Polysplenia Syndrome with Commun Mesenter, Reverse Pancreas, IVC Interruption Discovered in an Adult
F. Abakka, W. Chaja, N. Hammoune, B. Slioui, S. Bellasri, M. Athmane, A. Mouhcine
Sch J Med Case Rep | 619-620
DOI : 10.36347/sjmcr.2021.v09i06.001
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Polysplenia syndrome is anomaly associated with multiple spleens and anomalies of chest and abdominal organs. We present a case of polysplenia syndrome found in a 27-year-old man. Only those with mild anatomical abnormalities reach adulthood without a diagnosis. Radiological examinations are helpful to the diagnosis by showing the location and aspect of spleen, location of other organs in the abdomen, and identification of other associated anomalies. In this article, we illustrate anomalies of polysplenia syndrome and focus on abdominal organs.
Fahr's Syndrome- An Interesting Case Presentation
Y. Bouktib, K.Elhadri, B.Boutakioute, M.Ouali El Idrissi, N.CherifIdrissi El Ganouni
Sch J Med Case Rep | 621-623
DOI : 10.36347/sjmcr.2021.v09i06.002
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Idiopathic basal ganglia calcification (IBGC), commonly referred to as Fahr’s disease, is a rare neurological disorder characterized by the abnormal, symmetrical, and bilateral calcification of the basal ganglia and other brain regions. Patients typically present in their forties and fifties with various neurologic and/or psychiatric symptoms, including movement disorders, Parkinsonism, psychosis, and depression. The pathophysiology of this disease is not completely understood; however, several gene mutations have been identified in the pathogenesis of Fahr’s disease. These mutations display an autosomal dominant inheritance pattern. Furthermore, the regional phenotypic expression of calcifications differs greatly from patient to patient, as do their clinical presentations. Here, we describe a patient who presented with psychiatric manifestations and imaging consistent with Fahr’s disease.
Isolated Splenic Tuberculosis - A Rare Condition: A Case Report
Y. Bouktib, W Adegbindin, Pr Benzalim, Pr Alj
Sch J Med Case Rep | 624-626
DOI : 10.36347/sjmcr.2021.v09i06.003
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Tuberculosis remains one of the most prevalent and fatal infectious diseases in spite of considerable improvements in medical science. Tuberculosis is an important health problem in developing countries. There are few cases of solitary splenic tuberculosis reported in the literature internationally Here we report a case of surgically confirmed mass-forming solitary splenic tuberculosis in a 54-year-old woman who presented with abdominal discomfort for 4 months, but with no other symptoms. Laboratory data provided no specific information for diagnosis. Abdominal ultrasonography revealed a large hypoechoic lesion within the spleen. Computed tomography scan of the abdomen showed a solitary hypodense lesion.
Pneumomediastinum Secondary to Cocaine Use
Y. Bouktib, S. Tadsaoui, B.Boutakioute, M. Ouali El Idrissi, N. Cherif Idrissi El Ganouni
Sch J Med Case Rep | 627-628
DOI : 10.36347/sjmcr.2021.v09i06.004
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Spontaneous pneumomediastinum (SPM) and subcutaneous emphysema are rare complications of illicit drug abuse. Thorough history, examination, and investigations are required to rule out fatal complications such as oesophageal perforation. We present a case of a 22 year-old male presenting with pleuritic chest pain one day after cocaine inhalation and ingesting ecstasy. Conservative supportive management is appropriate when this occurs spontaneously without radiological evidence of visceral perforation.
Imaging of Primary Synovial Osteochondromatosis: A Case Report
F. Abakka, M. OualiIdrissi, Y.Zouine, B.Boutakioute, N. CherifIdrissi El Ganouni, A. Benhima, I. Abkari, H. Essaidi
Sch J Med Case Rep | 629-636
DOI : 10.36347/sjmcr.2021.v09i06.005
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Synovial chondromatosis (primary or idiopathic) is characterised by the formation of multiple nodules of hyaline cartilage under the synovial membrane. These nodules may be released into the joint cavity and are typically numerous and of similar shape and size. They may agglomerate with each other and form masses that are sometimes large. Radiographically, isolated non-specific synovial swelling, multiple intra-articular calcifications or osteochondromes, extrinsic erosions of the bone opposite or reactive hyperostosis may be seen. The joint space is normal or enlarged, which is suggestive of the diagnosis (chondromal interposition/articular cartilage hypertrophy). The arthroscanner or, better still, the MRI, allows a precise assessment of the local extension. The semiology is influenced by the subsynovial or free nature of the chondromas, and by their degree of mineralisation and ossification. The treatment consists essentially of a synovectomy as complete as possible.
