Anesthesic Management of Cervical Disc Herniation During Prégnancy: A Case Report
Mehdi Samali, Mohammed Rabi Andaloussi, Said Khallikane, Amine Meskine, Abdelghafour Koundi, Mustapha Bensghir
Sch J Med Case Rep | 871-874
DOI : 10.36347/sjmcr.2020.v08i10.001
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Cervical herniation during pregnancy is a extremely rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression. Anesthesic management should also include measures to maintain the mean arterial pressure to improve spinal cord perfusion. Furthermore, spine surgery in pregnant patients needs special consideration in terms of positioning and in the postoperative period. We present a case of a 28-year-old white woman at 18 weeks of gestation with a cervical disc herniation. Fiberoptic bronchoscope-guided nasal intubation was a safe option to ensure a higher rate of successful endotracheal intubation while minimizing the risk of aggravating the injury. Her care posed other multiples challenges that required a multidisciplinary team approach. Conclusions: The case of our patient serves as a reminder of this rare condition and its implications regarding anesthesia.
Pulsatile Proptosis: Think About the Carotid-Cavernous Fistula
Ayman El Farouki, Hassan Doulhousn, Habib Bellamlih, Soufiane Belabbes
Sch J Med Case Rep | 875-877
DOI : 10.36347/sjmcr.2020.v08i10.002
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Carotid-cavernous fistula is an abnormal communication between the cavernous sinus and the carotid arterial system. The clinical presentation is dominated by pulsatile proptosis. We report the case of a 31-year-old man who presented with a recent onset of pulsatile proptosis. A cerebral angio-CT scan revealed a left-sided dilation of the cavernous sinus veins due to a direct carotid cavernous fistula. The patient was referred to radiology department where and endovascular approach was performed.
Myocarditis Associated with Venlafaxine Overdose and Role of CYP2D6
Sofia Kaddaf, Mohammed Amine Ktiri, Nadif Mariam, Adolphe Kasango, Yann Rosamel, Pascal Goube
Sch J Med Case Rep | 878-881
DOI : 10.36347/sjmcr.2020.v08i10.003
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Introduction: Venlafaxine is a serotonin-norepinephrine reuptake inhibitor used as an antidepressant that causes usually a mild cardiotoxicity when ingested in overdose. We report a case of a patient who developed rhabdomyolysis and acute heart failure with LV thrombus attributed to venlafaxine overdose. After venlafaxine discontinuation, there was rapid improvement, with regression of the radiological abnormalities and normalization of the LVEF. Case report: A 21-year-old man was admitted to the intensive care for acute renal failure secondary to rhabdomyolysis (CPK > 140000 UI/L) 7 hours after the ingestion of an 11 g of VENLAFLAXINE, complicated by acute pulmonary edema with acute respiratory distress. The electrocardiogram showed T wave inversion in anterior leads, but normal QRS and QTc duration. Initial troponin T was 1005 µg/L BNP: 13 045 pg/ml .The patient developed severe acute pulmonary edema. The left ventricular shortening fraction was 56% on echocardiography with anteroseptal akinesis with a non-mobile round echodensity measuring 13 x 9 mm, consistent with an LV thrombus. The coronary arteries appear normal at coronary angiography. The patient was anuric and required continuous venovenous hemofiltration. Management consisted in noninvasive ventilation and dobutamine associated with intravenous isotonic saline, bicarbonate, and loop diuretics to control left ventricular dysfunction. Ventilator and cardiac support were maintained for 48 hours. Progressive improvement in respiratory failure was observed, and creatine kinase level decreased to 336 U/L on day 4, The patient was discharged from the intensive care unit on day 10, to Cardiology department with curative anticoagulation, Cardiac magnetic resonance imaging at Day 20 revealed edema of the anteroseptal walls on T2-weighted images and the T1 mapping, Furthermore, The anterospetal segment of the left ventricle was hypokinetic, and the echodensity structure was no longer visible in either a..........
