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Subacute aortic dissection presenting as heart failure due to aortic valve insufficiency and right coronary artery dissection. 亚急性主动脉夹层表现为心力衰竭，由于主动脉瓣功能不全和右冠状动脉夹层。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-02 DOI: 10.1136/bcr-2026-272319
Hediyeh Vaseli, Rosalind Groenewoud, Edward Percy, Christina Luong
{"title":"Subacute aortic dissection presenting as heart failure due to aortic valve insufficiency and right coronary artery dissection.","authors":"Hediyeh Vaseli, Rosalind Groenewoud, Edward Percy, Christina Luong","doi":"10.1136/bcr-2026-272319","DOIUrl":"https://doi.org/10.1136/bcr-2026-272319","url":null,"abstract":"<p><p>Subacute thoracic aortic aneurysm dissection (TAAD) often presents with a clinical profile distinct from its acute form, which can closely mimic common cardiac conditions, risking diagnostic delay. We report a case of subacute TAAD presenting initially with progressive dyspnoea due to severe aortic regurgitation (AR), culminating in congestive heart failure with reduced left ventricular ejection fraction. Diagnosis was confirmed with CT angiography. Surgical repair was performed using the Hemi-Yacoub technique. The postoperative course was complicated by paroxysmal atrial fibrillation, which necessitated pacemaker implantation. At the 6-month follow-up, the patient demonstrates recovery of left ventricular ejection fraction to 50%. This case highlights the importance of considering aortic pathology in patients with heart failure of unclear origin, particularly when accompanied by a new diastolic murmur or echocardiographic evidence of significant AR.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891100","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
Rapid progression of a small penetrating aortic ulcer to rupture in the setting of Staphylococcus aureus bacteraemia. 在金黄色葡萄球菌菌血症的情况下，小的穿透性主动脉溃疡迅速发展为破裂。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-02 DOI: 10.1136/bcr-2026-274076
Agnieszka Mijalska, Sylwia Barańska, Mateusz Jadeszko, Jerzy Głowiński
{"title":"Rapid progression of a small penetrating aortic ulcer to rupture in the setting of <i>Staphylococcus aureus</i> bacteraemia.","authors":"Agnieszka Mijalska, Sylwia Barańska, Mateusz Jadeszko, Jerzy Głowiński","doi":"10.1136/bcr-2026-274076","DOIUrl":"https://doi.org/10.1136/bcr-2026-274076","url":null,"abstract":"<p><p>An octogenarian woman with heart failure, atrial fibrillation and asthma was admitted with a cervical phlegmon and methicillin-sensitive <i>Staphylococcus aureus</i> bacteraemia. Initial CT angiography (CTA) showed a small infrarenal penetrating aortic ulcer without rupture, peri-aortic haematoma or pseudoaneurysm and conservative management was adopted. Three weeks later, she developed acute abdominal pain and anaemia. Repeat CTA showed rapid progression of the lesion to a contained rupture. Emergency endovascular repair was performed using a straight AFX VELA infrarenal endograft component. At 18-month follow-up, she had recovered clinically and CTA showed a stable endograft without endoleak or radiological features indicative of stent-graft infection.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891094","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
Retained naso-orbital wooden foreign body: diagnostic challenge and management. 鼻眶木质异物：诊断挑战及处理。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-01 DOI: 10.1136/bcr-2026-274781
Rahul Bansal, Prem Sagar, Ramaneeshwaran Murugesan, Sindhura Thanneru, Nivedhitha M, Rajeev Kumar
{"title":"Retained naso-orbital wooden foreign body: diagnostic challenge and management.","authors":"Rahul Bansal, Prem Sagar, Ramaneeshwaran Murugesan, Sindhura Thanneru, Nivedhitha M, Rajeev Kumar","doi":"10.1136/bcr-2026-274781","DOIUrl":"https://doi.org/10.1136/bcr-2026-274781","url":null,"abstract":"<p><p>A retained wooden foreign body in the naso-orbital region is rare and poses significant diagnostic challenges. We report a case of a young male presenting with an alleged history of trauma followed by pain and visual disturbance. Clinical examination and detailed radiologic evaluation led to the diagnosis of retained foreign body in the naso-orbital complex. The foreign body was successfully removed via a tailored surgical approach with multidisciplinary involvement. Wooden foreign bodies carry a high risk of infection being organic nature, necessitating prompt removal and adequate antimicrobial therapy. This case highlights the importance of considering retained organic foreign bodies in atypical presentations, recognising radiological pitfalls and adopting an appropriate surgical strategy to ensure complete removal without complications.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873002","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
