25.05.2023: Paraduodenal hernia is a rare form of congenital internal hernia and can lead to small bowel obstruction. This case report describes the case of a young boy who was admitted with acute exacerbation of chronic abdominal pain. A previously healthy teenage boy had been suffering from abdominal pain for over a year. The pain was cramp-like in nature, in the centre of the abdomen, and lasted for several minutes a few times a week. The pain often subsided when the patient lay down flat. Following investigation by a paediatrician nine months previously, he was referred to the Department of Surgery...

16.01.2023: Drug-induced aseptic meningitis is a rare but serious condition that should be suspected in patients with meningitis who test negative for a microbiological agent. The medical history is presented here of a woman with recurrent urinary tract infections where meningitis symptoms arose after repeated exposure to a frequently prescribed drug. A woman in her fifties had been prescribed trimethoprim 160 mg × 2 for a urinary tract infection by her GP. After the first dose of trimethoprim, she developed chills, fever, vomiting and loose stools, and she was admitted to hospital due to her worsening...

20.07.2021: Tularaemia can be challenging to diagnose. Here we present a case illustrating how pulmonary tularaemia can be an important radiological differential diagnosis to lung cancer. A man in his fifties contacted his general practitioner on account of fever, reduced general condition and a dry cough. An initial PCR test on a pharyngeal swab was negative for SARS-CoV-2. He was given an appointment three weeks after symptom onset; upon presentation at the medical centre, he still had profuse night sweats and a dry cough, but was now afebrile. He was a former smoker with a history of about 20 pack...

28.06.2021: We now have a good understanding of the acute complications of COVID-19, but we know less about possible long-term sequelae. The aim of this case report is to raise awareness of subacute thyroiditis as a potential complication of COVID-19. A previously healthy man in his forties who used no regular medications was diagnosed with SARS-CoV-2 infection after a positive polymerase chain reaction (PCR) test on a nasopharyngeal swab. The infection caused mild symptoms, with a few days of fever and cough, but required no specific treatment. The man then had three weeks of good health, before...

08.06.2021: Acute appendicitis usually begins with diffuse abdominal pain that migrates to the lower right quadrant and is followed by peritonitis. The clinical picture of the patient presented here also included a painful mass in the right groin. A woman in her eighties presented to the emergency department with a 1.5-day history of abdominal pain. She had a temperature of 38.4 °C, heart rate of 106 bpm, respiratory rate of 24 breaths/min, and blood pressure of 107/60 mmHg. She had comorbid COPD (GOLD 3), polymyalgia rheumatica and temporal arteritis, and her regular medications included prednisolone 2.5...

27.05.2021: An acute increase in tryptase levels is a reliable indicator of mast cell activation. Here, we present a case in which acute measurement of tryptase revealed a rare and potentially serious condition. The report is a reminder of how a correct diagnosis can depend on performing the right test at the right time. A woman in her forties was referred to the allergology outpatient clinic after repeated episodes of tachycardia, flushing and near syncope, each lasting approximately ten minutes. The episodes were accompanied by nasal congestion and rhinorrhoea, and sometimes by palmar itching, shortness...

29.04.2021: A young woman had a headache for a few days, before developing a fatal cerebral haemorrhage ten days after vaccination with the ChstraOx1 nCoV-19 vaccine from AstraZeneca. The patient was a female healthcare worker in her thirties, with no known heredity for cerebrovascular disease. Eleven months before the event in question, she had undergone an uncomplicated childbirth, but with 1500 ml of bleeding. At the end of her pregnancy, she had mild preeclampsia, which was treated with labetalol 100 mg × 2. Her blood pressure improved quickly after childbirth, and labetalol was discontinued. At the...

28.04.2021: Two young, healthy doctors were diagnosed with deep vein thrombosis 27 and 29 days, respectively, after receiving the AstraZeneca ChAdOx1 nCoV-19 vaccine. Both had a negative D-dimer test and a low Wells score. A woman in her thirties and a man in his forties were vaccinated against COVID-19 with the AstraZeneca vaccine (ChAdOx1 nCoV-19). They were diagnosed with deep vein thrombosis 27 and 29 days after vaccination, respectively. Both were of normal weight and non-smokers with normal levels of physical activity. They had no underlying illnesses and had not been subject to trauma, surgery...

