awareness among healthcare providers is paramount for early diagnosis and optimal management of HPS-associated complications.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945175"},"PeriodicalIF":1.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598072","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

Imaging and Diagnostic Challenges in an 11-Year-Old Girl with Vaginal Agenesis: A Case Report.

IF 1

American Journal of Case Reports Pub Date : 2025-03-10 DOI: 10.12659/AJCR.944772

Betari Dhira Paramita, Dalri Muhammad Suhartomo, Mochamad Rizkar Arev Sukarsa, Andi Rinaldi, Aria Prasetya Ma'soem, Putri Nadhira Adinda Adriansyah

{"title":"Imaging and Diagnostic Challenges in an 11-Year-Old Girl with Vaginal Agenesis: A Case Report.","authors":"Betari Dhira Paramita, Dalri Muhammad Suhartomo, Mochamad Rizkar Arev Sukarsa, Andi Rinaldi, Aria Prasetya Ma'soem, Putri Nadhira Adinda Adriansyah","doi":"10.12659/AJCR.944772","DOIUrl":"https://doi.org/10.12659/AJCR.944772","url":null,"abstract":"BACKGROUND The prevalence of female genital tract anomalies is around 4-6.9%. Vaginal agenesis is a form of Müllerian agenesis and defined as the congenital absence of the vagina. It affects 1 in 5000 women. During normal fetal development, the Müllerian ducts combine to form the uterus, fallopian tubes, and most of the vagina. However, in cases of vaginal agenesis, the Müllerian ducts fail to fuse to form the upper part of the vagina. This report presents the case of an 11-year-old girl with vaginal agenesis evaluated using ultrasound. CASE REPORT An 11-year-old girl, Tanner stage II, presented with cyclic abdominal pain for 3 months and no menarche. After a hymenectomy for imperforate hymen in January 2023 failed to relieve symptoms, she was referred to our hospital. Physical examination showed a tender lower abdomen with no genital abnormalities. Transabdominal ultrasound was inconclusive for differentiating between a transverse vaginal septum and cervical agenesis with hematometra, and magnetic resonance imaging suggested hematometrocolpos due to a transverse vaginal septum. Intraoperatively, distal vaginal agenesis was identified, and vaginoplasty was performed, evacuating 200 mL of thick blood. The cervix and uterus were normal, and postoperative management included gradual vaginal dilation with a soft mold. This case highlights the diagnostic challenges of distal vaginal agenesis, particularly in patients with a history of imperforate hymen. CONCLUSIONS This report emphasizes the importance of accurate imaging and clinical evaluation in diagnosing reproductive anomalies such as distal vaginal agenesis. Developing techniques to enhance the specificity of imaging modalities is crucial for distinguishing vaginal agenesis from a transverse vaginal septum, ensuring appropriate surgical management and better patient outcomes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e944772"},"PeriodicalIF":1.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587532","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 58-Year-Old Man with a History of Autoimmune Thyroiditis Diagnosed with Mucosa-Associated Lymphoid Tissue Lymphoma and Papillary Carcinoma of the Thyroid.

IF 1

American Journal of Case Reports Pub Date : 2025-03-09 DOI: 10.12659/AJCR.946022

Naru Babaya, Sawa Yoshida, Shinsuke Noso, Yoshihisa Hiromine, Yasunori Taketomo, Takayuki Kimura, Hiroaki Kakutani, Takao Satou, Hiroshi Ikegami, Norikazu Maeda

{"title":"A 58-Year-Old Man with a History of Autoimmune Thyroiditis Diagnosed with Mucosa-Associated Lymphoid Tissue Lymphoma and Papillary Carcinoma of the Thyroid.","authors":"Naru Babaya, Sawa Yoshida, Shinsuke Noso, Yoshihisa Hiromine, Yasunori Taketomo, Takayuki Kimura, Hiroaki Kakutani, Takao Satou, Hiroshi Ikegami, Norikazu Maeda","doi":"10.12659/AJCR.946022","DOIUrl":"https://doi.org/10.12659/AJCR.946022","url":null,"abstract":"BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade B-cell non-Hodgkin's lymphoma. Autoimmune (Hashimoto's) thyroiditis is associated with thyroid MALT lymphoma, but co-existence with papillary thyroid carcinoma (PTC) has been less commonly reported. In this case report, we describe a 58-year-old man who presented with a 6-month history of hoarseness and an enlarged thyroid, and was diagnosed with Hashimoto's thyroiditis, MALT lymphoma, and PTC. CASE REPORT Upon referral to our hospital, he presented with an enlarged goiter and hoarseness. Based on preoperative findings, he was diagnosed with Hashimoto's thyroiditis, PTC in the left lobe, and possible malignant lymphoma in both thyroid lobes. However, whether the lymph node swelling around the neck and ¹⁸F-fluorodeoxyglucose uptake on positron emission tomography near the pancreas were related to the PTC, malignant lymphoma, or both remained unclear. Total thyroidectomy and lymph node dissection were performed to treat the PTC and to aid in the diagnosis of malignant lymphoma; the patient was diagnosed with PTC and MALT lymphoma, and lymphadenopathy was attributed to MALT lymphoma. The patient underwent postoperative chemotherapy with rituximab alone, and remission was maintained nearly 3 years after surgery. CONCLUSIONS This report highlights the association between Hashimoto's thyroiditis and thyroid MALT lymphoma, presents a rare finding of coexistent PTC and lymphadenopathy of initially unknown origin, and underscores the importance of histopathology in the diagnosis of these conditions.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946022"},"PeriodicalIF":1.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587610","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

Splenosis Masquerading as Endometriosis: A Rare Pelvic Post-Trauma Presentation.

