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Journal of Surgical Case Reports Dec 2023A female patient in her 60s with a history of Parkinson's disease developed epigastric and retrosternal chest pain, with associated vomiting. On examination, she had a...
A female patient in her 60s with a history of Parkinson's disease developed epigastric and retrosternal chest pain, with associated vomiting. On examination, she had a distended abdomen with no focal peritonism. A computed tomography (CT) pulmonary angiogram was organized, which demonstrated no evidence of pulmonary emboli, but an incidental finding of gas within the liver peripheries and gastric fundal wall. A plain film abdominal radiograph demonstrated a significantly distended stomach. Thus, acute gastric dilatation was diagnosed. A nasogastric tube was introduced and intravenous fluids were given promptly. An urgent CT scan of abdomen and pelvis with intravenous contrast demonstrated interval reduction with only minor residual gas evident within the left lobe of the liver and gastric fundal wall. We report the case of transient portal venous gas, secondary to acute gastric dilatation, most likely caused by a combination of opioid analgesia and gastric dysmotility from Parkinson's disease.
PubMed: 38164213
DOI: 10.1093/jscr/rjad705 -
Veterinary Medicine and Science Jan 2024A 6-year-old female neutered Persian cat presented with hyporexia and gradual weight loss over 6 months. Physical examination revealed cranial abdominal pain....
A 6-year-old female neutered Persian cat presented with hyporexia and gradual weight loss over 6 months. Physical examination revealed cranial abdominal pain. Haematology and serum biochemistry were within normal limits. Abdominal ultrasonography and a computed tomography scan suggested a non-neoplastic mass compressing the gallbladder. During an exploratory laparotomy, a duplex gallbladder with two separate cystic ducts was diagnosed intraoperatively. The mass identified using the imaging techniques was an abnormal right gallbladder which was distended with immobile mucoid bile and a thickened wall. The left gallbladder and cystic duct were grossly normal. A cholecystectomy of both gallbladders was performed. Histopathology of the right gallbladder identified chronic cholecystitis. The cat made a good recovery from surgery and reported complete resolution of its hyporexia and a return to normal body weight. This is the first report of a successful cholecystectomy of a duplex gallbladder with chronic cholecystitis of a single gallbladder.
Topics: Female; Cats; Animals; Cholecystitis; Cholecystectomy; Tomography, X-Ray Computed; Ultrasonography; Cat Diseases
PubMed: 38124456
DOI: 10.1002/vms3.1337 -
Medicine International 2024Intraligamental leiomyomas of the uterus are rare. Extremely rare are the huge intraligamental fibroids (>20 cm), whose pre-operative diagnosis and surgical management...
Intraligamental leiomyomas of the uterus are rare. Extremely rare are the huge intraligamental fibroids (>20 cm), whose pre-operative diagnosis and surgical management poses a challenge to everyday clinical practice. The present study describes the case of patient who was subjected to surgical treatment for a huge intraligamental leiomyoma of the uterus, which weighed 3,370 g. A 48-year-old patient, without menstrual disorders and with a medical history of atypical symptoms from the digestive tract, was referred for a gynecological examination. Upon a physical examination, the abdomen was found to be bloated and distended, with no signs of peritoneal irritation. An intra-abdominal mass was suspected, the upper margin of which was palpable at about the level of the xiphoid process. The findings of computed tomography and magnetic resonance imaging confirmed the presence of a huge intra-abdominal mass, which probably originated from the internal genital organs. Following consultation with the patient, surgical treatment with laparotomy was decided. Intraoperatively, a large pedunculated subserosal leiomyoma was found, arising from the right lateral wall of the uterus with retroperitoneal extension within the leaves of broad ligament. Following the resection of the intraligamental leiomyoma, which had significant surgical challenges, a total hysterectomy with bilateral adnexectomy was performed. The post-operative course was smooth. In addition, in the present study, a brief review of intraligamental leiomyomas of the uterus is presented, emphasizing the significant diagnostic and surgical challenges and potential intraoperative complications that may arise in the management of patients with this condition.
PubMed: 38107473
DOI: 10.3892/mi.2023.126 -
Frontiers in Veterinary Science 2023A 13-year-old neutered male Korean short-hair cat presented with anorexia, lethargy, and a severely distended abdomen, suggestive of ascites. Abdominocentesis yielded...
