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    15851 results match your criteria BMJ Case Reports [Journal]

    1 OF 318

    Pentobarbital-induced lactic acidosis following status epilepticus barbiturate coma.
    BMJ Case Rep 2018 Feb 22;2018. Epub 2018 Feb 22.
    Department of Medicine, University of Arizona, Tucson, Arizona, USA.
    We present a rare case of pentobarbital infusion causing propylene glycol-induced lactic acidosis, during refractory status epilepticus treatment in a 66-year-old man without seizure history. Read More

    Dieulafoy's lesion of the duodenum: a comparative review of 37 cases.
    BMJ Case Rep 2018 Feb 22;2018. Epub 2018 Feb 22.
    SUNY Downstate Medical Center, Brooklyn, NY, USA.
    Dieulafoy's lesion is an abnormally large, tortuous, submucosal vessel that erodes the overlying epithelium without primary ulceration or erosion. The lesion predominantly occurs in the proximal stomach but it is also reported in extragastric sites. The pathogenesis and precipitating factors are poorly understood. Read More

    Prolonged paralysis with atracurium use in a patient with Rubinstein-Taybi syndrome.
    BMJ Case Rep 2018 Feb 22;2018. Epub 2018 Feb 22.
    Medical Based Department, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
    Rubinstein-Taybi syndrome (RTS) is a rare autosomal dominant disorder that occurs due to a microdeletion of chromosome 16p13. The craniofacial abnormalities in these patients may pose a challenge for anaesthetist performing tracheal intubation. However, there are no known reported cases of drug interaction with non-depolarising muscle relaxant in patients with RTS. Read More

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    BMJ Case Rep 2018 Feb 22;2018. Epub 2018 Feb 22.
    Department of Internal Medicine, Michigan State University, Lansing, Michigan, USA.
    is a rapidly growing mycobacterium which is known to respond well to standard antibiotic treatment regimen. There are no specific guidelines for treatment. Antibiotics are chosen based on the bacterial sensitivity. Read More

    Budd-Chiari syndrome in a patient with ulcerative colitis.
    BMJ Case Rep 2018 Feb 22;2018. Epub 2018 Feb 22.
    Department of Radiodiagnosis, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
    We report a case of 26-year-old man who was admitted on our ward for the evaluation of ascites. He was a known case of inflammatory bowel disease(ulcerative colitis) and was on regular mesalamine therapy. On evaluation, he was having high serum ascites albumin gradient. Read More

    A womb like a broken heart.
    BMJ Case Rep 2018 Feb 22;2018. Epub 2018 Feb 22.
    Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
    Uterine perforation during hysteroscopic operative procedures is a potential complication well known to gynaecologists. Uterine septa are a commonly encountered Müllerian anomaly related to pregnancy loss and infertility. Hysteroscopic resection of septa has shown to improve pregnancy outcome. Read More

    Bullous eyelid.
    BMJ Case Rep 2018 Feb 22;2018. Epub 2018 Feb 22.
    Postgraduate Medicine, University of Toronto, Toronto, Canada.
    Periocular necrotising fasciitis is a rare but sight-threatening condition, which relies on clinical judgement to detect in a timely manner. A 51-year-old woman presented to a rural hospital with rapid onset bilateral eye swelling, erythema and pain and was started on broad spectrum intravenous antibiotics. Upon admission, she became septic and required fluid resuscitation and transfer to a higher level of care. Read More

    Gastric and duodenal ischaemia after transarterial chemoembolisation for hepatocellular carcinoma: an unexpected but significant complication.
    BMJ Case Rep 2018 Feb 21;2018. Epub 2018 Feb 21.
    Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.
    Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented with a gastrointestinal bleed from TACE. Read More

    Successful perioperative management in a patient with factor XI deficiency.
    BMJ Case Rep 2018 Feb 21;2018. Epub 2018 Feb 21.
    Hematology-Oncology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
    Factor XI (FXI) deficiency is an autosomal disorder which manifests as bleeding of varying severity. While homozygotes typically experience more dramatic bleeding symptoms, heterozygotes may experience clinically significant bleeding following surgical procedures or trauma, and therefore the condition is not purely recessive. The clinical significance of FXI deficiency is complicated in that FXI levels do not correlate well with bleeding severity, and in fact the bleeding risk is variable even for an individual in response to different haemostatic challenges. Read More

