1/44. Neurally mediated syncope in 2 patients with extracardiac disease.We describe the cases of 2 patients with repetitive episodes of syncope with profound bradycardia and hypotension. In both patients, the symptoms were initially thought to be neurally mediated and idiopathic but were ultimately determined to be triggered by serious underlying pathologic processes: a massive and locally invasive tumor of the hypopharynx in 1 patient and a gangrenous gallbladder in the other. Appropriate treatment resulted in a resolution of this syndrome in both patients. These cases emphasize the importance of an appropriate evaluation and broad differential diagnoses for patients with severe bradycardia and hypotension.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/44. Monoclonal cryoglobulinemia with extensive gangrene of all four extremities--a case report.The monoclonal immunoglobulin products of plasma cell neoplasm can give rise to a variety of manifestations including hyperviscosity, amyloidosis, cryoglobulinemia, neuropathy, and renal failure. A 50-year-old woman with monoclonal cryoglobulinemia developed extensive gangrene and ulceration of both hands and feet over several weeks requiring bilateral below-elbow and below-knee amputations. This case illustrates the importance of qualitative properties of paraprotein.- - - - - - - - - - ranking = 4.0856632994016E-5keywords = neoplasm (Clic here for more details about this article) |
3/44. Venous gangrene in a patient with adenocarcinoma of the lung.Cancer-related thromboembolism is a severe but not uncommon paraneoplastic syndrome in mucinous cancer patients. However, cancer-induced venous gangrene is extremely rare and has never been reported in the English literature. Here, we present a case of lung cancer complicated with venous gangrene of the left foot. An elevated serum anticardiolipin level was detected during hospitalization, but the patient's clinical condition stabilized after heparinization. We suggest that in cancer patients, an elevated serum anticardiolipin antibody level might be a warning sign of an impending thrombotic event and that low-molecular-weight heparin is a sensible choice in treating this kind of cancer-related thromboembolism.- - - - - - - - - - ranking = 0.0030894676183747keywords = cancer (Clic here for more details about this article) |
4/44. Acute torsion of the gallbladder: review of the literature and report of a case.A case report is presented, and the literature reviewed, of acute torsion of the gallbladder. Originally described as a rare pathological entity, it is being witnessed more frequently as a probable concomitant of increasing life expectancy. Because it is a benign condition if diagnosed rapidly and treated surgically, it should be considered in differential diagnostic possibilities. When encountered intraoperatively, prompt recognition of the process should lead to detorsion of the organ and cholecystectomy as the procedure of choice.- - - - - - - - - - ranking = 5keywords = gallbladder (Clic here for more details about this article) |
5/44. gallbladder torsion: case report and review of the literature.Torsion of the gallbladder is a surgical emergency, occurring mainly in the elderly. female is predominant to male with ratio 3 to 1. Despite its unknown etiology, the anatomical variations in the attachment of gallbladder which occur on the mobile mesentery to the inferior margin of the liver are usually found. When the gallbladder twists around the cystic duct and artery, torsion takes place with ensuing occlusion of the flow of bile and blood. Preoperative diagnosis is difficult to make; however, patients who receive prompt surgical treatment with cholecystectomy always get excellent outcomes. mortality rate is low with 3% to 5%. Here, we report on elderly male patient with gallbladder torsion at our hospital and review the existing literature.- - - - - - - - - - ranking = 4keywords = gallbladder (Clic here for more details about this article) |
6/44. Venous limb gangrene during warfarin treatment of cancer-associated deep venous thrombosis.BACKGROUND: The cause of cancer-associated venous limb gangrene is unknown but could paradoxically be due to warfarin. OBJECTIVE: To determine the pathogenesis of venous gangrene in a patient with cancer. DESIGN: Case report. SETTING: University hospital in ontario, canada. PATIENT: 66-year-old woman with metastatic lung cancer and deep venous thrombosis. MEASUREMENTS: Levels of vitamin k-dependent factors, additional coagulation factors, and thrombin-antithrombin complexes (marker of thrombin generation). RESULTS: During warfarin use, venous limb gangrene developed when the international normalized ratio (INR) reached 6.0 (therapeutic range, 2.0 to 3.0); at this time, the level of protein c (a vitamin k-dependent natural anticoagulant) was severely reduced, but thrombin-antithrombin complexes remained markedly elevated. The supratherapeutic INR was explained by the greatly reduced levels of factor vii, which correlated closely with protein c levels; therefore, the high INR was a surrogate marker for severely reduced protein c activity. CONCLUSION: warfarin may contribute to the pathogenesis of cancer-associated venous limb gangrene by leading to severe depletion of protein c while at the same time failing to reduce thrombin generation.- - - - - - - - - - ranking = 0.0049431481893995keywords = cancer (Clic here for more details about this article) |
