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Journal of Medical Case Reports Apr 2023Transverse colon volvulus is an uncommon cause of intestinal obstruction. It is a surgical emergency that can lead to bowel infarction, peritonitis, and death.
Transverse colon volvulus presenting as bowel obstruction, atelectasis, and displacement of the right lobe of the liver into the left upper abdominal quadrant: a case report.
BACKGROUND
Transverse colon volvulus is an uncommon cause of intestinal obstruction. It is a surgical emergency that can lead to bowel infarction, peritonitis, and death.
CASE PRESENTATION
We report a case of transverse colon volvulus in a 35-year-old Congolese immigrant man who had a rare presentation with features of intestinal obstruction associated with right lung collapse and left mediastinal shift.
CONCLUSION
This case is unusual because it presented with respiratory features that mimicked a pneumothorax in addition to features of intestinal obstruction. The use of point-of-care lung ultrasound was helpful in ruling out a pneumothorax, and this could help avoid situations such as unintentional chest drain insertions by other professionals who may encounter a similar case. Because transverse colon volvulus is rare, a high level of suspicion and awareness is required to make an accurate diagnosis.
Topics: Male; Humans; Adult; Intestinal Volvulus; Colon, Transverse; Pneumothorax; Intestinal Obstruction; Liver; Pulmonary Atelectasis
PubMed: 37031203
DOI: 10.1186/s13256-023-03840-1 -
Lung India : Official Organ of Indian... 2023The mediastinal teratomas can grow to a large size before becoming symptomatic. The symptoms are usually due to the compression of adjacent structures. A computed...
The mediastinal teratomas can grow to a large size before becoming symptomatic. The symptoms are usually due to the compression of adjacent structures. A computed tomographic scan of the chest is the investigation of choice for making a provisional diagnosis and planning for further management. Removal of large mediastinal/thoracic teratoma can be associated with various intraoperative and postoperative complications, which can be life-threatening sometimes. We operated on a patient with a large mediastinal mass extending into the right thoracic cavity up to the costo-phrenic angle. The postoperative period was eventful and required judicious intensive care. The patient eventually recovered with conservative treatment. A literature search was done on PubMed using the keywords benign mediastinal teratoma. Case series/original articles published in the last two decades, that is, after the year 2000, were evaluated. As per the review of the literature, the prevalence of benign mediastinal teratoma may be higher in eastern countries. Thoracoscopic surgery is the preferred modality except for cases with adhesions or infiltration into surrounding structures.
PubMed: 37006100
DOI: 10.4103/lungindia.lungindia_198_22 -
World Journal of Nuclear Medicine Mar 2023Hurthle cell thyroid carcinoma (HCTC) demonstrates inferior prognosis compared with other types of differentiated thyroid cancer (DTC), along with radioiodine...
Hurthle cell thyroid carcinoma (HCTC) demonstrates inferior prognosis compared with other types of differentiated thyroid cancer (DTC), along with radioiodine refractoriness and relatively poor I concentrating ability. We herein report a case of a middle-aged lady presenting with neck swelling for years, who on pre-surgery work-up was diagnosed to harbor metastatic nodal and lung lesions. Post-thyroidectomy and neck dissection, she was diagnosed with HCTC. Post-surgery, none of the lesions concentrated radioactive-iodine (RAI) sufficiently but showed FDG avid lesions as mediastinal nodes, lung nodules, solitary lytic sternal lesions, and unusual bilateral paraaortic abdominal nodes. She was put on tyrosine kinase inhibitor (sorafenib) and showed disease stabilization for the initial 3 years, but multiple toxicity symptoms while on sorafenib therapy that needed multiple dose adjustments. Over the period of the subsequent year, she developed significant disease progression with liver involvement. She was shifted to lenvatinib, which she tolerated well. The functional imaging profile with unusual metastatic sites, the aggressive clinical presentation and disease course of RAI refractory HCTC over 4 years on tyrosine kinase inhibitor therapy, and the role of molecular FDG-PET/CT imaging in disease monitoring and clinical management of such case is presented.
PubMed: 36923984
DOI: 10.1055/s-0042-1759615 -
Journal of the American College of... Apr 2023An otherwise healthy 16-year-old male presented to the pediatric emergency department 12 hours after accidental inhalation of 4-nitrophenyl chloroformate in a chemistry...
An otherwise healthy 16-year-old male presented to the pediatric emergency department 12 hours after accidental inhalation of 4-nitrophenyl chloroformate in a chemistry lab. His only pertinent findings were a complaint of chest tightness and decreased breath sounds on a pulmonary exam. He was found on chest radiograph to have a large right-sided pneumothorax with slight mediastinal shift and mild interstitial prominence. A chest tube was placed, and he recovered well. This case demonstrates pneumothorax as a possible complication of inhalation of caustic chemical substances and emphasizes the importance of thorough history-taking and clinical examination.
PubMed: 36923247
DOI: 10.1002/emp2.12928 -
Diagnostics (Basel, Switzerland) Feb 2023The use of a lung ultrasound (LUS) score has been described in the early phases of neonatal respiratory distress syndrome; however, there is still no data regarding the...