15.04.2021: Our Hand Surgical Unit has treated two young women for serious injuries to the ulnar nerve sustained during removal of contraceptive implants. To avoid permanent injuries, it is important that such implants are inserted correctly, and that patients are referred to a hand surgeon if it is suspected that an implant may prove difficult to remove. One form of contraception available in Norway is the Nexplanon® implant – a 2 mm × 4 cm soft plastic rod recommended for subcutaneous placement in the medial upper arm (1). We present the case histories of two women with slender upper arms who sustained...

17.02.2021: Most cases of thoracic injury do not require hospitalisation, but there are multiple potential complications. Haemothorax is among the most common cases requiring treatment. This case report describes an atypical presentation of delayed haemothorax in a patient following rib fractures. A man in his sixties was a front seat passenger in a collision between two vehicles. Upon arrival in hospital, the trauma team examined the patient. His condition was stable and physical examination only revealed tenderness of the left hemithorax. A CT scan from head to pelvis confirmed multiple fractures on the...

21.01.2021: This case report illustrates the challenges of diagnosing pulmonary embolism and sheds light on an association between thromboembolism and Klinefelter's syndrome. A man in his forties was admitted to the Department of Medicine with functional dyspnoea. Three weeks earlier, he had noticed swelling in his lower right leg and transient chest pain. He had had functional dyspnoea for two days and had fainted while climbing the stairs. Upon arrival at hospital, the patient was breathing normally, with blood pressure 124/84 mm Hg, heart rate 84 beats per minute, respiratory rate 16 per minute and...

11.01.2021: A man in his sixties was hospitalised with vision loss due to second-stage syphilis. Ocular syphilis is a rare and serious condition. The incidence of syphilis is increasing, and since delayed diagnosis can result in permanent visual impairment, syphilis should be considered as a possible cause in patients with vision loss. The patient contacted A&E because he had experienced relatively acute, painless loss of vision in his right eye four days previously. He described it as pronounced, darkened and blurry vision. An examination by an ophthalmologist revealed substantially reduced visual acuity...

14.12.2020: PCR and antibody-based tests for SARS-CoV-2 infection are a key part of the efforts to combat the COVID-19 pandemic. But as this case report shows, PCR testing for SARS-CoV-2 can sometimes provide more questions than answers. A previously healthy man responded to the challenges posed by the COVID-19 pandemic by voluntarily self-isolating from March 2020 until the following month, when he was due to begin military service at the KNM Harald Haarfagre basic training centre at Madla in Stavanger. While at home, he had sole use of one of the house's two bathrooms, but he ate meals together with...

23.11.2020: A child of early school age was hospitalised after several days of illness with abdominal pain, vomiting and a palpable mass in the upper abdomen. Further diagnostic workup revealed a very unusual cause. The child had been vomiting and experiencing abdominal pain for four days. The referring doctor had palpated a large mass in the upper abdomen. Last defecation was at least two days previously. The child was under paediatric psychiatric follow-up because of trichotillomania and trichotillophagia. On examination the patient's general condition was good, but there was a hard mass about 20 cm in...

26.10.2020: Treating scabies can be challenging. We describe an outbreak of scabies at a boarding school where increased tolerance to the first-line therapy was suspected. Five pupils at a boarding school were treated for suspected scabies. The pupils lived in shared rooms across five buildings. For about six months, the pupils received repeated permethrin treatment from the school nurse and the health personnel in their home countries. A doctor was contacted as the problem remained unresolved. The pupils belonged to the same group of friends, and two of them lived in the same room. All five came to the...

23.09.2020: We present a case history of a patient with severe dementia and COVID-19 who had a prolonged and fluctuating course of illness. The PCR tests for SARS-CoV-2 alternated between positive and negative results, which complicated the diagnosis and choice of isolation regime. A man in his sixties with severe Alzheimer-type dementia developed symptoms in the upper respiratory tract with a runny nose and a slight cough. Some months previously, he had been admitted from a nursing home to the psychogeriatric department because of psychomotor agitation. He had no previous history of cardiac or pulmonary...

27.08.2020: Diabetic ketoacidosis is rarely seen in patients with type 2 diabetes. Doctors and patients need to be aware that sodium-glucose cotransporter 2 (SGLT2) inhibitors increase the risk of diabetic ketoacidosis, also in patients with type 2 diabetes. Here we present the case of a woman in her forties hospitalised with severe diabetic ketoacidosis while undergoing treatment for a presumed type 2 diabetes. A woman in her forties awoke with a worsening of dyspnoea that started the previous evening. An ambulance was called, and on arrival the patient was awake, alert and oriented. Her respiratory rate...