ABSTRACT
We report the case of a 52-year-old man who had two syncopal episodes associated with coughing. Other than essential hypertension, he had no organic disease of the heart or lungs. Transient complete atrioventricular block following coughing was detected by electrocardiographic telemonitoring while resting. During that time, the patient experienced near-syncope similar to his previous syncopal episodes. He was treated successfully with permanent pacemaker implantation.
Subject(s)
Humans , Middle Aged , Atrioventricular Block , Cough , Electrocardiography , Heart , Hypertension , Lung , SyncopeABSTRACT
Heterotopic pancreas is a tissue histologically similar to normal pancreatic tissue found in a location other than the usual place, and having no anatomic or vascular connection with the pancreas itself. Heterotopic pancreas is usually asymptomatic and found incidentally. However, it can cause problems such as abdominal pain, melena, anemia, and severe bleeding. We report a case of a 29-year-old woman with obscure gastrointestinal bleeding caused by heterotopic pancreas located in Meckel's diverticulum. Gastroduodenoscopy and colonoscopy showed no bleeding focus. By capsule endoscopy and double balloon enteroscopy, a bleeding focus was suspected in the ileum. The patient received a laparoscopic resection of the Meckel's diverticulum. Pathologic examination revealed heterotopic pancreatic tissue within the muscular layer of the diverticulum. The patient recovered well without further bleeding.
Subject(s)
Adult , Female , Humans , Abdominal Pain , Anemia , Capsule Endoscopy , Colonoscopy , Diverticulum , Double-Balloon Enteroscopy , Hemorrhage , Hypogonadism , Ileum , Meckel Diverticulum , Melena , Mitochondrial Diseases , Ophthalmoplegia , PancreasABSTRACT
Pulmonary artery pseudoaneurysm (PAP) is a rare complication of septic pneumonia. It is potentially fatal because of the risk of massive hemoptysis. Treatment of PAP involving massive hemoptysis is by embolization or surgery. However, the progression of PAP after embolization has not been reported. A 59-year-old male who was recovering from septic pneumonia experienced massive hemoptysis. Computed tomography (CT) revealed PAP of the right pulmonary artery with surrounding consolidation, suggesting active hemorrhage. The patient was successfully treated with embolization of the right pulmonary artery. During outpatient follow-up, the amount of radiopaque embolized material gradually decreased on chest radiography. At 14 months after embolization, both the PAP and embolized material had disappeared on chest CT.
Subject(s)
Humans , Male , Middle Aged , Aneurysm, False , Follow-Up Studies , Hemoptysis , Hemorrhage , Outpatients , Pneumonia , Pulmonary Artery , ThoraxABSTRACT
Diabetic nephropathy is a common and serious complication of diabetes characterized by persistent proteinuria, hypertension and a progressive decline of renal function. However, non-diabetic renal disease can be present in diabetic patients and differential diagnosis of treatable disease is important. Minimal change nephrotic syndrome is characterized by normal light microscopic finding and effacement of foot process in electron microscope, but foot process effacement is not specific and it can be present in the glomeruli of the most glomerulopathy including diabetic nephropathy. Therefore, pathologic diagnosis of minimal change nephrotic syndrome combined with diabetic nephropathy is very difficult. However, we could exclude other glomerulopathy and diagnose minimal change nephrotic syndrome by clinical features in three type 2 diabetic patients with diabetic nephropathy and have successfully treated with corticosteroid.