Interruption of the inferior vena cava (IVC) with azygos continuation is an uncommon vascular anomaly that results from aberrant development during embryogenesis. We report a rare case of this anomaly, presenting with massive pulmonary embolism. Subsequent evaluation with abdominal CT scan revealed the congenital absence of retrohepatic IVC. The patient was successfully treated with anticoagulation. When deep venous thrombosis (DVT) develops in patients with no apparent risk factors, the presence of congenital IVC anomalies should be considered.
The incidence of intussusception is low in adults, particularly in the descending colon, due to the anatomical attachment of the descending colon to the retroperitoneum. Signet ring cell histology represents ~1% of colon adenocarcinomas and is associated with young patients and a poor clinical outcome. The present study describes a case of descending colo-colonic intussusception caused by signet ring cell carcinoma in a 27-year-old male. The patient presented with a history of intermittent left upper-quadrant abdominal pain for more than six months without any evident etiology. A computed tomography scan of the abdomen revealed left-sided colo-colonic intussusception. Upon laparotomy, a left hemicolectomy was performed according to intraoperative frozen-section pathology. Post-operative pathological evaluation revealed signet ring cell carcinoma invasion of the serosa, and 31.8% (7/22) of the regional lymph nodes were positive for cancerous cells. The post-operative course was uneventful and the patient was discharged on the tenth post-operative day.
A young woman presented with a dry cough present during the previous 4 weeks. A chest radiograph demonstrated diffuse interstitial infiltration in both lower lung fields. Fibreoptic bronchoscopic examination revealed multiple 2-3 mm elevated nodules on the bronchial surface and a mucosal biopsy showed extensive subepithelial infiltration of poorly differentiated adenocarcinoma without definite precancerous alteration in the overlying epithelium. Studies for the evaluation of primary tumour focus were performed. Oesophagogastroduodenoscopy showed advanced gastric cancer of Borrmann type III, and mucosal biopsy of the stomach showed poorly differentiated adenocarcinoma. The patient was treated three times with systemic chemotherapy, but her condition deteriorated. Three months after diagnosis, she died of complicated pneumonia. This is a rare case of endobronchial metastasis from stomach cancer. The stomach is an unusual site of endobronchial metastasis from extrathoracic primary malignancy.
Background: Aortic stenosis (AS) is one of the degenerative heart lesions mainly resulting from congenital defects and rheumatic diseases. This study aimed to determine maternal and fetal outcomes in pregnant women with moderate and severe AS. Methods: The clinical data of 26 pregnant women with AS treated between 2007 and 2019 in Beijing Anzhen Hospital were collected and retrospectively analyzed. Results: AS was diagnosed before pregnancy or after pregnancy in 16 (61.5%) and 10 (38.5%) patients, respectively. Except the peak velocity and mean pressure gradient, no significant difference in baseline cardiac parameters between the patients with moderate AS and severe/very severe AS, such as AS locations, previous heart failure symptoms, and heart function was seen. Heart failure and arrhythmia were complicated in 14 (53.8%) and 6 (23.1%) pregnancies, respectively. The rate of Caesarean deliveries was 85.7% in the patients with severe/very severe AS and 58.3% in the patients with moderate AS. There was no neonatal asphyxia or neonatal death in the cohort. Conclusions: The results of our study indicate the pre-conceptional evaluation and counseling should be performed in women with AS and those with symptomatic and severe AS are recommend to take cardiac surgery as appropriate before pregnancy.
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