Giant Cell Tumor (GCT) of Distal Femur with Pathological Fracture - A Case Report
Dr. Neetin P Mahajan, Dr. Kartik P Pande, Dr. Prasanna Kumar G S
Sch J Med Case Rep | 637-639
DOI : 10.36347/sjmcr.2021.v09i06.006
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Introduction: Giant cell tumor [GCT] is a relatively common, locally aggressive but most often a benign neoplasm that is associated with a large biological spectrum. The GCT accounts for 4-10% of all bone tumors and approximately 20% of all benign bone tumors. Case Report: We have a 35 year old male patient, who presented with right knee pain after a trivial trauma (history slip and fall while walking) and X ray revealed pathological fracture of the medial condyle of femur along with a lytic lesion. On further investigation with other modalities such as CT scan and MRI was suggestive of giant cell tumor in the distal femur confirmed with a biopsy, and the patient was referred to a higher centre for the management of the same with the pathological fracture of the medial condyle of the femur. Conclusion: The diagnosis of giant cell tumor, as seen, is made based on several factors taken into account including history, clinical examination, imaging techniques and finally the confirmatory biopsy of the lesion. This also helps in grading and staging of the tumor which helps in determining the prognosis and deciding the further treatment modalities.
Repurposing of Intravenous Piperacillin-Tazobactam in COVID Pneumonitis: A Case Report
Shoebul Haque, Farah Asif, Moidur Rehman, Abdul Qavi
Sch J Med Case Rep | 640-644
DOI : 10.36347/sjmcr.2021.v09i06.007
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Several patients with pneumonia-like symptoms of unknown cause were found linked to the wholesale market in Wuhan, China, in December 2019. The World Health Organization announced on March 11th, 2020, that the outbreak of “Corona Virus Disease 2019” (COVID-19) has become pandemic. At present, we are going through the second wave of infection. To date, no evidence consistently supports any treatment for COVID-19 patients, so identifying new therapeutic options seems beneficial in the management of this disease. This study aimed to report the role of piperacillin-tazobactam antibiotics in patients of COVID-19 disease with bacterial co-infection. In the present case report, the COVID-19 positive patient’s clinic-biochemical examination along with HR-CT scan were analyze. Furthermore, along with various symptomatic medications, the role Piperacillin-tazobactam was analyzed after administration. Results show that after administering intravenous piperacillin-tazobactam tothe patient, the patient's general condition improves. The patient’s routine blood investigations were to come to normal limits and breaths on normal roomair with SpO2 96%.Based on improvement in patient general condition, oxygen saturation, and in routine blood investigation, we can say that there is some hidden role of intravenous piperacillin-tazobactam injection in the management of COVID-19. Alternatively, we can say that we can decrease the severity of COVID-19 infection by inhibiting the bacterial co-infection. Piperacillin-tazobactam might be useful in the early stages of SARS-CoV-2 infection and the case of bacterial co-infection, although further research is needed to assess the role of piperacillin/ tazobactam in COVID-19 infection.
Right Main Bronchus Transection Post Blunt Trauma: A Case Report
M.R. Abdul Rashid, M.R Adli Azam, H Hairulfaizi, Z. Mohd Faizal Effendi, M.L Firdaus, J.A. Muiz, L Hamdan, M.N. Mohd Arif, M.K. Hamzah
Sch J Med Case Rep | 645-647
DOI : 10.36347/sjmcr.2021.v09i06.008
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Tracheobronchial Injury is a relatively uncommon condition which is associated with high mortality. Majority occurring from blunt chest trauma sustained from deceleration injury in road traffic accidents. We present a case of a 17-year-old young male who presented in the acute setting of post motorcycle accident with respiratory distress, subcutaneous emphysema, right pneumothorax and fracture of posterior right 8th-9th ribs. CT shows right main bronchus anterior wall tear, with extensive subcutaneous emphysema, pneumomediastinum, bilateral pneumothorax and pneumoperitoneum. Thoracotomy confirmed the findings. Lacerated segment of right lower lobe bronchus was resected and (end-to-end) anastomosis was performed. Post-surgery was complicated with empyema thoracis which required decortication. Early detection and prompt surgical repair is fundamental and carries a high success rate in tracheobronchial injuries, however post-surgery complications need to be entertained and managed adequately to ensure safe outcome.
