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Complex redo surgical revascularisation for progressive atheromatous disease in lower limb arteries. 下肢动脉进行性动脉粥样硬化疾病的复杂手术重建术。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-30 DOI: 10.1136/bcr-2025-266646
Suraj Pai, Suresh Pai, Pranav Parida
{"title":"Complex redo surgical revascularisation for progressive atheromatous disease in lower limb arteries.","authors":"Suraj Pai, Suresh Pai, Pranav Parida","doi":"10.1136/bcr-2025-266646","DOIUrl":"https://doi.org/10.1136/bcr-2025-266646","url":null,"abstract":"<p><p>We present the case of a man in the 50s with a decade-old history of surgical revascularisation for aortoiliac and femoropopliteal occlusive disease, who presented with new-onset critical limb ischaemia in the right lower extremity. A CT angiography revealed occlusion of the prior prosthetic femoropopliteal bypass graft and progression of atherosclerosis into the tibioperoneal segment, the distal vessel being patent but small-calibre posterior tibial artery. Considering the patient's extensive vascular history, vessel calcification and unsuitability for further prosthetic grafting, a redo bypass from the right common femoral artery to the posterior tibial artery was performed using a reversed great saphenous vein from the contralateral leg. Postoperative recovery was uneventful with return of distal pulses and symptomatic relief. This case highlights the importance of utility of saphenous vein graft not just in coronary artery disease, but also in surgical revascularisations in lower limb arteries that can be complex owing to their small size where prosthetic graft usage is not feasible.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205575","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
Idiopathic right ventricular outflow tract ventricular tachycardia-induced cardiomyopathy masquerading as MIS-C-associated myocarditis in a child. 儿童特发性右心室流出道室性心动过速引起的心肌病伪装为misc相关心肌炎。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-30 DOI: 10.1136/bcr-2025-267822
Benjamin Wei-Liang Ng, Keng-Tat Koh, Martin Ngie-Liong Wong
{"title":"Idiopathic right ventricular outflow tract ventricular tachycardia-induced cardiomyopathy masquerading as MIS-C-associated myocarditis in a child.","authors":"Benjamin Wei-Liang Ng, Keng-Tat Koh, Martin Ngie-Liong Wong","doi":"10.1136/bcr-2025-267822","DOIUrl":"https://doi.org/10.1136/bcr-2025-267822","url":null,"abstract":"<p><p>A previously healthy early adolescent male presented with respiratory distress and lethargy during the COVID-19 pandemic. Evaluation revealed ventricular tachycardia (VT), hepatomegaly, pleural effusion and cardiomegaly with impaired cardiac function. Positive COVID-19 antibodies suggested Multisystem Inflammatory Syndrome in Children (MIS-C)-associated myocarditis. Treatment with intravenous immunoglobulin, anti-inflammatory agents and amiodarone led to normalised cardiac function and arrhythmia resolution. However, VT recurred with myocardial dysfunction after stopping amiodarone. Further ECG reassessment identified focal VT originating from the right ventricular outflow tract (RVOT). Cardiac magnetic resonance showed no myocardial scarring, supporting the diagnosis of idiopathic RVOT-VT. Radiofrequency ablation was performed successfully, and the patient remained VT-free at 1-year follow-up. This case describes the rare presentation of idiopathic RVOT-VT causing cardiomyopathy, initially mimicking myocarditis. It highlights the limitations of current diagnostic modalities in distinguishing VT-induced cardiomyopathy from myocarditis and emphasises careful ECG and imaging evaluation to guide appropriate management and improve outcomes.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205585","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
Intercostal hepatic herniation through congenital rib agenesis in an infant. 婴儿先天性肋间性肝疝一例。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-30 DOI: 10.1136/bcr-2025-266642
Shadab B Maldar, Christopher Jude Pinto, Vijay Kubihal, Kushal Bhatkal
{"title":"Intercostal hepatic herniation through congenital rib agenesis in an infant.","authors":"Shadab B Maldar, Christopher Jude Pinto, Vijay Kubihal, Kushal Bhatkal","doi":"10.1136/bcr-2025-266642","DOIUrl":"https://doi.org/10.1136/bcr-2025-266642","url":null,"abstract":"","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205615","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
Clinical image of rare primary oral melanoma in a paediatric patient. 罕见的小儿原发性口腔黑色素瘤的临床影像。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-30 DOI: 10.1136/bcr-2025-265005
Ishani Rahate, Punit R Fulzele, Dhruvi R Solanki, Nilima Thosar
{"title":"Clinical image of rare primary oral melanoma in a paediatric patient.","authors":"Ishani Rahate, Punit R Fulzele, Dhruvi R Solanki, Nilima Thosar","doi":"10.1136/bcr-2025-265005","DOIUrl":"https://doi.org/10.1136/bcr-2025-265005","url":null,"abstract":"","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205541","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
