Browsing by Author "Wattsman, Terri-Ann"
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- Burkitt-type lymphoma incidentally found as the cause of acute appendicitis: a case report and review of literatureShahmanyan, Davit; Saway, Brian F.; Palmerton, Hannah; Rudderow, John S.; Reed, Christopher M.; Wattsman, Terri-Ann; Faulks, Emily R.; Collier, Bryan R.; Budin, Robert E.; Hamill, Mark E. (2021-09-24)Background Appendectomy remains one of the most common emergency operations. Recent research supports the treatment of uncomplicated appendicitis with antibiotics alone. While nonoperative management of appendicitis may be safe in some patients, it may result in missed neoplasms. We present a case of acute appendicitis where the final pathology resulted in a diagnosis of a Burkitt-type lymphoma. Case presentation An 18-year-old male presented to the emergency department with 24 h of right lower quadrant pain with associated urinary retention, anorexia, and malaise. Past medical history was significant for intermittent diarrhea and anal fissure. He exhibited focal right lower quadrant tenderness. Workup revealed leukocytosis and CT uncovered acute appendicitis with periappendiceal abscess and no appendicolith. Laparoscopic appendectomy was performed and found acute appendicitis with associated abscess abutting the rectum and bladder. Pathology of the resected appendix reported acute appendicitis with evidence of Burkitt-type lymphoma. A PET scan did not reveal any residual disease. Hematology/oncology was consulted and chemotherapy was initiated with an excellent response. Conclusions Appendiceal lymphomas constitute less than 0.1% of gastrointestinal lymphomas. Primary appendix neoplasms are found in 0.5–1.0% of appendectomy specimens following acute appendicitis. In this case, appendectomy allowed for prompt identification and treatment of an aggressive, rapidly fatal lymphoma resulting in complete remission.
- Preventing Severe Hypoglycemia with a Continuous Glucose Monitor Device in an Infant with Glycogen Storage Disease 1a undergoing a Gastrostomy Tube Placement: Case ReportWard, Chad; Washofsky, Anne; Nguyen, Emily; Fortune, Laura; Wattsman, Terri-Ann (2022-11-12)We describe a case in which a continuous glucose monitor (CGM) was used during hospitalization to safely prevent severe hypoglycemia in a 10-month-old male with glycogen storage disease 1a undergoing placement of a gastrostomy tube. The child was admitted to the hospital for placement of a gastrostomy tube given increased severe hypoglycemic episodes at home secondary to worsening feeding aversion. During hospitalization, the CGM was monitored before, during and after surgery. Severe hypoglycemic episodes were avoided while hospitalized. The CGM device assisted with the management and titration of continuous dextrose infusion while the child was fasting. The CGM device improved patient and family centered outcomes by reducing the need for frequent finger stick point-of-care glucose checks and allowed the family and anesthesiologist to carefully monitor the child’s blood glucose continuously during the procedure.