Acute pancreatitis and small bowel obstruction caused by a migratory gastric bezoar after dissolution therapy: A case report

paythelady.612 shared this article with you from Inoreader Acute pancreatitis and small bowel obstruction caused by a migratory gastric bezoar after dissolution therapy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3114-3119. doi: 10.12998/wjcc.v9.i13.3114. ABSTRACT BACKGROUND: Bezoars are conglomerates of indigestible foreign material that can be found in the gastrointestinal tract. Gastric ulcer, gastrointestinal perforation, and intestinal obstruction are the main complications. Acute pancreatitis secondary to bezoar is rare. Here, we present a rare case of a migratory gastric bezoar complicated by acute pancreatitis and small bowel obstruction after dissolution therapy. CASE SUMMARY: A-65-year-old woman underwent gastroscopy because of epigastric pain, which revealed a huge bezoar and a gastric ulcer 10 d prior. The patient was discharged with a prescription of drinking 1 L Coca-Cola daily for 6 d, without repeat gastroscopy. However, she suddenly developed epigastric pain, nausea and vomiting for 3 d. Abdominal computed tomography (CT) revealed mild inflammation of the pancreas. Magnetic resonance c holangiopancreatography showed no abnormalities in the pancreatic duct or common bile duct. The nasogastric tube still showed drainage of more than 1.6 L of dark fluid each day after symptomatic treatment. Abdominal CT re-examination suggested intestinal obstruction. Esophagogastroduodenoscopy revealed a huge yellowish hard mass in the jejunal lumen, and we used the basket and net to fragment the bezoar. She was discharged with a good outcome. CONCLUSION: Endoscopic therapy is the first choice for gastric bezoars. When mechanical disintegration cannot be achieved, timing of repeat endoscopy is important during Coca-Cola dissolution therapy. PMID:33969098 | PMC:PMC8080734 | DOI:10.12998/wjcc.v9.i13.3114 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic value of hemodynamic indices in patients with sepsis after fluid resuscitation

paythelady.612 shared this article with you from Inoreader Prognostic value of hemodynamic indices in patients with sepsis after fluid resuscitation Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3008-3013. doi: 10.12998/wjcc.v9.i13.3008. ABSTRACT BACKGROUND: Sepsis usually causes hemodynamic abnormalities. Hemodynamic index is one of the factors to identify the severity of sepsis and an important parameter to guide the procedure of fluid resuscitation. The present study investigated whether the assessment of hemodynamic indices can predict the outcomes of septic patients undergoing resuscitation therapy. AIM: To evaluate the prognostic value of hemodynamic indices in patients with sepsis after fluid resuscitation. METHODS: A retrospective study was conducted in 120 patients with sepsis at Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University between October 2016 and October 2019. All patients were treated with sodium chloride combined with dextran glucose injection for fluid resuscitation. Patients' hemodynamic parameters were monitored, including heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI), mean arterial pressure (MAP), central venous pressure (CVP), and central venous oxygen saturation. The prognostic value of hemodynamic indices was determined based on the prognosis status. RESULTS: During fluid resuscitation, 86 patients developed septic shock and 34 did not. Ninety-nine patients survived and 21 patients died at 28 d after the treatment. Heart rate, CI, mean arterial pressure, SVRI, and CVP were higher in patients with septic shock and patients who died from septic shock than in non-shock patients and patients who survived, and central venous oxygen saturation was lower in patients with shock and patients who died than in non-shock patients and the survivors (P < 0.05). When prognosis was considered as a dependent variable and hemodynamic parameters was considered as independent variables, the results of a logistic regression analysis showed that CI, SVRI, and CVP were indepen dent risk factors for septic shock, and CI was an independent risk factor for 28-d mortality (P < 0.05). CONCLUSION: Hemodynamic indices can be used to evaluate the prognosis of septic patients after fluid resuscitation. PMID:33969086 | PMC:PMC8080751 | DOI:10.12998/wjcc.v9.i13.3008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intracardiac, pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Intracardiac, pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3120-3129. doi: 10.12998/wjcc.v9.i13.3120. ABSTRACT BACKGROUND: We report a case of Intracardiac, pulmonary, and intravenous cement embolism after cement-augmented pedicle screw instrumentation in treating spondylolisthesis underlying osteoporotic bone, which was successfully managed by conservative treatment. We describe the treatment and outcome of the patient, hoping to shed light on the management of bone cement embolism. CASE SUMMARY: A 67-year-old female suffered from progressive low back pain and numbness in lower extremities for 30 years. She was diagnosed with L4 and L5 spondylolisthesis, spinal stenosis, and osteoporosis. The patient underwent spinal canal decompression, an interbody fusion of L4/5 and L5/S1, cement-augmented pedicle screw instrumentation in L4-L5 segments, and regular pedicle screw in S1 segments. Three days postoperatively, a sudden drop in oxygen saturation occurr ed. Computerized tomography scan confirmed Intracardiac, pulmonary, and intravenous embolism. The patient was treated conservatively by continuous low-flow oxygen inhalation, anti-coagulation, and antibiotic therapy for 1 mo and continued anticoagulation treatment for 6 mo. The patient showed no further symptoms in a 30-mo follow-up. CONCLUSION: Intracardiac, pulmonary cement embolism after cement-augmented pedicle screw instrumentation is extremely rare. Careful clinical and radiographic evaluation is required in multiple sites of bone cement embolism. Conservative treatment may be a primary consideration in scattered emboli without life-threatening conditions, but a clinical decision should be made on an individualized basis. PMID:33969099 | PMC:PMC8080748 | DOI:10.12998/wjcc.v9.i13.3120 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of positron emission tomography in primary carcinoma ex pleomorphic adenoma of the bronchus: A case report

