Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsSurgery for an Isolated Adrenal Metastasis of Gastric Cancer.
Adrenal metastasis is considered a rare hematogenous metastasis that develops after gastric cancer surgery. The chances of curative surgery are very low. It is usually unresectable. ⋯ The option of surgical treatment is recommended for isolated metachronous adrenal metastases. Curative surgical resection may positively impact the prognosis of patients in selected cases. Key Words: Gastric cancer, Adrenal metastasis, Surgical resection.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsA Delayed Presentation of Arginase Deficiency Presenting with Status Epilepticus.
Arginase 1(ARG1) deficiency is a rare disorder of the urea cycle. The presentation is usually late, leading to loss of intellectual milestones, spasticity and liver involvement. Hyperammonemic crises are rarely encountered. ⋯ Molecular genetic analysis of ARG1 gene showed a novel homozygous mutation. Although the presentation of ARG1 deficiency is usually chronic in the majority of patients, an acute crisis of encephalopathy due to hyperammonemia may occur and delayed diagnosis may lead to irreversible neurological damage. Key Words: Urea cycle disorder, Hyperammonemia, Argininemia, Encephalopathy.
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Umbilical venous catheterisation is a common bedside procedure in the neonatal intensive care unit (NICU). Complications including thrombus formation, thromboembolism, vessel perforation, haemorrhage, and central line-associated bloodstream infection can be seen after the procedure. Pyogenic liver abscess is a rare but life-threatening complication of umbilical venous catheterisation. ⋯ The patient was followed by serial US and the lesion was completely resolved after three weeks. In conclusion, clinical worsening associated with gastrointestinal symptoms in a cyanotic infant with UVC should raise suspicion for liver abscess. Key Words: Neonate, Hepatic abscess, Umbilical venous catheter, Cyanotic heart disease.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsImmature Teratoma with Growing Teratoma Syndrome and Gliomatosis Peritonei Coexistence.
Ovarian germ cell tumours constitute 5% of all ovarian cancers. During the natural course and treatment of these tumours , there may be more unusual cases. ⋯ Herein, we present a case of coexistence of gliomatosis peritonei and growing teratoma syndrome during the treatment of a 29-year female with immature ovarian teratoma. Key Words: Germ cell tumours , Growing teratoma syndrome, Gliomatosis peritonei, Ovaries.
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HIV infections have always been a stigma, and the majority of transplant centres avoid liver transplantation in patients having end-stage liver disease patients with HIV coinfection. HIV patients with end-stage liver disease having undetectable HIV viral load, CD4+ cell count of >100/ml, and negative history of AIDS-specific opportunistic infections are considered suitable candidates for liver transplantation. Fulfilling the above-mentioned criteria, we performed successful living donor liver transplantation (LDLT) procedure on a 58-year-old gentleman who presented with end-stage liver disease and HIV coinfection. Key Words: HIV, Living donor, Liver transplantation.