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Surgical Neurology International 2024C5 palsy (C5P) is a recognized potential postoperative complication of cervical spine surgery but has rarely been reported following an open esophageal diverticulectomy.
BACKGROUND
C5 palsy (C5P) is a recognized potential postoperative complication of cervical spine surgery but has rarely been reported following an open esophageal diverticulectomy.
METHODS
A 61-year-old underwent an open esophageal diverticulectomy for symptomatic Zencker's diverticulum.
RESULTS
Postoperatively, she presented with right upper extremity weakness and sensory deficits consistent with a C5P that was later confirmed by electromyography.
CONCLUSION
The potential for C5P after esophageal diverticulectomy for symptomatic Zencker's diverticulum is rare. Postoperative recognition and appropriate management are critical to recovery.
PubMed: 38840618
DOI: 10.25259/SNI_264_2024 -
The American Journal of Case Reports Jun 2024BACKGROUND We present an exceptional case of asystole and tracheal diverticulum rupture as a result of cardiopulmonary resuscitation (CPR) immediately following...
BACKGROUND We present an exceptional case of asystole and tracheal diverticulum rupture as a result of cardiopulmonary resuscitation (CPR) immediately following laparoscopic cholecystectomy performed at Riga 1st Hospital. Tracheal rupture after tracheal intubation is a severe but very rare complication that can be fatal. We present an incidental finding of the tracheal diverticulum and its rupture during CPR. CASE REPORT A 71-year-old woman (American Society of Anesthesiologists class II, body mass index 28.58) underwent a planned laparoscopic cholecystectomy. Preoperative chest X-ray showed no abnormalities. Endotracheal intubation was performed, with the first attempt with a 7-mm inner diameter cuffed endotracheal tube without an introducer. Five minutes after rapid desufflation of the pneumoperitoneum, severe bradycardia and hypotension occurred, followed by asystole. CPR was performed for a total of 2 min, until spontaneous circulation returned. Twenty hours after surgery, subcutaneous emphysema appeared on the chest. Computed tomography scan of the chest revealed subcutaneous neck emphysema, bilateral pneumothorax, extensive pneumomediastinitis, and a pocket-like, air-filled tissue defect measuring 10×32 mm in the distal third of the trachea, with suspected rupture. Two hours after the diagnosis was established, the emergent surgery was performed. The patient was completely recovered after 15 days. CONCLUSIONS Our case illustrates that tracheal diverticula is sometimes diagnosed by accident and too late, which then can lead to life-threatening situations. Tracheal rupture can be made not only by mechanical piercing by an endotracheal tube but also during interventions, such as CPR. Rapid desufflation of the pneumoperitoneum can lead to asystole, induced by the Bezold-Jarisch reflex.
Topics: Humans; Aged; Female; Cholecystectomy, Laparoscopic; Diverticulum; Tracheal Diseases; Intubation, Intratracheal; Cardiopulmonary Resuscitation; Heart Arrest; Rupture; Rupture, Spontaneous
PubMed: 38840414
DOI: 10.12659/AJCR.943639 -
Cureus May 2024Gastrointestinal bleeding from Meckel's diverticulum can be challenging to diagnose. We present a case of a 78-year-old man with painless hematochezia. Despite...
Gastrointestinal bleeding from Meckel's diverticulum can be challenging to diagnose. We present a case of a 78-year-old man with painless hematochezia. Despite undergoing standard investigations, the source of bleeding remained elusive until arteriography localized bleeding from Meckel's diverticulum. Prompt management involved embolization followed by laparoscopic resection. This case underscores the need to consider Meckel's diverticulum as a source of obscure gastrointestinal bleeding even in the elderly, as well as the need to use non-conventional diagnostic approaches when standard methods fail. The successful management of the case through embolization and laparoscopic resection highlights the crucial role interventional radiologists and surgeons play in the management of Meckel's diverticulum-related complications.
PubMed: 38836148
DOI: 10.7759/cureus.59685 -
Cureus May 2024Inverted colonic diverticulum (ICD) is an infrequent finding on colonoscopy, often misdiagnosed as colonic polyps. Further endoscopic intervention, such as polypectomy...
Inverted colonic diverticulum (ICD) is an infrequent finding on colonoscopy, often misdiagnosed as colonic polyps. Further endoscopic intervention, such as polypectomy or biopsy, may lead to colonic perforation. For that reason, the endoscopist should be aware of the possibility of detecting these lesions when performing a colonoscopy. Diagnosing an ICD can be confirmed by inspection and gentle eversion using the probe. In this case report, we present a patient who was found to have inverted colonic diverticulum as we highlight the importance of distinguishing it from colonic polyps in order to prevent severe complications.
PubMed: 38826976
DOI: 10.7759/cureus.59460 -
Cureus May 2024Being an uncommon and challenging disorder, acute aortic dissection (AAD) can have fatal outcomes in the event of missed diagnosis or treatment delay. AAD could easily...
Being an uncommon and challenging disorder, acute aortic dissection (AAD) can have fatal outcomes in the event of missed diagnosis or treatment delay. AAD could easily be misdiagnosed, as symptoms usually mimic other common clinical syndromes showing up in Accident and Emergency (A&E), including acute coronary syndrome (ACS), pericarditis, pulmonary embolism, acute abdomen, musculoskeletal pain, as well as presenting as heart failure, stroke, syncope, and absent peripheral pulses. We present a case of a 77-year-old female who presented to the medical decision unit with acute-onset chest, back, and abdominal pain that occurred on standing for six hours She was thought initially to have acute coronary syndrome based on electrocardiography (ECG) changes, troponin, a normal chest X-ray, and no blood pressure discrepancies in upper extremities. Due to worsening abdominal pain and a previous history of a perforated diverticulum, contrast computed tomography (CT) of the abdomen was arranged and this showed acute type B aortic dissection. By the time the CT was performed, the patient had been in hospital for 16 hours, almost 22 hours from the onset of pain.