Primary Antiphospholipid Syndrome (APS) and Systemic Lupus Erythematosus (SLE) with Multiple Deep Vein Thrombosis- Case Report
Dr. Krishna Kumar Dhakchinamoorthi, Dr. Ann Mary Alex, Dr. Nikhil Cherian Sam, Dr. Jeevanantham R, Mohamed Sulaiman G, Irene Mariya Kishore, Dr. Ashwin Karuppan V
Sch J Med Case Rep | 882-885
DOI : 10.36347/sjmcr.2020.v08i10.004
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Antiphospholipid syndrome (APS) is a complex disorder and associated with thrombosis which causes significant morbidity with antiphospholipid antibodies (aPL). Many percentages of patients with the systemic lupus erythematosus (SLE) were tested positive for aPL antibodies. However, patients in the early stage do not report to have SLE symptoms. In the present case, the primary APS antiphospholipid antibodies were present with multiple deep vein thrombosis. A 24-year-old female patient was admitted to the hospital for the complaints of excruciating pain over the left lower limb and swelling that extended till the groin. Further, the investigations were confirmed antiphospholipid syndrome through positive results of tests for anti-cardiolipin (ACLA), anti-nuclear antibody (ANA) and beta-2 glycoprotein. However, the presence of SLE is confirmed only by direct coombs test. In this case, SLE with APS antibody not triggered the syndrome, and there were no signs of any SLE syndrome, however, patients had multiple deep vein thrombosis and underwent for the catheter-directed thrombolytic procedure. In the present case, early diagnosis and sufficient treatment are required to prevent the progression of the disease.
Granular Corneal Dystrophy Type 1: About A Family
Aymane RIDALLAH, A.R. Kougou Ntoutoume, N. Boutimzine, O. Cherkaoui
Sch J Med Case Rep | 886-890
DOI : 10.36347/sjmcr.2020.v08i10.005
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Introduction: Groenouw type 1 granular corneal dystrophy is an autosomal dominant disease, with complete penetrance, following a mutation in the chromatin 5q31 transforming growth factor beta induced protein H3 gene (TGFβI) coding for keratoepithelin. It is a rare corneal condition that is clinically manifested by the presence of central-bilateral, symmetrical white-greyish corneal opacities in the form of snowflakes, involving the Bowman's membrane, the anterior, middle and posterior stroma. Often responsible for pain, photophobia, and a gradual decline in visual acuity. We describe the epidemiological, clinical, tomographic, genetic, and therapeutic aspects of this condition in a family of two children from a consanguineous marriage, whose parents are also affected. Patients and methods: We report the case of a family whose father, mother and their two children (a boy and a girl) are all suffering from type 1 granular dystrophy. Parents are linked by third-degree consanguinity. The first patient was a 6-year-old child, with no personal history, who had consulted for bilateral progressive lowering of visual acuity evolving since birth, with photophobia. We performed an interrogation, a biomicroscopic examination with photographs of the anterior segment, a paraclinical assessment including an optical coherence tomography of the anterior segment. Then we conducted a family survey by examining family members, including her father, mother, and sister. Results: The examination of the child found a BCVA at 5/10. The biomicroscopic examination revealed several small, superficial, central, whitish, confluent, snowflake-shaped, bilateral and symmetrical corneal lesions located on Bowman's membrane and sparing the limb, suggestive of granular corneal dystrophy, complicated with an organic amblyopia. Optical coherence tomography of the anterior segment revealed well-defined hyper-reflective deposits at Bowman's membrane, anterior and middle stroma. The orthoptic treatment ..
Successfully Treated Multifocal Chondrosarcoma in an Adult - A Case Report
Arun Vasudevan, Sreejith G Nair, Steffi Chacko, Saikumar Soman, Sindhu Nair P, Rani Rajasekharan, Bhaskar Subin Sugath, Manu Paul
Sch J Med Case Rep | 891-893
DOI : 10.36347/sjmcr.2020.v08i10.006
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Chondrosarcomas are malignant cartilaginous neoplasms with a variable clinical behavior. It often involves the axial skeleton and affects the elderly. It can be primary or secondary chondrosarcoma. Lung is the most common site of metastasis. Here we report a case of multifocal chondrosarcoma involving four different skeletal sites without lung metastasis. Multifocal chondrosarcoma in the absence of lung metastasis is an extremely rare presentation. It is a radioresistant and chemo resistant tumor except for few histologic variants. Surgery is the cornerstone in its management. Complete surgical excision with negative margins of all the involved sites is the preferred treatment modality. In this case it was possible to completely resect all the sites of disease involvement.
