Asian Journal of Case Reports in Medicine and Health

Gastrointestinal Stromal Tumor Presenting Uncommonly as an Intra-lesional Bleed after Antiplatelet Therapy: A Case Report

2023-02-03T09:48:29+00:00

Background: Gastrointestinal stromal tumors (GISTs) are rare but the most common mesenchymal tumors of the gastrointestinal tract. It has a variable clinical presentation, making early diagnosis difficult. We report a rare case of intra-lesional bleed as the initial presentation of gastric GIST.

Case Presentation: A middle-aged male patient, presented with the diagnosis of ST-elevation Myocardial Infarction. Angioplasty was done and he was kept on multiple blood thinners. Post-procedure, he became unstable and dropped hemoglobin level. Gastroscopy revealed submucosal gastric mass but no source of active bleeding was found. CT angiogram revealed intra-tumoral bleed within the mass. Hence, CT-guided empiric arterial embolization was done before mass would have ruptured. Later, the mass biopsy revealed GIST. Patient was thereafter managed with surgical resection and chemotherapy.

Conclusion: This is an unusual initial presentation of GIST. Life-threatening complications of GIST rupture can be prevented if diagnosed early.

Cytomegalovirus (CMV) as a Rare Cause of Gastritis in a Renal Transplant Recipient: A Case Study from Pakistan

2023-04-11T10:38:06+00:00

Cytomegalovirus (CMV) can cause wide spectrum of the diseases with large bowel been most commonly affected. However, it rarely effects the upper part of the alimentary canal including the esophagus and stomach. Here, we present to you a case of renal transplanted recipient with a post-transplant history of non-Hodgkin lymphoma evaluated for dyspepsia and was diagnosed to have CMV gastritis on histopathology.

Pontine-bulbar Hemorrhage in a Complicated form of Preeclampsia with Eclampsia and HELLP Syndrome “Case Report”

2023-05-03T13:10:13+00:00

The mortality rate from stroke in pregnant women is 1.4 per 100,000 births. Vascular malformations are the most common cause of hemorrhagic stroke in this population; preeclampsia and other risk factors have been identified. However, the cause of almost one in four strokes is unknown. Spontaneous intracranial hemorrhage (ICH) is less common but causes significant morbidity. Pontine-bulbar hemorrhage in the absence of trauma or dislocation of the vessels is an uncommon complication during pregnancy. Hypertension is the typical cause, Less frequently, these hemorrhages accompany a hemorrhagic diathesis or vascular malformation. We report the case of pontine-bulbar hemorrhage following an eclampsia attack. This case report aims to shed light on this complex medical situation, highlighting the need for careful consideration of the potential risks and benefits of treatment options.

Post-Traumatic Occlusion of the Renal Artery: A Case Report

2023-05-11T09:40:18+00:00

The present case report highlights about Post-traumatic occlusion of the renal artery. Renal artery thrombosis is a rare complication of blunt abdominal trauma, described for the first time by Von Recklinghausen in 1861. Our case is of a 32-year-old male admitted to the emergency department to manage a polytrauma due to a car accident occurring three hours before admission. The higher mobility of the left kidney on its vascular pedicle is thought to be the cause of the increased frequency of left renal artery injuries. Because of the various therapy choices available, it is especially important to distinguish between these two conditions. The management of traumatic renal artery occlusion is controversial and opinions are divided between immediate surgical revascularization and observation.

Synthetic Antimalarial Maculopathy: A Case Series

2023-05-12T07:05:51+00:00

Synthetic antimalarials (SAM) are drugs originally used for the prevention and treatment of malaria but, because of anti-inflammatory and immuno-modulatory activities, they have been since used to treat many other pathologies. Many side effects have been attributed to them, in particular ocular toxicity represented essentially by retinopathy or chloroquine maculopathy.

This maculopathy is reversible if diagnosed at an early stage, hence the importance of early detection in patients on long-term SAM.

Our study consists of a retrospective study about fifteen patients followed for various pathologies and under long-term SAM .The study highlighted the modalities of monitoring patients, the need of the long term ophthalmological follow-up in order to detect a beginning retinal toxicity and reduce the dosage or even discontinue treatment depending on the risk-benefit ratio and possible therapeutic alternatives. An initial ophthalmologic clinical and paraclinical review must be performed before initiating treatment.

Ophthalmoplegia Revealing an Orbital Metastasis Secondary to Breast Cancer: Case Report

2023-01-28T11:08:43+00:00

Orbital metastases are uncommon and breast cancer is the most common primary in women. The clinical presentation varies depending on the location of the metastasis in the orbit. The diagnosis of metastasis is evoked in the context of the patient's background, particularly if there is a known history of cancer, and on the appearance of the lesion on imaging. We report the case of a patient presenting ophthalmoplegia of the left eye revealing orbital metastases of breast cancer.

Inadvertent Gallbladder Stenting During Endoscopic Management of Choledocholithiasis Detected During Laparoscopic Cholecystectomy: A Case Report

2023-02-03T09:35:50+00:00

Endoscopic retrograde cholangiopancreaticography (ERCP) is the standard management protocol for choledocholithiasis, which more often than not involves a placement of stent in the common bile duct. Here we present a case of inadvertent stenting of the cystic duct and gallbladder during ERCP for choledocholithiasis which was detected during laparoscopic cholecystectomy. A 38 year old lady presented with jaundice and right upper quadrant pain, diagnosed with choledocholithiasis, underwent ERCP with stenting and stone extraction. After 6 weeks, she underwent laparoscopic cholecystectomy, when it was noticed that the biliary stent was inadvertently placed into the cystic duct and gallbladder. The stent was removed laparoscopically through a rent in the gallbladder and cystic duct stump clipped. We report this case to enhance awareness amongst surgeons regarding the unintended location of a biliary stent.

