Online Exclusives
Severe menorrhagia, unilateral ovarian mass, elevated inhibin levels, and severe hypothyroidism: An unusual presentation of Van Wyk and Grumbach syndrome
A 10 year old female presented with a 3 week history of persistent vaginal bleeding, lower abdominal pain, and generalized fatigue. Further work-up determined that she had severe autoimmune hypothyroidism, precocious puberty, and a large left cystic ovarian mass, consistent with Van Wyk and Grumbach syndrome. In addition, the patient had elevated inhibin A and B levels, which may be elevated in granulosa cell tumor. The patient was managed with thyroid hormone replacement therapy and careful observation.Laparoscopic repair of traumatic abdominal wall hernia from handlebar injury
A 14-year-old boy was seen at an outside hospital after falling over the handlebar of his bicycle and was discharged home. He was subsequently seen in our emergency department with complaints of persistent abdominal pain. A computed tomography scan of the abdomen revealed disruption of the muscles of the upper right abdominal wall containing the hepatic flexure of the colon, with a small amount of intraperitoneal free fluid noted. The patient underwent laparoscopic exploration using 3 ports (2-5 mm and 1-12 mm) and 2 separate stab incisions.Presentation and management of late-onset duodenomegaly in a teenager with chronic obstruction from malrotation
Anomalies of intestinal rotation typically present in infancy and early childhood. The diagnosis in older children and adults may be vague and delayed. We discuss a case and management of a patient with late-onset duodenomegaly with chronic obstruction from malrotation.