Unregulated skin-lightening cream use causing topical steroid-induced dermatitis and nodulocystic acne. 不规范的皮肤美白霜使用引起局部类固醇引起的皮炎和结节性痤疮。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-30 DOI: 10.1136/bcr-2025-267614
Sumedha Rajendra Zade, Sameer Uttamrao Khasbage
{"title":"Unregulated skin-lightening cream use causing topical steroid-induced dermatitis and nodulocystic acne.","authors":"Sumedha Rajendra Zade, Sameer Uttamrao Khasbage","doi":"10.1136/bcr-2025-267614","DOIUrl":"https://doi.org/10.1136/bcr-2025-267614","url":null,"abstract":"<p><p>A woman in her early 30s developed severe facial erythema, telangiectasia, burning sensation and progressive hyperpigmentation after 12 months of using an over-the-counter skin-lightening product labelled 'skin-lightening cream' purchased from a local beauty store. Laboratory analysis confirmed the presence of clobetasol propionate 0.05% w/w, which was not disclosed on the product label. Following discontinuation, she developed painful nodulocystic acne as a delayed complication. Treatment with topical calcineurin inhibitors, emollients, photoprotection and oral doxycycline resulted in partial improvement of erythema and telangiectasia, though acne management remained challenging. This case highlights the significant public health risks posed by unregulated cosmetic products containing undisclosed potent corticosteroids and emphasises the need for increased clinical vigilance and regulatory oversight.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205550","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
Clinicopathological challenges of diagnosing reactive infectious mucocutaneous eruption. 诊断反应性感染性皮肤粘膜疹的临床病理挑战。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-30 DOI: 10.1136/bcr-2024-264214
Tasmyn Soller, Inushi Ilangmage, Susan Keogh, Jye Gard
{"title":"Clinicopathological challenges of diagnosing reactive infectious mucocutaneous eruption.","authors":"Tasmyn Soller, Inushi Ilangmage, Susan Keogh, Jye Gard","doi":"10.1136/bcr-2024-264214","DOIUrl":"https://doi.org/10.1136/bcr-2024-264214","url":null,"abstract":"<p><p>Reactive infectious mucocutaneous eruption (RIME) is a skin eruption. It is often mistaken for other conditions that are associated with more severe sequelae that require high-level care, including toxic epidermal necrolysis and multisystem inflammatory conditions. RIME mimickers and the poor specificity of pathology tests for infectious causes of RIME have made the diagnosis and management of this disease challenging. Children with a respiratory prodrome, in the absence of suggestive drug exposures and an acute onset mucosal eruption limited to <10% surface area, are likely to have RIME.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205554","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
Milwaukee shoulder syndrome: an acutely swollen joint. 密尔沃基肩关节综合症：关节剧烈肿胀。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-30 DOI: 10.1136/bcr-2025-266425
Serena Ellen Patel, Holly Isobel Elizabeth West, Danielle Piper, William Goude
{"title":"Milwaukee shoulder syndrome: an acutely swollen joint.","authors":"Serena Ellen Patel, Holly Isobel Elizabeth West, Danielle Piper, William Goude","doi":"10.1136/bcr-2025-266425","DOIUrl":"https://doi.org/10.1136/bcr-2025-266425","url":null,"abstract":"<p><p>Milwaukee shoulder syndrome (MSS) is a rare crystal arthropathy associated with rapid joint destruction and notable morbidity.A female in her 80s presented to a district general hospital with a 2-week history of acute-on-chronic left shoulder pain. Examination revealed widespread left shoulder reduced range of movement, and plain X-ray and CT imaging showed global left humeral head destruction with a large joint effusion. Once other differentials, including septic arthritis and osteosarcoma, had been excluded, this patient was managed conservatively with analgesia, physiotherapy and a collar and cuff sling.Literature regarding MSS is scarce, and awareness of this diagnosis is even more so. But with the impact of reduced joint function on independence and quality of life, this syndrome is not one to miss. This case report aims to educate the reader about the importance of MSS as a rare differential in an acutely swollen, painful joint.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205557","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 sciatic hernia as a unique cause of hip pain: laparoscopic transabdominal preperitoneal (TAPP) repair with LiquiBandFIX8 anchoring technique. 作为髋关节疼痛的独特原因的坐骨疝的治疗：腹腔镜经腹腹膜前（TAPP）修复与LiquiBandFIX8锚定技术。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-29 DOI: 10.1136/bcr-2025-267492
Hannah Mathews, Balakrishnan Saravanan, Paul Wilson