    A child with tubulointerstitial nephritis and uveitis (TINU) syndrome.
    BMJ Case Rep 2018 Feb 17;2018. Epub 2018 Feb 17.
    Unidade de Nefrologia e Transplantação Renal Pediátrica, Departamento de Pediatria, Hospital de Santa Maria - Centro Hospitalar de Lisboa Norte, Lisboa, Portugal.
    Tubulointerstitial nephritis and uveitis syndrome is an uncommon disease, probably underdiagnosed in clinical practice. Its aetiology and pathogenesis remain unknown. This syndrome is defined by an association of uveitis and tubulointerstitial nephritis, with no evidence of systemic disease or infection that might cause both ocular and renal inflammation. Read More

    Takotsubo syndrome in a premenopausal patient.
    BMJ Case Rep 2018 Feb 17;2018. Epub 2018 Feb 17.
    Internal Medicine Functional Unit 2.5, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal.
    Takotsubo syndrome is a rare clinical condition, with a pathophysiology that is not fully understood. Characterised by an acute and usually reversible heart failure, the condition is often preceded by a stressful event. For the diagnosis of Takotsubo syndrome to be possible, the absence of coronary artery disease as a cause is required. Read More

    A quintessential syndrome with a rare marvelling aetiology: Rosai-Dorfman disease presenting as Conus-Cauda syndrome.
    BMJ Case Rep 2018 Feb 17;2018. Epub 2018 Feb 17.
    Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
    A 19-year-old woman presented with a history of severe lower backache and asymmetric proximal lower limb weakness during the past 3 months. In addition, she also suffered from lower motor neuron-type bladder and bowel symptoms. On examination, paraparesis was noted. Read More

    Disabling pansclerotic morphoea of childhood.
    BMJ Case Rep 2018 Feb 17;2018. Epub 2018 Feb 17.
    Department of Nephrology, University of Florida College of Medicine, Gainesville, Florida, USA.
    Disabling pansclerotic morphoea (DPM) of childhood is a severe and often fatal variant of deep morphoea. It usually starts in childhood and rarely seen in adults. The course of the disease is progressive with lifelong morbidity in the form of joint contractures and immobility. Read More

    NMDAR (N-methyl-D-aspartate receptor) encephalitis in a patient with MS (multiple sclerosis): a rare and challenging case.
    BMJ Case Rep 2018 Feb 17;2018. Epub 2018 Feb 17.
    Liaison Psychiatry, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK.
    We present a rare case of N-methyl-D-aspartate receptor (NMDAR) encephalitis in a 41-year-old Caucasian woman, who initially presented with prominent neuropsychiatric symptoms on the background of pre-existing multiple sclerosis. Here, the authors navigate the muddy water between neurology and psychiatry, describing the caveats of antibody testing with a misdiagnosed case of acute and transient psychotic episode. NMDAR encephalitis in MS is a rare condition, which can be easily confused with a new onset psychotic episode. Read More

    Late diagnosis: a case of rapidly progressive extranodal NK/T cell lymphoma, nasal type.
    BMJ Case Rep 2018 Feb 17;2018. Epub 2018 Feb 17.
    General Internal Medicine, Kakogawa Chuo Shimin Hospital, Kakogawa, Hyogo, Japan.
    Extranodal natural killer (NK)/T cell lymphoma, nasal type is a condition that has poor prognosis. Accurate diagnosis of lymphoma is made by pathological findings. We report a case of extranodal NK/T cell lymphoma, nasal type affecting the lung and liver and which was difficult to diagnose because of negative biopsy results from multiple sites. Read More

