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Right Atrium Hydatid Cyst at the Septal Leaflet of the Tricuspid Valve, Underwent TVR
Manochihr Timorian,
Abdul khaliq Munib,
Mohammad Rafi Hamidi
Issue:
Volume 2, Issue 1, March 2021
Pages:
1-3
Received:
15 October 2020
Accepted:
19 November 2020
Published:
15 January 2021
DOI:
10.11648/j.wjmcr.20210201.11
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Abstract: Echinococcus is an infection caused in human by the larval stage of Echinococcus granulosus, Echinococcus multilocularis, or Echinococcus vogeli. Slowly enlarging echinococcal cyst generally remains asymptomatic until their expanding size or their space occupying effect in an involved organ elicits symptoms. The most pathognomonic finding, if demonstrable is that of daughter cyst within the larger cyst. A specific diagnosis of E. granulosus infection can be made by the examination of aspiration fluid for protoscolices, but this is not recommended due to fear of spillage and anaphylactic reactions. Serodiagnostic assays can be useful, although a negative test doses not exclude the diagnosis of echinococcosis. Detection of antibody to specific echinococcal antigen by immunoblotting has the highest degree of specificity. The liver and the lungs are the most common sites of these cysts. Cardiac hydatid cysts are found in fewer than 2% of cases of hydatidosis. In 50% of such cardiac cases, there is multiple organ involvement. A 26-year-old female presented to our emergency department with dyspnea on exertion, and a mass lesion in her right atrium, her Investigations and pre-operative transthoracic echocardiography revealed the mass located in the right atrium at the septal leaflet of the Tricuspid Valve, which was confirmed a hydatid cyst during intraoperative intervention, along with no cysts of the lungs and liver. The lesion was successfully resected, and the tricuspid valve was replaced under Cardiopulmonarybypass.
Abstract: Echinococcus is an infection caused in human by the larval stage of Echinococcus granulosus, Echinococcus multilocularis, or Echinococcus vogeli. Slowly enlarging echinococcal cyst generally remains asymptomatic until their expanding size or their space occupying effect in an involved organ elicits symptoms. The most pathognomonic finding, if demon...
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“Transformation of Polycythemia Vera into Acute Myeloid Leukemia”: A Case Report with Review of the Literature
Karrati Ilham,
Jahdaoui Adil,
Ghita El Ghouat,
Yahyaoui Hicham,
Ait ameur Mustapha,
Chakour Mohamed
Issue:
Volume 2, Issue 1, March 2021
Pages:
4-6
Received:
16 January 2021
Accepted:
28 January 2021
Published:
9 February 2021
DOI:
10.11648/j.wjmcr.20210201.12
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Abstract: Polycythemia vera (PV), with essential thrombocythemia (ET) and primary myelofibrosis (PMF), belongs to the group of Philadelphia negative myeloproliferative neoplasms (MPN). PV is characterized in virtually all cases by the somatic JAK2 V617F mutation or another functionally similar JAK2 mutation that results in panmyelosis. Two phases of PV are recognized which include an initial polycythemic phase associated with elevated haemoglobin level, elevated haematocrit and increased red blood cells mass, and a later spent phase or post- polycythemic myelofibrosis phase, characterised by cytopenias including anaemia, ineffective haematopoiesis, bone marrow fibrosis, extramedullary haematopoiesis, and hypersplenism. The natural progression of PV includes a low incidence of evolution to a myelodysplastic or blast phase. Leukemic transformation in PV is described as a rare and late event, less common than primary myelofibrosis. The interval between diagnosis and leukemic evolution is highly variable, from a few years to >20 years; which implies a long-lasting exposure to myelosuppressive agents. Among the hematological transformations; evolution to secondary acute myeloid leukemia (AML) is associated with a poor prognosis; here we report a case of an 80 year old woman who progressed unusually to blast phase within two years of diagnosis of PV. The interest of this work lies in the fact that this transformation into AML occurred after a short period of evolution, which is not frequent enough in the literature.
Abstract: Polycythemia vera (PV), with essential thrombocythemia (ET) and primary myelofibrosis (PMF), belongs to the group of Philadelphia negative myeloproliferative neoplasms (MPN). PV is characterized in virtually all cases by the somatic JAK2 V617F mutation or another functionally similar JAK2 mutation that results in panmyelosis. Two phases of PV are r...
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Severe Crohn's Disease in Combination with Undifferentiated Autoimmune Liver Disease - A Case Report
Sergey Semenovich Gaiduk,
Mikhail Ivanovich Gromov,
Alexey Viktorovich Kosachev,
Ludmila Pavlovna Pivovarova
Issue:
Volume 2, Issue 1, March 2021
Pages:
7-10
Received:
27 January 2021
Accepted:
6 February 2021
Published:
23 February 2021
DOI:
10.11648/j.wjmcr.20210201.13
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Abstract: Crohn’s disease is a chronic autoimmune pathology of intestinal mucosa in the form of segmentary lesions of various parts with the development of transmural granulomatous inflammation and the formation of strictures, stenosis, fistulas, as well as damage to other organs. The disease tends to be developed mainly in young people. Over recent years anti-TNF mAb has been widely used in the treatment of Crohn’s disease. Case Report: from the age of 13 Patient A suffered from Crohn’s disease, weight deficit, muscular atrophy. At the age of 19, autoimmune hepatitis with developing cirrhosis joined. At the age of 22 there was another disease exacerbation. The efficiency of treatment with steroids, aminosalicylates and cytostatics was low. After replacing cytostatics with anti-TNF mAb, the patient’s condition became even worse: body weight, total protein, albumin, hemoglobin and coagulation indices decreased critically. A treatment in intensive care and multiple blood transfusions were required for the period of 1 year. Changes in the treatment strategy in the form of maintaining the therapy with steroids and aminosalicylates, withdrawing anti-TNF mAb and adding the plasma exchange and injection of native DNA (sodium deoxyribonucleate) led to an increase in body weight, total protein and hemoglobin to normal values, as well as improved bowel function and performance status. Under condition of sever Crohn’s disease with autoimmune hepatitis, the catabolic effects of the anti-TNF mAb can be extremely dangerous. In such a case, it is preferable to use steroids and aminosalicylates in combination with plasma exchange and reparation activators (e.g., native DNA).
