ABSTRACT
Acute pancreatitis is occasionally caused by endoscopic treatments or radiologic interventions of the pancreatobiliary tract. However, no reports indicate that acute pancreatitis resulted from the insertion of a percutaneous transhepatic cholangiography (PTCS) catheter in the common bile duct (CBD). A 65-year-old woman visited our hospital with acute cholangitis due to about 3 cm-sized CBD stones. We planned to perform PTCS because of the large stones and altered anatomy (Billroth II). The patient was discharged after tract dilatation and insertion of a PTCS catheter in the distal CBD without manipulations of Ampulla of Vater (AOV). However, she visited the emergency room due to acute pancreatitis at three days after discharge. Computed tomography revealed upstream dilation of the main pancreatic duct following the compressed area of a large stone and catheter. Thus, we report a case that presented with acute pancreatitis induced by insertion of a PTCS catheter without manipulations of AOV.
Subject(s)
Aged , Female , Humans , Ampulla of Vater , Catheters , Cholangiography , Cholangitis , Common Bile Duct , Dilatation , Emergency Service, Hospital , Pancreatic Ducts , PancreatitisABSTRACT
Chikungunya infection is caused by an arbovirus transmitted by the Aedes mosquito. A 19-year-old man who had traveled to the Republic of Surinam to perform volunteer work complained of a fever, arthralgia, articular stiffness, and a skin rash on both the arm and trunk. Chikungunya fever was diagnosed using a Chikungunya virus specific IgM antibody in an enzyme-linked immunosorbent assay (ELISA) using blood samples obtained during follow-up visits. In this report, we describe a case of imported Chikungunya fever that presented with arthralgia and a skin rash, with islands of normal skin, that occurred following travel to Surinam, South America.
Subject(s)
Humans , Young Adult , Aedes , Arboviruses , Arm , Arthralgia , Chikungunya virus , Culicidae , Enzyme-Linked Immunosorbent Assay , Exanthema , Fever , Follow-Up Studies , Immunoglobulin M , Islands , Skin , South America , Suriname , VolunteersABSTRACT
The use of levothyroxine is increasingly widespread. There are relatively few reports of acute massive levothyroxine intoxication leading to emergencies in adults, and such intoxication has a wide range of presentations. Although thyroid gland activity is suppressed by thyroid stimulating hormone as a result of overdose exposure to exogenous thyroid hormone, it is unclear what symptoms are to be expected in acute levothyroxine intoxication in the absence of the thyroid gland. We report a case of massive acute levothyroxine intoxication in a patient with total thyroidectomy, along with observed changes over time in thyroid hormone levels and symptoms. To the best of our knowledge, this report presents the first description of acute massive levothyroxine intoxication in the absence of a thyroid gland.