Focal nodular hyperplasia: a rare benign liver tumour in early childhood without predisposing factors. 局灶性结节性增生：一种罕见的儿童早期良性肝脏肿瘤，无易感因素。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-01 DOI: 10.1136/bcr-2025-270129
Nishant Agarwal, Tarun Kumar, Priya Mathew, Basant Kumar
{"title":"Focal nodular hyperplasia: a rare benign liver tumour in early childhood without predisposing factors.","authors":"Nishant Agarwal, Tarun Kumar, Priya Mathew, Basant Kumar","doi":"10.1136/bcr-2025-270129","DOIUrl":"https://doi.org/10.1136/bcr-2025-270129","url":null,"abstract":"<p><p>Focal nodular hyperplasia (FNH) is a rare benign hepatic lesion in children, particularly under 5 years of age. Most paediatric liver tumours in this age group are malignant, making an accurate diagnosis essential. We report a case of FNH involving the left hepatic lobe in a healthy child with no prior history of liver disease, chemotherapy or systemic illness. The child presented with a gradually enlarging abdominal mass and early satiety. Imaging with contrast-enhanced triple-phase CT demonstrated classical features of FNH, including arterial enhancement and a central scar. Due to the lesion's large size and associated symptoms, a left lateral segmentectomy was performed. Histopathology confirmed the diagnosis of FNH. Postoperative recovery was uneventful, and the patient remains well on long-term follow-up. This case highlights the diagnostic challenges of FNH in early childhood and the importance of considering benign hepatic lesions in the differential diagnosis of paediatric liver masses.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873032","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
Li-Fraumeni syndrome presenting with temporomandibular chondroblastic osteosarcoma following recurrent glioma. Li-Fraumeni综合征表现为复发性胶质瘤后的颞下颌软骨母细胞骨肉瘤。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-01 DOI: 10.1136/bcr-2026-273397
Sujeeth Kumar Shetty, Sonakshi Prakash, Devika M Krishna
{"title":"Li-Fraumeni syndrome presenting with temporomandibular chondroblastic osteosarcoma following recurrent glioma.","authors":"Sujeeth Kumar Shetty, Sonakshi Prakash, Devika M Krishna","doi":"10.1136/bcr-2026-273397","DOIUrl":"https://doi.org/10.1136/bcr-2026-273397","url":null,"abstract":"<p><p>A man in his 20s with recurrent glioma developed rapid-onset trismus and left temporomandibular swelling. Imaging revealed condylar destruction with a mineralised mass. Initial biopsy suggested chondroblastic osteosarcoma; germline testing confirmed Li-Fraumeni syndrome with a pathogenic <i>TP53</i> variant. He underwent segmental resection with temporomandibular joint disarticulation, facial-nerve sacrifice and vascularised free fibular flap reconstruction. The case underscores the need for germline testing in young patients with multiple primary malignancies and adherence to oncological principles despite challenging anatomy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872995","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
Suspected menopause nutraceutical-induced eosinophilic ascites: a rare clinical presentation. 怀疑更年期营养保健品引起的嗜酸性腹水：罕见的临床表现。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-01 DOI: 10.1136/bcr-2026-272658
Gemma Vicens-Novell, Alejandro Alonso-Galera, Rosa Muñoz-Cano, Joaquín Sáez-Peñataro
