CASE 855: FULL TB INFECTION with INCREASING CANCER MARKERS, Dr PHAN THANH HẢI, Dr PHẠM LÊ DIỄM CHI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A 18 year-old weakness man with neck nodes  and abdominal pain.  Thin, pale, height 165cm, weight 39kg. Pain but not existing abdominal guarding.

Ultrasound noted cervical lymph nodes and nothing detected in the abdomen. They were inflamed nodes but may due to infiltrated lymphoma.

But full body MSCT revealed many inflamed organs may suffer from TB infection.

Lab data showed positive TB in phlegm and increasing abnormally values of some cancer markers: CA-19.9, beta 2 microglobulin and CA-125 . The last one helps differentiating a pulmonary TB from other lung infections as published on medical literature.

The patient remains well after going through the anti-TB course of treatment.

CASE 854: FITZ- HUGH-CURTIS SYNDROME with High Value of CA 125, Dr PHAN THANH HẢI, Dr VÕ THỊ PHƯƠNG TRINH, MEDIC MEDICAL CENTER, HCMC VIETNAM

 A 32 year-old woman with epigastric and RUQ pain for 5 days.

Ultrasound detected PID both 2 sides,  many white spots in the liver and small amount of fluid in the pelvis. CRP and CA -125 was in high value : 365U/mL.

MSCT  confirmed the PID and inflamed hepatic pericapsule of FITZ- HUGH-CUTTIS syndrome. Liver may got multifocal of hemangioma.

A medical management has been done for this  external patient.

Reexamination of  3 times noted decreasing of PID and CEA value:135U/mL.

CASE 853: FISHBONE INDUCED APPENDICITIS, Dr PHAN THANH HẢI, Dr NGUYỄN NGỌC XUÂN GIANG, BÌNH AN HOSPITAL KIÊN GIANG - MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 77 year-old man with epigastric pain for 5 days then going down to the RLQ. He got no fever.

Ultrasound detected an 29.7x6mm inflamed appendix with a foreign body inside it. 

WBC 8.1x10 ^ 9 /L but CRP 46.17mg/L.

MSCT confirmed the appendicitis in an elderly patient with a fishbone inside.

Surgery was done and it existed a fishbone inside the inflamed appendix.

CASE 852: ACHALASIA, Dr PHAN THANH HAI, Dr VO NGUYEN THUC QUYEN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A 55 year-old woman with 5kg weight loss for 3 month as dysphagia.

Ultrasound detected cervical esophagial dilatation and positive bird beak sign of the cardial esophagus. It existed no tumor outside of the cardia of the stomach but having only a liver hemangioma in the left lobe.

Barium swallow on X-ray noted a rat's tail sign and esophagial dilatation that proved achalasia.

MSCT confirmed the achalasia.

The patient will going through a cardioesophagial ballooning and medical management.

CASE 851: GALLBLADDER CANCER, Dr PHAN THANH HAI, Dr LAM THI LE HANG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 83 year-old diabetic woman with flatulence for 2 months. No jaundice nor fever and negative sonoMurphy sign were noted.

Ultrasound detected GB stone and GB deformation which became a complexe heteroechoic vascular mass #68x45mm.

MSCT confirmed GB stone and GB tumor.

She denied surgery as aged patient with many disorders of cardiac fibrillation, diabetic and osteoporosis with 8 folds of risk of bone fracture.

CASE 850: IVC THROMBOSIS and CONTRACEPTIVE DRUG, Dr PHAN THANH HAI, Dr TRAN THI THANH NGA, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 24 year-old girl with a swollen painful right leg for 3 days. She used to be taken a contraceptive drug for 4 months as her acnea.  Two weeks after ceasing the drug her right leg got being swollen.

Right leg : 23-37-54mm

Left leg : 20-31-47mm

Ultrasound B -mode and Doppler detected thrombosis of her right leg vein, right iliac vein and in a part of the IVC. No thrombus into the right cardiac chamber.

Lab data : Rising D-Dimer : 3653ng/mL.

She was conservatory treated by fibrinolytic drug and anticoagulant.

CASE 849: SOLITARY MESENTERIC THROMBOSIS, Dr PHAN THANH HAI, Dr LE VAN TAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 49 year-old man with 14 day fever and epigastric pain and vomiting. Two times of ultrasound examination in another hospitals were nothing but failed in gastritis management.

Ultrasound in Medic Center detected an enlarged echogenic mesenteric vein diameter # 11mm and no flow in its lower part.

MSCT confirmed a thrombosis of a part of the mesenteric vein.

Lab data showed increased the platelets #544 H, WBC = 10,400 and positive Dengue fever Ig G.

As it exists no sign of bowel infarction a medical management was made. The pain was reduced for some days with a new generic of anticoagulant.