Introduction: Conversion disorder resulting from the developmental history of many years of sexual abuse in adolescent females who are never heard, is often a rare feature in our cultures. Consequently, they explain themselves in unusual symptoms. This is the rationale for this report which is an original case report of interest to a particular clinical specialty of mental health but it will have a broader clinical impact across medicine especially for general practitioners, on the need to reduce cases of missed diagnosis. The findings in this study therefore, will significantly advance our knowledge of conversion disorders and the different ways it can present, to cause diagnostic puzzles.
Case Presentation: A 16-year-old high school female student in Rivers State, Nigeria, presented to a primary care private clinic in August, 2015, with history of seizures with abnormal behavior. She was consequently referred to mental health physician for evaluation. On psychiatric interview and mental health examination, it was found out that the patient had pseudoseizures following serial sexual abuse by caregivers. Bio-psycho-social Model was employed in the management of this patient with good outcome.
Conclusions: The psychological factor of child abuse triggering this peudoseizure, points to the fact that parents should be more proactive and careful with their children in the guardianship of family members or friends and emphasizes the need for medical practitioners, to raise their index of suspicion in order to reduce cases of missed diagnosis.
Aims: Hereditary angioedema (HAE) is an uncommon disorder of the complement system due to a deficiency or dysfunction of the inhibitor of the first component of complement (C1-INH). Because abdominal symptoms may precede by several years the episodes of subcutaneous tissue swelling that are characteristic of HAE, patients may undergo inappropriate surgical and medical treatment for any of a wide range of presumptive, incorrect diagnoses.
Presentation of Case: A 21-year-old girl presented with history of multiple episodes of abdominal pain, swelling of abdomen and upper extremities and ascites. The patient underwent surgery four times and for several months was treated unsuccessfully as Crohn’s disease. A diagnosis of HAE was made on the patient’s and family’s history and on decreased level of complement component 4 (C4) and decreased activity of C1-INH. C1-INH antigen was normal. According to the decreased serum C1-INH activity and C4 concentration, the patient was finally diagnosed with type II HAE. In the absence of other medications the patient was treated with fresh frozen plasma (FFP).
Conclusion: HAE is a rare cause of abdominal pain; however it needs to be taken as one of the differential diagnosis of various acute abdomens in order to avoid unnecessary surgeries.
The Rhesus (Rh) blood type is one of the most complex and important blood groups in humans. Its assessment has remained a matter of primary importance in Neonatology, in order to prevent the hemolytic disease of the fetus and the newborn (HDFN). Anti-D antibodies cause the most severe form of HDFN, but there are also other Rh allo-antibodies capable of causing clinically severe HDFN. Hence, we report two cases of HDFN due to anti-Cw and anti-E antibodies, respectively, in which blood transfusion was needed because of important late-onset anemia.
The article presents the clinical case of renal cell carcinoma in a 15-year-old-girl. The research was held at Saratov Clinical Hospital №3 n.a. R.V. Mirotvortsev over the period from 2006 till 2011. One case of renal cell carcinoma in a child out of 497 cases of the same pathology in adult patients was revealed, studied and described in the work.
Aorto Esophageal Fistula (AEF) is a rare and fatal condition. No reports arepublished concerning AEF after minimally invasive esophagectomy (MIE) for esophageal cancer.
We describe three cases with AEF as a complication of MIE with intrathoracic esophagogastricanastomosis (IEA) and performed a review of the literature.
Patients presenting shortly after MIE and (IEA) with acute onset of hematemesis should be suspectedof having an AEF. Anastomosis leakage, inflammation, radiotherapy and even chyle leakage couldcontribute to AEF development, but the direct cause remains unknown. The shift of cervicalesophagogastric anastomosis (CEA) to IEA could be associated with a higher incidence of AEF after MIE.
This is the first review reported about AEF after MIE with IEA that includes the report of onesurviving patient. Diagnostic and treatment possibilities are discussed but results are poor. Earlydiagnosis and prompt treatment with endovascular stenting or surgery are currently the only way ofsurvival.