This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ http://www.casesjournal.com The latest articles from Cases Journal (ISSN 1757-1626) published by BioMed Central IntroductionGastric polyps exist in a wide variety of types, most of which are small and often benign. Discovery of gastric polyps during Endoscopy necessitates biopsies. Case presentationWe present a case report of an isolated diffuse hyperplastic gastric polyposis in a 26 years old Hispanic female when she was investigated for profound anemia. The Esophagogastroduodenoscopy revealed numerous gastric polyps filling the entire stomach. She was treated with near-total gastrectomy and her anemia resolved Conclusion: Isolated diffuse hyperplasic gastric polyposis with normal gastrin level is a rare entity and can present with severe anemia. http://www.casesjournal.com/content/1/1/130 Suriya Jayawardena, Dharshan Anandacoomaraswamy, Olga Burzyantseva and Muhammad Abdullah Cases Journal 2008, 1:130 2008-08-28 doi:10.1186/1757-1626-1-130 Cases Journal 1757-1626 1 130 2008-08-28 The expectant management of high grade renal injuries in hemodynamically stable children has gained increasing acceptance amongst paediatric surgeons. However, patients with grade 1V injury with complete renal transection have been identified as a subgroup with a poor outcome that may benefit from early operative intervention. Interestingly, both internal and external drainage have been independently utilised as part of the expectant approach. The former is more widely practiced and was first suggested by Haas et al who used it successfully in 5 patients with grade 1V renal trauma. Yet to be clearly established in this context is the value and timing of external drainage, particularly, when used in combination with internal stenting. Described is a child with complete renal transaction who was successfully managed with a combination of internal and external drainage. http://www.casesjournal.com/content/1/1/129 Costa Healy, Mohamed Hobeldin and Anies Mahomed Cases Journal 2008, 1:129 2008-08-27 doi:10.1186/1757-1626-1-129 Cases Journal 1757-1626 1 129 2008-08-27 Although uncommon and often asymptomatic, portal venous thrombosis can have catastrophic consequences for the individual it afflicts, particularly when the process propagates to involve the superior mesenteric vein. Familiarity with the condition's pathogenesis and presentation however permits early diagnosis and allows aggressive conservative management to achieve a successful outcome. Here we describe the successful outcome of such management for a 42-year-old male patient who developed this condition spontaneously. http://www.casesjournal.com/content/1/1/128 Muhammed Mushtaque, Ronan A Cahill, John J Sheehan and Richard B Stephens Cases Journal 2008, 1:128 2008-08-27 doi:10.1186/1757-1626-1-128 Cases Journal 1757-1626 1 128 2008-08-27 Inversion of the uterus through the uterine lower segment incision during a caesarean section is an extremely rare obstetric incident. It consists, though, an emergency complication that is potentially life-threatening, especially in cases of prolonged inversion, because haemodynamic instability and shock may occur. Prompt diagnosis and immediate uterine reversion are the key actions in the management of this serious complication. http://www.casesjournal.com/content/1/1/127 Dimitrios Vavilis, Dimitrios Tsolakidis, Dimitrios Athanatos, Antonios Goutzioulis and John N Bontis Cases Journal 2008, 1:127 2008-08-27 doi:10.1186/1757-1626-1-127 Cases Journal 1757-1626 1 127 2008-08-27 Mediastinal cysts have an unpredictable course but can cause complications such as infection or local pressure effects. Persons with mediastinal cysts can be asymptomatic for many years or can develop symptoms as a result of complications of the cyst. There is a lack of consensus on the best approach to managing those patients without symptoms. In this case report, a 56 year old woman with an indolent mediastinal cyst initially managed conservatively suddenly developed symptoms suggestive of an infected mediastinal cyst requiring surgical resection. http://www.casesjournal.com/content/1/1/126 Aldoph B Nanguzgambo, Martin Pike, Richard D Page, Grant F Benfield and Damian McKeon Cases Journal 2008, 1:126 2008-08-26 doi:10.1186/1757-1626-1-126 Cases Journal 1757-1626 1 126 2008-08-26 Necrotizing fasciitis is a rapidly progressive, life-threatening soft tissue bacterial infection. We present a serious case of a 43-year-old male who suffered from necrotizing fasciitis of the left leg in whom a delayed diagnosis caused multiorgan dysfunction. Early recognition of important symptoms is essential in the management and surgical debridement of necrotizing fasciitis. Treatment should include comprehensive supportive measures (early goal-directed