Open Access Case Study

Laparoscopic Salvage of Obstructed and Displaced Peritoneal Dialysis Catheter - Case Study

Jurij Janež

International Journal of Medical and Pharmaceutical Case Reports, Page 1-6
DOI: 10.9734/IJMPCR/2017/37981

This paper presented a case of a young male patient with end-stage renal failure, treated with chronic peritoneal dialysis, who was referred to our department due to peritoneal dialysis catheter malfunction, which was laparoscopically inserted three month earlier also in our institution. Diagnostic laparoscopy was performed. The catheter tip was displaced from pelvic region and was also wrapped with omentum. Laparoscopic salvage of the catheter was performed succsessfully. The postoperative course was uneventful and the catheter remained fully functional.

Open Access Case Study

Anesthetic Management of a Pregnant Woman with Limb-girdle Muscular Dystrophy in the Caesarean Section: A Case Study

Javad Sharbaf Javan, Kamran Ameli, Mona Moshref, Mitra Saberi, Horiea Pakniat

International Journal of Medical and Pharmaceutical Case Reports, Page 1-5
DOI: 10.9734/IJMPCR/2017/37824

In a study, we present the case of a 33-year-old obese patient with limb-girdle muscular dystrophy (LGMD) admitted for cesarean section. The patient was successfully managed by emergency caesarean section under spinal anesthesia. On physical examination after the operation, the force of the upper and lower extremity muscles were estimated to be 4/5 and 3/5, respectively. In this case, instead of epidural anesthesia we used spinal anesthesia, which is a safe technique recommended for emergency cesarean section in pregnant LGMD patients.

Open Access Case Study

A Large Solid Pseudopapillary Tumour of the Body and Tail of Pancreas: A Rare Entity Treated with Combined Modality

Satadru Biswas, Bidisha Bandyopadhyay, Hambir Chowdhury, Sukanta Chakraborty, Abhishek Basu, Subir Gangopadhyay

International Journal of Medical and Pharmaceutical Case Reports, Page 1-7
DOI: 10.9734/IJMPCR/2017/37962

Solid Pseudopapillary Tumour (SPPT) of the pancreas are rare tumours, accounting for only 1-2% of all pancreatic neoplasms. Increased rate of detection of this neoplasm in the last three decades is probably due to the increased awareness and the increased provision of imaging. Though surgery is the mainstay of its treatment, single agent chemotherapy with Inj. Gemcitabine is considered to be of choice for the adjuvant therapy in case of large tumours with high risk features.

We report here a case of a huge Solid Pseudopapillary Tumour (SPPT) of the Body and Tail of Pancreas [Stage pT2N0M0] in a 23 year old lady presenting with vague pain abdomen and vomiting. At first, it was suspected by Magnetic Resonance Cholangio-Pancreatography (MRCP) and finally it was diagnosed by histopathological examination of specimen obtained by surgery. Patient is now being treated with single agent adjuvant chemotherapy (Gemcitabine) and is completely asymptomatic.

Open Access Case Study

Amanita Phalloides Avoids Tumor Growth of Leukocytes with Philadelphia Chromosome: Case Report

Isolde Riede

International Journal of Medical and Pharmaceutical Case Reports, Page 1-7
DOI: 10.9734/IJMPCR/2017/38205

Background: Treatment failure in patients who have chronic myeloid leukemia (CML) using tyrosine kinase inhibitors is common due to development of secondary mutations. Amanita phalloides (Amanita) contains low dose of alpha-amanitin (amanitin),which inhibitis RNA polymerase II (RNAP) leading to slowing down of the growth of tumor cells without affecting normal cells.
Aim: To determine if Amanita inhibits the growth of Philadelphia chromosome (Ph1) carrying leukocytes in CML.

Methods: A patient with leukocytes carrying a Ph1 and loss of Y chromosome was treated with Amanita as the only tumor specific therapy. Pre-treatments with the tyrosine kinase inhibitors Imatinib and Nilotinib had to be terminated because of severe side effects. Monitoring was performed with blood cell count and quantitation of bcr-abl fusion transcripts.
Results: The disease state could be stabilized for nearly two years until now with Amanita alone. Whereas leucocyte´s tumor growth was inhibited, and cell count remained low, the percentage of bcr-abl fusion transcripts rose. Although the relative amount of lymphocytes decreased transiently, it remained stable in the range of 1.5/nl [0.6-4.7/nl] blood. Compared to the initial phase of CML diagnosis in 2008, leukocyte count is 5 fold reduced due to the Amanita therapy. 
Conclusions: Amanita can inhibit tumor growth of cells carrying Ph1. However, the cells with Ph1 and loss of Y chromosome have growth advantage over the cells without these mutations. The percentage of potential tumor cells increased, but without complications.

Open Access Case Study

Small Bowel Adenocarcinoma in a Nigerian Man: A Case Report

Abiodun Christopher Jemilohun, Alaba Moses Adesina, Mustapha Akanji Ajani, Theophilus Oludare Ajiro

International Journal of Medical and Pharmaceutical Case Reports, Page 1-7
DOI: 10.9734/IJMPCR/2017/39299

Malignancies of the small bowel are a rare occurrence with a worldwide incidence of less than 1.0 per 100,000 populations. Only 2% of the total annual incidence of digestive cancers occurs in the small intestine as compared to approximately 57% in the large intestine. This is in spite of the fact that the small intestine constitutes about 75% of the entire length and 90% of the absorptive surface area of the gastrointestinal tract while the large bowel measures only about 1.5 meters in length.

We report an 84-year old Nigerian man with ileal adenocarcinoma who presented initially with nonspecific symptoms. We faced a diagnostic dilemma because of the vagueness of his symptoms and the fact that all the initial endoscopic and radiologic investigations performed were negative despite a severely elevated plasma carcinoembryonic antigen and the finding of an umbilical metastatic nodule. The diagnosis was made after 7 weeks of the initial presentation when the patient had exploratory laparotomy because of newly developed features of complete intestinal obstruction.

This report highlights the need for physicians to heighten their index of suspicion for small bowel malignancies whenever a patient presents with features suggestive of gastrointestinal malignancy but conventional endoscopic or imaging modalities yielded negative results.