Category Archives: Case Report

Postpartum pancreatitis in young female – a rare case in the Emergency Department

Adrienn Nemeth1,2, Puiu Popescu2

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Emergency Department, Emergency County Hospital, Targu Mures, Romania

DOI: 10.2478/amma-2022-0018

Introduction: Acute pancreatitis is a condition that leads to multiple organ failure syndromes if not diagnosed and treated correctly. The most frequent causes of acute pancreatitis are gallstones, alcohol consumption, and elevated triglyceride serum level.
Case Presentation: A 21-year-old female presented to the emergency department with epigastric pain, nausea, vomiting, and diaphoresis. The patient had a non-complicated vaginal birth four months prior, had no personal history of illness, reported no alcohol consumption, and had a slender body constitution. Laboratory tests outlined a white blood cell count of 22.000/µL, elevated neutrophil count, lactate dehydrogenase 294 U/L, and lipemic serum sample reported for chemistry laboratory test. In addition, the contrast-enhanced computed tomography scan revealed severe pancreatitis, with an intraabdominal fluid collection.
Conclusions: This case report highlights the importance of correct early diagnosis in the postpartum and late postpartum period and raises awareness concerning the possibility of acute pancreatitis in a postpartum woman even if she does not have the two most common risk factors: gallstones or alcohol consumption.

Keywords: , , ,
Full text: PDF

Development of a low-grade glioma in an ischemic brain territory that evolved into a glioblastoma. A case report and brief literature review

Andrei-Cristian Fülöp1, Zeno Opriș1, Eugen-Francisc Fülöp2, Ioana-Geanina Ghilință3, Rita Szodorai4, Attila Kövecsi4

1. Department of Radiology, Emergency County Hospital, Targu Mures, Romania
2. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Paediatric Cardiology, Emergency County Hospital, Targu Mures, Romania
4. Department of Pathology, Emergency County Hospital, Targu Mures, Romania

DOI: 10.2478/amma-2022-0015

Introduction: Glioblastoma is one of the most common and aggressive brain tumours with a very high mortality rate. It often evolves from a late or misdiagnosed astrocytoma. Stroke is one of the most common pathologies of the brain, affecting approximately 1.1 million Europeans each year. This article presents the sequential development of a low-grade astrocytoma in an ischemic brain territory into a high-grade glioblastoma.
Case presentation: A 59-year-old patient presented to our hospital with severe headache and transient loss of balance and vision. Clinical findings and control imaging revealed the presence of an ischemic brain area in the left temporal lobe of the brain. Monthly brain magnetic resonance imaging (MRI) follow-up revealed the development of a low-grade astrocytoma in the ischemic territory, which later evolved into a glioblastoma.
Conclusions: Patients who suffer from a stroke should be closely monitored via MRI to prevent the rare development of tumour pathology in the affected territory.

Keywords: , , ,
Full text: PDF

Non syndromic congenital agenesis of multiple permanent teeth: Case series and recent literature review

Sowmya Sridhar1, Savil R Uchil1, Anupama P Nayak1, Ravikiran Ongole2, Suprabha BS1, Ashwin Rao1, Karuna YM1

1. Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
2. Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

DOI: 10.2478/amma-2022-0013

Introduction: Hypodontia refers to the congenital absence of less than six teeth. This absence may be unilateral or bilateral. Though the congenital agenesis of bilateral mandibular/ maxillary incisors has often been reported in literature, however, the congenital absence of bilateral mandibular and maxillary incisors, as well as the mandibular second molar- giving rise to a total of six missing permanent teeth in an apparently healthy individual has not been reported earlier.
Case presentation: This case series presents two cases of a 10- and 11-year-old children with presence of retained deciduous anterior in both arches with absence of permanent successors and also aims to review the literature regarding etiology, clinical implications and management in such cases.
Conclusions: It is essential that practitioners monitor the developing dentition with establishment of a proper review schedule. Non-eruption of the permanent tooth more than one year later than expected, or even after six months following the emergence of the contralateral tooth, warrants a high degree of suspicion. A multidisciplinary team, including pediatric, restorative and orthodontic specialists, is advised. In addition, prior to formulation of any treatment plan, due consideration to the general issues such as the patient’s systemic and oral health, motivation and expectations should be given.

