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A 26-year-old man had no significant past medical history but had a family history of dissecting aortic aneurysm in his mother at the age of 40. The patient has a normal physical appearance and does not have any features that suggest Marfan's syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, ANCA-positive vasculitis, or Takayasu's arteritis. The patient does not have disproportionately long extremities, hypertelorism, a bifid or broad uvula, craniosynostosis, cleft palate, club foot, translucent skin, soft velvety skin, easy bleeding, or easy bruising. He presented with cough, shortness of breath, and chest pain for 10 days. The patient's blood pressure on admission was 93/73 mmHg, heart rate was 115 bpm, and respiratory rate was 37 bpm. His laboratory work showed hemoglobin 9 Gm/dL, WBC 16 k/ μ L, ESR 12 mm/hr, CRP 2 mg/dL, D-dimer 942 ng/mL, BNP 1000 pg/mL, and troponin T 0.05 ng/mL. Chest X-ray at the time of presentation showed bilateral pulmonary infiltrates ( Figure 1(a) ). He was treated outside the hospital for bronchopneumonia but did not improve. When a CT scan of the chest showed a dissecting aneurysm of the ascending aorta , the patient was transferred to our hospital and successfully underwent aortic dissection repair. Resuspension of the aortic valve and replacement of the ascending aorta with a 24 mm hemashield gold interposition graft were performed. The patient did well postoperatively but remained intubated due to high respiratory rate during CPAP trials. This was likely due to pulmonary edema, as evidenced by bilateral lower lung field opacities seen on chest X-ray ( Figure 1(b) ). CPAP weaning trials were performed daily, and he was successfully extubated on postoperative day 5. The patient was discharged home on carvedilol 12.5 mg twice a day. A follow-up 3D reconstruction of the aorta 82 days after the surgery is shown in Figure 3 . Three months after aortic dissection repair, the patient returned to our hospital with new complaints of sharp back pain. On physical examination, a new diastolic murmur was heard at the left sternal border. CT angiography with 3D reconstruction showed a dissection of the aortic arch with dilated aortic root measuring 5.3 cm. The origins of the innominate artery, left common carotid artery, and left subclavian artery were dissected focally, and the dissection continued down into the common iliac arteries bilaterally . Echocardiogram showed severe aortic insufficiency with ejection fraction 50%. Because of the progression of his chronic dissection, the dilated aortic root, and severe aortic insufficiency, the patient underwent reoperation. The right axillary artery was cannulated via an 8 mm hemashield graft. Venous drainage was accomplished using a 2-stage venous cannula via the right atrium. Once on bypass, systemic cooling was begun with an eventual bladder temperature of 16–20 degrees C. Cardiac arrest and myocardial protection were accomplished using retrograde cold blood cardioplegia and systemic hypothermia. During the cooling phase, the aortic valve and ascending aorta were replaced with a number 29 On-X valved conduit. The right and left main coronary arteries were reimplanted into the ascending aortic graft. With continuous antegrade cerebral perfusion via the right axillary cannula and a presumed patent circle of Willis, total circulatory arrest was achieved and the aortic arch was replaced. A number 26 hemashield graft was used with a number 12 and number 8 graft attached end to end to the innominate and left carotid arteries, respectively. The proximal ends of the two grafts were attached previously to the arch graft using 5-0 prolene suture. A piece of reversed saphenous vein was used in end to end fashion for the left subclavian artery which was unusually small. The proximal end of the saphenous vein was attached to the arch graft with 5-0 prolene suture. The number 26 hemashield graft was used in an “elephant trunk” fashion. He did well after surgery and was discharged home on warfarin, amlodipine, carvedilol, and losartan. Due to the family history of aortic dissection in his mother at early age, genetic studies on the patient and his children were performed. The genomic DNA was extracted from peripheral blood and was amplified using standard procedures by touchdown PCR of all coding exons with their exon-intron boundaries of ACTA2 and sequencing 6 other genes using forward and reverse primers located in the flanking introns. The PCR products were analyzed by gel electrophoresis and visualized by ethidium bromide staining on 2% agarose gels. The genetic studies revealed no mutations in ACTA2, TGFBR1, TGFBR2, TGFB2, MYH11, MYLK, SMAD3, or FBN1. The patient was referred to John Ritter research program in the University of Texas Medical School at Houston for additional genetic testing.
3.919922
0.981445
sec[1]/p[0]
en
0.999998
25104961
https://doi.org/10.1155/2014/842872
[ "aortic", "graft", "dissection", "artery", "using", "number", "chest", "ascending", "aorta", "hemashield" ]
[ { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "LA8A.3", "title": "Congenital supravalvar aortic stenosis" }, { "code": "BD40.1", "title": "Atherosclerosis of aorta" }, { "code": "BB71.Z", "title": "Aortic valve insufficiency, unspecified" }, { "code": "LA8B.2Y", "title": "Other specified congenital anomaly of aorta or its branches" }, { "code": "NE84", "title": "Failure or rejection of transplanted organs or tissues" }, { "code": "EL53", "title": "Skin graft failure" }, { "code": "EL54", "title": "Composite graft failure" }, { "code": "PK99.2", "title": "Orthopaedic devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "PK95.2Y", "title": "Other specified neurological devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" } ]
=== ICD-11 CODES FOUND === [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [LA8A.3] Congenital supravalvar aortic stenosis Definition: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalvar aortic stenosis' is described as three forms: an hourglass deformity, a fibrous membrane, and a diffuse narrowing of the ascending aorta. Supravalvar aortic stenosis may involve the coronary artery ostia, and the aortic leaflets may be tethered. The coronary arteries can become tortuous and dilate Also known as: Congenital supravalvar aortic stenosis | stenosis of aorta | supravalvular aortic stenosis | stricture of aorta | congenital narrowed aorta Excludes: Congenital aortic valvar stenosis [BD40.1] Atherosclerosis of aorta Also known as: Atherosclerosis of aorta | aorta atheroma | aorta calcification | aorta arteriosclerosis | aortic degeneration [BB71.Z] Aortic valve insufficiency, unspecified Also known as: Aortic valve insufficiency, unspecified | Aortic valve insufficiency | aortic insufficiency | aortic valve incompetency | AI - [aortic incompetence] [LA8B.2Y] Other specified congenital anomaly of aorta or its branches Also known as: Other specified congenital anomaly of aorta or its branches | Congenital anomaly of ascending aorta | Hypoplasia of ascending aorta | Congenital ascending aorta aneurysm or dilation | congenital ascending aortic aneurysm or dilation [NE84] Failure or rejection of transplanted organs or tissues Also known as: Failure or rejection of transplanted organs or tissues | organ transplant rejection | transplant failure | transplant rejection | Bone-marrow transplant rejection [EL53] Skin graft failure Definition: Failure of skin graft tissue to engraft as intended Also known as: Skin graft failure | Split skin graft failure | Full thickness skin graft failure [EL54] Composite graft failure Definition: Failure of composite graft tissue (e.g. skin and cartilage) to engraft as intended Also known as: Composite graft failure [PK99.2] Orthopaedic devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Definition: Orthopaedic related prosthetic and other implants, materials and accessory devices were involved in an adverse related incident Also known as: Orthopaedic devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Surgical operation with implant of artificial internal orthopaedic device associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Orthopaedic devices associated with injury or harm, limb prosthesis | Orthopaedic devices associated with injury or harm, joint prosthesis | Mechanical complication of internal joint prosthesis Excludes: Wear of articular bearing surface of joint prosthesis | Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [PK95.2Y] Other specified neurological devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Other specified neurological devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Mechanical complication of nerve graft === GRAPH WALKS === --- Walk 1 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --EXCLUDES--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --- Walk 2 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --EXCLUDES--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --- Walk 3 --- [LA8A.3] Congenital supravalvar aortic stenosis Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalva... --EXCLUDES--> [?] Congenital aortic valvar stenosis Def: A congenital cardiovascular malformation of the aortic valve in which there is narrowing or stricture (obstruction to flow). Additional information: 'Congenital aortic valvar stenosis' arises most co... --EXCLUDES--> [?] Congenital subaortic stenosis --- Walk 4 --- [LA8A.3] Congenital supravalvar aortic stenosis Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalva... --PARENT--> [LA8A] Congenital anomaly of a ventriculo-arterial valve or adjacent regions Def: A congenital cardiovascular malformation of a ventriculo-arterial valve or its immediate subvalvar and supravalvar regions.... --CHILD--> [LA8A.0] Congenital anomaly of pulmonary valve Def: A congenital malformation of the heart where the pulmonary valve is abnormal.... --- Walk 5 --- [BD40.1] Atherosclerosis of aorta --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease --EXCLUDES--> [?] Cerebral ischaemic stroke due to intracranial large artery atherosclerosis --- Walk 6 --- [BD40.1] Atherosclerosis of aorta --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease --EXCLUDES--> [?] Coronary atherosclerosis Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i...
[ "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --EXCLUDES--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....", "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --EXCLUDES--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....", "[LA8A.3] Congenital supravalvar aortic stenosis\n Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta.\n\nAdditional information: 'Congenital supravalva...\n --EXCLUDES--> [?] Congenital aortic valvar stenosis\n Def: A congenital cardiovascular malformation of the aortic valve in which there is narrowing or stricture (obstruction to flow).\n\nAdditional information: 'Congenital aortic valvar stenosis' arises most co...\n --EXCLUDES--> [?] Congenital subaortic stenosis", "[LA8A.3] Congenital supravalvar aortic stenosis\n Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta.\n\nAdditional information: 'Congenital supravalva...\n --PARENT--> [LA8A] Congenital anomaly of a ventriculo-arterial valve or adjacent regions\n Def: A congenital cardiovascular malformation of a ventriculo-arterial valve or its immediate subvalvar and supravalvar regions....\n --CHILD--> [LA8A.0] Congenital anomaly of pulmonary valve\n Def: A congenital malformation of the heart where the pulmonary valve is abnormal....", "[BD40.1] Atherosclerosis of aorta\n --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease\n --EXCLUDES--> [?] Cerebral ischaemic stroke due to intracranial large artery atherosclerosis", "[BD40.1] Atherosclerosis of aorta\n --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease\n --EXCLUDES--> [?] Coronary atherosclerosis\n Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i..." ]
BD5Z
Diseases of arteries or arterioles, unspecified
[ { "from_icd11": "BD5Z", "icd10_code": "I7389", "icd10_title": "Other specified peripheral vascular diseases" }, { "from_icd11": "BD5Z", "icd10_code": "I7419", "icd10_title": "Embolism and thrombosis of other parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7411", "icd10_title": "Embolism and thrombosis of thoracic aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7410", "icd10_title": "Embolism and thrombosis of unspecified parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7381", "icd10_title": "Erythromelalgia" }, { "from_icd11": "BD5Z", "icd10_code": "I745", "icd10_title": "Embolism and thrombosis of iliac artery" }, { "from_icd11": "BD5Z", "icd10_code": "I789", "icd10_title": "Disease of capillaries, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I748", "icd10_title": "Embolism and thrombosis of other arteries" }, { "from_icd11": "BD5Z", "icd10_code": "I749", "icd10_title": "Embolism and thrombosis of unspecified artery" }, { "from_icd11": "BD5Z", "icd10_code": "I781", "icd10_title": "Nevus, non-neoplastic" }, { "from_icd11": "BD5Z", "icd10_code": "I788", "icd10_title": "Other diseases of capillaries" }, { "from_icd11": "BD5Z", "icd10_code": "I744", "icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I70-I79", "icd10_title": "" }, { "from_icd11": "BD5Z", "icd10_code": "I74", "icd10_title": "Arterial embolism and thrombosis" }, { "from_icd11": "BD5Z", "icd10_code": "I73", "icd10_title": "Other peripheral vascular diseases" } ]
I7389
Other specified peripheral vascular diseases
We report the case of a nonsmoker in her sixties with NTBE secondary to pulmonary adenocarcinoma. Relevant past medical history included MS diagnosed a decade ago and had been undergoing treatment with dimethyl fumarate 240 mg twice daily since 2017. Additionally, she had a major depressive disorder diagnosed three years before her hospital admission. This was accompanied by a challenging mental health history, including multiple suicide attempts. Her psychiatric regimen involved olanzapine, venlafaxine, and lorazepam. Regular appointments with a psychiatrist were scheduled due to her condition and a history of benzodiazepine abuse. Upon presenting at the emergency department, the patient reported several concerning symptoms. These included a drooping left facial lip, slurred speech, and delirium. Further evaluation revealed her medical records indicating a baseline crural paresis grade 4 on her right leg and generalized hyperreflexia with clonus, which had persisted for more than 10 seconds. In the emergency room (ER), her speech exhibited notable impairment. It was characterized by slurred speech, dysphemia, paraphasia, and errors in repetition. Importantly, a recent ER admission had been necessitated by benzodiazepine abuse, with a positive test for lorazepam on a urinary drug panel (although excessive intake couldn't be ruled out). During the physical examination, additional neurological signs emerged such as left grasp, left glabellar, and palmomental reflexes, pronation of the right upper extremity, a dystonic posture of the right foot, mild spasticity of the lower extremities, and motor deficits in the right lower extremity. The patient denied experiencing fever, cough, shortness of breath, or any other cardiorespiratory symptoms. Vaccination status was up to date. Notably, prior screenings revealed normal colorectal results five years ago, with pending cervical and breast screenings. However, due to her lack of smoking history, lung cancer screening had not been performed. Initial observations included diminished lung sounds on the left hemithorax and regular tachycardia upon cardiopulmonary auscultation. Remarkably, no digital clubbing or palpable lymphadenopathy was present. Subsequent workup tests unveiled arterial blood gas analysis with hypocapnia, sinus tachycardia, and a blood count suggesting leukocytosis with neutrophilia. Her C-reactive protein (CRP) level was measured at 50 mg/L. Two sets of blood cultures were collected for further investigation. Chest radiography demonstrated bilateral pneumonia with a left pleural effusion while an electrocardiogram indicated sinus tachycardia. A head CT scan ruled out acute vascular events or bleeding. Further imaging, including a subsequent chest CT, revealed a moderate left pleural effusion, consolidation of the left lower lobe, and opacities/ground-glass changes in the left lung, indicative of infectious/inflammatory alterations and chronic pulmonary embolism. Small adenopathies in the mediastinum and hilum were also observed, suggesting a reactive etiology. No abdominal changes were reported. transthoracic echocardiogram (TTE) results showed no cardiac abnormalities. Treatment encompassed parenteral antibiotics, systemic anticoagulation, and admission to medical floors. Physical rehabilitation and speech therapy were initiated to address neurological deficits, resulting in an initial positive clinical response. However, subsequent complications emerged. On the tenth day, the patient's condition required further interventions, which involved administering broad-spectrum antibiotics and providing supplemental oxygen. Subsequently, a follow-up chest X-ray revealed left-sided pneumonia, albeit with a reduced pleural effusion. It's important to note that blood cultures returned negative results, and this was also the case for atypical agents serology and autoimmune panel. A head MRI demonstrated diffusion restriction in the cortical and subcortical gray matter in the left frontoparietal and temporal regions, as well as the right occipital region. These findings suggested embolism and indicated evidence of MS progression. Around the twentieth day of hospitalization, empirical treatment for infective endocarditis was initiated. Transesophageal echocardiography (TOE) revealed an 8 mm vegetation on the aortic valve, despite the patient having a minimal likelihood of infective endocarditis based on the modified Duke criteria. Despite her condition, with fever and hypoxemia persisting and no improvement observed despite two different antibiotic courses, a new set of blood cultures was obtained, and empiric therapy for infective endocarditis was initiated. A TOE uncovered an 8 mm vegetation situated between the coronary and noncoronary aortic cusps , providing crucial insights into the patient's condition.
3.996094
0.979004
sec[1]/p[0]
en
0.999998
PMC10576842
https://doi.org/10.7759/cureus.45271
[ "blood", "speech", "included", "lung", "tachycardia", "cultures", "chest", "pleural", "effusion", "initiated" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "MA80.Z", "title": "Speech or language disturbances, unspecified" }, { "code": "MB23.L", "title": "Pressured speech" }, { "code": "6B60.5", "title": "Dissociative neurological symptom disorder, with speech disturbance" }, { "code": "MB25.02", "title": "Disorganised thinking" }, { "code": "MA81", "title": "Speech dysfluency" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [MA80.Z] Speech or language disturbances, unspecified Also known as: Speech or language disturbances, unspecified | Speech or language disturbances | speech defect NOS | speech disorder NOS | problem with voice production [MB23.L] Pressured speech Definition: Speech in which the person feels undue pressure to get the words out. The person’s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person talks without any social stimulation and may continue to talk even though no one is listening. Also known as: Pressured speech Excludes: Schizophrenia or other primary psychotic disorders | Bipolar or related disorders [6B60.5] Dissociative neurological symptom disorder, with speech disturbance Definition: Dissociative neurological symptom disorder, with speech disturbance is characterised by symptoms such as difficulty with speaking (dysphonia), loss of the ability to speak (aphonia) or difficult or unclear articulation of speech (dysarthria) that are not consistent with a recognised disease of the nervous system, a neurodevelopmental or neurocognitive disorder, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissoci Also known as: Dissociative neurological symptom disorder, with speech disturbance | Functional neurological symptom disorder, with speech disturbance | Functional speech disorder [MB25.02] Disorganised thinking Definition: A disturbance in the associative thought process typically manifested in speech in which the person shifts suddenly from one topic to another that is unrelated or minimally related to the first. The individual gives no indication of being aware of the disconnectedness or illogicality of their thinking. Also known as: Disorganised thinking | thought derailment | loose associations | disorganised speech [MA81] Speech dysfluency Definition: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limits of normal variation and results in reduced intelligibility and significantly affects communication. It can involve repetitions of sounds, syllables or words, prolongations, word breaks, blockage of production, excessive use of interjections, and rapid short bursts of speech. Also known as: Speech dysfluency | speech impediment NOS | Adult onset cluttering | Adult onset stammering | Adult onset stuttering Excludes: Developmental language disorder | Developmental speech or language disorders | Developmental speech fluency disorder === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.41] Microscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.0] Finding of opiate drug in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] Microscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
A 17-year-old Caucasian male was diagnosed with severe idiopathic acquired aplastic anemia in January 2007. He had no related genotypically matched donor for HSCT, so he underwent a 5-month course of therapy with cyclosporine and antithymocyte globulin with no response. In February 2008, he received an allogeneic HSCT from an HLA-matched unrelated donor (10/10 HLA antigens). The preparative regimen consisted of alemtuzumab, fludarabine, and cyclophosphamide. Graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus and methotrexate (starting day 1). He showed evidence of hematopoietic engraftment on day 17. Digestive tract GVHD (biopsy proven) developed on day 25 and was treated with corticosteroids (prednisone at 1 mg/Kg twice a day) and tacrolimus, with gradual resolution. The evaluation on day 33 showed complete chimerism and a normal bone marrow. He was discharged on day 41 with tacrolimus, oral prednisone and antifungal prophylaxis with fluconazole 400 mg/day. His outpatient course was complicated by gradual development of leucopenia, requiring granulocyte colony-stimulating-factor therapy. On day 115, the patient was admitted to the hospital for febrile neutropenia with cough and odynophagia. He received antibiotic therapy with piperacillin plus tazobactam and amikacin although no infectious agent was isolated. Cytomegalovirus and Epstein-Barr virus infections were also excluded. The day 119 evaluation showed complete chimerism and normal bone marrow. He recovered and was discharged on day 125. He did well until day 165, when he was admitted for an acute tonsillitis with febrile neutropenia. A cervical computerized tomography (CT) showed an abscess in the peritonsillar space. A tonsillar biopsy was made which revealed a polymorphic infiltrate eosinophil-rich and no other findings. No infectious agent was isolated. He received antibiotic therapy with piperacillin plus tazobactam and antifungal prophylaxis with posaconazole. As he maintained fever, clindamycin was added to therapy in order to increase the synergistic effect against anaerobes (essentially mouth anaerobes that are partially covered by piperacillin and tazobactam) and to increase peritonsillar tissue antibiotic diffusion, thus allowing methicillin-resistant Staphylococcus aureus coverage. There was resolution of the febrile episode and the patient was discharged on day 179. At this time, he maintained GVHD therapy with steroids and tacrolimus and antifungal prophylaxis with posaconazole (200 mg three times daily). Close followup was done. Although somewhat better, the patient maintained persistent complaints of cough and serous sputum. The haematological values were stable. On the thoracic X-ray ( Figure 1(a) ) there was small pulmonary node that gradually enlarged so he forwarded a thoracic CT, on day 192 which revealed a cavitated lesion on the right superior pulmonary lobe. Galactomannan antigen was negative. Bronchoscopy and bronchoalveolar lavage (BAL) were performed. Thoracic surgery was proposed, but the patient was considered not fit to such intervention. At this time, antifungal treatment with voriconazole was started. Nevertheless, the patient's clinical condition began to deteriorate with the development of persistent cough (no differences on sputum), dyspnea, headaches, otalgia, fever, and neutropenia. On day 211 he was admitted to the hospital. The patient developed hemoptysis and acute respiratory and renal failure, so he required intensive care unit (ICU) admission. The fungal culture result of the BAL revealed a Rhizomucor sp. infection on day 215. Liposomal amphotericin B and caspofungin combination therapy was started. The patient started to get better, and he was discharged from the ICU to the ward on day 223. However, he maintained persistent fever and the pulmonary cavitated nodule continued to get worse on thoracic X-ray image ( Figure 1(b) ). On day 237, he started to complain of right periorbital edema and gradually developed sinusitis, exoftalmia, and amaurosis of the right eye. CT scan of the perinasal sinuses revealed an infiltrative lesion of the perinasal sinuses with ethmoiditis and compression of the right optic nerve . Ethmoidectomy was performed on day 264. Pathology analysis showed signs of ethmoiditis and numerous fungal hyphae (Figures 3(a) – 3(f) ). Microbiological analysis revealed fungal infection due to Scedosporium apiospermum . As his clinical condition continued to deteriorate, antifungal combination therapy was changed to posaconazole along with liposomal amphotericin B, but no response was obtained. On day 310, he started to complain of persistent headache, and on day 322, he developed left hemiparesis and dysarthria probably due to rhinoencephalitis. Consciousness became gradually depressed and death overcame on day 324 post HSCT.
3.933594
0.977539
sec[1]/p[0]
en
0.999998
21547214
https://doi.org/10.1155/2011/830769
[ "antifungal", "prophylaxis", "tacrolimus", "discharged", "maintained", "persistent", "thoracic", "hsct", "gvhd", "febrile" ]
[ { "code": "MG54", "title": "Finding of fungus resistant to antimicrobial drugs" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" }, { "code": "PH48", "title": "Exposure to or harmful effects of undetermined intent of other or unspecified drugs, medicaments or biological substances" }, { "code": "QC05.Y", "title": "Other specified prophylactic measures" }, { "code": "MC14", "title": "Eye discharge" }, { "code": "MF58", "title": "Urethral discharge" }, { "code": "PA80.0", "title": "Unintentionally struck by projectile from handgun" }, { "code": "MF3Y", "title": "Other specified symptoms, signs or clinical findings involving the female genital system" } ]
=== ICD-11 CODES FOUND === [MG54] Finding of fungus resistant to antimicrobial drugs Also known as: Finding of fungus resistant to antimicrobial drugs | Antifungal resistant Candida auris | Antifungal resistant Aspergillus [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics [PH48] Exposure to or harmful effects of undetermined intent of other or unspecified drugs, medicaments or biological substances Also known as: Exposure to or harmful effects of undetermined intent of other or unspecified drugs, medicaments or biological substances | drug related harm | Exposure to or harmful effects of undetermined intent of systemic antibiotics | Exposure to or harmful effects of undetermined intent of penicillins | Exposure to or harmful effects of undetermined intent of cephalosporins or other beta-lactam antibiotics [QC05.Y] Other specified prophylactic measures Also known as: Other specified prophylactic measures | Other prophylactic chemotherapy | chemoprophylaxis | prophylactic chemotherapy | Systemic prophylactic chemotherapy [MC14] Eye discharge Also known as: Eye discharge [MF58] Urethral discharge Also known as: Urethral discharge | Urethrorrhoea | observation of urethral discharge | discharge from urethra | UD - [urethral discharge] Includes: Urethrorrhoea | Penile discharge [PA80.0] Unintentionally struck by projectile from handgun Also known as: Unintentionally struck by projectile from handgun | handgun discharge causing accidental injury | accidental handgun discharge | gun for single hand use | pistol discharge Includes: gun for single hand use [MF3Y] Other specified symptoms, signs or clinical findings involving the female genital system Also known as: Other specified symptoms, signs or clinical findings involving the female genital system | Other signs or symptoms in breast | Breast engorgement, not elsewhere classified | breast congestion | engorgement of breast === GRAPH WALKS === --- Walk 1 --- [MG54] Finding of fungus resistant to antimicrobial drugs --PARENT--> [?] Finding of microorganism resistant to antimicrobial drugs --PARENT--> [?] General symptoms, signs or clinical findings --- Walk 2 --- [MG54] Finding of fungus resistant to antimicrobial drugs --PARENT--> [?] Finding of microorganism resistant to antimicrobial drugs --PARENT--> [?] General symptoms, signs or clinical findings --- Walk 3 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Alcohol intoxication Def: Alcohol intoxication is a clinically significant transient condition that develops during or shortly after the consumption of alcohol that is characterised by disturbances in consciousness, cognition,... --EXCLUDES--> [?] Possession trance disorder Def: Possession trance disorder is characterised by trance states in which there is a marked alteration in the individual’s state of consciousness and the individual’s customary sense of personal identity ... --- Walk 4 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --PARENT--> [?] Harmful effects of substances --CHILD--> [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified --- Walk 5 --- [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance --PARENT--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances --CHILD--> [PB20] Unintentional exposure to or harmful effects of opioids or related analgesics --- Walk 6 --- [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance --PARENT--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances --CHILD--> [PB21] Unintentional exposure to or harmful effects of sedative hypnotic drugs or other CNS depressants
[ "[MG54] Finding of fungus resistant to antimicrobial drugs\n --PARENT--> [?] Finding of microorganism resistant to antimicrobial drugs\n --PARENT--> [?] General symptoms, signs or clinical findings", "[MG54] Finding of fungus resistant to antimicrobial drugs\n --PARENT--> [?] Finding of microorganism resistant to antimicrobial drugs\n --PARENT--> [?] General symptoms, signs or clinical findings", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Alcohol intoxication\n Def: Alcohol intoxication is a clinically significant transient condition that develops during or shortly after the consumption of alcohol that is characterised by disturbances in consciousness, cognition,...\n --EXCLUDES--> [?] Possession trance disorder\n Def: Possession trance disorder is characterised by trance states in which there is a marked alteration in the individual’s state of consciousness and the individual’s customary sense of personal identity ...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --PARENT--> [?] Harmful effects of substances\n --CHILD--> [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified", "[PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance\n --PARENT--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances\n --CHILD--> [PB20] Unintentional exposure to or harmful effects of opioids or related analgesics", "[PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance\n --PARENT--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances\n --CHILD--> [PB21] Unintentional exposure to or harmful effects of sedative hypnotic drugs or other CNS depressants" ]
MG54
Finding of fungus resistant to antimicrobial drugs
[ { "from_icd11": "MG54", "icd10_code": "U841", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A95S", "icd10_title": "Adverse effect of other bacterial vaccines, sequela" }, { "from_icd11": "NE60", "icd10_code": "T50B95A", "icd10_title": "Adverse effect of other viral vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A25A", "icd10_title": "Adverse effect of mixed bacterial vaccines without a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A91A", "icd10_title": "Poisoning by other bacterial vaccines, accidental (unintentional), initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T498X5A", "icd10_title": "Adverse effect of other topical agents, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48905A", "icd10_title": "Adverse effect of unspecified agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48995A", "icd10_title": "Adverse effect of other agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A15A", "icd10_title": "Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50B15A", "icd10_title": "Adverse effect of smallpox vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T416X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T419X3A", "icd10_title": "" } ]
U841
The patient was a 78-year-old woman who presented to her primary care physician with nausea and upper abdominal pain. She was referred to our hospital for further examination and treatment. There was no notable family history. Laboratory data showed mild elevation of a single tumor marker (carcinoembryonic antigen, 1.9 ng/mL; carbohydrate antigen 19-9, 2.0 U/mL; carbohydrate antigen 125, 44.5 U/mL; alpha-fetoprotein, 8.9 ng/mL) and no other significant abnormal findings. Upper gastrointestinal endoscopy showed an advanced infiltrative ulcerative tumor in the lesser curvature extending from the antrum to the middle of the body of the stomach . Endoscopic biopsy of the gastric tumor showed poorly differentiated adenocarcinoma with signet ring cell carcinoma. Colonoscopy showed a 4-mm polyp in the mid-transverse colon . Cold snare polypectomy further revealed poorly differentiated adenocarcinoma with signet ring cell carcinoma. Computed tomography displayed enhanced wall thickening in the lesser curvature of the stomach from the antrum to the middle of the body . The regional lymph nodes showed no enlargement. Magnetic resonance cholangiopancreatography showed no obvious abnormal findings in the gallbladder, cystic duct, or common bile duct (Additional file 1 ). We considered this to be a case of colonic metastasis of gastric cancer. Although further examinations using fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography were not performed, the patient had a gastric obstruction that was considered to be advanced gastric cancer. Because it was feared that bleeding from the tumor would occur, a gastrectomy was planned. Intraoperatively, the diagnostic peritoneal washing cytology examination yielded negative results for malignant cells, and no peritoneal dissemination was observed. We attempted a distal gastrectomy; however, a positive intraoperative rapid pathology diagnosis led to a total gastrectomy, lymph node dissection, and cholecystectomy. Gastric cancer did not directly invade the transverse colon. Because the location of the colonic lesion was difficult to determine, colon resection was not performed. The surgical specimen revealed a type 3 gastric tumor centered in the antrum and pylorus that was 180 mm × 170 mm, with no grossly apparent abnormalities in the gallbladder . The histologic examination showed similar morphologic features of the gastric and colonic tumors . Hematoxylin and eosin staining revealed poorly differentiated adenocarcinoma with signet ring cell carcinoma. The mucosal surface of the colonic tumor was covered by normal mucosa with partial features of adenoma. In addition, immunohistochemistry showed that these tumor cells were positive for cytokeratin (CK) 7 and negative for CK20. In the gastric tumor, human epidermal growth factor receptor 2 was negative, the combined positive score of programmed death ligand-1 was 1–5, and high microsatellite instability was not observed (data not shown). In addition to advanced lymph node metastasis and lymphatic and venous invasion, tumor invasion was seen at the proximal and distal margins or within the wall of the gallbladder neck (microscopic residual tumor). According to the Japanese classification of gastric carcinoma, the final pathological diagnosis was poorly differentiated adenocarcinoma with signet ring cell carcinoma, pT4a, INFc, Ly1a, V1a, pPM1, pDM1, and pN3a (3: 4/4; 5: 1/1; 6: 4/4; 12a: 1/1; total: 10/31) . Fig. 1 Upper gastrointestinal endoscopy revealed an advanced infiltrative ulcerative tumor in the lesser curvature extending from the antrum to the middle of the body of the stomach Fig. 2 Colonoscopy revealed a 4-mm polyp in the mid-transverse colon (arrows) Fig. 3 Computed tomography revealed enhanced wall thickening in the lesser curvature of the stomach from the antrum to the middle of the body (red arrows) Fig. 4 Surgical specimen revealed a type 3 gastric tumor centered in the antrum and pylorus measuring 180 mm × 170 mm Fig. 5 A – F Histologic examinations of the gastric and colonic tumors. A Hematoxylin and eosin staining of the gastric tumor shows poorly differentiated adenocarcinoma with signet ring cell carcinoma (×20). Scale bar, 1000 μm. B , C Immunohistochemistry staining of the gastric tumor cells yields positive results for CK7 ( B ; ×200) and negative results for CK20 ( C ; × 200). Scale bar, 100 μm. D Hematoxylin and eosin staining of the colonic tumor shows poorly differentiated adenocarcinoma with signet ring cell carcinoma (×20). The mucosal surface of the colonic tumor shows normal mucosa with partial features of adenoma. Scale bar, 1000 μm. E , F Immunohistochemistry staining of the colonic tumor cells yields positive results for CK7 ( E ; ×200) and negative results for CK20 ( F ; ×200). Scale bar, 100 μm. CK cytokeratin
4.085938
0.973145
sec[1]/p[0]
en
0.999998
36930379
https://doi.org/10.1186/s40792-023-01622-x
[ "tumor", "gastric", "colonic", "carcinoma", "antrum", "poorly", "differentiated", "adenocarcinoma", "signet", "ring" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "DA4Z", "title": "Diseases of stomach, unspecified" }, { "code": "DA60.Z", "title": "Gastric ulcer, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LB13.Z", "title": "Structural developmental anomalies of stomach, unspecified" }, { "code": "DA42.73", "title": "Chronic atrophic gastritis of unknown aetiology" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [DA4Z] Diseases of stomach, unspecified Also known as: Diseases of stomach, unspecified | disorder of stomach | gastropathy NOS | gastric disease NOS | stomach disease NOS [DA60.Z] Gastric ulcer, unspecified Also known as: Gastric ulcer, unspecified | Gastric ulcer | stomach ulcer | Cushings ulcer | cushing's ulcer of stomach [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB13.Z] Structural developmental anomalies of stomach, unspecified Also known as: Structural developmental anomalies of stomach, unspecified | Structural developmental anomalies of stomach | Malformations of stomach [DA42.73] Chronic atrophic gastritis of unknown aetiology Definition: Persistent or recurrent inflammation of the gastric mucosa with atrophy leading to decreased hydrochloric acid concentration in the gastric juice. Atrophic gastritis frequently progresses from chronic gastritis. Also known as: Chronic atrophic gastritis of unknown aetiology | Gastric atrophy | atrophic gastritis | AG - [atrophic gastritis] | CAG - [chronic atrophic gastritis] Includes: Gastric atrophy === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --PARENT--> [?] Symptoms, signs or clinical findings involving the skin --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the skin", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
Clinical evidence and data supporting the use of factor concentrates in acquired coagulopathy have been increasing, but choosing this approach over plasma transfusion depends heavily on the clinical context. Although certain coagulation factors may be rapidly replenished by factor concentrates, they can be depleted again if there is no surgical control of bleeding. Durila and Malosek recently described the case of a 33-year-old woman who suffered from multiple traumatic injuries (ISS, 59) after a motor vehicle collision . This patient required endotracheal intubation in the field and was brought to the hospital in hemorrhagic shock (pH 7.0, base excess −18.5 mmol/l) requiring norepinephrine to sustain blood pressure (70/40 mmHg). The obvious injury sites were an occipital open cranial wound and open fracture of the left thigh. In addition, free fluid was detected in the peritoneal cavity by ultrasound. The initial thromboelastometry traces showed delayed coagulation (EXTEM CT 112 s; normal 35–80 s), late fibrinolysis on EXTEM, and borderline fibrinogen (FIBTEM MCF 7 mm; normal 9–25 mm) . The initial hemostatic intervention included 2 g of tranexamic acid, 4 g of fibrinogen (Haemocomplettan, CSL Behring, Germany), and four units of FFP and RBCs. The 1:1 ratio transfusion of FFP and RBCs was continued while intraabdominal and intracranial bleeding sources were sought and repaired by the surgical team. After an hour, the repeat thromboelastometry showed delayed coagulation (EXTEM CT 114 s), thrombocytopenia (EXTEM MCF 35 mm; normal 53–72 mm), and hypofibrinogenemia (FIBTEM MCF 5 mm) . The complex coagulopathy was managed with 1,200 units of 4-factor PCC (Prothromplex Total; Baxter, Austria), four units of random donor platelets, and an additional 4 g of fibrinogen. The combined hemostatic therapies normalized thromboelastometry parameters , but the patient remained hemodynamically unstable, requiring continued norepinephrine infusion. This prompted the care team to look for another source of surgical bleeding, and splenic bleeding and intracranial bleeding sites were newly found by the contrast-enhanced computed tomography. After these were repaired, the patient became stable. Over the course of 8 h, 30 units of RBCs, 26 units of FFP, four units of platelets, 1,200 IU of PCC, and 10 g of fibrinogen were administered to this patient. In the end, the authors reported a favourable outcome of this case including no neurological deficit and no acute lung or kidney injury associated with blood transfusion . Perioperative use of fibrinogen-rich components such as cryoprecipitate or fibrinogen concentrate has not been commonly used in Japan since plasma-derived (unheated) fibrinogen concentrate was recalled over hepatitis outbreak in the late 1980s . However, Yamamoto et al. recently reported that the off-label use of (pathogen-inactivated) fibrinogen concentrate ( n =25) in thoracic aortic replacement to maintain plasma fibrinogen level of 150 mg/dl was associated with a 58% reduction in the overall requirements for RBCs, FFP, and platelets when compared to the age-matched historical control ( n =24) in which FFP and platelets were the only hemostatic measures . Perioperative use of fibrinogen replacement can be considered as an adjunct to plasma transfusion, and the dosing can be optimized by fibrin-specific viscoelastic testing . Figure 3 Examples of rotational thromboelastometric tracings. (A) Pre-treatment: traces obtained from a bleeding patient who incurred major trauma. Prolonged clotting time (CT) and late clot breakdown are notable on EXTEM. Fibrinogen level was on the borderline based on FIBTEM. Laboratory coagulation results were shown, but these results were not reported until the second ROTEM measurements were completed. Normal ranges for EXTEM and FIBTEM are as follows: EXTEM-CT 42–74 s, A 10 43–65 mm, and MCF 49–71 mm; FIBTEM-A 10 9–24 mm, MCF 9–25 mm. (B) On treatment: traces obtained after the initial treatment with 2 g of tranexamic acid and 4 g of fibrinogen along with ongoing 1:1 transfusion of RBCs and plasma. No improvement was seen in CT and MCF values of EXTEM. Fibrin polymerization was worsened on FIBTEM. (C) Normalized coagulation: traces obtained after the combined therapies using 1,200 IU of 4-factor PCC, 2 g of fibrinogen, and four units of platelets. Despite normal traces of EXTEM and FIBTEM, bleeding continued, and additional surgical hemostasis was established over the course of 8 h. The combination of allogeneic blood products and factor concentrates was crucial for managing massive volume depletion and ongoing bleeding. (D) Dosing of factor concentrates: the dose calculations for PCC and fibrinogen concentrate used in the protocol. BW = body weight. Adapted from the reference with permission. MTP = massive transfusion protocol.