paythelady.612 shared this article with you from Inoreader Role of positron emission tomography in primary carcinoma ex pleomorphic adenoma of the bronchus: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2811-2815. doi: 10.12998/wjcc.v9.i12.2811. ABSTRACT BACKGROUND: Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported. CASE SUMMARY: We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and review the associated literature for further comparison, including age, clinical manifestations, and diagnostic process. This patient had no history of neoplasms of the salivary gland. CONCLUSION: Positron emission tomography played an important role in the staging work-up of primary carcinoma of ex pleomorphic adenoma. Long-term follow-up was necessary for further prognosis analysis. PMID:33969063 | PMC:PMC8058676 | DOI:10.12998/wjcc.v9.i12.2811 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute urinary retention in the first and second-trimester of pregnancy: Three case reports

paythelady.612 shared this article with you from Inoreader Acute urinary retention in the first and second-trimester of pregnancy: Three case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3130-3139. doi: 10.12998/wjcc.v9.i13.3130. ABSTRACT BACKGROUND: Acute urinary retention (AUR) is rare during pregnancy. CASE SUMMARY: We report on three pregnant women with AUR between the 10th and 18th wk of gestation. Case 1 was first diagnosed as urinary tract infection and developed a urinary tract infection due to urinary retention caused by urethral obstruction. Case 2 had a history of previous abdominal surgery for pelvic tuberculosis, leading to severe adhesions and a persistent retroverted uterus. In case 3, healthcare providers focused on the patient's gastrointestinal symptoms and did not investigate her inability to void. Case 1 required manual disimpaction of the uterus and the knee-chest position. The other cases required immediate catheterization. The condition resolved in cases 1 and 2; these patients had normal pregnancies. Case 3 had severe complications at the time of consultation, leading to an abortion. CONCLUSION: Retroverted uterus is the most common cause of AUR. Prompt recognition and diagnosis are required. Clinicians should be aware of the risk factors, etiology, and clinical presentation of AUR in the first and second trimester of pregnancy. PMID:33969100 | PMC:PMC8080742 | DOI:10.12998/wjcc.v9.i13.3130 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intramuscular hematoma in rhabdomyolysis patients treated with low-molecular-weight heparin: Report of two cases