therapy, adequate ventilation strategy, activated protein C dosage, tight glucose control, steroids, renal replacement therapy) and early antibiotic therapy based on microbiologic monitoring. The pathophysiology and etiologic factors of necrotizing fasciitis are discussed. http://www.casesjournal.com/content/1/1/125 Piotr Smuszkiewicz, Iwona Trojanowska and Hanna Tomczak Cases Journal 2008, 1:125 2008-08-23 doi:10.1186/1757-1626-1-125 Cases Journal 1757-1626 1 125 2008-08-23 Objective is to report the immediate use of High-Frequency Oscillatory ventilation in an adult acute respiratory distress syndrome. The setting was an intensive care unit at the Military Teaching Hospital of Toulon. Our patient was a 64-yr-old Caucasian male who developed acute respiratory distress syndrome in the course of severe falciparum malaria. The intervention was the initial use of HFO to minimise ventilator-induced lung injury. Measurement and Main Results: rapid improvement of PaO2/fraction of inspired oxygen from 172 mmHg (NIV) to 310 mmHg with HFO. No ventilator-induced injury on CT scan after 5 days of invasive ventilation. Conclusions: in contrast with previous studies, we successfully used lung protective ventilation with HFO immediately. Further studies, with immediate, rather than rescue use of HFO ventilation, are needed. http://www.casesjournal.com/content/1/1/124 Philippe PH Goutorbe, Yves Y Asencio, Julien J Bordes, Ambroise A Montcriol, Bertrand B Prunet and Eric E Meaudre Cases Journal 2008, 1:124 2008-08-22 doi:10.1186/1757-1626-1-124 Cases Journal 1757-1626 1 124 2008-08-22 We are reporting a very rare case of primary bronchogenic squamous cell carcinoma (SCC) with bone metastasis in a 13-year-old boy. A brief review of the English literature on this rare neoplasm in childhood is presented. http://www.casesjournal.com/content/1/1/123 Jeff F Wang, Bo Wang, Joshua A Jansen, Eric E Santos and Deba P Sarma Cases Journal 2008, 1:123 2008-08-22 doi:10.1186/1757-1626-1-123 Cases Journal 1757-1626 1 123 2008-08-22 In this rare case a non-immunocompromised patient with old Tuberculosis on low dose of steroids presents with oppurtunistic infection of a weakly aerobic gram positive acid fast, filamentous bacteria called Nocardia. An 80 year old non-smoking white female presented with cough, shortness of breath and purulent sputum. Initial antibiotics given were not helpful. Later microbial diagnosis was Nocardia in sputum sample which was uncommon in a non-immunocompromised .She responded to co-trimoxazole therapy. http://www.casesjournal.com/content/1/1/122 Kaushik Sanyal and Kanagasabesan Sabanathan Cases Journal 2008, 1:122 2008-08-21 doi:10.1186/1757-1626-1-122 Cases Journal 1757-1626 1 122 2008-08-21 IntroductionExpressionless face associated with multiple contractures has been encountered in an infant. There is a wide range of misconception regarding the categorization of children with multiple contractures among different pediatric disciplines. The fundamental element in categorizing children with multiple contractures is "the etiological understanding". In the absence of concomitant neuromuscular disease, however, the search for other reasons is mandatory. Our present paper signifies the necessity of proper interpretations of unusual clinical and radiographic features. Case presentationWe describe a 3-months-old-infant presented with the phenotypic and the radiographic features consistent with the diagnosis of Stuve-Wiedemann syndrome. We report what might be the first clinical report of Stuve-Wiedemann syndrome from a consanguineous family in Austria. Conclusion: Congenital limitations of the hips in a newborn infant raise the possibility of " Congenital Hip Dislocation". As congenital hip dislocation is a dysplastic process. Here further knowledge by the pediatrician and the orthopaedic surgeon is needed. Our present patient appears to constitute a distinct pathological entity consistent with Stuve-Wiedemann syndrome (SWS). Superti-Furga et al, and Cormier-Daire et al, also suggest that Stuve-Wiedemann syndrome and Schwartz-Jampel syndrome type 2 are allelic conditions. We wish to stress that, given the rarity of syndromic malformation complex, our impression is that it is more common than it is reported. http://www.casesjournal.com/content/1/1/121 Ali Al Kaissi, Monika Rumpler, Robert Csepan, Franz Grill and Klaus Klaushofer Cases Journal 2008, 1:121 2008-08-21 doi:10.1186/1757-1626-1-121 Cases Journal 1757-1626 1 121 2008-08-21 We describe a case of bilateral femoral neck fractures secondary to transient osteoporosis of pregnancy, which were diagnosed after delivery due to the desire to avoid ionising radiation. These fractures were presumed to be secondary to transient osteoporosis of pregnancy and were treated successfully with internal