4.15625
0.949707
sec[1]/sec[4]/p[0]
en
0.999999
25705417
https://doi.org/10.1186/s40560-014-0060-5
[ "fibrinogen", "extem", "bleeding", "fibtem", "factor", "transfusion", "this", "plasma", "coagulation", "traces" ]
[ { "code": "3B14.0", "title": "Hereditary deficiency of factor I" }, { "code": "MG27", "title": "Haemorrhage, not elsewhere classified" }, { "code": "GA21.0", "title": "Postcoital or contact bleeding" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "DB98.A", "title": "Hepatic haemorrhage" }, { "code": "GA20.3", "title": "Abnormal regularity of uterine bleeding" }, { "code": "3B14.Z", "title": "Other inherited coagulation factor deficiency with bleeding tendency, unspecified" }, { "code": "3B14.1", "title": "Hereditary factor X deficiency" }, { "code": "3B11.Z", "title": "Hereditary factor IX deficiency, unspecified" }, { "code": "PB6Z", "title": "Unspecified unintentional cause of morbidity or mortality" } ]
=== ICD-11 CODES FOUND === [3B14.0] Hereditary deficiency of factor I Definition: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen. Afibrinogenaemia (complete absence of fibrinogen) and hypofibrinogenaemia (reduced plasma fibrinogen concentration) correspond to quantitative anomalies of fibrinogen while dysfibrinogenaemia corresponds to a functional anomaly of fibrinogen. Hypo- and dysfibrinogenaemia may be frequently combined Also known as: Hereditary deficiency of factor I | Deficiency of factor 1 | Hereditary fibrinogen deficiency | Deficiency of fibrinogen | congenital fibrinogenopenia [MG27] Haemorrhage, not elsewhere classified Definition: Bleeding or escape of blood from a vessel. Also known as: Haemorrhage, not elsewhere classified | arterial haemorrhage | bleeding | extravasation of blood | Haemorrhage NOS Excludes: Obstetric haemorrhage | Haemorrhage or haematoma complicating a procedure, not elsewhere classified | Fetal blood loss [GA21.0] Postcoital or contact bleeding Definition: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual bleeding after sexual intercourse. Confirmation is by transvaginal imaging to identify any structural abnormalities. Also known as: Postcoital or contact bleeding | Postcoital bleeding | bleeding after intercourse | PCB - [postcoital bleeding] | postcoital haemorrhage [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [DB98.A] Hepatic haemorrhage Definition: Traumatic or nontraumatic spontaneous bleeding in the liver. The most common cause of the latter is the rupture of liver tumours. Also known as: Hepatic haemorrhage | haemorrhage of liver | hepatic bleeding | hepatorrhagia | liver haemorrhage Excludes: Hepatic haemorrhage due to hepatocellular carcinoma [GA20.3] Abnormal regularity of uterine bleeding Definition: A condition of the genital system affecting females, caused by hormonal disturbances. This condition is characterised by abnormal menstruation, with a between cycle variation of 2-20 days. Also known as: Abnormal regularity of uterine bleeding | Irregular menstrual bleeding | irregular cycle menstruation | irregular menses | irregular menstrual cycle [3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified Also known as: Other inherited coagulation factor deficiency with bleeding tendency, unspecified | Other inherited coagulation factor deficiency with bleeding tendency | Hereditary factor V deficiency | Proaccelerin deficiency | Owren disease [3B14.1] Hereditary factor X deficiency Definition: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms. Also known as: Hereditary factor X deficiency | Congenital Stuart factor deficiency | Stuart-Prower factor deficiency | Deficiency of factor X | congenital factor x deficiency [3B11.Z] Hereditary factor IX deficiency, unspecified Also known as: Hereditary factor IX deficiency, unspecified | Hereditary factor IX deficiency | factor 9 deficiency | factor IX deficiency | hereditary factor IX deficiency disease [PB6Z] Unspecified unintentional cause of morbidity or mortality Also known as: Unspecified unintentional cause of morbidity or mortality | Exposure to unspecified factor | Exposure to unspecified factor causing fracture | Exposure to unspecified factor causing other and unspecified injury | accidental cause NOS === GRAPH WALKS === --- Walk 1 --- [3B14.0] Hereditary deficiency of factor I Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen.... --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui... --CHILD--> [3B14.1] Hereditary factor X deficiency Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms.... --- Walk 2 --- [3B14.0] Hereditary deficiency of factor I Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen.... --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui... --CHILD--> [3B14.0] Hereditary deficiency of factor I Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen.... --- Walk 3 --- [MG27] Haemorrhage, not elsewhere classified Def: Bleeding or escape of blood from a vessel.... --EXCLUDES--> [?] Obstetric haemorrhage --CHILD--> [?] Intrapartum haemorrhage --- Walk 4 --- [MG27] Haemorrhage, not elsewhere classified Def: Bleeding or escape of blood from a vessel.... --EXCLUDES--> [?] Obstetric haemorrhage --CHILD--> [?] Haemorrhage in early pregnancy --- Walk 5 --- [GA21.0] Postcoital or contact bleeding Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ... --PARENT--> [GA21] Nonmenstrual bleeding disorders --CHILD--> [GA21.Z] Nonmenstrual bleeding disorders, unspecified --- Walk 6 --- [GA21.0] Postcoital or contact bleeding Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ... --PARENT--> [GA21] Nonmenstrual bleeding disorders --RELATED_TO--> [?] Postprocedural nonmenstrual uterine bleeding Def: Uterine bleeding occurring after procedure (i.e. uterine surgery, induced abortion, …)...
[ "[3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --CHILD--> [3B14.1] Hereditary factor X deficiency\n Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms....", "[3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --CHILD--> [3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....", "[MG27] Haemorrhage, not elsewhere classified\n Def: Bleeding or escape of blood from a vessel....\n --EXCLUDES--> [?] Obstetric haemorrhage\n --CHILD--> [?] Intrapartum haemorrhage", "[MG27] Haemorrhage, not elsewhere classified\n Def: Bleeding or escape of blood from a vessel....\n --EXCLUDES--> [?] Obstetric haemorrhage\n --CHILD--> [?] Haemorrhage in early pregnancy", "[GA21.0] Postcoital or contact bleeding\n Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ...\n --PARENT--> [GA21] Nonmenstrual bleeding disorders\n --CHILD--> [GA21.Z] Nonmenstrual bleeding disorders, unspecified", "[GA21.0] Postcoital or contact bleeding\n Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ...\n --PARENT--> [GA21] Nonmenstrual bleeding disorders\n --RELATED_TO--> [?] Postprocedural nonmenstrual uterine bleeding\n Def: Uterine bleeding occurring after procedure (i.e. uterine surgery, induced abortion, …)..." ]
3B14.0
Hereditary deficiency of factor I
[ { "from_icd11": "3B14.0", "icd10_code": "D682", "icd10_title": "Hereditary deficiency of other clotting factors" }, { "from_icd11": "MG27", "icd10_code": "R58", "icd10_title": "Hemorrhage, not elsewhere classified" }, { "from_icd11": "GA21.0", "icd10_code": "N930", "icd10_title": "Postcoital and contact bleeding" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R3129", "icd10_title": "Other microscopic hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R3121", "icd10_title": "Asymptomatic microscopic hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R311", "icd10_title": "Benign essential microscopic hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R319", "icd10_title": "Hematuria, unspecified" }, { "from_icd11": "MF50.4Z", "icd10_code": "R31", "icd10_title": "Hematuria" }, { "from_icd11": "DB98.A", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB98.A", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB98.A", "icd10_code": "K768", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "GA20.3", "icd10_code": "N926", "icd10_title": "Irregular menstruation, unspecified" }, { "from_icd11": "GA20.3", "icd10_code": "N925", "icd10_title": "Other specified irregular menstruation" } ]
D682
Hereditary deficiency of other clotting factors
Since the age of 12 years , the patient presented with episodes of headache with migraine aura, dizziness, vertigo, and vomiting. The results of neurological examination and complementary tests (computed tomography (CT) scans, magnetic resonance imaging (MRI), and wakefulness electroencephalogram) were unremarkable. Hematomas, stroke, and other organic pathologies were discarded. Pharmacotherapy: Flunarizine, rizatriptan, and dexketoprofen trometamol. At the age of 16 years , she suffered episodes of disconnection from the environment compatible with epileptic seizures together with loss of urine. Neurological tests (CT scans, MRI, somatosensory evoked potentials, cerebrospinal fluid (CSF) analysis, and sleep deprivation electroencephalogram) were performed, and the results indicated frequent generalized epileptiform discharges during the non-REM sleep phase, characterized by left temporal-parietal focal epileptiform discharges of poor persistence. Diagnosis: Epilepsy with complex partial seizures. Treatment: Valproic acid and follow-up in the neurology clinic, with 13 clinical evaluations between 2007 and 2012. At the age of 22 years , the patient entered the Neurology Service because of complaints of paresthesia and weakness in the hands and reduced sensitivity in the lower limbs. The gait showed no signs of organicity. Complementary neurological tests (CT scans, MRI of the spine, CSF analysis, and neuromuscular examination) were conducted, and a diagnosis of progressive paraparesis and proprioceptive and vibratory sensitivity disorder as well as mild impairment of the left-central somesthetic pathway was made. Other results were unremarkable. At the age of 23 years , the patient presented with heaviness and diffuse paresthesia in the lower limbs and returned to the Neurology Service for complete examination. Neurological examination: Lower-limb muscle strength was 4 + to 5. Osteotendinous reflexes (OTR) were hypoactive in the lower limbs and normal in the upper limbs. Tactile and algesic sensitivity was normal. Vibratory and positional sensitivity was reduced in the lower limbs and normal in the upper limbs. Cortical sensitivity was normal. Dysmetria in finger-nose maneuvers and dysdiadochokinesia were not observed. Romberg score of 3. Sensory ataxic gait was observed. Meningeal signs were absent. Complementary tests (CT scans, thoracic and lumbar MRI, somatosensory evoked potentials, electroencephalogram, and CSF analysis) were with unremarkable results. Autoimmune, nutritional, infectious, and demyelinating causes were discarded. Diagnosis: The etiology of gait ataxia was uncertain, but this condition may be correlated with acute posterior coronary syndrome. Treatment: Withdrawal of valproic acid. The patient was discharged with problems in ambulation (ambulation was accomplished with two crutches). No specific therapy was recommended and a mental health consultation was requested. At the age of 24 years , the patient returned to the Neurology Clinic because of several episodes of urinary incontinence, limited ambulation, and a decrease in tactile sensitivity from the pubic to the foot region. An exhaustive study of the case was conducted again. Neurological examination: Palpation of Arnold’s nerve was painful bilaterally. Symmetrical OTR was 2/4 in the upper limbs and 3/4 in the lower limbs with an increase in the reflexogenic area. There was a tendency to present equinus deformity of the foot and claw fingers. Alteration of the arthrokinetic sensitivity and loss of vibratory sensitivity in the lower limbs was present. Moderate tactile agnosia. Romberg score of 3. Non-claudication of the limbs in Barré maneuvers. No detectable changes in the index tests. The results of finger-nose tests indicated severe bilateral dysmetria with left side predominance. Ataxic-spastic gait with increase of the base of support and unstable rotation was present. Walking on tips and heels was impossible. Tandem gait was unstable. Additional tests included positron emission tomography (measures brain metabolism with injection of fluorodeoxyglucose), and the results indicated a correlation between cerebellar hypometabolism and clinical symptoms. Diagnosis: Possible spinocerebellar ataxia of genetic origin. A genetic study was conducted: A family history of this disorder was not observed, and the results of common genetic tests (FXN, SCA1, SCA2, SCA3, SCA6, SCA7, SCA8, SCA12, SCA17, and DRPLA) were unremarkable. Therefore, a genetic cause of ataxia was discarded. Symptomatic drug treatment with ibuprofen and rizatriptan was prescribed, and the patient was referred to physical and occupational therapy. During that year, the symptoms improved, and the patient managed to walk with one crutch. At the age of 25 years , the patient was referred for sexual health consultation.
4
0.980957
sec[1]/sec[0]/p[0]
en
0.999997
31699074
https://doi.org/10.1186/s12905-019-0833-z
[ "limbs", "sensitivity", "neurological", "gait", "scans", "unremarkable", "neurology", "genetic", "episodes", "complementary" ]
[ { "code": "ND56.1", "title": "Open wound of unspecified body region" }, { "code": "LB9Z", "title": "Structural developmental anomalies of the skeleton, unspecified" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "5B51&XS25", "title": "Severe wasting in infants, children or adolescents" }, { "code": "ND55", "title": "Other injuries of leg, level unspecified" }, { "code": "4A85.0Z", "title": "Drug hypersensitivity of unspecified type" }, { "code": "9D45", "title": "Impairment of light sensitivity" }, { "code": "DA08.Y", "title": "Other specified diseases of hard tissues of teeth" }, { "code": "8D88.Y", "title": "Other specified autonomic neuropathies" }, { "code": "4B07", "title": "Acquired lymphocytosis" } ]
=== ICD-11 CODES FOUND === [ND56.1] Open wound of unspecified body region Also known as: Open wound of unspecified body region | cut NOS | open wound NOS | penetrating wound NOS | Puncture wound with foreign body unspecified body region Excludes: Traumatic amputations involving multiple body regions | Open wounds involving multiple body regions | traumatic amputation NOS [LB9Z] Structural developmental anomalies of the skeleton, unspecified Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS [FB56.6] Other specified soft tissue disorders Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia [ND55] Other injuries of leg, level unspecified Also known as: Other injuries of leg, level unspecified | other injuries of lower limb, level unspecified | Superficial injury of leg, level unspecified | Abrasion of leg, level unspecified | Contusion of leg, level unspecified Excludes: Fracture of leg, level unspecified | Injuries involving multiple body regions [4A85.0Z] Drug hypersensitivity of unspecified type Also known as: Drug hypersensitivity of unspecified type | Drug or pharmacological agents hypersensitivity | medicinal hypersensitivity | drug sensitivity NOS [9D45] Impairment of light sensitivity Also known as: Impairment of light sensitivity | Vision sensitivity deficiencies | Day blindness | Impairment of dark adaptation | Moderate Impairment of Dark adaptation [DA08.Y] Other specified diseases of hard tissues of teeth Also known as: Other specified diseases of hard tissues of teeth | Decalcification of teeth | Dentine hypersensitivity | dentin sensitivity | sensitive dentine [8D88.Y] Other specified autonomic neuropathies Also known as: Other specified autonomic neuropathies | Autonomic neuropathy due to Fabry’s Disease | Autonomic neuropathy due to Refsum’s Disease | Autonomic neuropathy due to Allgrove syndrome | Autonomic neuropathy due to Tangier’s disease [4B07] Acquired lymphocytosis Also known as: Acquired lymphocytosis | Reactive lymphocytosis | Stress lymphocytosis | Hypersensitivity reactions of unspecified nature | disorder due to immune hypersensitivity reaction Excludes: Chronic lymphocytic leukaemia or small lymphocytic lymphoma === GRAPH WALKS === --- Walk 1 --- [ND56.1] Open wound of unspecified body region --EXCLUDES--> [?] Traumatic amputations involving multiple body regions --EXCLUDES--> [?] Other injuries of arm, level unspecified --- Walk 2 --- [ND56.1] Open wound of unspecified body region --EXCLUDES--> [?] Open wounds involving multiple body regions --CHILD--> [?] Open wounds involving thorax with abdomen, lower back or pelvis --- Walk 3 --- [LB9Z] Structural developmental anomalies of the skeleton, unspecified --PARENT--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --CHILD--> [LB70] Structural developmental anomalies of cranium Def: Any condition caused by failure of the cranium to correctly develop during the antenatal period.... --- Walk 4 --- [LB9Z] Structural developmental anomalies of the skeleton, unspecified --PARENT--> [?] Structural developmental anomalies of the skeleton Def: A deformation established before birth of an anatomical structure of one or more bones.... --CHILD--> [LB72] Structural developmental anomalies of shoulder girdle Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period.... --- Walk 5 --- [FB56.6] Other specified soft tissue disorders --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --EXCLUDES--> [?] Mononeuropathy --- Walk 6 --- [FB56.6] Other specified soft tissue disorders --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --EXCLUDES--> [?] Radiculopathy
[ "[ND56.1] Open wound of unspecified body region\n --EXCLUDES--> [?] Traumatic amputations involving multiple body regions\n --EXCLUDES--> [?] Other injuries of arm, level unspecified", "[ND56.1] Open wound of unspecified body region\n --EXCLUDES--> [?] Open wounds involving multiple body regions\n --CHILD--> [?] Open wounds involving thorax with abdomen, lower back or pelvis", "[LB9Z] Structural developmental anomalies of the skeleton, unspecified\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....\n --CHILD--> [LB70] Structural developmental anomalies of cranium\n Def: Any condition caused by failure of the cranium to correctly develop during the antenatal period....", "[LB9Z] Structural developmental anomalies of the skeleton, unspecified\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....\n --CHILD--> [LB72] Structural developmental anomalies of shoulder girdle\n Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period....", "[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --EXCLUDES--> [?] Mononeuropathy", "[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --EXCLUDES--> [?] Radiculopathy" ]
ND56.1
Open wound of unspecified body region
[ { "from_icd11": "ND56.1", "icd10_code": "T141", "icd10_title": "" }, { "from_icd11": "LB9Z", "icd10_code": "Q8789", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" }, { "from_icd11": "LB9Z", "icd10_code": "Q8781", "icd10_title": "Alport syndrome" }, { "from_icd11": "LB9Z", "icd10_code": "Q742", "icd10_title": "Other congenital malformations of lower limb(s), including pelvic girdle" }, { "from_icd11": "LB9Z", "icd10_code": "Q749", "icd10_title": "Unspecified congenital malformation of limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q740", "icd10_title": "Other congenital malformations of upper limb(s), including shoulder girdle" }, { "from_icd11": "LB9Z", "icd10_code": "Q741", "icd10_title": "Congenital malformation of knee" }, { "from_icd11": "LB9Z", "icd10_code": "Q875", "icd10_title": "Other congenital malformation syndromes with other skeletal changes" }, { "from_icd11": "LB9Z", "icd10_code": "Q748", "icd10_title": "Other specified congenital malformations of limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q89", "icd10_title": "Other congenital malformations, not elsewhere classified" }, { "from_icd11": "LB9Z", "icd10_code": "Q65-Q79", "icd10_title": "" }, { "from_icd11": "LB9Z", "icd10_code": "Q73", "icd10_title": "Reduction defects of unspecified limb" }, { "from_icd11": "LB9Z", "icd10_code": "Q730", "icd10_title": "Congenital absence of unspecified limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q731", "icd10_title": "Phocomelia, unspecified limb(s)" }, { "from_icd11": "LB9Z", "icd10_code": "Q74", "icd10_title": "Other congenital malformations of limb(s)" } ]
T141
An 82-year-old Japanese male (height, 178cm; weight, 56.1kg; BMI, 18.7kg/m 2 ) with persistent epigastric pain and nausea was transported to our hospital. He had a history of esophagogastric junction cancer (pT3N0M0 pStageIIA), following neoadjuvant chemotherapy, he had undergone a robotic-assisted thoracoscopic esophagectomy and gastric tube reconstruction via a subcutaneously route with three-field lymphadenectomy at another hospital 3 months prior. He experienced postoperative chylothorax, which improved with conservative management. Following rehabilitation, he was discharged home 7 weeks ago. On arrival at our ER, his oxygen saturation was 98% on room air, pulse rate was 85bpm, blood pressure was 150/80 mmHg. The patient presented with spontaneous pain and tenderness in the upper abdomen. Blood test revealed an elevated white blood cell level of 11110/μL. The remaining blood test results were normal. Computed tomography revealed that the proximal jejunum had herniated through the esophageal hiatus into the left thoracic cavity, with dilation of the subcutaneous gastric tube and duodenum . He was diagnosed with intestinal obstruction due to diaphragmatic hernia after esophageal surgery. He presented during nighttime hours, was urgently admitted for observation with the intention of elective surgery for the following day or thereafter. A nasogastric tube was inserted. However, nine hours after admission, the patient suddenly complained of difficulty breathing. He subsequently developed shock. His blood pressure was 106/65 mmHg, pulse rate of 150bpm, respiratory rate of 30/min with an O2 saturation of 97% on high-flow nasal cannula FiO2:0.4, cyanosis and peripheral coldness appeared. Arterial blood gas test at the time showed metabolic acidosis, a pH of 7.153, PaCO2 of 30 mmHg, PaO2 of 91 mmHg, BE of −18.3 mmol/L, and lactate level of 10.3 mmol/L. Chest X-ray showed a severe mediastinal shift to the right, suggesting obstructive shock due to intestinal hernia into the thoracic cavity . It was suggested that not only the respiratory status but also the circulatory dynamics had rapidly worsened, and based on the chest X-ray findings, obstructive shock caused by the herniated small intestine in the thoracic cavity was suspected. Immediate surgical decompression of the thoracic cavity was considered necessary to improve the situation, We planned emergency surgery, but shortly after endotracheal intubation was performed on the ward, he experienced cardiac arrest. The initial waveform indicated ventricular fibrillation (VF), and defibrillation was applied twice. After transitioning to pulseless electrical activity (PEA), resulting in the return of spontaneous circulation (ROSC) 20min later, but continuous adrenaline infusion was required to maintain blood pressure. Surgery was promptly initiated. Here is the surgical schema . An upper midline abdominal incision was made to avoid the subcutaneous gastric tube. It was observed that the small intestine had herniated from the esophageal hiatus into the left thoracic cavity, where it was strangulated by the diaphragmatic crura. A portion of the diaphragmatic crura was incised to manually reduce the herniated small intestine back into the abdominal cavity. After that, there was some improvement of blood pressure, and as continuous adrenaline infusion could be discontinued, it was diagnosed of obstructive shock due to herniated small intestine. Approximately 2000 mL of bloody pleural fluid was observed in the left thoracic cavity. The herniated small intestine measured approximately 220 cm in length, extending from a point approximately 5 cm distal to the ligament of Treitz. Although the small intestine was congested, the congestion improved and intestinal peristalsis was observed after reduction, leading to the decision not to perform small bowel resection. After aspirating as much bloody pleural fluid as possible, the esophageal hiatus was closed in two layers with 2–0 non-absorbable sutures. Left thoracic and abdominal drainage tubes were placed before closure. The operation time was 102 min. Postoperatively, shock state persisted. Acute kidney injury (AKI) developed, necessitating renal replacement therapy. Additionally, hypoxic-ischemic encephalopathy led to prolonged impaired consciousness. Despite continued intensive care, the patient developed ischemic perforation of the descending colon and aspiration pneumonia, died 29 days after surgery. Fig. 1 The proximal jejunum had herniated through the esophageal hiatus into the left thoracic cavity Fig. 2 Severe mediastinal shift to the right, suggesting obstructive shock due to intestinal hernia into the thoracic cavity Fig. 3 The small intestine had herniated from the esophageal hiatus into the left thoracic cavity, was strangulated by the diaphragmatic crura
3.851563
0.97998
sec[1]/p[0]
en
0.999997
39557728
https://doi.org/10.1186/s40792-024-02071-w
[ "thoracic", "cavity", "blood", "herniated", "small", "intestine", "esophageal", "shock", "hiatus", "tube" ]
[ { "code": "CA44", "title": "Pyothorax" }, { "code": "NA80.Y&XJ1C6", "title": "Thoracic haematoma" }, { "code": "LB30.7", "title": "Ectopic or pelvic kidney" }, { "code": "NA80.5", "title": "Abrasion of thorax" }, { "code": "ND35", "title": "Traumatic amputations involving multiple body regions" }, { "code": "DA08.0", "title": "Dental caries" }, { "code": "1F25.01", "title": "Chronic pulmonary coccidioidomycosis" }, { "code": "DA08.0&XA5R09", "title": "Caries limited to enamel" }, { "code": "CB2Z", "title": "Pleural, diaphragm or mediastinal disorders, unspecified" }, { "code": "DC51.1", "title": "Peritoneal adhesions" } ]
=== ICD-11 CODES FOUND === [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [LB30.7] Ectopic or pelvic kidney Definition: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones Also known as: Ectopic or pelvic kidney | Congenital displaced kidney | congenital misplaced kidney | congenital malposition of kidney | congenital prolapsed kidney Includes: Congenital displaced kidney | Malrotation of kidney [NA80.5] Abrasion of thorax Also known as: Abrasion of thorax | Abrasion of front wall of thorax | Abrasion of back wall of thorax [ND35] Traumatic amputations involving multiple body regions Also known as: Traumatic amputations involving multiple body regions | avulsion involving multiple body regions | Traumatic amputation of both hands | Traumatic amputation of one hand and other arm, any level, except hand | traumatic amputation of upper limb and other hand Includes: avulsion involving multiple body regions Excludes: traumatic amputation of leg NOS | traumatic amputation of arm NOS | Open wounds involving multiple body regions [DA08.0] Dental caries Definition: A condition characterised by localised destruction of calcified tissue, initiated on the tooth surface by decalcification of the enamel, followed by the enzymatic lysis of organic structures, resulting in cavity formation. Also known as: Dental caries | Dental decay | carious teeth | dental cavity | saprodontia Includes: Dental decay [1F25.01] Chronic pulmonary coccidioidomycosis Definition: A chronic form of pulmonary coccidioidomycosis. Pulmonary sequelae occur in approximately 5% of all cases of acute pulmonary coccidioidomycosis. Also known as: Chronic pulmonary coccidioidomycosis | coccidioidal lung granuloma | Coccidioidal nodules | Coccidioidal cavities | Coccidioidal pyopneumothorax [CB2Z] Pleural, diaphragm or mediastinal disorders, unspecified Also known as: Pleural, diaphragm or mediastinal disorders, unspecified [DC51.1] Peritoneal adhesions Definition: Disorders of peritoneum sticking by scar tissue or fibrosis Also known as: Peritoneal adhesions | abdominal adhesion | adhesive peritoneal band | peritoneal adhesion | peritoneal band Excludes: Adhesions of large intestine with obstruction | Postprocedural pelvic peritoneal adhesions | Intestinal adhesions or bands of small intestine with obstruction === GRAPH WALKS === --- Walk 1 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with... --CHILD--> [?] Bronchopleural tuberculosis --- Walk 2 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with... --PARENT--> [?] Tuberculosis of the respiratory system Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M.... --- Walk 3 --- [LB30.7] Ectopic or pelvic kidney Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones... --PARENT--> [LB30] Structural developmental anomalies of kidneys Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period.... --CHILD--> [LB30.0] Renal agenesis or other reduction defects of kidney Def: A series of conditions resulting in reduced kidney function including a congenital absence of both kidneys... --- Walk 4 --- [LB30.7] Ectopic or pelvic kidney Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones... --PARENT--> [LB30] Structural developmental anomalies of kidneys Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period.... --CHILD--> [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --- Walk 5 --- [NA80.5] Abrasion of thorax --PARENT--> [NA80] Superficial injury of thorax Def: Damage inflicted on the surface or shallow tissues of the thorax as the direct or indirect result of an external force, with or without disruption of structural continuity.... --CHILD--> [NA80.2] Other or unspecified superficial injuries of breast --- Walk 6 --- [NA80.5] Abrasion of thorax --PARENT--> [NA80] Superficial injury of thorax Def: Damage inflicted on the surface or shallow tissues of the thorax as the direct or indirect result of an external force, with or without disruption of structural continuity.... --RELATED_TO--> [?] Sequelae of superficial injury or open wound of neck or trunk
[ "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...\n --CHILD--> [?] Bronchopleural tuberculosis", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...\n --PARENT--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....", "[LB30.7] Ectopic or pelvic kidney\n Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones...\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --CHILD--> [LB30.0] Renal agenesis or other reduction defects of kidney\n Def: A series of conditions resulting in reduced kidney function including a congenital absence of both kidneys...", "[LB30.7] Ectopic or pelvic kidney\n Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones...\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --CHILD--> [LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....", "[NA80.5] Abrasion of thorax\n --PARENT--> [NA80] Superficial injury of thorax\n Def: Damage inflicted on the surface or shallow tissues of the thorax as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --CHILD--> [NA80.2] Other or unspecified superficial injuries of breast", "[NA80.5] Abrasion of thorax\n --PARENT--> [NA80] Superficial injury of thorax\n Def: Damage inflicted on the surface or shallow tissues of the thorax as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --RELATED_TO--> [?] Sequelae of superficial injury or open wound of neck or trunk" ]
CA44
Pyothorax
[ { "from_icd11": "CA44", "icd10_code": "J869", "icd10_title": "Pyothorax without fistula" }, { "from_icd11": "CA44", "icd10_code": "J860", "icd10_title": "Pyothorax with fistula" }, { "from_icd11": "CA44", "icd10_code": "J85-J86", "icd10_title": "" }, { "from_icd11": "CA44", "icd10_code": "J86", "icd10_title": "Pyothorax" }, { "from_icd11": "LB30.7", "icd10_code": "Q632", "icd10_title": "Ectopic kidney" }, { "from_icd11": "LB30.7", "icd10_code": "Q63", "icd10_title": "Other congenital malformations of kidney" }, { "from_icd11": "ND35", "icd10_code": "T05", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T050", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T051", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T052", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T053", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T054", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T055", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T056", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T058", "icd10_title": "" } ]
J869
Pyothorax without fistula
A 24-year-old man was riding a motorcycle and collided with a large truck crossing the street ahead him. Radiography revealed bilateral Galeazzi fracture-dislocations with dorsally dislocated ulnar heads and ulnar styloid fractures . Closed reduction was performed under sedation, but both fracture-dislocations were irreducible. Three hours after the injury, the patient underwent an emergency operation. The right simple radius fracture was fixed with a 7-hole 3.5-mm limited contact dynamic compression plate (LC-DCP; Synthes, Oberdorf, Switzerland) through an anterior approach. Due to the lack of a suitable implant, the left comminuted radius fracture was fixed temporarily with an external fixator, to reduce the dislocated ulnar head. However, the patient complained of pain in his right wrist, and postoperative radiography of the right side revealed dorsal subluxation of the ulnar head . Computed tomography (CT) performed under passive pronation and supination showed acceptable congruity of the left DRUJ in rotation, along with persistent dorsal subluxation of the right ulnar head . One week after the primary operation, the patient underwent an additional operation. The left comminuted radius fracture was fixed with a locking compression plate (LCP), consisting of an extra-long 10-hole 2.4-mm distal radius plate (Synthes) in bridging plate fashion through the anterior approach while maintaining reduction with an external fixator. Iliac cancellous bone was grafted due to improved fracture healing. Following achievement of stable fixation of the radius with the LCP, the external fixator was removed. A manual stressing test under fluoroscopic imaging showed that the left DRUJ was slightly loose, but its congruity was good, and passive forearm rotation was smooth and fully possible, thereby obviating the need for additional internal fixation of the ulnar styloid. To reduce the dorsally dislocated ulnar head, the right DRUJ was exposed on the ulnar head through a dorsoulnar approach. There were no tears in the triangular fibrocartilage complex (TFCC) and no tendon incarceration in the DRUJ. We observed palmar displacement of the avulsion fragment of the ulnar styloid process by the ulnar collateral ligament and periosteum of the ulna, with the avulsion fragment causing dorsal displacement of the ulnar head. The fragment was fixed by tension band wiring fixation, resulting in the anatomical reduction and stabilization of the DRUJ. Both arms were splinted in supination . Immediately, postoperative rehabilitation of the wrist and elbow was started without restriction, and active and active-assisted rotation of the forearm from neutral to full supination were allowed. Two weeks after the 2nd operation, CT under gentle passive rotation was reexamined. Acceptable reduction of the distal ulnar head and stability of both DRUJs in pronation were confirmed . and active rotation of both forearms was started. Splints were removed at 5 weeks, and passive rotation was permitted. Nine months after the injury, all hardware of both forearm were removed. At the 13-month follow-up, radiographs showed no subluxation of both ulnar heads . The patient’s forearm motion was restored to almost normal, with pronation and supination of 75° and 85° on the right and 80° and 85° on the left, respectively. Both DRUJs were slightly loose, and the patients had mild pain in his right wrist in hyperpronation; however, the patient had no pain in his left wrist and returned to normal life as a factory worker. Fig. 1 Anteroposterior and lateral radiographs of both forearms at initial diagnosis. Simple fracture of the right radius ( a , b ) and comminuted fracture of the left radius ( c , d ) were observed. Both distal ulnar heads were dislocated dorsally Fig. 2 Anteroposterior and lateral radiographs after emergency operation. Despite anatomical reduction in the right radius, dorsal subluxation of the ulnar head was observed. The left radius was fixed with an external fixator, and DRUJ was reduced. Distal pins were inserted into the second metacarpal bone and proximal pins into the radius shaft Fig. 3 Axial plane CT imaging after emergency surgery. a Right in supination. b Right in pronation. c Left in supination. d Left in pronation. Persistent dorsal subluxation of the right ulnar head was observed ( a , b ), whereas the left DRUJ showed almost normal congruity ( c , d ) Fig. 4 Anteroposterior and lateral radiographs after additional surgery. a Right . b Left Fig. 5 Axial plane CT imaging after surgery. a Right in pronation. b Left in pronation. Both DRUJs showed almost normal congruity Fig. 6 Anteroposterior and lateral radiographs at 13-month follow-up. a Right . b Left . Bone union of both forearms was achieved, and neither subluxation nor dislocation of the distal ulnar heads was observed
3.962891
0.977051
sec[1]/p[0]
en
0.999997
22610302
https://doi.org/10.1007/s11751-012-0136-5
[ "ulnar", "both", "radius", "head", "fracture", "pronation", "druj", "subluxation", "supination", "rotation" ]
[ { "code": "LB99.3", "title": "Ulnar hemimelia" }, { "code": "8C10.1", "title": "Lesion of ulnar nerve" }, { "code": "LD2F.1Y", "title": "Other specified syndromes with multiple structural anomalies, not of environmental origin" }, { "code": "BD30.00&XA23B7", "title": "Ulnar artery embolism" }, { "code": "BD30.01&XA23B7", "title": "Ulnar artery thrombosis" }, { "code": "LB99.6", "title": "Acheiria" }, { "code": "MB51.Z", "title": "Diplegia of upper extremities, unspecified" }, { "code": "LB9A.4", "title": "Apodia" }, { "code": "LB51", "title": "Anorchia or microorchidia" }, { "code": "9D90.2", "title": "Moderate vision impairment" } ]
=== ICD-11 CODES FOUND === [LB99.3] Ulnar hemimelia Definition: Ulnar hemimelia is a congenital ulnar deficiency of the forearm characterised by complete or partial absence of the ulna bone. Also known as: Ulnar hemimelia | Longitudinal reduction defect of ulna | agenesis of ulna | congenital absence of ulna | congenital absence of ulna with or without absence of some distal elements [8C10.1] Lesion of ulnar nerve Also known as: Lesion of ulnar nerve | mononeuritis ulnar nerve | Tardy ulnar nerve palsy | Tardy ulnar nerve palsy post humeral fracture | Ulnar nerve cubital tunnel syndrome Includes: Tardy ulnar nerve palsy Excludes: Injury of ulnar nerve at upper arm level | Injury of ulnar nerve at forearm level | Injury of ulnar nerve at wrist or hand level [LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin Also known as: Other specified syndromes with multiple structural anomalies, not of environmental origin | 46,XX disorder of sex development - anorectal anomalies | 46,XX DSD - anorectal anomalies | Aarskog-Scott syndrome | Aarskog syndrome [LB99.6] Acheiria Definition: A condition caused by failure of one or both hands to develop during the antenatal period. Also known as: Acheiria | Congenital absence of hand | agenesis of hand | congenital absence of hand and finger | congenital absence of hand and wrist [MB51.Z] Diplegia of upper extremities, unspecified Also known as: Diplegia of upper extremities, unspecified | Diplegia of upper extremities | paralysis of both upper limbs | both upper extremity paralysis | diplegia of upper limbs [LB9A.4] Apodia Definition: A condition caused by failure of the foot to develop during the antenatal period. Also known as: Apodia | Congenital absence of foot | agenesis of foot | congenital absence of foot or toe | congenital absence of foot or toe, unspecified side [LB51] Anorchia or microorchidia Definition: A disorder affecting males, caused by an abnormality occurring in sex development during the antenatal period. This disorder is characterised by individuals who are born with absence of the testes, or with testes that are deficient in size and function. Confirmation is by physical examination, identification of low testosterone levels but elevated follicle stimulating hormone and luteinizing hormone levels in a blood sample, or imaging. Also known as: Anorchia or microorchidia | Absence or aplasia of testis, unilateral | congenital absence of testis, unilateral | congenital absent testicle | congenital absence of testis [9D90.2] Moderate vision impairment Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision] Includes: visual impairment category 2, in both eyes === GRAPH WALKS === --- Walk 1 --- [LB99.3] Ulnar hemimelia Def: Ulnar hemimelia is a congenital ulnar deficiency of the forearm characterised by complete or partial absence of the ulna bone.... --PARENT--> [LB99] Reduction defects of upper limb Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB99.0] Amelia of upper limb Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb.... --- Walk 2 --- [LB99.3] Ulnar hemimelia Def: Ulnar hemimelia is a congenital ulnar deficiency of the forearm characterised by complete or partial absence of the ulna bone.... --PARENT--> [LB99] Reduction defects of upper limb Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB99.1] Humeral agenesis or hypoplasia --- Walk 3 --- [8C10.1] Lesion of ulnar nerve --EXCLUDES--> [?] Injury of ulnar nerve at forearm level --PARENT--> [?] Injury of nerves at forearm level --- Walk 4 --- [8C10.1] Lesion of ulnar nerve --EXCLUDES--> [?] Injury of ulnar nerve at forearm level --CHILD--> [?] Laceration of ulnar nerve at forearm level --- Walk 5 --- [LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin --PARENT--> [LD2F.1] Syndromes with multiple structural anomalies, not of environmental origin --RELATED_TO--> [?] Waardenburg-Shah syndrome Def: In this syndrome the phenotype includes not only the classical features of Waardenburg syndrome but also Hirschsprung disease. It may be caused by mutations in SOX10, EDN3 or EDNRB genes.... --- Walk 6 --- [LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin --PARENT--> [LD2F.1] Syndromes with multiple structural anomalies, not of environmental origin --RELATED_TO--> [?] Waardenburg-Shah syndrome Def: In this syndrome the phenotype includes not only the classical features of Waardenburg syndrome but also Hirschsprung disease. It may be caused by mutations in SOX10, EDN3 or EDNRB genes....
