Der Internist
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This article presents the case of a 70-year-old obese patient with severe bilateral leg pain due to deep vein thrombosis. After unsuccessful venous recanalization, computed tomography angiography revealed an abdominal aortic aneurysm 15 cm in diameter with total compression of the inferior vena cava. For venous decompression as well as rupture prophylaxis, conventional open surgical repair was performed.
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We report about a 43-year-old man who presented to the emergency department in septic shock with nonspecific gastrointestinal symptoms. Sonography and computed tomography (CT) could not identify the location of the infection in the patient who had undergone liver transplantation and has a mechanical mitral valve. ⋯ Transesophageal echocardiography showed prosthetic endocarditis. The findings regressed markedly under ampicillin.
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The acute porphyrias are a group of four metabolic defects in which the heme synthesis in the liver is disrupted. They are characterized by massively painful acute attacks, which can be life-threatening if not diagnosed. To raise the awareness for these rare disorders, a heme molecule in cartoon style is introduced, which accurately explains the basic biochemical processes in the body and mediates important information on the acute hepatic porphyrias in a simplified and attractive way. The article is complemented by a case report.