Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsEthylenediaminetetraacetic Acid-induced Pseudothrombocytopenia in Association with Graves' Hyperthyroidism.
Ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia (EDTA-PTCP) is an in vitro phenomenon of EDTA-induced platelet aggregation. A number of mechanisms have been proposed to account for this phenomenon. EDTA-PTCP has been found in healthy subjects and patients with a variety of conditions, including viral infections, cardiovascular disease, liver disease, neoplastic diseases and autoimmune diseases. ⋯ With the improvement of hyperthyroidism, the phenomenon of EDTA-PTCP disappeared. So far, EDTA-PTCP related to Graves' hyperthyroidism has not been reported in the literature. Key Words: Hyperthyroidism, Thrombocytopenia, Autoimmune diseases, Platelet aggregation, Edetic acid.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsA Giant Esophageal Epiphrenic Diverticulum Causing Dysphagia, Fungal Infection and Aspiration Pneumonia in an Elderly Patient.
Esophageal epiphrenic diverticulum is a rare condition. We present a case of a 70-year male with no known comorbidities who presented with dysphagia, cough, fever, and weight loss for 3 months. CT chest with contrast showed an out-pouching arising from the distal dorsal oesophagus, 15.6 cm long with 0.9 cm neck, containing food particles causing compression and consolidation of adjacent lung segments. ⋯ A biopsy of diverticular mucosa showed fungal hyphae and spores and was negative for malignancy. The patient was given antifungals and showed significant improvement of symptoms but considering the huge size of the diverticulum, he was referred to a thoracic surgeon. Key Words: Epiphrenic diverticulum, Dysphagia, Aspiration pneumonia, Fungal infection.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsDigital Necrosis Due to Septic Embolism: An Unseen Complication of Gangrenous Cholecystitis.
Gangrenous cholecystitis is one of the most severe complications of cholelithiasis. It causes serious morbidity and mortality. The main pathology in this complication is progressive vascular insufficiency, which may lead to necrosis and perforation of the gallbladder wall. ⋯ Embolism and necrosis in distant organs as a complication of gangrenous cholecystitis have not been reported till date. In this case, we present a patient, who developed necrosis of the fingers and toes due to septic embolism as a complication of gangrenous cholecystitis. Key Words: Cholelithiasis, Acute cholecystitis, Gangrene, Necrosis.