American Journal of Case Reports最新文献_第3页

Severe COVID-19 Pneumonia, Opportunistic Candida krusei Infection, and Acute Respiratory Distress Syndrome with Pulmonary Arterial Hypertension Treated with Bosentan: A Case Report.

IF 1

American Journal of Case Reports Pub Date : 2025-02-24 DOI: 10.12659/AJCR.946400

Killen H Briones-Claudett, Killen H Briones-Zamora, Jaime Galo Benites Solis, Doménica I Huilcapi Borja, Karelys Nicole Arteaga Ocaña, Maria Antonieta Touriz Bonifaz, Pedro Barberan-Torres, Michelle Grunauer

{"title":"Severe COVID-19 Pneumonia, Opportunistic Candida krusei Infection, and Acute Respiratory Distress Syndrome with Pulmonary Arterial Hypertension Treated with Bosentan: A Case Report.","authors":"Killen H Briones-Claudett, Killen H Briones-Zamora, Jaime Galo Benites Solis, Doménica I Huilcapi Borja, Karelys Nicole Arteaga Ocaña, Maria Antonieta Touriz Bonifaz, Pedro Barberan-Torres, Michelle Grunauer","doi":"10.12659/AJCR.946400","DOIUrl":"10.12659/AJCR.946400","url":null,"abstract":"BACKGROUND Despite global vaccination efforts, COVID-19 still necessitates effective treatments for severe cases that can quickly escalate to life-threatening complications, such as acute respiratory distress syndrome (ARDS) and secondary pulmonary arterial hypertension (PAH). Here, we present the clinical journey of a 73-year-old Ecuadorian man who developed severe COVID-19 pneumonia complicated by an opportunistic Candida krusei infection and ARDS, subsequently progressing to long-term PAH, managed with bosentan, an endothelin 1 (ET-1) antagonist. CASE REPORT The patient, vaccinated with 2 doses of CoronaVac, experienced severe COVID-19 complications, including ARDS and secondary PAH, further complicated by a C. krusei infection. Despite prompt mechanical ventilation and intensive care, his condition rapidly deteriorated. Clinical evaluation confirmed COVID-19-associated ARDS, secondary PAH, and C. krusei infection through bronchoalveolar lavage. The therapeutic approach combined bosentan (125 mg twice daily) with dual antifungal therapy, leading to significant stabilization and eventual discharge. Post-discharge assessments showed persistent cardiopulmonary dysfunction, consistent with post-COVID-19 syndrome. CONCLUSIONS This case highlights critical COVID-19 complications in a vaccinated patient. While vaccination may provide substantial protection, COVID-19 pneumonia treated with corticosteroids can increase the risk of opportunistic infections like C. krusei, and ARDS can lead to pulmonary fibrosis and PAH. This case underscores the need for research on therapeutic strategies for complex COVID-19 cases and emphasizes comprehensive, personalized care for managing COVID-19 complications and sequelae.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946400"},"PeriodicalIF":1.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484257","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

Rare Lacrimal Gland Melanoma: A Case Report and Treatment Insights.

IF 1

American Journal of Case Reports Pub Date : 2025-02-23 DOI: 10.12659/AJCR.946361

Reinhard Told, Ana-Iris Schiefer, Christoph Hoeller, Adrian Reumueller, Judith Kreminger, Roman Dunavoelgyi

