Acute liver failure with thrombotic microangiopathy due to sodium valproate toxicity: A case report

paythelady.612 shared this article with you from Inoreader Acute liver failure with thrombotic microangiopathy due to sodium valproate toxicity: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4310-4317. doi: 10.12998/wjcc.v9.i17.4310. ABSTRACT BACKGROUND: Sodium valproate is widely used in the treatment of epilepsy in clinical practice. Most adverse reactions to sodium valproate are mild and reversible, while serious idiosyncratic side effects are becoming apparent, particularly hepatotoxicity. Herein, we report a case of fatal acute liver failure (ALF) with thrombotic microangiopathy (TMA) caused by treatment with sodium valproate in a patient following surgery for meningioma. CASE SUMMARY: A 42-year-old man who received antiepileptic treatment with sodium valproate after surgery for meningioma exhibited extreme fatigue, severe jaundice accompanied by oliguria, soy sauce-colored urine, and ecchymosis. His postoperative laboratory values indicated a rapid decreased platelet count and hemoglobin level, severe liver and kidney dysfunction, and disturbance of the coagulation system. He was diagnosed with drug-induced liver failure combined with TMA. After plasma exchange combined with hemoperfusion, pulse therapy with high-dose methylprednisolone, and blood transfusion, his liver function deteriorated, and finally, he died. CONCLUSION: ALF with TMA is a rare and fatal adverse reaction of sodium valproate which needs to be highly valued. PMID:34141795 | PMC:PMC8173405 | DOI:10.12998/wjcc.v9.i17.4310 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Design and development of a new type of phimosis dilatation retractor for children

paythelady.612 shared this article with you from Inoreader Design and development of a new type of phimosis dilatation retractor for children Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4159-4165. doi: 10.12998/wjcc.v9.i17.4159. ABSTRACT BACKGROUND: Phimosis is one of the most common diseases in children. Early selection of appropriate treatment for phimosis in children is beneficial to the development of their reproductive organs and significantly improves the prognosis of phimosis in children. Although traditional circumcision is the most widely used, it has many disadvantages, including postoperative bleeding and incision infection, pain, obvious scars on the surgical incision, and unsatisfactory appearance. In addition, there is much controversy regarding treatment options and timing at home and abroad. Surgical procedures such as circumcision and cerclage for children with excessively long foreskin will greatly affect the normal life of children after the operation. Young children need general anesthesia, but this anesthesia carries a great risk. AIM: To design a new ch ildren phimosis dilatation retractor for children phimosis. METHODS: The children phimosis was dilated with an elastic dilation frame, in order to expand the foreskin mouth and expose the penis head, and after that, the phimosis was cured. RESULTS: A new type of phimosis dilatation retractor was designed, which can gently dilate the prepuce at multiple angles and in multiple directions at the same time. It has obtained the national patent for clinical application. CONCLUSION: The phimosis dilatation retractor based on the principle of elastically expanding the prepuce can achieve the purpose of expanding the phimosis. The clinical application shows that the effect of the children phimosis retractor is significant, which is worth promoting. PMID:34141778 | PMC:PMC8173439 | DOI:10.12998/wjcc.v9.i17.4159 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lateral epicondyle osteotomy approach for coronal shear fractures of the distal humerus: Report of three cases and review of the literature

paythelady.612 shared this article with you from Inoreader Lateral epicondyle osteotomy approach for coronal shear fractures of the distal humerus: Report of three cases and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4318-4326. doi: 10.12998/wjcc.v9.i17.4318. ABSTRACT BACKGROUND: Coronal shear fractures of the distal humerus are rare injuries and are technically challenging to manage. Open reduction and internal fixation (ORIF) has become the preferred treatment because it provides anatomical reduction, stable internal fixation, and early motion, but the optimal surgical approach remains controversial. CASE SUMMARY: We report three cases of coronal shear fractures of the distal humerus treated successfully by ORIF via a novel surgical approach, in which lateral epicondyle osteotomy was performed based on the extended lateral approach. We named the novel surgical approach the lateral epicondyle osteotomy approach. All patients underwent surgical treatment and were discharged successfully. All patients had excellent functional results according to the Mayo elbow performance score. The average range o f motion was 118° in flexion/extension and 172° in pronation/ supination. Only case 2 had a complication, which was implant prolapse. CONCLUSION: We demonstrated that the lateral epicondyle osteotomy approach in ORIF is effective and safe for coronal shear fractures of the distal humerus. PMID:34141796 | PMC:PMC8173410 | DOI:10.12998/wjcc.v9.i17.4318 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patients with functional bowel disorder have disaccharidase deficiency: A single-center study from Russia