Abstract: Crohn’s disease is a chronic autoimmune pathology of intestinal mucosa in the form of segmentary lesions of various parts with the development of transmural granulomatous inflammation and the formation of strictures, stenosis, fistulas, as well as damage to other organs. The disease tends to be developed mainly in young people. Over recent years an...
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Emphysematous Pyelonephritis Complicated by Sub Capsular Renal Hematoma: A Case Report
Ahmed Belkouch,
Mustapha Nousair,
Saad Zidouh,
Rachid Sirbou,
Said Jidane,
Lahcen Belyamani
Issue:
Volume 2, Issue 1, March 2021
Pages:
11-14
Received:
10 September 2020
Accepted:
27 September 2020
Published:
4 March 2021
DOI:
10.11648/j.wjmcr.20210201.14
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Abstract: Emphysematous pyelonephritis is a rare and serious life-threatening condition due to a fulminant infection of the urinary tract. It is most often seen in diabetics and is defined by the presence of gas in the renal parenchyma secondary to bacterial infection. We highlight an unusual presentation (extensive renal sub capsular hematoma) of this condition and detail diagnostic and management considerations, including choice of imaging modalities. We present the case of a 63-year-old woman admitted to the emergency room for the management of severe sepsis secondary to an emphysematous pyelonephritis complicated by a large subcapsular hematoma of the kidney having extended into the omental bursa. To our knowledge, this complication is unique and never has been reported in the literature. Surgical treatment was necessary to control this severe infection. The medical and surgical management of emphysematous pyelonephritis must be aggressive and well-coordinated, early diagnosis, antibiotics and assessment for operative intervention are essential. Diabetes is the principal risk factor as well as immunodepression. The prognosis remains poor of this serious infection. Sub capsular hematoma is unusual and a good parameter to assess the severity of this infection. The presence pf gas in the urinary tract is the sign of the presence of an active anaerobe infection.
Abstract: Emphysematous pyelonephritis is a rare and serious life-threatening condition due to a fulminant infection of the urinary tract. It is most often seen in diabetics and is defined by the presence of gas in the renal parenchyma secondary to bacterial infection. We highlight an unusual presentation (extensive renal sub capsular hematoma) of this condi...
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Spontaneous Renal Forniceal Rupture Secondary to Fecal Impaction
Mzyiene Mohammed,
Ziba Ouima Justin Dieudonné,
Adnan Ettanji,
Bekkaoui Oussami,
Garcia Leal Carmina,
Manescu Mihai Razvan
Issue:
Volume 2, Issue 1, March 2021
Pages:
15-18
Received:
15 February 2021
Accepted:
1 March 2021
Published:
9 March 2021
DOI:
10.11648/j.wjmcr.20210201.15
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Abstract: Rupture of the pyelocaliceal cavities or rupture of the renal fornix (RFR) with retro-peritoneal extravasation of urine is a rare urological complication most frequently associated with acute obstruction of the urinary tract by a calculus. It is a potential urologic emergency and management of a fornix rupture is not standardized. The aim of this case report is to highlight fecal impactation as a rare cause of spontaneous renal fornical rupture in an elderly woman and to present our management. We present the case of a 84-year-old Ms, admitted in emergency room with an occlusive syndrome associated with acute urinary retention. An initial biological assessment was carried out objectifying: Hemoglobin 16.4 g/dl, a biological inflammatory syndrome with leukocytes at 17,500/mm predominantly neutrophils at 14,670/mm, Platelets at 1,29,000/mm, PCR at 115 mg/l, TP at 79%, Creatinine at 196umol/l, urea at 21.8 mmol/m, serum potassium at 3.81 mmol/l, slight hyper natremia at 148 mmol/l and hypoproteinemia at 52.9 g/l. The contrast enhanced computed tomography realed a giant fecal impactation with hydronephrosis and rupture of the fornix in connection with the giant fecal impaction. Evacuation of the fecalome and the placement of double –J ureteral stent led to a clinical and biologic improvement of the patient’s health. The Computed Tomography (CT) review at 6 weeks showed a disappearance of the leakage of contrast product and the absence of dilation of the pyelo-caliceal cavities with a double -J stent in place. This case illustrates a conservative management of rupture of pyelocaliceal cavities.
Abstract: Rupture of the pyelocaliceal cavities or rupture of the renal fornix (RFR) with retro-peritoneal extravasation of urine is a rare urological complication most frequently associated with acute obstruction of the urinary tract by a calculus. It is a potential urologic emergency and management of a fornix rupture is not standardized. The aim of this c...
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