CASE 882: FETAL HYDROPS, Dr PHAN THANH HẢI, Dr JASMINE THANH XUÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 25 year-old woman with the first normal pregnancy, but in the 21th week there was her fetal hydrops: pleural effusions both two sides, ascites and body edema.

Prenatal ultrasound detected fetal hydrops and helping guided thoracocentesis in 3 times for every  10 days.

At the 25th week, the fetus came back to normal status, no pleural effusion nor ascites and edema.

Amniotic fluid biopsy result no sign of infection. 

And no abnormal structure of the fetus to find out.

The continuity of follow-up are in progress for the case of unknown ascites and pleural effusion of the fetus in a normal pregnancy.

REFERENCE:

https://www.childrenshospital.org/conditions-treatments/hydrops-fetalis

CASE 880-881: ACHALASIA, Dr PHAN THANH HẢI , Dr ĐINH MINH TUẤN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 Two cases in women with epigastric discomfort and weight loss for one year.

Ultrasound and barium swallow test detected achalasia and confirmed later by gastroendoscopy.

CASE 1: Woman 30 year-old with loss of weight for one year.

CASE 2: Woman 27 year-old, weight loss for one year.

Esophagial dilation manoeuver were done for dilpatation of the narrrowed esophagus.

DISCUSSION:

After the esophagial dilation may get fibrosis of the narrow esophagial part.

And there were cases of pseudoachasia due to hernia and esophasial cancer.

CASE 878-879: ADRENAL TUMOR, Dr PHAN THANH HẢI, Dr TRƯƠNG THỊ MỸ HOÀNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 Two cases of right adrenal tumors in women detected spontanously by abdominal ultrasound and confirmed later by MRI [case 1] and MSCT (case 2).

Based on ADRENAL-RADS the two adrenal tumor were classified.

CASE 1: A 30 year-old HTA woman for 7 years; going to Medic in an hypertensive crisis # HTA=212/90mmHg, with a right adrenal tumor # 25x16mm on emergency ultrasound.

Surgery was done: Malignant cortex adrenal tumor. Post-op 2 months, coming back normal arterial tension and hormones.

CASE 2:  A 50 year-old woman in check-up,  with adrenal tumor # 21x23mm.

Surgery removed a right  adrenal adenoma.

CASE 877: ABDOMINAL PAIN due to FISHBONE: Dr PHAN THANH HẢI, Dr LÊ THỐNG NHẤT, MEDIC MEDICAL CENTER, HCMC , VIETNAM

 A 55 year-old man with abdominal pain for 3 days in right flank.

Ultrasound noted a  #46x12mm fluid-filled appendix.

But MSCT detected a wall-off transverse colon abscess with a # 14mm transwalled colonic fishbone.

Open surgery was done for removed partial colon with a fishbone.

CASES 875-876: FIBROCYSTIC CHANGE of BREAST with CLASSIFIED BI-RADS 5, Dr PHAN THANH HẢI, Dr NẠI THỊ HƯƠNG THOANG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Two cases of breast tumor classified BI-RADS 5 with disconcordance between ultrasound features and core biopsy and  immunohistochemical staining results.

 

CASE 01:  

A 22 year-old girl with right breast mass: solid and microcalcifications. Ultrasound findings were malignant characteristic but FNAC and IHC resulted a fibrocystic changeof the breast.

CASE 02:

A 44 year-old woman with malignant breast tumor: solid, spiculated border, tissue contraction that were on left breast ultrasound examination.

FNAC, and 2 times of core biopsy were fibrocystic change results. Lumpectomy for biopsy result was non-malignant mass with immunohistochemical (IHC) staining.

CASE 874 : GASTRIC OUTLET OBSTRUCTION due to PANCREATIC CANCER, Dr PHAN THANH HẢI, Dr TRẦN MỘC HIỆP, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 55 year-old woman with epigastric pain, flatulence for 2 months that failed in gastric management. Two days before she vomited out the old gastric contents.

Ultrasound detected a dilated stomach and obstruction of extra and intrahepatic biliary ducts which may due to pancreatic head tumor #30x35 mm. CBD dilated # 15-17mm in diameter.

Lab data showed increased CA 19.9.

MSCT confirmed head of pancreas tumor which made obstruction of biliary ducts and  the stomach in dilatation.

Open surgery was done for removing the pancreatic tumor and performing the gastroenterology anastomosis and common bile duct- ileum anastomosis.

Result of pathology was adenocarcinoma metastasized duodenum, transverse colon and lymph node.

Reference:

CASE 872-873 : REMOVED APPENDICITIS before 15 hours, Dr PHAN THANH HẢI, Dr NGUYỄN ĐỨC MINH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 Two cases of  acute appendicitis diagnosed by ultrasound at 12th and 14 th hour from onset.

CASE 1

A 37 year-old woman with epigastric pain from 2:00am and going to the umbilical region which was not released with Phosphalugel; then she went to Medic Center at 5:00am. WBC:15x10^9/L CRP:2.0mg/L

Ultrasound detected an #60x15 mm inflamed appendix  which appeared as finger sign, and uterine fibroma.

MSCT confirmed an acute appendicitis.

  

Endoscopic surgery was done at 13:00pm with a diagnostic of a congestion appendicitis.

CASE 2:

A 47 year-old man with a sudden epigastric pain at 9:00am. WBC 10.9x10^9/L,  CRP  4.91mg/L.

Endoscopy noted an acute gastritis.

But ultrasound detected an 62mm long acute appendicitis [thick wall:2.7mm].

He entered the hospital at 01:00 pm and the inflamed appendix removed by endoscopic surgEru at 5 :00 pm in the same day.