Successful Treatment of Acute Respiratory Distress Syndrome with Extracorporeal Membrane Oxygenation in a Leptospirosis Patient: A Case Report
M.R. Abdul Rashid, Z. Mohd Faizal Effendi, J.A. Muiz, L Hamdan, ML Firdaus, MN Zuraini, Z Zuhrah, AL Aizatul Isla, Navinsatku, G Haslan, M.N. Mohd Arif, M.K. Hamzah
Sch J Med Case Rep | 648-649
DOI : 10.36347/sjmcr.2021.v09i06.009
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Leptospirosis is an infectious condition with a wide clinical spectrum that can present with mild symptoms to severe life threatening situations. Amongst this spectrum, Acute Pulmonary Distress and Haemorrhage can manifest, which poses a challenging dilemma in the management of these patients. Inadequate ventilatory strategies can lead to high mortality within this group of patients. Early detection, prompt treatment, with good interdepartmental communication and good team work are essential. We present a case of a 28-year-old young male who presented in the acute setting with respiratory distress, and pulmonary haemorrhage which was successfully treated with venovenous extra corporeal membrane oxygenation.
Original Research Article
June 15, 2021
COVID 19: Incidence and Treatment Outcome in Pakistan: A Case Study of a Private Hospital of Karachi
Gulnaz Elahi, Irfan Elahi, Ikram Ul Haq
Sch J Med Case Rep | 650-656
DOI : 10.36347/sjmcr.2021.v09i06.010
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Objectives of the study: To find out the incidence of Covid 19 in patients reporting to a tertiary care private hospital set up and to find out its treatment outcome. Methodology: Study Design: Descriptive cross sectional six months’ study conducted in a private hospital, Karachi, Pakistan. Non-probability convenient consecutive sampling was used for the study. A total of 367 patients reported to the OPD of the hospital were included for the study who were screened during the study period. Out of these, 328 (89.4%) patients were found Covid 19 positive. Inclusion and Exclusion Criteria: Patients complaining of fever, dry cough and tiredness were further checked and interrogated for other symptoms e. g. aches and pains, sore throat, diarrhea, conjunctivitis, headache, loss of taste and smell, skin rash, discoloration of fingers or toes. Once these symptoms were found to be present investigation further continued with the diagnostic tests. Patients who did not come under the inclusion criteria were excluded from the study. Research Procedure: The following tests were conducted for further confirmation: Rapid antigen test, COVID PCR, COVID Antibodies, Chest X-ray, HRCT - CT scan of the chest, inflammatory Markers - (Ferritin, LDH, Dimers). Conclusion: COVID 19 pandemic is an unprecedented crisis and it has altered the lifestyles of people. Out of the total suspected cases 89.4% were confirmed for Covid 19 and the cure rate was 87%, while the death ratio was recorded 2.5%.
Placental Site Trophoblastic Tumor – A Systematic Review
Biju Azariah M, Manisha Verma, Divya T, Jayaprakash PG
Sch J Med Case Rep | 657-662
DOI : 10.36347/sjmcr.2021.v09i06.011
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Placental site trophoblastic tumor (PSTT), a rare form of gestational trophoblastic disease (GTD) has a wide clinical and biological spectrum with benign to malignant potential. PSTT can occur after any type of pregnancy and no specific risk factors have been established. Mitotic index is the most important prognostic factor in determining the outcome of disease. Though early and benign disease is cured with surgery, for advanced metastatic disease, chemotherapy plays an important role in management. However, chemotherapy resistance is a main obstacle in achieving adequate control in patients with advanced disease. This article reviews the literature on this rare disease and tries to provide a comprehensive view on its management.
