Forearm arteries entrapment syndrome: a rare cause of recurrent angioaccess thrombosis.

Entrapment syndrome below or just above the elbow is uncommon. These rare causes of neurologic or vascular entrapment are linked to anomalous anatomical structures. No case of entrapment syndrome has been reported in patients with angioaccess for hemodialysis. We report, for the first time, forearm arteries entrapment in two patients presenting with recurrent angioaccess for hemodialysis thrombosis. Anatomical, radiologic, and surgical features of these uncommon syndromes are discussed.     

Ureterorectal fistula: a rare cause of recurrent bacteriuria

The differential diagnosis of recurrent bacteriuria includes a host of conditions very familiar to urologists. Ureterorectal fistula represents an unusual clinical entity that can cause recurrent bacteriuria. We present a patient who ultimately proved to have such a fistula. We review the available literature and comment on the significance of this condition.     

Pheochromocytoma: a rare cause of childhood hypertensive encephalopathy

Pheochromocytomas are rare neuroendocrine tumours of chromaffin tissues. They are catecholamine secreting tumours which cause severe hypertension and other systemic disturbances. Of all the causes of childhood hypertension, pheochromocytoma constitutes less than 1%. We report the case of a 12 years old child who presented with hypertensive encephalopathy, confirmed histologically to be secondary to pheochromocytoma, and cured with meticulous critical care and surgical resection.     

Nephrotic syndrome: a rare cause of acute coronary syndrome in a child

Patients with nephrotic syndrome are at risk of developing thrombosis in both veins and arteries. Various manifestations in different organs have been reported. Thrombi in heart seen, associated with multiorgan thrombosis have been reported on autopsy earlier, but only once in a living patient with nephrotic syndrome. Here, we report a 13 years old boy with steroid-resistant nephrotic syndrome, who developed an asymptomatic but potentially hazardous large intracardiac thrombus. The child developed nephrotic syndrome at the age of 9 years and had multiple recurrences. At the age of 13 years, he developed myocardial infarction (MI) due to embolism from a large intracardiac thrombus. Later on, he was treated with heparin and warfarin anticoagulation.     

A rare cause of recurrent priapism: hereditary angioedema

Hereditary angioedema is a rare disease, which is caused by deficiency of compleman c1 esterase inhibitor regulatory protein in the compleman system. Priapism is involuntary, painful and prolonged erection of penis more than 4 h without sexual desire. In this case report, we elucidated a patient diagnosed with hereditary angioedema while he had recurrent priapism.     

Infective endocarditis: a rare cause of acute coronary syndrome

This is a case report of a 26 years old female who presented in emergency with sudden onset of chest heaviness and dyspnoea. She had suffered a stroke in the past and was treated with anti-tuberculous medication. Her ECG revealed STelevation myocardial infarction and thrombolysis was performed but was unsuccessful. Further workup during in-hospital stay revealed evidence of infective endocarditis and Streptococcus species were isolated. She was started on penicillin and gentamycin with good recovery. This case presented a management problem during initial presentation as there was insufficient data on thrombolysis during such situation. It is also a diagnostic problem as the initial picture was dominated by acute coronary syndrome. There is need to develop consensus based on expert opinion about management in such situations.     

A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

We describe a case of life-threatening small bowel haemorrhage in a 56 year old man, who was found to have partial midgut malrotation at laparotomy. An association between congenital malrotation and gastrointestinal haemorrhage has not previously been reported in this age group. We discuss the association between gut malrotation and small intestinal pathology and describe the principles of management in these patients.     

A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare.     

Rectal tuberculosis: A rare cause of recurrent rectal suppuration

Tuberculosis affecting the rectum is a rare extra‐pulmonary form of the disease that needs recognition, because it requires specific treatment and avoids multiple, unwarranted surgical interventions. The following discussion is centred on a case of rectal tuberculosis, a disease that rarely affects the anorectal region. The condition was diagnosed on histology and was successfully treated medically with complete resolution.     

Bronchial adenoma: an unusual cause of recurrent pneumonia in childhood

Primary lung tumors are rare in childhood and often overlooked owing to the nonspecific presentation. We report the case of a 15-year-old boy with a 3-year history of recurrent pneumonia always involving the right lower lobe due to bronchial mucinous adenoma. After endoscopic removal the tumor recurred locally, necessitating open surgical resection of the tumor. In a child with localized recurrent pneumonia of uncertain pathogenesis, the differential diagnosis should include a primary lung tumor. Bronchial adenomas should not be removed endoscopically; patients must undergo open thoracotomy for surgical excision.     

Diverticulosis of the main bronchi: a rare cause of recurrent bronchopneumonia in a child.

Diverticulosis of the main bronchi, not associated with other organ abnormalities, developed in a 12 year old child. This abnormality caused recurrent bronchopneumonia in the lung with the main bronchi diverticulosis. Fibreoptic bronchoscopy helped to locate the lesion and selective bronchography, with injection of contrast medium through the suction channel of the fibreoptic bronchoscope, showed the morphology of this rare malformation.     

Mesenchymal cystic hamartoma of the lung: a rare cause of pneumothorax

A 14-year-old girl had a left spontaneous pneumothorax. Because closed chest tube drainage failed to obtain expansion of the lung, thoracoscopic bullectomy was performed. Pathological examination of the bulla resulted in the diagnosis of mesenchymal cystic hamartoma, which is a rare cause of pneumothorax.