{"title":"Rare Lacrimal Gland Melanoma: A Case Report and Treatment Insights.","authors":"Reinhard Told, Ana-Iris Schiefer, Christoph Hoeller, Adrian Reumueller, Judith Kreminger, Roman Dunavoelgyi","doi":"10.12659/AJCR.946361","DOIUrl":"10.12659/AJCR.946361","url":null,"abstract":"BACKGROUND Melanoma is a malignant transformation of melanocytes known for its capacity to metastasize, necessitating early diagnosis and intervention. While over 97% of melanomas are diagnosed with a known primary site, such as the skin, eye, or mucous membranes, rare cases like melanoma of unknown primary (MUP) can present with atypical manifestations, highlighting the need for comprehensive examinations. CASE REPORT In January 2023, a 68-year-old woman presented with a 4-week history of swelling and discoloration in her left upper eyelid, revealing a hard, livid mass indicative of malignancy. Surgery and subsequent histopathology confirmed epithelioid cell melanoma in the lacrimal gland. Although no other primary melanoma sites were found, imaging and biopsy in August 2023 identified metastatic spread to her lungs. Despite proton radiotherapy, progression led to thoracoscopic surgery for metastasis resection in September 2023. Further re-evaluation revealed metastases in both lungs, leading to her enrolment in a trial comparing PD-1 (programmed death ligand 1) antibody plus LAG-3 (lymphocyte activation gene 3) antibody with PD-1 monotherapy. Subsequent progression required treatment with ipilimumab and nivolumab, which resulted in near complete regression of the orbital tumor. Unfortunately, she later developed serious complications, including hypophysitis, lung infection, renal failure, and viral meningitis, which ultimately led to her death in April 2024. CONCLUSIONS This case report highlights the diagnostic challenge in distinguishing between melanoma of known and unknown primary origins. It emphasizes the importance of thorough histological work-up and heightened suspicion for melanoma of the lacrimal gland, despite its rarity, to ensure prompt diagnosis and treatment due to its metastatic potential.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946361"},"PeriodicalIF":1.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484239","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

Rare Presentation of Middle Ear Neuroendocrine Tumor: A Case Report. 罕见的中耳神经内分泌肿瘤：病例报告

IF 1

American Journal of Case Reports Pub Date : 2025-02-22 DOI: 10.12659/AJCR.945602

Nan Zeng, Qiong Yang, Jing Hu, Shang Yan

{"title":"Rare Presentation of Middle Ear Neuroendocrine Tumor: A Case Report.","authors":"Nan Zeng, Qiong Yang, Jing Hu, Shang Yan","doi":"10.12659/AJCR.945602","DOIUrl":"10.12659/AJCR.945602","url":null,"abstract":"BACKGROUND Neuroendocrine tumors (NETs) of the middle ear are exceptionally rare, representing less than 2% of primary ear tumors in adults. These neoplasms originate from neuroendocrine cells within the middle ear cavity, posing significant diagnostic and therapeutic challenges. CASE REPORT We present a 27-year-old man with a 2-month history of left-sided hearing loss, tinnitus, and ear fullness. Comprehensive assessments, including tuning fork tests, pure tone audiometry, computed tomography (CT) scan of the temporal bone, and magnetic resonance imaging (MRI), were conducted. Differential diagnoses, included cholesteatoma and other middle ear masses, but chronic suppurative otitis media was not considered due to the intact tympanic membrane. Intraoperative findings revealed a pale pink mass encasing the ossicular chain, confirmed as a neuroendocrine tumor (CK [+], Syn [+++], CK18 [+], EMA [++], CD56 [-], CgA [+], Ki67 [2%+]) by immunohistochemistry. The tumor was excised via an endoscopic tympanotomy. Postoperative follow-up over 2 years showed no recurrence or metastasis, and the patient reported no significant hearing impairment affecting quality of life. CONCLUSIONS Middle ear neuroendocrine tumors require meticulous diagnostic workup and precise surgical intervention. This case adds to the limited body of evidence supporting that middle ear neuroendocrine tumors, although rare, can be managed effectively with tailored surgical approaches. Continued case reporting will be vital to enhance understanding and to refine treatment guidelines for optimal patient outcomes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945602"},"PeriodicalIF":1.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476975","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

Treatment of Post-COVID-19 Pulmonary Aspergilloma: Insights from a Clinical Case. 后 COVID-19 肺曲霉瘤的治疗：一个临床病例的启示。

