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1.
Ann Med Surg (Lond) ; 85(11): 5816-5819, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37915630

RESUMO

Introduction: Idiopathic occlusion of the Foramen of Monro is extremely rare in adults. The occlusion is classified into four types, with the first being the most infrequent. This condition induces noncommunicating hydrocephalus with the ensuing increased intracranial pressure symptoms. Headache is usually the chief complaint. Presentation of the case: The authors present a case of a 28-year-old female who presented with a chronic headache that was unresponsive to analgesics. No other neurological deficits were present. Fundoscopic examination revealed the presence of bilateral papillary edema. Computed tomography scan results showed bilateral enlargement of the lateral ventricles of the brain. A subsequent MRI scan ruled out secondary causes of occlusion, such as colloid cysts, meningiomas, or choroid plexus tumors, which entailed an idiopathic etiology.Treatment options include ventriculoperitoneal shunt insertion and septostomy with foraminoplasty. The former option is currently the treatment of choice, yet it is notorious for its ramifications, including foreign body reaction, breakage, and mechanical problems. The latter option is free of these risks; however, it requires meticulousness and precision to avoid damaging the fornix, which leads to impaired memory function. Conclusion: Septostomy with unilateral foraminoplasty could yield better outcomes if it is performed fastidiously.

2.
Int J Surg Case Rep ; 111: 108833, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37776684

RESUMO

INTRODUCTION: The implantation of a fertilized ovum outside of the normal uterine cavity is referred to as ectopic pregnancy, most frequently in the fallopian tube. Unilateral tubal twins are a rare diagnosis since they occur in around 1 in 125,000 spontaneous pregnancies. PRESENTATION OF CASE: We report a case of A 39 -year- old female (Gravida 6, para 6) who presented to the emergency department with continuous abdominal pain and with vaginal bleeding, Transvaginal Ultrasound,and positive hCG levels suggested having an ectopic pregnancy that was managed by surgical laparotomy that revealed a twin ectopic pregnancy. DISCUSSION: By using transvaginal ultrasound and urine/serum beta-human chorionic gonadotropin (bHCG) tests, early ectopic pregnancy identification has improved, reducing related morbidity and death. In our case, a gestational sac was detected during a vaginal ultrasound and the high level of bHCG (63,000) suggested an ectopic pregnancy. Surgical management was chosen because the pregnant sac was on the verge of bursting. CONCLUSION: This case serves as a reminder of the importance of considering the potential for having twin ectopic pregnancies.

3.
Ann Med Surg (Lond) ; 85(7): 3630-3633, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37427163

RESUMO

Intussusception is a common finding among children. Conversely, it is infrequent in adults. Colonic lipomas are generally clinically silent making them a very rare aetiology of intussusception. Presentation of case: The authors present a case of a 48-year-old male who presented to the emergency department suffering from severe abdominal pain. Following examination and investigations, a giant lipoma (GL) in the transverse colon was identified via ultrasound which showed the classical "target sign" Intussusception among adults is unusual as it accounts for only 1% of bowel obstruction cases. Being colo-colonic makes it even more unlikely since it occurs only in 17% of intestinal obstruction cases. GLs exceeding 5 cm in size can present with a variety of symptoms. Intussusception is an uncommon presentation of a GL. Preoperative diagnosis of GL-induced intussusception is highly improbable and surgical resection is the treatment of choice. Conclusion: Despite the dominance of the asymptomatic presentation of lipomas, considering its diagnosis in the case of an intussusception-induced acute abdomen should cross physicians' minds.

4.
Ann Med Surg (Lond) ; 78: 103885, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35734664

RESUMO

Introduction and importance: Double gallbladders are a rare anomaly occur in biliary system during the fetal life. In most cases they are asymptomatic, but in few patients, they can progress as a sever disease. Preoperative diagnose is essential in order to prevent surgery complexities and prevent the undesired complications. Case presentation: We described a typical case of symptomatic duplicate gallbladder in a 42-year-old man who suffered from chronic abdominal symptoms without determining the cause. The accessory gallbladder was discovered by imagining screening tools which included ultrasound and magnetic resonance cholangiopancreatography and was treated successfully with laparoscopic cholecystectomy, where both gallbladders were removed without any complications. Clinical discussion: Double gallbladder are rare abnormality occur in fetal life during the fifth and sixth weeks of pregnancy. In most cases they show zero symptoms and can be easily wandered off during typical preoperative screening. Therefor many diagnostic tools were developed to investigate this anomaly in order to prevent its unwanted outcomes and to help the surgeon in deciding the best surgical approach for each presenting case. Conclusion: In order to prevent complications during surgery, it is vital that we investigate the presence of a double gallbladder in a surgical patient before the procedure.

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