fixation despite delayed presentation. We discuss the role of MRI in the evaluation of hip pain in pregnancy. http://www.casesjournal.com/content/1/1/120 Charles A Willis-Owen, Jas S Daurka, Alvin Chen and Angus Lewis Cases Journal 2008, 1:120 2008-08-21 doi:10.1186/1757-1626-1-120 Cases Journal 1757-1626 1 120 2008-08-21 IntroductionWhile catheter angiography has traditionally been used to assess the caliber and course of the superficial temporal artery prior to its use as a conduit for external carotid artery to internal carotid artery (EC-IC) bypass, computed tomographic angiography (CTA) has become increasingly used in the diagnostic assessment of cerebral vasculature. We demonstrate the application of CTA for evaluation of the superficial temporal artery as a vascular conduit for EC-IC bypass.Case presentationA female in the fourth decade of life presented with the chief complaint of headache. CTA of the Circle of Willis revealed an unruptured fusiform aneurysm of the M1 segment of the right middle cerebral artery (MCA). We performed CTA for the preoperative assessment of the STA for a putative EC-IC bypass procedure, and correlated this to conventional external carotid angiography. Reformatted CTA provided excellent surface visualization of the STA and its course in relationship to the cranial and zygomatic surfaces, and correlated well with findings on the conventional angiogram. Conclusion: CTA may eventually prove sufficient for use in assessing the STA in preparation for EC-IC bypass. http://www.casesjournal.com/content/1/1/119 Khashayar Farsad, Reyaad A Hayek, Alexander C Mamourian and Jonathan A Friedman Cases Journal 2008, 1:119 2008-08-21 doi:10.1186/1757-1626-1-119 Cases Journal 1757-1626 1 119 2008-08-21 A 45 years old lady presented with abdominal pain was diagnosed of multiple peritoneal and hepatic hydatid cysts on CT scan was retrospectively found to suffered blunt abdominal trauma. http://www.casesjournal.com/content/1/1/118 Nimish J Shah, Nikunj K Vithalani, Rahul K Chaudhary and Prashant N Mohite Cases Journal 2008, 1:118 2008-08-21 doi:10.1186/1757-1626-1-118 Cases Journal 1757-1626 1 118 2008-08-21 Perianal contracture lead to intestinal obstruction whenever there is involvement of anal orifice. In this case, anus and perianal skin up to two cm was normal; however both gluteal folds were fused because of post burn scar leaving a very small opening which lead to faecal impaction and sub acute intestinal obstruction. http://www.casesjournal.com/content/1/1/117 Jagdeep S Thakur, C g S Chauhan, Vijay K Diwana and Anamika Thakur Cases Journal 2008, 1:117 2008-08-21 doi:10.1186/1757-1626-1-117 Cases Journal 1757-1626 1 117 2008-08-21 Plasmacytoma are extramedullary accumulations of plasma cells. Most extramedullary Plasmacytomas are associated with the upper respiratory tract. The mediastinum is rarely involved. We report a rare case of mediastinal plasmacytoma with multiple myeloma. The patient is 66 year old woman presented with bone pains and mediastinal mass on CT scan and MRI. The preliminary diagnosis of occult lung cancer with mediastinal involvement, and widespread skeletal metastasis was made, although lymphoproliferative disorder along with germ cell tumor was also kept in differentials. The diagnosis of mediastinal plasmacytoma with multiple myeloma was made after extensive investigations http://www.casesjournal.com/content/1/1/116 Ashiq Masood, Kanan H. Hudhud, A Z Hegazi and Gaffar Syed Cases Journal 2008, 1:116 2008-08-21 doi:10.1186/1757-1626-1-116 Cases Journal 1757-1626 1 116 2008-08-21 IntroductionTuberculosis remains a serious disease worldwide. Anti-tuberculosis campaigners many times face negative tuberculin skin tests after Bacille Calmette Guerin vaccination. Increasing tuberculin units might be a solution. However, is skin reaction a linear function of tuberculin dose? Are there any side-effects when higher tuberculin doses are administered? Case presentationSix simultaneous Mantoux tuberculin skin tests, using 1, 2, 5, 10, 20, and 50 tuberculin units (88 altogether) of purified protein derivative RT23 per 0.1 mL were applied in a healthy male Greek 35-years-old, with known natural Mycobacterium tuberculosis primary infection since five years. Skin indurations 72 hours later were 15, 22, 23, 19, 23, and 27 mm respectively. Conclusion: No linear relation between tuberculin dose and skin reaction observed; skin reaction increased as tuberculin dose increased but with a decreasing rate, especially after 2 TUs, which seem correctly defined for detection of natural infection. No side-effects occurred. http://www.casesjournal.com/content/1/1/115 Ioannis DK Dimoliatis and Christos AD Liaskos Cases Journal 2008, 1:115 2008-08-20 doi:10.1186/1757-1626-1-115 Cases Journal 1757-1626 1 115 2008-08-20