Ectopic opening of the common bile duct into the duodenal bulb with recurrent choledocholithiasis: A case report

paythelady.612 shared this article with you from Inoreader Ectopic opening of the common bile duct into the duodenal bulb with recurrent choledocholithiasis: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 6;9(19):5332-5338. doi: 10.12998/wjcc.v9.i19.5332. ABSTRACT BACKGROUND: Ectopic opening of the common bile duct is a condition with low incidence. Patients with an ectopic common bile duct opening have a high incidence of common bile duct stones and acute cholangitis. Patients with atypical symptoms and imaging findings are easily misdiagnosed; moreover, it is difficult to retrieve stones by endoscopic retrograde cholangiopancreatography, and common bile duct stones are prone to postsurgical recurrence. CASE SUMMARY: A 45-year-old male patient presented with "intermittent upper abdominal pain and elevated liver enzymes for 1 wk". Transabdominal ultrasound indicated dilation of the common bile duct and the presence of stones. Magnetic resonance imaging showed that the common bile duct was dilated with stones and that its opening was ectopic. Endoscopic retrograde cholangiopancreatography revealed an ab normal opening of the common bile duct into the duodenal bulb and the presence of common bile duct stones. Laparoscopic extrahepatic choledochectomy and hepatoenteric anastomosis were performed. After surgery, the patient recovered well and was discharged. The patient has been followed up for 2 years since the operation. He has not experienced stone recurrence, and his liver function and quality of life are good. CONCLUSION: Improved understanding of ectopic opening of the common bile duct is needed for clinicians to provide patients with appropriate treatment. PMID:34307586 | PMC:PMC8283612 | DOI:10.12998/wjcc.v9.i19.5332 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hemoglobin Fukuoka caused unexpected hemoglobin A1c results: A case report

paythelady.612 shared this article with you from Inoreader Hemoglobin Fukuoka caused unexpected hemoglobin A<sub>1c</sub> results: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5568-5574. doi: 10.12998/wjcc.v9.i20.5568. ABSTRACT BACKGROUND: Glycated hemoglobin (Hb) (HbA1c) is an indicator that is used to diagnose and monitor the treatment of diabetes. Many factors can affect the detection of HbA1c. One of the most important of these factors is the Hb variant. Here, we report a rare Hb variant and evaluate its effect on HbA1c. CASE SUMMARY: A 35-year-old man was suspected of harboring an Hb variant following the measurement of HbA1c with the Variant II Turbo 2.0 Hb detection system during a routine examination. Subsequently, we used the Arkray HA-8160 and ARCHITECT c4000 system to reanalyze HbA1c. Finally, the Hb variant was detected with a Capillary2FP analyzer that operates on the principle of capillary electrophoresis. We also used gene sequencing to investigate the mutation site. The value of HbA1c detected with the Variant II Turbo 2.0 system was 52.7%. However, the Arkray HA-8160 system did not display a result while the ARCHITECT c16000 system showed a result of 5.4%. The Capillary2FP analyzer did not reveal any abnormal Hb zones. However, gene sequencing identified the presence of a mutation in the Hb β2 chain [CD2(CAC>TAC), His>Tyr, HBB: c.7C>T]; the genotype was Hb Fukuoka. CONCLUSION: Hb variants could cause abnormal HbA1c results. For patients with Hb variants, different methods should be used to detect HbA1c. PMID:34307611 | PMC:PMC8281434 | DOI:10.12998/wjcc.v9.i20.5568 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Brugada syndrome associated with out-of-hospital cardiac arrest: A case report