Role of Imaging in the Diagnosis of an Enteric Duplication Cyst of the Esophagus: A Case Report
Hayat Bakali, Amine Nejmeddine, Zineb Abbad El Andaloussi, Aicha Merzem, Hasna Belgadir, Nadia Moussali and Naima Elbenna
Sch J Med Case Rep | 663-666
DOI : 10.36347/sjmcr.2021.v09i06.012
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Aims: Show the importance of imaging in the diagnosis of enteric cysts of the esophagus and the main differences with other mediastinal cystic lesions. Presentation of case: We report a case of an enteric cyst of the esophagus, in a 25 year old patient, with dyspnea on exertion. X-ray shows an oval opacity in the posterior mediastinum and the CT scan and MRI show a cystic mass of the posterior mediastinum, presenting intimate contact with the esophagus, with discreet wall contrast enhancement. Discussion and Conclusion: Enteric duplication cysts are rare congenital malformations formed during the embryonic development of the digestive tract. They are usually detected prenatally or in the first years of life. Their size, location, type and presence of complications produce a varied clinical presentation and different imaging findings. They most frequently occur in the small intestine, particularly the ileum, but can occur anywhere along the gastrointestinal tract. In the case of an enteric cyst of the esophagus, the first imaging method for diagnosis is the chest x-ray because of the breathing difficulty patients can experience due to compression of the airway. Magnetic resonance (MR) and computed tomography (CT) can help the radiologist in the diagnosis and the surgeon by evaluating more precisely the mass measurements and describing its anatomical relationship with the vessels and surrounding organs. Confirmation remains histological.
Ovarian Ectopic Pregnancy – A Case Report of Two Cases
Dr. Parul Garg, Dr. Vaneet Kaur, Dr. Navjot Kaur, Dr. Shilpa Pal, Dr. Bikramjit Singh
Sch J Med Case Rep | 667-669
DOI : 10.36347/sjmcr.2021.v09i06.013
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Primary ovarian pregnancy occurs very rarely and usually in young women using intra uterine device. We present two case reports where young primigravida females presented with pain abdomen and were diagnosed as ectopic pregnancy on ultrasonography and confirmed on histopathology examination as Ovarian ectopic after partial oophorectomy.
Multiple Brain Abscesses and Tetraventricular Hydrocephalus Complicating Enterobacter cloacae Sepsis in a Premature Infant: A Case Report and Literature Review
W. Quiddi, S. Eddyb, F. Bennaoui, N El Idrissi Slitine, M-R-F Maoulainine, A. H. Laamrani, N. Soraa
Sch J Med Case Rep | 670-672
DOI : 10.36347/sjmcr.2021.v09i06.014
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Enterobacter cloacae, a facultative anaerobic Gram-negative bacterium, is part of human enteric flora. However, it has gained clinical significance since it has been reported as a major culprit for bloodstream nosocomial infections during last few decades. Enterobacter cloacae can infect both immune-competent and immunocompromised patients. Unfortunately, this pathogen resistant to many antibiotics due to the possession of certain chromosomal enzymes. In the present case report, a premature infant suffered from Enterobacter cloacae sepsis, complicated by brain abscesses and tetraventricular hydrocephalus. The infant underwent surgical drainage of the abscesses with placement of an external bypass drain and was put on broad-spectrum antibiotics with good recovery later one.
Paragangliomas of Nasal Cavity: A Case Report
Niema Benkhraba, Mohamed Ali Gliti, Ihssane Allouch, Sophia Nitassi, Bencheikh Razika, Benbouzid Mohamed Anas, Abdelilah Oujilal, Leila Essakalli Houssyni
Sch J Med Case Rep | 673-675
DOI : 10.36347/sjmcr.2021.v09i06.015
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Paraganglioma is a rare neuroendocrine tumor. Nasal localization is very rare. Head and neck paragangliomas represent only 0.6% of head and neck tumors and 3% of all paragangliomas. The treatment is based on surgery. Radiotherapy is indicated if the surgery does not provide complete resection. We report the case of a 36-year-old patient who has had left nasal obstruction with epistaxis for 2 years. The CT scan shows a solid mass centered on the left nasal cavity, puffy, without signs of aggression, benign-looking. The patient underwent a complete endoscopic endonasal tumor removal after preoperative external carotid embolization. Pathological analysis with immunohistochemistry confirmed the diagnosis of paraganglioma. The follow-up to the treatment was favorable.
Cystic Dilatation of Main Bile Duct: About A Case
Hassan DOULHOUSNE, Salah BENELHEND, Mohammed-Jaouad FASSI FIHRI, Hicham BABA, El Medhi ATMANE, Abdelghani EL FIKRI, Abdelilah MOUHSINE
Sch J Med Case Rep | 676-677
DOI : 10.36347/sjmcr.2021.v09i06.016
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Cystic dilatation of the bile ducts is a rare congenital malformation. It’s due to an abnormality of the bilio-pancreatic junction which may involve the extra and/or intrahepatic bile ducts. According to Todani, there are several types depending on the site, shape and distribution of the malformation. It’s evoked in front of the inconstant clinical triad: pain, jaundice and mass. Ultrasound and better sectional imaging confirm the diagnosis. Surgical excision is the treatment of choice to prevent malignant degeneration of the cyst wall and bile ducts.