paythelady.612 shared this article with you from Inoreader Patients with functional bowel disorder have disaccharidase deficiency: A single-center study from Russia Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4178-4187. doi: 10.12998/wjcc.v9.i17.4178. ABSTRACT BACKGROUND: Functional bowel disorder (FBD) may be caused by a decrease in disaccharidase activity. Thus, the timely diagnosis of disaccharidase deficiency could lead to a better prognosis in patients with this condition. AIM: To determine the potential value of intestinal disaccharidases glucoamylase, maltase, sucrase, and lactase in understanding the etiology and pathogenesis of FBD. METHODS: A total of 82 FBD patients were examined. According to the Rome IV criteria (2016), 23 patients had diarrhea-predominant irritable bowel syndrome (IBS), 33 had functional diarrhea, 10 had constipation-predominant IBS, 4 had functional constipation, and 12 had mixed IBS. The Dahlqvist method was used to measure disaccharidase activity in the brush-border membrane of mature enterocytes of the small intestine, in duodenal biopsies obtained during e sophagogastroduodenoscopy. RESULTS: Lactase deficiency was detected in 86.5% of patients, maltase deficiency in 48.7%, sucrase deficiency in 50%, and glucoamylase deficiency in 84.1%. The activities of all enzymes were reduced in 31.7% of patients, and carbohydrase deficiency was detected in 63.5% of patients. The low activity of enzymes involved in membrane digestion in the small intestine was found in 95.2% of patients. CONCLUSION: In 78 of the 82 patients with FBD, gastrointestinal symptoms were associated with disaccharidase deficiency. PMID:34141780 | PMC:PMC8173401 | DOI:10.12998/wjcc.v9.i17.4178 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pancreatic neuroendocrine carcinoma in a pregnant woman: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Pancreatic neuroendocrine carcinoma in a pregnant woman: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4327-4335. doi: 10.12998/wjcc.v9.i17.4327. ABSTRACT BACKGROUND: Portal venous thromboembolism caused by malignant pancreatic neuroendocrine tumor metastasis, as the initial presentation of portal hypertension and upper gastrointestinal bleeding, is a rare entity. To our knowledge, there are no reports of this entity in pregnant women. We describe a case of pancreatic neuroendocrine carcinoma during pregnancy with hematemesis and hematochezia as the initial presentation and review the literature to analyze the demographic, clinical, and pathological features to provide a reference for clinical diagnosis and treatment. CASE SUMMARY: A 40-year-old woman presented with hematemesis and hematochezia at 26-wk gestation; she had no other remarkable medical history. The physical examination revealed normal vital signs, an anemic appearance, and lower abdominal distension. Abdominal color Doppler ultra sonography showed portal vein thrombosis, splenomegaly, intrauterine pregnancy, and intrauterine fetal death. Esophagogastroduodenoscopy revealed esophageal and gastric varicose veins and portal hypertensive gastropathy. Contrast-enhanced computed tomography demonstrated multiple emboli formation in the portal and splenic veins, multiple round shadows in the liver with a slightly lower density, portal vein broadening, varicose veins in the lower esophagus and gastric fundus, splenomegaly, bilateral pleural effusion, ascites and pelvic effusion, broadening of the common bile duct, and increased uterine volume. According to the results of Positron emission tomography-computed tomography and immunohistochemical staining, the final diagnoses were that the primary lesion was a pancreatic neuroendocrine tumor and that there were secondary intrahepatic metastases and venous cancer thrombogenesis. CONCLUSION: Upper gastrointestinal bleeding in a pregnant woman may be caused by portal hypertension due to a malignant pancreatic neuroendocrine tumor. PMID:34141797 | PMC:PMC8173422 | DOI:10.12998/wjcc.v9.i17.4327 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19 in gastroenterology and hepatology: Lessons learned and questions to be answered