paythelady.612 shared this article with you from Inoreader Brugada syndrome associated with out-of-hospital cardiac arrest: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 6;9(19):5345-5351. doi: 10.12998/wjcc.v9.i19.5345. ABSTRACT BACKGROUND: Brugada syndrome (BrS) is an inherited disease characterized by an electrocardiogram (ECG) with a coved-type ST-segment elevation in the right precordial leads (V1-V3), which predisposes to sudden cardiac death (SCD) due to polymorphic ventricular tachycardia or ventricular fibrillation in the absence of structural heart disease. We report the case of a 29-year-old man with out-of-hospital cardiac arrest. BrS is associated with a high incidence of SCD in adults, and increasing the awareness of BrS and prompt recognition of the Brugada ECG pattern can be lifesaving. CASE SUMMARY: A 29-year-old man suffered from out-of-hospital cardiac arrest, and after defibrillation, his ECG demonstrated a coved-type elevated ST segment in V1 and V2. These findings were compatible with type 1 Brugada pattern, and ECG of his brother showed a type 2 Brugada pattern. The diagnosis was BrS, NYHF IV, multiple organ dysfunction syndrome, sepsis, and hypoxic ischemic encephalopathy. The patient had no arrhythmia episodes after discharge throughout a follow-up period of 36 mo. CONCLUSION: Increasing awareness of BrS and prompt recognition of the Brugada ECG pattern can be lifesaving. PMID:34307588 | PMC:PMC8283591 | DOI:10.12998/wjcc.v9.i19.5345 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Giant androgen-producing adrenocortical carcinoma with atrial flutter: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Giant androgen-producing adrenocortical carcinoma with atrial flutter: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5575-5587. doi: 10.12998/wjcc.v9.i20.5575. ABSTRACT BACKGROUND: Adrenocortical carcinoma (ACC), the second most aggressive malignant tumor, lacks epidemiological data worldwide; therefore, every new case can improve the understanding of the pathology and treatment of this malignancy. CASE SUMMARY: We present the case of a 66-year-old Caucasian woman with a giant androgen-producing ACC (21 cm × 17 cm × 12 cm; 2100 g), without metastases, which unusually presented with an acute onset of atrial flutter and congestive heart failure. The cardiac complications observed in our case support the hypothesis that androgen excess in women is a cardiovascular risk factor. Androgen excess in women can be a rare cause of reversible dilated cardiomyopathy, therefore a comprehensive approach to the patient is essential to improve the recognition of androgen-secreting ACC. The atrial flutter was remitted aft er initiation of drug treatment during admission. The severe heart failure was totally remitted at 6 mo after radical open surgery to remove the giant ACC. CONCLUSION: Radical open surgery to remove a giant androgen-producing ACC was the first-line treatment to cure the excess of androgen, which determined the total remission of cardiac complications at 6 mo after surgery in the women of this case report. PMID:34307612 | PMC:PMC8281402 | DOI:10.12998/wjcc.v9.i20.5575 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Obesity in people with diabetes in COVID-19 times: Important considerations and precautions to be taken

paythelady.612 shared this article with you from Inoreader Obesity in people with diabetes in COVID-19 times: Important considerations and precautions to be taken Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5358-5371. doi: 10.12998/wjcc.v9.i20.5358. ABSTRACT At the end of 2019, a new disease with pandemic potential appeared in China. It was a novel coronavirus called coronavirus disease 2019 (COVID-19). Later, in the first quarter of 2020, the World Health Organization declared the outbreak of this disease a pandemic. Elderly people, people with comorbidities, and health care professionals are more vulnerable to COVID-19. Obesity has been growing exponentially worldwide, affecting several age groups. It is a morbidity that is associated with genetic, epigenetic, environment factors and/or interaction between them. Obesity is associated with the development of several diseases including diabetes mellitus, mainly type 2. Diabetes affects a significant portion of the global population. Obesity and diabetes are among the main risk factors for the development of severe symptoms of COVID-19, and individuals with these conditions constitute a risk group. Based on a literature review on obesity in people with diabetes in the framework of the COVID-19 pandemic, this study presents updated important considerations and care to be taken with this population. PMID:34307590 | PMC:PMC8281433 | DOI:10.12998/wjcc.v9.i20.5358 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detection of short stature homeobox 2 and RAS-associated domain family 1 subtype A DNA methylation in interventional pulmonology

