Acta clinica Croatica
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Acta clinica Croatica · Dec 2022
Case ReportsACUTE MYOCARDIAL INFARCTION IN A 58-YEAR-OLD FEMALE WITH ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM THE RIGHT SINUS OF VALSALVA.
We report a case of a 58-year-old female with a history of hypertension, hypercholesterolemia and diabetes type 2, who was admitted to the coronary care unit with continuous substernal severe chest pain persisting for two hours. Her electrocardiogram showed ST-elevation acute myocardial infarction. ST-segment elevation was noted in leads I and aVL and ST-segment depression in leads II, III and V3-V5. ⋯ In conclusion, primary percutaneous coronary intervention (PCI) of diagonal branch was performed with balloon dilatation and thrombolysis in myocardial infarction TIMI 3 flow was achieved. After PCI, she had no chest pain. At 5-year clinical follow-up, the patient was asymptomatic.
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Acta clinica Croatica · Dec 2022
Case ReportsCHRONIC PSEUDO-OBSTRUCTION OF THE SIGMOID COLON: A CASE REPORT.
Chronic intestinal pseudo-obstruction (CIPO) is a rare syndrome characterized by signs of intestinal obstruction lasting for 6 months or more, in the absence of a definitive cause of obstruction. We report a case of CIPO in a 49-year-old female patient with a 6-month history of ongoing irregular bowel movements, manifested as constipation and diarrhea accompanied by abdominal pain and bloated feeling. Contrast-enhanced abdominal computed tomography and magnetic resonance enterography revealed focal thickening of a segment of the lienal flexure and intermittent areas of wider and narrower caliber along the sigmoid colon. ⋯ Following the procedure, symptoms regressed with a significant improvement in the quality of life. The patient has been regularly monitored in an outpatient setting and reports absence of the symptoms since the procedure. Pathophysiology of the resected section revealed more prominent lymphatic tissue, follicular arrangement, and reactively altered germinal centers, which can suggest CIPO.
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Acta clinica Croatica · Dec 2022
Case ReportsTRANSIENT PSEUDOHYPOALDOSTERONISM SECONDARY TO URINARY TRACT INFECTION IN A MALE INFANT WITH UNILATERAL HYDRONEPHROSIS DUE TO PRIMARY OBSTRUCTIVE MEGAURETER: A CASE REPORT.
We present a case of transient form of type 1 pseudohypoaldosteronism (S-PHA) in a 1.5-month-old male infant who presented with lethargy, failure to thrive, severe hyponatremia (Na=118 mmol/L), hypochloremia (Cl=93 mmol/L) and fever due to urinary tract infection. Potassium levels were normal. Markedly elevated serum aldosterone level and elevated serum renin confirmed the diagnosis of pseudohypoaldosteronism. ⋯ Although a rare occurrence, S-PHA can be a potentially life-threatening condition in infants if not recognized and treated appropriately. Therefore, serum concentrations of electrolytes should be obtained in every child diagnosed with obstructive anomaly of the urinary tract and/or acute cystopyelonephritis. On the other hand, every child diagnosed with S-PHA should be evaluated for obstructive anomaly of the urinary tract.
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Acute interstitial pneumonia (AIP) is a rare idiopathic interstitial pneumonia with histology finding of diffuse alveolar damage (DAD). It is characterized by progressive hypoxic respiratory failure, high mortality rate, and absence of guidelines for its treatment. ⋯ Oxygen therapy and high-dose parenteral corticosteroids led to gradual improvement and resulted in complete respiratory recovery. Since there are no existing guidelines for treating AIP, more case reports and case series if not randomized control trials are warranted in order to define the most effective therapeutic modality.
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Acta clinica Croatica · Dec 2022
COMPARISON OF FLEXIBLE LARYNGEAL MASK INSERTION AND ENDOTRACHEAL INTUBATION IN ADENOTONSILLECTOMY SURGERY.
This study compared the effectiveness of flexible laryngeal mask (F-LMA) insertion and endotracheal intubation in pediatric patients undergoing adenotonsillectomy surgery. A total of 60 patients aged 2-12 years were included in the study. Patients were divided into the F-LMA group (n=30) and endotracheal tube (ETT) group (n=30). ⋯ Both the insertion time and recovery time were shorter in the F-LMA group than in the ETT group (16.93±4.84 s vs. 23.93±8.74 s; and 10±2 min vs. 14.5±3 min; p<0.001 both). The airway pressure measurements at 5-min intervals were significantly lower in the F-LMA group than in the ETT group (p<0.001). F-LMA may be a useful alternative to ETT for adenotonsillectomy surgery because it is safe, provides shorter induction and recovery times, reduces intraoperative airway pressure, and provides an adequate operative field of view.