Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 9 de 9
Filter
Add more filters










Database
Language
Publication year range
1.
J Med Cases ; 14(11): 356-361, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38029055

ABSTRACT

Crohn's disease is an inflammatory disease that typically affects the bowels but can also have many different extraintestinal manifestations. One of those complications is immunoglobulin A nephropathy (IgAN), which is one of the most encountered renal lesions in the setting of Crohn's disease. Another point of focus for Crohn's patients is the risk of cancer, with a higher risk of colorectal cancer but also extraintestinal neoplasia such as hepatobiliary, hematological, and urinary tract neoplasia. We present the case of a young patient suffering from long-term Crohn's disease and subsequent IgAN leading to end-stage kidney disease and hemodialysis. The patient was diagnosed young and had undergone multiple surgeries and different treatments in various countries. He then presented in our center already with advanced chronic renal failure from IgAN that was unknown due to poor multidisciplinary follow-up. Shortly after starting hemodialysis, he developed a large abdominal mass, first thought to result from Crohn's-related fistula. This mass turned out to be a urachal adenocarcinoma, a rare type of bladder cancer with an especially poor prognosis. It is not known whether this type of cancer is associated with either Crohn's disease or IgAN, and no such association has been previously described. The treatment of urachal cancer usually relies on surgery, with the addition of chemotherapy in some cases. Unfortunately for our patient, his case was already so advanced at the moment of diagnosis that he was excluded from curative treatment and quickly passed away thereafter. This case illustrates many important aspects of the rigorous follow-up that is needed for Crohn's patients, with regular check-ups, screening investigations, and the need for multidisciplinary evaluation. Furthermore, it describes the development of a rare type of cancer in the setting of Crohn's disease and IgAN, with no prior established link between these different pathologies.

2.
BMC Nephrol ; 24(1): 116, 2023 04 27.
Article in English | MEDLINE | ID: mdl-37106351

ABSTRACT

BACKGROUND: Peritoneal dialysis (PD) depends upon a functioning and durable access to the peritoneal cavity. Many techniques exist to insert a peritoneal catheter, showing similar outcomes and benefits. Blind percutaneous insertion represents a bedside intervention predominantly performed by nephrologists requiring only local anesthesia, sedation and minimal transcutaneous access. Although current guidelines recommend insertion techniques allowing visualization of the peritoneal cavity, the blind percutaneous approach is still widely used and has been proven safe and effective to bring durable peritoneal dialysis access. Herein, we described a rare case of jejunal perforation secondary to blind PD catheter placement, and conduct a review of the current medical literature describing early bowel perforations secondary to PD catheter placement, gathering descriptions of symptomatology and outcomes and their relations to the insertion technique. CLINICAL PRESENTATION: We herein describe the case of a 48 year-old patient with a history of appendectomy who suffered from triple jejunal perforation after blind percutaneous insertion and subsequent embedment of his peritoneal catheter. Accurate diagnosis was made 1 month after insertion due to atypical clinical presentation and because physicians had no access to the peritoneal cavity after catheter embedment. After surgical repair and broad-spectrum antibiotics, the patient was switched to HD. CONCLUSION: Early catheter-related visceral injury is a rare, yet threatening condition that is almost always causing a switch to hemodialysis or death. Our review highlights that laparoscopic catheter placement might bring better outcomes if perforation occurs, as it allows immediate diagnosis and treatment. On the contrary, catheter embedment may delay clinical diagnosis and therefore bring worse outcomes.


Subject(s)
Intestinal Perforation , Laparoscopy , Peritoneal Dialysis , Humans , Middle Aged , Renal Dialysis/adverse effects , Catheterization/methods , Catheters, Indwelling/adverse effects , Peritoneal Dialysis/adverse effects , Peritoneal Dialysis/methods , Laparoscopy/adverse effects , Intestinal Perforation/etiology , Intestinal Perforation/surgery
3.
Respirol Case Rep ; 11(4): e01127, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36994108

ABSTRACT

Hemodialyzed patients with COVID-19 are at risk for severe complications from acute respiratory distress syndrome, requiring admission to the intensive-care unit for invasive mechanical ventilation. Post tracheotomy stenosis can be a life-threatening condition that commonly occurs after iatrogenic injury secondary to tracheotomy or tracheal intubation. We report a case of a 44-year-old female patient on maintenance haemodialysis who presented a COVID-19-related ARDS that required mechanical ventilation for 4 weeks, followed by a persistent stridor and finally succumbed, 1 month after being discharged from intensive care unit, from a severe respiratory distress due to a tracheal stenosis. Our aim is to highlight the importance of the early recognition and management of post tracheotomy stenosis in patients with persistent respiratory difficulty as stridor after prolonged intubation requiring tracheotomy, in order to improve the prognosis of these patients.