[ "[LB99.3] Ulnar hemimelia\n Def: Ulnar hemimelia is a congenital ulnar deficiency of the forearm characterised by complete or partial absence of the ulna bone....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.0] Amelia of upper limb\n Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb....", "[LB99.3] Ulnar hemimelia\n Def: Ulnar hemimelia is a congenital ulnar deficiency of the forearm characterised by complete or partial absence of the ulna bone....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.1] Humeral agenesis or hypoplasia", "[8C10.1] Lesion of ulnar nerve\n --EXCLUDES--> [?] Injury of ulnar nerve at forearm level\n --PARENT--> [?] Injury of nerves at forearm level", "[8C10.1] Lesion of ulnar nerve\n --EXCLUDES--> [?] Injury of ulnar nerve at forearm level\n --CHILD--> [?] Laceration of ulnar nerve at forearm level", "[LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin\n --PARENT--> [LD2F.1] Syndromes with multiple structural anomalies, not of environmental origin\n --RELATED_TO--> [?] Waardenburg-Shah syndrome\n Def: In this syndrome the phenotype includes not only the classical features of Waardenburg syndrome but also Hirschsprung disease. It may be caused by mutations in SOX10, EDN3 or EDNRB genes....", "[LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin\n --PARENT--> [LD2F.1] Syndromes with multiple structural anomalies, not of environmental origin\n --RELATED_TO--> [?] Waardenburg-Shah syndrome\n Def: In this syndrome the phenotype includes not only the classical features of Waardenburg syndrome but also Hirschsprung disease. It may be caused by mutations in SOX10, EDN3 or EDNRB genes...." ]
LB99.3
Ulnar hemimelia
[ { "from_icd11": "LB99.3", "icd10_code": "Q715", "icd10_title": "Longitudinal reduction defect of ulna" }, { "from_icd11": "8C10.1", "icd10_code": "G5622", "icd10_title": "Lesion of ulnar nerve, left upper limb" }, { "from_icd11": "8C10.1", "icd10_code": "G5621", "icd10_title": "Lesion of ulnar nerve, right upper limb" }, { "from_icd11": "8C10.1", "icd10_code": "G5620", "icd10_title": "Lesion of ulnar nerve, unspecified upper limb" }, { "from_icd11": "8C10.1", "icd10_code": "G5623", "icd10_title": "Lesion of ulnar nerve, bilateral upper limbs" }, { "from_icd11": "8C10.1", "icd10_code": "G562", "icd10_title": "Lesion of ulnar nerve" }, { "from_icd11": "LB99.6", "icd10_code": "Q7131", "icd10_title": "Congenital absence of right hand and finger" }, { "from_icd11": "LB99.6", "icd10_code": "Q7133", "icd10_title": "Congenital absence of hand and finger, bilateral" }, { "from_icd11": "LB99.6", "icd10_code": "Q7130", "icd10_title": "Congenital absence of unspecified hand and finger" }, { "from_icd11": "LB99.6", "icd10_code": "Q713", "icd10_title": "Congenital absence of hand and finger" }, { "from_icd11": "MB51.Z", "icd10_code": "G830", "icd10_title": "Diplegia of upper limbs" }, { "from_icd11": "LB9A.4", "icd10_code": "Q7231", "icd10_title": "Congenital absence of right foot and toe(s)" }, { "from_icd11": "LB9A.4", "icd10_code": "Q7230", "icd10_title": "Congenital absence of unspecified foot and toe(s)" }, { "from_icd11": "LB9A.4", "icd10_code": "Q723", "icd10_title": "Congenital absence of foot and toe(s)" }, { "from_icd11": "LB51", "icd10_code": "Q550", "icd10_title": "Absence and aplasia of testis" } ]
Q715
Longitudinal reduction defect of ulna
The final diagnosis was sarcomatoid squamous cell carcinoma. Sarcomatoid or the spindle-cell variant of squamous cell carcinoma is a rare variant that usually arises in sun-damaged or irradiated skin. It generally appears as an exophytic tumor or an ulcerated mass on the sun-exposed skin of elderly patients. The case under discussion is an atypical presentation of this rare entity as it has presented in an immunocompetent, non-irradiated young adult in the third decade without any external ulceration. Histologically, it is composed of atypical spindle cells arranged in a whorled pattern. Unlike conventional squamous cell carcinoma (SCC), the tumor cells infiltrate the dermis singly without the formation of nests or cords. The connection to the overlying epidermis, if present, is supporting evidence for the diagnosis. Mitoses and bizarre pleomorphic giant cells may be frequently seen. Deep infiltration of the dermis, subcutis, and underlying fascia is common. Sarcomatoid SCC was initially reported by Martin and Stewart in 1935. It was believed that previous radiation was the most important cause, as 6 out of the 8 patients reported had a history of radiation. It was also thought to be an aggressive form of SCC, as 4 of these 8 patients died of cancer. This was disputed in 1950 in a report of five cases by Strauss in which none of the patients had a history of radiation exposure. In 1972, Smith proposed that when spindle cell SCCs arise in a site of previous radiation, they tend to have a more aggressive course, as would be expected. When they arise de novo, Smith proposed that these lesions do not exhibit a more aggressive behavior than conventional SCC. Spindle cell SCC has also been reported in renal transplant recipients, in which 1 of 4 patients developed metastatic disease. Unfortunately, no large studies have been conducted regarding the prognosis of spindle cell SCC, especially comparing de novo lesions with radiation-associated lesions. The clinical morphology gave rise to several possibilities. Among them are subcutaneous fungal infections, rhinoscleroma, mycobacterial infections, cervicofacial actinomycosis, Wegener's granulomatosis, lethal midline granuloma, syphilis, Churg-Strauss syndrome, sinonasal sarcoidosis, fibrocytic tumors, such as atypical fibroxanthoma, malignant fibrous histiocytoma, squamous cell carcinoma, basal cell carcinoma, desmoplastic melanoma, polymorphic reticulosis, berylliosis, etc. On routine histopathology, all the granulomatous or infective etiologies could be effectively ruled out. Despite the positive report of fungal culture, blastomycosis was an unlikely possibility on clinical grounds (absence of warty growths, etc.). The absence of either fungal elements or granulomas helped to discount the possibility altogether. The positive fungal culture and the improvement on oral itraconozole could be ascribed to secondary infection. The differential diagnosis could be narrowed down to spindle cell tumors, such as atypical fibroxanthoma including its non-pleomorphic variant, spindle cell melanoma, soft tissue tumors, and spindle-celled SCC. This was one of those cases where immunohistochemistry was imperative in order to diagnose and to prognosticate. Spindle cell and desmoplastic melanoma and poorly differentiated cutaneous metastases could be negated by the S-100 protein negativity. Soft tissue tumors were negated by the absence of the intermediate filament desmin. The non-staining by HMB-45 further bolstered the absence of involvement of melanocytes. The presence of high molecular weight cytokeratins (CK5/6) and the absence of CD10 helped the diagnosis in favor of SCC as opposed to atypical fibroxanthoma, including the non-pleomorphic variant of the latter. It may be remarked here that atypical fibroxanthoma, first described by Helwig in 1961, is a spindle cell tumor of mesenchymal origin, that also presents (like spindle cell SCC) in the sun-damaged skin of the elderly and is morphologically indistinguishable from the latter on routine hematoxylin and eosin (H and E) stained sections. The non-pleomorphic variant of atypical fibroxanthoma, first described by Calonje et al. in 1993, is so very indistinguishable from this variant of SCC as to be termed by some to be the same condition. In some of these cases, even immunohistochemistry is also not enough to differentiate between these conditions. For example, some poorly differentiated sarcomatoid SCCs may show loss of cytokeratin expression making the diagnosis even more challenging. In these cases, electron microscopy is the only recourse. The presence of tonofilaments and desmosomes confirms an epithelial origin. Poorly differentiated sarcomatoid SCC, however, may not always have evidence of tonofilaments and desmosomes, making them indistinguishable from sarcomas.
4.515625
0.469482
sec[1]/p[0]
en
0.999996
20101326
https://doi.org/10.4103/0019-5154.53172
[ "cell", "spindle", "atypical", "variant", "that", "sarcomatoid", "carcinoma", "patients", "radiation", "these" ]
[ { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "9A96.3", "title": "Primary anterior uveitis" }, { "code": "3A61.Z", "title": "Acquired pure red cell aplasia, unspecified" }, { "code": "9A78.1", "title": "Corneal pigmentations or deposits" }, { "code": "2C25.Y", "title": "Other specified malignant neoplasms of bronchus or lung" }, { "code": "2D4Y", "title": "Other specified malignant neoplasms of unspecified primary sites" }, { "code": "2F2Y", "title": "Other specified benign cutaneous neoplasms" }, { "code": "2C24.1", "title": "Squamous cell carcinoma of trachea" } ]
=== ICD-11 CODES FOUND === [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine [5C56.20] Mucolipidosis Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2 Excludes: Sialidosis (mucolipidosis type 1) [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] [9A96.3] Primary anterior uveitis Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid. Also known as: Primary anterior uveitis | anterior chamber cell [3A61.Z] Acquired pure red cell aplasia, unspecified Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia [9A78.1] Corneal pigmentations or deposits Also known as: Corneal pigmentations or deposits | Haematocornea | corneal blood staining | keratohaemia | Kayser-Fleischer ring Includes: Haematocornea | Kayser-Fleischer ring | Krukenberg spindle [2C25.Y] Other specified malignant neoplasms of bronchus or lung Also known as: Other specified malignant neoplasms of bronchus or lung | Bronchial endocrine tumour | Bronchial neuroendocrine tumour | Bronchial carcinoid tumour | Bronchiolo-alveolar carcinoma of lung [2D4Y] Other specified malignant neoplasms of unspecified primary sites Also known as: Other specified malignant neoplasms of unspecified primary sites | Neuroendocrine tumour of unspecified site | Neuroendocrine tumour NOS | NET- Neuroendocrine tumour NOS | neuroendocrine carcinoma of unspecified site [2F2Y] Other specified benign cutaneous neoplasms Also known as: Other specified benign cutaneous neoplasms | Benign tumours of cutaneous smooth muscle | Pilar leiomyoma | Cutaneous leiomyoma | Piloleiomyoma [2C24.1] Squamous cell carcinoma of trachea Also known as: Squamous cell carcinoma of trachea | Papillary squamous cell carcinoma of trachea | Basaloid squamous cell carcinoma of trachea | Clear cell squamous cell carcinoma of trachea | Verrucous carcinoma of trachea === GRAPH WALKS === --- Walk 1 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism --- Walk 2 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --CHILD--> [MF92] Chyluria Def: Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white.... --- Walk 3 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Mucolipidosis type 4 Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu... --PARENT--> [?] Sphingolipidosis --- Walk 4 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Wolman disease Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir... --PARENT--> [?] Lysosomal acid lipase deficiency Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater... --- Walk 5 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da... --- Walk 6 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da...
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF92] Chyluria\n Def: Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white....", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Sphingolipidosis", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] Lysosomal acid lipase deficiency\n Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy\n Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da...", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy\n Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da..." ]
MF9Y
Other specified clinical findings on examination of urine, without diagnosis
[ { "from_icd11": "3A51.1", "icd10_code": "D571", "icd10_title": "Sickle-cell disease without crisis" }, { "from_icd11": "3A61.Z", "icd10_code": "D609", "icd10_title": "Acquired pure red cell aplasia, unspecified" }, { "from_icd11": "3A61.Z", "icd10_code": "D608", "icd10_title": "Other acquired pure red cell aplasias" }, { "from_icd11": "3A61.Z", "icd10_code": "D60", "icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]" }, { "from_icd11": "9A78.1", "icd10_code": "H18049", "icd10_title": "Kayser-Fleischer ring, unspecified eye" }, { "from_icd11": "9A78.1", "icd10_code": "H180", "icd10_title": "Corneal pigmentations and deposits" } ]
D571
Sickle-cell disease without crisis
A 52-year-old man presented with FAP. At the age of 34 years, he underwent a two-stage restorative proctocolectomy and a hand-sewn ileal J-pouch anal anastomosis at a previous hospital because of FAP co-presenting with sigmoid colon cancer. The clinical stage according to the TNM 8th edition was T3 N1b M0, Stage IIIB. Adjuvant chemotherapy was not prescribed and regular observation was undertaken. He had no other symptoms, including constipation, and he did not visit the hospital for follow-up 1 year postoperatively. However, 6 years following surgery, he experienced abdominal distension and constipation. He visited our emergency department with complaints of severe pain in his lower abdomen. On physical examination, signs of peritoneal irritation were observed throughout the abdomen, and anal strictures were palpable upon digital examination. Laboratory examination demonstrated an elevated white blood cell (WBC) count of 13,800/μl and a C-reactive protein (CRP) level of 2.19 mg/dl. Computed tomography (CT) of the abdomen revealed a pneumoperitoneum . Perforation of the digestive tract was also diagnosed. Accordingly, laparotomy was performed on the day of admission. A large amount of cloudy ascites in the abdominal cavity was observed, and the blind end of the ileal J-pouch was enlarged. A 2-mm perforation was observed at the top of the pouch, and the upper part of the blind end was resected using a stapler . Gastrointestinal gastrography during surgery revealed an anastomotic stricture . The perforation was found to have been caused by increased intraluminal pressure in the extended pouch from the anastomotic stricture; hence, the anastomotic stricture was manually dilated to 20 mm in diameter . Histopathological examination revealed no significant findings on the mucosal or muscular surfaces, and only inflammatory findings on the serous surface were observed (perforation and peritonitis) . The patient was discharged 22 days postoperatively. Following this episode, the patient had no symptoms and was unable to visit the hospital for follow-up. Eighteen years after initial surgery (12 years after the first perforation), he presented with severe abdominal pain. Laboratory examinations revealed an elevated WBC count of 17,900/μl and CRP level of 1.79 mg/dl. CT demonstrated free air in the abdomen , and physical examination revealed that pain and the abdominal signs, which were mild at the time of presentation, gradually increased in severity until peritoneal irritation symptoms were subsequently observed throughout. Therefore, intestinal perforation was suspected, and laparotomy was performed. Contaminated ascites and inflammation of the ileum in the abdominal cavity and a 2-mm perforation at the top of the ileal J-pouch were once again observed. The perforation was repaired followed by abdominal intraperitoneal drainage and temporary loop ileostomy . Postoperative endoscopy revealed multiple mucosal ulcers , and gastrointestinal gastrography revealed stricture of the anastomotic segment . The patient was discharged 27 days after surgery without complications. After 1 month, the multiple mucosal ulcers improved without antibiotics. Fig. 1 Findings upon initial perforation. a Computed tomography. CT revealed free air and fluid collection around the blind end of the J-pouch (arrow), and perforation of the digestive tract was suspected. b Gastrointestinal gastrographic findings during surgery. Gastrointestinal gastrography revealed an anastomotic stricture. This appeared to cause an increase in the intraluminal pressure in the J-pouch. c , d Excised specimen findings. Gross appearance of the excised specimen. A 2-mm perforation was observed at the top of the blind end of the J-pouch. Inflammatory findings were observed on the serous surface ( c ). No ulcers were observed on the mucosal surface ( d ) Fig. 2 Schemes of the operation. a Operation during the first perforation. A 2-mm perforation at the top of the pouch was resected using a stapler ①. An anastomotic stricture was observed, and it was manually dilated to 20 mm in diameter ②. b Operation during the second perforation. A 2-mm perforation at the top of the pouch was once again observed and primary repair was performed ③. Temporary loop ileostomy was performed Fig. 3 Findings upon the second perforation. a , b Contrast-enhanced computed tomography. Contrast-enhanced CT revealed free air (arrow: a ) and fluid collection around the blind end of the J-pouch (arrow: b ). c Endoscopic observation and gastrointestinal gastrography findings after surgery. Endoscopy revealed multiple ulcers in the ileal J-pouch, and gastrointestinal gastrography revealed an anastomotic stricture. d Gastrointestinal gastrographic findings after surgery. Gastrointestinal gastrography revealed an anastomotic stricture again
3.958984
0.980469
sec[1]/p[0]
en
0.999998
34982288
https://doi.org/10.1186/s40792-021-01355-9
[ "perforation", "pouch", "gastrointestinal", "anastomotic", "stricture", "abdominal", "gastrography", "blind", "ileal", "abdomen" ]
[ { "code": "CA0A.Z", "title": "Chronic rhinosinusitis, unspecified" }, { "code": "CA0Y&XA3523", "title": "Perforation of nasal sinus" }, { "code": "NB32.31", "title": "Laceration of lung" }, { "code": "ME24.31", "title": "Perforation of large intestine" }, { "code": "9A76", "title": "Corneal ulcer" }, { "code": "GC7C", "title": "Caesarean scar defect of uterus" }, { "code": "LB12.4", "title": "Congenital diverticulum of oesophagus" }, { "code": "DA40.3", "title": "Gastric diverticulum" }, { "code": "LB11", "title": "Congenital diverticulum of pharynx" }, { "code": "LD44.N0", "title": "CATCH 22 phenotype" } ]
=== ICD-11 CODES FOUND === [CA0A.Z] Chronic rhinosinusitis, unspecified Also known as: Chronic rhinosinusitis, unspecified | Chronic rhinosinusitis | Chronic sinusitis | chronic sinusitis NOS | unspecified sinusitis [NB32.31] Laceration of lung Also known as: Laceration of lung | perforated lung NOS | pulmonary perforation NOS [ME24.31] Perforation of large intestine Definition: Perforation of large intestine is a complete penetration of the colonic wall, often resulting in the leakage of luminal contents into the abdominal cavity. Perforation of large intestine results in the potential for bacterial contamination of the abdominal cavity and peritonitis. Also known as: Perforation of large intestine | bowel perforation NOS | Non-traumatic perforation of large intestine Excludes: Diverticular disease of large intestine | Ulcerative colitis | Crohn disease [9A76] Corneal ulcer Definition: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection. Also known as: Corneal ulcer | cornea ulcer | ulcerative keratitis | corneal ulcer NOS | Central corneal ulcer Includes: Central corneal ulcer | Ring corneal ulcer | Corneal ulcer with hypopyon [GC7C] Caesarean scar defect of uterus Definition: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar defect of uterus, such as postmenstrual spotting, dysmenorrhea, or unexplained infertility, this is known as Caesarean scar disorder. Also known as: Caesarean scar defect of uterus | caesarean uterine scar defect | uterine pouch | caesarean scar niche | caesarean section scar diverticulum [LB12.4] Congenital diverticulum of oesophagus Definition: A very rare congenital diverticulum which is typically located just above the cricopharyngeal junction. It is usually asymptomatic unless complicated by an inflammatory process. If the diverticulum compresses the trachea or is associated with oesophageal stenosis or fistula, the symptoms of stridor, progressive dysphagia, respiratory distress, severe choking, and regurgitation may be present from birth. Also known as: Congenital diverticulum of oesophagus | congenital oesophageal diverticulum | Congenital oesophageal pouch | diverticulum of oesophagus | oesophageal pouch Includes: Congenital oesophageal pouch | oesophageal pouch Excludes: Diverticulum of oesophagus, acquired [DA40.3] Gastric diverticulum Definition: Gastric diverticulum is a disorder having out-pouchings from the gastric wall. Also known as: Gastric diverticulum | diverticulum of stomach | gastric diverticula | stomach diverticula | stomach diverticulum Excludes: Congenital diverticulum of stomach [LB11] Congenital diverticulum of pharynx Definition: A condition caused by failure of the pharynx to correctly develop during the antenatal period. This condition may present with difficulty swallowing, or may be asymptomatic. Confirmation is through observation of a diverted pharynx by imaging. Also known as: Congenital diverticulum of pharynx | Pharyngeal pouch | congenital pharyngeal pouch | pharyngeal diverticula | pharyngeal diverticulitis Excludes: pharyngeal pouch syndrome [LD44.N0] CATCH 22 phenotype Definition: Monosomy 22q11 (DiGeorge Velocardiofacial syndrome, DGS/VCF) syndrome is a chromosomal anomaly characterised by the association of several variable malformations: hypoplastic thymus and parathyroid glands, congenital conotruncal heart defects, a subtle but characteristic facial dysmorphism, cleft palate or velar insufficiency, and learning difficulties. Also known as: CATCH 22 phenotype | Conotruncal anomalies face syndrome | Velocardiofacial syndrome | Shprintzen syndrome | Sedlackova syndrome Includes: Pharyngeal pouch syndrome | DiGeorge syndrome | Velocardiofacial syndrome === GRAPH WALKS === --- Walk 1 --- [CA0A.Z] Chronic rhinosinusitis, unspecified --PARENT--> [CA0A] Chronic rhinosinusitis Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d... --EXCLUDES--> [?] Acute sinusitis Def: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries o... --- Walk 2 --- [CA0A.Z] Chronic rhinosinusitis, unspecified --PARENT--> [CA0A] Chronic rhinosinusitis Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d... --EXCLUDES--> [?] Acute sinusitis Def: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries o... --- Walk 3 --- [NB32.31] Laceration of lung --PARENT--> [NB32.3] Certain injuries of lung --CHILD--> [NB32.32] Inhalation injury of lung --- Walk 4 --- [NB32.31] Laceration of lung --PARENT--> [NB32.3] Certain injuries of lung --CHILD--> [NB32.31] Laceration of lung --- Walk 5 --- [ME24.31] Perforation of large intestine Def: Perforation of large intestine is a complete penetration of the colonic wall, often resulting in the leakage of luminal contents into the abdominal cavity. Perforation of large intestine results in th... --EXCLUDES--> [?] Diverticular disease of large intestine Def: This refers to the clinical entity characterised by the presence of sac-like outpocketings of the colonic mucosa and submucosa through weak points of the muscle layer of the large intestine. This cont... --PARENT--> [?] Diverticular disease of intestine Def: Diverticula are a major burden of illness in an aging population, presenting with bleeding or in form of a diverticulitis. Many are asymptomatic. Most diverticula (pseudodiverticula) occur in the colo... --- Walk 6 --- [ME24.31] Perforation of large intestine Def: Perforation of large intestine is a complete penetration of the colonic wall, often resulting in the leakage of luminal contents into the abdominal cavity. Perforation of large intestine results in th... --RELATED_TO--> [?] Injury of colon --PARENT--> [?] Injury of intra-abdominal organs
[ "[CA0A.Z] Chronic rhinosinusitis, unspecified\n --PARENT--> [CA0A] Chronic rhinosinusitis\n Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...\n --EXCLUDES--> [?] Acute sinusitis\n Def: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries o...", "[CA0A.Z] Chronic rhinosinusitis, unspecified\n --PARENT--> [CA0A] Chronic rhinosinusitis\n Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...\n --EXCLUDES--> [?] Acute sinusitis\n Def: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries o...", "[NB32.31] Laceration of lung\n --PARENT--> [NB32.3] Certain injuries of lung\n --CHILD--> [NB32.32] Inhalation injury of lung", "[NB32.31] Laceration of lung\n --PARENT--> [NB32.3] Certain injuries of lung\n --CHILD--> [NB32.31] Laceration of lung", "[ME24.31] Perforation of large intestine\n Def: Perforation of large intestine is a complete penetration of the colonic wall, often resulting in the leakage of luminal contents into the abdominal cavity. Perforation of large intestine results in th...\n --EXCLUDES--> [?] Diverticular disease of large intestine\n Def: This refers to the clinical entity characterised by the presence of sac-like outpocketings of the colonic mucosa and submucosa through weak points of the muscle layer of the large intestine. This cont...\n --PARENT--> [?] Diverticular disease of intestine\n Def: Diverticula are a major burden of illness in an aging population, presenting with bleeding or in form of a diverticulitis. Many are asymptomatic. Most diverticula (pseudodiverticula) occur in the colo...", "[ME24.31] Perforation of large intestine\n Def: Perforation of large intestine is a complete penetration of the colonic wall, often resulting in the leakage of luminal contents into the abdominal cavity. Perforation of large intestine results in th...\n --RELATED_TO--> [?] Injury of colon\n --PARENT--> [?] Injury of intra-abdominal organs" ]
CA0A.Z
Chronic rhinosinusitis, unspecified
[ { "from_icd11": "CA0A.Z", "icd10_code": "J329", "icd10_title": "Chronic sinusitis, unspecified" }, { "from_icd11": "CA0A.Z", "icd10_code": "J324", "icd10_title": "Chronic pansinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J320", "icd10_title": "Chronic maxillary sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J322", "icd10_title": "Chronic ethmoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J323", "icd10_title": "Chronic sphenoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J328", "icd10_title": "Other chronic sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J321", "icd10_title": "Chronic frontal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J30-J39", "icd10_title": "" }, { "from_icd11": "CA0A.Z", "icd10_code": "J32", "icd10_title": "Chronic sinusitis" }, { "from_icd11": "ME24.31", "icd10_code": "K631", "icd10_title": "Perforation of intestine (nontraumatic)" }, { "from_icd11": "9A76", "icd10_code": "H16003", "icd10_title": "Unspecified corneal ulcer, bilateral" }, { "from_icd11": "9A76", "icd10_code": "H16031", "icd10_title": "Corneal ulcer with hypopyon, right eye" }, { "from_icd11": "9A76", "icd10_code": "H16001", "icd10_title": "Unspecified corneal ulcer, right eye" }, { "from_icd11": "9A76", "icd10_code": "H16072", "icd10_title": "Perforated corneal ulcer, left eye" }, { "from_icd11": "9A76", "icd10_code": "H16002", "icd10_title": "Unspecified corneal ulcer, left eye" } ]
J329
Chronic sinusitis, unspecified
A 74-year-old man with melanoma treated with anti-PD1 (pembrolizumab) experienced a catheter-related bacteremia due to multidrug-resistant P. aeruginosa in December 2017 . He was treated successfully with colistin and meropenem that he received during 11 days. He developed spinal pain during summer 2018 and spondylodiscitis with spinal abscess was diagnosed in December 2018. Aspiration revealed pan drug-resistant P. aeruginosa in culture, with resistance to all antibiotics including ceftazidime/avibactam (MIC 64 mg/L), ceftolozane/tazobactam (MIC > 256 mg/L) and colistin (MIC 8 mg/L). He received in a French hospital colistin (colistimethate sodium; 3 MUI/8 h) and rifampin 900 mg once a day, and as he developed acute mild kidney injury, antibiotics were rapidly stopped. The patient was admitted in our referral center for the management of complex BJI ( http://www.crioac-lyon.fr ) with severe pain. He was bedridden and required continuous infusion of opioid. As no active antibiotic was available for the treatment, phage therapy, that was already used in our institution, was envisaged as salvage therapy. The strain was sent to two different private companies (in France and in the USA) to test their phages in development, and to a European military laboratory that have purified phages. Unfortunately, the strain was fully resistant to all available phages. Therefore, we developed a unique academic collaboration between universities and hospitals located in three different European countries (Switzerland, Belgium, and France) that allowed us to identify three different lytic phages active on the patient initial P. aeruginosa isolate, to produce them separately, and to administer them as a pre-assembled personalized three-phage cocktail to the patient, in the shortest possible time . Fig. 1 Timeline of the most relevant surgical procedures (green), microbiological results (light blue), opioid therapy (dark blue), antibiotic therapies (dark gray), and phage therapy (magenta). Clinical events are indicated in black. The red cross indicated withdrawal of antibiotics due to the occurrence of a serious adverse event (mild kidney injury). Fig. 2 Imaging of the patient before and after treatment. A Gadolinium T1-weighed MRI of the spine showing L2-L3 disc abscess and L3-L4 spondylodiscitis; B CT-scan showing mirror-like bone destruction from either side of the L2-L3 abscess; C X-ray performed at the end of the follow-up showing no loosening of the spinal osteosynthesis and the adequate position of the intersomatic cages at L2-L3 and L3-L4 level with anterior bone fusion; D Local aspect of the lumbar scar at the end of the follow-up, showing no inflammation nor discharge. Fig. 3 Morphologic description of the phages used to treat the patient and description of their activity on the patient’s strains. A EM micrographs of phage vB_PaeP_4029; B EM micrographs of phage vB_PaeP_4032; C EM micrographs of phage vB_PaeP_4034; D Phagogram (spot test) of phages vB_PaeP_4034 and vB_PaeP_4029 on production strain PAO1; E Phagogram (spot test) of phage vB_PaeP_4032 on production strain ATCC-15442-MINI; F Phagogram (spot test) of phages vB_PaeP_4034, vB_PaeP_4032, and vB_PaeP_4029 on the patient strain; G One of the two P. aeruginosa morphotypes cultured from a bone sample taken from the second-stage surgery procedure, that was close to the initial strain; H One of the two P. aeruginosa corresponds to a stable Small Colony Variant (SCV) morphotype; I Visualization of Plaque Forming Units (PFU) of the phage vB_PaeP_4029 on the patient’s strains isolated before phage therapy or during the second-stage surgery procedure; J Visualization of Plaque Forming Units (PFU) of the phage vB_PaeP_4032 on the patient’s strains isolated before phage therapy or during the second-stage surgery procedure; K Visualization of Plaque Forming Units (PFU) of the phage vB_PaeP_4034 on the patient’s strains isolated before phage therapy or during the second-stage surgery procedure. Table 1 Phagogram (Efficiency of Plating [EOP]) of the non-purified phages on the patient strain. vB_PaeP_4029 vB_PaeP_4032 vB_PaeP_4034 Titer on production strain 8 × 10 9 2 × 10 9 8 × 10 9 Titer on patient strain 4 × 10 8 2 × 10 7 6 × 10 8 EOP score on patient strain 5 × 10 −2 1 × 10 −2 7,5 × 10 −2 Table 2 Determination of EOP scores of the three phages on the patient’s strains isolated before phage therapy or during the second-stage surgery procedure (2 morphotypes, including one SCV morphotype). Strain Initial strain Second stage surgery Morphotype 1 Second stage surgery Morphotype 2 Phage vB_PaeP_4029 vB_PaeP_4032 vB_PaeP_4034 vB_PaeP_4029 vB_PaeP_4032 vB_PaeP_4034 vB_PaeP_4029 vB_PaeP_4032 vB_PaeP_4034 EOP score 5.6 × 10 −2 1.2 × 10 −3 1.4 × 10 −1 1 × 10 −1 1.1 × 10 −3 1.3 × 10 −1 1.5 × 10 −2 8.3 × 10 −5 1.1 × 10 −2
4.109375
0.904297
sec[1]/p[0]
en
0.999998
PMC9306240
https://doi.org/10.1038/s41467-022-31837-9
[ "phage", "strain", "phages", "stage", "aeruginosa", "that", "strains", "three", "phagogram", "morphotype" ]
[ { "code": "FA24.4", "title": "Juvenile systemic arthritis" }, { "code": "ND33", "title": "Dislocations, strains or sprains involving multiple body regions" }, { "code": "ND56.3", "title": "Dislocation or strain or sprain of unspecified body region" }, { "code": "NB53.5", "title": "Strain or sprain of lumbar spine" }, { "code": "ND51.0", "title": "Dislocation or strain or sprain of unspecified joint or ligament of trunk" }, { "code": "9D50", "title": "Visual discomfort" }, { "code": "9B71.3&XS5S", "title": "Retinopathy of prematurity, Stage 2" }, { "code": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" }, { "code": "GB61.0", "title": "Chronic kidney disease, stage 1" }, { "code": "GB60.0", "title": "Acute kidney failure, stage 1" } ]
=== ICD-11 CODES FOUND === [FA24.4] Juvenile systemic arthritis Definition: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eruptions) and by an equal sex ratio. Fever peaks are associated with transient cutaneous eruptions and diffuse erythematosis or urticarial-like lesions. The presence of arthritis is essential for diagnosis but may appear later in the disease course. The number of sites affected is variable (mono-, oli Also known as: Juvenile systemic arthritis | Still disease | Juvenile systemic onset arthritis complicated by macrophage activation syndrome | Juvenile systemic arthritis, multiple sites | juvenile arthritis with systemic onset, multiple sites [ND33] Dislocations, strains or sprains involving multiple body regions Also known as: Dislocations, strains or sprains involving multiple body regions | Dislocations, strains or sprains involving head with neck | Dislocations, sprains and strains of sites classifiable as head or neck level | Multiple dislocations of head and neck | Multiple sprains of head and neck [ND56.3] Dislocation or strain or sprain of unspecified body region Also known as: Dislocation or strain or sprain of unspecified body region | subluxation NOS | Dislocation or subluxation | dislocation NOS | Traumatic subluxation of joint Excludes: multiple dislocations, sprains and strains NOS [NB53.5] Strain or sprain of lumbar spine Definition: A collective term for muscle and ligament injuries of the tissues associated with the lumbar spine without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. Also known as: Strain or sprain of lumbar spine | Lumbar sprain | Lumbar strain | Lumbosacral sprain | Lumbosacral strain [ND51.0] Dislocation or strain or sprain of unspecified joint or ligament of trunk Also known as: Dislocation or strain or sprain of unspecified joint or ligament of trunk | Back dislocation | Back sprain | Back strain | Dislocation of vertebra, not elsewhere classified [9D50] Visual discomfort Also known as: Visual discomfort | Asthenopia | eye strain | simple eye strain | Scintillating scotoma Includes: Asthenopia [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease [GB61.0] Chronic kidney disease, stage 1 Definition: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²) Also known as: Chronic kidney disease, stage 1 | chronic renal failure, stage 1 | CKD - [chronic kidney disease] stage 1 | normal or increased eGFR (>90 ml/min/1.73m²) Includes: chronic renal failure, stage 1 [GB60.0] Acute kidney failure, stage 1 Definition: Rate of change of serum creatinine: Increase 1.5-1.9 times baseline within 7 days OR increase by 0.3 mg/dl increase within 48 h OR Magnitude of urine output: <0.5 ml/kg/h for 6-12 hours Also known as: Acute kidney failure, stage 1 | Acute nontraumatic kidney injury, mild | Acute nontraumatic kidney injury, stage 1 | AKI - [acute kidney injury] stage 1 | AKI - [acute kidney injury] mild Includes: Acute nontraumatic kidney injury, mild === GRAPH WALKS === --- Walk 1 --- [FA24.4] Juvenile systemic arthritis Def: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eru... --PARENT--> [FA24] Juvenile idiopathic arthritis Def: Juvenile idiopathic arthritis (JIA) is the term used to describe a group of inflammatory articular disorders of unknown cause that begin before the age of 16 and last over 6 weeks. Six disorders have ... --EXCLUDES--> [?] Rheumatoid arthritis with splenomegaly and leukopenia Def: The triad of rheumatoid arthritis (RA), splenomegaly, and neutropaenia is called Felty's syndrome. Persistent neutropaenia (<2000/mm3) must be present, but the complete triad is not required for a dia... --- Walk 2 --- [FA24.4] Juvenile systemic arthritis Def: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eru... --PARENT--> [FA24] Juvenile idiopathic arthritis Def: Juvenile idiopathic arthritis (JIA) is the term used to describe a group of inflammatory articular disorders of unknown cause that begin before the age of 16 and last over 6 weeks. Six disorders have ... --EXCLUDES--> [?] Juvenile dermatomyositis Def: Juvenile dermatomyositis is the early-onset form of dermatomyositis, a systemic autoimmune inflammatory muscle disorder, characterised by proximal muscle weakness, evocative skin lesion, and systemic ... --- Walk 3 --- [ND33] Dislocations, strains or sprains involving multiple body regions --PARENT--> [?] Injuries involving multiple body regions --EXCLUDES--> [?] Frostbite Def: Frostbite is injury from ice formation within tissues resulting from contact with cold air, liquids or metals. It is most commonly due to excessive exposure of skin to sub-zero environmental temperatu... --- Walk 4 --- [ND33] Dislocations, strains or sprains involving multiple body regions --PARENT--> [?] Injuries involving multiple body regions --EXCLUDES--> [?] Frostbite Def: Frostbite is injury from ice formation within tissues resulting from contact with cold air, liquids or metals. It is most commonly due to excessive exposure of skin to sub-zero environmental temperatu... --- Walk 5 --- [ND56.3] Dislocation or strain or sprain of unspecified body region --EXCLUDES--> [?] Dislocations, strains or sprains involving multiple body regions --CHILD--> [?] Dislocations, strains or sprains involving thorax with lower back or pelvis --- Walk 6 --- [ND56.3] Dislocation or strain or sprain of unspecified body region --EXCLUDES--> [?] Dislocations, strains or sprains involving multiple body regions --CHILD--> [?] Dislocations, strains or sprains involving multiple regions of arm
[ "[FA24.4] Juvenile systemic arthritis\n Def: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eru...\n --PARENT--> [FA24] Juvenile idiopathic arthritis\n Def: Juvenile idiopathic arthritis (JIA) is the term used to describe a group of inflammatory articular disorders of unknown cause that begin before the age of 16 and last over 6 weeks. Six disorders have ...\n --EXCLUDES--> [?] Rheumatoid arthritis with splenomegaly and leukopenia\n Def: The triad of rheumatoid arthritis (RA), splenomegaly, and neutropaenia is called Felty's syndrome. Persistent neutropaenia (<2000/mm3) must be present, but the complete triad is not required for a dia...", "[FA24.4] Juvenile systemic arthritis\n Def: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eru...\n --PARENT--> [FA24] Juvenile idiopathic arthritis\n Def: Juvenile idiopathic arthritis (JIA) is the term used to describe a group of inflammatory articular disorders of unknown cause that begin before the age of 16 and last over 6 weeks. Six disorders have ...\n --EXCLUDES--> [?] Juvenile dermatomyositis\n Def: Juvenile dermatomyositis is the early-onset form of dermatomyositis, a systemic autoimmune inflammatory muscle disorder, characterised by proximal muscle weakness, evocative skin lesion, and systemic ...", "[ND33] Dislocations, strains or sprains involving multiple body regions\n --PARENT--> [?] Injuries involving multiple body regions\n --EXCLUDES--> [?] Frostbite\n Def: Frostbite is injury from ice formation within tissues resulting from contact with cold air, liquids or metals. It is most commonly due to excessive exposure of skin to sub-zero environmental temperatu...", "[ND33] Dislocations, strains or sprains involving multiple body regions\n --PARENT--> [?] Injuries involving multiple body regions\n --EXCLUDES--> [?] Frostbite\n Def: Frostbite is injury from ice formation within tissues resulting from contact with cold air, liquids or metals. It is most commonly due to excessive exposure of skin to sub-zero environmental temperatu...", "[ND56.3] Dislocation or strain or sprain of unspecified body region\n --EXCLUDES--> [?] Dislocations, strains or sprains involving multiple body regions\n --CHILD--> [?] Dislocations, strains or sprains involving thorax with lower back or pelvis", "[ND56.3] Dislocation or strain or sprain of unspecified body region\n --EXCLUDES--> [?] Dislocations, strains or sprains involving multiple body regions\n --CHILD--> [?] Dislocations, strains or sprains involving multiple regions of arm" ]