paythelady.612 shared this article with you from Inoreader COVID-19 in gastroenterology and hepatology: Lessons learned and questions to be answered Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4199-4209. doi: 10.12998/wjcc.v9.i17.4199. ABSTRACT BACKGROUND: Although coronavirus disease 2019 (COVID-19) presents primarily as a lower respiratory tract infection, increasing data suggests multiorgan, including the gastrointestinal (GI) tract and liver, involvement in patients who are infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). AIM: To provide a comprehensive overview of COVID-19 in gastroenterology and hepatology. METHODS: Relevant studies on COVID-19 related to the study aim were undertaken through a literature search to synthesize the extracted data. RESULTS: We found that digestive symptoms and liver injury are not uncommon in patients with COVID-19 and varies in different individuals. The most common GI symptoms reported are diarrhea, nausea, vomiting, and abdominal discomfort. Other atypical GI symptoms, such as loss of smell and taste and G I bleeding, have also been reported along with the evolvement of COVID-19. Liver chemistry abnormalities mainly include elevation of aspartate transferase, alanine transferase, and total bilirubin. It is postulated to be related to the binding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus to the angiotensin converting enzyme-2 receptor located on several different human cells. CONCLUSION: Standardized criteria should be established for diagnosis and grading of the severity of GI symptoms in COVID-19 patients. Gastroenterology and hepatology in special populations, such as children and elderly, should be the focus of further research. Future long-term data regarding GI symptoms should not be overlooked. PMID:34141782 | PMC:PMC8173430 | DOI:10.12998/wjcc.v9.i17.4199 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary primitive neuroectodermal tumor in the pericardium-a focus on imaging findings: A case report

paythelady.612 shared this article with you from Inoreader Primary primitive neuroectodermal tumor in the pericardium-a focus on imaging findings: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4336-4341. doi: 10.12998/wjcc.v9.i17.4336. ABSTRACT BACKGROUND: Primitive neuroectodermal tumors (PNETs) are rare, sporadic malignant tumors of the peripheral nervous system, bone, or soft tissues. However, to the best of our knowledge, only three cases of PNET in the pericardium have been reported in the English literature, and their magnetic resonance imaging findings have not previously been described. CASE SUMMARY: A 3-year-old boy was hospitalized with a 1-wk history of recurrent vomiting and weakness. Detailed history-taking revealed no evidence of heart disease. Computed tomography demonstrated a soft tissue mass in the left pericardial cavity with heterogeneous contrast enhancement. The border between the mass and the heart was poorly defined. Thoracotomy revealed a mass invading the left ventricle, with a high risk of bleeding. The mass was considered inoperable. A biopsy was perform ed, and the histological and immunohistochemical findings confirmed the diagnosis of primary PNET of the pericardium. The patient received four cycles of standard chemotherapy. Chest magnetic resonance imaging 3 mo after the initiation of chemotherapy revealed that the tumor in the pericardium still existed, but its volume had slightly decreased. The patient was lost to follow-up, and the final outcome was therefore unknown. CONCLUSION: Medical imaging plays an important role in defining the pericardial origin of PNET and understanding its characteristics. Magnetic resonance imaging can provide more information on the tumor than computed tomography and may thus aid therapeutic planning. PMID:34141798 | PMC :PMC8173412 | DOI:10.12998/wjcc.v9.i17.4336 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ex vivo liver resection followed by autotransplantation in radical resection of gastric cancer liver metastases: A case report