A Case Report on Amniotic Band Disease

2023-02-23T12:49:23+00:00

Amniotic band disease (ABD) is a complex and relatively rare set of birth defects. These malformations mainly concern the limbs, the craniofacial region and the thoracoabdominal axis. The severity of these malformations is highly variable, starting from isolated skin furrows to visceral malformations that are often incompatible with life. The prognosis of ABD in the presence of craniofacial and visceral polymalformations is known and bleak. The situation is quite different in the case of superficial and isolated constriction of a limb. A medical termination of pregnancy is generally advised in the presence of severe craniofacial and visceral malformations, while isolated malformations of the limbs are accessible to surgical treatment at birth. We reported 1 case of ABD.

A Case Report on Systemic Lupus Erythematosus in a 21 Year Old Indian Female

2023-04-04T12:25:24+00:00

Background: SLE is a systemic auto-immune disease that mostly affects females and has a wide range of clinical symptoms and immunological abnormalities. Lupus may have an impact on almost any organ, but the kidney and central nervous system are the most noticeable and destructive. Each patient's level of severity can vary, resulting in anything from little organ damage to significant cutaneous involvement and a long-lasting remission to death. Additionally, the severity of the condition can vary widely, with the majority of patients experiencing flare-ups followed by protracted remissions.

Case Presentation: A 21-year-old female patient was brought to the female medicine department with the primary symptoms of face rashes, hair loss, abdominal pain dating back eight months, and joint pain spanning two to three years. The patient was diagnosed with SLE based on his medical history, physical examination, and laboratory tests. Her vital signs were continuously watched during her 14-day hospital stay, and several laboratory tests were run to rule out any organ or organ system damage. Her primary drugs were NSAIDs, antimalarials, and corticosteroids.

Conclusion: It has been determined that the patient has been afflicted with the disease for the last two years based on investigative reports and patient history. She was unable to have a timely medical examination due to her precarious financial situation, which caused a delay in her treatment. Due to the fact that this ailment can only be controlled and not fully healed, the patient needs therapy and counselling.

Pulse Oximetry-facilitated Arterial Cannulation in Pediatric Anesthesia for Cardiac Surgery

2023-04-20T07:58:25+00:00

Invasive blood pressure monitoring is required in cardiac surgery for several reasons. Arterial cannulation in pediatrics is a daily challenge for anesthesiologists. Localization of the artery before catheterization is usually done by palpation or guided by ultrasounds. These two techniques are not always efficient and sometimes generate complications and a considerable loss of time. Through this clinical case, we describe a simple and innovative technique inspired by our daily practice allowing locating the artery with the help of pulse oximetry.

Intracranial Hemorrhage in Pregnancy: Case Report and Review of Literature

2023-04-26T10:32:00+00:00

Intracranial hemorrhage during pregnancy is a rare but life-threatening event during pregnancy. There is a major risk of maternal and fetal death and morbidity. The risk of hemorrhage increases during the third trimester and is greatest during labor and postpartum.

We report a dramatic case of a 33-year-old primigravida 38 weeks by gestation complicated by eclampsia and intracranial hemorrhage with cerebral mass effect. She was managed by an emergency cesarean section and craniotomy but without desirable results, we were not able tosave the patient, she died on day 2. The publication of such cases could provide another insight into pre-eclampsia and its life-threatening complications.

Acinetobacter baumannii: A Rare Organism Causing Blood Stream Infection in a Five-Year Old Girl in South-East Nigeria

2023-05-15T14:56:26+00:00

Aim: Acinetobacter baumannii is an aerobic Gram-negative coccobacilli found in the environment, which causes predominantly nosocomial infections in humans. However, the incidence of community acquired infections is on the increase. It is characterized high resistance to the environment and the ability to develop resistance to commonly prescribed antimicrobials. Its clinical features are non-specific and range from a benign transient bacteremia to fulminant septic shock. Carbapenems are recommended for first line treatment. This series presentation aims to increase awareness of this condition.

Presentation of Cases: A case of a five-year old girl who presented with features suggestive of an upper respiratory tract infection in Enugu State, South-East Nigeria is reported. She also had a history of recent travel to Europe. Serial haematologic investigations showed evidence of worsening bacteremia and blood culture revealed Acinetobacter baumannii. She was managed with intravenous Meroponem and was discharged sixteen days after presentation.

Discussion: In this case, the finding of Acinetobacter baumannii from blood culture followed an initial non response to conventional antibiotics and the history of recent travel to Europe. This organism has hitherto not been isolated in our environment, and is a significant cause of nosocomial infections with high morbidity and mortality. Isolation of this organism requires BACTEC culture methods. Its high resilience and multidrug resistance makes it difficult to treat.

Conclusion: The incidence of community acquired Acinetobacter baumannii is on the increase. Management involves a high index of suspicion, prompt and accurate isolation of infecting strains and the proper choice of antibiotic regimens.