Small bowel lymphoma accounts for 10%-30% of gastro-intestinal tumors. Clinical presentation is not specific. CT scans helps the diagnosis showing some characteristic appearances such as wall thickening of the loops, enlarged lymph nodes and infiltration of mesenteric fat. Pseudoaneurysmal intestinal dilatation is uncommon and may cause bowel obstruction which is a diagnostic and therapeutic emergency. We report the case of a 73-year-old man, who presented for occlusive syndrome revealing hail lymphoma. Pseudoaneurysmal intestinal dilatation is an uncommon presentation of lymphoma that should evoke the diagnosis especially when associated to wall thickening of the loops and lymphadenopathy.
Background: Lemmel syndrome is a rare and misdiagnosed etiology of obstructive jaundice due to a periampullary duodenal diverticulum causing a mechanical obstruction of the common bile duct. It represents an obstructive jaundice with the absence of choledocholithiasis or pancreaticobiliary tumors. It is an underreported entity due to the absence of specific pathognomonic signs. Case presentation: A 77-year-old-woman admitted for sepsis, due to an ascending cholangitis, underwent a MRCP and a gastroduodenoscopy revealing Lemmel’s syndrome. Due to failure of ERCP, the patient underwent surgical derivation. Conclusion: Lemmel syndrome represents an uncommon diagnosis of obstructive jaundice, that shouldn’t be neglected if no other organic cause is detected. It is usually asymptomatic, however some patients can develop symptoms and complications such as cholangitis, as is the case of our patient. Imaging allows diagnosis, with MRCP as the modality of choice to confirm diagnosis. Endoscopy is the first line treatment.
Minimally invasive gynecologic surgery such as hysteroscopy has a low risk of complications. Infections, however, are more common in the presence of risk factors such as smoking, history of pelvic inflammatory disease, and endometriosis. We report the case of a patient who underwent operative hysteroscopy without immediate complications and was admitted 2 days later to the emergency department in a severe state of septic shock. With multiple organ failures requiring admission to an intensive care unit, the patient died despite extensive antibiotic therapy and vasoactive drugs. Ascending infection can be a potentially fatal complication of hysteroscopy, even in the absence of known risk factors.
Brown tumors are non-neoplastic bone lesions caused by an abnormal remodeling of the bone that may occur with primary or secondary hyperparathyroidism. Their radiological aspect: lytic and aggressive can easily be misdiagnosed for a malignant origin hence the importance of knowing that diagnosis is to be considered through both clinical context and radiological semiology, which will be detailed via this case of a 32-year-old female patient with an end-stage kidney disease, admitted for facial disfiguration and palpable masses corresponding to brown tumors affecting the maxilla and the mandibular bone.
Metastatic tumors of the nasal cavity and paranasal sinuses are much less common than primary cancer in this location. The clinical symptomatology is not specific. We report a case of frontal metastasis of a 49-year-old patient treated for a rectal adenocarcinoma without other secondary localizations. The treatment is based on radiotherapy or chemotherapy. Hence the value of recognizing sinus metastases and differentiating them from infection affection.
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