An unusual nasopharyngeal foreign body with unusual presentation

Upper aerodigestive tract may harbour foreign bodies such as sponges, grains, toy parts, stones, paper, insects, cotton, glass ball, etc. These objects may go undetected for days or even weeks. A metallic foreign body after being inhaled and ultimately being lodged in the nasopharynx is a rare entity. We report a case of an unusual nasopharyngeal foreign body (glass ball) presenting with symptoms of nasal regurgitation and change in voice in a 2-year boy. The foreign body was diagnosed by X-ray skull lateral view including nasopharynx and was removed under general anesthesia.

An unusual presentation of acute gastric volvulus in the elderly patient: a case report and literature review

Gastric volvulus is nothing but the torsion of stomach in thoracic cavity by more than 1800 along its transverse or longitudinal axis. A very rare case occurring both in male and female. The term first described by Berti after doing an autopsy of a female, in 1886. We found a case of 65 years old male with history of dyspepsia since, 1 year with history of vomiting and pain abdomen since, 1 day. On evaluation, clinically gurgling sound heard on left side chest and with investigations like USG and CT whole abdomen, we came to know about mesentrico axial volvulus which is more common in children. Acute gastric volvulus cases have high mortality rate also requires emergency surgery. Gastric volvulus is very rare with variable and non-specific clinical presentations, hence high level of suspicion for radiologic diagnosis may require. Acute gastric volvulus is a potentially life-threatening occurrence with a good outcome when treated in a timely fashion. Chronic volvulus may be more difficult to recognize. Timely diagnosis with proper treatment can potentially decreases morbidity and mortality of the patient.

Cáncer epidermoide en piel cabelluda, presentación inusual. Reporte un caso / Epidermoid cancer on scalp, an unusual presentation. A case report

Resumen Se presenta el caso clínico de una paciente de 47 años de edad, la cual cursó con una lesión en piel cabelluda de gran dimensión (10 X 10 cm de diámetro) de un año de evolución. Se realizó estudio histopatológico, que reportó cáncer epidermoide moderadamente diferenciado. La tomografia de cráneo mostró tumoración de piel cabelluda que erosiona el cráneo. Fue tratada en servicio de oncología médica y servicio de radioterapia para reducción de masa tumoral, radioterapia y 5 ciclos de cisplatino más docetaxel. Al existir respuesta favorable, se interviene quirúrgicamente con rotación de colgajos y colocación de injerto. El estudio histopatológico postratamiento reportó: carcinoma epidermoide moderadamente diferenciado, permeación vascular que infiltra dermis y tejido subcutáneo; fragmento óseo sin datos de neoplasia viable. Se continuó manejo con capecitabina como mantenimiento. La paciente falleció 5 años después del diagnóstico con metástasis pulmonares. El objetivo de la presentación de este caso es resaltar que el cáncer de piel puede presentarse de forma inusual y en pacientes con factores de riesgo poco frecuentes, como en este caso. La sospecha clínica oportuna conducirá al establecimiento del diagnóstico y tratamiento adecuados.

Abstract This is a case report of a female patient of 47 years of age. She presented a large scalp injury, 10 cm wide, with a year of evolution. The histopathological study reported a moderately differentiated squamous cell carcinoma and the tomography showed a scalp tumor eroding the skull. She was treated at the medical oncology services and radiation therapy services for debulking, radiotherapy and 5 cycles of cisplatin plus docetaxel. If the response is favorable, a surgical intervention will be performed with rotation flaps and a graft placement. The post-treatment histopathological study reported: a moderately differentiated epidermoid carcinoma, vascular permeation infiltrating dermis and subcutaneous tissue and bone fragments with no viable neoplasm data. Capecitabine was prescribed as maintenance. The patient died 5 years after the diagnosis because of pulmonary metastases. The aim of this case report is to make emphasis in the fact that skin cancer can occur in unusual ways and in patients with rare risk factors like this case. Timely clinical suspicion may lead to a favorable diagnosis and treatment.

Acute Non-Fulminant Viral Hepatitis E Presenting with Acute Pancreatitis—An Unusual Presentation

Acute pancreatitis is considered to be an extremely rare extrahepatic manifestation of acute viral hepatitis E. The incidence is reported to be around 5%–6% in the available case series. It has usually been reported in non-fulminant cases of acute viral hepatitis E in the second or third week of illness, with a favourable outcome. Here, we report the case of a young male subject with acute viral hepatitis E presenting as acute pancreatitis at its onset and exhibiting a prolonged recovery phase. To the authors’ knowledge, such a presentation of acute viral hepatitis E as acute pancreatitis at its inception has been only sparsely reported in the available literature.

Uncommon Presentation of Infective Endocarditis / Lao Medical Journal

@#Diagnosis of infective endocarditis is challenging as the clinical diversity of the disease sometimes misleads clinicians in the recognition, correct diagnosis and rapid treatment, which are important to reduce the morbidity and mortality associated with this disease. We report the case of a 14-year-old girl who presented with left axillary pain and fever. She was eventually diagnosed with infective endocarditis caused by Abiotropia defectiva, complicated by a large saccular aneurysm of the left axillary artery.@*@#