Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsCecal Diverticulitis: A Diagnosis to Keep in Mind When Evaluating Acute Appendicitis.
Cecal diverticulitis is a rare cause of right lower-quadrant abdominal pain. As its symptoms mimic those of acute appendicitis, the final diagnosis in the patients is generally confirmed after surgery. Herein, we report a 45-year man who was admitted to the department of emergency with lower right abdominal pain. ⋯ Based on my experience, I advise that CT can be used to differentiate cecal diverticulitis from the acute appendicitis. In uncomplicated cases, conservative approaches are advised. Key Words: Cecal diverticulitis, Computed tomography, Acute appendicitis, Conservative treatment.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsColonic Obstruction Secondary to Phytobezoar Caused by Vitex Agnus-Castus Seeds: A Case Report.
Plant seeds of Vitex agnus-castus (chaste berry) are known for benefits in reproductive health and also reduce bloating, depression, headache, and constipation. Plant seeds are a rare cause of phytobezoars. Bezoar is a formation of mass by piling up of material that is ingested but not digested or partially digested at any level of the gastrointestinal tract. ⋯ Bezoars causing colonic obstruction can be treated by medical observation, endoscopic intervention, or surgical procedure. Herein, we present a case of colonic obstruction secondary to bezoar composed of plant seeds of Vitex agnus-castus and our approach to this condition. Key Words: Chaste berry, Vitex agnus-castus, Phytobezoar, Colonic obstruction.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsPersistent Left Superior Vena Cava: A Rare Finding for the Internists.
A case of a South Asian quinquagenarian gentleman is reported, who was admitted with septic shock and displayed a TYPE II persistent left superior vena cava (PLSVC) after insertion of a central venous catheter, diagnosed on the basis of chest X-ray findings and dilated coronary sinus on transthoracic echocardiography. As the patient was in septic shock, the central venous catheter was retained and vasopressor therapy was instituted with careful hemodynamic monitoring. ⋯ Treating physicians should be aware of a possible PLSVC, particularly when a guide wire or a catheter takes a left parasternal course. Key Words: Persistent left superior vena cava, Septic shock, Central venous catheter.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsCarpometacarpal Joint Dislocations as a Rare Cause of Hand Pain.
Carpometacarpal joint dislocations represent not more than 1% of all hand injuries due to stable joint structures and high-energy trauma mechanism. Unfortunately, there are many missed cases suffering from ongoing pain and loss of function because of difficulty in diagnosis. Here we present a case of a healthy 42-year male who presented to the emergency department with hand pain after a punch injury. ⋯ In the case of carpometacarpal joint fracture or dislocations, early diagnosis and reduction are the most critical steps to avoid severe morbidity, and it is only possible with careful evaluation of physical and radiological findings. In conclusion, as seen in our case, emergency physicians should remain vigilant in the diagnosis and treatment of rare traumatic injuries. Key Words: Carpometacarpal joints, Dislocation, Hand injury, Pain.