FA24.4
Juvenile systemic arthritis
[ { "from_icd11": "FA24.4", "icd10_code": "M0820", "icd10_title": "Juvenile rheumatoid arthritis with systemic onset, unspecified site" }, { "from_icd11": "FA24.4", "icd10_code": "M082", "icd10_title": "Juvenile rheumatoid arthritis with systemic onset" }, { "from_icd11": "ND33", "icd10_code": "T03", "icd10_title": "" }, { "from_icd11": "ND33", "icd10_code": "T030", "icd10_title": "" }, { "from_icd11": "ND33", "icd10_code": "T031", "icd10_title": "" }, { "from_icd11": "ND33", "icd10_code": "T032", "icd10_title": "" }, { "from_icd11": "ND33", "icd10_code": "T033", "icd10_title": "" }, { "from_icd11": "ND33", "icd10_code": "T034", "icd10_title": "" }, { "from_icd11": "ND33", "icd10_code": "T038", "icd10_title": "" }, { "from_icd11": "ND33", "icd10_code": "T039", "icd10_title": "" }, { "from_icd11": "ND56.3", "icd10_code": "T143", "icd10_title": "" }, { "from_icd11": "NB53.5", "icd10_code": "S335XXA", "icd10_title": "Sprain of ligaments of lumbar spine, initial encounter" }, { "from_icd11": "NB53.5", "icd10_code": "S335", "icd10_title": "Sprain of ligaments of lumbar spine" }, { "from_icd11": "NB53.5", "icd10_code": "S337", "icd10_title": "" }, { "from_icd11": "ND51.0", "icd10_code": "T092", "icd10_title": "" } ]
M0820
Juvenile rheumatoid arthritis with systemic onset, unspecified site
Two representative CR patients with stage IV NSCLC, who received oligometastatic treatments with radiation and surgery, are shown in Fig. 4 a-g and Fig. 4 h-o. The first patient was treated with a chemotherapeutic regimen followed by EGFR-TKI, and the oligometastatic lesions were controlled with radiation and surgery . A male in his 50s consulted our institution for dyspnea, and was hospitalized due to bilateral malignant pleural effusion, malignant pericardial effusion and cardiac tamponade . He was diagnosed as Stage IVA (cT1aN2M1a) adenocarcinoma . Biopsy of an enlarged right-sided lower pretracheal lymph node (#3) confirmed N2. After pericardial drainage, a chemotherapeutic regimen with cisplatin + gemcitabine was administered. After 4 courses of cisplatin + gemcitabine treatment, the pleural and pericardial effusions disappeared . Gefitinib was started. He complained of left femoral pain. Metastases were demonstrated by bone scintigraphy in the left femoral bone and left hip joint on day 548 . After the radiation therapy (total 45Gy: 3 Gy/fraction x 15 fractions) to the left femoral area, joint replacement surgery was performed. The primary lesion gradually enlarged thereafter , and the mass in the right upper lobe of the lung was surgically removed . Pathological examination revealed this tumor to be an adenocarcinoma showing a mixture of the acinar subtype and the solid type . The EGFR mutations were, however, negative. There were no mutations of EGFR exon 18 G719X, exon 21 L858R, exon 21 L861Q, exon 19 deletion, and exon 20 T790M. The patient was also negative for the Alk mutation based on the immunohistochemistry and fluorescence in situ hybridization (FISH) methods. Numerous inflammatory cell infiltration was observed around the tumor , and many lymphoid follicles were also detected in the resected lung tumor , demonstrating strong immune responses against the tumor. The CR has been maintained over 5 years since initial treatment without previous one-year therapy. Fig. 4 Two representative complete remission (CR) patients with oligometastases in stage IV. The first CR patient in stage IV is shown in a-g. A male in his 50s presented with dyspnea, and bilateral malignant pleural and pericardial effusions were observed on the chest X-ray ( a ) and the CT ( b ). He was diagnosed as stage IVA (cT1aN2M1a) adenocarcinoma. After pericardial drainage followed by chemotherapy, the pleural and pericardial effusions disappeared ( c ). He complained of left femoral pain, and bone scintigraphy revealed bone metastases in the left femoral bone and left hip joint ( d ). After radiation therapy, he underwent joint replacement surgery. The primary lesion, located in the right upper lobe, showed gradual enlargement ( e ) and was surgically removed ( f ). The CR has since been maintained, based on head MRI and PET/CT ( g ). The second patient with brain metastases achieving CR is shown in h-o. A male in his 30s consulted our hospital due to loss of consciousness. A tumor was detected in the right upper lobe ( h , i ). There was no lymph node swelling, while a solitary brain metastasis was observed in the right temporal lobe ( j ). He was diagnosed as stage IVA (cT2aN0M1b) large cell carcinoma. Cyber-knife therapy for this lesion and surgery for the primary lesion were performed. After 4 courses of a first-line chemotherapy, three new brain metastases were detected in the left cerebellum, the right occipital lobe, and the left parietal lobe by head MRI. Cyber-knife treatments for these lesions were done. He subsequently complained of headache. Brain metastases in the left occipital lobe ( k ), the left cerebellum, and the right occipital lobe ( l ) were demonstrated by head MRI. Brain surgeries were performed for these lesions. The brain tumors and the lung tumor ultimately disappeared, as shown by the head MRI ( m , n ) and the PET/CT ( o ) Fig. 5 Cytological findings in a stage IV patient with complete remission (CR), shown in Fig. 4 a-g. Carcinoma cells were confirmed by Papanicolaou staining of pericardial effusion ( a , b ). This carcinoma was a very aggressive type, based on the presence of numerous mitotic cells ( b ). Carcinoma cells stained positive for Ber-EP4 ( c ), indicating these cells to be adenocarcinoma, not mesothelioma Fig. 6 Pathological findings of the lung tumor resected from the right upper lobe, shown in Fig. 4 e. Hematoxylin and eosin staining of the resected tumor is shown. Pathological examination revealed this tumor to be an adenocarcinoma showing a mixture of the acinar type ( a ) and the solid type ( b ). Numerous inflammatory cells around ( a ) and inside ( b ) the tumor are indicated by the white arrows. A lot of lymphoid follicles are visible inside the tumor ( b ). These inflammatory cells demonstrate marked immune response
4.144531
0.854004
sec[2]/sec[2]/p[3]
en
0.999998
31752884
https://doi.org/10.1186/s12931-019-1235-3
[ "tumor", "lobe", "stage", "shown", "pericardial", "brain", "cells", "adenocarcinoma", "femoral", "metastases" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "CB40.2", "title": "Pulmonary collapse" }, { "code": "LA75.0", "title": "Accessory lobe of lung" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "JA8A.1", "title": "Malformation of placenta" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [CB40.2] Pulmonary collapse Also known as: Pulmonary collapse | Atelectasis | lung collapse | pulmonary atelectasis | pulmonary collapse with atelectasis Includes: Atelectasis Excludes: Primary atelectasis of newborn | tuberculous atelectasis, not confirmed | tuberculous atelectasis, confirmed [LA75.0] Accessory lobe of lung Definition: An extra lobe of lung beyond the 3 on the right and the 2 on the left Also known as: Accessory lobe of lung | supernumerary lung lobe | azygos lobe of lung | azygos lobe fissure of lung | azygos lobe [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [JA8A.1] Malformation of placenta Also known as: Malformation of placenta | variation of placenta form | deformity of placenta | placental deformity | Abnormal placenta NOS === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --PARENT--> [?] Overweight or localised adiposity Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th... --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --PARENT--> [02] Neoplasms Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair.... --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --PARENT--> [?] Overweight or localised adiposity\n Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 6-year-old Chinese girl presented with three months of numbness and two months of weakness in her extremities. Three months before admission, the patient developed right foot numbness and subsequently recovered. Two months before admission, weakness in the right lower limb developed, which manifested as claudication. Later, her symptoms worsened to flaccid paralysis of the bilateral limbs, and the patient was referred to the neurological department of the local hospital. Physical examination revealed right peripheral facial paralysis, right eye ptosis and flaccid paralysis of bilateral limbs. Laboratory examinations, such as blood cell levels, were unremarkable, and the patient was presented with normal liver and kidney function. The erythrocyte sedimentation rate (ESR) was 33 mm/h. Cerebrospinal fluid (CSF) protein concentration was 311 mg/dl. CSF revealed the presence of pleocytosis (25 × 10 6 /l, normal range 0–15 ×10 6 /l), with lymphocyte predominance. CSF IgM was 0.638 mg/ml. Cultivation of CSF and autoimmune encephalitis-associated antibodies was negative. Brain Magnetic Resonance Imaging (MRI) showed subdural effusion. The patient received two doses of methylprednisolone pulse and intravenous immunoglobulin (IVIG) therapy, but the disease progressed to incontinence of the stool and urine and involuntary movement of both lower extremities. The patient was subsequently transferred to the neurological department of our hospital to determine the etiology of the disease. On examination, right facial paralysis was noted. Decreased muscle strength and involuntary movement of both lower limbs were observed. The sensation of both lower limbs was lost to pin, touch, temperature and position. Cerebellar signs and cranial nerve examination were negative. Deep tendon reflexes showed hyporeflexia. Skin examination revealed dark-red papules throughout the body with a white atrophic center. After a detailed inquiry of her medical history, the patient had round to oval dark-red papules with white calcification centers on her left forefinger and dorsal wrist at the age of 20 days. These papules progressed throughout the body, subsided within two weeks and subsequently recurred. Additional laboratory results were as follows: routine blood and urine tests were unremarkable, and the patients presented with normal liver and kidney function. Repeated ESR was 10 mm/h. Cerebrospinal fluid (CSF) protein concentration was 2,215 mg/dl which is higher than before. CSF revealed the normal range of granulocyte. Her plasma D-dimer level was 0.76 mg/l (normal range 0–0.243 mg/l). The serum folate, lactate and vitamin B12 levels were normal. Antinuclear antibodies and anti-double stranded DNA antibodies were negative. The patient was positive for an antineutrophil cytoplasmic antibody. Vascular ultrasound was normal. Brain Magnetic Resonance Imaging (MRI) showed left hemisphere atrophy, subdural effusion, widespread calcification foci, hemorrhagic foci and local vasculitis . Due to the possible diagnosis of autoimmune-associated vasculitis, the patient was then transferred to our rheumatic department. No specific genetic mutations were found after whole-genome sequencing was completed. Skin biopsy of papules on the left lower limb and right upper limb revealed dermal necrosis, thickening of the vascular wall, local hyperkeratosis and hypokeratosis, as well as perivascular lymphocytic infiltration in the upper dermis without mucin disposition . The diagnosis of Degos disease was made based on characteristic papules, disease course and histopathological findings. A methylprednisolone pulse (20 mg/kg/d), oral prednisone (2 mg/kg), intravenous immunoglobulin (IVIG) (2 g/kg), intravenous cyclophosphamide (0.8 g/m 2 ) and aspirin were prescribed. The skin lesions recovered, but there was no significant improvement in neurological manifestations after 1 month of combined treatment. Repeated brain MRI showed lacunar infarction, and the size of the ischemic area increased . Second doses of methylprednisolone pulse, IVIG, and intravenous cyclophosphamide were prescribed. Approximately half a month later, involuntary movement of both lower limbs was more frequent, and repeated brain MRI showed an increased amount of subdural effusion . Later, the patient underwent surgery involving the right blurred hole on the right scalp with external drainage. The specimen collected during surgery showed inflammatory cell infiltration . Oral hydroxychloroquine (5 mg/kg), thalidomide (3 mg/kg), and methotrexate (10 mg/m 2 ) were added as prednisolone-sparing agents. However, the neurological symptoms of the patient deteriorated to lower limb paralysis and areflexia. Her parent asked for discharge and was not followed up later. Unfortunately, the patient died 10 months after the first initiation.
4.039063
0.97998
sec[1]/p[0]
en
0.999996
PMC11257897
https://doi.org/10.3389/fped.2024.1374150
[ "paralysis", "limbs", "papules", "limb", "neurological", "brain", "intravenous", "both", "subsequently", "department" ]
[ { "code": "MB5Z", "title": "Paralytic symptoms, unspecified" }, { "code": "DA93.0", "title": "Paralytic ileus" }, { "code": "8C74.1Z", "title": "Periodic paralysis, unspecified" }, { "code": "NE61", "title": "Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified" }, { "code": "MD11.Y", "title": "Other specified abnormalities of breathing" }, { "code": "ND56.1", "title": "Open wound of unspecified body region" }, { "code": "LB9Z", "title": "Structural developmental anomalies of the skeleton, unspecified" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "5B51&XS25", "title": "Severe wasting in infants, children or adolescents" }, { "code": "ND55", "title": "Other injuries of leg, level unspecified" } ]
=== ICD-11 CODES FOUND === [MB5Z] Paralytic symptoms, unspecified Also known as: Paralytic symptoms, unspecified | paralysis syndrome | incomplete paralysis | complete paralysis | paresis [DA93.0] Paralytic ileus Definition: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need to be complete, but the intestinal muscles must be so inactive that it leads to a functional blockage of the intestine. Also known as: Paralytic ileus | adynamic ileus | Paralytic ileus of bowel | ileus NOS | paralysis of bowel Excludes: Obstructive ileus of small intestine due to impaction | Gallstone ileus of small intestine [8C74.1Z] Periodic paralysis, unspecified Also known as: Periodic paralysis, unspecified | Periodic paralysis | Westphal disease | periodic myotonia | myoplegic dystrophy [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified Also known as: Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, alcohols | alcohol poisoning | alcohol toxicity | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, Ethanol Excludes: corrosions | Bacterial foodborne intoxications [MD11.Y] Other specified abnormalities of breathing Also known as: Other specified abnormalities of breathing | Bradypnoea | Choking sensation | Hypoventilation | hypoventilation syndrome NOS [ND56.1] Open wound of unspecified body region Also known as: Open wound of unspecified body region | cut NOS | open wound NOS | penetrating wound NOS | Puncture wound with foreign body unspecified body region Excludes: Traumatic amputations involving multiple body regions | Open wounds involving multiple body regions | traumatic amputation NOS [LB9Z] Structural developmental anomalies of the skeleton, unspecified Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS [FB56.6] Other specified soft tissue disorders Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia [ND55] Other injuries of leg, level unspecified Also known as: Other injuries of leg, level unspecified | other injuries of lower limb, level unspecified | Superficial injury of leg, level unspecified | Abrasion of leg, level unspecified | Contusion of leg, level unspecified Excludes: Fracture of leg, level unspecified | Injuries involving multiple body regions === GRAPH WALKS === --- Walk 1 --- [MB5Z] Paralytic symptoms, unspecified --PARENT--> [?] Paralytic symptoms --PARENT--> [?] Symptoms or signs involving the nervous system --- Walk 2 --- [MB5Z] Paralytic symptoms, unspecified --PARENT--> [?] Paralytic symptoms --CHILD--> [MB50] Tetraplegia --- Walk 3 --- [DA93.0] Paralytic ileus Def: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need... --RELATED_TO--> [?] Transitory ileus of newborn Def: Transient intestinal obstruction of functional rather than anatomical origin which is not uncommon in the first few days of life. As surgery may be strongly contraindicated in this group, the differen... --PARENT--> [?] Paralytic ileus Def: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need... --- Walk 4 --- [DA93.0] Paralytic ileus Def: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need... --EXCLUDES--> [?] Gallstone ileus of small intestine Def: Small bowel obstruction due to stenosis resulting from impaction of gallstones.... --PARENT--> [?] Obstructive ileus of small intestine due to impaction Def: Small bowel obstruction may result when a substance such as gallstone or enterolith is too large to traverse the small intestine, especially at the ileocecal valve.... --- Walk 5 --- [8C74.1Z] Periodic paralysis, unspecified --PARENT--> [8C74.1] Periodic paralysis Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or... --CHILD--> [8C74.1Y] Other specified periodic paralysis --- Walk 6 --- [8C74.1Z] Periodic paralysis, unspecified --PARENT--> [8C74.1] Periodic paralysis Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or... --CHILD--> [8C74.10] Hypokalaemic periodic paralysis Def: Hypokalaemic periodic paralysis (hypoPP) is a muscle channelopathy characterised by episodes of muscle paralysis lasting from a few to 24-48 hours and associated with a fall in blood potassium levels....
[ "[MB5Z] Paralytic symptoms, unspecified\n --PARENT--> [?] Paralytic symptoms\n --PARENT--> [?] Symptoms or signs involving the nervous system", "[MB5Z] Paralytic symptoms, unspecified\n --PARENT--> [?] Paralytic symptoms\n --CHILD--> [MB50] Tetraplegia", "[DA93.0] Paralytic ileus\n Def: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need...\n --RELATED_TO--> [?] Transitory ileus of newborn\n Def: Transient intestinal obstruction of functional rather than anatomical origin which is not uncommon in the first few days of life. As surgery may be strongly contraindicated in this group, the differen...\n --PARENT--> [?] Paralytic ileus\n Def: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need...", "[DA93.0] Paralytic ileus\n Def: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need...\n --EXCLUDES--> [?] Gallstone ileus of small intestine\n Def: Small bowel obstruction due to stenosis resulting from impaction of gallstones....\n --PARENT--> [?] Obstructive ileus of small intestine due to impaction\n Def: Small bowel obstruction may result when a substance such as gallstone or enterolith is too large to traverse the small intestine, especially at the ileocecal valve....", "[8C74.1Z] Periodic paralysis, unspecified\n --PARENT--> [8C74.1] Periodic paralysis\n Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or...\n --CHILD--> [8C74.1Y] Other specified periodic paralysis", "[8C74.1Z] Periodic paralysis, unspecified\n --PARENT--> [8C74.1] Periodic paralysis\n Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or...\n --CHILD--> [8C74.10] Hypokalaemic periodic paralysis\n Def: Hypokalaemic periodic paralysis (hypoPP) is a muscle channelopathy characterised by episodes of muscle paralysis lasting from a few to 24-48 hours and associated with a fall in blood potassium levels...." ]
MB5Z
Paralytic symptoms, unspecified
[ { "from_icd11": "MB5Z", "icd10_code": "G8384", "icd10_title": "Todd's paralysis (postepileptic)" }, { "from_icd11": "MB5Z", "icd10_code": "G8331", "icd10_title": "Monoplegia, unspecified affecting right dominant side" }, { "from_icd11": "MB5Z", "icd10_code": "G8389", "icd10_title": "Other specified paralytic syndromes" }, { "from_icd11": "MB5Z", "icd10_code": "G8383", "icd10_title": "Posterior cord syndrome" }, { "from_icd11": "MB5Z", "icd10_code": "G8381", "icd10_title": "Brown-Sequard syndrome" }, { "from_icd11": "MB5Z", "icd10_code": "G8382", "icd10_title": "Anterior cord syndrome" }, { "from_icd11": "MB5Z", "icd10_code": "G8332", "icd10_title": "Monoplegia, unspecified affecting left dominant side" }, { "from_icd11": "MB5Z", "icd10_code": "G8334", "icd10_title": "Monoplegia, unspecified affecting left nondominant side" }, { "from_icd11": "MB5Z", "icd10_code": "G8330", "icd10_title": "Monoplegia, unspecified affecting unspecified side" }, { "from_icd11": "MB5Z", "icd10_code": "G839", "icd10_title": "Paralytic syndrome, unspecified" }, { "from_icd11": "MB5Z", "icd10_code": "G83", "icd10_title": "Other paralytic syndromes" }, { "from_icd11": "MB5Z", "icd10_code": "G833", "icd10_title": "Monoplegia, unspecified" }, { "from_icd11": "MB5Z", "icd10_code": "G838", "icd10_title": "Other specified paralytic syndromes" }, { "from_icd11": "MB5Z", "icd10_code": "G82", "icd10_title": "Paraplegia (paraparesis) and quadriplegia (quadriparesis)" }, { "from_icd11": "DA93.0", "icd10_code": "K567", "icd10_title": "Ileus, unspecified" } ]
G8384
Todd's paralysis (postepileptic)
A 30-year-old female with acute hepatitis was referred to our hospital in 1995. She had been asymptomatic until the disease onset. She had no history of significant medical condition, blood transfusion, or daily intake of medicine and did not consume alcohol. Her serum alanine aminotransferase (ALT) level had fluctuated from 300 to 1116 IU/L for 3 months before admission. On admission, laboratory examinations revealed total bilirubin 2.5 mg/dL, aspartate transaminase (AST) 842 IU/L, ALT 956 IU/L, alkaline phosphatase 153 IU/L, γ-glutamyl transpeptidase 68 IU/L, γ-globulin 2.3 g/dL, and immunoglobulin G 2,710 mg/dL. Hepatitis B virus surface antigen and hepatitis C virus antibody were negative, antinuclear antibody was weakly positive (1:40, homogeneous), anti-smooth muscle antibody was positive (1:320), and anti-mitochondrial antibody was negative. Human leukocyte antigen was positive for DR-4. Histological analysis of the liver revealed marked interface hepatitis with rosette formation in the parenchyma. On the basis of these findings, she was diagnosed with autoimmune hepatitis and started on prednisolone (30 mg/day). Her serum ALT level gradually declined. Her prednisolone dose was tapered to 10–15 mg/day, which was administered with ursodeoxycholic acid (UDCA; 600 mg/day) to maintain her ALT level <40 IU/L. Since 2002, she had been treated by a doctor at home, and the aforementioned regimen was continued. In 2008, she developed steroid-induced cataract and was referred to our hospital to consult about treatment options for autoimmune hepatitis. At the time of referral, she was 150 cm in height and weighed 43.5 kg (body mass index 19.3 kg/m 2 ), and she was being administered 12.5 mg/day of prednisolone and 600 mg/day of UDCA, and her serum AST and ALT levels were 23 and 34 IU/L, respectively. We added azathioprine (100 mg/day) to this regimen and gradually tapered the prednisolone dose to 10 mg/day; her ALT level was maintained between 22 and 40 IU/L with occasional mild flare-ups. In May 2012, she complained shortness of breath and easy fatigability and significant pallor was noted on physical examination. A hemogram revealed hemoglobin 6.4 g/dL, mean red cell volume 117.3 fL, reticulocyte count 0.6 %, white blood cell count 2,600 cells/μL, and platelet count 207,000 cells/μL. Laboratory serum analyses revealed total protein 6.0 g/dL, albumin 3.7 g/dL, AST 32 IU/L, ALT 42 IU/L, lactic acid dehydrogenase 221 IU/L, and normal bilirubin and alkaline phosphatase levels. Her serum iron level was 214 μg/dL, erythropoietin level was 3,750 mIU (normal 9.1–32.8 mIU), and vitamin B12 and folic acid levels were 307 pg/mL (normal 233–914 pg/mL) and 3.3 ng/mL (normal 3.6–12.9 ng/mL), respectively. She showed no symptoms of recent infection, such as fever or myalgia, and gastrointestinal endoscopy showed no evidence of hemorrhagic lesions. She was initially suspected of having azathioprine-induced anemia; therefore, azathioprine was discontinued. A red cell transfusion was performed, which increased her hemoglobin level to 8.3 g/dL; however, after 4 weeks, her hemoglobin levels decreased to 6.1 g/dL . Another transfusion was performed; however, severe anemia kept recurring and repeat transfusions were required. Her reticulocyte count was consistently low (0.2–0.6 %) except just after transfusion. In July 2012, bone marrow aspiration was performed, which revealed hypocellular bone marrow with an absence of erythroblasts. Giant proerythroblast was not observed and her serum was negative for immunoglobulin (Ig)M antibody to parvovirus B19, although viral DNA was not examined. Therefore, she was diagnosed with acquired PRCA on the basis of these findings, and CsA was administered on September 2012 at an initial dose of 6 mg/kg/day (250 mg/day). After 7 weeks, her hemoglobin level and reticulocyte count both showed considerable improvement (12.4 g/dL and 2.4 %, respectively). The CsA dose was gradually reduced and maintained at 1.6 mg/kg/day (70 mg/day) since April 2013, without relapse of anemia. Her cyclosporine trough blood level has ranged from 69 to 88 ng/mL. In October 2012, UDCA was discontinued and the prednisolone dose was tapered to 9 mg/day; prednisolone has been maintained at 8 mg/day since January 2013. The mild fluctuations in serum AST and ALT levels noted after azathioprine discontinuation ceased after initiating CsA therapy. Her AST and ALT levels have remained <20 IU/L for 8 months since the initiation of therapy. Fig. 1 Clinical course of the patient in the present study. Aza azathioprine, PSL prednisolone, UDCA ursodeoxycholic acid, CsA cyclosporine A, BW body weight, ANA antinuclear antibody, ASMA anti-smooth muscle antibody, IgG immunoglobulin G, ALT alanine aminotransferase, Hb hemoglobin dosage of all medicines is expressed as dose/day
4.042969
0.976074
sec[1]/p[0]
en
0.999996
24523831
https://doi.org/10.1007/s12328-013-0448-0
[ "serum", "antibody", "prednisolone", "hepatitis", "azathioprine", "hemoglobin", "count", "transfusion", "acid", "udca" ]
[ { "code": "NE80.3", "title": "Other serum reactions" }, { "code": "5D0Y", "title": "Other specified metabolic disorders" }, { "code": "5B91.0", "title": "Hypercalcaemia" }, { "code": "4A84.Y", "title": "Other specified anaphylaxis" }, { "code": "5C50.F2", "title": "Homocarnosinosis" }, { "code": "JA86.Y", "title": "Maternal care for other specified fetal problems" }, { "code": "MA14.14", "title": "Anti-nuclear antibody positive" }, { "code": "MA14.13", "title": "Anti-nuclear antibody negative" }, { "code": "JA86.0", "title": "Maternal care for red cell antibodies" }, { "code": "MA14.1C", "title": "Raised antibody titre" } ]
=== ICD-11 CODES FOUND === [NE80.3] Other serum reactions Also known as: Other serum reactions | Allergic reaction to serum | serum allergy | Complications of vaccination, protein sickness | Protein sickness Excludes: serum hepatitis [5D0Y] Other specified metabolic disorders Also known as: Other specified metabolic disorders | Disorders of plasma-protein metabolism, not elsewhere classified | abnormal protein transport | dysproteinaemia | Absence of albumin in blood [5B91.0] Hypercalcaemia Definition: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused by dehydration secondary to urinary losses of calcium, water and other electrolytes, and to an increase in membrane potential caused by the elevation in extracellular fluid ionized calcium concentration. Patients with moderate to severe hypercalcaemia often complain of nausea and vomiting, symptoms Also known as: Hypercalcaemia | Calcium excess | elevated serum calcium | hypercalcaemic crisis | hypercalcaemic syndrome [4A84.Y] Other specified anaphylaxis Also known as: Other specified anaphylaxis | Latex-induced anaphylaxis | Anaphylaxis due to latex | Latex anaphylaxis | Anaphylactic shock due to serum [5C50.F2] Homocarnosinosis Definition: Homocarnosinosis is a metabolic defect characterised by progressive spastic diplegia, intellectual deficit and retinitis pigmentosa. This extremely rare disorder has been reported in only one family, namely a woman and three of her children. The latter showed but their mother was symptom free. It is therefore uncertain whether there is a relationship between the biochemical defect and the clinical symptoms. Inheritance in the reported family seems to be autosomal dominant. Also known as: Homocarnosinosis | Homocarnosinase deficiency | Serum carnosinase deficiency [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MA14.14] Anti-nuclear antibody positive Also known as: Anti-nuclear antibody positive | ANA - [anti-nuclear antibody] positive [MA14.13] Anti-nuclear antibody negative Also known as: Anti-nuclear antibody negative | ANA - [anti-nuclear antibody] negative [JA86.0] Maternal care for red cell antibodies Definition: Maternal care for rhesus or other isoimmunization Also known as: Maternal care for red cell antibodies | Maternal care for rhesus isoimmunization | Rh factor immunization affecting management of pregnancy | Rh incompatibility | Rh incompatibility with hydrops fetalis [MA14.1C] Raised antibody titre Also known as: Raised antibody titre | antibody titre above reference range | high antibody titre | increased antibody titre Excludes: isoimmunization, in pregnancy affecting fetus or newborn === GRAPH WALKS === --- Walk 1 --- [NE80.3] Other serum reactions --RELATED_TO--> [?] Serum sickness vasculitis Def: An acute vasculitic illness typified by fever, arthralgia and urticarial vasculitis resulting from an immune complex-mediated (type III) immune reaction to foreign protein. Historically this was large... --EXCLUDES--> [?] Drug-associated immune complex vasculitis Def: Small vessel vasculitis typically presenting predominantly in the skin due to systemic exposure to certain drugs in predisposed individuals.... --- Walk 2 --- [NE80.3] Other serum reactions --RELATED_TO--> [?] Serum sickness vasculitis Def: An acute vasculitic illness typified by fever, arthralgia and urticarial vasculitis resulting from an immune complex-mediated (type III) immune reaction to foreign protein. Historically this was large... --EXCLUDES--> [?] Drug-associated immune complex vasculitis Def: Small vessel vasculitis typically presenting predominantly in the skin due to systemic exposure to certain drugs in predisposed individuals.... --- Walk 3 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --CHILD--> [5D0Y] Other specified metabolic disorders --- Walk 4 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --CHILD--> [5D01] Tumour lysis syndrome Def: This is a group of metabolic complications that can occur after treatment of cancer, usually lymphomas and leukaemias, and sometimes even without treatment. These complications are caused by the break... --- Walk 5 --- [5B91.0] Hypercalcaemia Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ... --RELATED_TO--> [?] Myopathy due to hypercalcaemia --PARENT--> [?] Hypercalcaemia Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ... --- Walk 6 --- [5B91.0] Hypercalcaemia Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ... --RELATED_TO--> [?] Myopathy due to hypercalcaemia --PARENT--> [?] Neurological disorders due to an excess of micro or macro nutrients
[ "[NE80.3] Other serum reactions\n --RELATED_TO--> [?] Serum sickness vasculitis\n Def: An acute vasculitic illness typified by fever, arthralgia and urticarial vasculitis resulting from an immune complex-mediated (type III) immune reaction to foreign protein. Historically this was large...\n --EXCLUDES--> [?] Drug-associated immune complex vasculitis\n Def: Small vessel vasculitis typically presenting predominantly in the skin due to systemic exposure to certain drugs in predisposed individuals....", "[NE80.3] Other serum reactions\n --RELATED_TO--> [?] Serum sickness vasculitis\n Def: An acute vasculitic illness typified by fever, arthralgia and urticarial vasculitis resulting from an immune complex-mediated (type III) immune reaction to foreign protein. Historically this was large...\n --EXCLUDES--> [?] Drug-associated immune complex vasculitis\n Def: Small vessel vasculitis typically presenting predominantly in the skin due to systemic exposure to certain drugs in predisposed individuals....", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D0Y] Other specified metabolic disorders", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D01] Tumour lysis syndrome\n Def: This is a group of metabolic complications that can occur after treatment of cancer, usually lymphomas and leukaemias, and sometimes even without treatment. These complications are caused by the break...", "[5B91.0] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...", "[5B91.0] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Neurological disorders due to an excess of micro or macro nutrients" ]
NE80.3
Other serum reactions
[ { "from_icd11": "NE80.3", "icd10_code": "T880XXA", "icd10_title": "Infection following immunization, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8061XA", "icd10_title": "Other serum reaction due to administration of blood and blood products, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8069XA", "icd10_title": "Other serum reaction due to other serum, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8062XA", "icd10_title": "Other serum reaction due to vaccination, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T806", "icd10_title": "Other serum reactions" }, { "from_icd11": "NE80.3", "icd10_code": "T880", "icd10_title": "Infection following immunization" }, { "from_icd11": "5C50.F2", "icd10_code": "E7281", "icd10_title": "Disorders of gamma aminobutyric acid metabolism" }, { "from_icd11": "5C50.F2", "icd10_code": "E728", "icd10_title": "Other specified disorders of amino-acid metabolism" }, { "from_icd11": "JA86.Y", "icd10_code": "O26841 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26843 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26849 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O3680X0 ", "icd10_title": "" }, { "from_icd11": "JA86.0", "icd10_code": "O360930", "icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360920", "icd10_title": "Maternal care for other rhesus isoimmunization, second trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360130", "icd10_title": "Maternal care for anti-D [Rh] antibodies, third trimester, not applicable or unspecified" } ]
T880XXA
Infection following immunization, initial encounter
The following excerpt illustrates the genre through a new doctor’s first experience of responsibility for acute care. The referential narrative elements, the abstract, orientation and complication, describe an acute situation where actions were urgently required. The evaluative narrative, the resolution and evaluation that follows, suggests that while the junior doctor takes the predominant role, he does not see himself as acting completely autonomously and responsibility is shared with the senior doctor who reviews and judges his decisions. He is clear that it is the absence of someone more experienced that compels his action. Though he felt trepidation in undertaking the action, he was able to draw on earlier experience as a student. Previously rehearsed ABCDE training drills offered a sense of structure and perhaps reassurance. Success was measured through having achieved all the actions a more senior clinician would have done. With this came a growing sense of capability: …on AMU [Acute Medical Unit] where I was left to deal with that one myself [abstract]. A patient had been brought up from A&E [Accident and Emergency] with an upper GI [gastrointestinal] bleed, the nurse had wafted the notes in front of my face saying that the early warning score [a numerical indicator of severity] of potential clinical [sic] was over 10, can I come and see him now, and I thought well there’s only four of us on, they’re all busy, I haven’t seen them in a while, I’ll have to go and see him myself [orientation]. Went in and he promptly vomited up 2 litres of blood in front of me, and so I thought I’m going to have to do something quick [complication], I got someone to bleep the registrar [UK equivalent of resident] and then I went into A, B, C, D, E mode,… assessing him thoroughly, knew that blood would take a while, that we probably couldn’t activate major haemorrhage pathway yet, knew that his blood pressure needed maintaining, knew that his haemoglobin needed boosting up, so I ordered the blood and I also ordered albumin as well, which was something that I’d seen done in A&E on my fifth year rotation and I just recalled back to that and thought I’m going to have to do it, there’s nothing else I can do. Started giving him a lot of fluid whilst we were waiting for that ...albumin and blood [resolution]. The registrar rang back after all this had happened, asked me what had happened, what I’d done and he said ‘I can’t do anything else, I’ll come up shortly.’ And he came up, didn’t really change what I’d done, rang the blood bank to speed things up a little bit more and… the patient was okay. He went to endoscopy next morning, was banded and discharge home about a week later [evaluation]. FYID3. For newly qualified doctors there can be a stark contrast in their experiences as a student. For some the realities of the first weeks of work are harsh, feeling alone in their quests: …in my first…or in my second week [abstract], but it was only like day three, my senior was off sick for the whole week and there was no consultant [UK equivalent of attending] in the hospital, so it was just me [orientation]. So checking blood results, I’d get obsessed with minute abnormalities [complication] that now I’d just be like ‘well, that’s fine’, but at the time I was like what do I do with this phosphate level –it’d be basically normal, but I wouldn’t know that it was…, I didn’t know what it did, I didn’t know whether I should be worried or not, so you know, stress was…[evaluation] SITE 4, Group 1, FGCT2. and: [Interviewer: You make it sound as if you were very alone?] …with those surgical twilight shifts, it certainly felt like that. I mean you can be quite alone at times [complication], if your SHOs [senior house officer, also known as core trainees, UK equivalent of junior resident] are off, your registrar’s in clinic and things are going wrong and you can’t reach anybody –yeah, definitely, times when you feel very alone [evaluation]. SITE 1, Group 2, FGID3. These lonely and stressful experiences reach a resolution in our newly qualified doctors’ minds when they concluded that this was the only way to learn and so their quests became rites of passage: there are a lot of things that you will only learn in those moments, in those horrible, terrifying, heart-wrenching moments when you are an F1…moments when you just, like, you want to cry, but you will not learn those things until it is your time and you’re an F1 and you’re in that horrible situation –that’s the only time you’re going to learn it. …you can prepare a medical student as much as you want, but those moments aren’t going to come until their name is the name that’s going to be signed and they’re the ones that the nurses are looking to for an answer –it’s just not going to happen [resolution]. SITE 1, Group 2, FGID2.