Gastric Perforation on an Intragastric Balloon: A Rare but Fatal Complication
Abderrahim Ait Abderrhim, Hicham Bouhdouti, Karim Ibnmajdoub, Imane Toughrai, Khalid Maazaz
Sch J Med Case Rep | 894-897
DOI : 10.36347/sjmcr.2020.v08i10.007
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Obesity is one of the most important public health issues due to its prevalence and associated complications. Endoscopic treatment with the introduction of an intragastric balloon (BIG) is a temporary aid that helps achieve weight loss and changes in eating habits. The results are encouraging in terms of weight loss and improvement of comorbidity factors; but this technique, despite being spectacular, still exposes it to serious and fatal complications such as gastric perforation by compression of the wall. Our article has well treated this complication in terms of its rarity; its severity and pathophysiology which makes our work interesting to improve endoscopic techniques of ballooning and modifies the monitoring times.
Testicular Choriocarcinoma Revealed By Lower Digestive Bleeding: Case Report
Hicham Ncir, Zakaria Dahami, Mouhssine Errehan, Mohammed Oubihi, Mohammed Amine Lakmichi, Said Mohammed Moudouni, Ismail Sarf
Sch J Med Case Rep | 898-900
DOI : 10.36347/sjmcr.2020.v08i10.008
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Choriocarcinoma are neoplasms that develop from testicular germ cells in humans. Testicular choriocarcinoma metastases are often hemorrhagic, mainly from the brain or lungs. Digestive metastasis is a rare and have a poor prognosis when they bleed. We report the observation of a young patient of 36 years, hospitalized for melena of average abundance, evolving in a context of general condition alteration, the radiological assessment discovers an intestinal intussusception with a peritoneal effusion of average abundance, hepatic and pulmonary nodules of probably metastatic origin. The urogenital examination finds an enlarged left testicle, the ultrasound confirms the presence of testicular nodules and the head of the epididymis of tumor-like appearance, the blood dosage of the hormone HCG is high, the patient underwent a median laparotomy with left inguinal orchiectomy, the anatomopathological and immunohistochemical study confirms the diagnosis of testicular choriocarcinoma. The frequency of atypical choriocarcinoma metastases is very low and treatment is mainly based on chemotherapy.
Congenital Osteofibrous Dysplasia of the Tibia: A Case Report Discovered In the Neonatal Age
Jalal H, El Mortaji H, Alami Y, Basraoui D, Mouhtadi A, Elfezzazi R
Sch J Med Case Rep | 901-903
DOI : 10.36347/sjmcr.2020.v08i10.009
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Osteofibrous dysplasia is a benign and rare bone lesion which involves most often the tibia or simultaneously the tibia and the fibula bones. It is usually diagnosed during childhood or early adolescence. Although its limited evolutionary potential, it can lead to bone deformities as well as local pain. The classic radiological appearance shows zones of well-defined intracortical osteolysis as well as a curvature with an anterior apex of the diaphysis. Its evolution is characterized by a progression of the lesion and bone deformation variable during childhood then a stabilization followed by a progressive resolution in the adulthood. We report the case of an osteofibrous tibia dysplasia revealed by a deformation of the left leg in a 10-day-old female newborn.
Diffuse Cavernous Hemangioma: Rectal Cancer Mimic
H. El Mortaji, B. Boutakioute, M. Ouali Idrissi, N. Cherif Idrissi El Ganouni
Sch J Med Case Rep | 904-907
DOI : 10.36347/sjmcr.2020.v08i10.010
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Diffuse cavernous hemangioma of the rectum (DCHR) is a rare benign tumor of vascular origin. It affects mainly young adults. The clinical presentation is non-specific, therefore many patients are incorrectly diagnosed for several years. Imaging features may be helpful. CT can be predictive by showing phleboliths and MRI seems to be valuable and specific enough to make the diagnosis with certainty. We present a case of a 53-year old male patient with a history of recurrent and painless rectal bleeding evolving for 5 years who was finally diagnosed of diffuse cavernous hemangioma of the rectum.