paythelady.612 shared this article with you from Inoreader Detection of short stature homeobox 2 and RAS-associated domain family 1 subtype A DNA methylation in interventional pulmonology Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5391-5397. doi: 10.12998/wjcc.v9.i20.5391. ABSTRACT One of the most important aspects of interventional pulmonology is to obtain tissue or liquid samples of the chest to diagnose a respiratory disease; however, it is still possible to obtain insufficient tissue or cytologic specimens. Indeed, methylation detection is an effective method by which to establish a diagnosis. This review focuses on the clinical application of short stature homeobox 2 and RAS-associated domain family 1 subtype A DNA methylation detection in interventional pulmonology, including bronchoscopic fluid biopsy, transbronchial needle aspiration, and pleural effusion. PMID:34307592 | PMC:PMC8281403 | DOI:10.12998/wjcc.v9.i20.5391 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spinal dural arteriovenous fistula 8 years after lumbar discectomy surgery: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Spinal dural arteriovenous fistula 8 years after lumbar discectomy surgery: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5594-5604. doi: 10.12998/wjcc.v9.i20.5594. ABSTRACT BACKGROUND: Spinal dural arteriovenous fistula (SDAVF) is an extremely rare vascular malformation of the central nervous system that is often confused with degenerative spinal disorders due to similar early symptoms and clinical features. Here, we report a case of SDAVF recurrence 8 years after lumbar spine surgery and summarize relevant literature. CASE SUMMARY: A 54-year-old male was admitted to our hospital complaining of lower back pain, numbness in both lower extremities and intermittent claudication. Subsequent imaging identified lumbar spinal stenosis. Following surgical treatment, the patient's symptoms significantly resolved, and he was able to perform daily activities. However, similar symptoms appeared 8 years later, followed by confirmation of SDAVF diagnosis. The patient underwent neurosurgery 7 mo after symptom onset. The follo w-up period lasted 14 mo, and the patient remains with marginal neurological symptoms. CONCLUSION: This case highlights the importance of prompt SDAVF diagnosis. Due to its nonspecific clinical presentation, the clinical experience of the surgeon and definitive imaging examination are indispensable. Additionally, timely neurosurgery is effective and may significantly improve patient outcomes. PMID:34307614 | PMC:PMC8281401 | DOI:10.12998/wjcc.v9.i20.5594 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Esophageal manifestation in patients with scleroderma

paythelady.612 shared this article with you from Inoreader Esophageal manifestation in patients with scleroderma Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5408-5419. doi: 10.12998/wjcc.v9.i20.5408. ABSTRACT The esophagus is the most commonly affected part of the gastrointestinal system in patients with systemic sclerosis (SSc). Esophageal involvement may lead to a significant reduction in patient quality of life. The exact pathophysiology is complex and not yet fully elucidated. Ultimately, esophageal smooth muscle becomes atrophied and replaced by fibrous tissue leading to severe motility disturbance of the distal esophagus. Symptoms are mainly attributed to gastroesophageal reflux disease and to esophageal dysmotility. Compelling evidence has correlated esophageal involvement to the severity of pulmonary disease. No formed guidelines exist about the diagnostic modalities used to assess esophageal disease in patients with SSc, though upper gastrointestinal endoscopy is the first and most important modality used as it can reveal alterations commonly observed in patients with SSc. Further exploration can be made by high resolution manometry and pH-impedance study. Proton pump inhibitors remain the mainstay of treatment, while prokinetic agents are commonly used as add-on therapy in patients with symptoms attributed to gastroesophageal reflux disease not responding to standard therapy as well as to motility disturbances. Gastroesophageal reflux disease symptoms in patients with SSc are frequently difficult to manage, and new therapeutic modalities are emerging. The role of surgical treatment is restricted and should only be preserved for resistant cases. PMID:34307594 | PMC:PMC8281422 | DOI:10.12998/wjcc.v9.i20.5408 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perianal superficial CD34-positive fibroblastic tumor: A case report

