Seizure, A Shocking Effect of a Lightning Strike on Aerodrome: A Case Report.

Lightning injuries have a high morbidity and mortality because of the electrical effects on the circulatory, respiratory, and central nervous systems. Most lightning-related deaths occur immediately after injury due to fatal arrhythmias or respiratory failure. We describe the case of a patient who experienced a seizure and respiratory distress secondary to a lightning strike and how our team was able to stabilize and transport the patient. Ultimately, in this particular case study, the patient survived with minimal residual neurologic and hemodynamic effects. Based on this clinical vignette, we review the pathophysiology of lightning injuries and the predictive factors of positive outcomes in such unusual accidents.

Middle segment pancreatectomy: Does it deserve a second chance? Report of three cases and review of the literature.

INTRODUCTION AND IMPORTANCE: Meddle segment pancreatectomy (MP) is a parenchyma-sparing surgical procedure that has recently been proposed for treatment of benign or attenuated malignant tumors. However, this procedure is not fully recognized. CASE PRESENTATION: We herein report 3 patients undergoing MP for tumors of pancreas body and tail. The first patient was a 38-year-old woman with a neuroendocrine tumor, the second was a 42-year-old woman with a serous cystic neoplasm and the 3rd patient was 57 years old, with mucinous cystadenoma. A MP with spleen preservation was performed in the 3 patients, with ligatures of splenic vessels in the first patient. Only one patient developed a pancreatic fistula, which was managed medically. In our 3 patients, no endocrine or exocrine insufficiency was observed, but the first patient showed a disease recurrence with liver metastasis 3 years after surgery. CLINICAL DISCUSSION: Middle pancreatectomy can not only avoid the pancreatic effects of extensive resections, but it is also a technique that has a very low operative or postoperative mortality rate. CONCLUSION: MP is a feasible, safe procedure with several advantages, but which unfortunately remains rarely practiced.

Sclerosing Encapsulating Peritonitis: Solving the Diagnosis Challenge of a Rare Entity.

Sclerosing encapsulating peritonitis (SEP) is an unusual fibroinflammatory disease of the peritoneum marked by the development of a fibrous membrane enveloping generally the small intestines. The knowledge around this subject is not completely understood. And the etiology can be either idiopathic or secondary to several diseases, treatments, and/or medications. We present a case of a 52-year-old man suffering from atypical clinical symptoms including recurrent abdominal ascites and intestinal obstruction. An abdominal computed tomography showed findings typical of SEP. Therefore, the patient benefited from exploratory laparotomy, which confirmed the diagnosis of idiopathic SEP. Postoperatively, he again had an episode of bowel obstruction, but this was controlled with steroids. Diagnosis of SEP is a real challenge to surgeons, gastroenterologists, and radiologists. And imagery is very helpful to make the diagnosis. Consequently, it is imperative that all hospital practitioners should distinguish between this lesion and other etiology of acute peritonitis.

An exceptional collision tumor: gastric calcified stromal tumor and pancreatic adenocarcinoma.

The authors report an exceptional case of collision tumor comprised of a gastric calcified stromal tumor and a pancreatic adenocarcinoma. The pancreatic tumor was detected fortuitously on the histological exam of resection specimen.