IF 1

American Journal of Case Reports Pub Date : 2025-02-21 DOI: 10.12659/AJCR.946456

Atif S Siddiqui

{"title":"Treatment of Post-COVID-19 Pulmonary Aspergilloma: Insights from a Clinical Case.","authors":"Atif S Siddiqui","doi":"10.12659/AJCR.946456","DOIUrl":"10.12659/AJCR.946456","url":null,"abstract":"BACKGROUND This report presents the case of a 49-year-old man with pulmonary aspergilloma 6 months after hospitalization and mechanical ventilation for COVID-19 who was treated with robot-assisted lobectomy. COVID-19-associated pulmonary aspergillosis is a life-threatening complication of SARS-CoV-2 infection. Aspergilloma, a delayed complication of COVID-19, is rare. Major risk factors for pulmonary aspergilloma include neutropenia, solid organ transplantation, prolonged high-dose corticosteroid therapy, hematological malignancy, cytotoxic therapy, acquired immunodeficiency syndrome, and chronic granulomatous disease. Common symptoms include cough, shortness of breath, fatigue, wheezing, weight loss, fever, and chest pain. Hemoptysis is the most severe complication of pulmonary aspergilloma. Treatment options include antifungals, bronchial artery embolization, and surgery. Surgical treatment is considered definitive for patients who do not respond to antifungal medications. CASE REPORT We describe the case of a 49-year-old man with pulmonary aspergilloma who developed a delayed sequela of SARS-CoV-2 infection. He presented to a pulmonary clinic 6 months after a severe COVID-19-related hospitalization, with symptoms of mild hemoptysis, cough, and shortness of breath. A computed tomography scan of the chest revealed a right upper lobe cavitary lesion approximately 9.6×6.1 cm in size. Bronchoalveolar lavage during bronchoscopy revealed Aspergillus fumigatus. The patient did not respond to antifungal treatment and was successfully treated with a robotic-assisted lobectomy. CONCLUSIONS Aspergillus infection should be considered in COVID-19 survivors with pulmonary symptoms. Minimally invasive robotic lobectomy is a feasible option for high-risk patients with post-COVID-19 aspergilloma and hemoptysis who are resistant to medical treatment.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946456"},"PeriodicalIF":1.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469521","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

Vision-Threatening Complications of Juxtapapillary Retinal Capillary Hemangioma: A Case of Retinal Artery Occlusion.

IF 1

American Journal of Case Reports Pub Date : 2025-02-20 DOI: 10.12659/AJCR.946514

Jingnan Han, Siyu Wang, Yuedong Hu

{"title":"Vision-Threatening Complications of Juxtapapillary Retinal Capillary Hemangioma: A Case of Retinal Artery Occlusion.","authors":"Jingnan Han, Siyu Wang, Yuedong Hu","doi":"10.12659/AJCR.946514","DOIUrl":"10.12659/AJCR.946514","url":null,"abstract":"BACKGROUND Juxtapapillary retinal capillary hemangioma (JRCH) is a rare vascular hamartoma that, when present, can cause many complications. We report a case of branch retinal artery occlusion (BRAO) in the setting of progressive exophytic JRCH, which, to the best of our knowledge, has not been reported until now. CASE REPORT The patient was 34-year-old woman who presented with visual blurring and visual field defects of the left eye and with no significant medical history. Fundoscopy and other auxiliary examinations revealed a red, elevated mass at the optic disc with surrounding hemorrhage and vascular abnormalities. JRCH was then diagnosed, and she underwent conservative treatment. However, 3 days later, during the follow-up, she developed a worsened best corrected visual acuity (BCVA) and visual field defect. The optical coherence tomography angiography found swelling of the tumor, macular edema, and vascular occlusion of the inferior macula; therefore, secondary BRAO was diagnosed. With emergency treatments, the tumor size reduced during the follow-up; however, the vision field, BCVA, and vascular occlusion were not improved. CONCLUSIONS JRCH are rare benign tumors associated with progressive vision loss due to complications such as macular exudate and retinal detachment. Various treatments, including laser, radiotherapy, and anti-angiogenic intravitreal (anti-VEGF) injections, have been suggested; however, the optimal approach is unclear. JRCH complicated with BRAO has not been reported before. Our report suggests that the tumor was closely related to the retinal arteriovenous system, and BRAO could be a vision-threatening complication of JRCH that deserves more attention.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946514"},"PeriodicalIF":1.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459982","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