IF 1

American Journal of Case Reports Pub Date : 2025-03-08 DOI: 10.12659/AJCR.946307

Khaled Abdul Jawad, Kathryn Denny, Tijani S Osumah, Komal Arora, Sarah E Allen, Christopher J Esper

{"title":"Splenosis Masquerading as Endometriosis: A Rare Pelvic Post-Trauma Presentation.","authors":"Khaled Abdul Jawad, Kathryn Denny, Tijani S Osumah, Komal Arora, Sarah E Allen, Christopher J Esper","doi":"10.12659/AJCR.946307","DOIUrl":"10.12659/AJCR.946307","url":null,"abstract":"BACKGROUND Splenosis is the ectopic autotrasplantation of splenic tissue that can follow trauma to the spleen or splenectomy and can occur anywhere in the peritoneal cavity or extraperitoneally. Splenosis can present incidentally without symptoms or with various symptoms depending on size and location. We describe a case of pelvic splenosis mimicking endometriosis in presentation. CASE REPORT A 37-year-old woman presented with dyspareunia, dysmenorrhea, and infertility >10 years after a motor vehicle accident requiring splenectomy. Examination revealed suprapubic and uterine tenderness with no retrocervical tenderness or palpable nodularity. Imaging (ultrasound, computed tomography, and magnetic resonance) revealed multiple pelvic masses of unknown etiology concerning for endometriosis, malignancy, or splenosis. Diagnostic laparoscopy with surgical resection of the cul-de-sac masses was performed and pathology confirmed splenosis. The patient reported resolution of her complaints postoperatively, resulting in improved quality of life. CONCLUSIONS Although splenosis is a known condition that can occur after trauma, pelvic splenosis is less often described in the gynecologic literature, leading to diagnostic ambiguity with uterine and ovarian masses as well as endometriosis. We describe a case of splenosis presenting similarly to endometriosis with the aim to improve awareness and diagnostic accuracy of these confounding conditions.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946307"},"PeriodicalIF":1.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587534","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}

引用次数: 0

Two Cases of Revisional Urinary Diversion from Ureterocutaneostomy to Ileal Conduit: A Staged Urinary Diversion Strategy for Patients with Bladder Cancer in the Targeted and Immunotherapy Era.

IF 1

American Journal of Case Reports Pub Date : 2025-03-07 DOI: 10.12659/AJCR.946924

Yuki Tanaka, Hideki Takeshita, Kazuki Yokota, Sonin Chon, Kenta Fujii, Ayano Ishida, Masahiro Arai, Kojiro Tachibana, Shoichi Nagamoto, Sachi Kitayama, Yohei Okada, Akihiro Yano, Kawakami Satoru

{"title":"Two Cases of Revisional Urinary Diversion from Ureterocutaneostomy to Ileal Conduit: A Staged Urinary Diversion Strategy for Patients with Bladder Cancer in the Targeted and Immunotherapy Era.","authors":"Yuki Tanaka, Hideki Takeshita, Kazuki Yokota, Sonin Chon, Kenta Fujii, Ayano Ishida, Masahiro Arai, Kojiro Tachibana, Shoichi Nagamoto, Sachi Kitayama, Yohei Okada, Akihiro Yano, Kawakami Satoru","doi":"10.12659/AJCR.946924","DOIUrl":"10.12659/AJCR.946924","url":null,"abstract":"BACKGROUND Cutaneous ureterostomy (CU) is a commonly used urinary diversion procedure, particularly for patients with poor prognosis, such as those with advanced cancer, a single kidney, or older age. CU is technically easier and faster to perform than other procedures, such as ileal conduit and ileal neobladder, as it does not involve the intestines, thus reducing the risk of postoperative intestinal complications and metabolic abnormalities. However, CU has several drawbacks, including difficulty in achieving a catheter-free status, frequent urinary tract infections, and concerns about long-term renal function, which can negatively impact a patient's quality of life. Recent advancements in the treatment of advanced metastatic urothelial cancer, particularly with immune checkpoint inhibitors and antibody-drug conjugates, have significantly improved the prognosis of patients with urothelial carcinoma. As a result, some patients who underwent CU and were initially considered to have poor prognosis achieved long-term remission. For these patients, the next goal is to establish a stable urinary diversion method that minimizes management effort and reduces the risk of infection and renal dysfunction. CASE REPORT This report presents 2 cases of revisional urinary diversion from CU to ileal conduit in patients with locally advanced bladder cancer who initially underwent CU and achieved long-term remission with pembrolizumab. Both patients achieved catheter-free status and preserved renal function postoperatively. CONCLUSIONS These cases highlight the potential benefits of staged urinary diversion in improving the quality of life of bladder cancer survivors in an era of targeted immunotherapy.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946924"},"PeriodicalIF":1.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574195","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}

引用次数: 0

Chronic Post-Prandial Epigastric Pain Associated with Median Arcuate Ligament Syndrome and Atherosclerosis of the Celiac Trunk in An Elderly Woman: A Case Report.