paythelady.612 shared this article with you from Inoreader Perianal superficial CD34-positive fibroblastic tumor: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5605-5610. doi: 10.12998/wjcc.v9.i20.5605. ABSTRACT BACKGROUND: Superficial CD34-positive fibroblast tumors (SCPFTs) are newly recognized fibroblast and myofibroblast tumors representing intermediate tumors. To the best of our knowledge, fewer than 50 cases have been reported. Perianal SCPFT has not been previously reported. CASE SUMMARY: A 55-year-old man was hospitalized upon discovering a painless perianal lump 10 d prior. Physical examination showed a lump of approximately 3 cm × 4 cm in the 7 to 8 o'clock direction in the perianal area. Perianal abscess was considered the primary diagnosis. Lump removal surgery was performed under epidural anesthesia. Postoperative pathology showed a well-circumscribed, soft tissue-derived, spindle-cell tumor with strong CD34 positivity by immunohistochemistry. The final diagnosis was perianal SCPFT. There were no complications, and the patient was foll owed for more than 8 mo without recurrence or metastasis. CONCLUSION: We report a case of perianal superficial CD34-positive fibroblast tumor. This rare mesenchymal neoplasm has distinctive histomorphology, which is important for diagnosis. Comprehensive consideration of clinical information, imaging, histology, and immunohistochemistry is important for diagnosis. PMID:34307615 | PMC:PMC8281416 | DOI:10.12998/wjcc.v9.i20.5605 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of gastrointestinal system on transmission and pathogenesis of SARS-CoV-2

paythelady.612 shared this article with you from Inoreader Role of gastrointestinal system on transmission and pathogenesis of SARS-CoV-2 Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5427-5434. doi: 10.12998/wjcc.v9.i20.5427. ABSTRACT Coronavirus disease 2019 (COVID-19) continues to pose a significant threat to global health. Primary prevention remains as a major strategy against the pandemic. Current evidence proves that aerosol and droplet-based routes are the main means of transmission of COVID-19 but other ways should be sought in order to prevent possible collateral transmission. The gastrointestinal system may be one such route. Angiotensin converting enzyme 2 is the target entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is abundantly expressed in the gastrointestinal tract. SARS-CoV-2 is able to infect human enterocytes similar to severe acute respiratory syndrome and Middle Eastern respiratory syndrome. Herein this review, we discuss the current knowledge regarding the role of gastrointestinal transmission in transmission and pathoph ysiology of COVID-19. PMID:34307596 | PMC:PMC8281423 | DOI:10.12998/wjcc.v9.i20.5427 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Low-dose clozapine-related seizure: A case report and literature review

paythelady.612 shared this article with you from Inoreader Low-dose clozapine-related seizure: A case report and literature review Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jul 16;9(20):5611-5620. doi: 10.12998/wjcc.v9.i20.5611. ABSTRACT BACKGROUND: Treatment-resistant schizophrenia is a severe form of schizophrenia characterized by poor response to at least two antipsychotic drugs and is typically treated with clozapine. However, clozapine lowers the epileptic threshold, leading to seizures, which are severe side effects of antipsychotics that result in multiple complications. Clozapine-related seizures are generally considered to be dose-dependent and especially rare in the low-dose (150-300 mg/d) clozapine treated population. Due to clinical rarity, little is known about its clinical characteristics and treatment. CASE SUMMARY: A 62-year-old Chinese man with a 40-year history of treatment-resistant schizophrenia presented to the Emergency Department with symptoms of myoclonus, consciousness disturbance and vomiting after taking 125 mg clozapine. Upon admission, the patien t had a suddenly generalized tonic-clonic seizure lasting for about half a minute with persistent disturbance of consciousness, fever, cough and bloody sputum, which was considered to be low-dose clozapine-related seizure. After antiepileptic and multiple anti-infection treatments, the patient was discharged without epileptic or psychotic symptoms. CONCLUSION: Our aim is to highlight the early prevention and optimal treatment of clozapine-related seizure through case analysis and literature review. PMID:34307616 | PMC:PMC8281419 | DOI:10.12998/wjcc.v9.i20.5611 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.