    When a polyp is not a polyp: incidental finding of a sigmoid schwannoma at first colonoscopic screening.
    BMJ Case Rep 2018 Feb 17;2018. Epub 2018 Feb 17.
    Department of Surgery, Albany Stratton VA Medical Center, Albany, New York, USA.
    Schwannomas, peripheral nerve sheath tumours arising from Schwann cells, are often associated with inherited disorders such as neurofibromatosis. Gastrointestinal schwannomas, while rare, have been reported in those without personal or family history of neurofibromatosis. Diagnoses of these lesions, however, typically follow evaluations prompted by symptomatic presentations associated with abdominal pain, rectal bleeding, change in bowel habits or positive results on faecal occult blood tests performed for colorectal cancer screening. Read More

    Bladder necrosis: 'A man without a bladder'.
    BMJ Case Rep 2018 Feb 17;2018. Epub 2018 Feb 17.
    Department of Urology, VU University Medical Center, Amsterdam, The Netherlands.
    Since the use of antibiotics, bladder necrosis has become a rare condition. We report a case of bladder necrosis in a 90-year-old man following urinary retention. After insertion of a transurethral catheter (TUC), 2 L of urine was evacuated. Read More

    Renal nutcracker syndrome in a young lady: unusual findings and endovascular management.
    BMJ Case Rep 2018 Feb 16;2018. Epub 2018 Feb 16.
    Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
    Nutcracker syndrome (NCS) is caused by compression of left renal vein (LRV), usually between the aorta and the superior mesenteric artery (SMA). This can lead to obstruction of flow into the inferior vena cava and secondary left renal venous hypertension. Despite potential serious consequences, diagnosing NCS is often challenging, circuitous and commonly delayed. Read More

    The cat did it: erythema nodosum and additional atypical presentations ofinfection in immunocompetent hosts.
    BMJ Case Rep 2018 Feb 16;2018. Epub 2018 Feb 16.
    Medicine, Laniado Hospital, Sanz Medical Centre, Netanya, Israel.
    A healthy patient presented with painful skin lesions on the anterior surface of her legs. Erythema nodosum was diagnosed but all the usual causes were ruled out. The finding of bilateral enlarged axillary lymph nodes with necrosis and granulomas led to the diagnosis ofinfection, an unusual cause of erythema nodosum. Read More

    Implant of a left atrial appendage occluder device (Watchman) and leadless pacing system (Micra) through the same venous access in a single sitting.
    BMJ Case Rep 2018 Feb 16;2018. Epub 2018 Feb 16.
    Gleneagles JPMC & Cardiac Centre RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam.
    A left atrial appendage occluder device (Watchman) and leadless pacemaker (Micra) was implanted from a single right femoral vein access in a 73-year-old female patient with persistent atrial fibrillation and symptomatic tachy-brady syndrome and unable to take oral anticoagulants. Standard methods of implantation were followed for both procedures. The Watchman device was implanted first followed by dilatation of the same venous access site in order to implant Micra transcatheter pacing system. Read More

    Fistulation between a colonic J-Pouch and the upper vagina in an irradiated pelvis: a rare complication following low anterior resection with colonic J-pouch anal anastomosis for rectal cancer.
    BMJ Case Rep 2018 Feb 16;2018. Epub 2018 Feb 16.
    Department of General Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
    Formation of a colonic J-pouch with anastomosis to the rectal stump is an accepted form of reconstruction after low anterior resection (LAR) for rectal carcinoma. It is thought this can help prevent the onset of LAR syndrome as well as improve the quality of life in the first two years following surgery. Rectovaginal fistulation is a recognised complication of this form of surgery usually occurring because of technical failure leading to inclusion of the vaginal wall into the stapled anastomosis. Read More

    Polymicrobial bacterial pericarditis and cardiac tamponade caused by pericardial penetration of an adjustable gastric band.
    BMJ Case Rep 2018 Feb 16;2018. Epub 2018 Feb 16.
    Department of Cardiology, Haaglanden Medical Centrum, The Hague, Netherlands.
    We describe a case of polymicrobial bacterial pericarditis withand, caused by pericardial penetration of the tip of the catheter of a laparoscopic adjustable gastric band (LAGB). The patient developed a cardiac tamponade, and subsequently emergency pericardiocentesis was performed. Analysis of earlier CT scans showed that the tip of the catheter had migrated through the liver and through the diaphragm into the pericardium, and was in contact with the myocardium. Read More