paythelady.612 shared this article with you from Inoreader <em>Ex vivo</em> liver resection followed by autotransplantation in radical resection of gastric cancer liver metastases: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4221-4229. doi: 10.12998/wjcc.v9.i17.4221. ABSTRACT BACKGROUND: Radical resection of gastric cancer liver metastases (GCLM) can increase the 5-year survival rate of GCLM patients. However, patients may lose the theoretical feasibility of surgery due to the critical location of liver metastasis in some cases. CASE SUMMARY: A 29-year-old woman had a chief complaint of chronic abdominal pain for 1 year. Abdominal computed tomography and magnetic resonance imaging examinations suggested a mass of unknown pathological nature located between the first and second hila and the margin of the lower segment of the right lobe of the liver. The anterior wall of the gastric antrum was unevenly thickened. The diagnosis of (gastric antrum) intramucosal well-differentiated adenocarcinoma was histopathologically confirmed by puncture biopsy with gastroscopy guidance. She underwent radical resection (excision o f both gastric tumors and ex vivo liver resection followed by autotransplantation simultaneously) followed by XELOX adjuvant chemotherapy. Without serious postoperative complications, the patient was successfully discharged on the 20th day after the operation. Pathological examination of the excised specimen indicated that gastrectomy with D2 lymph node dissection for primary gastric tumors and R0 resection for liver metastases were achieved. The resected mass was confirmed to be poorly differentiated gastric carcinoma (hepatoid adenocarcinoma with neuroendocrine differentiation) with liver metastases in segments VIII. No recurrence or metastasis within the liver was found during a 7.5-year follow-up review that began 1 mo after surgery. CONCLUSION: Application of ex vivo liver resection followed by autotransplantation in radical resection for GCLM can help selected patients with intrahepatic metastases located in complex sites obtain a favorable clini cal outcome. PMID:34141784 | PMC:PMC8173424 | DOI:10.12998/wjcc.v9.i17.4221 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Minimally invasive surgery for glycogen storage disease combined with inflammatory bowel disease: A case report

paythelady.612 shared this article with you from Inoreader Minimally invasive surgery for glycogen storage disease combined with inflammatory bowel disease: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4342-4347. doi: 10.12998/wjcc.v9.i17.4342. ABSTRACT BACKGROUND: Inflammatory bowel disease (IBD) is rare in patients with glycogen storage disease (GSD). In GSD patients, a decrease in the number of neutrophils leads to prolonged intestinal infection, leading to the formation of chronic inflammation and eventually the development of IBD. Minimally invasive surgery for patients with IBD has been proven to reduce inflammatory responses and postoperative risks and ultimately promote rapid recovery. Herein we discuss minimally invasive surgery and the perioperative management in a patient with GSD and IBD. CASE SUMMARY: A 23-year-old male had GSD Ib associated with IBD-like disease for 10 years. Despite standard treatments, such as mesalazine, prednisone and adalimumab, the patient eventually developed colonic stenosis with incomplete ileus. After adequate assessment, the patient was treated with minimally invasive surgery and discharged in stable condition. CONCLUSION: Minimally invasive surgery for patients with IBD and GSD is safe, feasible and effective. PMID:34141799 | PMC:PMC8173400 | DOI:10.12998/wjcc.v9.i17.4342 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Eosinophilic gastroenteritis with abdominal pain and ascites: A case report

paythelady.612 shared this article with you from Inoreader Eosinophilic gastroenteritis with abdominal pain and ascites: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4238-4243. doi: 10.12998/wjcc.v9.i17.4238. ABSTRACT BACKGROUND: Eosinophilic gastroenteritis (EGE) is a rare disease that presents many unspecific gastroenterological symptoms. The disease includes three types depending on the depth of eosinophil infiltration in the gastrointestinal tract. The serosal type is the most rare, presenting as ascites. CASE SUMMARY: A 34-year-old man presented with abdominal pain, diarrhea without bloody stool, or nausea. Laboratory test results revealed a peripheral blood eosinophil count (4.85 × 109/L), which was remarkedly elevated. Computed tomography scan demonstrated extensive intestinal wall edema thickening in the duodenum, jejunum, ascending colon and transverse colon; multiple exudative effusion surrounding the intestinal tract, and ascites in the abdominal cavity. A series of examinations excluded eosinophil elevation in secondary diseases. E ndoscopic multipoint biopsy detected eosinophilic infiltration in the mucous layer of the transverse colon, with ≥ 50 eosinophils/high power field. All symptoms vanished after a few days of steroid therapy and ascites disappeared within 2 wk. CONCLUSION: EGE should be considered in patients with abdominal pain, ascites, and eosinophilia. Multiple point biopsies are essential for diagnosis. PMID:34141786 | PMC:PMC8173428 | DOI:10.12998/wjcc.v9.i17.4238 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.