Journal of Clinical Case Reports

Hereditary angioedema is a rare autosomal dominant disorder with prevalence estimated at 1/50,000, C1-INH levels may be decreased or normal, with an accompanied decrease in functionality, characterized by non-itchy and non-pitting swelling of subcutaneous and sub mucosal tissues of the face, extremities, genitalia, gastrointestinal tract, and upper airways, which can be life-threatening when located to the airways. It has been reported hereditary angioedema with ascites, but characterized with pleural effusion is rare. We describe a case of 30-year-old woman with pleural effusion for attracting attention of medical staff.

Extramedullary Hematopoiesis (EMH) is a compensatory phenomenon to insufficient bone marrow function to maintain the circulatory demands. EMH occurs most commonly in the reticuloendothelial system such as spleen, Liver and lymph nodes, or in para osseous sites. EMH in the adrenal is rare with fewer than 10 cases reported, presenting as a giant adrenal mass are extremely rare. We report 38-year-old women with history of β-thalassemia since childhood. Computed Tomography (CT) was revealed a giant right adrenal mass with heterogeneous density mimicking a tumor mass with moderate splenomegaly associated, after excluding hormonal secretion. Ultrasound-guided biopsy was performed and reported fibrocollagenous tissue displaying trilineage haematopoiesis in favor of adrenal EMH, thus malignancy is eliminated. As a giant mass, treatment was an excision surgery associated with iterative transfusions to prevent recurrence. In daily practice, practitioners should pay attention to the differential diagnosis in any patients with chronic hematologic disorders suggestive for EMH even of uncommon location. A confirmatory preoperative biopsy is recommended to avoid unnecessary procedure.

Objectives: Shoats (sheep and goats) are selective feeders; however, indigestible foreign bodies are ingested mostly as a result of long-term feed shortages, mineral and nutritional deficits. In developing countries like Ethiopia, sheep and goats are commonly kept extensively and they have easy access to household wastes, rubbish on the roadsides, residential and market places. As a result, evidence-based interventions are needed to lessen the effects of foreign bodies on the production efficiency of the small ruminants. The aim of this study was to determine the frequency of foreign bodies in sheep and goats, as well as their gastrointestinal distributions and types.

Result: Foreign bodies were found in the stomachs of 89 (22.08%) of the 403 small ruminants (192 sheep and 211 goats) examined during the study period. Of them, 44 sheep (22.91%) and 45 goats (21.32%) were found to have different types foreign bodies. Plastic 47 (46.0%) was the most frequent foreign body discovered, while mixed plastic and cloth 1 (0.98%) was the least common. The rumen had the largest percentage of foreign bodies (69.6%), followed by the reticulum (16.7%), and the abomasum (13.7%). The prevalence of foreign body recorded in less than 2 years, 2-3 years and greater than 3 years old were 15.73% (28/178), 25.88% (44/170) and 30.9% (17/55), respectively. Besides, 15.58% (31/199), 28.14% (56/199) and 40% (2/5) prevalence of foreign bodies were recorded in good, medium and poor body conditions, respectively. There was a statistically significant variation in prevalence of foreign bodies between age groups and body conditions (p<0.05).

Conclusion: According to this study, the presence of various types of indigestible foreign bodies in three main compartments of the shoats' stomach (rumen, reticulum, and abomasum) has a significant impact on the animals' production. Appropriate waste management and husbandry methods should be designed and executed to reduce the risk of ingestion and the impact of indigestible foreign bodies on small ruminant production.