3.523438
0.825195
sec[4]/p[1]
en
0.999996
31960189
https://doi.org/10.1007/s10459-020-09959-w
[ "that", "blood", "going", "what", "like", "those", "complication", "resolution", "senior", "this" ]
[ { "code": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" } ]
=== ICD-11 CODES FOUND === [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood === GRAPH WALKS === --- Walk 1 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.0] Migraine without aura Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu... --- Walk 2 --- [8A80.Z] Migraine, unspecified --PARENT--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --CHILD--> [8A80.0] Migraine without aura Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu... --- Walk 3 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 4 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 5 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm Def: Incorrect dose - too high... --- Walk 6 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --PARENT--> [?] Causes of healthcare related harm or injury
[ "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.0] Migraine without aura\n Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu...", "[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.0] Migraine without aura\n Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu...", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --PARENT--> [?] Causes of healthcare related harm or injury" ]
8A80.Z
Migraine, unspecified
[ { "from_icd11": "8A80.Z", "icd10_code": "G43B0", "icd10_title": "Ophthalmoplegic migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43409", "icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A0", "icd10_title": "Cyclical vomiting, in migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D0", "icd10_title": "Abdominal migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43709", "icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A1", "icd10_title": "Cyclical vomiting, in migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43509", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43719", "icd10_title": "Chronic migraine without aura, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43501", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C0", "icd10_title": "Periodic headache syndromes in child or adult, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43401", "icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43419", "icd10_title": "Hemiplegic migraine, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43B1", "icd10_title": "Ophthalmoplegic migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C1", "icd10_title": "Periodic headache syndromes in child or adult, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D1", "icd10_title": "Abdominal migraine, intractable" } ]
G43B0
Ophthalmoplegic migraine, not intractable
We present the case of a 60-year-old, right-handed, woman who suffered from a 9-months history of fatigue and weakness in the right limbs. Neurological examination revealed an ataxic gait, moderate right upper extremity dysmetria, and slight right hemiparesis. No previous history of CNS surgery or trauma was present, and no major comorbidities were reported. The patient underwent a preoperative brain MRI which disclosed a mass contiguous to the left tentorial free edge and extending into the ipsilateral thalamic and mesencephalic regions. The tumor was hypointense on T1-weighted images (WI) and on T2-WI , and hyper/isointense on Fluid Attenuated Inversion Recovery (FLAIR) sequences. Postcontrast T1-WI showed heterogeneous enhancement of the lesion , which was 31 millimeters in maximum diameter, and associated with moderate edema in the surrounding brain parenchyma. Magnetic Resonance spectroscopy (MRS) disclosed a reduction in N-acetyl-aspartate (NAA), and an increase in choline (Cho) and creatine (Cr) peaks with a reduction of Cho/NAA ratio in the tumor area, suggesting the glial nature of the lesion. In the suspicion of brain metastasis, a total body 18-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography ( 18 F-FDG PET-CT) scan was acquired, displaying an increased tracer metabolism in the lesion without evidencing any extracranial pathologic uptake. Moreover, a brain computed tomography (CT) scan showed granular calcifications inside the lesion. Taking into consideration the neuroradiological findings, surgery was thought to be appropriate to both reduce the mass effect and make a definitive histological diagnosis. In the operating room, the patient was positioned supine and, under microscopic guidance, we decided to approach the lesion through a transtemporal tranventricular route in order to gain a wider control on both the lesion and its vascularization. The lesion was encountered in the left tentorial hiatus and appeared as an extraparenchymal, red and capsular mass with an arterialized surface . The mass displayed a dense consistency and extended into the mesencephalic-thalamic region, occupying both the crural and ambient cisterna. At the beginning of the resection procedure, an excessive bleeding from the vascularised surface occurred, thus leading to an immediate interruption of the procedure. Postoperatively a brain Digital Subtraction Angiography (DSA) was performed and the presence of a thrombosed giant aneurysm was excluded. Moreover, DSA showed a delayed and intense arterio-venous blush fed by the P2 tract of posterior cerebral artery (PCA) and by superior cerebellar artery (SCA) afferents. Given that embolization of the tumor was considered unsafe by our interventional neuroradiology team, we decided to proceed with a re-operation through the same previous surgical route. During the second surgical procedure, we achieved a subtotal removal of the tumor without any surgical complication. Although the tumor exhibited an intense and homogenous fluorescence, the use of the dedicated filter (YELLOW 560) was not necessary because the pathologic tissue was already recognizable for its high vascularization. On the contrary, In vivo intraoperative confocal microscopy was useful in confirming the presence of the pathologic tissue, showing the presence of high cellularity and vascularized lesion . The tumor specimen underwent histological examination, which reported the presence of blood vessels, smooth muscle cells, and collagen tissue . Immunochemistry disclosed positivity for actin protein on smooth muscle cells, for CD31 and CD34 on endothelial cells, and for vimentin on mesenchymal tissue. On the contrary, STAT6, GFAP, and EMA antigens were not detected. The Ki67 index ranged from 4 to 5% and no necrosis was identified. These characteristics were ultimately consistent with the diagnosis of leiomyoma. Postoperatively, the patient displayed mild expressive dysphasia and moderate right hemiparesis. . The patient was then transferred to a rehabilitation setting on the fifth day after surgery and both speech disturbance and strength deficit gradually ameliorated. Considering the subtotal resection and the benign histopathological features, a 5-months brain MRI was programmed. When MRI was performed, a significant disease recurrence was disclosed . At this regard, we think that the disease recurrence was mainly due to the presence of residual tumor left after the second surgical procedure. Therefore, after a multidisciplinary discussion and taking into consideration the risk associated with reoperation, the patient was referred to the radiation therapy specialist at our Institution. The patient has completed a full cycle of radiation therapy, without any other neurological deficit, and is now waiting for the follow-up MRI.
4.082031
0.976074
sec[1]/p[0]
en
0.999996
PMC9800865
https://doi.org/10.3389/fonc.2022.1072270
[ "lesion", "tumor", "brain", "presence", "disclosed", "both", "tissue", "which", "tomography", "without" ]
[ { "code": "FA5Z", "title": "Arthropathies, unspecified" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" } ]
=== ICD-11 CODES FOUND === [FA5Z] Arthropathies, unspecified Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Inflammatory arthropathies --- Walk 2 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Osteoarthritis Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art... --- Walk 3 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --CHILD--> [?] Soft tissue disorders --- Walk 4 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --CHILD--> [?] Arthropathies --- Walk 5 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --CHILD--> [ME60.0] Skin lesion of uncertain nature Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made.... --- Walk 6 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --CHILD--> [ME60.0] Skin lesion of uncertain nature Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made....
[ "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Inflammatory arthropathies", "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Osteoarthritis\n Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art...", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --CHILD--> [?] Soft tissue disorders", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --CHILD--> [?] Arthropathies", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --CHILD--> [ME60.0] Skin lesion of uncertain nature\n Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made....", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --CHILD--> [ME60.0] Skin lesion of uncertain nature\n Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made...." ]
FA5Z
Arthropathies, unspecified
[ { "from_icd11": "FA5Z", "icd10_code": "M00-M25", "icd10_title": "" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "ME60.Z", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MD41", "icd10_code": "R911", "icd10_title": "Solitary pulmonary nodule" }, { "from_icd11": "MD41", "icd10_code": "R91", "icd10_title": "Abnormal findings on diagnostic imaging of lung" }, { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" } ]
M00-M25
An 84-year-old male was transported to the Emergency Department of our hospital for abdominal pain and vomiting. He had a history of hypertension and cerebral infarction. His vital signs were as follows: pulse, 136 beats/min; blood pressure, 154/75 mmHg; saturation, 93 % in room air; and body temperature, 36.9 °C. His abdomen was not distended, but there was local tenderness with muscular defense in the right upper abdomen. Laboratory data showed a white blood cell count of 26,800/μL with 91.0 % neutrophils, hemoglobin of 15.4 g/dL (normal level, >13.5 g/dL), glycated hemoglobin A1c (HbA1c) of 6.9 % (National Glycohemoglobin Standardization Program) (normal level, <6.2 %), fasting blood sugar of 195 mg/dL (normal level, <109 mg/dL), aspartate aminotransferase of 23 IU/L (normal level, <31 IU/L), alanine aminotransferase of 12 IU/L (normal level, <40 IU/L), alkaline phosphatase of 249 IU/L (normal level, <210 IU/L), total bilirubin of 1.2 mg/dL (normal level, <1.2 mg/dL), γ-guanosine triphosphate of 17 IU/L (normal level, <73 IU/L), serum creatinine of 1.23 mg/dL (normal level, <1.1 mg/dL), and C-reactive protein of 5.93 mg/dL (normal level, <0.3 mg/dL). Urinary analysis showed 1+ glucose and 3+ bacteria. Arterial blood gas analysis showed respiratory alkalosis and decreased pCO 2 of 25.5 mmHg (normal level, <32 mmHg). These clinical findings fulfilled the diagnostic criteria for systemic inflammatory response syndrome and sepsis. An abdominal X-ray showed irregular gas accumulation in the right lateral abdomen . Computed tomography (CT) indicated stones and gas accumulation in the thickened wall and lumen of the gallbladder. CT also detected pneumobilia, subserosal gas around the hepatoduodenal ligament, and massive pneumoretroperitoneum behind the ascending mesocolon . A diagnosis was difficult to make because we could not exclude the possibility of perforation of the duodenum and large intestine. Thereafter, emergency surgery was carried out with a diagnosis of both EC and gastrointestinal perforation. Intraoperative findings revealed acute cholecystitis; the gallbladder wall was destructed with severe inflammation, especially in the neck of the gallbladder. With mobilization of the right-sided colon and mesocolon, an odor-free foamy abscess was observed along the loose connective tissue of the right retroperitoneum and extended continuously to the hepatoduodenal ligament and Calot’s triangle . Unexpectedly, no evidence of perforation was observed in the stomach, duodenum, or large intestine during surgery. Therefore, we performed cholecystectomy with lavage drainage. Postoperative management of the infection was performed with administration of meropenem three times of 0.5 g for 10 days. Because laboratory data fulfilled the criteria of disseminated intravascular coagulation (The revised Japanese Association for Acute Medicine) , recombinant human thrombomodulin was administered to improve sepsis-induced disseminated intravascular coagulation for 5 days. He was medicated with a ventilator because of aspiration pneumonia, and was weaned off ventilatory support by day 5 after surgery. Histological findings indicated acute cholecystitis with gangrenous change . Klebsiella pneumoniae was isolated from the culture of the abscess, and it was considered the cause of EC, pneumobilia, and pneumoretroperitoneum. Eventually, he recovered and was transferred to another rehabilitation hospital. Fig. 1 An abdominal X-ray. In the spine position, an irregular gas image was observed in the right lateral abdomen, corresponding to pneumoretroperitoneum (arrows) Fig. 2 Abdominal CT findings. a : CT showed a thickened wall and intramural air of the gallbladder, suggesting emphysematous cholecystitis (white arrows). b : Pneumobilia was detected in the intrahepatic bile duct (black arrows). The gallbladder contained air within the lumen (white arrows). Subserosal free air was detected in the hepatoduodenal ligament and around the pancreas head (white arrowheads). c : Massive pneumoretroperitoneum was observed behind the right-sided colon (white arrows). d : Pneumoretroperitoneum extended to the retroperitoneal space behind the ascending mesocolon, bordered by the cecum and iliopsoas muscle (white arrows) Fig. 3 Intraoperative photograph. After mobilization of the right-sided colon, the retroperitoneal space became obvious with an odor-free foamy abscess along the loose connective tissue of the retroperitoneum (black arrowheads). The gallbladder exhibited acute gangrenous cholecystitis with a destructed wall. GB: gallbladder, RK: right kidney, A: appendix, RC: right-sided colon Fig. 4 Microscopic finding of the resected specimen (H-E staining, ×100). The GB wall exhibited acute suppurative inflammation: hemorrhagic, necrotic changes with neutrophil infiltration
4.011719
0.973145
sec[1]/p[0]
en
0.999995
26463667
https://doi.org/10.1186/s12876-015-0345-8
[ "gallbladder", "white", "arrows", "wall", "pneumoretroperitoneum", "abdominal", "blood", "abdomen", "cholecystitis", "sided" ]
[ { "code": "DC12.Z", "title": "Cholecystitis, unspecified" }, { "code": "DC10.01", "title": "Obstruction of gall bladder" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "ME24.35&XA8KL9", "title": "Perforation of gallbladder" }, { "code": "DC10.2", "title": "Fistula of gallbladder or bile duct" }, { "code": "EF5Y", "title": "Other specified dermatoses attributable to hyperviscosity or microvascular occlusion" }, { "code": "JB41.1", "title": "Deep phlebothrombosis in the puerperium" }, { "code": "EB60.Y", "title": "Lichen sclerosus of other specified sites" }, { "code": "MC80.00", "title": "White coat hypertension" }, { "code": "1F2D.2", "title": "White piedra" } ]
=== ICD-11 CODES FOUND === [DC12.Z] Cholecystitis, unspecified Also known as: Cholecystitis, unspecified | Cholecystitis | gallbladder inflammation [DC10.01] Obstruction of gall bladder Also known as: Obstruction of gall bladder | obstruction of gallbladder | gallbladder obstruction | Constriction of gallbladder | gallbladder constriction [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [DC10.2] Fistula of gallbladder or bile duct Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs. Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula [EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion Also known as: Other specified dermatoses attributable to hyperviscosity or microvascular occlusion | Cutaneous microvascular occlusion by platelet plugs | Cutaneous microvascular disturbances due to myeloproliferative disorder-associated platelet plugs | Cutaneous microvascular disturbances due to paroxysmal nocturnal haemoglobinuria-associated platelet plugs | Cutaneous microvascular occlusion by emboli [JB41.1] Deep phlebothrombosis in the puerperium Also known as: Deep phlebothrombosis in the puerperium | postnatal deep vein thrombosis | postpartum deep phlebothrombosis | postpartum deep-vein thrombosis | DVT - [deep venous thrombosis] postnatal [EB60.Y] Lichen sclerosus of other specified sites Also known as: Lichen sclerosus of other specified sites | Extragenital lichen sclerosus | Guttate lichen sclerosus | White spot disease | Guttate scleroderma [MC80.00] White coat hypertension Definition: Persistently elevated office blood pressure readings with persistently normal out-of-the-office readings. Also known as: White coat hypertension | white coat syndrome [1F2D.2] White piedra Definition: A disease of the hair shaft, caused by an infection with the fungi Trichosporon beigelii. This disease is characterised by irregular, soft, white, or light brown nodules which adhere to the hair follicle. Transmission is by direct contact with contaminated soil or water, or by airborne transmission. Confirmation is by identification of Trichosporon beigelii in a hair follicle sample. Also known as: White piedra | Trichosporosis nodosa Includes: Trichosporosis nodosa === GRAPH WALKS === --- Walk 1 --- [DC12.Z] Cholecystitis, unspecified --PARENT--> [DC12] Cholecystitis Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 2 --- [DC12.Z] Cholecystitis, unspecified --PARENT--> [DC12] Cholecystitis Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 3 --- [DC10.01] Obstruction of gall bladder --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --CHILD--> [DC10.00] Obstruction of cystic duct --- Walk 4 --- [DC10.01] Obstruction of gall bladder --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --CHILD--> [DC10.01] Obstruction of gall bladder --- Walk 5 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --EXCLUDES--> [?] Postprocedural endocrine or metabolic disorders Def: Any endocrine or metabolic disorder caused by or subsequent to any medical procedure.... --- Walk 6 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.1] Acquired absence of genital organs
[ "[DC12.Z] Cholecystitis, unspecified\n --PARENT--> [DC12] Cholecystitis\n Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC12.Z] Cholecystitis, unspecified\n --PARENT--> [DC12] Cholecystitis\n Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC10.01] Obstruction of gall bladder\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --CHILD--> [DC10.00] Obstruction of cystic duct", "[DC10.01] Obstruction of gall bladder\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --CHILD--> [DC10.01] Obstruction of gall bladder", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --EXCLUDES--> [?] Postprocedural endocrine or metabolic disorders\n Def: Any endocrine or metabolic disorder caused by or subsequent to any medical procedure....", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.1] Acquired absence of genital organs" ]
DC12.Z
Cholecystitis, unspecified
[ { "from_icd11": "DC12.Z", "icd10_code": "K812", "icd10_title": "Acute cholecystitis with chronic cholecystitis" }, { "from_icd11": "DC12.Z", "icd10_code": "K819", "icd10_title": "Cholecystitis, unspecified" }, { "from_icd11": "DC12.Z", "icd10_code": "K81", "icd10_title": "Cholecystitis" }, { "from_icd11": "DC12.Z", "icd10_code": "K818", "icd10_title": "" }, { "from_icd11": "DC10.01", "icd10_code": "K820", "icd10_title": "Obstruction of gallbladder" }, { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" }, { "from_icd11": "DC10.2", "icd10_code": "K833", "icd10_title": "Fistula of bile duct" }, { "from_icd11": "DC10.2", "icd10_code": "K823", "icd10_title": "Fistula of gallbladder" }, { "from_icd11": "JB41.1", "icd10_code": "O871", "icd10_title": "Deep phlebothrombosis in the puerperium" }, { "from_icd11": "1F2D.2", "icd10_code": "B362", "icd10_title": "White piedra" } ]
K812
Acute cholecystitis with chronic cholecystitis
Ask the patient about the nature of the workplace, what they experienced, the person’s social network, the alleged perpetrator and their supporters, the timeline of events, sick leave utilisation and impact on productivity or career progress, as well as the resultant effects on self-esteem, anxiety, depressive and other psychiatric symptoms. Gender, race and cultural identity may be factors in why an employee is singled out for bullying, and should be explored sensitively. The role of the workplace structures, such as human resource management 13 as well as line-management needs to be considered (See Table 2 , Vignette 1.1 for an example). Table 2. Clinical Vignette (This is an entirely fictionalised example) Vignette 1.1 Alina, a scientist working at a government research institute, states she has been bullied by her supervising manager who initially shouted at her in full view of her subordinate staff regarding alleged underperformance. She has subsequently observed and had reported to her by co-workers, ongoing denigration by this manager regarding the allegations over the last 24 months (she has not been able to attend work for 6 months). Alina considers there is a racial and gender element in the bullying, as she is a South East Asian, and there have been derogatory comments referring to her using stereotypical Asian characterisations such as punctiliousness and formality in work interactions. She reports marked worrying, sleep disturbance, and the inability to attend work due to panic episodes. Her GP has arranged for medical leave, now up to 6 months, and has referred her to the psychiatrist for specialist advice on managing her anxiety, rehabilitation and eventual return-to-work. Vignette 1.2-continued The treating psychiatrist conducts a comprehensive assessment, covering the workplace bullying, workplace organisational responses including human resources and rehabilitation provider. Alina lodged a formal complaint about the alleged perpetrator’s behaviour 18 months ago, and states that she was then subjected to ongoing bullying by the same manager, who was allegedly exonerated by the manager’s supervisor. Her manager then launched a counter-complaint of unprofessional behaviour from Alina which remains under investigation by organisational human resources. Alina has been advised she will be required by her public service employer to be assessed by a work-appointed psychiatrist regarding her ongoing suitability for employment. The treating psychiatrist diagnoses a generalised anxiety disorder and panic disorder recommending pharmacotherapy (SSRI) and psychological therapy, and further leave to undertake treatment. Her psychiatrist recommends that the patient seek industrial advocacy (union or legal) advice regarding the manager’s behaviour and complaint regarding the patient, as well as in relation to her work-mandated psychiatric assessment. Vignette 1.3-continued Alina has agreed to undertake a graduated return-to-work program. She indicates that she has continued to receive denigration from her supervisor in email correspondence, via phone and reported to her by work colleagues. However, her employer states that no further investigation of the bullying will occur, as her supervisor’s manager has exonerated her supervisor. In view of the ongoing bullying and harassment by her supervisor, the psychiatrist recommends that Alina undertake a graduated return-to-work program in a different work section reporting to a different supervisor. She undertakes a successful graduated return-to-work, and receiving good references from her current supervisor, begins applying for alternative employment, in view of the above experiences with her current employer. Alina transfers to another separate governmental agency in a new role as a full-time employee. Vignette 1.4-continued In her new employment, as with any workplace, Alina finds there are some difficult interactions. Due to the context of her experiences of workplace bullying, she consults her psychiatrist. Her psychiatrist explores with Alina the sense-making of the workplace bullying in how it affected her self-esteem (including racial and gender stereotyping), sensitisation to awareness of bullying, professional identity, and future career goals. Alina decides to join a science, technology, engineering and mathematics advocacy NGO as a diversity representative, and continues to explore ways to advocate for systemic change for prevention of bullying, as well as respect for diversity in her workplace. She focuses on developing new research interests and networks that will enhance her skills, opportunities and ultimately, her professional reputation, as a bulwark against future bullying. Alina also actively increases her social networks outside of work, and contact with friends and family.
3.693359
0.812988
sec[1]/p[1]
en
0.999996
36670519
https://doi.org/10.1177/10398562231153021
[ "alina", "work", "bullying", "workplace", "psychiatrist", "manager", "supervisor", "vignette", "that", "regarding" ]
[ { "code": "QF28", "title": "Difficulty or need for assistance with work activities" }, { "code": "QD83.0", "title": "Problem associated with uncongenial work" }, { "code": "QD83.1", "title": "Problem associated with stressful work schedule" }, { "code": "QE50.2", "title": "Problem associated with relationships with people at work" }, { "code": "CA23.0", "title": "Allergic asthma" }, { "code": "QE82.2", "title": "Personal history of psychological abuse" }, { "code": "QB31.0Z", "title": "Fitting or adjustment of external prosthetic device, unspecified" }, { "code": "QF21", "title": "Difficulty or need for assistance with general life tasks or life management" }, { "code": "QB30.Z", "title": "Adjustment or management of implanted devices, unspecified" }, { "code": "QB31.4", "title": "Fitting or adjustment of hearing aid" } ]
=== ICD-11 CODES FOUND === [QF28] Difficulty or need for assistance with work activities Also known as: Difficulty or need for assistance with work activities | need for assistance with work activities | difficulty with work activities [QD83.0] Problem associated with uncongenial work Also known as: Problem associated with uncongenial work | difficult conditions at work [QD83.1] Problem associated with stressful work schedule Also known as: Problem associated with stressful work schedule | difficult work schedule | problem with work schedule [QE50.2] Problem associated with relationships with people at work Also known as: Problem associated with relationships with people at work | discord with boss or workmates [CA23.0] Allergic asthma Definition: Allergic asthma is the most easily recognised asthma phenotype, which often commences in childhood and is associated with a past and/or family history of allergic diseases such as eczema, allergic rhinitis, or food or drug allergy. Examination of the induced sputum of these patients before treatment often reveals eosinophilic airway inflammation. The main trigger is the exposure to inhaled allergens, such as dust mite and pollens, to which the affected individual has previously been sensitized. Also known as: Allergic asthma | Allergen-induced asthma | allergic asthma without stated status asthmaticus | Predominantly allergic asthma without stated status asthmaticus | predominantly allergic asthma [QE82.2] Personal history of psychological abuse Definition: Personal history of non-accidental verbal or symbolic act that results in significant psychological harm. This category is applied to the victim of the maltreatment, not the perpetrator. Also known as: Personal history of psychological abuse | bullying | child verbal abuse | child emotional abuse | Personal history of psychological maltreatment Excludes: History of spouse or partner violence, psychological [QB31.0Z] Fitting or adjustment of external prosthetic device, unspecified Also known as: Fitting or adjustment of external prosthetic device, unspecified | Fitting or adjustment of external prosthetic device | fitting of prosthesis NOS | management of prosthesis NOS [QF21] Difficulty or need for assistance with general life tasks or life management Also known as: Difficulty or need for assistance with general life tasks or life management | difficulty with carrying out tasks and daily routine | life management problem | difficulty with life management tasks | Difficulty with dealing with change such as relocation Includes: difficulty with carrying out tasks and daily routine [QB30.Z] Adjustment or management of implanted devices, unspecified Also known as: Adjustment or management of implanted devices, unspecified | Adjustment or management of implanted devices | management of implanted prosthesis | management of implanted device [QB31.4] Fitting or adjustment of hearing aid Also known as: Fitting or adjustment of hearing aid | fitting of auditory device | management of hearing aid | fitting of hearing aid === GRAPH WALKS === --- Walk 1 --- [QF28] Difficulty or need for assistance with work activities --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management --- Walk 2 --- [QF28] Difficulty or need for assistance with work activities --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management --- Walk 3 --- [QD83.0] Problem associated with uncongenial work --PARENT--> [QD83] Problem with employment conditions --CHILD--> [QD83.1] Problem associated with stressful work schedule --- Walk 4 --- [QD83.0] Problem associated with uncongenial work --PARENT--> [QD83] Problem with employment conditions --CHILD--> [QD83.0] Problem associated with uncongenial work --- Walk 5 --- [QD83.1] Problem associated with stressful work schedule --PARENT--> [QD83] Problem with employment conditions --CHILD--> [QD83.Y] Other specified problem with employment conditions --- Walk 6 --- [QD83.1] Problem associated with stressful work schedule --PARENT--> [QD83] Problem with employment conditions --CHILD--> [QD83.1] Problem associated with stressful work schedule
[ "[QF28] Difficulty or need for assistance with work activities\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management", "[QF28] Difficulty or need for assistance with work activities\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management", "[QD83.0] Problem associated with uncongenial work\n --PARENT--> [QD83] Problem with employment conditions\n --CHILD--> [QD83.1] Problem associated with stressful work schedule", "[QD83.0] Problem associated with uncongenial work\n --PARENT--> [QD83] Problem with employment conditions\n --CHILD--> [QD83.0] Problem associated with uncongenial work", "[QD83.1] Problem associated with stressful work schedule\n --PARENT--> [QD83] Problem with employment conditions\n --CHILD--> [QD83.Y] Other specified problem with employment conditions", "[QD83.1] Problem associated with stressful work schedule\n --PARENT--> [QD83] Problem with employment conditions\n --CHILD--> [QD83.1] Problem associated with stressful work schedule" ]
QF28
Difficulty or need for assistance with work activities
[ { "from_icd11": "QD83.0", "icd10_code": "Z565", "icd10_title": "Uncongenial work environment" }, { "from_icd11": "QD83.1", "icd10_code": "Z563", "icd10_title": "Stressful work schedule" }, { "from_icd11": "QE50.2", "icd10_code": "Z564", "icd10_title": "Discord with boss and workmates" }, { "from_icd11": "CA23.0", "icd10_code": "J450", "icd10_title": "" }, { "from_icd11": "QE82.2", "icd10_code": "Z87820", "icd10_title": "Personal history of traumatic brain injury" }, { "from_icd11": "QE82.2", "icd10_code": "Z8781", "icd10_title": "Personal history of (healed) traumatic fracture" }, { "from_icd11": "QE82.2", "icd10_code": "Z87890", "icd10_title": "Personal history of sex reassignment" }, { "from_icd11": "QE82.2", "icd10_code": "Z87898", "icd10_title": "Personal history of other specified conditions" }, { "from_icd11": "QE82.2", "icd10_code": "Z87892", "icd10_title": "Personal history of anaphylaxis" }, { "from_icd11": "QE82.2", "icd10_code": "Z87828", "icd10_title": "Personal history of other (healed) physical injury and trauma" }, { "from_icd11": "QE82.2", "icd10_code": "T7431XA", "icd10_title": "Adult psychological abuse, confirmed, initial encounter" }, { "from_icd11": "QE82.2", "icd10_code": "Z87821", "icd10_title": "Personal history of retained foreign body fully removed" }, { "from_icd11": "QE82.2", "icd10_code": "Z8782", "icd10_title": "Personal history of other (healed) physical injury and trauma" }, { "from_icd11": "QE82.2", "icd10_code": "T743", "icd10_title": "Psychological abuse, confirmed" }, { "from_icd11": "QE82.2", "icd10_code": "Z623", "icd10_title": "Hostility towards and scapegoating of child" } ]
Z565
Uncongenial work environment
A 31-year-old nullipara woman with systemic lupus erythematosus (SLE) and antiphospholipid syndrome spontaneously conceived and was referred to our teaching university hospital as a high-risk patient because of oral warfarin use for antiphospholipid syndrome. She was treated with prednisolone 5 mg/day for 11 years and tacrolimus 3 mg/day for 4 years. Warfarin was replaced by subcutaneous self-administration of unfractionated heparin calcium (10,000 IU/day), and low-dose aspirin (100 mg/day) was started from 6 weeks of gestation. At the prenatal checkup, the ultrasonography revealed that there was no placenta previa, and the placenta accreta spectrum was not pointed out. Other than the finding of mild asymmetric fetal growth restriction (about –1.5 standard deviation), her pregnancy course was uneventful. At 37 weeks of gestation, she was admitted to our hospital because of premature rupture of membranes without the onset of labor. Continuous intravenous heparin was started instead of subcutaneous administration to prevent thrombosis which was stopped before labor induction. Labor was induced by intravenous injection of oxytocin. Cesarean delivery was performed because of the lack of change in cervical dilatation of 4 cm for 2 consecutive days. In addition, her body temperature was elevated (>38°C) at the time of surgery, and she was diagnosed with clinical chorioamnionitis. Surgery was performed without any incident until the delivery of the placenta. However, soon after the baby's birth, uterine inversion occurred even without pulling of the umbilical cord, owing to excessive uterine atony. Moreover, as part of the placenta was strongly adhered to the lower posterior wall of the uterus, placenta accreta was diagnosed . Manual removal of the placenta and correction of uterine inversion were successfully performed. As continuous bleeding from the placental attachment area and uterine atony was observed even with the usage of uterotonics, such as oxytocin (10 units) and methylergometrine (0.2 mg), UBT was retrogradely attempted through the opened uterine incision, with the balloon (Fuji Metro; Fuji Latex Co., Ltd. Tokyo, Japan) placed in the uterine isthmus. The balloon was inflated with 300-mL saline, but excessive uterine atony and very thin and edematous myometrium did not allow us to accomplish the hemostasis only with UBT. Therefore, once the balloon was removed, the IVCS was performed. As we previously reported, 10 the two sutures, using 1-Monocryl (Ethicon, Inc., Somerville, NJ), were placed on the uterine isthmus vertically through the anterior to the posterior wall to compress the lower uterine segment. As bleeding continued despite the large decrease in the bleeding amount, the balloon was retrogradely inserted again through the opened uterine incision into the uterine isthmus and inflated with 150-mL saline along with the usage of the uterotonics, and hemostasis was accomplished once. However, because excessive uterine atony and resultant severe atonic bleeding from the uterine corpus occurred again even with bimanual compression, uterotonics, and 1 g of tranexamic acid, a second balloon was retrogradely placed into the uterine corpus through the opened uterine incision and inflated with 500-mL saline to directory press the cavum of the uterine corpus . Complete hemostasis was accomplished using intrauterine double-balloon tamponade in combination with IVCS, and then the uterine incision was closed. A marking stitch was placed on the end of the tube of the lower initial balloon to distinguish the location of the two balloons. The total blood loss was 1,738 mL. The hemoglobin level before the operation was 10.4 g/dL. The lowest hemoglobin level during the procedure was 4.7 g/dL. Transfusion of 8 units of red blood and 6 units of fresh frozen plasma was performed; however, additional compression sutures, UAE and hysterectomy were avoided. With all measures, including blood transfusion, the hemoglobin level after the operation was 8.7 g/dL. For postoperative management, intravenous and oral steroids and continuous intravenous unfractionated heparin (10,000 IU/day) followed by an adjusted dose of warfarin (target prothrombin international normalized ratio of 1.5–2.0, requiring 2.5 mg/day warfarin) were administered. On postoperative day 1, the two balloons were deflated and removed (the lower balloon first followed by the upper balloon), with careful attention to recurrent uterine inversion. Uterine inversion, suture-related pelvic pain, and infection due to uterine ischemia were not observed. The patient was discharged from the hospital 16 days after surgery after controlling the dose of warfarin. She continued outpatient postoperative follow-up, with no signs of subsequent suture-related complications at the 6-month follow-up visit.