Keywords: , ,
Full text: PDF

Use of the continuous glucose monitoring system in the management of hypoglicemia in insulin autoimmune syndrome

Andrada Raluca Pop1, Claudia Emanuela Ruscanu2, Gabriela Roman1, Ionela Maria Pascanu2

1. Diabetes Center, Emergency County Hospital Cluj Napoca, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania
2. Endocrinology Center, Emergency County Hospital Targu Mures, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0011

Background: Insulin autoimune syndrome (IAS), also known as Hirata’s disease, is a rare cause of spontaneous hyperinsulinemic hypoglicemia characterised by the presence of autoantibodies directed against human insulin (IAA).
Case Report: A 48-year-old Caucasian female patient with IAS was studied in two different periods, for 7 days each, using a continuous monitoring system (CGM) under various treatment regimens, i.e diet modification and corticosteroids therapy.
Discussions: The use of CGM in autoimmune hypoglycemia is encouraged and must be taken into consideration in order to prevent episodes of hypoglicemia. Including of IAS and quantification of IAA in differential diagnosis in patients with hypoglicemia episodes and negative imaging results can prevent patients from going through unnecessary procedures.

Keywords: , , ,
Full text: PDF

Abdominal wall metastases due to a squamous cell carcinoma of the lung: Case report and literature review

Corina Florica Ioniță1, Ioana Iulia Cojocaru2, Adriana Gomotîrceanu1, Bogdan Andrei Suciu3, Doina Milutin2, Alexandru Ilie Butilcă4, Călin Dragoș Molnar3, Ioana Halmaciu3

1. Topmed Medical Center, Târgu Mureș, Romania
2. County Emergency Clinical Hospital Targu Mures, Romania
3. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
4. Recovery Clinic Hospital, Cluj Napoca, Romania

DOI: 10.2478/amma-2022-0010

Introduction: At the time of diagnosis, most patients with lung cancer are in an inoperable stage, with distant metastases. Most often, these patients have metastases to the brain, adrenal glands, liver, or bones. This article presents the case of a patient with non-small-cell lung cancer (NSCLC) metastases in the abdominal wall.
Case presentation: A 67-year-old patient came to our service reporting the existence of a tumor 5 cm in diameter, located at the level of the abdominal wall, without other clinical symptoms. Surgical excision of the tumor was performed. The postoperative evolution was favorable, with the patient discharged on the third postoperative day. Histological examination of the resected specimen revealed metastasis of squamous cell carcinoma of the lung.
Conclusions: The appearance of a tumor in the abdominal wall of patients with NSCLC may raise the suspicion of metastasis at this level.

Keywords: , ,
Full text: PDF

Prosthetic management of acquired dentate maxillectomy defects: A clinical case series

Vineet Sharma, Jyoti Paliwal, Balwant Singh Gurjar, Kamal Kumar Meena

Department of Prosthodontics and Crown and Bridge, RUHS College of Dental Sciences, Jaipur, India

DOI: 10.2478/amma-2022-0009

Acquired maxillectomy defects produce hypernasal speech, food, and liquid regurgitation into the nasal cavity, impaired deglutition and mastication, and cosmetic deformity. Furthermore, patients with acquired maxillary defects face psychosocial stigma, which has a negative impact on their quality of life. Prosthetic rehabilitation of such defects is required for stomatognathic system restoration and oroantral communication obturation. This case series discusses the fabrication of surgical, interim, and definitive obturator prostheses to restore the acquired dentate maxillectomy defects of three cancer patients. All patients had their treatment in the prosthodontics department of the RUHS College of Dental Sciences. The surgical obturator prosthesis was made before surgery, whereas the interim and definitive obturators were made one month and six months after surgery, respectively. The surgical obturator formed a shield between the surgical pack and the oral cavity. After the surgical obturator and packing were removed, an interim obturator was inserted for three to six months to allow the surgical site to heal. After the surgical site had healed, the fabrication of the definitive obturator began. Prosthetic rehabilitation with obturator prostheses sealed the acquired tissue defects of the palate and restored swallowing, speaking, chewing capacity, and cosmetic value, as well as significantly improved the quality of life of these patients.

Keywords: , , , ,
Full text: PDF

Pier Abutment: Bridge the gap with Non rigid connector – A clinical case report

Vineet Sharma, Kamal Kumar Meena, Balwant Singh Gurjar, Ramawatar Nagar

Department of Prosthodontics and crown & bridge, RUHS College of Dental Sciences, Jaipur, India

DOI: 10.2478/amma-2022-0008

Pier abutment is defined as a freestanding abutment with edentulous space on both sides. This case report described the rehabilitation of a patient who presented to the department with the primary complaint of missing teeth and difficulty in mastication. Intraoral examination revealed missing right maxillary canine and the second premolar, with the lone standing first premolar acting as a pier abutment. To reduce the stress transferred to the abutment and prosthetic assembly, a non-rigid (Tenon-mortise) connector was used in the case, with a keyway (mortise) distal to the pier abutment and a key (Tenon) mesial to the distal pontic.