4.
IDCases ; 28: e01498, 2022.
Article in English | MEDLINE | ID: mdl-35479107

ABSTRACT

Non-typhoidal Salmonella (NTS) disease is usually a self-limiting infection presenting with digestive symptoms. However, disseminated presentation with involvement of secondary infectious sites is observed. We report diagnostic specificities and challenges related to the management of three patients with invasive NTS (iNTS) and secondary infectious locations. Among the seven patients (age range 46 - 83 years), four (two with extra-digestive infectious sites) had at least one immune debilitating condition. Two patients were incidentally discovered with iNTS and deceased after developing a septic shock despite antimicrobial treatment. Two individuals recovered under medical treatment without complications. Three other patients presented with secondary infectious sites. Case 1 suffered from urinary tract infection and dorsolumbar spondylodiscitis that responded well to antimicrobials and surgery. Abdominal prosthetic aortic aneurysm was diagnosed in case 2 and medical treatment only was applied. After four years of follow-up, he remains under antimicrobial treatment. Case 3 presented with conjoint thoracic aortic aneurysm and cutaneous abscesses managed with antimicrobials and surgery. Atherosclerosis and previous vascular intervention were the predisposing events for vascular involvement. iNTS is a serious disease carrying a high risk of mortality or secondary locations. Secondary locations can be managed by long duration antimicrobial therapy combined with surgery. Spine and aortitis are the most frequent secondary locations. Multi-drug resistant NTS represent an additional risk of mortality. Public health measures should be implemented to limit the spread of NTS to humans and the emergence of drug resistance.

5.
Cureus ; 14(2): e22203, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35308674

ABSTRACT

Background In this study, we aimed to compare two outbreaks of coronavirus disease 2019 (COVID-19) in Belgium in tomographic and biological-clinical aspects with artificial intelligence (AI). Methodology We performed an observational retrospective study. Adult patients who were symptomatic in the first seven days with COVID-19 infection, diagnosed by chest computed tomography (CT) and/or reverse transcription-polymerase chain reaction, were included in this study. The first wave of the pandemic lasted from March 25, 2020, to May 25, 2020, and the second wave lasted from October 7, 2020, to December 7, 2020. For each wave, two subgroups were defined depending on whether respiratory failure occurred during the course of the disease. The quantitative estimation of COVID-19 lung lesions was performed by AI, radiologists, and radiology residents. The chest CT severity score was calculated by AI. Results In the 202 patients included in this study, we found statistically significant differences for obesity, hypertension, and asthma. The differences were predominant in the second wave. Moreover, a mixed distribution (central and peripherical) of pulmonary lesions was noted in the second wave, but no differences were noted regarding mortality, respiratory failure, complications, and other radiological and biological elements. Chest CT severity score was among the risk factors of mortality and respiratory failure. There was a mild agreement between AI and visual evaluation of pulmonary lesion extension (K = 0.4). Conclusions Between March and December 2020, in our cohort, for the majority of the parameters analyzed, we did not record significant changes between the two waves. AI can reduce the experience and performance gap of radiologists and better establish a hospitalization criterion.

6.
Int J Emerg Med ; 15: 3, 2022.
Article in English | MEDLINE | ID: mdl-35079294

ABSTRACT

Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more and more atypical presentations of COVID-19 are being reported. Here, we present and discuss non-convulsive status epilepticus (NCSE) as presenting symptom of SARS-CoV-2 infection at the Emergency Department.

7.
Hemodial Int ; 25(4): E44-E47, 2021 10.
Article in English | MEDLINE | ID: mdl-34133066

ABSTRACT

Neurological manifestations of coronavirus disease 2019 (COVID-19) often have tragic repercussions. Although many reports of neurological complications of severe acute respiratory syndrome coronavirus 2 infection exist, none of them are of patients on hemodialysis, who have a fivefold greater risk of stroke than the general population. In this report, we emphasize the importance of being vigilant for mild stroke in high risk populations-such as patients on hemodialysis-with COVID-19, since these conditions have overlapping symptoms.


Subject(s)
COVID-19 , Cognitive Dysfunction , Nervous System Diseases , Cognitive Dysfunction/etiology , Humans , Renal Dialysis/adverse effects , SARS-CoV-2
8.
Radiol Case Rep ; 15(10): 1829-1831, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32793325

ABSTRACT

We report a case of a middle-aged woman who presented to our emergency department with increasing headache in a nontraumatic setting. The presence of intracranial air was an unexpected finding on nonenhanced computed tomography (CT). CT and magnetic resonance imaging could not identify the origin of the bone defect responsible for pneumocephalus. CT cisternography was able to demonstrate the presence of a cerebrospinal fluid fistula resulting in pneumocephalus. This case highlights the role of CT cisternography to identify and localize small osseous defects and cerebrospinal fluid fistulas when CT and magnetic resonance imaging findings are normal.

SELECTION OF CITATIONS
SEARCH DETAIL
...