4.03125
0.970703
sec[0]/p[0]
en
0.999998
34466659
https://doi.org/10.1055/s-0041-1733990
[ "uterine", "balloon", "placenta", "warfarin", "because", "intravenous", "inversion", "atony", "bleeding", "incision" ]
[ { "code": "GA1Z&XA99N3", "title": "Noninflammatory disorders of uterus, except cervix" }, { "code": "GA01.Z", "title": "Inflammatory disorders of the uterus, except cervix, unspecified" }, { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" }, { "code": "NB92.6", "title": "Injury of uterus" }, { "code": "GC04.1Y", "title": "Other specified fistulae involving female genital tract" }, { "code": "BC43.5", "title": "Stress-induced cardiomyopathy" }, { "code": "BB62.Z", "title": "Mitral valve prolapse, unspecified" }, { "code": "PA50.Z&XE3J3", "title": "Balloon accident injuring occupant" }, { "code": "PK91.2Y", "title": "Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "PK91.13", "title": "Cardiovascular devices associated with injury or harm, intra-aortic balloon pump" } ]
=== ICD-11 CODES FOUND === [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified Also known as: Inflammatory disorders of the uterus, except cervix, unspecified | Inflammatory disorders of the uterus, except cervix | inflammatory disease of the uterus | uterine inflammatory disease | uterus inflammation [GA16.Y] Other specified acquired abnormalities of uterus, except cervix Also known as: Other specified acquired abnormalities of uterus, except cervix | Polyp of corpus uteri | intrauterine polyp | polyp of body of uterus | polyp of uterus [NB92.6] Injury of uterus Also known as: Injury of uterus | uterine injury | intrauterine injury NOS | Injury of uterus without open wound into cavity | Injury of uterus with open wound into cavity [GC04.1Y] Other specified fistulae involving female genital tract Also known as: Other specified fistulae involving female genital tract | Other female intestinal-genital tract fistulae | Intestinouterine fistula | enterouterine fistula | Cervicosigmoidal fistula [BC43.5] Stress-induced cardiomyopathy Definition: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocardial infarction, but with non-specific electrocardiographic ST elevation and T wave changes, and minimal myocardial enzymatic release, in the absence of coronary stenosis. Also known as: Stress-induced cardiomyopathy | Takotsubo cardiomyopathy | stress cardiomyopathy | broken heart syndrome | apical ballooning syndrome Includes: Takotsubo cardiomyopathy [BB62.Z] Mitral valve prolapse, unspecified Also known as: Mitral valve prolapse, unspecified | Mitral valve prolapse | systolic click-murmur syndrome | ballooning mitral valve | Barlow syndrome [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Cardiovascular devices associated with injury or harm, conduits | Mechanical complication of other cardiac and vascular devices and implants | Mechanical complication of artificial heart | Mechanical complication of vascular balloon implant or device [PK91.13] Cardiovascular devices associated with injury or harm, intra-aortic balloon pump Also known as: Cardiovascular devices associated with injury or harm, intra-aortic balloon pump | IABP - [intra-aortic balloon pump] | Mechanical complication of intra-aortic counterpulsation device Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm === GRAPH WALKS === --- Walk 1 --- [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i... --CHILD--> [GA01.Y] Other specified inflammatory disorders of the uterus, except cervix --- Walk 2 --- [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i... --CHILD--> [GA01.Y] Other specified inflammatory disorders of the uterus, except cervix --- Walk 3 --- [GA16.Y] Other specified acquired abnormalities of uterus, except cervix --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix).... --RELATED_TO--> [?] Caesarean scar defect of uterus Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar... --- Walk 4 --- [GA16.Y] Other specified acquired abnormalities of uterus, except cervix --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix).... --RELATED_TO--> [?] Caesarean scar defect of uterus Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar... --- Walk 5 --- [NB92.6] Injury of uterus --PARENT--> [NB92] Injury of urinary or pelvic organs --CHILD--> [NB92.2] Injury of bladder --- Walk 6 --- [NB92.6] Injury of uterus --PARENT--> [NB92] Injury of urinary or pelvic organs --CHILD--> [NB92.2] Injury of bladder
[ "[GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified\n --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix\n Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i...\n --CHILD--> [GA01.Y] Other specified inflammatory disorders of the uterus, except cervix", "[GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified\n --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix\n Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i...\n --CHILD--> [GA01.Y] Other specified inflammatory disorders of the uterus, except cervix", "[GA16.Y] Other specified acquired abnormalities of uterus, except cervix\n --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix\n Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....\n --RELATED_TO--> [?] Caesarean scar defect of uterus\n Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar...", "[GA16.Y] Other specified acquired abnormalities of uterus, except cervix\n --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix\n Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....\n --RELATED_TO--> [?] Caesarean scar defect of uterus\n Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar...", "[NB92.6] Injury of uterus\n --PARENT--> [NB92] Injury of urinary or pelvic organs\n --CHILD--> [NB92.2] Injury of bladder", "[NB92.6] Injury of uterus\n --PARENT--> [NB92] Injury of urinary or pelvic organs\n --CHILD--> [NB92.2] Injury of bladder" ]
GA1Z&XA99N3
Noninflammatory disorders of uterus, except cervix
[ { "from_icd11": "GA01.Z", "icd10_code": "N719", "icd10_title": "Inflammatory disease of uterus, unspecified" }, { "from_icd11": "GA01.Z", "icd10_code": "N71", "icd10_title": "Inflammatory disease of uterus, except cervix" }, { "from_icd11": "NB92.6", "icd10_code": "S3763XA", "icd10_title": "Laceration of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S3769XA", "icd10_title": "Other injury of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S3760XA", "icd10_title": "Unspecified injury of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S376", "icd10_title": "Injury of uterus" }, { "from_icd11": "BB62.Z", "icd10_code": "I341", "icd10_title": "Nonrheumatic mitral (valve) prolapse" }, { "from_icd11": "PA50.Z&XE3J3", "icd10_code": "V960", "icd10_title": "Balloon accident injuring occupant" } ]
N719
Inflammatory disease of uterus, unspecified
A 46-year-old woman complained of visual and gait disturbances and increasing headaches that had started some days earlier. Physical examination revealed a hemianopia to the right and restricted orientation to time without additional neurological deficits. A first magnetic resonance imaging (MRI) was performed, which revealed a large contrast-enhancing lesion within the left occipital lobe . The patient was transferred to the department of neurosurgery at our university hospital. After interdisciplinary discussion in the neuro-oncological board, tumor resection was indicated and performed by use of intraoperative neuronavigation without any additional deficits. Neuropathological examination confirmed an unmethylated but isocitrate dehydrogenase 1 (IDH1) R132H-mutated glioblastoma with a high proliferation rate (MIB‑1: 15–20% immunopositive tumor cells). Combined radiotherapy and chemotherapy with adjuvant temozolomide (TMZ) (EORTC/-NCIC trial protocol ) was indicated according to our institutional guidelines. Subsequently, the patient developed steroid-induced psychosis and tapering of steroids along with pentoxifylline and boswellia treatment was recommended. At this time MRI showed significant contrast-enhancement and perilesional edema and dexamethasone was prescribed . The patient recovered clinically and follow-up MRI displayed partial recovery of brain edema . After discontinuation of steroids, the patient redeveloped symptoms of depression and MRI showed recurrence of brain edema. At this stage steroids were readministered while continuing with the intensified TMZ chemotherapy. After completion of the second cycle, the patient complained of mild hemiparesis graded as 4/5 on the medical research council (MRC) scale for muscle strength, hemiparesthesia, and constant fatigue. At this point in time MRI showed persisting signs of edema and contrast-enhancement suspicious of tumor progression . Fig. 1 time (t) = 0. Preoperative axial T2-weighted images ( a ) show a hyperintense space-occupying lesion ( arrow ) located in the left occipital lobe. In addition, hyperintense changes are displayed laterally to the thalami of both sides and the occipital forceps of the corpus callosum ( a , arrowheads ). After administration of gadolinium ( b ) the lesion shows marked rim enhancement ( arrow ) and central necrosis on T1-weighted images. On postoperative T2-weighted images a large resection defect is visible ( c ). The hyperintense signal intensity changes remain stable (arrowheads ). On T1-weighted postcontrast images ( d ) at the same point in time complete tumor resection is shown ( arrow ) Fig. 2 t = 7 weeks. On-going combined radiotherapy and chemotherapy. The hyperintense signal intensity changes have markedly increased on axial T2-weighted images ( a , arrowheads ). No signs of a solid residual tumor are on display ( a , arrow ). On contrast-enhanced T1-weighted images ( b ) a thick patchy rim of contrast enhancement along the margins of the tumor resection is visible ( arrow ) interleaved with smaller areas of regressive changes ( arrowhead ). On axial cerebral blood volume (CBV) maps of perfusion-weighted MR images ( c ) no hyperperfusion is visible in the areas of increased contrast enhancement ( arrow ) Fig. 3 t = 14 weeks. Additional treatment with corticosteroids. The perifocal edema has clearly regressed on axial fluid attenuated inversion recovery (FLAIR) images ( a , arrow ). The signal intensity changes of the occipital forceps and the right sided perithalamic region have remained stable ( a , arrowheads ). On T1-weighted postcontrast images contrast ( b ) enhancement at the margins of the tumor resection has clearly regressed ( arrow ) Fig. 4 t = 26 weeks. At the end of the second cycle of the intensified chemotherapy with temozolomide the patient complained of mild right-sided hemiparesis. Axial T2-weighted images ( a ) show an increasing perifocal edema ( arrowheads ) around the tumor resection ( arrow ). On axial T1-weighted images after administration of gadolinium ( b ) a thick patchy rim of enhancement can be seen along the margins of the initial tumor resection ( arrow ). Note the additional contrast-enhancing lesion located in the white matter adjacent to the right thalamus ( arrowhead ) most likely corresponding to additional manifestation of the underlying tumor. After reoperation a large resection defect can be seen on axial T2-weighted images ( c , arrow ). The perifocal edema is basically stable ( c , arrowheads ). On axial contrast-enhanced T1-weighted images ( d ) discrete enhancement is visualized along the borders of the tumor resection ( arrow ). Note the bulky contrast-enhancing portions infiltrating the occipital forceps of the corpus callosum and the white matter lateral to the left thalamus ( arrowheads )
4.074219
0.972168
sec[0]/p[0]
en
0.999996
33625551
https://doi.org/10.1007/s00062-021-01006-4
[ "weighted", "arrow", "tumor", "contrast", "resection", "enhancement", "axial", "edema", "arrowheads", "time" ]
[ { "code": "MG43.5", "title": "Excessive weight loss" }, { "code": "MG43.6", "title": "Excessive weight gain" }, { "code": "MG44.11", "title": "Failure to thrive in infant or child" }, { "code": "5B80.0Z", "title": "Overweight, unspecified" }, { "code": "JA65.2", "title": "Excessive weight gain in pregnancy" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" } ]
=== ICD-11 CODES FOUND === [MG43.5] Excessive weight loss Definition: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health. Also known as: Excessive weight loss | abnormal decrease in weight | abnormal weight loss | unintended weight loss | weight loss NOS [MG43.6] Excessive weight gain Definition: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantity or rate to create risk to the individual’s health. Also known as: Excessive weight gain | abnormal increase in weight | abnormal weight gain | unintended weight gain Excludes: Obesity [MG44.11] Failure to thrive in infant or child Definition: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender. Also known as: Failure to thrive in infant or child | failure to gain weight | failure to thrive NOS | FTT - [failure to thrive] syndrome Excludes: Failure to thrive in newborn | Anorexia Nervosa | Avoidant-restrictive food intake disorder [5B80.0Z] Overweight, unspecified Also known as: Overweight, unspecified | Overweight [JA65.2] Excessive weight gain in pregnancy Definition: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy. Also known as: Excessive weight gain in pregnancy | excessive weight gain in pregnancy, unspecified trimester | maternal obesity syndrome | maternal obesity without hypertension | abnormal weight gain in pregnancy Excludes: Gestational oedema without hypertension [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS === GRAPH WALKS === --- Walk 1 --- [MG43.5] Excessive weight loss Def: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health.... --PARENT--> [MG43] Symptoms or signs concerning food or fluid intake Def: Symptoms or signs concerning food and fluid intake include anorexia, polydipsia, polyphagia, feeding difficulties or mismanagement, abnormal weight loss, abnormal weight gain, insufficient intake of f... --CHILD--> [MG43.1] Overeating Def: The consumption of excess food in relation to energy and nutritional requirements.... --- Walk 2 --- [MG43.5] Excessive weight loss Def: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health.... --PARENT--> [MG43] Symptoms or signs concerning food or fluid intake Def: Symptoms or signs concerning food and fluid intake include anorexia, polydipsia, polyphagia, feeding difficulties or mismanagement, abnormal weight loss, abnormal weight gain, insufficient intake of f... --CHILD--> [MG43.2] Abulia Def: Abulia is state of poverty of behaviour and speech output, lack of initiative, loss of emotional responses, psychomotor slowing, and prolonged speech latency.... --- Walk 3 --- [MG43.6] Excessive weight gain Def: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantit... --EXCLUDES--> [?] Obesity Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet... --CHILD--> [?] Drug-induced obesity --- Walk 4 --- [MG43.6] Excessive weight gain Def: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantit... --EXCLUDES--> [?] Obesity Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet... --CHILD--> [?] Obesity due to energy imbalance Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet... --- Walk 5 --- [MG44.11] Failure to thrive in infant or child Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender.... --EXCLUDES--> [?] Failure to thrive in newborn Def: When newborn’s current weight or rate of weight gain is significantly below that of other newborns of similar age and gender.... --PARENT--> [?] Feeding problems of newborn Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn.... --- Walk 6 --- [MG44.11] Failure to thrive in infant or child Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender.... --PARENT--> [MG44.1] Lack of expected normal physiological development Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang... --EXCLUDES--> [?] Delayed puberty Def: This is when an organism has passed the usual age of onset of puberty with no physical or hormonal signs that it is beginning. Puberty may be delayed for several years and still occur normally, in whi...
[ "[MG43.5] Excessive weight loss\n Def: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health....\n --PARENT--> [MG43] Symptoms or signs concerning food or fluid intake\n Def: Symptoms or signs concerning food and fluid intake include anorexia, polydipsia, polyphagia, feeding difficulties or mismanagement, abnormal weight loss, abnormal weight gain, insufficient intake of f...\n --CHILD--> [MG43.1] Overeating\n Def: The consumption of excess food in relation to energy and nutritional requirements....", "[MG43.5] Excessive weight loss\n Def: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health....\n --PARENT--> [MG43] Symptoms or signs concerning food or fluid intake\n Def: Symptoms or signs concerning food and fluid intake include anorexia, polydipsia, polyphagia, feeding difficulties or mismanagement, abnormal weight loss, abnormal weight gain, insufficient intake of f...\n --CHILD--> [MG43.2] Abulia\n Def: Abulia is state of poverty of behaviour and speech output, lack of initiative, loss of emotional responses, psychomotor slowing, and prolonged speech latency....", "[MG43.6] Excessive weight gain\n Def: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantit...\n --EXCLUDES--> [?] Obesity\n Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet...\n --CHILD--> [?] Drug-induced obesity", "[MG43.6] Excessive weight gain\n Def: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantit...\n --EXCLUDES--> [?] Obesity\n Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet...\n --CHILD--> [?] Obesity due to energy imbalance\n Def: Obesity is a chronic complex disease defined by excessive adiposity that can impair health. It is in most cases a multifactorial disease due to obesogenic environments, psycho-social factors and genet...", "[MG44.11] Failure to thrive in infant or child\n Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender....\n --EXCLUDES--> [?] Failure to thrive in newborn\n Def: When newborn’s current weight or rate of weight gain is significantly below that of other newborns of similar age and gender....\n --PARENT--> [?] Feeding problems of newborn\n Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn....", "[MG44.11] Failure to thrive in infant or child\n Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender....\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --EXCLUDES--> [?] Delayed puberty\n Def: This is when an organism has passed the usual age of onset of puberty with no physical or hormonal signs that it is beginning. Puberty may be delayed for several years and still occur normally, in whi..." ]
MG43.5
Excessive weight loss
[ { "from_icd11": "MG43.5", "icd10_code": "R634", "icd10_title": "Abnormal weight loss" }, { "from_icd11": "MG43.6", "icd10_code": "R635", "icd10_title": "Abnormal weight gain" }, { "from_icd11": "5B80.0Z", "icd10_code": "E669", "icd10_title": "Obesity, unspecified" }, { "from_icd11": "JA65.2", "icd10_code": "O2603", "icd10_title": "Excessive weight gain in pregnancy, third trimester" }, { "from_icd11": "JA65.2", "icd10_code": "O2601", "icd10_title": "Excessive weight gain in pregnancy, first trimester" }, { "from_icd11": "JA65.2", "icd10_code": "O2602", "icd10_title": "Excessive weight gain in pregnancy, second trimester" }, { "from_icd11": "JA65.2", "icd10_code": "O260", "icd10_title": "Excessive weight gain in pregnancy" }, { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" } ]
R634
Abnormal weight loss
A 30-year-old woman with a 5-month history of pancolitis UC presented with an exacerbation of UC and was admitted to a nearby hospital. She had previously been treated with oral 5-aminosalicylic acid (5ASA) medication. She had no significant medical or family history. Oral steroid therapy with prednisone (20 mg/day) was initiated, and she was transferred to our hospital because of an exacerbation of UC on the 14th day of hospitalization. The patient was treated with high-dose intravenous steroid therapy consisting of prednisolone (50 mg/day) and a calcineurin inhibitor. Subtotal colectomy with ileostomy and a mucosal fistula was performed because of refractory UC 5 days after the patient was transferred to our hospital, and neovascular growth on the serosal surface was observed from the rectum to the transverse colon . The resected specimen showed pancolitis compatible with UC, and a demarcation line existed in the transverse colon without backwash ileitis . On postoperative day (POD) 8, vomiting was noticed and diagnosed as small bowel obstruction by computed tomography (CT). An ileus tube was inserted on POD12. On POD15, fever was observed, and antibiotics were administered for Enterococcus faecium sepsis. On POD18, bleeding from the stoma and ileus tube was observed. On POD20, the abdominal pain worsened, and a CT scan revealed bowel obstruction and bleeding , which led to a reoperation. Intraoperatively, 230 cm from the ligament of Treitz, the ileum was found to be narrowed by adhesions to the ileal mesentery, and multiple erosions and ulcers were observed in the entire small bowel from the ligament of Treitz . Although there was little inflammation of the mucosa between the ulcers, ulcers were mostly observed in the small bowel, 100 cm from the ligament of Treitz, and the ileum was perforated at 220 cm from the ligament of Treitz . Jejunostomy, lavage, adhesiolysis, and a simple closure of the perforated ileum were performed . The clinical course after the reoperation is shown in Fig. 4 . Esophagogastroduodenoscopy (EGD) after reoperation showed no bleeding in the esophagus, stomach, or duodenum. Tests for cytomegalovirus (CMV) antigenemia and glutamate dehydrogenase, and toxin A/B assays for Clostridioides difficile infection were negative. Stool cultures showed normal flora. The patient was diagnosed with post-colectomy pan-enteritis and treated with high-dose steroid therapy with prednisolone (40 mg/day) immediately after reoperation, and infliximab (IFX; 5 mg/kg) was administered due to worsening bleeding on the 3rd day after reoperation. She was admitted to the intensive care unit (ICU) for massive blood transfusion due to bleeding. She required blood transfusion with 58 units of red blood cells, 40 units of fresh frozen plasma, and 25 units of platelets in the ICU, and bleeding decreased on the day after the initiation of biologic therapy. On the 5th day of biologic therapy, the blood transfusion was stopped, and the patient left the ICU. Bleeding from the stoma completely disappeared around the 10th day after the initiation of biologic therapy. The jejunostomy was closed 8 weeks after the reoperation, and the patient was discharged home 5 weeks later. At seven months after colectomy, she is receiving in IFX (5 mg/kg/8 weeks) as maintenance therapy. No rectal perforation or bleeding was observed during the course of this treatment. Fig. 1 Preoperative and intraoperative findings in colectomy. A Preoperative colonoscopy showed continuous diffuse granularity, ulceration, and loss of vascular pattern from the rectum to the transverse colon. B Intraoperatively, new vascular growth on the serosal surface from the rectum to the transverse colon was observed. C The resection specimen showed pancolitis compatible with UC, and a demarcation line existed at the transverse colon Fig. 2 Computed tomography image taken before reoperation. Computed tomography image before reoperation showed extravascular leakage (upper arrow) and caliber change (lower arrow) Fig. 3 Intraoperative findings in reoperation. A Punched-out ulcers were observed in the entire small bowel from the Treitz ligament. B Intraoperative endoscopy revealed multiple erosions and ulcers in the small intestine. C The ileum was perforated at 220 cm from the Treitz ligament. D Jejunostomy, lavage, adhesiolysis, and a simple closure of the perforated ileum were performed Fig. 4 Clinical course after reoperation. Total bleeding was 12898 ml, and blood transfusion with 58 units of red blood cell, 40 units of fresh frozen plasma, and 25 units of platelet were required after reoperation. EGD esophagogastroduodenoscopy, ICU intensive care unit, POD postoperative day, IFX infliximab, RBC red blood cell, FFP fresh frozen plasma, sBP systolic blood pressure, dBP diastolic blood pressure
3.996094
0.977539
sec[1]/p[0]
en
0.999996
39196494
https://doi.org/10.1186/s40792-024-02003-8
[ "reoperation", "bleeding", "blood", "ligament", "treitz", "transverse", "colon", "small", "bowel", "ileum" ]
[ { "code": "MG27", "title": "Haemorrhage, not elsewhere classified" }, { "code": "GA21.0", "title": "Postcoital or contact bleeding" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "DB98.A", "title": "Hepatic haemorrhage" }, { "code": "GA20.3", "title": "Abnormal regularity of uterine bleeding" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "FA34.1", "title": "Disorder of ligament" } ]
=== ICD-11 CODES FOUND === [MG27] Haemorrhage, not elsewhere classified Definition: Bleeding or escape of blood from a vessel. Also known as: Haemorrhage, not elsewhere classified | arterial haemorrhage | bleeding | extravasation of blood | Haemorrhage NOS Excludes: Obstetric haemorrhage | Haemorrhage or haematoma complicating a procedure, not elsewhere classified | Fetal blood loss [GA21.0] Postcoital or contact bleeding Definition: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual bleeding after sexual intercourse. Confirmation is by transvaginal imaging to identify any structural abnormalities. Also known as: Postcoital or contact bleeding | Postcoital bleeding | bleeding after intercourse | PCB - [postcoital bleeding] | postcoital haemorrhage [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [DB98.A] Hepatic haemorrhage Definition: Traumatic or nontraumatic spontaneous bleeding in the liver. The most common cause of the latter is the rupture of liver tumours. Also known as: Hepatic haemorrhage | haemorrhage of liver | hepatic bleeding | hepatorrhagia | liver haemorrhage Excludes: Hepatic haemorrhage due to hepatocellular carcinoma [GA20.3] Abnormal regularity of uterine bleeding Definition: A condition of the genital system affecting females, caused by hormonal disturbances. This condition is characterised by abnormal menstruation, with a between cycle variation of 2-20 days. Also known as: Abnormal regularity of uterine bleeding | Irregular menstrual bleeding | irregular cycle menstruation | irregular menses | irregular menstrual cycle [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [FA34.1] Disorder of ligament Also known as: Disorder of ligament | disorder of ligament, unspecified site | ligament disorder | disease of ligament | ligament deformity Excludes: Chronic instability of knee | familial ligamentous laxity === GRAPH WALKS === --- Walk 1 --- [MG27] Haemorrhage, not elsewhere classified Def: Bleeding or escape of blood from a vessel.... --EXCLUDES--> [?] Fetal blood loss Def: Fetal blood loss is a loss of blood from the fetal circulation during pregnancy, labour, or delivery. Due to the small volume of fetal blood that is present, even a small loss can lead to anaemia or f... --CHILD--> [?] Fetal blood loss from ruptured cord Def: The umbilical cord can rupture during labour and delivery and lead to fetal blood loss. Possible reasons include: traction on an abnormally short cord, a cord that is entangled around the fetus, a thi... --- Walk 2 --- [MG27] Haemorrhage, not elsewhere classified Def: Bleeding or escape of blood from a vessel.... --EXCLUDES--> [?] Fetal blood loss Def: Fetal blood loss is a loss of blood from the fetal circulation during pregnancy, labour, or delivery. Due to the small volume of fetal blood that is present, even a small loss can lead to anaemia or f... --CHILD--> [?] Fetal blood loss from placenta Def: Fetal blood loss can result from placental abruption, which is when the placenta separates from the uterine wall prior to delivery. Placental abruptions occur under conditions of maternal hypertension... --- Walk 3 --- [GA21.0] Postcoital or contact bleeding Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ... --PARENT--> [GA21] Nonmenstrual bleeding disorders --RELATED_TO--> [?] Postprocedural nonmenstrual uterine bleeding Def: Uterine bleeding occurring after procedure (i.e. uterine surgery, induced abortion, …)... --- Walk 4 --- [GA21.0] Postcoital or contact bleeding Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ... --PARENT--> [GA21] Nonmenstrual bleeding disorders --CHILD--> [GA21.Z] Nonmenstrual bleeding disorders, unspecified --- Walk 5 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.4Z] Haematuria, unspecified --- Walk 6 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria
[ "[MG27] Haemorrhage, not elsewhere classified\n Def: Bleeding or escape of blood from a vessel....\n --EXCLUDES--> [?] Fetal blood loss\n Def: Fetal blood loss is a loss of blood from the fetal circulation during pregnancy, labour, or delivery. Due to the small volume of fetal blood that is present, even a small loss can lead to anaemia or f...\n --CHILD--> [?] Fetal blood loss from ruptured cord\n Def: The umbilical cord can rupture during labour and delivery and lead to fetal blood loss. Possible reasons include: traction on an abnormally short cord, a cord that is entangled around the fetus, a thi...", "[MG27] Haemorrhage, not elsewhere classified\n Def: Bleeding or escape of blood from a vessel....\n --EXCLUDES--> [?] Fetal blood loss\n Def: Fetal blood loss is a loss of blood from the fetal circulation during pregnancy, labour, or delivery. Due to the small volume of fetal blood that is present, even a small loss can lead to anaemia or f...\n --CHILD--> [?] Fetal blood loss from placenta\n Def: Fetal blood loss can result from placental abruption, which is when the placenta separates from the uterine wall prior to delivery. Placental abruptions occur under conditions of maternal hypertension...", "[GA21.0] Postcoital or contact bleeding\n Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ...\n --PARENT--> [GA21] Nonmenstrual bleeding disorders\n --RELATED_TO--> [?] Postprocedural nonmenstrual uterine bleeding\n Def: Uterine bleeding occurring after procedure (i.e. uterine surgery, induced abortion, …)...", "[GA21.0] Postcoital or contact bleeding\n Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ...\n --PARENT--> [GA21] Nonmenstrual bleeding disorders\n --CHILD--> [GA21.Z] Nonmenstrual bleeding disorders, unspecified", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] Haematuria, unspecified", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria" ]
MG27
Haemorrhage, not elsewhere classified
[ { "from_icd11": "MG27", "icd10_code": "R58", "icd10_title": "Hemorrhage, not elsewhere classified" }, { "from_icd11": "GA21.0", "icd10_code": "N930", "icd10_title": "Postcoital and contact bleeding" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R3129", "icd10_title": "Other microscopic hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R3121", "icd10_title": "Asymptomatic microscopic hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R311", "icd10_title": "Benign essential microscopic hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R319", "icd10_title": "Hematuria, unspecified" }, { "from_icd11": "MF50.4Z", "icd10_code": "R31", "icd10_title": "Hematuria" }, { "from_icd11": "DB98.A", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB98.A", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB98.A", "icd10_code": "K768", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "GA20.3", "icd10_code": "N926", "icd10_title": "Irregular menstruation, unspecified" }, { "from_icd11": "GA20.3", "icd10_code": "N925", "icd10_title": "Other specified irregular menstruation" }, { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" } ]
R58
Hemorrhage, not elsewhere classified
A 17-year-old male mixed-breed dog weighing 3.8 kg was transferred for diagnosis and medical treatment related to a very large abdominal mass. Hyperkeratosis, alopecia in the trunk and ear margin, a pendulous prepuce, enlarged nipples, unilateral scrotal testis, thoracolumbar kyphosis , and frequent urination were observed during a physical examination. A preputial swab showed an exfoliative cytology similar to the vaginal cytology of female dogs in estrus, which is different from that of normal males . An ill-defined margin and marked homogenous soft-tissue opacity of a mass (11 × 6 cm) in the right-middle abdomen resulted in left cranial displacement of a descending, transverse colon and stomach and left caudal displacement of the intestinal loops . The additional relatively well-defined homogenous soft-tissue opacity of a mass (6.4 × 4.3 cm) in the caudal abdomen at the L5 pelvic inlet level causing cranial displacement of the intestinal loops was detected via radiography . Ultrasonography showed two severely enlarged, heterogenous masses in the abdomen. The larger abdominal mass included multiple cystic lesions in the parenchyma with echogenic and anechoic fluid and moderate blood signals . Information about the other abdominal organs taken from the ultrasonography was limited due to the volume of the masses. The blood analysis results presented pancytopenia (Table 1 ). The serum estradiol concentration was 267.8 pg/mL, which is approximately 18 times higher than the upper margin of the reference interval. The testosterone level was 0.602 ng/mL, which is lower than the normal reference interval in intact males (Table 1 ) and within the reference range of a dog with a Sertoli cell tumor (SCT) (0.1–2 ng/mL ). Therefore, the mass in the abdomen was suspected to be an SCT secreting estradiol strongly. Despite the risk of complications during and after surgery due to pancytopenia and the old age of the patient, the owner wanted the mass to be removed to relieve the discomfort and complications caused by the mass. Thus, the coagulation time, such as PT/APTT, was analyzed for a laparotomy, and these values were in the normal range (Table 1 ). The mass was too large to be extracted via a routine laparotomy; accordingly, the incision line was extended to the xiphoid process cranially. The diaphragm was abnormally pushed forward by the mass which occupied almost the entire abdominal cavity. Stay sutures were applied to the mass to remove it from the abdominal cavity carefully . The mass was removed successfully, and then dissected . A pampiniform plexus-like vascular structure and a smooth muscle structure with a Y shape linked to the mass were found , and one of its horns was isolated from the mass. While the other horn remained intact, we moved to the caudal abdomen and found the urinary bladder was collapsed and unable to distend as well as bilateral prostatic enlargement with abscess . The dog became hypotensive during the removal of the prostatic abscess, so the surgical procedure, including removal of the entire uterus-suspected structure and draining of pus in the prostate, was stopped and transfusion, dopamine, dobutamine, and vasopressin were administered to overcome the hypotension. The patient recovered from hypotension, but cardiopulmonary arrest suddenly occurred 36 h after surgery. Although the cardiac and pulmonary function was recovered by cardiopulmonary cerebral resuscitation, the patient failed to recover his brain function and died within 12 h. Histologic examination of the suspected testicular tumor mass allowed diagnosis of the mass as a collision tumor of malignant seminoma with SCT . Fig. 2 Photographs from physical examination and preputial cytology of Case 2. a hyperkeratosis and alopecia in trunk and thoracolumbar kyphosis; b pendulous prepuce and enlarged nipples; c nucleated round epithelial cells and neutrophils in preputial cytology of normal male dog (× 200); d superficial epithelial cells in preputial cytology of Case 2 (× 200). Diff-quik stain was used for the cytology. Scale bar= 50 um Fig. 3 Ultrasonography and abdominal radiography findings in surgery and histological examination of the testicular tumor of Case 2. a abdominal mass including multiple cystic lesions with various echogenicities and blood signals. b and c kyphosis and ill-defined margin, marked homogenous soft tissue opacity of a mass in the right-middle abdomen (11 × 6 cm); d , e , and f exposed, removed, and dissected abdominal mass, respectively; g smooth muscle structure with Y shape connected to the mass; h urinary bladder that failed to distend and prostate containing pus; i collision tumor including malignant seminoma ( arrow ) and Sertoli cell tumor ( asterisk ) (× 12.5), scale bar = 400 um; j malignant seminoma (× 400), scale bar = 5 um
4.167969
0.952148
sec[1]/sec[1]/p[0]
en
0.999996
28576146
https://doi.org/10.1186/s12917-017-1068-6
[ "abdominal", "cytology", "abdomen", "tumor", "margin", "preputial", "which", "structure", "enlarged", "kyphosis" ]
[ { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "NB51.0&XA3KX0", "title": "Laceration without foreign body of abdominal wall" }, { "code": "NB9Y", "title": "Other specified injuries to the abdomen, lower back, lumbar spine or pelvis" }, { "code": "MB70.6", "title": "Abnormal cytological findings in cerebrospinal fluid" }, { "code": "MA16.Z", "title": "Cytological findings in blood, blood-forming organs, or the immune system, unspecified" }, { "code": "MF9C", "title": "Abnormal findings on cytological and histological examination of urine" }, { "code": "MA16.Y", "title": "Other specified cytological findings in blood, blood-forming organs, or the immune system" }, { "code": "MG66", "title": "Abnormal cytological findings in specimens from other organs, systems and tissues" } ]
=== ICD-11 CODES FOUND === [MD81.3] Acute abdomen Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain [JA01.0] Abdominal pregnancy Definition: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy. Also known as: Abdominal pregnancy | abdomen pregnancy | intraperitoneal pregnancy Excludes: Maternal care for viable fetus in abdominal pregnancy | Delivery of viable fetus in abdominal pregnancy [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS [NB9Y] Other specified injuries to the abdomen, lower back, lumbar spine or pelvis Also known as: Other specified injuries to the abdomen, lower back, lumbar spine or pelvis | Abdominal wall trauma | Injury of pelvic floor | pelvic floor blunt injury | pelvic floor blunt trauma [MB70.6] Abnormal cytological findings in cerebrospinal fluid Also known as: Abnormal cytological findings in cerebrospinal fluid [MA16.Z] Cytological findings in blood, blood-forming organs, or the immune system, unspecified Also known as: Cytological findings in blood, blood-forming organs, or the immune system, unspecified | Cytological findings in blood, blood-forming organs, or the immune system [MF9C] Abnormal findings on cytological and histological examination of urine Also known as: Abnormal findings on cytological and histological examination of urine [MA16.Y] Other specified cytological findings in blood, blood-forming organs, or the immune system Also known as: Other specified cytological findings in blood, blood-forming organs, or the immune system [MG66] Abnormal cytological findings in specimens from other organs, systems and tissues Also known as: Abnormal cytological findings in specimens from other organs, systems and tissues === GRAPH WALKS === --- Walk 1 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --PARENT--> [?] Symptoms or signs involving the digestive system or abdomen --- Walk 2 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --CHILD--> [MD81.0] Abdominal tenderness --- Walk 3 --- [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --EXCLUDES--> [?] Delivery of viable fetus in abdominal pregnancy Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the... --PARENT--> [?] Other assisted single delivery --- Walk 4 --- [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --EXCLUDES--> [?] Delivery of viable fetus in abdominal pregnancy Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the... --PARENT--> [?] Other assisted single delivery --- Walk 5 --- [ME04.Z] Ascites, unspecified --PARENT--> [ME04] Ascites Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma... --CHILD--> [ME04.Y] Other specified ascites --- Walk 6 --- [ME04.Z] Ascites, unspecified --PARENT--> [ME04] Ascites Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma... --PARENT--> [?] Symptoms related to the lower gastrointestinal tract or abdomen
[ "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --PARENT--> [?] Symptoms or signs involving the digestive system or abdomen", "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --CHILD--> [MD81.0] Abdominal tenderness", "[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --EXCLUDES--> [?] Delivery of viable fetus in abdominal pregnancy\n Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the...\n --PARENT--> [?] Other assisted single delivery", "[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --EXCLUDES--> [?] Delivery of viable fetus in abdominal pregnancy\n Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the...\n --PARENT--> [?] Other assisted single delivery", "[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --CHILD--> [ME04.Y] Other specified ascites", "[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --PARENT--> [?] Symptoms related to the lower gastrointestinal tract or abdomen" ]
