INTRODUCTION: We review the clinical applications of magnetic resonance cholangiopancreatography (MRCP) and illustrate them with clinical examples. METHODS: A literature search was performed in MedLine using the keywords "MR cholangiopancreatography" and "MRCP". The relevant articles were reviewed. The radiology information system was searched for MRCP examinations performed from July 1999 ...

We present a case of acute pancreatitis after a course of clarithromycin. An 84-year-old woman died of suspected pneumonia and cardiac failure. Autopsy surprisingly revealed acute pancreatitis. Except for the use of clarithromycin no other cause for her acute pancreatitis was obvious. Pancreatitis induced by clarithromycin has been reported twice ...

CONTEXT: Few data exist about the incidence of drug-induced pancreatitis in the general population. Drugs are related to the etiology of pancreatitis in about 1.4-2% of cases. Statins are generally well tolerated. Acute pancreatitis has been reported in a few cases treated with atorvastatin, fluvastatin, lovastatin and simvastatin. CASE REPORT: ...

The difficulties in establishing a diagnosis of acute disseminated encephalomyelitis (ADEM) are illustrated in this case report, which attempts to raise awareness of the condition among general physicians, since they are the practitioners most likely to see such acute neurological presentations. Clinical and investigative features which raise the index of ...

BACKGROUND: Induction of ovulation in the course of infertility treatment is increasingly commonplace in the 21st century. As a consequence, it can be expected that previously unrecognized complications of the procedure will be reported. CASE: A 36-year-old woman presented with severe pelvic pain and hyponatremia after ovarian stimulation with gonadotropins. ...

OBJECTIVE: Because of the low incidence of pancreatic ascites, only case reports and case series have been published, and no randomized controlled trials have been performed to find out which is the best therapeutic approach. The aim of this study was to evaluate the utility of the different treatments for ...

CONTEXT: Pancreatic neoplasms are an uncommon aetiology of acute pancreatitis. Pancreatic neuroendocrine tumours are a rare subgroup of pancreatic neoplasms. CASE REPORT: We report on three patients having acute pancreatitis secondary to pancreatic neuroendocrine tumours, one of them with severe pancreatitis, and review the published cases up to now. Only ...

Acute epiglottitis is an inflammatory, edematous disease of the epiglottis and adjacent structures, usually caused by Haemophilus influenzae type b. It is a life-threatening condition, occurring mainly in childhood. There have never been any reports of this condition in Taiwan. We report a case of 4-year-old boy who presented with ...

We present a case report from 2001 of the first parasitologically confirmed case of acute Chagas disease in Suriname. The patient had never left Suriname, and was probably infected by an adventitious species of Panstrongylus in his house in the capital city, Paramaribo. The patient was treated with nifurtimox, and ...

Acute macular neuroretinopathy (AMNR) is a rare condition that produces transient or permanent visual impairment. Typical cases have acute onset multifocal scotomas that correspond rather precisely with reddish, flat, or depressed circumscribed lesions in the macula. These lesions are wedge-shaped and generally point toward the fovea. The pathophysiology of AMNR ...

An acutely thrombosed abdominal aortic aneurysm (AAA) is a rare but devastating complication of aortic aneurysms. Incidence in reported series is approximately 0.7-2.8% of surgically managed AAA cases with an associated mortality rate of 50%. To date there have been only 46 cases of acutely occluded AAAs reported in the ...

BACKGROUND: Esotropia during opiate withdrawal is a new clinical syndrome that has only recently been reported in the literature. METHODS: Clinical case series. RESULTS: Five patients with acute esotropia during opiate withdrawal are presented. In four there was evidence of underlying hyperopia and/or other strabismogenic features. CONCLUSIONS: The precise cause ...

Acute mastoiditis is the most frequent intratemporal complication of otitis media. The bacteriology of acute otitis media is changing continuously and it differs markedly from the bacteriology of acute mastoiditis. Moraxella catarrhalis (M. catarrhalis) is the third most common bacteria found in acute otitis media, and in recent years its ...

BACKGROUND: Pancreatic pseudocyst in pregnancy is a rare condition whose management is not standardized. STUDY DESIGN: We combine one case report with nine others published in the literature since 1980. The cases are compiled to provide a descriptive review of this condition. RESULTS: The natural history of pancreatic pseudocysts in ...

A 42-year-old woman presented with acute visual loss in the left eye with funduscopic evidence of marked retinal periphlebitis (frosted angiitis) and a macular star. Extensive serologic testing identified no etiology. The purpose of this report is to review the clinical features and systemic associations of acute frosted angiitis, a ...

A 66-year-old man with secondary progressive multiple sclerosis presented with a flaccid areflexic tetraparesis evolving over a 6-week period. Clinical examination and subsequent investigation confirmed a diagnosis of sub-acute inflammatory demyelinating polyradiculoneuropathy (sub-acute IDP). Nephrotic-range proteinuria and thrombocytopaenia were also noted at the time of presentation-histopathological investigation of the former ...

