Background: Conn's syndrome is a curable condition if identified properly. It is characterized by autonomous secretion of aldosterone from the adrenal gland cortex. Its morbidity is related to the increased risk of cardiovascular diseases. Case presentation: We report the case of a 48-year-old man of African descent presenting with generalized tonicclonic seizure and coma secondary to hypertensive encephalopathy. A biochemical evaluation revealed a very high aldosterone level and an undetectable renin level, both are compatible with primary aldosteronism. The presentation of the following confirms the diagnosis of primary aldosteronism: spontaneous hypokalemia, an undetectable renin level, and a high aldosterone level. Abdominal computed tomography revealed a left adrenal adenoma. Adrenal venous sampling confirmed lateralization of aldosterone excretion from the left adrenal gland. Our patient underwent left laparoscopic adrenalectomy that confirmed a left functional adrenal adenoma. After 12 months of follow up, his hypertension was controlled on only one antihypertensive drug which was down from four drugs preoperatively. Conclusion: Conn's syndrome, in this case, was complicated by coma secondary to seizure. Adrenalectomy normalized the hypokalemia and improved resistant hypertension. Potassium supplementation and several antihypertensives were discontinued as our patient became normokalemic and normotensive on one antihypertensive agent.
Bladder neck leiomyoma presenting with gross haematuria and clot retention is a rare clinical scenario. A thirty-three-year-old female presented to the emergency department with a history of lower abdominal pain and gross haematuria for a few days. Abdominal and pelvic ultrasonography examination was complimented with CT and MRI scans showing a 7.6 × 7 × 6.5 cm well-defined mass at the bladder base. There was also pelvic and retroperitoneal lymphadenopathy. Laparotomy with enucleation of the mass along with lymph node biopsy was performed with satisfactory control of the bleeding. Histopathology confirmed the diagnosis of leiomyoma of the bladder neck associated with tuberculous lymphadenopathy.
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