The use of a lung ultrasound (LUS) score has been described in the early phases of neonatal respiratory distress syndrome; however, there is still no data regarding the application of the LUS score to neonates with a congenital diaphragmatic hernia (CDH). The objective of this observational cross-sectional study was to explore, for the first time, the postnatal changes in LUS score patterns in neonates with CDH, with the creation of a new specific CDH-LUS score. We included all consecutive neonates with a prenatal diagnosis of CDH admitted to our Neonatal Intensive Care Unit (NICU) from June 2022 to December 2022 who underwent lung ultrasonography. Lung ultrasonography (LUS) was determined at scheduled time points: (T0) during the first 24 h of life; (T1) at 24-48 h of life; (T2) within 12 h of surgical repair; (T3) a week after the surgical repair. We used a modified LUS score (CDH-LUS), starting from the original 0-3 score. We assigned 4 as a score in the presence of herniated viscera in the hemithorax (liver, small bowel, stomach, or heart in the case of a mediastinal shift) in the preoperative scans or pleural effusions in the postoperative scans. We included in this observational cross-sectional study 13 infants: twelve/13 had a left-sided hernia (2 severe, 3 moderate, and 7 mild cases), while one patient had a right-sided severe hernia. The median CDH-LUS score was 22 (IQR 16-28) during the first 24 h of life (T0), 21 (IQR 15-22) at 24-48 h of life (T1), 14 (IQR 12-18) within 12 h of surgical repair (T2) and 4 (IQR 2-15) a week after the surgical repair (T3). The CDH-LUS significantly dropped over time from the first 24 h of life (T0) to a week after the surgical repair (T3), according to ANOVA for repeated measures. We showed a significant improvement in CDH-LUS scores from the immediate postoperative period, with normal ultrasonographic evaluations a week after surgery in most patients.
PubMed: 36900042
DOI: 10.3390/diagnostics13050898 -
Journal of Surgical Case Reports Mar 2023A woman in her 50s was admitted to the emergency department with a 3-day history of abdominal pain, mainly in the right hypochondrium, radiating to the back, associated...
A woman in her 50s was admitted to the emergency department with a 3-day history of abdominal pain, mainly in the right hypochondrium, radiating to the back, associated with postprandial vomiting and dysphagia. The abdominal ultrasound study found no abnormalities. Laboratory tests showed increased C-reactive protein levels, creatinine and high white blood cell count without a left shift. Abdominal computed tomography scan exhibited mediastinal herniation, twist and perforation of the gastric fundus associated with air-fluid levels in the lower mediastinum. The patient underwent diagnostic laparoscopy requiring laparotomy conversion due to hemodynamic instability related to the pneumoperitoneum. During the intensive care unit (ICU) stay, thoracoscopy with pulmonary decortication was performed to treat complicated pleural effusion. After ICU and standard infirmary bed recovery, the patient was discharged from the hospital. This report illustrates a case of perforated gastric volvulus as the cause of nonspecific abdominal pain.
PubMed: 36896157
DOI: 10.1093/jscr/rjad102 -
Revista Da Sociedade Brasileira de... 2023
Topics: Humans; Child; Echinococcosis, Pulmonary; Albendazole
PubMed: 36820670
DOI: 10.1590/0037-8682-0599-2022 -
Anti-cancer Drugs Sep 2023The development of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) represents a paradigm shift in the treatment of lung cancer with EGFR... (Review)
Review
Successful neoadjuvant treatment of EGFR exon 19 deletion combined with TP53 mutation in non-small cell lung cancer using aumolertinib after osimertinib-induced myocardial damage: a case report and literature review.
The development of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) represents a paradigm shift in the treatment of lung cancer with EGFR mutations. Aumolertinib has been shown to be a safe agent in the registry study. However, successful rechallenge with aumolertinib following osimertinib-induced myocardial damage has not been reported. In this article, a case of neoadjuvant therapy for lung adenocarcinoma is retrospectively analyzed, and the relevant literature is reviewed. The patient was diagnosed with stage IIIA lung adenocarcinoma, and genetic testing revealed EGFR exon 19 deletion mutation combined with Tumor Protein p53 (TP53) mutation. The mutation abundance is 33.5 and 14%, respectively. One month after osimertinib treatment, the patient developed myocardial damage, and abnormal indicators such as myocardial enzyme spectrum showed abnormalities and cardiac insufficiency, followed by pulmonary hypertension and pulmonary edema. Aumolertinib was subsequently used for treatment, following which the myocardial enzyme spectrum returned to normal, and the symptoms of bilateral interstitial edema disappeared. In addition to the disappearance of adverse reactions, the therapeutic effect was excellent; the lung lesions and mediastinal lymph nodes were significantly reduced, and the operation was successfully conducted. This is the first report of successful neoadjuvant treatment of EGFR exon 19 deletion combined with TP53 mutation in NSCLC using aumolertinib after osimertinib-induced myocardial damage. The results suggested that aumolertinib had fewer adverse reactions in patients with EGFR exon 19 deletion combined with TP53 mutation, and aumolertinib may be a potential neoadjuvant therapy for stage IIIA lung cancer.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Neoadjuvant Therapy; Retrospective Studies; Tumor Suppressor Protein p53; ErbB Receptors; Protein Kinase Inhibitors; Aniline Compounds; Mutation; Adenocarcinoma of Lung; Exons
PubMed: 36800249
DOI: 10.1097/CAD.0000000000001496 -
Journal of Thoracic Disease Jan 2023
PubMed: 36794129
DOI: 10.21037/jtd-22-1420