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Key Clinical Message: The pelvic and peritoneal hydatidosis occurs mostly after the traumatic rupture or surgical spillage of Echinococcus from liver or spleen. The treatment is surgical aiming to eradicate local disease, preventing complications, and reducing recurrences. Abstract: We report a unique case of a 26-year-old male who presented with acute urinary retention and abdominal distention. Later, CT-urography revealed peritoneal and pelvic hydatidosis behind this presentation, which was managed surgically.
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Introduction: Arachnoid cysts are intra-arachnoid lesions filled with cerebrospinal fluid. They account for ~1% of all intracranial mass lesions and are non-neoplastic collections of cerebrospinal fluid within an anomalous arachnoid enclosure. Case presentation: The authors report a 35-year-old Arabian male who presented to the ER with a history of sudden loss of consciousness, anisocoria, and right hemiparesis. Contrast tomography showed a large frontoparietotemporal cyst (7.7×5.8×5.4) with uncal herniation and a midline shift of 12 mm. An emergency left FTP craniotomy with an excision of the cyst was performed. Discussion: Arachnoid cysts can be categorized as primary or secondary, arising congenitally or due to factors like trauma, infection, or neoplasia. It can rupture, leading to internal bleeding, causing symptoms such as headaches, seizures, and neurological decline. Rapid diagnosis is vital, with cranial computed tomography scans preferred for emergencies. Treatment options include surgical intervention like craniotomy, fenestration, or cyst peritoneal shunts. For uncal herniation, surgery can be successful and results depends on the amount of herniation. Conclusion: Although benign, the arachnoid cysts led to uncal herniation when they become 'tension' cysts. A high level of suspicion is crucial for early recognition of the condition. Timely intervention has shown positive recovery outcomes.
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Introduction: Acute oral intoxication of pretilachlor, a synthetic chloroacetanilide herbicide, can present similar clinical manifestations of organophosphorus toxicity in humans. Case presentation: A 15-year-old male was admitted after suicidal ingestion of pretilachlor poison, with decreased consciousness and blood-mixed vomiting. Discussion: Pretilachlor is a colorless and odorless liquid that can cause neurotoxicity and carcinogenicity due to its prolonged exposure. The effects of acute oral exposure are mild and may differ from chronic exposure. Individuals exposed to chloroacetanilides may not show symptoms or experience vomiting and neurological issues. Clinical manifestations such as vomiting, excessive lacrimation, bowel and bladder incontinence, bradycardia, and hypotension can be observed in both organophosphate poisoning and pretilachlor poisoning, making accurate diagnosis challenging, particularly in resource-limited settings like ours. There is no specific antidote for pretilachlor poisoning. Treatment focuses on symptomatic care and monitoring the patient's hemodynamics as per standard protocol. Conclusion: This case underscores the need for prompt stabilization, vigilant monitoring, and supportive care to ensure timely recovery in pretilachlor poisoning cases despite similarities with organophosphate poisoning. It emphasizes the importance of educating and raising awareness among physicians about potential mimickers like organophosphates.
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Key Clinical Message: Pancreas divisum (PD) can be one of the causes of unexplained chronic abdominal pain. In PD, the dominant duct drains the majority of the pancreas via the minor papilla, which can be conveyed in the imaging as crossing duct sign. Abstract: We report a case a of 16-year-old man who presented with unexplained chronic abdominal pain. Contrast-enhanced computed tomography and magnetic resonance cholangiopancreatography showed a bulky pancreas, but his pancreatic enzymes were normal. The crossing duct sign was prominent in imaging, which confirmed the diagnosis of PD.
ABSTRACT
The vitello-intestinal duct normally regresses with the development. But, in certain cases, it could persist and present as Meckel's diverticulum. Here we report a case of an eight-year-old boy presenting with peri-umbilical abdominal pain, vomiting and loose stool. He was initially diagnosed and managed as acute appendicitis but did not improve, rather developed features of intestinal obstruction. Exploratory laparotomy was done which revealed persistent vitello-intestinal duct and was managed surgically. This case report highlights that in any case of suspected acute appendicitis, the complications of persistent vitello-intestinal duct should be considered as one of the differentials. Keywords: appendicitis; case reports; intestinal obstruction; laparotomy; omphalomesenteric duct.