Cases reported "Constriction, Pathologic"

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1/245. Wasting of the small hand muscles in upper and mid-cervical cord lesions.

    Four patients are described with destructive rheumatoid arthritis of the cervical spine and neurogenic wasting of forearm and hand muscles. The pathological connection is not immediately obvious, but a relationship between these two observations is described here with clinical, radiological, electrophysiological and necropsy findings. Compression of the anterior spinal artery at upper and mid-cervical levels is demonstrated to be the likely cause of changes lower in the spinal cord. These are shown to be due to the resulting ischaemia of the anterior part of the lower cervical spinal cord, with degeneration of the neurones innervating the forearm and hand muscles. These findings favour external compression of the anterior spinal artery leading to ischaemia in a watershed area as the likeliest explanation for this otherwise inappropriate and bizarre phenomenon.
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keywords = upper
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2/245. Bilateral ophthalmoplegia and exophthalmos complicating central hemodialysis catheter placement.

    We describe a 58-year-old woman who presented with bilateral ophthalmoplegia, exophthalmos, and headache and was found to have retrograde internal jugular vein flow secondary to a high-grade obstruction of the ipsilateral brachiocephalic vein from a previous hemodialysis catheter placement. The patient had also a high-flow dialysis graft in the ipsilateral arm. The cranial and extracranial venous system congestion resolved, and the signs disappeared soon after a balloon angioplasty and stent placement at the level of the obstruction.
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ranking = 0.062688876122973
keywords = headache
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3/245. Helical computed tomographic minimum-intensity projection of a slit in an airway obstruction.

    We treated a 54-year-old man with an anastomotic obstruction after a right upper sleeve lobectomy. By using minimum intensity projection images that were generated from helical computed tomographic data sets that indicated a twisted slit enhanced with air a few millimeters in length, through anastomosis to the distal bronchus, we successfully treated the obstruction by bronchoscopic balloon dilatation.
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ranking = 0.2
keywords = upper
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4/245. Posttraumatic intestinal stenosis presenting as a perforation: report of a case.

    A 78-year-old woman was admitted to the hospital after falling into a ditch approximately 1 m deep and sustaining a blunt abdominal trauma with a left femur fracture. On the tenth day after admission, symptoms of a small bowel obstruction occurred. A nasogastric tube was inserted, and the symptoms thus improved. She sometimes complained of abdominal pain during the 12 months after the fall, but recovered with conservative management. The next year, she was readmitted to the hospital for a pin extraction of the left femur bone. During this admission, 15 months since her admission after her fall, she again complained of abdominal pain. abdominal pain increased with a muscular defense, and abdominal x-rays revealed free air. She was referred to our hospital with a diagnosis of perforative peritonitis, and emergency surgery was performed. Upon laparotomy, circumferential stenoses of the small bowel were recognized in the proximal segments about 40cm, 80cm, and 100cm from the ileocecal region. In addition, a perforation and prominent dilatation of the bowel segment was observed just proximal to the stenosis about 100cm from the ileocecal region. She underwent a small intestinal resection at two sites. There were no findings of an intestinal specific ulcer, such as Crohn's disease, intestinal tuberculosis, or malignancy, based on the results of a histopathological examination.
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ranking = 2.2861789026638
keywords = abdominal pain
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5/245. Treatment of may-thurner syndrome with catheter-directed thrombolysis and stent placement, complicated by heparin-induced thrombocytopenia.