A 13-year-old neutered male Korean short-hair cat presented with anorexia, lethargy, and a severely distended abdomen, suggestive of ascites. Abdominocentesis yielded serosanguineous fluid. A subsequent diagnostic workup, including blood tests, ascitic fluid analysis, imaging studies [radiography, ultrasound, and computed tomography (CT)], and histopathological examination, was performed to identify the underlying cause. Imaging studies revealed characteristics of encapsulating peritoneal sclerosis (EPS) such as peritoneal thickening, fat stranding, and calcification. During laparotomy, fibrous membranes encapsulating the abdominal organs and ascites were observed, and multiple calcified regions were detected on the abdominal wall. Histopathological analysis confirmed the diagnosis of poorly differentiated invasive malignant neoplasms, which were further classified as carcinomatosis based on positive cytokeratin and negative vimentin immunohistochemistry results. To our knowledge, this is the first report of sclerosing peritoneal carcinomatosis with osseous metaplasia in a cat.
PubMed: 38105775
DOI: 10.3389/fvets.2023.1298736 -
Journal of Comparative Pathology Jan 2024An adult sulphur-crested cockatoo (Cacatua galerita) was unexpectedly found dead and was presented for post-mortem examination. Macroscopically, the proventricular wall...
An adult sulphur-crested cockatoo (Cacatua galerita) was unexpectedly found dead and was presented for post-mortem examination. Macroscopically, the proventricular wall was expanded by an infiltrative off-white mass, 10 mm in diameter, with secondary mucosal ulceration. Cytological examination of impression smears revealed a neoplastic epithelial cell population forming occasional well-defined acini with secretory product. Histologically, the neoplastic cells were predominantly arranged in acini and tubules, with fewer in small clusters, supported by a desmoplastic stroma. Neoplastic cells were polygonal, with mostly well-demarcated cell boundaries and a moderate amount of eosinophilic cytoplasm that was multifocally markedly distended by more intensely eosinophilic material. There was an increased nuclear-to-cytoplasmic ratio with moderately sized to large nuclei (approximately 15 μm diameter) with lightly to densely stippled chromatin and single or paired prominent basophilic nucleoli. The mitotic count was 19 in 10 high-power fields (2.37 mm), with scattered bizarre mitotic figures and atypia including moderate anisocytosis and anisokaryosis and moderate cellular and nuclear pleomorphism. There was frequent intratubular brightly eosinophilic proteinaceous material, which was Alcian blue and periodic acid‒Schiff positive. Proventricular lymphovascular invasion was detected, with metastases within the ventriculus and lungs. The macroscopic, cytological and histological appearance of the neoplasm was consistent with a proventricular adenocarcinoma.
Topics: Animals; Cockatoos; Adenocarcinoma
PubMed: 38101282
DOI: 10.1016/j.jcpa.2023.11.004 -
Communications Biology Dec 2023The mechanisms leading to changes in mesoscale chromatin organization during cellular aging are unknown. Here, we used transcriptional activator-like effectors, RNA-seq...
The mechanisms leading to changes in mesoscale chromatin organization during cellular aging are unknown. Here, we used transcriptional activator-like effectors, RNA-seq and superresolution analysis to determine the effects of genotoxic stress on oocyte chromatin structure. Major satellites are organized into tightly packed globular structures that coalesce into chromocenters and dynamically associate with the nucleolus. Acute irradiation significantly enhanced chromocenter mobility in transcriptionally inactive oocytes. In transcriptionally active oocytes, irradiation induced a striking unfolding of satellite chromatin fibers and enhanced the expression of transcripts required for protection from oxidative stress (Fermt1, Smg1), recovery from DNA damage (Tlk2, Rad54l) and regulation of heterochromatin assembly (Zfp296, Ski-oncogene). Non-irradiated, senescent oocytes exhibit not only high chromocenter mobility and satellite distension but also a high frequency of extra chromosomal satellite DNA. Notably, analysis of biological aging using an oocyte-specific RNA clock revealed cellular communication, posttranslational protein modifications, chromatin and histone dynamics as the top cellular processes that are dysregulated in both senescent and irradiated oocytes. Our results indicate that unfolding of heterochromatin fibers following acute genotoxic stress or cellular aging induced the formation of distended satellites and that abnormal chromatin structure together with increased chromocenter mobility leads to chromosome instability in senescent oocytes.
Topics: Animals; Heterochromatin; Oocytes; Chromatin; Histones; Chromatin Assembly and Disassembly; Mammals
PubMed: 38086992
DOI: 10.1038/s42003-023-05641-0 -
Cureus Nov 2023The most common benign tumor that affects female reproductive system is a uterine fibroid or leiomyomas, especially during their reproductive years. The prevalence is...
The most common benign tumor that affects female reproductive system is a uterine fibroid or leiomyomas, especially during their reproductive years. The prevalence is around 20-40% women in the age group of 14-45 years. The following case report proffers the diagnosis and management of a female diagnosed with uterine fibroids. In this case a 45-year-old woman presented to the tertiary rural hospital with an unusually large distended abdomen which on examination and imaging revealed a big fibroid growing inside the uterus. The case highlights the significance of a collaborative approach involving gynecologists, interventional radiologists, and surgeons. Their combined expertise provides patients with various treatment options: medical management, minimally invasive procedures, and surgical interventions. During the decision-making process, factors such as the patient's age, desire for fertility preservation, and impact of fibroids on her quality of life are taken into account. This particular case showcases successful pre-hysterectomy uterine artery embolization of large uterine leiomyoma while emphasizing the importance of personalized care and shared decision making for optimal patient outcomes.