7/44. abdominal wall sinus due to impacting gallstone during laparoscopic cholecystectomy: an unusual complication.During laparoscopic cholecystectomy, perforation of the gallbladder can occurs in < or = 20% of cases, while gallstone spillage occurs in < or = 6% of cases. In most cases, there are no consequences. gallstones can be lost in the abdominal wall as well as the abdomen during extraction of the gallbladder. The fate of such lost gallstones, which can lead to the formation of an abscess, an abdominal wall mass, or a persistent sinus, has not been studied adequately. Herein we report the case of a persistent sinus of the abdominal wall after an emergent laparoscopic cholecystectomy in an 82-year-old woman with gangrenous cholecystitis and perforation of the friable wall in association with an empyema of the gallbladder. The culture of the obtained pus was positive for escherichia coli. After a small leak of dirty fluid from the wound of the epigastric port site of 4 months' duration, surgical exploration under local anesthesia revealed that the sinus was caused by spilled gallstones impacting into the abdominal wall between the posterior sheath and left rectus abdominalis muscle. The removal of the stones resulted in complete healing. Long-term complications after laparoscopic cholecystectomy involving the abdominal wall are rare but important possible consequences that could be avoided.- - - - - - - - - - ranking = 3keywords = gallbladder (Clic here for more details about this article) |
8/44. Acute gangrenous colitis proximal to obstructive cancer of the sigmoid colon.Two cases of massive gangrenous inflammation of the colon proximal to obstructive carcinomatous lesions, the so-called obstructive colitis, are reported. Because of the rarity of this condition, the etiological factors responsible for this entity are not yet clear. The detailed pathological and microbiological studies at the time of operation are essential to their further clarification.- - - - - - - - - - ranking = 0.0024715740946998keywords = cancer (Clic here for more details about this article) |
9/44. Acalculous gangrenous cholecystitis in a young adult: a gastrointestinal manifestation of polyarteritis nodosa.The authors report a rare case of an acalculous gangrenous cholecystitis due to a form of vasculitis, polyarteritis nodosa (PAN). An 18-year-old man was admitted to the hospital with worsening symptoms of nausea, fever, intermittent abdominal pain, and high blood pressure that lasted for 4 days. After a sequential work-up, a diagnostic laparoscopy was performed and revealed a gangrenous cholecystitis with spontaneous perforation. Laparoscopic cholecystectomy was performed successfully. The patient had an uneventful recovery period and was discharged on the second postoperative day. The histopathologic examination showed gangrenous and perforated gallbladder, vasculitis, and clues of PAN. The purpose of this article is to describe a rare condition in a young patient that was diagnosed and treated with minimally invasive surgery.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
10/44. Digital ischemia and gangrene preceding renal neoplasm. An association with sarcomatoid adenocarcinoma of the kidney.A 63-year-old woman had acute onset of rapidly progressive Raynaud phenomenon and digital gangrene. Prior to the detection of a sarcomatoid renal carcinoma, prominemt hypergammaglobulinemia, microhematuria, and weight loss were noted. Following nephrectomy, the patient showed improvement of the Raynaud phenomenon, with complete healing of digital ulcers and decrease of gama-globulin levels. Immunofluroescence studies demonstrated substantial deposits of IgG that lined the tumor cells in a linear and diffuse pattern. Electron-dense deposits were seen in the endothelium of arterioles int the tumor by electron microscopy. These findings suggest that antibodies to tumor antigens may have participated in the induction of digital vasculitis and Raynaud phenomenon.- - - - - - - - - - ranking = 0.00016342653197607keywords = neoplasm (Clic here for more details about this article) |
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