Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsBroad Complex Tachycardia, Addison's disease, and Ascending Flacid Paralysis: An Interesting Case on Cardiology Floor.
Broad complex tachycardia is a common presentation in the cardiology emergency room but is not always due to ventricular tachycardia, especially in a young patient who has other important medical illnesses and with no underlying cardiac illness. We present a case of a 40-year male who was admitted with complaints of palpitation associated with rapidly progressive weakness of lower limbs progressing to quadriparesis in about 10 hours. ⋯ His muscle power improved dramatically as potassium levels normalized and he recovered completely. Key Words: Acute flaccid paralysis, Hyperkalemia, Broad complex tachycardia.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsPrimary Hepatic Sarcomatoid Carcinoma Presenting with Dysphagia: A Rare Presentation.
A 50-year male presented with vomiting and dysphagia for 2 weeks. Laboratory workup showed a positive serology for hepatitis C and normal serum α-fetoprotein (AFP) levels. CT abdomen revealed a large lesion in the right lobe of the liver extending upto the lower esophagus causing significant luminal narrowing and dysphagia. ⋯ Thus, a diagnosis of sarcomatoid carcinoma was made on the basis of morphological and immunohistochemical features. Due to unresectable disease and poor functional status, palliative care was opted for. Key Words: Dysphagia, Vomiting, Liver biopsy, Sarcomatoid carcinoma.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsMale Urethral Diverticulum with Stones Presenting as Acute Urinary Retention.
The urethral diverticulum is an outpouching of the urethral wall communicating with its lumen. Acquired male urethral diverticulum is a rare entity and arises secondary to intervention or distal urethral obstruction. Most patients present with lower urinary tract symptoms (LUTS). ⋯ On workup, he was found to have a large tubular urethral diverticulum in the anterior urethra with multiple stones and urethral strictures. The case was managed endoscopically with optical urethrotomy and fragmentation and retrieval of stones using a semi-rigid ureteroscope and pneumatic lithoclast. Key Words: Urethra, Diverticulum, Male, urethral calculus, Lithoclast.
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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.