RESUMEN
Gas gangrene, a subset of necrotizing myositis, is a bacterial infection that produces gas in tissues in gangrene. It is usually caused by Clostridium species, most commonly Clostridium perfringens. Streptococcus anginosus is a rare cause of gas gangrene, with very few cases reported. We report a rare case of traumatic gas gangrene caused by S. anginosus in a 57-year-old female with diabetes after being stabbed with scissors.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Infecciones Bacterianas , Clostridium , Clostridium perfringens , Diabetes Mellitus , Gangrena , Gangrena Gaseosa , Miositis , Streptococcus anginosus , StreptococcusRESUMEN
Endoscopic retrograde cholangiopancreatography (ERCP)-related complications should be promptly and properly managed in accordance with the type and severity of the complication and the comorbidity of the patient. Neurologic complications occur very rarely, but despite of the prompt management, the patient status can severely deteriorate and sometimes result in fatality. A female patient visited SAM Medical Center for abdominal pain and yellow skin. She has taken a current medication for essential hypertension since 10 years ago. Initial laboratory findings showed obstructive jaundice and abdominal computed tomography (CT) showed two common bile duct stones with moderate dilation of bile duct. Her vital sign with oxygen saturation was stable until the first attack of seizure 12 hours later after removal of stones through the ERCP. Emergent brain CT and magnetic resonance imaging revealed multiple cerebral infarctions of both hemispheres with right predominance of middle cerebral artery territory and no evidence of air emboli. She died four days later despite of intensive care including high oxygen therapy and intravenous broad spectrum antibiotics with antiplatelet drug. We report a rare, delayed occurrence of a fatal multiple cerebral infarctions 12 hours after ERCP.
Asunto(s)
Femenino , Humanos , Dolor Abdominal , Antibacterianos , Conductos Biliares , Encéfalo , Infarto Cerebral , Colangiopancreatografia Retrógrada Endoscópica , Conducto Colédoco , Comorbilidad , Hipertensión , Cuidados Críticos , Ictericia Obstructiva , Imagen por Resonancia Magnética , Arteria Cerebral Media , Oxígeno , Convulsiones , Piel , Signos VitalesRESUMEN
Patients with massive pulmonary embolism may present with severe dyspnea at rest, syncope, or cardiac arrest. Early diagnosis and treatment are essential to reduce mortality; however, patient-specific factors can influence the hemodynamic effect of pulmonary embolism. Here, we present a case of massive pulmonary embolism masked by a ventricular septal defect in a 73-year-old female.
Asunto(s)
Anciano , Femenino , Humanos , Disnea , Diagnóstico Precoz , Paro Cardíaco , Defectos del Tabique Interventricular , Hemodinámica , Máscaras , Mortalidad , Embolia Pulmonar , SíncopeRESUMEN
Brunner's gland adenoma is a rare benign small bowel neoplasm and it represents 10% of small bowel benign tumor. Most of adenoma manifest as polypoidal, multiple and size does not exceed 1 cm and mostly asymptomatic, but the lesion larger than 1cm is solitary and can cause bleeding, obstruction, intussusception and there are some reports of showing malignant transformation. Until the present, there are two cases of over cm huge Brunner's gland adenoma in Korea and each of their chief complaint was abdominal discomfort and melena, but there is no case report of over 8cm Brunner's gland adenoma accompanied with acute bleeding as seen in this case. We diagnosed an 8cm sized, huge duodenal Brunner's gland adenoma which accompanied with acute bleeding and treated it by endoscopic resection using an IT-knife, successfully.