Extragastrointestinal Stromal Tumor Mimicking Appendicitis: A Case Study.

IF 1

American Journal of Case Reports Pub Date : 2025-02-19 DOI: 10.12659/AJCR.944665

Ricardo Martinez, Michael Lezcano, Jonak Randhawa, Shahryar Aijaz, Yara Al Mazouni, Ahmed Altamimi, Norka Camacho-Perez, Feras Othman, Andrew M O'Neill, Joshua A Simon

{"title":"Extragastrointestinal Stromal Tumor Mimicking Appendicitis: A Case Study.","authors":"Ricardo Martinez, Michael Lezcano, Jonak Randhawa, Shahryar Aijaz, Yara Al Mazouni, Ahmed Altamimi, Norka Camacho-Perez, Feras Othman, Andrew M O'Neill, Joshua A Simon","doi":"10.12659/AJCR.944665","DOIUrl":"10.12659/AJCR.944665","url":null,"abstract":"BACKGROUND Extragastrointestinal stromal tumors (E-GISTs) are a rare subtype of gastrointestinal stromal tumors (GISTs) that develop outside of the gastrointestinal tract from interstitial cells of Cajal, exhibiting specific markers such as CD117 and DOG1. These tumors often present diagnostic challenges, particularly when their clinical manifestations mimic other abdominal conditions, such as acute appendicitis. CASE REPORT A 75-year-old male patient with a history of multiple comorbidities presented to the Emergency Department with symptoms of chronic pain in the right lower quadrant. Imaging studies, including computed tomography scans, revealed a large heterogeneous density mass measuring 11.3×9.2 cm in the right lower quadrant and a dilated appendix with wall thickening. Subsequent surgical resection with right hemicolectomy and primary anastomosis was performed, and postoperative considerations included adjuvant therapy with imatinib, due to spindle cell morphology and high mitotic activity. Histopathological examination and immunohistochemical staining confirmed the diagnosis, showing positive CD117, DOG1, Bcl-2, D2-40, and WT1 markers. CONCLUSIONS This case report aims to highlight the complexities in diagnosing E-GISTs with atypical presentations and emphasizes the critical role of comprehensive imaging and histopathological assessments in achieving an accurate diagnosis and guiding appropriate management strategies. The successful diagnosis and management highlight the critical role of imaging modalities and immunohistochemical analysis in guiding treatment decisions, while postoperative care, including targeted therapy, is crucial for reducing the risk of recurrence and improving patient outcomes. Future research should focus on optimizing postoperative management strategies and investigating the potential of intraoperative biopsies for tumors abutting adjacent structures.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e944665"},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450518","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

Emergency Management of Cut Throat Injury: A Report of 2 Cases.