OBJECTIVE: To report a case of acute pancreatitis in a patient receiving a combination formulation of irbesartan and hydrochlorothiazide (HCTZ). CASE SUMMARY: A 33-year-old white woman developed acute pancreatitis 10 days after starting irbesartan 300 mg and hydrochlorothiazide 12.5 mg for treatment of hypertension. Her symptoms disappeared and serum concentrations ...

We report a case of acute disseminated intravascular coagulation (DIC) developed during menstruation in an adenomyosis patient. No known predisposing factor for DIC such as infection or pregnancy was involved in this case. As anticoagulation therapy and supplementation of coagulation factors quickly improve the state, surgical removal of the uterus ...

Pancreatic encephalopathy is a rare complication of acute pancreatitis. Clinical features include focal neurological signs and acute onset of dementia. This picture can fluctuate over time: cyclic progression with remission and relapses has been described. We present the case of a 43-year-old man who, after an acute episode of pancreatitis, ...

Renal enlargement in acute lymphoblastic leukaemia is well reported in literature from Western Countries. However there are very few reports from developing countries. Bilateral symmetrical enlargement of kidneys as a primary presentation of acute lymphoblastic leukaemia is rare. We report a child who had acute lymphoblastic leukaemia presenting with bilateral ...

Due to the devastating nature of acute retinal necrosis syndrome (ARNS), early diagnosis is essential. 5 cases of clinically diagnosed ARNA were investigated for CMC, herpes simplex and varicella zoster virus (VZV) infections. Of the three VZV IgM positive cases, two were positive in acute blood samples and one in ...

We report a case of giant benign pancreatic mucinous cystadenoma in a 19-year-old woman with celiac disease and polycystic kidneys. She presented with a history of moderate episodic left flank pain evolving for a few weeks before becoming acute the night before her admission. We provide radiological and histological material ...

Since the first documented case of a particular form of pancreatitis with hypergammaglobulinaemia, similar cases have been reported, leading to the concept of an autoimmune related pancreatitis or so-called "autoimmune pancreatitis". Although it has not yet been widely accepted as a new clinical entity, the present article discusses the recent ...

It has been accepted widely that excessive humoral mediators play important roles in the pathogenesis of organ failure in patients with severe acute pancreatitis (SAP) and that infection of the pancreas due to bacterial translocation (BT) is the most frequent cause of death in SAP. On the other hand, it ...

Chronic pancreatitis is a rare differential diagnosis of obstructive jaundice and/or recurrent abdominal pain in childhood and adolescence. The hereditary calcifying and the noncalcifying obstructive form are the two major forms of juvenile chronic pancreatitis. Other causes include cystic fibrosis, hyperparathyroidism, hyperlipoproteinemia and ascariasis. Even less common is the so ...

This case report involves the anesthetic management of a rare case of adult epiglottitis. It is unique in that there are real photographs of the illness and a previously undocumented use of a specific airway adjunct in acute epiglottitis, the Bullard laryngoscope. Management of the case from start to finish ...

OBJECTIVE: Mycoplasma pneumoniae is responsible for approximately 20% of community-acquired pneumonia. A wide variety of extrapulmonary manifestations related to M. pneumoniae infection can occur. The diagnosis of M. pneumoniae and its association with acute pancreatitis is briefly reviewed. CLINICAL PRESENTATION: We describe the case of a 9-year-old boy with clinical ...

We report the case of a 49-year-old patient who developed hemobilia and acute pancreatitis from an arterioportal fistula after a percutaneous liver biopsy, and we analyze diagnostic testing and management based on a concise review of the available literature. Hemobilia can present as late as 10 days after liver biopsy. ...

Acute calcific discitis in the pediatric population is a well-described entity and may rarely involve the adult population. Acute calcific discitis does occur in adults, presenting clinically with the abrupt onset of severe back pain with a classic radiographic calcification of the disc similar to that of a discogram; it ...

Acute pericarditis has been described as an extraintestinal manifestation of inflammatory bowel disease (IBD), as well as a consequence of IBD treatment, specifically sulfasalazine and mesalamine. Until now, there have been no reported cases of constrictive pericarditis associated with IBD or its treatment. A 37-year-old woman with a 24-year history ...

A review of the literature reveals only 12 reported cases of laryngeal gout. We describe three further cases of laryngeal gout, the largest series ever published. The first case is previously undescribed acute gouty cricoarytenoiditis resulting in acute airway embarrassment requiring tracheotomy, and then we describe two cases of chronic ...

Isotretinoin is a vitamin-A derivative most commonly utilized in the treatment of severe recalcitrant nodulocystic acne. Derangement of lipid metabolism leading to increased triglyceride and cholesterol level has been reported after taking this drug. We report the case of a 43-year-old female with no identifiable risk factor for pancreatitis who ...

Porphyrias are inherited disorders of heme biosynthesis. ALA dehydratase porphyria (ADP) and congenital erythropoietic porphyria (CEP) are autosomal recessive porphyrias, and are typically expressed at birth or in childhood. However, a few cases of late-onset recessive porphyrias have been reported. Recently we encountered a late-onset ADP patient who developed symptoms ...