{"title":"Suspected menopause nutraceutical-induced eosinophilic ascites: a rare clinical presentation.","authors":"Gemma Vicens-Novell, Alejandro Alonso-Galera, Rosa Muñoz-Cano, Joaquín Sáez-Peñataro","doi":"10.1136/bcr-2026-272658","DOIUrl":"https://doi.org/10.1136/bcr-2026-272658","url":null,"abstract":"<p><p>A middle-aged woman presented with a 2-month history of ascites without associated symptoms. She reported taking no regular medication, except for a menopause supplement for the preceding 4 months. Initial blood investigation revealed marked peripheral eosinophilia (49%) but was otherwise unremarkable. Analysis of the ascitic fluid demonstrated a predominance of eosinophils (90%) with no evidence of malignancy.Abdominal ultrasonography identified liver lesions; however, malignancy was excluded by CT. Gastroscopy findings were normal and biopsies showed no malignant features. Tumour markers were within normal limits, except for an elevated CA-125 level. Autoimmune and infectious causes were excluded and no other underlying cause for the ascites was identified.Following discontinuation of the dietary supplement, both the ascites and eosinophilia resolved within a month without specific treatment. The temporal relationship and subsequent clinical improvement after withdrawal highlight the supplement as a possible contributing factor to eosinophilic ascites and hypereosinophilia.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872972","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
Systemic amyloidosis diagnosed by labial salivary gland biopsy. 通过唇唾液腺活检诊断系统性淀粉样变性。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-01 DOI: 10.1136/bcr-2025-270079
Fiona Lam Guan, Conor O'Gorman, Simon Rajendran, Amanda Willis
{"title":"Systemic amyloidosis diagnosed by labial salivary gland biopsy.","authors":"Fiona Lam Guan, Conor O'Gorman, Simon Rajendran, Amanda Willis","doi":"10.1136/bcr-2025-270079","DOIUrl":"https://doi.org/10.1136/bcr-2025-270079","url":null,"abstract":"<p><p>A patient in his 60s presented to the local emergency department with symptoms of acute decompensating heart failure. Following initial investigations under cardiology he was transferred to haematology, where a provisional diagnosis of cardiac amyloidosis was established. Unfortunately, it was not possible to obtain an appropriate tissue sample for confirmation of diagnosis, and the patient was referred to oral medicine for consideration of a buccal fat pad biopsy. A labial salivary gland (LSG) biopsy was undertaken and demonstrated amyloid deposits staining salmon pink with Congo red under light microscopy and an apple-green birefringence with polarised light. The blocks were transferred to the National Amyloidosis Centre where a diagnosis of amyloid light-chain amyloidosis was made. LSG biopsy is a minimally invasive and effective method in the diagnosis of systemic amyloidosis.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872954","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
Topical crushed morphine tablets for dressing-related pain in a malignant fungating wound in a resource-limited palliative care setting. 局部碾碎吗啡片敷料相关疼痛的恶性真菌伤口在资源有限的姑息治疗设置。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-01 DOI: 10.1136/bcr-2026-273958
Darshak Sanyal, Arun Ghoshal, Anuja Damani, Seema R Rao
{"title":"Topical crushed morphine tablets for dressing-related pain in a malignant fungating wound in a resource-limited palliative care setting.","authors":"Darshak Sanyal, Arun Ghoshal, Anuja Damani, Seema R Rao","doi":"10.1136/bcr-2026-273958","DOIUrl":"https://doi.org/10.1136/bcr-2026-273958","url":null,"abstract":"<p><p>Malignant fungating wounds are often linked to severe dressing-related pain that may continue despite adequate systemic opioid treatment. Topical opioids have shown pain relief in small clinical studies and case series, most often in compounded hydrogel formulations.We describe a woman in her 70s with metastatic breast cancer and a painful, malignant, fungating wound managed in a palliative care unit in India. In addition to systemic oral morphine, crushed immediate-release morphine tablets (20 mg) were applied directly to the ulcer during dressing changes, due to the unavailability of compounded preparations. This approach consistently reduced dressing-related incident pain (from 7-8/10 to 3-4/10), enhanced patient tolerance of wound care and showed no signs of local irritation or systemic opioid toxicity over 12 days.In resource-limited settings without access to compounded medications and advanced wound care products, applying crushed morphine tablets directly could be a practical, affordable method to manage incident pain associated with malignant wounds. This technique might also be useful in other palliative care situations within similar low- and middle-income country environments.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872968","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