    Recurrent epistaxis leading to diagnosis of primary sinonasal melanoma.
    BMJ Case Rep 2018 Feb 16;2018. Epub 2018 Feb 16.
    Internal Medicine, Saint Joseph Mercy Ann Arbor Hospital, Ypsilanti, Michigan, USA.
    A 48-year-old man presented to urgent care with recurrent epistaxis over 6 months. Initially, nosebleeds were controlled with packing or cautery. Ultimately, he was referred to ear, nose and throat department and underwent nasal endoscopy which revealed polypoid tissue. Read More

    Fungal liver abscess in an immunocompetent patient who underwent repeated ERCPs and subtotal cholecystectomy.
    BMJ Case Rep 2018 Feb 15;2018. Epub 2018 Feb 15.
    Department of Gastroenterology, Homerton University Hospital NHS Foundation Trust, London, UK.
    We report a case of a previously healthy female patient who initially presented with fever, jaundice and right upper quadrant pain three days after dilatation and stenting of a stricture of the common bile duct (CBD). During an earlier admission, the patient had undergone endoscopic retrograde cholangiopancreatography (ERCP) having presented with fevers and biliary dilatation on ultrasound. The ERCP features were more consistent with Mirizzi's Syndrome. Read More

    Salvage from cervical dystocia in third degree uterovaginal prolapse: Duhrssen's incision.
    BMJ Case Rep 2018 Feb 14;2018. Epub 2018 Feb 14.
    Department of Obstetrics and Gynaecology, King Georges Medical University Lucknow, Lucknow, India.
    We present a case of a 28-year-old woman second gravida with a full-term pregnancy who presented to us in active phase of labour with third degree uterovaginal prolapse complicated by entrapment of fetal head by dystocia of cervix and fetal distress. Patient was immediately shifted to the operation theatre and prompt delivery was conducted by giving Duhrssen's incision on the highly vascular, oedematous prolapsed cervix. The outcome was an alive and healthy male baby. Read More

    Biopsy-proven multiple sclerosis in an adult patient with atypical craniometaphyseal dysplasia.
    BMJ Case Rep 2018 Feb 14;2018. Epub 2018 Feb 14.
    Unit of Genetics of Neurodegenerative and Metabolic Diseases, IRCCS Fondazione "Istituto Neurologico C Besta", Milano, Italy.
    Craniometaphyseal dysplasia (CMD) is a rare condition characterised by progressive, diffuse hyperostosis of cranial and long bones, with compression of cranial nerves, linked to mutations inorgenes. Here we describe an adult case with clinical features of CMD, who developed cerebral expansive lesion of undetermined nature. Brain biopsy revealed active demyelinating lesions, consistent with multiple sclerosis. Read More

    Agenesis of dorsal pancreas in a young adult: a rare cause of diabetes mellitus.
    BMJ Case Rep 2018 Feb 14;2018. Epub 2018 Feb 14.
    Department of Medicine, Chhatrapati Shahuji Maharaj Medical University (King George Medical University), Lucknow, India.
    Dorsal pancreatic agenesis is an extremely rare entity characterised by absence of body and tail of pancreas, while there are so many other developmental anomalies of the pancreas that have been reported. Here we report a 25-year-old young man who presented with pain in the abdomen, recurrent loose stools and hyperglycaemia. On radiological imaging study, there was complete agenesis of the dorsal pancreas except for thin stripe of tissue at the level of the uncinate process. Read More

    Isolated bladder schwannoma: a rare presentation.
    BMJ Case Rep 2018 Feb 14;2018. Epub 2018 Feb 14.
    Department of Urology, Frimley Health NHS Foundation Trust, Slough, UK.
    Bladder schwannoma is a rare tumour arising from Schwann cells in nerve sheaths. It is usually more common in patients diagnosed with neurofibromatosis. However, isolated cases of urinary bladder schwannoma is incredibly rare, attributing to <0. Read More