paythelady.612 shared this article with you from Inoreader Intramuscular hematoma in rhabdomyolysis patients treated with low-molecular-weight heparin: Report of two cases Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2838-2844. doi: 10.12998/wjcc.v9.i12.2838. ABSTRACT BACKGROUND: Rhabdomyolysis is a serious complication of heat stroke. Unlike that in acute kidney injury, the risk of muscle bleeding in rhabdomyolysis is often ignored and can substantially increase via the widespread use of anticoagulants, leading to the formation of intramuscular hematoma. CASE SUMMARY: During the summer, a middle-aged man and an elderly man were diagnosed with heat stroke, rhabdomyolysis, and acute renal impairment. Low-dose enoxaparin sodium was initiated for prophylaxis of deep vein thrombosis after the disease was stabilized with continuous renal replacement therapy. After that, the patients' hemoglobin decreased progressively, and no obvious intracranial, thoracic, digestive, or skin bleeding tendency was found. However, one of the patients had hip muscle pain, and computed tomography and color ultrasound confi rmed that the patients separately had lumbar back and hip intermuscular hematoma. After discontinuation of anticoagulant drugs and monitoring of the steady increase in hemoglobin, the intermuscular hematomas were gradually absorbed. Following the use of prophylactic anticoagulation therapy, the patients' hemoglobin showed a progressive downward trend. Hematoma formation in the lumbosacral and buttock muscles was confirmed after excluding bleeding in typical regions (such as the digestive tract, thoracic cavity, and abdominal cavity). Anticoagulant drugs were discontinued immediately, and nutritional support was increased. Subsequently, the hemoglobin levels gradually increased, and the hematoma volumes gradually decreased. CONCLUSION: Patients with rhabdomyolysis have a risk of muscle bleeding, and inappropriate use of anticoagulants may lead to an increased risk or even to the formation of an intermuscular hematoma. When continuous blood loss is found in the body, the possibi lity of bleeding in the muscles and more typical sites should be considered. PMID:33969067 | PMC:PMC8058680 | DOI:10.12998/wjcc.v9.i12.2838 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sarcoidosis mimicking metastases in an echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase positive non-small-lung cancer patient: A case report

paythelady.612 shared this article with you from Inoreader Sarcoidosis mimicking metastases in an echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase positive non-small-lung cancer patient: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3140-3146. doi: 10.12998/wjcc.v9.i13.3140. ABSTRACT BACKGROUND: Rearrangements of the anaplastic lymphoma kinase (ALK) gene (ALK-positive) represent an oncogenic driver in approximately 3%-5% of non-small-lung cancer (NSCLC) patients. Sarcoidosis is a multisystem disease, and its reported incidence in Asia is 1 or less per 100000 people per year. The co-occurrence of sarcoidosis and ALK-positive NSCLC is rare, and ALK-positive lung cancer is likely to spread quickly. Therefore, the co-occurrence of sarcoidosis is more easily misdiagnosed as metastatic lung cancer by radiological examination. CASE SUMMARY: A 50-year-old man had a nodule in the left superior lobe, many small nodules in left superior and right lungs, and enlarged bilateral hilar, mediastinal, and right supraclavicular lymph nodes. Computed tomography-guided pulmonary biopsy of the nodule in the left superior lobe revealed echinod erm microtubule-associated protein-like 4 gene-ALK positive NSCLC with concomitant noncaseating granuloma. This patient was treated with crizotinib. Thirty days later, a chest computed tomography scan revealed a dramatic decrease in the size of the left superior lobe nodule; however, the lesions in the right lung progressed. The right supraclavicular lymph nodes showed granulomas, and no tumor cells were identified in the specimens. The angiotensin-converting enzyme level was high. After 1 wk of methylprednisolone treatment, a significant response of all lesions was revealed. Following radical resection of the lung cancer, noncaseating granulomas were observed in both lung tissues and lymph nodes, which resulted in a diagnosis of echinoderm microtubule-associated protein-like 4-ALK positive NSCLC accompanied with sarcoidosis. CONCLUSION: Our experience illustrates that pathological evidence is needed to confirm metastatic disease, especially when some suspected metastatic lesi ons are negative for malignancy. PMID:33969101 | PMC:PMC8080747 | DOI:10.12998/wjcc.v9.i13.3140 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.