Keywords: , , ,
Full text: PDF

Chest wall secondary chondrosarcoma caused by malignant degeneration of an enchondroma: case report and literature review

Corina Florica Ioniță1, Ioana Iulia Cojocaru2, Adriana Gomotîrceanu1, Bogdan Andrei Suciu3, Doina Milutin2, Anca Alexandra Molnar2, Vlad Neag2, Ioana Hălmaciu3

1. Topmed Medical Center, Târgu Mureș, Romania
2. Emergency County Hospital, Targu Mures, Romania
3. Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0006

Introduction: Enchondromas are benign tumors originating in the cartilaginous tissue of the hyaline gristle, rarely located in the chest wall. They sometimes undergo a sarcomatous transformation, becoming secondary chondrosarcomas.
Case presentation: We present the case of a 53-year-old patient who, following a chest computed tomography scan performed after a thoracic trauma, was diagnosed with an osteolytic tumor at the chondrocostal junction of rib 4. Surgery was performed, with partial straight resection of ribs 3–5. Histopathological examination of the resection piece identified the existence of a chest wall chondrosarcoma on the background of malignant degeneration of an enchondromatosis lesion. The postoperative evolution was favorable, and the patient was discharged on the eighth postoperative day.
Conclusion: In patients with even asymptomatic chest wall enchondromas, periodic clinical evaluation of these lesions is required, given their risk of malignant degeneration.

Keywords: , ,
Full text: PDF

Rehabilitation of maxillary arch with attachment-retained reinforced single complete denture

Oana Cella Andrei1, Daniela-Ioana Tărlungeanu1, Ruxandra Mărgărit2, Gabriela Ciavoi3, Adriana Bisoc1

1. Department of Removable Prosthodontics, UMF Carol Davila Bucuresti
2. Department Of Restorative Odontotherapy, UMF Carol Davila Bucuresti
3. Department Of Dental Medicine, University of Oradea

DOI: 10.2478/amma-2022-0003

Introduction: Fracture of maxillary complete denture is a common problem for dentists and denture wearers, occurring especially when it is opposing mandibular natural teeth or fixed and implant-sustained restorations; to prevent it, various methods and materials are available.
Case presentation: This case is of a patient losing his old maxillary removable partial denture due to the mobility of the frontal abutments. Considering the age of the patient and the status of the mandibular arch, completely restored and having a mix of natural teeth, fixed and implant-sustained restorations, the functional and esthetic rehabilitation of the maxillary arch, and also the long-term resistance of the denture, are a serious prosthetic challenge. An association between ball attachments, metal-casted reinforcement and masking agents for both are described, underlying their role in the treatment’s succes.
Conclusion: The age and health status of the patient and the situation of the mandibular arch imposed the construction of a functional, strong and stable maxillary denture; the technique described in this article offers a good functional and esthetical result and benefits the patient, even if the implant-prosthetic therapy is not available.

Keywords: , ,
Full text: PDF

Maturogenesis of an immature necrotic tooth with an extensive perirapical lesion using platelet rich fibrin

Bhaswati Chakraborty1, Ashwin Rao2

1. Department of Dentistry, Calcutta National Medical College and Hospital, West Bengal University of Health Sciences, Kolkata, West Bengal, India
2. Department of Paediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

DOI: 10.2478/amma-2022-0001

Introduction: Earlier, treatment of immature necrotic tooth focussed only on surgical endodontic management and apexification procedures. Regenerative endodontic therapies have called for a paradigm shift in management of such cases. Prognosis becomes challenging though at times due to chronicity of infection, inadequate disinfection of canal space and cytotoxic nature of irrigants used hindering the survival of the apical stem cells.
Case presentation: This report highlights the management of a long-standing case of an immature necrotic tooth with an extensive periapical lesion in a 12 year old male patient. The protocol of regenerative endodontic procedure using platelet rich fibrin (PRF) was followed. Follow up visits at 1week, 3months and 12 months revealed a successful clinical and radiological outcome leading to progressive maturogenesis of the tooth.
Conclusion: The case report favours the possibility of stem cells of apical papilla being viable even in chronic periapical lesions. Hence conservative approach involving regenerative endodontic therapies should always be sought for as first line of treatment in such cases.

Keywords: , , ,
Full text: PDF