MD81.3
Acute abdomen
[ { "from_icd11": "MD81.3", "icd10_code": "R100", "icd10_title": "Acute abdomen" }, { "from_icd11": "JA01.0", "icd10_code": "O0000", "icd10_title": "Abdominal pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.0", "icd10_code": "O000", "icd10_title": "Abdominal pregnancy" }, { "from_icd11": "ME04.Z", "icd10_code": "R180", "icd10_title": "Malignant ascites" }, { "from_icd11": "ME04.Z", "icd10_code": "R18", "icd10_title": "Ascites" }, { "from_icd11": "MB70.6", "icd10_code": "R836", "icd10_title": "Abnormal cytological findings in cerebrospinal fluid" }, { "from_icd11": "MF9C", "icd10_code": "R8281", "icd10_title": "Pyuria" }, { "from_icd11": "MF9C", "icd10_code": "R828", "icd10_title": "Abnormal findings on cytological and histological examination of urine" }, { "from_icd11": "MG66", "icd10_code": "R896", "icd10_title": "Abnormal cytological findings in specimens from other organs, systems and tissues" } ]
R100
Acute abdomen
An 82-year-old man with no symptoms visited our hospital for routine postoperative follow-up examinations after esophagectomy for esophageal cancer. At the age of 70, he had undergone thoracic esophagectomy trans right thoracic approach with gastric tube reconstruction via the antethoracic route. The follow-up upper gastrointestinal endoscopy showed a Type 0-IIc lesion measuring 30 mm in length in the lower part of the gastric tube , and histopathological examination of biopsy specimens revealed features consistent with poorly differentiated adenocarcinoma. The primary lesions could not be detected by computed tomography (CT), and there was no obvious lymph node metastasis or distant metastasis. We made the diagnosis of gastric tube cancer, B-12-O, Type 0-IIc, T1b, N0, M0, cStage IA (Japanese Classification of Gastric Carcinoma). Ideally, total resection of the gastric tube would have been indicated for the lesion, as it was a poorly differentiated adenocarcinoma with submucosal invasion. However, because of the advanced age of the patient (82 years), high surgical invasiveness of total resection of the gastric tube, and relatively early stage of the diagnosed cancer, we considered distal gastric tube resection with preservation of the RGEA as a potentially suitable surgical strategy for the patient. To examine the feasibility of performing such a surgical procedure, we repeated the upper gastrointestinal endoscopy and clipped the oral side of the tumor to confirm the location and extent of the lesion . Thereafter, an upper gastrointestinal series was performed to reconfirm the location of the clip, and we recognized that distal gastric tube resection could be surgically performed . 3D-CT angiography showed that the dominant region of supply of the RGEA was distributed towards the upper part of the gastric tube . Therefore, we determined that preservation of the RGEA would be required to perform distal gastric tube resection. A midline incision was made along the previous surgical scar, the abdomen was opened, dissection was performed around the gastric tube, and the RGEA was exposed. The RGEA supplying blood to the gastric tube was identified and preserved. The extent of the tumor was determined by palpation of the endoscopic clip, and elevation of the small intestine up to the chest wall was also confirmed. The dissection line of the gastric tube was determined to allow complete resection of the tumor, and several vessels branching from the RGEA and entering the gastric wall in the resection area were ligated. We did not perform the lymph node dissection and the sentinel node navigation surgery because of no perigastric lymph nodes recognized during the surgery and the risk of conversion to total resection of the gastric tube due to RGEA injury. The stomach on the oral side and duodenum on the anal side of the tumor were divided using an automatic suturing device, and the distal gastric tube resection was completed. The duodenal stump was closed as a blind end. The small intestine was pulled up to the chest wall and an antecolic Roux-en-Y reconstruction was completed . The operation time was 252 min, and the blood loss was 44 ml. The postoperative course was uneventful, and the patient was discharged on postoperative day 12. The histopathological diagnosis was gastric tube cancer, B-12-O, pType 0-IIa, por2 > tub1, pT1bN0M0, pStage 1A (Japanese Classification of Gastric Carcinoma) . No adjuvant chemotherapy was administered. The patient has remained free of recurrence until now, 17 months since the surgery. Fig. 1 Preoperative upper gastrointestinal endoscopy findings. A Type 0-IIc lesion of 30 mm in length was found in the lower part of the gastric tube, and pathological examination of biopsy specimen revealed poorly differentiated adenocarcinoma Fig. 2 Endoscopic clipping. Marking clipping on the oral side of the tumor was performed to confirm the location and extent of the lesion Fig. 3 Upper gastrointestinal series findings. We reconfirmed the location of the clip and recognized that performing the distal gastric tube resection may be possible Fig. 4 3D-CT angiography findings. The dominant region of the RGEA was distributed to the upper part of the gastric tube Fig. 5 Schema of distal gastric tube resection with preservation of the right gastroepiploic artery and Roux-en-Y reconstruction. The dissection line of reconstructed gastric tube, duodenum and the branches of the RGEA (dotted line). ( RGEA right gastroepiploic artery) Fig. 6 Pathological findings. Pathological examination of the resected material revealed poorly differentiated adenocarcinoma with submucosal invasion. a Macroscopic examination showed gastric tube cancer of 27 × 25 mm. b Hematoxylin and eosin staining results, ×4. c Hematoxylin and eosin staining results, ×20
4.058594
0.964844
sec[1]/p[0]
en
0.999998
34928456
https://doi.org/10.1186/s40792-021-01340-2
[ "gastric", "tube", "resection", "rgea", "cancer", "gastrointestinal", "lesion", "tumor", "part", "poorly" ]
[ { "code": "DA4Z", "title": "Diseases of stomach, unspecified" }, { "code": "DA60.Z", "title": "Gastric ulcer, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "LB13.Z", "title": "Structural developmental anomalies of stomach, unspecified" }, { "code": "DA42.73", "title": "Chronic atrophic gastritis of unknown aetiology" }, { "code": "GA07.Z&XA3EF0", "title": "Inflammatory disease of fallopian tube" }, { "code": "JA01.1", "title": "Tubal pregnancy" }, { "code": "GB90.Y", "title": "Other specified disorders of kidney or ureter" }, { "code": "GB54", "title": "Tubulo-interstitial nephritis, not specified as acute or chronic" }, { "code": "AB10.Z", "title": "Disorders of Eustachian tube, unspecified" } ]
=== ICD-11 CODES FOUND === [DA4Z] Diseases of stomach, unspecified Also known as: Diseases of stomach, unspecified | disorder of stomach | gastropathy NOS | gastric disease NOS | stomach disease NOS [DA60.Z] Gastric ulcer, unspecified Also known as: Gastric ulcer, unspecified | Gastric ulcer | stomach ulcer | Cushings ulcer | cushing's ulcer of stomach [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB13.Z] Structural developmental anomalies of stomach, unspecified Also known as: Structural developmental anomalies of stomach, unspecified | Structural developmental anomalies of stomach | Malformations of stomach [DA42.73] Chronic atrophic gastritis of unknown aetiology Definition: Persistent or recurrent inflammation of the gastric mucosa with atrophy leading to decreased hydrochloric acid concentration in the gastric juice. Atrophic gastritis frequently progresses from chronic gastritis. Also known as: Chronic atrophic gastritis of unknown aetiology | Gastric atrophy | atrophic gastritis | AG - [atrophic gastritis] | CAG - [chronic atrophic gastritis] Includes: Gastric atrophy [JA01.1] Tubal pregnancy Definition: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy. Also known as: Tubal pregnancy | Fallopian pregnancy | fallopian tube pregnancy | Tubal abortion | Rupture of fallopian tube due to pregnancy Includes: Fallopian pregnancy | Tubal abortion [GB90.Y] Other specified disorders of kidney or ureter Also known as: Other specified disorders of kidney or ureter | Other secondary disorders of kidney or ureter | Other disorders of kidney and ureter NEC | Inflammatory diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis | Infectious diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis [GB54] Tubulo-interstitial nephritis, not specified as acute or chronic Definition: A disease characterised by inflammation of and damage to tubules or the interstitium of the kidney while sparing the glomeruli secondary to immune reaction or toxic agent. Also known as: Tubulo-interstitial nephritis, not specified as acute or chronic | tubulo-interstitial nephritis | renal disease with interstitial nephritis | Congenital pyelitis | Cystopyelitis Excludes: calculous pyelonephritis [AB10.Z] Disorders of Eustachian tube, unspecified Also known as: Disorders of Eustachian tube, unspecified | Disorders of Eustachian tube | auditory tube disorder | disease of Eustachian tube | Eustachian tube dysfunction === GRAPH WALKS === --- Walk 1 --- [DA4Z] Diseases of stomach, unspecified --PARENT--> [?] Diseases of stomach Def: This is a group of conditions characterised as being in or associated with the stomach.... --EXCLUDES--> [?] Gastrostomy malfunction --- Walk 2 --- [DA4Z] Diseases of stomach, unspecified --PARENT--> [?] Diseases of stomach Def: This is a group of conditions characterised as being in or associated with the stomach.... --CHILD--> [DA40] Acquired anatomical alterations of the stomach Def: This group incorporates gastric disorders principally due to acquired morphological changes of the stomach.... --- Walk 3 --- [DA60.Z] Gastric ulcer, unspecified --PARENT--> [DA60] Gastric ulcer Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th... --EXCLUDES--> [?] Malignant neoplasms of stomach Def: A primary or metastatic malignant neoplasm involving the stomach.... --- Walk 4 --- [DA60.Z] Gastric ulcer, unspecified --PARENT--> [DA60] Gastric ulcer Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th... --CHILD--> [DA60.2] Helicobacter pylori associated and drug-induced gastric ulcer --- Walk 5 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.Y] Other specified acquired absence of organs --- Walk 6 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.Y] Other specified acquired absence of organs
[ "[DA4Z] Diseases of stomach, unspecified\n --PARENT--> [?] Diseases of stomach\n Def: This is a group of conditions characterised as being in or associated with the stomach....\n --EXCLUDES--> [?] Gastrostomy malfunction", "[DA4Z] Diseases of stomach, unspecified\n --PARENT--> [?] Diseases of stomach\n Def: This is a group of conditions characterised as being in or associated with the stomach....\n --CHILD--> [DA40] Acquired anatomical alterations of the stomach\n Def: This group incorporates gastric disorders principally due to acquired morphological changes of the stomach....", "[DA60.Z] Gastric ulcer, unspecified\n --PARENT--> [DA60] Gastric ulcer\n Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th...\n --EXCLUDES--> [?] Malignant neoplasms of stomach\n Def: A primary or metastatic malignant neoplasm involving the stomach....", "[DA60.Z] Gastric ulcer, unspecified\n --PARENT--> [DA60] Gastric ulcer\n Def: Gastric ulcer is defined as a distinct breach in the mucosa of the stomach as a result of caustic effects of acid and pepsin in the lumen. Histologically, gastric ulcer is identified as necrosis of th...\n --CHILD--> [DA60.2] Helicobacter pylori associated and drug-induced gastric ulcer", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.Y] Other specified acquired absence of organs", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.Y] Other specified acquired absence of organs" ]
DA4Z
Diseases of stomach, unspecified
[ { "from_icd11": "DA60.Z", "icd10_code": "K259", "icd10_title": "Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K255", "icd10_title": "Chronic or unspecified gastric ulcer with perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K254", "icd10_title": "Chronic or unspecified gastric ulcer with hemorrhage" }, { "from_icd11": "DA60.Z", "icd10_code": "K257", "icd10_title": "Chronic gastric ulcer without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K250", "icd10_title": "Acute gastric ulcer with hemorrhage" }, { "from_icd11": "DA60.Z", "icd10_code": "K256", "icd10_title": "Chronic or unspecified gastric ulcer with both hemorrhage and perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K253", "icd10_title": "Acute gastric ulcer without hemorrhage or perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K252", "icd10_title": "Acute gastric ulcer with both hemorrhage and perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K251", "icd10_title": "Acute gastric ulcer with perforation" }, { "from_icd11": "DA60.Z", "icd10_code": "K25", "icd10_title": "Gastric ulcer" }, { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" }, { "from_icd11": "LB13.Z", "icd10_code": "Q402", "icd10_title": "Other specified congenital malformations of stomach" }, { "from_icd11": "LB13.Z", "icd10_code": "Q403", "icd10_title": "Congenital malformation of stomach, unspecified" }, { "from_icd11": "DA42.73", "icd10_code": "K2940", "icd10_title": "Chronic atrophic gastritis without bleeding" }, { "from_icd11": "DA42.73", "icd10_code": "K2941", "icd10_title": "Chronic atrophic gastritis with bleeding" } ]
K259
Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation
An 82-year-old man with atrial fibrillation, emphysema, chronic heart failure-associated cardiomegaly, and a history of aortic stenting for an abdominal aortic aneurysm was found to have a lung tumor in the left upper lobe during a follow-up evaluation of the aortic stenting . The diagnosis was stage 1A2 (cT1bN0M0) primary lung squamous cell carcinoma. Edoxaban tosilate hydrate which had been used for the treatment of atrial fibrillation was discontinued the day before surgery. Then, continuous intravenous infusion of 10,000 units/day of heparin was started, which was terminated 9 h before surgery. No thrombus was detected on lower limb venous ultrasound, but his preoperative D-dimer was elevated to 9.3 μg/ml. He underwent a left upper lobectomy without mediastinal nodal dissection through a mini-thoracotomy. The incomplete anterior interlobar fissure was divided with three 45-mm Echelon Endopath TM cartridges (Ethicon, Cincinnati, OH, USA). The operative time was 189 min, and the intraoperative blood loss was 120 mL. Chest radiograph taken soon after the surgery showed that the chest tube was inserted in the direction of the apex with suction of − 10 cmH 2 O and that there was no worsening of cardiac enlargement . A total of 10,000 units/day of heparin infusion was re-started 3 h after the surgery, and the postoperative course was uneventful for approximately 14 h until the next morning when his blood pressure decreased to approximately 85/60 mmHg. Chest drain drainage in 14 h was 100 ml and serobloody. Although his blood pressure recovered to approximately 130/80 mmHg within 2 h, 28 h after the surgery, he suddenly lost consciousness, and his blood pressure decreased to approximately 75/40 mmHg. Enhanced computed tomography (CT) of the chest revealed cardiac tamponade with extravasation of the contrast agent at the apex of the heart . He was transferred to a tertiary care cardiac center where emergency surgery was performed, and a laceration was noted on the posterolateral branch of the left circumflex (LCX) artery . In addition, oozing was observed from the coronary vein and myocardia around the bleeding point of the LCX artery, and another laceration was found on the pericardium over the bleeding point of the LCX artery. No anomalies, such as an aneurysm, or significant calcifications existed around the LCX artery laceration. Although the coronary artery injury was successfully repaired, he had several postoperative complications, including gastrointestinal perforation, septic shock, respiratory failure, and renal failure. Despite intensive treatment, he died of multiple organ failure 35 days after the lung surgery. No malformed staples were identified on the staple lines even after careful palpation at the time of autopsy, but two staples at the multiple firing junction protruded perpendicularly to the cut surface . One of the two staples was formed firmly to the lung, which was painful for us to palpate . Fig. 1 a Preoperative chest computed tomography. A preoperative chest computed tomography shows a 1.5-mm solid nodule with spicula in the left upper lobe (white arrow). b Chest radiograph taken soon after the surgery. A chest radiograph taken soon after the surgery shows that the drain tube is inserted in the direction of the pulmonary apex and that there is no worsening of cardiac enlargement Fig. 2 a Postoperative chest computed tomography in axial section. A postoperative enhanced chest computed tomography reveals hemorrhagic cardiac tamponade and extravascular leakage of contrast agent (red arrow) is shown in the pericardium. The staple line dividing the interlobar fissure is shown by the white arrow. b Postoperative chest computed tomography in coronal section. A postoperative enhanced chest computed tomography in coronal section reveals that the hemorrhagic tamponade and extravascular leakage of contrast agent (red arrow) is located at the apex of the heart. c Intraoperative image of coronary artery repair. A laceration is noted on the posterolateral branch of the left circumflex artery and blood was spurting out (white arrow) Fig. 3 a Whole staple line dividing the anterior interlober fissure at the time of autopsy. The whole staple line dividing the anterior interlober fissure is shown at the time of autopsy. Two staples (white arrow) at the multiple firing junction protrude perpendicularly to the cut surface. The distal end of the staple line is ligated with silk. No malformed staples are noted even after careful palpation. b Enlarged image of two protruding staples at the multiple firing junction at the time of autopsy. An enlarged image of two protruding staples at the multiple firing junction are shown at the time of autopsy. One of the two staples is formed fimly to the lung and painful for us to palpate (white arrow)
4.03125
0.975586
sec[1]/p[0]
en
0.999998
PMC11533472
https://doi.org/10.1186/s44215-024-00143-9
[ "chest", "staples", "computed", "tomography", "artery", "arrow", "time", "postoperative", "lung", "blood" ]
[ { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB27", "title": "Pleural effusion" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "NA80.Y&XJ1C6", "title": "Thoracic haematoma" }, { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "BD52", "title": "Certain specified disorders of arteries or arterioles" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "BD52.2", "title": "Stricture of artery" }, { "code": "BD40.Z", "title": "Atherosclerotic chronic arterial occlusive disease, unspecified" } ]
=== ICD-11 CODES FOUND === [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB27] Pleural effusion Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate Includes: Pleurisy with effusion Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [BD52] Certain specified disorders of arteries or arterioles Also known as: Certain specified disorders of arteries or arterioles | Aortic dilatation - joint hypermobility - arterial tortuosity | Generalised arterial calcification of infancy | Median arcuate ligament syndrome | Aortic root abscess Excludes: collagen (vascular) diseases | Hypersensitivity angiitis | Acute arterial occlusion [BD52.3] Rupture of artery Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula Excludes: traumatic rupture of artery - see injury of blood vessel by body region [BD52.2] Stricture of artery Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery [BD40.Z] Atherosclerotic chronic arterial occlusive disease, unspecified Also known as: Atherosclerotic chronic arterial occlusive disease, unspecified | Atherosclerotic chronic arterial occlusive disease | arteriosclerosis, NOS | generalised atherosclerosis | atherosclerosis NOS === GRAPH WALKS === --- Walk 1 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes Def: !markdown In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre... --- Walk 2 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics --- Walk 3 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Chylous effusion Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho... --PARENT--> [?] Other pleural conditions Def: Any other condition effecting the thin serous membrane enveloping the lungs and lining the thoracic cavity... --- Walk 4 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Pleurisy Def: Pleurisy or Pleuritis is the medical term for inflammation of the pleura. The most common cause of pleuritis is infection, but it can also be caused by lupus, rheumatoid arthritis, and certain medicin... --CHILD--> [?] Subacute pleurisy --- Walk 5 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --PARENT--> [?] Lung infections Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source.... --RELATED_TO--> [?] Influenza Def: Any disease of the respiratory system, caused by an infection with influenza virus. These diseases are characterised by fever, cough, headache, myalgia, arthralgia, or malaise. Transmission is by inha... --- Walk 6 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with... --PARENT--> [?] Tuberculosis of the respiratory system Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....
[ "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...", "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Chylous effusion\n Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho...\n --PARENT--> [?] Other pleural conditions\n Def: Any other condition effecting the thin serous membrane enveloping the lungs and lining the thoracic cavity...", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Pleurisy\n Def: Pleurisy or Pleuritis is the medical term for inflammation of the pleura. The most common cause of pleuritis is infection, but it can also be caused by lupus, rheumatoid arthritis, and certain medicin...\n --CHILD--> [?] Subacute pleurisy", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --PARENT--> [?] Lung infections\n Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source....\n --RELATED_TO--> [?] Influenza\n Def: Any disease of the respiratory system, caused by an infection with influenza virus. These diseases are characterised by fever, cough, headache, myalgia, arthralgia, or malaise. Transmission is by inha...", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...\n --PARENT--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M...." ]
CB7Z
Diseases of the respiratory system, unspecified
[ { "from_icd11": "CB7Z", "icd10_code": "J989", "icd10_title": "Respiratory disorder, unspecified" }, { "from_icd11": "CB7Z", "icd10_code": "X", "icd10_title": "" }, { "from_icd11": "CB7Z", "icd10_code": "J09-J18", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J910", "icd10_title": "Malignant pleural effusion" }, { "from_icd11": "CB27", "icd10_code": "J918", "icd10_title": "Pleural effusion in other conditions classified elsewhere" }, { "from_icd11": "CB27", "icd10_code": "J90", "icd10_title": "Pleural effusion, not elsewhere classified" }, { "from_icd11": "CB27", "icd10_code": "J90-J94", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J91", "icd10_title": "Pleural effusion in conditions classified elsewhere" }, { "from_icd11": "CA44", "icd10_code": "J869", "icd10_title": "Pyothorax without fistula" }, { "from_icd11": "CA44", "icd10_code": "J860", "icd10_title": "Pyothorax with fistula" }, { "from_icd11": "CA44", "icd10_code": "J85-J86", "icd10_title": "" }, { "from_icd11": "CA44", "icd10_code": "J86", "icd10_title": "Pyothorax" }, { "from_icd11": "MD30.Z", "icd10_code": "R0781", "icd10_title": "Pleurodynia" }, { "from_icd11": "MD30.Z", "icd10_code": "R0782", "icd10_title": "Intercostal pain" }, { "from_icd11": "MD30.Z", "icd10_code": "R079", "icd10_title": "Chest pain, unspecified" } ]
J989
Respiratory disorder, unspecified
A 40-year-old woman with chronic kidney disease (unknown etiology) underwent haemodialysis treatment for eight years and, after that period, she received a kidney transplant from a deceased donor (DDKT). The patient had no family history of nephropathy. Ten years after this DDKT, there was graft loss due to chronic graft changes. She was submitted to haemodialysis for four more years and underwent a second DDKT. In this second transplant, rabbit antithymocyte globulin was used as induction therapy, and sodium mycophenolate, tacrolimus, and prednisone as maintenance immunosuppression. Two months later, she presented with antibody-mediated acute rejection (Banff 2 types I and II) and responded to treatment with prednisolone, plasmapheresis, and intravenous human immunoglobulin, maintaining stable creatinine around 1.6 mg/dL. One year after DDKT, she presented asthenia, myalgia, and a body temperature of 39ºC. Central nervous symptoms were absent. There was no hepato-splenomegaly or cutaneous lesions. Haemoglobin was 6.1 g/dL, MCV: 95 fL, leukocytes: 1.6 × 109/µL, neutrophils: 1.3 × 109/µL, platelets: 143 × 109/µL, reticulocyte count: 112 × 109/L and blood creatinine was 11.8 mg/dL requiring dialysis. The median of haematological parameters and body temperature is represented as the median (range minimum and maximum) during hospitalization (Table 1 ). The patient was not tested for EBV infection. Blood qPCR (quantitative real-time polymerase chain reaction) for cytomegalovirus (CMV) showed 5219 IU/Ml. Ganciclovir was started at 1.25 mg/kg/day and maintained for 21 days until qPCR became negative. Urine culture revealed > 100,000 cols of Escherichia coli and Klebsiella pneumoniae ; 5 days later, Acinetobacter baumanii and Klebsiella pneumoniae grew in the urine (sediment showed 135 leukocytes per higher power field). Thirteen days later, urine culture was negative, and thirty-two days later, urinary sediment showed no leukocytes. Blood culture was positive for oxacillin-resistant Staphylococcus haemolyticus. During these episodes of infection, the patient used ceftriaxone, cefepime, amikacin, and meropenem and required regular red blood cell transfusions. Blood counterimmune electrophoresis (fungal polysaccharide antigen search) was positive for Aspergillus sp (1/3). A computed tomography scan of the chest and abdomen revealed pulmonary nodules with suspicion of angioinvasive fungal infection and absence of organomegaly. The patient was treated with voriconazole. Fifteen days after the initial presentation, the immunosuppressants were discontinued, leaving only prednisone. The patient had a past medical history of hypertriglyceridemia and hyperferritinemia from the beginning of the second KT (kidney transplant). One year after the second KT, the patient had persistent hyperferritinemia (1,911 ng/mL – 3,268 ng/mL, median 2,093 ng/mL) and hypertriglyceridemia (113 mg/dL—397 mg/dL, median 239 mg/dL). A kidney biopsy (29 days after admission) revealed diffuse histiocytic infiltration and was negative for adenovirus, CMV, and Polyoma BK. Mononuclear cells of the interstitium in the kidney biopsy showed positivity for CD68 (histiocyte), and the biopsy was negative for S100 protein which ruled out Langerhans cell histiocytosis (LCH). A bone marrow aspirate smear revealed hemophagocytic figures, whereas bone marrow histology was normal (both procedures were performed 36 days after patient admission). The patient did not receive any other treatment, such as high-dose steroids or IVIG (Intravenous Immunoglobulin). The patient was discharged 40 days later, with haemoglobin 10.4 g/L, evolved with definitive graft loss, and has been on haemodialysis for three years since the onset of the massive histiocytes renal interstitial infiltration. Table 1 Laboratory data from the patient during the 40 days of admission at the hospital Variable Median Range (Min – Max) Reference value Temperature (ºC) 36.3 35–39 36–37.8 Haemoglobin (g/dL) 8.45 6.1–10.4 12.4–16.1 Hematocrit (%) 27 18–32 35.4–4.3 WBC (× 10 9 /µL) 2.9 0.6–12.8 4.05–11.84 Neutrophil(× 10 9 /µL) 1.95 0–11.8 1.7–7.2 Platelets (× 10 9 /µL) 157 91–283 203–445 PT 1.03 0.98–1.43 < 1.3 aPTT 1.22 0.96–1.8 < 1.26 Reference values according to the local university hospital laboratory WBC White Blood Cell counts, PT prothrombin time, aPTT activated partial thromboplastin time Fig. 1 A Glomerulus in the patterns of normality and interstitium expanded by numerous mononuclear cells—see arrows (Masson's trichome staining 40 × lens). B Mononuclear cells of the interstitium showed positivity for CD68 (histiocyte)—see arrows—and were negative for S100 protein (Immuno-histochemistry. 40 × lens). C Interstitium expanded by numerous mononuclear cells—see arrows—(hematoxylin and eosin staining 5 × lens; insert 100 × lens)
4.058594
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0.999996
36978015
https://doi.org/10.1186/s12882-023-03135-z
[ "blood", "kidney", "median", "ddkt", "mononuclear", "cells", "interstitium", "lens", "haemodialysis", "transplant" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "GB6Z", "title": "Kidney failure, unspecified" }, { "code": "LB30.1", "title": "Renal dysplasia" }, { "code": "NB92.0Y", "title": "Other specified injury of kidney" }, { "code": "LB30.7", "title": "Ectopic or pelvic kidney" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [GB6Z] Kidney failure, unspecified Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS [LB30.1] Renal dysplasia Definition: A condition characterised by abnormal development of one or both kidneys. Also known as: Renal dysplasia | congenital renal dysplasia | dysplasia of kidney | dysplastic kidney | Primary renal dysplasia Excludes: Autosomal dominant polycystic kidney disease [NB92.0Y] Other specified injury of kidney Also known as: Other specified injury of kidney | Injury of kidney without open wound into cavity | Injury of kidney with open wound into cavity | Haematoma of kidney | traumatic perirenal haematoma [LB30.7] Ectopic or pelvic kidney Definition: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones Also known as: Ectopic or pelvic kidney | Congenital displaced kidney | congenital misplaced kidney | congenital malposition of kidney | congenital prolapsed kidney Includes: Congenital displaced kidney | Malrotation of kidney === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Certain conditions originating in the perinatal period Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later.... --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.0] Finding of opiate drug in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Certain conditions originating in the perinatal period\n Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
A 72-year-old healthy farmer man presented with a painless slowly growing mass in his plantar aspect of right foot in May 2018. At first, the small soft tissue mass grew in the foot plantar location for approximately 6 months ago and then slowly developed in his heel during nine months ago. He is a farmer in the north of Iran, sometimes he worked on his farm with hard shoes or even without shoes in paddy rice. He told a persistent history of previous trauma to his foot plantar for a long time. Additionally, no history of cancer elicited. On physical examination, an 11 × 4.5 × 3 cm firm and irregular mass palpated on his right foot plantar that extended to heel overlying with unremarkable skin. The plain radiography of foot showed a large subcutaneous soft tissue mass in plantar area and heel, possibly with peripheral chunky calcification . Magnetic resonance images (MRI) displayed an irregular subcutis soft tissue mass extending from posterior lower leg to ankle, hind foot, and forefoot laterally and involving calcaneus inferiorly. The images showed heterogeneous and relatively hypointense signal intensity on T1-weighted images and hyperintense signal intensity on T2 . The lesion did not invade subjacent bone or muscle but extended into subcutaneous areas and providing extensive subcutis edema. Computed tomography (CT) of the chest, abdomen, and pelvis did not show metastatic or other lesions. Routine laboratory testing was unremarkable. The clinical and imaging findings were suggestive of a malignant soft tissue mass. The patient referred to our institute for biopsy. Due to the large size of the lesion, a core biopsy performed. Histopathology examination showed a malignant neoplasm characterized by the proliferation of anaplastic spindle cell with the presence of lacy osteoid matrix and immature bone. The mitotic activity (>10 mitoses per 10 high-power fields), and atypical mitotic figures noted. Immunohistochemistry analyses indicated that the tumor cells expressed CD99 (85%), osteocalcin (90%), and vimentin (95%) and didn't express smooth muscle actin (SMA), desmin, S100 protein, EMA, pan-cytokeratin, and PLAP. The stain for the Ki-67 analogous MIB-1 shows high proliferative activity with values around 30% . The patient was diagnosed with subcutaneous extraskeletal osteosarcoma as stage II, grade 3 (according to the World Health Organization system). The patient received adjuvant chemotherapy and radiotherapy preoperatively, although ESOs are relatively chemoresistant compared to osseous osteosarcomas. Four weeks later, the wide localized resection of the mass performed included an 8 cm skin graft. This resection included excision of the deep plantar fascia below the lesion. Grossly, the tumors were hemorrhagic and focally necrosis and firmly attached to the fascia, and it lied in contact with the periosteum of the calcaneus bone. The connective tissue capsule surrounded the tumor and adhered to the subjacent structures that made surgical dissection difficult . However, the tumor infiltrates to the subcutis. There was no evidence of overlying skin ulceration. Histologically, all the mass sections showed 95% tumor necrosis. (Percentage of tumor necrosis, as follows: a good responder, ≥90%, or a poor responder, <90%). Two weeks after surgery, a postoperative MRI showed only edema which was related to soft tissue congestion. No areas of suspicious enhancement or inguinal lymphadenopathy were seen. Fig. 1 Plain radiograph: Anteroposterior views show soft tissue mass in plantar and heel of right foot (A), lateral view shows subcutaneous soft tissue mass in foot plantar and heel with slight calcaneus periosteal irregularity of calcaneus bone (B). Fig. 1 Fig. 2 T1- and T2-weighted MRI in sagittal (A, B) and axial (c) planes demonstrating a large soft tissue mass superficial to the deep plantar fascial plane and embedded within the subcutaneous and deep dermis tissue. The lesion has a low signal intensity on T1weighted images (A) and heterogeneous signal intensity on T2-weighted images (B, C). Fig. 2 Fig. 3 Microscopic appearance of subcutaneous soft tissue tumor shows osteoid formation surrounded by malignant osteoblastic cells without interposition of cartilage (A, B) (HE, ×100), (C) (HE, ×200), neoplastic cells with marked atypia (pleomorphic, hyperchromatic) and bizarre giant tumor cells noted (D) (HE, ×200). Immunohistochemistry staining: cytoplasmic positive immunoreactivity of CD99 in tumoral cells of osteosarcoma (IHC ×200) (E), cytoplasmic positive immunoreactivity of osteocalcin in tumoral cells of osteosarcoma (IHC ×200) (F). Fig. 3 Fig. 4 Intraoperative macroscopic appearance of subcutaneous soft tissue tumor indicates tumor was marginally resected and preserved the major neuro-vascular bundles, tendons and muscles (A, B). Fig. 4
4.085938
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33076190
https://doi.org/10.1016/j.ijscr.2020.09.062
[ "tissue", "soft", "plantar", "tumor", "foot", "subcutaneous", "cells", "heel", "calcaneus", "signal" ]
[ { "code": "FB6Z", "title": "Soft tissue disorders, unspecified" }, { "code": "MC85", "title": "Gangrene" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" }, { "code": "4A43.3", "title": "Mixed connective tissue disease" }, { "code": "FB56.1", "title": "Residual foreign body in soft tissue" }, { "code": "FB52", "title": "Soft tissue disorders in diseases classified elsewhere" }, { "code": "1E80.1", "title": "Plantar warts" }, { "code": "8C11.6", "title": "Lesion of plantar nerve" }, { "code": "ED55.Z", "title": "Palmoplantar keratoderma, unspecified" } ]
=== ICD-11 CODES FOUND === [FB6Z] Soft tissue disorders, unspecified Also known as: Soft tissue disorders, unspecified | disease of soft tissue NOS | unspecified soft tissue disorder, site unspecified | disorder of soft tissue | disorder of soft tissue NOS [MC85] Gangrene Definition: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply. Also known as: Gangrene | gangrene NOS | dry gangrene | wet gangrene | ulcerative gangrene Excludes: Pyoderma gangrenosum | Gas gangrene | Polymicrobial necrotising fasciitis [FB56.6] Other specified soft tissue disorders Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease [4A43.3] Mixed connective tissue disease Definition: Mixed connective tissue disease is an overlapping syndrome combining features of systemic lupus erythematosus, systemic sclerosis, and polymyositis with the presence of autoantibodies to U1-ribonucleoprotein. Raynaud’s phenomenon is seen in nearly all patients and pulmonary arterial hypertension is the most common cause of death in MCTD patients. Also known as: Mixed connective tissue disease | Sharp syndrome | MCTD - [mixed connective tissue disease] | Paediatric-onset mixed connective tissue disease | Paediatric-onset Sharp syndrome [FB56.1] Residual foreign body in soft tissue Also known as: Residual foreign body in soft tissue | residual foreign body in soft tissue, site unspecified | foreign body in soft tissue | Residual foreign body in soft tissue, multiple sites | Residual foreign body in soft tissue, shoulder region Excludes: Foreign body granuloma of skin | Foreign body granuloma of soft tissue, not elsewhere classified [FB52] Soft tissue disorders in diseases classified elsewhere Definition: This is a group of disorders affecting tissues that connect, support, or surround other structures and organs of the body, not being bone and occur in diseases classified elsewhere. Also known as: Soft tissue disorders in diseases classified elsewhere [1E80.1] Plantar warts Definition: Viral warts affecting the plantar surfaces of the feet including the weight-bearing skin of the toes. They are often painful and are difficult to eradicate. In most cases, however, they do eventually resolve spontaneously. Also known as: Plantar warts | Verruca plantaris | Verrucae on sole of foot | Mosaic plantar warts [8C11.6] Lesion of plantar nerve Definition: Disease or damage to the medial and/or lateral plantar nerves, branches of the tibial nerve below the level of the tarsal tunnel secondary to insult. Also known as: Lesion of plantar nerve | Lesion of lateral plantar nerve | Lesion of medial plantar nerve | Morton metatarsalgia | Morton neuroma Excludes: Tarsal tunnel syndrome | Injury of lateral plantar nerve | Injury of medial plantar nerve [ED55.Z] Palmoplantar keratoderma, unspecified Also known as: Palmoplantar keratoderma, unspecified | Palmoplantar keratodermas | Hyperkeratosis of palms and soles | Palmoplantar hyperkeratosis | Palmar hyperkeratosis === GRAPH WALKS === --- Walk 1 --- [FB6Z] Soft tissue disorders, unspecified --PARENT--> [?] Soft tissue disorders --CHILD--> [?] Miscellaneous specified soft tissue disorders Def: This is a group of other disorders, which are not defined elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --- Walk 2 --- [FB6Z] Soft tissue disorders, unspecified --PARENT--> [?] Soft tissue disorders --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --- Walk 3 --- [MC85] Gangrene Def: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply.... --PARENT--> [?] Symptoms or signs involving the circulatory system --RELATED_TO--> [?] Fear of cardiovascular disease --- Walk 4 --- [MC85] Gangrene Def: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply.... --EXCLUDES--> [?] Gas gangrene Def: Gas gangrene or clostridial myonecrosis is a potentially fatal, rapidly progressive necrotizing infection of muscle and soft tissue resulting from bacterial invasion of healthy muscle from adjacent tr... --PARENT--> [?] Other bacterial diseases --- Walk 5 --- [FB56.6] Other specified soft tissue disorders --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --EXCLUDES--> [?] Radiculopathy --- Walk 6 --- [FB56.6] Other specified soft tissue disorders --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone.... --CHILD--> [FB56.2] Myalgia Def: This is a disorder characterised by pain in a muscle or group of muscles....