IF 1

American Journal of Case Reports Pub Date : 2025-02-18 DOI: 10.12659/AJCR.946414

Guoping Dai, Xin Yan

{"title":"Emergency Management of Cut Throat Injury: A Report of 2 Cases.","authors":"Guoping Dai, Xin Yan","doi":"10.12659/AJCR.946414","DOIUrl":"10.12659/AJCR.946414","url":null,"abstract":"BACKGROUND Cut throat injury (CTI) is a type of penetrating neck injury that is an emergency in otorhinolaryngology and head and neck surgery. CASE REPORT We report 2 cases of CTI in zone 2. Patient 1 had severe injury to the larynx, trachea, and esophagus due to attempted suicide, whereas Patient 2 had a ruptured larynx due to attempted homicide, without injury to the vocal cords. The emergency doctor only used gauze to compress the neck rather than inserting a tracheal cannula through the opening immediately to maintain airway patency. Patient 1 had dyspnea at 1 point. Fortunately, Patient 2 had a stable neck wound did not bleed much, with few blocking blood clots. After performing a low tracheotomy in these 2 patients, the neck injury was repaired, gastric tubes were placed, and gastric enteral feeding diet was commenced. Both patients received anti-infection treatment and professional psychiatric therapy after surgery, and both recovered well. CONCLUSIONS Airway management is the critical first step, and the tracheal cannula should be inserted through the opening in the injured larynx for the first time to maintain airway patency; patients whose condition is unstable should undergo immediate surgical exploration, and those whose condition is stable without hard signs should undergo enhanced neck CT to assess the injury; prompt psychiatric care is also critical.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946414"},"PeriodicalIF":1.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442305","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

A 20-Year-Old Woman with Metachronous Polyostotic Simple (Unicameral) Bone Cysts in 9 Sites: A Case Report.

IF 1

American Journal of Case Reports Pub Date : 2025-02-17 DOI: 10.12659/AJCR.946165

Nicole Liddy, Sten H Kajitani, John M Gross, Ying Zou, Brock Lindsey, Albert J Aboulafia

{"title":"A 20-Year-Old Woman with Metachronous Polyostotic Simple (Unicameral) Bone Cysts in 9 Sites: A Case Report.","authors":"Nicole Liddy, Sten H Kajitani, John M Gross, Ying Zou, Brock Lindsey, Albert J Aboulafia","doi":"10.12659/AJCR.946165","DOIUrl":"10.12659/AJCR.946165","url":null,"abstract":"BACKGROUND Simple (unicameral) bone cysts (SBCs) are benign, fluid-filled bone lesions that are typically solitary and can be unicameral (single chamber) or septated. Most commonly affecting the long bones of children and adolescents, SBCs can be asymptomatic or associated with pain or fractures. Multifocal SBCs, featuring multiple cysts across different bones, are exceptionally rare and pose unique diagnostic and therapeutic challenges. Here, we report an exceptional case of a 20-year-old woman with multifocal SBCs affecting 9 known anatomical sites and discuss the unique diagnostic and therapeutic challenges. CASE REPORT A 20-year-old woman presented with right proximal tibia pain after a fall. Radiographs and MRI revealed radiolucent lesions in the proximal tibia, distal tibia, and fibula, with additional lesions identified on whole-body scintigraphy in the left proximal and distal tibia, left proximal humerus, and pelvis. Initial biopsy was suggestive of SBCs but inconclusive, and surgical biopsy was required for definitive diagnosis. Histologic evaluation confirmed SBCs, demonstrating cyst walls, cholesterol clefts, and fibrin-like deposits. Treatment included curettage, local adjuvant therapy with argon beam and doxycycline, bone grafting, and doxycycline sclerotherapy for pelvic and distal extremity lesions. At 17 months after treatment, the patient remained asymptomatic, with imaging showing sclerosis and near-complete resolution of the lesions. CONCLUSIONS This report presented a rare case of a young woman with multiple SBCs across 9 anatomical sites. Overall, the management of multifocal SBCs requires a multidisciplinary approach, involving orthopedic surgeons, radiologists, and pathologists for optimal outcomes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946165"},"PeriodicalIF":1.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434180","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

Right Bundle Branch Block on ECG as a Predictor of Sudden Cardiac Arrest Due to Pulmonary Embolism.

