Jayme D Mancini*
Department of Osteopathic Manipulative Medicine, NYIT College of Osteopathic Medicine, Northern Boulevard, Old Westbury, New York, USA
Received date: 01/04/2017Accepted date: 01/04/2017Published date: 08/04/2017
Visit for more related articles at Journal of Clinical and Medical Case Studies
In this issue of Journal of Clinical and Medical Case Studies, case reports of rare conditions, surgical case series, and documentation of iatrogenic conditions are presented with extensive clinical images and descriptions of management. Although uncontrolled case reports are not specifically hypothesis-generated, these case reports provide insight into how physicians diagnose and manage health and disease in order for medical scientists to generate useful clinical or translational hypotheses to improve care.
Gall bladder, Hemangioma
In this issue of Journal of Clinical and Medical Case Studies, case reports of rare conditions, surgical case series, and documentation of iatrogenic conditions are presented with extensive clinical images and descriptions of management. Although uncontrolled case reports are not specifically hypothesis-generated, these case reports provide insight into how physicians diagnose and manage health and disease in order for medical scientists to generate useful clinical or translational hypotheses to improve care.
Case reports are essential when conditions are rare and/or underdiagnosed, making larger studies challenging. The rare conditions in this issue include torsion of the gallbladder (a.k.a. gallbladder volvulus) [1], macrophage activation syndrome, cavernous splenic hemangioma, and congenital anomalies. Gallbladder volvulus is a rare condition (estimated incidence of one in 365,520 hospital admissions) typically identified during cholecystectomy in less than 0.1% of patients who are tentatively diagnosed with acute cholecystitis. Macrophage activation syndrome is a hyperinflammatory condition involving hypercytokinemia that is more commonly found in rheumatologic disorders. Macrophage activation syndrome [2] is particularly challenging to accurately diagnose and differentiate from other hyperinflammatory disorders. Along with rare conditions, this issue presents case reports of underdiagnosed conditions such as atrial septal defects in adults and surgical management of challenging pathophysiology. Atrial septal defects [3] are present in approximately 100 per 1,00,000 live births, typically asymptomatic until adulthood if they remain unclosed.
Other valuable information from case reports is the communication of potentially unidentified or rarely occurring iatrogenic effects and management of the effects to other health care professionals and scientists. In this issue, iatrogenic conditions such as deep vein thrombosis from third generation contraceptives and splenectomy-induced intra-hepatic splenosis with the rare cavernous splenic hemangioma are reported [4].
Carefully selected cases evaluated in uncontrolled case series are particularly useful when further assessing the risks and benefits of invasive procedures for which sham-controls are inappropriate. In this issue, a retrospective study of laparoscopy, as a less invasive method for biopsy of deep intra-abdominal lymph nodes, was found useful in providing adequate sampling for the histopathological analysis required for diagnosis of conditions such as lymphoma and to confirm spread of malignant disease. In addition, case reports of the diagnosis and management of diverse obstetrical conditions and complications are included.
One of which, demonstrates the importance of pre-screening patients for hereditary hemorrhagic telangiectasia and the arteriovenous malformations that are commonly found in the pulmonary, cerebral, and hepatic circulations. Case reports and series are often the first step in advancing medical care through clinical education and inspiring further research.
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