    may-thurner syndrome is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein thrombosis and severe leg edema. We report the case of a 41-year-old female who presented with severe left leg edema present for 1 day. One week earlier she had experienced acute shortness of breath and pleuritic chest pain. Duplex ultrasound revealed a left iliofemoral deep vein thrombosis. A computed tomography (CT) scan performed for abdominal pain revealed thrombosis of the entire left common and external iliac veins. A ventilation-perfusion scan diagnosed a pulmonary embolism. The patient was treated with systemic intravenous heparin and catheter-directed thrombolysis of the iliofemoral deep vein thrombosis. Complete thrombolysis and iliofemoral vein patency was achieved over 5 days. A persistent stenosis in the left common iliac vein consistent with may-thurner syndrome was alleviated with percutaneous balloon angioplasty and placement of a Wallstent. heparin therapy was terminated at the time of stenting because of suspected heparin-induced thrombocytopenia. The patient was started on a continuous infusion of 10% dextran 40, and warfarin therapy was initiated. heparin-induced antibodies were confirmed by a C-14 serotonin release assay. The endovascular reconstruction remains patent 4 months later. heparin-induced thrombocytopenia complicating endovascular reconstruction of the iliofemoral venous system in a patient with may-thurner syndrome is an uncommon occurrence. This case and a review of the literature are discussed.
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ranking = 1.2361839588807
keywords = abdominal pain, chest
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6/245. radiation-induced bronchial stenosis: a new cause of platypnea-orthodeoxia.

    Platypnea-orthodeoxia is encountered in a variety of cardiac, pulmonary, and hepatic disorders. We report its occurrence in a 59-year-old man who had had combined external-beam and high dose-rate iridium brachytherapy for a stage I non-small-cell carcinoma of the right upper lobe 2 years earlier. The post-radiation course was complicated by a severe radiation bronchitis; the onset of platypnea-orthodeoxia signalled the development of severe bronchial stenosis that was transiently relieved, initially by dilatation, and later by stent placement, though the patient ultimately died of a pulmonary hemorrhage. The dosage of brachytherapy given, the combined external-beam therapy, and the long survival after completion of radiation therapy were likely factors in the development of bronchial stenosis. We discuss the tomographic and bronchoscopic features of radiation-induced bronchial stenosis.
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ranking = 0.2
keywords = upper
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7/245. Bronchial obstruction after upper lobectomy: kinked bronchus relieved by stenting.

    Post resectional kinking of the lower lobe bronchus caused obstructive symptoms in 2 patients following upper lobectomy. Exaggerated upward displacement of the remaining lower lobe seemed to be causative. Intrabronchial stenting relieved the obstruction in each case with satisfactory intermediate term results.
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ranking = 1
keywords = upper
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8/245. Supraarterial decompression myotomy for myocardial bridging in a child.

    A 10-year-old boy presented with a history of exertional chest pain. An electrocardiogram demonstrated an inferior apical myocardial infarction. Cardiac catheterization revealed myocardial bridging of the left anterior descending coronary artery with evidence of intramyocardial obstruction during systole. The patient underwent successful treatment with supraarterial decompression myotomy and remains symptom free at 1 year.
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ranking = 0.09309450754876
keywords = chest
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9/245. Case report: percutaneous balloon dilatation and ureteral stenting for tuberculous renal infundibular and ureteral strictures.

    A 23-year-old woman developed progressive obstructive uropathy due to multiple renal infundibular and ureteral strictures while on drug treatment for renal tuberculosis. communication between isolated upper and mid-pole calyces, and the ureter, was established by percutaneous guidewire manipulation. The strictures were successfully managed using percutaneous balloon catheter dilatation and ureteral stenting without the need for open surgical exploration. kidney function was preserved at one year follow-up.
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ranking = 0.2
keywords = upper
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10/245. Hepatobiliary cystadenoma presenting with intermittent inferior vena caval obstruction.

    Hepatobiliary cystadenomas are rare benign tumours. They form as multilocular cysts in and around the liver. Their presentation is usually at a late stage when their size causes symptoms. We report a case of a 44-year-old woman presenting with abdominal pain, which was attributed to a multiloculate liver cyst. After intially refusing surgery she relented once intermittent inferior vena caval obstruction had developed. The cyst was found to be a hepatic cystadenoma.
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ranking = 1.1430894513319
keywords = abdominal pain
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