IF 1

American Journal of Case Reports Pub Date : 2025-03-06 DOI: 10.12659/AJCR.946075

Doan Duc Dung, Nguyen The Thoi, Nguyen Huu Thanh, Do Xuan Chien, Manh Duc Ngo, Nguyen Xuan Muoi

{"title":"Chronic Post-Prandial Epigastric Pain Associated with Median Arcuate Ligament Syndrome and Atherosclerosis of the Celiac Trunk in An Elderly Woman: A Case Report.","authors":"Doan Duc Dung, Nguyen The Thoi, Nguyen Huu Thanh, Do Xuan Chien, Manh Duc Ngo, Nguyen Xuan Muoi","doi":"10.12659/AJCR.946075","DOIUrl":"10.12659/AJCR.946075","url":null,"abstract":"BACKGROUND Post-prandial abdominal pain due to bowel ischemia can be caused by stenosis (atherosclerosis) or by compression of the arteries of the celiac axis. Median arcuate ligament syndrome (MALS) results from compression at the origin of the celiac trunk by the arcuate ligament. This report describes a 66-year-old woman with chronic post-prandial epigastric pain associated with atherosclerosis of the celiac trunk, managed with angioplasty and stenting combined with MALS. CASE REPORT A 66-year-old female patient with a history of dyslipidemia presented with chronic epigastric pain with post-prandial episodes for 4 years. Two years before the admission, her pain increased with meals and was not relieved by empirical treatment for gastritis. An esophagogastroduodenoscopy and colonoscopy showed chronic gastritis. One year later, a resection of the gastric submucosal tumor was performed, without improving her symptoms. In this presentation, the prompt computed tomography revealed hook-shaped stenosis of the celiac trunk and mild post-stenosis dilatation, highly suggestive of MALS. However, the patient refused to undergo surgery despite the benefit of this intervention. Concurrently, moderately severe atherosclerosis of the celiac trunk was detected during intra-vessel imaging. The patient was treated individually and underwent angioplasty with stenting. At a 5-month follow-up, the patient's condition was stable and she had no gastrointestinal symptoms. CONCLUSIONS Due to the low prevalence and nonspecific symptoms of MALS, physicians should be highly suspicious of this disease, especially in patients with post-prandial abdominal pain. Angioplasty and stenting can be performed in selected patients with MALS and atherosclerosis of the celiac trunk.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946075"},"PeriodicalIF":1.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567678","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}

引用次数: 0

Non-Traumatic Thyroid Cartilage Fracture from Sudden Neck Motion: Clinical Insights.

IF 1

American Journal of Case Reports Pub Date : 2025-03-05 DOI: 10.12659/AJCR.946084

Pierre Attal, Ben-Zion Horwitz, Jen-Yves Sichel, Chanan Shaul

{"title":"Non-Traumatic Thyroid Cartilage Fracture from Sudden Neck Motion: Clinical Insights.","authors":"Pierre Attal, Ben-Zion Horwitz, Jen-Yves Sichel, Chanan Shaul","doi":"10.12659/AJCR.946084","DOIUrl":"10.12659/AJCR.946084","url":null,"abstract":"BACKGROUND The thyroid cartilage is the most prominent laryngeal cartilage located beneath the hyoid bone. Non-traumatic fractures of the larynx, including the thyroid cartilage, are rare and can occur when the glottis is closed and intrathoracic pressure suddenly increases. This report describes the case of a 42-year-old man presenting with hoarseness and pain when swallowing and a diagnosis of non-traumatic thyroid cartilage fracture following sudden neck movement, highlighting the importance of recognizing atypical mechanisms of laryngeal injury. CASE REPORT A 42-year-old healthy man experienced a \"pop\" in his neck during sudden sharp head turning while driving. Five days later, he presented to the hospital with progressive odynophagia and hoarseness. Initial diagnostic workup included computed tomography imaging, which revealed a non-displaced anterior thyroid cartilage fracture with surrounding air. Fiberoptic laryngoscopy demonstrated left vocal cord thickening with preserved mobility, and a barium swallow study was unremarkable. Based on these findings and stable airway status, conservative management was initiated with antibiotics and airway monitoring. The patient was discharged after 2 days and demonstrated complete symptom resolution at 1-month follow-up. CONCLUSIONS This report has presented a rare case of non-traumatic thyroid cartilage fracture following sudden neck motion. The case highlights the importance of careful history and imaging of the structures of the neck, particularly in patients presenting with voice changes, even without apparent trauma. Furthermore, it supports the efficacy of conservative management in stable, non-displaced laryngeal fractures.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946084"},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558324","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}

引用次数: 0