Pulmonary Artery Aneurysms Revealing Behçet's Disease
Hajar EL Mortaji, Hanane EL Hammaoui, Badr Boutakioute, Mariem Ouali Idrissi, Najat Cherif Idrissi Ganouni
Sch J Med Case Rep | 908-910
DOI : 10.36347/sjmcr.2020.v08i10.011
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Pulmonary arterial aneurysm is defined by a dilation of the pulmonary artery. It should not be confused with a false aneurysm; Witch is due to a breach in the vessel wall. Known since the 18th century when syphilis and tuberculosis were endemic, aneurysms of the pulmonary artery became rare with the advent of antibiotics. In Behçet's disease, arterial involvement is rare and has a poor prognosis. We report a case of bilateral aneurysms involving the lobar and segmental pulmonary arteries during Behçet's disease in a 45-year-old patient who presented with hemoptysis. The chest X-ray showed bilateral round pulmonary opacities. The thoracic CT scan showed multiple bilateral aneurysms of the lobar and segmental pulmonary arteries. The evolution was spectacular under medical treatment. The peculiarity of this case lies in the rarity of arterial involvement during Behçet's disease in general and in the rarity of the segmental arterial involvement in particular; as well as in the good evolution under medical treatment even with the presence of hemoptysis.
Aortopulmonary Window: A Two Cases Report and Literature Review
El –Alaoui Mohamed, Jourani Sara, Zalle Issaka, Boumzebra Drissi
Sch J Med Case Rep | 911-914
DOI : 10.36347/sjmcr.2020.v08i10.012
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Aortopulmonary window (APW) is a rare congenital cardiac anomaly.These malformations originate an important left-right shunt with congestive heart failure in the first days or months of life, and early development of severe pulmonary hypertension.7 Until the present, only about 300 cases have been published; for the most part as isolated reports.3-5We report our experience with surgical treatment of APW in 2 consecutive patients in the first years of life. Two infants respectively 4 years old male, 6-month-old male have been referred to our hospital with a medical history of dyspnea, tachypnoea without cyanosis and history of recurrent pulmonary infections. There was no perinatal illness in both infants. An APW diagnostic was performed byechocardiography and type I was identified. The anatomical defects have been repaired surgically using synthetic patch and autologous pericardial patch according to the anatomical type. Additional gests were also performed. The surgical procedures were uneventful. Post-operative course was favourable in one infant with best post-operative recovery. However one infant deceased in day 10 post-operative due to sepsis chock. In conclusion surgical repair is the gold standard of the treatment of APW with good results. Due to the irreversible pulmonary vascular disease this malformation should be diagnosed early and repaired at the diagnosis.
Primary Synovial Sarcoma of Lung
Dr. J. Rajitha, Dr. S.Srikanth
Sch J Med Case Rep | 915-918
DOI : 10.36347/sjmcr.2020.v08i10.013
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Primary synovial sarcoma of lung is an extremely rare tumor. We report a case of a 50 year old male, who complained shortness of breath and hemoptysis. He had heterogeneously enhancing soft tissue density in right upper lobe. Trucut biopsy revealed spindle cell neoplasm and he underwent right lobectomy. Histopathological examination of lobectomy specimen revealed monophasic variant of synovial sarcoma. On immunohistochemistry tumor cells positive for vimentin, bcl-2, CD99 and immunonegative for cytokeratin. Based on clinical, imageological, histopathology and immunohistochemistry finally concluded it as primary synovial sarcoma of lung.
Original Research Article
Oct. 29, 2020
Indication, Clinical Profile and Management of Bullous Disease of Lung during COVID Pandemic
Dr. Karunakara Padhy, Dr. Nirupama Devi, Dr. Thitta Mohanty
Sch J Med Case Rep | 919-922
DOI : 10.36347/sjmcr.2020.v08i10.014
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The outbreak of covid-19 pandemic has lead to a great health care challenge. Though the pathophysiology understanding has improved, but still health care workers are at greater risk. World Health Organisation (WHO) and governmental policy is focusing on covid-19 management, but non-covid patients of cardiac and lung disease need equal and sometimes more attention particularly urgent and emergency cases. In bullous disease of lung presenting with dyspnoea should not be neglected as covid patient and should be treated with proper diagnosis and management. We present six cases of bullous disease who presented with high grade dyspnoea and undergone surgical treatment with strict inclusion and exclusion criteria during this pandemic. Proper perioperative covid protocols were followed in all cases.