PubMed: 38826924
DOI: 10.7759/cureus.59556 -
Journal of Surgical Case Reports May 2024Perforation of Meckel's diverticulum caused by heterotopic pancreas is a rare condition. Despite recent improvements in imaging studies, Meckel"'s diverticulitis and...
Perforation of Meckel's diverticulum caused by heterotopic pancreas is a rare condition. Despite recent improvements in imaging studies, Meckel"'s diverticulitis and heterotopic pancreas are difficult to diagnose preoperatively and are often diagnosed during autopsy or laparotomy. Symptomatic patients are typically >1 year, and cases of infants displaying symptoms are rarely reported. We report a rare case of heterotopic pancreas in Meckel's diverticulum causing perforation in an infant. In cases of infants presenting with unexplained acute abdominal pain, there should be a high index of suspicion for congenital gastrointestinal malformations. Prompt action in the form of exploratory laparotomy or laparoscopy is crucial to prevent the escalation of complications and to definitively confirm the diagnosis.
PubMed: 38826858
DOI: 10.1093/jscr/rjae375 -
International Journal of Surgery Case... Jul 2024Colocolic intussusception occur in less than 5 % of all cases of intussusception. Median age at presentation is 4.4 years. Usually presents with features of intestinal...
INTRODUCTION AND IMPORTANCE
Colocolic intussusception occur in less than 5 % of all cases of intussusception. Median age at presentation is 4.4 years. Usually presents with features of intestinal obstruction. Common causes include pathological lead points like juvenile polyps, Meckel's diverticulum and lymphoma. However, rarely occurs without an organic cause as presented in the index case.
CASE PRESENTATION
We present a case of colocolic intussusception in a 5-year-old boy with clinical evidence of blood-stained mucoid stools, abdominal distention and post prandial vomiting. CT-scan confirmed the clinical diagnosis. Surgical exploration revealed left-sided colocolic intussusception without a pathological lead point.
CLINICAL DISCUSSION
Most cases of colonic intussusception have a pathological lead point. Clinical features are unspecific but mostly present with intestinal obstruction, hence, a CT-scan aids in establishing the diagnosis.
CONCLUSION
Colocolic intussusception is a rare subtype of intussusception in the paediatric age group especially in the absence of a pathological lead point. This case report presents a rare case of colocolic intussusception without pathological lead point, highlighting the importance of advanced imaging modalities like CT-scan in establishing the diagnosis and guiding management.
PubMed: 38824742
DOI: 10.1016/j.ijscr.2024.109841 -
Journal of Surgical Case Reports May 2024Appendiceal diverticulum is a rare condition that usually presents with symptoms similar to acute appendicitis. Although imaging can be used to aid the diagnosis of this...
Appendiceal diverticulum is a rare condition that usually presents with symptoms similar to acute appendicitis. Although imaging can be used to aid the diagnosis of this condition, it is usually confirmed postoperatively on the basis of histology. Because of an increased risk of appendiceal neoplasms, the usual management is prophylactic appendicectomy. We report the case of a 70-year-old lady with no symptoms referred from her GP surgery for a positive faecal immunochemical test as part of the bowel screening programme. Colonoscopy showed a mass at the appendiceal orifice with normal histology. She underwent an appendicectomy with a small cuff of caecal resection. The lesion was ~8 cm at its maximum dimension and showed appendiceal diverticulum. Appendiceal diverticulum is an important differential diagnosis to consider in patients with atypical history of acute appendicitis or positive faecal immunochemical test with no other symptoms.
PubMed: 38817791
DOI: 10.1093/jscr/rjae349 -
Annals of Pediatric Cardiology 2023Pentalogy of Cantrell is a rare congenital anomaly involving the anterior diaphragm, pericardium, sternum, peritoneum, and associated intracardiac defects. In this...
Pentalogy of Cantrell is a rare congenital anomaly involving the anterior diaphragm, pericardium, sternum, peritoneum, and associated intracardiac defects. In this report, we describe a neonate with pentalogy of Cantrell evaluated with multimodality imaging and successfully managed by a multidisciplinary team.
PubMed: 38817252
DOI: 10.4103/apc.apc_188_23 -
Cureus Apr 2024Intussusception is one of the most common causes of acute intestinal obstruction in infancy and early childhood. Most cases of intussusception tend to occur in infancy,...
Intussusception is one of the most common causes of acute intestinal obstruction in infancy and early childhood. Most cases of intussusception tend to occur in infancy, between the ages of four and six months. The causes can be split into two categories: non-pathologic and pathologic. Non-pathological causes include administration of the rotavirus vaccine, dehydration, and recent illness. Pathological causes can be attributed to Meckel's diverticulum (in 75% of cases), polyps (15%), and lymphoma or other tumors (3%). Intussusception rarely occurs in infants less than three months of age. If intussusception does occur in patients under three months of age, the cause is idiopathic in up to 75% of the cases. Additionally, myoglandular-type polyps are exceedingly rare and very rarely occur in patients under the age of 50. This case report discusses the diagnosis and treatment of intussusception in a two-month-old male patient who initially presented to the pediatric inpatient unit for dehydration secondary to a suspected viral illness, later developing colicky abdominal pain and bloody stools. He was found to have colo-colonic intussusception with a myoglandular-type polyp lead point. In discussing this case, the aim is to teach about intussusception and myoglandular-type polyps, as well as reveal a rarity in both etiologies for this age group.
PubMed: 38813337
DOI: 10.7759/cureus.59273