Glabellar Hatchet Flap for Reconstruction of the Nasal Dorsum – A Case Report
Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Narayanamurthy Sundaramurthy, Anand Prasath Jayachandiran, Suresh Rajendran
Sch J Med Case Rep | 678-680
DOI : 10.36347/sjmcr.2021.v09i06.017
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Reconstruction of nasal defects presents a challenge for the reconstructive surgeon due to the complicated aesthetic subunits of the nose and limited available adjacent mobile skin with varying color, texture, and thickness. The ideal tissue needs to be of similar color, texture, and thickness to that of the defect. The glabellar flap is the ideal flap for closure of proximal nasal dorsal defects. Here, we present a case of a soft tissue defect in the proximal third of the nasal dorsum which was resurfaced with the glabellar hatchet flap.
Experience of Management of Intractable Postherpetic Neuralgia on Perineum: A Case Report
Ye Ji Lee, Su Yeon Kim, Woo Yong Lee, Yun-Hee Lim
Sch J Med Case Rep | 681-683
DOI : 10.36347/sjmcr.2021.v09i06.018
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Herpes zoster is a transient disease caused by the reactivation of latent varicella zoster virus. Approximately one in every three people develops herpes zoster during their life time. Postherpetic neuralgia is the most common complication associated with herpes zoster, and it often persists for several years and even for a lifetime despite the pharmacological treatment. A 74-year-old woman experienced severe postherpetic neuralgia on the coccyx and the vulva for 18 months. Authors performed six times of fluoroscopy-guided nerve blocks including pudendal nerve block, ganglion impar block, and L1 transforaminal epidural block. With repeated nerve blocks, her numeric rating scale decreased from 8 to 4, and after 5 months, her pain was controlled only with oral medication. Postherpetic neuralgia might be treated with nerve blocks regardless of its duration.
Hemorrhagic Eye Involvement in Acute Myeloid Leukemia
Kougou Ntoutoume AR, Mekyna S, Tachfouti S, Cherkaoui O
Sch J Med Case Rep | 684-686
DOI : 10.36347/sjmcr.2021.v09i06.019
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Purpose: Through an observation, we focus on the ocular hemorrhagic manifestations during AML and the role of the ophthalmologist in the management of this condition. Methods: We report the case of a 14-year-old boy whose hemorrhagic ocular involvement was indicative of an AML. Results: This patient with no known history was sent for an ophthalmology consultation for a sudden decline in bilateral visual acuity associated with a bilateral periorbital ecchymosis. The interrogation found an effort of vomiting preceding the ocular symptoms and a notion of purpuric spots on the lower limbs 3 months ago. Distance visual acuity has been rated at 1/10 on the right and counts the fingers on the left. Examination of the anterior segment mainly revealed periorbital ecchymosis and diffuse bilateral subconjunctival hemorrhage. Fundus analysis revealed bilateral diffuse retinal hemorrhage, premacular retro-hyaloid hemorrhage on the right and macular hemorrhage on the left. An emergency blood count showed anemia with hemoglobin (Hb) level of 5.5g/dL and thrombocytopenia at 15,000/µL. Hyperleukocytosis at 126420/µL with monocytes at 84700/µL and neutrophils at 3312/µL. The patient was immediately referred to a hematologist and an oncologist. The investigations and the myelogram made it possible to make the diagnosis of acute myeloid leukemia. Conclusions: Although the ophthalmologist plays a secondary role in the treatment of leukemia, he must be able to recognize the eye symptoms indicative of systemic disease and collaborate with hematologists and oncologists in the follow-up and management of patients.
Bilateral Levator Aponeurosis Disinsertion Following Stevens – Johnson Syndrome: Case Report
Sunday Nnamdi Okonkwo, Ernest Ikechukwu Ezeh, Emmanuel Olu Megbelayin
Sch J Med Case Rep | 687-689
DOI : 10.36347/sjmcr.2021.v09i06.020
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Stevens–Johnson syndrome is complex immunological syndrome characterized by acute blistering of skin and mucous membrane. The disease frequently involves the eye and can cause blindness. Here we report an unusual occurrence of bilateral blepharoptosis due to bilateral levator aponeurosis dehiscence following Stevens –Johnson’s syndrome.