A case is reported of combined coliform and anaerobic bacterial infection of the lacrimal sac, a condition of which there is only one other published case report. In addition, a literature review is presented of the bacteriology of acute dacryocystitis as it applies to this case. Recommendations for the microbiological ...

Pancreatic panniculitis is a rare complication that occurs in 0.3-3% of patients with pancreatic diseases. Most of the cases reported to date were associated with adenocarcinoma and acute or chronic pancreatitis. We here present an 88-year-old man who was admitted to our institution with a nonfunctional neuroendocrine carcinoma of the ...

Three cases involving a previously unreported association of acute pancreatic damage following convulsive status epilepticus (SE) are presented. A review of literature failed to reveal a similar association between SE and acute pancreatic damage. As possible pathophysiological mechanisms of this so far unknown sequel of SE, increased intraduodenal pressure during ...

We report on the case of a healthy young boy who developed a fulminant myocarditis due to acute coinfection with erythrovirus (parvovirus B19) and human herpesvirus 6 (HHV-6) in the absence of an antiviral immune response. We suggest that the HHV-6-induced immunosuppression enhanced dissemination of parvovirus B19, which led to ...

A rare event of acute free perforation of gall bladder with biliary peritonitis in a case of calculous cholecystitis in a 28 years old pregnant lady occurring in the absence of the usual factors associated with gall stone disease is reported. The clinical features resembled acute appendicitis and a pre-operative ...

Two children with incidentally-diagnosed ectopic pancreatic tissue in the jejunum at surgery for extrahepatic biliary atresia (EHBA) and choledochal cyst (CC) are reported. No case has been reported in the literature describing the association of a CC with ectopic pancreas, and only one case of EHBA associated with ectopic pancreas ...

Schistosomal cholecystitis is a rare entity with less than 10 cases described in the medical literature [1-3]. It is unclear whether schistosomal eggs deposited in the wall of the gallbladder trigger a clinically manifest acute cholecystitis, since most of the cases described were also found to have concomitant gallstones. Herein, ...

We report a male case of 3-hydroxyisobutyric aciduria (3HiB-uria) with severe brain damage. He had mild asphyxia at birth. He needed tube feeding for a month. He showed mild dysmorphic features, including low set ears, a long philtrum and micrognathia. At 4 months of age he had acute encephalopathy. Thereafter, ...

It is often speculated that an inflamed gallbladder weeps bile to produce bile peritonitis. This may be so, but more likely the problem is a peritoneal effusion in a jaundiced patient which thus resembles bile. So-called "spontaneous or idiopathic biliary peritonitis" in acute acalculous cholecystitis without a proven cause is ...

Acute pancreatitis is an uncommon cause of abdominal pain during pregnancy, and rarely progresses to the necrotizing from of the disease in this clinical setting. Hyperlipidemia is an infrequent cause of acute pancreatitis. Whereas only 100 cases of hyperlipidemia-induced necrotizing pancreatitis have been reported in the literature to date, all ...

Acute tumour lysis syndrome (ATLS) is a well recognised complication of treatment of a variety of malignant disorders. It commonly occurs in patients with non-Hodgkin's lymphoma (NHL) and acute lymphoblastic leukaemia (ALL) with the administration of combined cytotoxic chemotherapy. It is rarely reported after single-agent corticosteroid therapy. We present two ...

The segmental infarction of the greater omentum is a rare cause of acute abdomen. Its etiology is uncertain although several predisposing factors have been underlined such as congenital venous anomalies, sudden change of position and substantial meal. The clinical picture simulates an appendicitis or cholecystitis, thus being difficult to make ...

PURPOSE: To report the possible effects of heroin withdrawal on binocular vision. METHODS: A case series of patients is presented in whom esotropia developed on cessation of heroin use. RESULTS: In each case the esotropia was concomitant and prismatic correction restored binocular single vision. Intermittent spontaneous control occurred in one ...

We recently observed numerous microspheroliths consisting of microscopic organized crystalline structures of varying shapes, sizes, and colors in a bile specimen from a 65-yr-old woman obtained directly from the gallbladder during a surgical procedure for cholecystectomy. Detection of microspheroliths could be very useful in the diagnostic approach to patients with ...

Spontaneous resolution of acute hydrocephalus without aspiration of cerebral fluid is rare. In a neonate born at full term this has only been reported once before. We report on one further case that was caused by intraventricular haemorrhage (IVH). The probable mechanism is resolution of the acute haemorrhage in the ...

Gangliocytic paragangliomas (GPs) are exceedingly rare tumors that arise in close proximity of the papillaof Vater. Nevertheless, jaundice is an uncommon presenting symptom, reported in only 3 of 125 casesdescribed in the literature to date, with gastrointestinal bleeding being more common.Association between GPs and neurofibromatosis 1 (NF-1), described in two ...

Myocarditis associated with bacterial enteritis has only rarely been described and the pathogenesis is unclear. Herein we report a case where a young adult developed myocarditis during the acute stage of an infection with Salmonella heidelberg and Campylobacter jejunii/coli. The patient's troponin I value was elevated. We suggest that use ...