Tongue Squamous Cell Carcinoma and Ill Fitting Dental Prostheses
Nouha Dammak, Sameh Sioud, Maroua Garma, Mounir Omami, Adel Bouguezzi, Abdellatif Chokri, Mohamed Habib Hamdi, Jamil Selmi
Sch J Med Case Rep | 923-926
DOI : 10.36347/sjmcr.2020.v08i10.015
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Introduction: Squamous cell carcinoma (SCC) of the tongue has a relatively high incidence of all oral cancers. Some studies have reported a relationship between dental prostheses and tongue SCC. The aim of this work was to warn dentist against the fatal consequences of inappropriate dental prostheses. Observation: A 64-year-old female patient consulted with the chief complain of a tongue ulceration. This lesion has been related to an ill fitting mandibular dental prosthesis. Clinical and histological finding confirmed the diagnosis of SCC. Conclusion: Chronic trauma presents a risk factor for oral cancers, so a big attention must be given to teeth or dental protheses in the treatment of premalignant lesions or cancers of the oral cavity.
Facial Botriocytoma: Post Trauatism by Cow Horn in A Young Patient
N. Belhaj, I. Boumendil, H. Rahim, H. Ait Taleb Oumhand, S. Nitassi, A. Oujilal, R. Bencheikh, M. A. Benbouzid, L. Essakalli
Sch J Med Case Rep | 927-928
DOI : 10.36347/sjmcr.2020.v08i10.016
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Facial botriocytoma is a benign skin tumor; it is a very common conjunctive-vascular lesion whose starting point is often a small inflammatory wound. Initial skin trauma is often found. Surgical exeresis must remove the lesion completely with often healthy skin safety margins.in this work we report the case of young patient who presente facial botriocytoma one day post traumatic by cow horn.
Retrograde Urethrography Examination in Penile Fracture: Case Report
Iwan Purnomo Aji, Fikri Rizaldi
Sch J Med Case Rep | 929-930
DOI : 10.36347/sjmcr.2020.v08i10.017
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Penile fracture is an uncommon condition. Fracture of the penis is a tear in the tunica albuginea of the corpora cavernosa that may be associated with injury to the corpus spongiosum and urethra. We describe the case of a 51-year-old man who presented with acute penile pain, penile swelling, and a hematuria after a blunt trauma during sexual intercourse. Retrograde urethrography examination revealed extravasation from distal penile urethra into the cavernous structure. In cases of penile fracture, retrograde urethrography can be used for definitive diagnosis.
Dysgenic Secondary Congenital Glaucoma (About 10 Cases): Experience of the Ophthalmology Department of CHU HASSAN II-Fez
Dr. Hind Saidi, Pr Fouad Chraibi, Dr. Ouail Hassimi, Dr. Sarah Ech-Cherif El Kettani, Pr Ahmed Bennis, Pr Meriem Abdellaoui, Pr Idriss Benatiya Andaloussi
Sch J Med Case Rep | 931-933
DOI : 10.36347/sjmcr.2020.v08i10.018
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Congenital glaucoma secondary to anterior segment malformation is a rare pathology. The purpose of our study is to analyze the epidemiological and clinical aspects of children with secondary congenital glaucoma and to evaluate the therapeutic results of these patients. Over a period of 5 years, we reported ten eyes from six childrens who were treated all of them by trabeculectomy with mitomycin by the same operator. The middle age was 3,8 mounths with a sex ratio around 0,5 males per females. Bilateral glaucoma was found in 66% of cases. The average initial intra-ocular pressure was 22,5 mmHg, the average follow-up was 24mounths with a total success of 23% and partial success of 40%. The prognosis was worse for dysgenesic secondary glaucoma.
Anesthésic Managment of A Pregnant Woman With Cerebral Arteriovenous Malformation: A Case Report
Mehdi Samali, Said Khallikane, Mohammed Rabi Andaloussi, Amine Meskine, Abdelghafour Koundi, Mustapha Bensghir
Sch J Med Case Rep | 934-936
DOI : 10.36347/sjmcr.2020.v08i10.019
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Cerebral arteriovenous malformations (AVM) are rare in pregnancy , Intracranial hemorrhage due to rupture of an AVM during pregnancy can have serious consequences on the health of the mother and the fetus. We report the case of a pregnant woman with AVM presented to our hospital at 39th week of Gestationnnel age, and Caesarean section under general anesthesia was performed successfully. Conclusions: Patients with symptomatic AVM during pregnancy are challenging in terms of medical approach in general, and of anesthetic management in particular. in the absence of consensus the anesthetic technique should be discussed on a case-by-case.
