జర్నల్ ఆఫ్ క్లినికల్ కేస్ రిపోర్ట్స్

Adenoid cystic carcinoma is an uncommon tumour of the salivary and mucous glands which has been recognized for more than one hundred years. In 1359, Billroth originated the word cylindroma in describing histologically four salivary gland tumours, one of which had recurred nine times after excision over a twenty year period. The term cylindroma was in common usage until Foote and Frazell expressed their preference for the name adenoid cystic carcinoma in 1953. They credited the late James Ewing for having used that term for many years. The tumour has been variously referred to as “cylindroma,” “basiloma,” “adenocystic basiloid carcinoma,” and “adenoepithelioma”.

An 89 year old female with a history of myocardial infarction, chronic heart failure, hypertension, and atrial fibrillation was transferred to our institution with circulatory insufficiency. The patient had been undergone treatment for in-stent restenosis of the middle left ascending artery 1 week back. Her systolic blood pressure was 70 mm Hg with evident cyanosis over the whole body surface. Arterial blood gas analysis revealed severe metabolic acidosis and the patient exhibited severe hypovolemia. Initiation of dopamine therapy and transfusion ameliorated the circulatory failure. Three days after admission, she discharged massive bloody stools without absence of abdominal pain; colonoscopy revealed segmental pattern of mucosa necrosis in the sigmoid colon. Enhanced abdominal computed tomography revealed neither thrombus nor embolus in the mesenteric artery. Blood flow to the sigmoid colon was evident, prompting a diagnosis of non-occlusive mesenteric ischemia. Although emergency surgery was recommended, the patient declined and died of panperitonitis following conservative therapy. In addition to circulatory insufficiency caused by heart failure in this case, the intestinal ischemia also resulted from hypovolemia, diuretics and digitalis therapy, and arteriosclerosis.

Iodinated contrast medium, administered during several diagnostic tests may be frequent cause of anaphylactic reactions or rashes. Thrombocytopenia after injection of iodinated contrast medium is a most rare adverse event, but several published reports have shown that this complication is more common than previously thought. In patients with acute drug induced thrombocytopenia, antibody tests are often negative. Thrombocytopenia due to iodinated contrast medium is transient, but the patient is made sensitive to the drug; further examinations should therefore always be performed in the absence of iodinated contrast medium.

Abdominal tuberculosis continues to be a major problem in many regions of the world. The lack of specific signs and symptoms of abdominal tuberculosis involving the intestinal tract frequently leads to missed or delayed diagnosis. They are usually present with weight loss, abdominal pain and bowel disturbance or in severe complications like obstruction, perforation, and fistula formation. Though presenting as intussusceptions is uncommon hence we present such a case of Jejunojejunal intussusceptions caused by abdominal tuberculosis in a 16 year old male since it is an extremely rare complication.

Closed suction drainage is well accepted method of drainage of wounds. It prevents development of seroma, haematoma, wound dehiscence and leading to infection. There are different types of drainage of wound, like tube, corrugated rubber tube drainage, and negative suction drainage. We present to you the simplest negative suction drainage system by using readily available resources in the operation theatre, with no extra cost for innovation.

Background: Impacted foreign bodies in the esophagus can easily cause mucosal ulceration, inflammation and infections which may result in various fatal complications. Computed tomography was determined to be very useful in the diagnosis of impacted fish bones in the esophagus. Aim: Demonstrate incorrect imaging interpretation as result of enteric opacification following oral administration of medications. Case presentation: A seventy-seven year old woman was referred regarding odynophagia after eating fish. A computed tomography scan of the neck and chest showed a 5 cm long bone in the upper esophagus. However, rigid esophagoscopy failed to identify a bone. Amiodarone is fat-soluble iodine rich antiarrhythmic agent. In our case the high iodine content of amiodarone caused the deceptive computed tomography scan. Conclusion: Medications’ radio-opacification may confuse the physician while searching for foreign bodies.

Systemic Lupus Erythematosus (SLE) is an autoimmune collagen vascular disease, which produces widespread damage to multiple organs. The spectrum of cardiac vascular involvement in young SLE is not elucidated completely. This report mainly describes a 27 year old girl with 20 year history of SLE presenting with both AMI (acute myocardial infarction) and PAH. Coronary angiography shows stenosis in LAD (left anterior descending artery), and occlusion in LCX (left circumflex artery). The right heart catheterization showed elevated pulmonary artery pressure (93/32/57 mmHg); acute vasoreactivity testing was negative to adenosine. Prothrombotic conditions such as homocysteine, anti-cardiolipin antibody, lupus anticoagulant levels were all normal. This is the first case that CAD and PAH happened together in one lupus patient in literature reported.

Absence of one mullerian duct results in a unicornuate uterus with only one fallopian tube. Torsion of sufficient degree to arrest uterine circulation and produce an acute abdominal catastrophe is rare. We report a case of fallopian and ovarian tube agenesis with torsion of uterus. This combination of abnormalities has never been reported.

In adults, the gallbladder measures approximately 8 cm (3.1 in) in length and 4 cm (1.6 in) in diameter when fully distended. Deviation in the size of the gall bladder is common but mega size is rare. We present a rare case of mega gallbladder measuring 21×4 cm.