Acute angle closure in a pseudophakic eye with pseudoexfoliative syndrome: management when conventional medical and laser therapies fail. 假性剥脱综合征假性晶状眼急性闭角：当常规医学和激光治疗失败时的处理。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-01 DOI: 10.1136/bcr-2026-274695
Hannah Kamgarpour, Grace A Borchert, Claire W Ruan, Kenneth Ooi, Ian C Francis
{"title":"Acute angle closure in a pseudophakic eye with pseudoexfoliative syndrome: management when conventional medical and laser therapies fail.","authors":"Hannah Kamgarpour, Grace A Borchert, Claire W Ruan, Kenneth Ooi, Ian C Francis","doi":"10.1136/bcr-2026-274695","DOIUrl":"https://doi.org/10.1136/bcr-2026-274695","url":null,"abstract":"<p><p>Pseudoexfoliation syndrome is a common cause of secondary open-angle glaucoma but rarely presents with acute angle closure in pseudophakic eyes, where management may be challenging when conventional medical and laser therapies fail. We report the case of an 82-year-old pseudophakic woman with known pseudoexfoliation syndrome who presented with acute right eye pain, visual loss, an intraocular pressure of 65 mmHg, a shallow anterior chamber and vitreous prolapse into the anterior chamber. Medical therapy, anterior vitreous disruption and laser peripheral iridotomy failed to adequately reduce intraocular pressure. Office-based trans-pars plana needle aspiration of liquefied vitreous resulted in immediate deepening of the anterior chamber and reduction in intraocular pressure. Visual acuity recovered fully, and intraocular pressure remained controlled with topical therapy after 7 months. This case suggests that office-based trans-pars plana needle aspiration may represent a useful emergency management option in carefully selected patients with refractory acute angle closure associated with pseudoexfoliation syndrome.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872981","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
Pulmonary arteriovenous malformation (PAVM) with hereditary haemorrhagic telangiectasia (HHT): a rare cause of paradoxical embolic stroke. 肺动静脉畸形（PAVM）与遗传性出血性毛细血管扩张（HHT）：一个罕见的原因矛盾栓塞性中风。
IF 0.4
BMJ Case Reports Pub Date : 2026-09-01 DOI: 10.1136/bcr-2026-274226
Sofia Frangiamore, Abinas Gurung, Praphull Shukla, Prasanna Aghoram
{"title":"Pulmonary arteriovenous malformation (PAVM) with hereditary haemorrhagic telangiectasia (HHT): a rare cause of paradoxical embolic stroke.","authors":"Sofia Frangiamore, Abinas Gurung, Praphull Shukla, Prasanna Aghoram","doi":"10.1136/bcr-2026-274226","DOIUrl":"https://doi.org/10.1136/bcr-2026-274226","url":null,"abstract":"<p><p>Pulmonary arteriovenous malformation (PAVM), a manifestation of hereditary haemorrhagic telangiectasia (HHT), is rarely encountered but a significant cause of seemingly cryptogenic strokes. In cases of PAVM, there is an abnormal connection between pulmonary arteries and veins which leads to right-to-left shunting, resulting in mainly hypoxaemia and dyspnoea but more dangerously can cause paradoxical embolic strokes.We present a woman in her 40s with no prior known medical comorbidities attending with a right-sided hemiparesis and diffusion-weighted MRI sequence of the brain confirming a left thalamic infarction. After detailed investigation, she was found to have PAVM and HHT, explaining her stroke. She was successfully treated with transcatheter embolisation and continued on single antiplatelet therapy with no further recurrence of strokes since then. This case highlights the importance of thorough investigation of young strokes when no immediate or apparent cause is found, especially in the absence of risk factors.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 9","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872965","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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