Modification of the modified Graham patch repair for duodenal perforation using the gastrocolic ligament: Two case reports.

Introduction: Gastroduodenal perforations are relatively common surgical emergencies with mortality rates as high as 40%. The Graham patch repair is one surgical approach but may need to be modified when the patient lacks viable omentum. The gastrocolic ligament can be utilized to repair these perforations for coverage.

Through their eyes: Empathetic learning for frontline healthcare providers to improve care for the patient living with dementia.

Evoking emphatic care and committing to an elder-friendly environment for older adults living with dementia is a focus at many Nurses Improving Care for Healthsystem Elders (NICHE) member organizations. Improved dementia knowledge and skills for treating older adults optimize clinical outcomes and patient and family satisfaction. The dementia protocol utilized in NICHE organizations recommends providing a safe therapeutic environment and caregiver education and support.

Novelty in the gut: a review of the gastrointestinal manifestations of syphilis.

Syphilis is a systemic infection caused by the spirochete . It is transmitted during pregnancy or through sexual contact. Signs and symptoms vary depending on the clinical stage of the disease.

Inferior Clinical Outcomes Following Endoscopic Proximal Hamstring Repair in Patients With Chronic Degenerative Tears Despite the Use of Dermal Allograft Augmentation.

Purpose: To compare clinical outcomes in patients undergoing endoscopic proximal hamstring repair with and without dermal allograft augmentation.

Methods: A retrospective review of prospectively collected data was performed on patients undergoing endoscopic proximal hamstring repair (PHR) and proximal hamstring repair with dermal allograft augmentation (PHR-A) by a single surgeon between 2016 and 2023. Augmentation was utilized for cases of chronic degenerative tears (≥6 weeks from the time of initial injury) where hamstring tissue quality was deemed poor intraoperatively.

Rectal Adenocarcinoma With Pagetoid Spread: A Novel Entity.

Perianal Paget's disease (PPD) is a rare skin adenocarcinoma that arises in the apocrine glands of the perianal region. It is often misdiagnosed as eczema, leukoplakia, squamous cell carcinoma, Bowen's disease, lichen planus, or condylomata acuminata. We report a case of a 63-year-old male who presented to the emergency room (ER) for evaluation of an anal mass that had persisted over 6 months.

Surgical treatment of coexisting intra and extralobar sequestration in an infant.

Pulmonary sequestration is a rare congenital malformation in which a nonfunctional segment of lung tissue has no communication with the tracheobronchial tree and does not participate in gas exchange. We present a rare case of a 20-month old female with extralobar pulmonary sequestration that was diagnosed at birth. The patient was also found to have a coexisting intralobar sequestration, found during surgery.

Pulmonary Kaposi Sarcoma in the Era of Antiretroviral Therapy: A Case Series.

Kaposi sarcoma (KS) is an angioproliferative neoplasm that affects the skin and lymph nodes. Human herpesvirus-8 (HHV-8) triggers KS by infecting the endothelium and inducing angiogenesis through the production of vascular endothelial growth factors and cytokines. KS is characterized by purplish or hyperpigmented plaques involving the skin and mucous membranes, and visceral involvement is very rare.

Symptomatic Valvular and Subvalvular Stenosis: A Case Report.

Aortic stenosis is a common valvular disease that is expected to become more prevalent with the aging population. It is often undiagnosed in socioeconomically deprived groups. Diagnosis relies on echocardiography, and additional imaging techniques such as cardiac computed tomography (CCT) and cardiovascular magnetic resonance (CMR) are increasingly used.

Recognizing serotonin syndrome in the intensive care unit: a case report of serotonin syndrome in a patient taking amitriptyline, buprenorphine, pregabalin, and fentanyl.

Background: Despite its life-threatening nature, serotonin syndrome (SS) often eludes initial recognition and remains an underreported condition that can occur with the administration of serotonergic drugs alone or in combination with other medications known to increase levels of serotonin. The diagnosis of SS relies on clinical assessment, as laboratory tests and imaging studies cannot definitively confirm the condition. The majority of reported cases of SS involve polypharmacy rather than single-drug overdose.

A Case of Cardiac Tamponade With Biventricular Heart Failure in the Setting of Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease targeting multiple organs through immune complexes. Pericarditis and pericardial effusions are often encountered; however, cases of biventricular failure are notably less common in the setting of SLE. We report a 43-year-old male patient presenting with cardiac tamponade with biventricular failure in SLE.

A Unique Presentation of Bacterial Group G Streptococcus Myopericarditis.

Perimyocarditis and myopericarditis are inflammatory conditions of the pericardium and myocardium, often of idiopathic or infectious etiology, with viral infections being the most common. Nonrheumatic streptococcal myopericarditis (NSM) is a rare condition that can mimic acute myocardial infarction. This case report presents a 22-year-old male with no prior medical history who developed NSM following a streptococcal pharyngitis infection.

Orogastric Tube Fracture and Ingestion in a Patient With Hyperacute Delirium: A Unique and Potentially Catastrophic Complication.

Orogastric tubes (OGTs) are frequently used to administer feeds and medications to critically ill patients. They are inserted blindly, with a low first-pass success rate and frequent benign complications. OGT fractures and ingestion are exceedingly rare, with only two cases reported to date.

Alpha-Fetoprotein-Producing Hepatoid Adenocarcinoma of the Stomach.

Hepatoid adenocarcinoma of the stomach (HAS) is a rare type of gastric cancer with unique clinicopathological features. HAS has a poor prognosis because of early liver, lung, and lymph node metastasis. Owing to its rarity and malignant potential, data on its pathophysiology and management are scarce.

Psoas Muscle Morphology: A Novel Classification System and Its Anatomic Relationship with Adjacent Neurovascular Structures.

Study Design: Cross-sectional radioanatomic study.

Objective: To introduce a classification system using MRI to describe psoas morphology and examine the position of nearby neurovascular structures.

Summary Of Background Data: Oblique lumbar interbody fusion (OLIF) and lateral lumbar interbody fusion (LLIF) offer sagittal malignment correction and reduced morbidity.

The Silent Band: Laparoscopic Adjustable Gastric Band Erosion as an Incidental Finding During Endoscopy.

Laparoscopic adjustable gastric banding (LAGB) is a bariatric procedure that was introduced in the early 1990s and offers a minimally invasive and reversible option for weight loss. Initially popular due to its simplicity and effectiveness, LAGB's long-term success has been limited by complications such as port-site infection, pouch dilatation, and gastric band erosion. Herein, we describe a rare case of gastric band erosion found incidentally during endoscopy a decade after placement.