PubMed: 38046766
DOI: 10.7759/cureus.48169 -
Cureus Oct 2023Pregnancy in rudimentary horn is an uncommon presentation of an ectopic pregnancy. It needs a very high degree of suspicion for diagnosis and the diagnosis becomes...
Pregnancy in rudimentary horn is an uncommon presentation of an ectopic pregnancy. It needs a very high degree of suspicion for diagnosis and the diagnosis becomes difficult in cases with previous vaginal deliveries. A 25-year-old female patient with two spontaneous vaginal deliveries and a history of spontaneous abortion at five months visited the obstetric emergency department with a history of five months of amenorrhea with pain abdomen and breathlessness for one day. On abdominal examination abdomen was distended, and rigid, and tenderness was present. Paracentesis was done where blood was present. On bimanual examination, cervical motion tenderness was present, and left-sided fornices fullness was present. The patient was admitted, and her sonography was done for suspicion of a ruptured uterus or ectopic pregnancy. The sonography report showed a bulky uterus with decidual reactions and a well-defined pregnancy of 21 weeks and 6 days in the right adnexal region with hemoperitoneum suggesting suspicion of ruptured ectopic pregnancy. After initial treatment and arrangement of two units of packed red blood cells after proper grouping and cross-matching for the patient, laparotomy was done. At the time of surgery, there was a right-sided rupture of non-communicating rudimentary horn pregnancy with a unicornuate uterus. A dead fetus of 600 grams lies in the peritoneal cavity with two liters of hemoperitoneum. Timely diagnosis and laparotomy saved the life of the patient.
PubMed: 38034141
DOI: 10.7759/cureus.48015 -
Brazilian Journal of Veterinary Medicine 2023We report a two-month-old male cat weighing 630 grams with congenital hypothyroidism. The main complaints were difficulty defecating for more than three days and...
We report a two-month-old male cat weighing 630 grams with congenital hypothyroidism. The main complaints were difficulty defecating for more than three days and prostration. Physical examination revealed a broad, flat face, a short neck, enlarged submandibular lymph nodes, chemosis, mild bilateral mucopurulent ocular discharge, seborrheic coat, with gingival thickening around the upper and lower deciduous incisor teeth with partial eruption. The abdomen was distended due to constipation and right unilateral cryptorchidism. Based on this, feline congenital hypothyroidism was suspected. Hormonal tests (free T4 by equilibrium dialysis of 0.06 ng/dl, total T4 of 0.1 ng/ml and TSH of 4.7 ng/ml) confirmed this. Treatment was started with levothyroxine sodium (5-32.2 µg/kg/day). After 120 days of treatment, there was clinical stabilization. Then the patient underwent orchiectomy of the left and of the right ectopic testicles, and at 380 days of treatment, the thyroid scintigraphy showed intense uptake of the radiopharmaceutical by both thyroid lobes and a significant increase in volume. Clinical evaluation showed weight gain (2.6 kilograms during treatment), improvement in the shape of the skull, and a notable increase in body size. At 17 months of age, hormone values were within the reference limits after administration of levothyroxine sodium (32.2µg/kg/day).
PubMed: 38024778
DOI: 10.29374/2527-2179.bjvm003423 -
Cureus Oct 2023Leiomyomas are non-cancerous tumors emerging from the smooth muscle cells and fibroblasts of the myometrium. They are the most common pelvic tumors in females and are...
Leiomyomas are non-cancerous tumors emerging from the smooth muscle cells and fibroblasts of the myometrium. They are the most common pelvic tumors in females and are usually asymptomatic. Parasitic leiomyomas have been defined as unusual variants of pedunculated leiomyomas. When symptomatic, leiomyomas can cause abnormal uterine bleeding, pelvic pain/pressure, and reproductive effects, such as infertility or adverse pregnancy outcomes. Treatment varies depending on age, symptoms, and the preference to preserve fertility. In this article, we describe the case of a 58-year-old woman who presented for a scheduled cervical cancer screening in primary healthcare. Upon objective examination, the patient exhibited a distended and tense abdomen, along with edema in the lower limbs. These symptoms were associated with fatigue and weight gain over the last few months. Subsequent investigation led to an exploratory laparotomy which revealed a massive abdominal mass, measuring approximately 45 cm in diameter and weighing 35 kg. The findings were suggestive of a parasitic leiomyoma.
PubMed: 38021790
DOI: 10.7759/cureus.47361