    Intestinal obstruction caused by a strangulating adnexa: a rare complication of ovarian sparing hysterectomy.
    BMJ Case Rep 2018 Feb 14;2018. Epub 2018 Feb 14.
    Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
    Intestinal obstruction caused by a remnant fallopian tube from previous hysterectomy is a rare entity that has been reported once in the literature. We report the case of a 61-year-old woman who presented with both small and large bowel obstructions caused by a strangulating remnant fallopian tube. She had an ovarian sparing hysterectomy 16 years ago and was diagnosed with antiphospholipid syndrome. Read More

    Localised nasopharyngeal amyloidosis: the importance of postoperative follow-up.
    BMJ Case Rep 2018 Feb 14;2018. Epub 2018 Feb 14.
    Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
    Localised nasopharyngeal amyloidosis is rare. Findings on physical examination and invasive pattern on CT scan can be misleading as it can resemble nasopharyngeal carcinoma. A 64-year-old man presented with left aural fullness for 6 months. Read More

    Giant cell tumour of the patella with local recurrence: successful management with excision, curettage and artificial bone grafting.
    BMJ Case Rep 2018 Feb 14;2018. Epub 2018 Feb 14.
    Newcastle University, Newcastle upon Tyne, UK.
    Primary patellar neoplasms are rare, comprising 0.12% of primary bone tumours; thus, no standardised treatment related to staging exists. 70%-90% of primary patellar neoplasms are benign or intermediate with giant cell tumour (GCT) being the most common. Read More

    Acute rheumatic fever presenting as complete heart block: report of an adolescent case and review of literature.
    BMJ Case Rep 2018 Feb 11;2018. Epub 2018 Feb 11.
    Cardiology, All India Institute of Medical Sciences, Newdelhi, India.
    A 14-year-old boy suffering from chronic rheumatic heart disease came to the emergency department with recurrent episodes of presyncope and syncope. He was found to have complete heart block (CHB) and required temporary pacemaker insertion. Further workup revealed that CHB was secondary to acute rheumatic carditis. Read More

    Spontaneous pneumomediastinum.
    BMJ Case Rep 2018 Feb 11;2018. Epub 2018 Feb 11.
    ENT, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
    Spontaneous pneumomediastinum is the presence of free air within the mediastinum that is not associated with trauma. It is a rare, self-limiting condition that can cause widespread subcutaneous surgical emphysema. We present the case of a 12-year-old boy who presented with widespread spontaneous surgical emphysema and pneumomediastinum, with no history of trauma or respiratory tract disease. Read More

    Bilobed gallbladder: a rare congenital anomaly.
    BMJ Case Rep 2018 Feb 11;2018. Epub 2018 Feb 11.
    Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.
    Bilobed gallbladder is a rare form of duplication of gallbladder. Preoperative diagnosis is important to avoid peroperative complications; however, it is also a challenge as imaging reports are often confounding. A case of bilobed gallbladder managed successfully laparoscopically is presented. Read More

    'If there were water we should stop and drink': neurofibromatosis presenting with diabetes insipidus.
    BMJ Case Rep 2018 Feb 11;2018. Epub 2018 Feb 11.
    Department of Neurology, Mercy University Hospital, Cork, Ireland.
    A 58-year-old right-handed woman presented to our institution with a 1-month history of polydipsia and polyuria. She had a remote history of neurofibroma excision by dermatology and, on examination, was noted to meet the clinical diagnostic criteria for neurofibromatosis type 1. Laboratory investigations revealed hypernatraemia and elevated serum osmolality, accompanied by reduced urinary osmolality. Read More

    Atypical presentation of atypical haemolytic uraemic syndrome.
    BMJ Case Rep 2018 Feb 11;2018. Epub 2018 Feb 11.
    Department of Pediatrics, Stony Brook University Hospital, Stony Brook, New York, USA.
    A 17-year-old girl presented with fever, myalgia, vomiting for 1 month and oliguria and dyspnoea for 4 days. She was tachycardic,hypertensive, with pedal oedema and decreased breath sounds. She had high serum creatinine (3 mg/dL), anaemia, thrombocytopenia, leucocytosis and eosinophilia with schistocytes. Read More

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