{"title":"Management of sciatic hernia as a unique cause of hip pain: laparoscopic transabdominal preperitoneal (TAPP) repair with LiquiBandFIX8 anchoring technique.","authors":"Hannah Mathews, Balakrishnan Saravanan, Paul Wilson","doi":"10.1136/bcr-2025-267492","DOIUrl":"https://doi.org/10.1136/bcr-2025-267492","url":null,"abstract":"<p><p>Sciatic hernias are the rarest form of pelvic floor hernia and pose significant diagnostic challenge due to their variable presentations. We present a case of an elderly female with progressive right-sided hip pain and an inability to weight-bear, ultimately diagnosed via MRI as a sciatic hernia containing small bowel. A successful laparoscopic transabdominal preperitoneal (TAPP) repair was performed with the mesh fixated and peritoneum closed using the novel device, LiquiBandFIX8. No complications were experienced intraoperatively, and there was full symptom resolution and no recurrence at follow-up. This case highlights the atypical presentation of sciatic hernias and further adds to the existing literature on the management of this condition. Laparoscopic TAPP repair combined with anchoring using LiquiBandFIX8 is a safe and effective treatment option, providing minimal invasiveness and favourable postoperative outcomes. Its use may represent an important advancement in repair of sciatic hernia.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198135","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
Cardiac tamponade secondary to ruptured amoebic liver abscess. 阿米巴肝脓肿破裂继发于心脏填塞。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-28 DOI: 10.1136/bcr-2025-267813
Abhinav Aggarwal, Chirag Agrawal, Vaibhav Mishra, Shrividya Shrishakumar, Archana Malik, Lakshay Diva, Anwar Hussian Ansari, Devesh Kumar
{"title":"Cardiac tamponade secondary to ruptured amoebic liver abscess.","authors":"Abhinav Aggarwal, Chirag Agrawal, Vaibhav Mishra, Shrividya Shrishakumar, Archana Malik, Lakshay Diva, Anwar Hussian Ansari, Devesh Kumar","doi":"10.1136/bcr-2025-267813","DOIUrl":"https://doi.org/10.1136/bcr-2025-267813","url":null,"abstract":"<p><p>A young man in his 20s presented with shortness of breath for 2 hours, with a history of fever and abdominal pain for 10 days. On preliminary examination, he was visibly tachypnoeic and hypotensive, with a raised jugular venous pulse and muffled heart sounds. Additionally, there was profound tenderness in the right hypochondrium. Transthoracic echocardiography revealed a dilated, non-collapsing inferior vena cava and collapsed right-sided chambers of the heart, confirming the diagnosis of cardiac tamponade due to a massive, circumferential pericardial effusion (2.8 cm in maximum dimension). Subsequent drainage of the pericardial effusion was done using a 6-French pigtail catheter. Interestingly, the pericardial fluid appeared thick and greyish brown in colour, resembling a typical 'anchovy-sauce-like' appearance, raising the suspicion of a ruptured amoebic liver abscess with extension into the pericardium. Ultrasonography of the abdomen revealed a single, well-defined abscess on the left lobe of the liver (6 cm×5 cm×4 cm) with free communication into the pericardium. Contrast-enhanced CT of the chest and abdomen revealed transdiaphragmatic extension of the liver abscess into the pericardial cavity. Amoebic serology was reactive, and the wet mount microscopy was negative for <i>Entamoeba histolytica</i> The patient was managed conservatively with daily aspiration of the pericardial fluid from the pigtail, intravenous antibiotics and intravenous metronidazole for 10 days. Therapeutic pleurocentesis of the right pleural effusion was additionally carried out. He had a complete recovery with no sequelae and was subsequently discharged after 10 days.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190780","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
Mercury toxicity presenting as uncontrolled hypertension in two children due to the use of complementary and alternative medicine. 汞中毒表现为不受控制的高血压在两个儿童由于使用补充和替代药物。
IF 0.6
BMJ Case Reports Pub Date : 2025-09-28 DOI: 10.1136/bcr-2025-265318
Sharon Pradeeptha, Magdalenal Robert, Anish Sam, Merin Abraham
{"title":"Mercury toxicity presenting as uncontrolled hypertension in two children due to the use of complementary and alternative medicine.","authors":"Sharon Pradeeptha, Magdalenal Robert, Anish Sam, Merin Abraham","doi":"10.1136/bcr-2025-265318","DOIUrl":"https://doi.org/10.1136/bcr-2025-265318","url":null,"abstract":"<p><p>Two children aged <5 years presented with paraesthesias, limb pain, behavioural disturbances, weight loss and poor sleep for 2.5 months and had hypertension on examination.Extensive evaluation for aetiologies of hypertension, including catecholamine-secreting and neural crest tumours, cardiac, endocrine and renal causes, was inconclusive.History subsequently revealed the use of alternative Indian medicine in both children. Heavy metal toxicity was suspected and was confirmed with elevated 24-hour urinary mercury levels. Both children responded well to chelation therapy with dimercaprol and had resolution of symptoms on follow-up.These two cases highlight that heavy metal toxicity in children is an evolving health concern of global importance. Hence, knowledge about the presence of heavy metals as an ingredient in some alternative medicines, seeking history about their usage and suspecting the varied clinical manifestations of heavy metal toxicity is essential while evaluating a child with uncontrolled hypertension.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190813","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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