IF 1

American Journal of Case Reports Pub Date : 2025-02-16 DOI: 10.12659/AJCR.946074

Chunliang Wang, Yuzhu Fan, Guiting Liang, Yu Chen, Ping Wang

{"title":"Right Bundle Branch Block on ECG as a Predictor of Sudden Cardiac Arrest Due to Pulmonary Embolism.","authors":"Chunliang Wang, Yuzhu Fan, Guiting Liang, Yu Chen, Ping Wang","doi":"10.12659/AJCR.946074","DOIUrl":"10.12659/AJCR.946074","url":null,"abstract":"BACKGROUND High-risk pulmonary embolism (PE) refers to a subset of massive PE that can lead to sudden cardiac arrest (SCA) or hemodynamic collapse. It is crucial to identify the clues that might precede high-risk PE in resuscitated SCA. The presence of right bundle branch block (RBBB) with a QR pattern in V1 on the electrocardiogram (ECG) has a high positive predictive value for diagnosing cardiac arrest caused by high-risk PE. Therefore, we present a case study of SCA caused by high-risk PE. CASE REPORT A 44-year-old woman with no medical history presented to the emergency room due to SCA. The first ECG showed sinus tachycardia and RBBB with a QR pattern in V1. The clinical manifestations, particularly the abnormal ECG findings, led to the consideration of high-risk PE. Urgent thrombolytic therapy was administered before confirmation with computed tomographic pulmonary angiogram (CTPA). The patient was eventually diagnosed with antiphospholipid antibody syndrome and treated with warfarin. CONCLUSIONS RBBB with a QR pattern in V1 on ECG has a high positive predictive value for the diagnosis of cardiac arrest caused by high-risk PE. Furthermore, the presence of a QR pattern in V1 performs as an independent predictor for high-risk PE patients who may require advanced treatments, including systemic thrombolysis or invasive embolectomy. It is worth further exploring the prioritization of thrombolysis for high-risk PE patients before confirmation with CTPA, when ECG findings strongly suggest the diagnosis.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946074"},"PeriodicalIF":1.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426221","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

Mesosigmoid Fossa Herniation: A Case of Jejunal Obstruction.

IF 1

American Journal of Case Reports Pub Date : 2025-02-15 DOI: 10.12659/AJCR.944817

Ippokratis Intzidis, Eleni Karlafti, Angeliki Vouchara, Xanthippi Mavropoulou, Elisavet Psoma, Nikoletta Pyrrou, Stavros Panidis, Aris Ioannidis, Anestis Karakatsanis, Daniel Paramythiotis

{"title":"Mesosigmoid Fossa Herniation: A Case of Jejunal Obstruction.","authors":"Ippokratis Intzidis, Eleni Karlafti, Angeliki Vouchara, Xanthippi Mavropoulou, Elisavet Psoma, Nikoletta Pyrrou, Stavros Panidis, Aris Ioannidis, Anestis Karakatsanis, Daniel Paramythiotis","doi":"10.12659/AJCR.944817","DOIUrl":"10.12659/AJCR.944817","url":null,"abstract":"BACKGROUND Internal hernias, a rare type of herniation, occur through deficits of peritoneum or mesentery/mesocolon. Herniation of the small intestine into the mesosigmoid fossa is an extraordinary situation. A possible diagnostic delay may lead to intestinal ischemia, perforation, or even necrosis. CASE REPORT A 47-year-old woman was admitted in our Emergency Department with a 24-hour colic pain that started at the epigastrium and then moved to the left pelvic region. Small-bowel obstruction due to internal herniation was diagnosed based on clinical, radiological, and laboratory examination results. We encountered a loop of jejunum that was herniated into the mesosigmoid fossa, making this a unique case, as in most such cases the internal herniated loops are loops of ileum. CONCLUSIONS The key role of computed tomography (CT) is highlighted and the characteristic sign of \"C-shaped cluster\" is mentioned in the literature for intersigmoid hernia. Although internal mesosigmoid hernia is rare, it should be always kept in mind when the patient's digestive tract is affected. Our main purpose here is to highlight this rare entity for our fellow surgeons.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e944817"},"PeriodicalIF":1.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426195","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