by Zainab Jalal, Asad Ullah, Ladan Mohammadi and Jeanne Spencer
Case Report
Thyrotoxic hypokalemic periodic paralysis (THPP) is a sporadic form of hypokalemic periodic paralysis (HPP), a rare disease which is manifested as painless muscle weakness in the presence of hyperthyroidism and hypokalemia. Our patient was recently diagnosed with hyperthyroidism due to Graves’ disease and was started on antithyroid therapy. He presented few months later with upper and lower extremity weakness along with finding of hypokalemia in the background of hyperthyroidism. He was given potassium replacement therapy with resolution of symptoms.
American Journal of Medical Case Reports. 2017, 5(2), 48-49. DOI: 10.12691/ajmcr-5-2-7
Pub. Date: March 07, 2017
7595 Views2944 Downloads
by Ali Al Mashani, Neeraj Salhotra, Azmat Ali, Munthir Al Zabin, Salim Al Abri, Arshad Kabir Khan and Ahmed Al Risi
Data Report
An extra rib arising from seventh cervical vertebra is termed as cervical rib. The condition is a congenital anomaly. Thoracic outlet syndrome is the common presentation. [1] Resection of the rib alleviate the symptoms. We present here our experience of cervical rib resection and a critical analysis of condition with literature review.
American Journal of Medical Case Reports. 2017, 5(2), 43-47. DOI: 10.12691/ajmcr-5-2-6
Pub. Date: March 04, 2017
14416 Views2855 Downloads
by Chaozer Er, Eunice Chua Shumin and Navin Kuthiah
Case Report
Peripheral arterial disease can be treated with angioplasty. Complications of percutaneous angioplasty include arterial occlusion, thromboembolism and arterial rupture. I report a case of lower limb proximal deep vein thrombosis (DVT) that developed 1 day after a peripheral arterial angioplasty via common femoral artery approach. My literature search failed to identify any previously reported cases. The incidence of DVT following coronary intervention via femoral artery catheterization was reported to be 0.05% but the incidence of DVT following peripheral angioplasty remains unknown. This case showed that DVT can happen after peripheral angioplasty and further studies should be conducted to document its incidence. This also raised the point if routine short course of anticoagulation is required after angioplasty of lower limb to prevent DVT.
American Journal of Medical Case Reports. 2017, 5(2), 41-42. DOI: 10.12691/ajmcr-5-2-5
Pub. Date: March 03, 2017
8722 Views2430 Downloads
by Pyong Wha Choi
Case Report
Mechanical ileus is a common condition that physicians encounter in the emergency room. Adhesions should be considered first in a patient with a history of surgery, and other causes of bowel obstruction, such as colorectal cancer can be in the differential diagnosis. However, an unusual cause of mechanical ileus can make diagnosis difficult. Internal hernia is a representative unusual condition that is difficult to diagnose preoperatively. Here, we present a case of broad ligament hernia with strangulated small bowel obstruction. A 41-year-old woman presented with abdominal pain and distension since 3 days. Plain abdominal X-ray showed a loop of dilated bowel without free air. Emergent computed tomography revealed diffuse dilatation in the proximal-to-mid-ileal loop, with an abrupt luminal narrowing at the mid-ileum, but there was no evidence of bowel ischemia. Despite conservative management, the symptoms worsened, and peritoneal signs were apparent. During the operation, the terminal ileum was found to be herniated into a defect of the broad ligament. Because gangrenous changes were present, the incarcerated bowel was resected; an end-to-end anastomosis was performed, and the defect of the broad ligament was closed. This was an unusual case of internal hernia that could not be preoperatively diagnosed. Although the preoperative diagnosis was difficult because of its rarity, a high degree of suspicion is necessary; this diagnosis should be included in the differential evaluation of a female patient with mechanical ileus.
American Journal of Medical Case Reports. 2017, 5(2), 38-40. DOI: 10.12691/ajmcr-5-2-4
Pub. Date: March 03, 2017
10813 Views3400 Downloads
by Samasuk Thammachantha, Pichest Metarugcheep and Yodkhwan Wattanasen
Case Report
Cholesterol granuloma is chronic inflammatory lesion of head and neck region, caused by bleeding of mucosal vessels of paranasal sinus. Histologically, the lesion shows aggregate of cholesterol crystals surrounded by foreign-body giant cell reaction. The symptoms vary depending on location of an expansile mass and Magnetic resonance imaging (MRI) are helpful in distinguish this disease from mucocoele. We present a case of cholesterol granuloma in the right sphenoid sinus of a 52-year-old man, with the oculomotor nerve dysfunction but sparing pupillary reflex.
American Journal of Medical Case Reports. 2017, 5(2), 35-37. DOI: 10.12691/ajmcr-5-2-3
Pub. Date: February 27, 2017
7595 Views2021 Downloads
by Abid Shah, Maihemuti Axiyan, Erol Nargileci, Adam Schussheim, Robert Fishman and Greg Marrinan
Case Report
Cocaine remains one of the most commonly abused drugs in the United States and ingestion often presents with chest pain. The American Heart Association (AHA) published guidelines in 2008 on cocaine associated myocardial infarction (MI) to help assess and manage patients with obstructive coronary artery disease (CAD) in a timely manner. Cocaine may cause MI through increased platelet activation or through coronary vasoconstriction and spasm. However, cocaine induced myocarditis presenting as ST elevation myocardial infarction (STEMI) is uncommon. We report a case of a 35-year-old male with no significant medical history who presented with an 8-hour history of central chest pain. The patient admitted to ingesting cocaine within the last 8 hours and urine toxicology was positive for cocaine metabolites. EKG showed ST segment elevations in leads I and aVL and the patient was taken urgently for coronary angiography. Coronary angiography revealed no significant obstructive CAD. Transthoracic echocardiogram showed mildly reduced left ventricular ejection fraction (LVEF) and Cardiac MRI showed late gadolinium enhancement of the inferior and septal segments consistent with myocarditis. Cardiac MRI with contrast is a useful modality in differentiating ischemic from non- ischemic causes of STEMI after cardiac catheterization.
American Journal of Medical Case Reports. 2017, 5(2), 32-34. DOI: 10.12691/ajmcr-5-2-2
Pub. Date: February 23, 2017
12499 Views4340 Downloads
by Nishant Tripathi and Niki Koirala
Case Report
Prolonged erection is a relatively uncommon phenomenon and can become a medical emergency if it progresses to priapism. Even though appropriate management of priapism and prolonged erection supports early involvement of urologists, this may not always be feasible due to unavailability of these specialists. In such scenarios, conservative non-surgical methods must be attempted. However, very few guidelines and evidence-based treatment modalities exist in the literature making management of prolonged erection conjectural and challenging. Here we describe a case of prolonged erection successfully resolved with subcutaneous terbutaline.
American Journal of Medical Case Reports. 2017, 5(2), 29-31. DOI: 10.12691/ajmcr-5-2-1
Pub. Date: February 21, 2017
6866 Views2165 Downloads