[ "[FB6Z] Soft tissue disorders, unspecified\n --PARENT--> [?] Soft tissue disorders\n --CHILD--> [?] Miscellaneous specified soft tissue disorders\n Def: This is a group of other disorders, which are not defined elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....", "[FB6Z] Soft tissue disorders, unspecified\n --PARENT--> [?] Soft tissue disorders\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....", "[MC85] Gangrene\n Def: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply....\n --PARENT--> [?] Symptoms or signs involving the circulatory system\n --RELATED_TO--> [?] Fear of cardiovascular disease", "[MC85] Gangrene\n Def: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply....\n --EXCLUDES--> [?] Gas gangrene\n Def: Gas gangrene or clostridial myonecrosis is a potentially fatal, rapidly progressive necrotizing infection of muscle and soft tissue resulting from bacterial invasion of healthy muscle from adjacent tr...\n --PARENT--> [?] Other bacterial diseases", "[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --EXCLUDES--> [?] Radiculopathy", "[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --CHILD--> [FB56.2] Myalgia\n Def: This is a disorder characterised by pain in a muscle or group of muscles...." ]
FB6Z
Soft tissue disorders, unspecified
[ { "from_icd11": "FB6Z", "icd10_code": "M60-M79", "icd10_title": "" }, { "from_icd11": "MC85", "icd10_code": "R02", "icd10_title": "" }, { "from_icd11": "MC85", "icd10_code": "I96", "icd10_title": "Gangrene, not elsewhere classified" }, { "from_icd11": "FB56.6", "icd10_code": "M7981", "icd10_title": "Nontraumatic hematoma of soft tissue" }, { "from_icd11": "FB56.6", "icd10_code": "M7989", "icd10_title": "Other specified soft tissue disorders" }, { "from_icd11": "FB56.6", "icd10_code": "M798", "icd10_title": "Other specified soft tissue disorders" }, { "from_icd11": "GB61.Z", "icd10_code": "N183", "icd10_title": "Chronic kidney disease, stage 3 (moderate)" }, { "from_icd11": "GB61.Z", "icd10_code": "N189", "icd10_title": "Chronic kidney disease, unspecified" }, { "from_icd11": "GB61.Z", "icd10_code": "N250", "icd10_title": "Renal osteodystrophy" }, { "from_icd11": "GB61.Z", "icd10_code": "N18", "icd10_title": "Chronic kidney disease (CKD)" }, { "from_icd11": "4A43.3", "icd10_code": "M351", "icd10_title": "Other overlap syndromes" }, { "from_icd11": "4A43.3", "icd10_code": "M35", "icd10_title": "Other systemic involvement of connective tissue" }, { "from_icd11": "FB56.1", "icd10_code": "M795", "icd10_title": "Residual foreign body in soft tissue" }, { "from_icd11": "FB52", "icd10_code": "M73", "icd10_title": "" }, { "from_icd11": "FB52", "icd10_code": "M738", "icd10_title": "" } ]
M60-M79
A 58-year-old man previously underwent left axillary-bilateral femoral artery bypass grafting at another hospital for atypical coarctation due to Takayasu’s arteritis. He was re-hospitalized approximately 10 years later due to heart failure, and a progressive decrease in left ventricular contractility was observed, with the left ventricular ejection fraction (LVEF) decreasing from 54 to 28%. Although multiple antihypertensive drugs were administered, he was referred to our hospital to investigate the cause of the progressive decrease in left ventricular contractility and repeated heart failure due to poor blood pressure control. He had comorbidities, including pemphigoid. 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET-CT) performed at the previous hospital did not detect an accumulation of 18 F-FDG in the aorta. His laboratory data were as follows: creatinine, 2.93 mg/dL; blood urea nitrogen, 65.7 mg/dL; estimated glomerular filtration rate, 19 mL/min/1.73 m 2 ; C-reactive protein (CRP), 0.54 mg/dL; N-terminal pro-brain natriuretic peptide (NT-pro BNP), 17,014 pg/mL; aldosterone, 119 (reference value 36–240) pg/ml; and plasma renin activity, 10.6 (reference value 0.2–2.3) ng/ml/h. His blood pressure values were as follows: right upper limb, 168/108 mmHg; upper left limb, 169/99 mmHg; right lower limb, 143/98 mmHg; and left lower limb, 131/101 mmHg. The ankle brachial index (ABI) values of the right and left were 0.85 and 0.78, respectively. Preoperative transthoracic echocardiography showed a LVEF of 28%. There was no left ventricular asynergy, and the wall motion showed diffuse severe hypokinesis. Left ventricular wall thickness of the interventricular septum (IVS) and posterior wall (PW) were 13 mm and 12 mm, respectively. Left ventricular hypertrophy was also observed. The left ventricular end diastolic and systolic diameters (LVDd and LVDs) were 57.4 mm and 47.5 mm, respectively, and left ventricular enlargement was detected. No significant valvular dysfunction was observed. Contrast-enhanced CT showed a patent left axillary artery—both femoral artery bypass and collateral circulation to the lower extremity artery . Significant calcification was observed from the distal thoracic descending aorta to the abdominal aorta, and severe stenosis was suspected at the same site . Aortography showed severe stenosis of the aorta from below the celiac artery to the abdominal aorta below the renal artery. Blood flow in the superior mesenteric artery flowed from the well-developed collateral circulation from the celiac artery, and flow imaging of the bilateral renal arteries was delayed . Coronary angiography showed no abnormal findings, including at the entrance. Contrast-enhanced cardiac magnetic resonance imaging (MRI) revealed no apparent delayed contrast on the left ventricular wall, and T1 mapping images of cardiac MRI presented no significant increase in the T1 value on the left ventricular wall (1,050 ms by 1.5 T modified Look-Locker inversion recovery method; the average value of normal control at our hospital was 1,000 ms), and fibrosis of the left ventricular wall was considered mild . Although CRP was weakly positive, CT showed only severe calcification of the aorta, and PET-CT performed at the previous hospital did not show active inflammation in the aorta due to Takayasu’s arteritis. Therefore, we decided to perform open surgery for uncontrolled renal hypertension and a progressive decrease in left ventricular contractility due to decreased bilateral renal blood flow. To reliably reduce afterload, we performed descending thoracic aorta-abdominal aorta bypass using a large-diameter graft and revascularization of the bilateral renal arteries via the great saphenous vein grafts. Fig. 1 Preoperative computed tomography. a Preoperative 3D-CT showing the patent left axillary artery-bilateral common femoral artery bypass. Many collateral circulations to the lower extremity arteries are present. b 3D-CT of the thoracoabdominal aorta showing a high degree of calcification and stenosis around the descending aorta to the abdominal aorta (arrowhead) Fig. 2 Preoperative aortography, magnetic resonance imaging, and postoperative computed tomography. a Aortography showing the superior mesenteric artery (SMA) imaged by the well-developed collateral circulation from the celiac artery (CA). Bilateral renal arteriography was delayed. Severe stenosis is observed in the epigastric aorta of the renal artery (arrowhead). b T1 mapping images on visceral MRI shows a slight increase in the T1 value of the left ventricular wall and no fibrosis progression on the left ventricular wall. c Postoperative 3D-CT showing that the descending thoracic aorta-abdominal aorta bypass and bilateral renal artery bypass were patent
4.164063
0.963379
sec[1]/p[0]
en
0.999995
34348745
https://doi.org/10.1186/s13019-021-01598-5
[ "aorta", "artery", "ventricular", "wall", "renal", "bypass", "blood", "abdominal", "tomography", "limb" ]
[ { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "LA8A.3", "title": "Congenital supravalvar aortic stenosis" }, { "code": "BD40.1", "title": "Atherosclerosis of aorta" }, { "code": "BB71.Z", "title": "Aortic valve insufficiency, unspecified" }, { "code": "LA8B.2Y", "title": "Other specified congenital anomaly of aorta or its branches" }, { "code": "BD52", "title": "Certain specified disorders of arteries or arterioles" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "BD52.2", "title": "Stricture of artery" }, { "code": "BD40.Z", "title": "Atherosclerotic chronic arterial occlusive disease, unspecified" }, { "code": "LA89.Z", "title": "Functionally univentricular heart, unspecified" } ]
=== ICD-11 CODES FOUND === [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [LA8A.3] Congenital supravalvar aortic stenosis Definition: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalvar aortic stenosis' is described as three forms: an hourglass deformity, a fibrous membrane, and a diffuse narrowing of the ascending aorta. Supravalvar aortic stenosis may involve the coronary artery ostia, and the aortic leaflets may be tethered. The coronary arteries can become tortuous and dilate Also known as: Congenital supravalvar aortic stenosis | stenosis of aorta | supravalvular aortic stenosis | stricture of aorta | congenital narrowed aorta Excludes: Congenital aortic valvar stenosis [BD40.1] Atherosclerosis of aorta Also known as: Atherosclerosis of aorta | aorta atheroma | aorta calcification | aorta arteriosclerosis | aortic degeneration [BB71.Z] Aortic valve insufficiency, unspecified Also known as: Aortic valve insufficiency, unspecified | Aortic valve insufficiency | aortic insufficiency | aortic valve incompetency | AI - [aortic incompetence] [LA8B.2Y] Other specified congenital anomaly of aorta or its branches Also known as: Other specified congenital anomaly of aorta or its branches | Congenital anomaly of ascending aorta | Hypoplasia of ascending aorta | Congenital ascending aorta aneurysm or dilation | congenital ascending aortic aneurysm or dilation [BD52] Certain specified disorders of arteries or arterioles Also known as: Certain specified disorders of arteries or arterioles | Aortic dilatation - joint hypermobility - arterial tortuosity | Generalised arterial calcification of infancy | Median arcuate ligament syndrome | Aortic root abscess Excludes: collagen (vascular) diseases | Hypersensitivity angiitis | Acute arterial occlusion [BD52.3] Rupture of artery Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula Excludes: traumatic rupture of artery - see injury of blood vessel by body region [BD52.2] Stricture of artery Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery [BD40.Z] Atherosclerotic chronic arterial occlusive disease, unspecified Also known as: Atherosclerotic chronic arterial occlusive disease, unspecified | Atherosclerotic chronic arterial occlusive disease | arteriosclerosis, NOS | generalised atherosclerosis | atherosclerosis NOS [LA89.Z] Functionally univentricular heart, unspecified Also known as: Functionally univentricular heart, unspecified | Functionally univentricular heart | Univentricular cardiopathy | Single ventricle | univentricular heart === GRAPH WALKS === --- Walk 1 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [BD50] Aortic aneurysm or dissection Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ... --- Walk 2 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --EXCLUDES--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --- Walk 3 --- [LA8A.3] Congenital supravalvar aortic stenosis Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalva... --EXCLUDES--> [?] Congenital aortic valvar stenosis Def: A congenital cardiovascular malformation of the aortic valve in which there is narrowing or stricture (obstruction to flow). Additional information: 'Congenital aortic valvar stenosis' arises most co... --PARENT--> [?] Congenital anomaly of aortic valve Def: A congenital cardiovascular malformation where the aortic valve is abnormal.... --- Walk 4 --- [LA8A.3] Congenital supravalvar aortic stenosis Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalva... --PARENT--> [LA8A] Congenital anomaly of a ventriculo-arterial valve or adjacent regions Def: A congenital cardiovascular malformation of a ventriculo-arterial valve or its immediate subvalvar and supravalvar regions.... --EXCLUDES--> [?] Common arterial trunk Def: A congenital cardiovascular malformation in which a single arterial trunk arises from the heart, giving origin sequentially to the coronary arteries, one or more pulmonary arteries, and the systemic a... --- Walk 5 --- [BD40.1] Atherosclerosis of aorta --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease --EXCLUDES--> [?] Chronic vascular disorders of intestine --- Walk 6 --- [BD40.1] Atherosclerosis of aorta --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease --RELATED_TO--> [?] Atherosclerotic retinopathy Def: This is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol, and causes persistent or acute damage to the retina of the eye....
[ "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD50] Aortic aneurysm or dissection\n Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ...", "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --EXCLUDES--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....", "[LA8A.3] Congenital supravalvar aortic stenosis\n Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta.\n\nAdditional information: 'Congenital supravalva...\n --EXCLUDES--> [?] Congenital aortic valvar stenosis\n Def: A congenital cardiovascular malformation of the aortic valve in which there is narrowing or stricture (obstruction to flow).\n\nAdditional information: 'Congenital aortic valvar stenosis' arises most co...\n --PARENT--> [?] Congenital anomaly of aortic valve\n Def: A congenital cardiovascular malformation where the aortic valve is abnormal....", "[LA8A.3] Congenital supravalvar aortic stenosis\n Def: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta.\n\nAdditional information: 'Congenital supravalva...\n --PARENT--> [LA8A] Congenital anomaly of a ventriculo-arterial valve or adjacent regions\n Def: A congenital cardiovascular malformation of a ventriculo-arterial valve or its immediate subvalvar and supravalvar regions....\n --EXCLUDES--> [?] Common arterial trunk\n Def: A congenital cardiovascular malformation in which a single arterial trunk arises from the heart, giving origin sequentially to the coronary arteries, one or more pulmonary arteries, and the systemic a...", "[BD40.1] Atherosclerosis of aorta\n --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease\n --EXCLUDES--> [?] Chronic vascular disorders of intestine", "[BD40.1] Atherosclerosis of aorta\n --PARENT--> [BD40] Atherosclerotic chronic arterial occlusive disease\n --RELATED_TO--> [?] Atherosclerotic retinopathy\n Def: This is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol, and causes persistent or acute damage to the retina of the eye...." ]
BD5Z
Diseases of arteries or arterioles, unspecified
[ { "from_icd11": "BD5Z", "icd10_code": "I7389", "icd10_title": "Other specified peripheral vascular diseases" }, { "from_icd11": "BD5Z", "icd10_code": "I7419", "icd10_title": "Embolism and thrombosis of other parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7411", "icd10_title": "Embolism and thrombosis of thoracic aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7410", "icd10_title": "Embolism and thrombosis of unspecified parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7381", "icd10_title": "Erythromelalgia" }, { "from_icd11": "BD5Z", "icd10_code": "I745", "icd10_title": "Embolism and thrombosis of iliac artery" }, { "from_icd11": "BD5Z", "icd10_code": "I789", "icd10_title": "Disease of capillaries, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I748", "icd10_title": "Embolism and thrombosis of other arteries" }, { "from_icd11": "BD5Z", "icd10_code": "I749", "icd10_title": "Embolism and thrombosis of unspecified artery" }, { "from_icd11": "BD5Z", "icd10_code": "I781", "icd10_title": "Nevus, non-neoplastic" }, { "from_icd11": "BD5Z", "icd10_code": "I788", "icd10_title": "Other diseases of capillaries" }, { "from_icd11": "BD5Z", "icd10_code": "I744", "icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I70-I79", "icd10_title": "" }, { "from_icd11": "BD5Z", "icd10_code": "I74", "icd10_title": "Arterial embolism and thrombosis" }, { "from_icd11": "BD5Z", "icd10_code": "I73", "icd10_title": "Other peripheral vascular diseases" } ]
I7389
Other specified peripheral vascular diseases
A 47-year-old man was referred to our interventional radiology department for an incidentally discovered visceral aneurysm. Five months prior, he had reported somatic fractures of T12 and L1 as a consequence of a motorbike accident and was treated with vertebral fusion with rods and screws. Contrast multislice computed tomography performed during rehabilitation revealed a 2.8-cm saccular aneurysm directly connecting the proximal SMA with the CA, which was critically compressed by the median arcuate ligament . The patient was hemodynamically stable (BP, 128/86; HR, 77) and asymptomatic, and laboratory test results were within normal limits. The patient was diagnosed with Bühler aneurysm. The endovascular approach was chosen after a multidisciplinary consultation with abdominal and vascular surgeons and patient counseling. Right transfemoral aortography was performed under local anesthesia. After a failed attempt to catheterize the CA, an injection after SMA engagement showed a saccular AOB aneurysm interposed between the superior wall of the SMA and the inferior floor of the post-stenotic CA. A retrograde high flow running from the SMA to the common hepatic and splenic arteries was observed. The aneurysm involved a 3-cm-long AOB. No takeoff or landing zone for direct stent-graft sealing of the Bühler aneurysm was observed in this anatomic presentation. Conventional coiling was attempted; however, the detachable coils prolapsed from the aneurysm and were withdrawn before detachment. At this point, the sheath was upsized to a 45-cm-long 10-Fr armed sheath (Super Arrow-Flex, Arrow) . A self-expandable 9 × 50-mm polytetrafluoroethylene (PTFE) stent graft (Viabahn; Gore, Phoenix, AZ, USA) was deployed in the SMA in the LL projection. The length of the Viabahn was chosen to exclude the AOB while preserving the flow in the pancreaticoduodenal arcades. A 0.035-inch Amplatz guidewire was left as a safety wire in the SMA through the SG. Then, a pre-curved 5-Fr catheter (Glidecath; Terumo) was advanced parallel to the safety wire and wedged between the Viabahn and the native wall. A 2.7-Fr microcatheter (Progreat; Terumo, Ja) pre-charged with a 0.014-inch Pilot guidewire was then coaxially advanced through the 5-Fr catheter alongside the stent graft in a periprosthetic manner. Once the Progreat tip was inside the saccular aneurysm, framing and packed coiling of the AOB aneurysm were achieved by releasing an overall length of 385 cm of detachable coils . A 9 × 20-mm angioplasty balloon was then inflated at a low pressure inside the Viabahn for better wall apposition. Completion angiography showed a patent mesenteric stent graft with retrograde opacification of the CA and no residual backflow inside the aneurysm. Femoral hemostasis was achieved using an 8-Fr Angio-Seal (Terumo). The patient was discharged 2 days later, and he was given dual antiplatelets for 3 months and lifelong cardioaspirin. Follow-up clinical and instrumental imaging tests were scheduled, and the last computed tomography angiogram performed 9 years later ruled out aneurysm enlargement or reperfusion with regular patency of the Viabahn and CAs . Fig. 1 Preoperative imaging of the arch of Bühler (AOB) aneurysm. A Contrast sagittal CT-scan showing a 2.8 cm saccular aneurysm (arrowhead) without mural thrombus originating from SMA. Substantial pre-occlusive stenosis of celiac trunk (arrow) by LAM. B Pre stenting selective angiography of SMA, in AP projection (accessory right hepatic artery (black arrow)), and oblique projection C allows insight into this anatomy variant. A 0.035 “Amplatz guidewire as safety wire is stabilized in SMA (white arrowhead) while the working 0.014”micro-guidewire end in splenic artery (white arrow) after looping inside the aneurysm. A small accessory right hepatic artery (black arrow) is also present. D Its origin (arrowhead) on VR3D reconstruction was thereafter covered by Viabahn without consequences Fig. 2 Operative imaging. A Angiography in LL projection: Viabahn is positioned over the safety wire before deployment bridging the micro guidewire left inside the aneurysm. Rods and screws for osteosynthesis in vertebral bodies are visible. B Schematic drawing after Viabahn deployment. The 5 Fr catheter-microcatheter coaxial system (white arrowhead) is wedged between the stentgraft and the artery wall while the armed 10 Fr sheath ( black arrow) is maintained in place by the safety wire (white arrow) in SMA. C Final control angiography. Injection through the sheath after high density packed coiling of the AOB aneurysm on image. D Final schematic drawing of aneurysm exclusion Fig. 3 Contrast CT-scan sagittal reconstruction of SMA at 9 year follow-up showing the Viabahn patency. Imaging is noised by coils and orthopedic devices (*). Patient remains asymptomatic
4.046875
0.960449
sec[1]/p[0]
en
0.999996
38198119
https://doi.org/10.1186/s42155-023-00416-4
[ "aneurysm", "viabahn", "arrow", "guidewire", "safety", "wire", "inside", "saccular", "wall", "stent" ]
[ { "code": "BD51.Z", "title": "Aneurysm and dissection of unspecified artery" }, { "code": "BD75.Y", "title": "Venous varicosities of other specified sites" }, { "code": "BA81", "title": "Coronary artery aneurysm" }, { "code": "BB02.1Z", "title": "Aneurysm of pulmonary artery, unspecified" }, { "code": "BD51.4", "title": "Aneurysm or dissection of renal artery" }, { "code": "QB84", "title": "Follow-up care involving removal of fracture plate or other internal fixation device" }, { "code": "9B71.1&XS5S", "title": "Hypertensive Retinopathy, Stage 2, focal arteriolar narrowing, marked generalised arteriolar narrowing, arteriovenous nicking, opacity, “copper wiring” of arteriolar wall, or a combination of these signs" }, { "code": "DB60.2", "title": "Third degree haemorrhoids" }, { "code": "CA24", "title": "Bronchiectasis" }, { "code": "8B22.6", "title": "Familial cerebral saccular aneurysm" } ]
=== ICD-11 CODES FOUND === [BD51.Z] Aneurysm and dissection of unspecified artery Also known as: Aneurysm and dissection of unspecified artery | Arterial aneurysm or dissection, excluding aorta | cirsoid aneurysm NOS | false aneurysm NOS | ruptured aneurysm NOS [BD75.Y] Venous varicosities of other specified sites Also known as: Venous varicosities of other specified sites | Caput medusae | Jugular venous aneurysm | jugular vein aneurysm | Orbital varices [BA81] Coronary artery aneurysm Definition: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. Also known as: Coronary artery aneurysm | aneurysm of coronary vessels | aneurysmal lesion of coronary artery | arteriovenous aneurysm of coronary vessels | coronary aneurysm Excludes: Congenital coronary arterial aneurysm | Mucocutaneous lymph node syndrome [BB02.1Z] Aneurysm of pulmonary artery, unspecified Also known as: Aneurysm of pulmonary artery, unspecified | Aneurysm of pulmonary artery | pulmonary artery aneurysm | PA - [pulmonary artery aneurysm] | pulmonary aneurysm [BD51.4] Aneurysm or dissection of renal artery Also known as: Aneurysm or dissection of renal artery | aneurysm of renal artery | renal artery aneurysm | renal aneurysm [QB84] Follow-up care involving removal of fracture plate or other internal fixation device Also known as: Follow-up care involving removal of fracture plate or other internal fixation device | Change of internal fixation device | change of fixation device | change of Kirschner wire | Checking of internal fixation device Excludes: removal of external fixation device [DB60.2] Third degree haemorrhoids Definition: (grade III): Third-degree haemorrhoids remain prolapsed unless pushed gently back into the anal canal, and they can be reduced manually. Also known as: Third degree haemorrhoids | stage III haemorrhoids | grade III haemorrhoids | Haemorrhoids (bleeding) that prolapse with straining, and require manual reduction back inside the anal canal Includes: Haemorrhoids (bleeding) that prolapse with straining, and require manual reduction back inside the anal canal [CA24] Bronchiectasis Definition: Bronchiectasis is an abnormal widening of one or more airways. Normally, tiny glands in the lining of the airways make a small amount of mucus. Mucus keeps the airways moist and traps any dust and dirt in the inhaled air. Because bronchiectasis creates an abnormal widening of the airways, extra mucus tends to form and pool in parts of the widened airways. Widened airways with extra mucus are prone to infection. Also known as: Bronchiectasis | bronchiectasis NOS | Bronchiectasis with airway obstruction | Dilatation of bronchus | bronchial dilatation Excludes: tuberculous bronchiectasis, confirmed | Respiratory tuberculosis, not confirmed [8B22.6] Familial cerebral saccular aneurysm Definition: These are pouch-like expansions of arteries inside the skull that are familial. Also known as: Familial cerebral saccular aneurysm === GRAPH WALKS === --- Walk 1 --- [BD51.Z] Aneurysm and dissection of unspecified artery --PARENT--> [BD51] Arterial aneurysm or dissection, excluding aorta --EXCLUDES--> [?] Arteriovenous fistula, acquired --- Walk 2 --- [BD51.Z] Aneurysm and dissection of unspecified artery --PARENT--> [BD51] Arterial aneurysm or dissection, excluding aorta --EXCLUDES--> [?] Arteriovenous fistula, acquired --- Walk 3 --- [BD75.Y] Venous varicosities of other specified sites --PARENT--> [BD75] Venous varicosities of sites other than lower extremity --CHILD--> [BD75.2] Vulval varices Def: Congested and dilated vulval veins, occurring particularly in association with pregnancy.... --- Walk 4 --- [BD75.Y] Venous varicosities of other specified sites --PARENT--> [BD75] Venous varicosities of sites other than lower extremity --CHILD--> [BD75.0] Sublingual varices Def: Varicose veins on the underside of the tongue... --- Walk 5 --- [BA81] Coronary artery aneurysm Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times.... --CHILD--> [BA81.1] Coronary artery aneurysm with rupture --PARENT--> [BA81] Coronary artery aneurysm Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times.... --- Walk 6 --- [BA81] Coronary artery aneurysm Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times.... --EXCLUDES--> [?] Congenital coronary arterial aneurysm Def: A congenital cardiovascular malformation in which there is one or more localized dilation(s) of a coronary vessel. Additional information: coronary artery aneurysms are usually seen in two forms, sa... --PARENT--> [?] Congenital anomaly of coronary artery Def: A congenital cardiovascular malformation of a coronary artery. This includes absence of a coronary, anomalous origin or course, dilation or stenosis, and fistulas. Additional information: congenital ...
[ "[BD51.Z] Aneurysm and dissection of unspecified artery\n --PARENT--> [BD51] Arterial aneurysm or dissection, excluding aorta\n --EXCLUDES--> [?] Arteriovenous fistula, acquired", "[BD51.Z] Aneurysm and dissection of unspecified artery\n --PARENT--> [BD51] Arterial aneurysm or dissection, excluding aorta\n --EXCLUDES--> [?] Arteriovenous fistula, acquired", "[BD75.Y] Venous varicosities of other specified sites\n --PARENT--> [BD75] Venous varicosities of sites other than lower extremity\n --CHILD--> [BD75.2] Vulval varices\n Def: Congested and dilated vulval veins, occurring particularly in association with pregnancy....", "[BD75.Y] Venous varicosities of other specified sites\n --PARENT--> [BD75] Venous varicosities of sites other than lower extremity\n --CHILD--> [BD75.0] Sublingual varices\n Def: Varicose veins on the underside of the tongue...", "[BA81] Coronary artery aneurysm\n Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....\n --CHILD--> [BA81.1] Coronary artery aneurysm with rupture\n --PARENT--> [BA81] Coronary artery aneurysm\n Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....", "[BA81] Coronary artery aneurysm\n Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....\n --EXCLUDES--> [?] Congenital coronary arterial aneurysm\n Def: A congenital cardiovascular malformation in which there is one or more localized dilation(s) of a coronary vessel. \n\nAdditional information: coronary artery aneurysms are usually seen in two forms, sa...\n --PARENT--> [?] Congenital anomaly of coronary artery\n Def: A congenital cardiovascular malformation of a coronary artery. This includes absence of a coronary, anomalous origin or course, dilation or stenosis, and fistulas.\n\nAdditional information: congenital ..." ]
BD51.Z
Aneurysm and dissection of unspecified artery
[ { "from_icd11": "BD51.Z", "icd10_code": "I728", "icd10_title": "Aneurysm of other specified arteries" }, { "from_icd11": "BD51.Z", "icd10_code": "I729", "icd10_title": "Aneurysm of unspecified site" }, { "from_icd11": "BD51.Z", "icd10_code": "I72", "icd10_title": "Other aneurysm" }, { "from_icd11": "BA81", "icd10_code": "I2542", "icd10_title": "Coronary artery dissection" }, { "from_icd11": "BA81", "icd10_code": "I2541", "icd10_title": "Coronary artery aneurysm" }, { "from_icd11": "BA81", "icd10_code": "I254", "icd10_title": "Coronary artery aneurysm and dissection" }, { "from_icd11": "BB02.1Z", "icd10_code": "I281", "icd10_title": "Aneurysm of pulmonary artery" }, { "from_icd11": "BD51.4", "icd10_code": "I722", "icd10_title": "Aneurysm of renal artery" }, { "from_icd11": "QB84", "icd10_code": "Z4733", "icd10_title": "Aftercare following explantation of knee joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4732", "icd10_title": "Aftercare following explantation of hip joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z472", "icd10_title": "Encounter for removal of internal fixation device" }, { "from_icd11": "QB84", "icd10_code": "Z471", "icd10_title": "Aftercare following joint replacement surgery" }, { "from_icd11": "QB84", "icd10_code": "Z4731", "icd10_title": "Aftercare following explantation of shoulder joint prosthesis" }, { "from_icd11": "QB84", "icd10_code": "Z4781", "icd10_title": "Encounter for orthopedic aftercare following surgical amputation" }, { "from_icd11": "QB84", "icd10_code": "Z4789", "icd10_title": "Encounter for other orthopedic aftercare" } ]
I728
Aneurysm of other specified arteries
Diagnosis and treatment: The patient’s initial diagnosis was acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The treatment regimen included cefotaxime (2.0 g, ivgtt, q12h) as an anti-infective, methylprednisolone (20 mg, iv, qd) and nebulized inhalation (budesonide 2 mg plus terbutaline 5 mg, bid) to relieve airway spasms and the use of a non-invasive ventilator (Philips V60) to improve ventilation. On hospital day 6, the patient’s temperature was normal, but she still experienced shortness of breath and had yellowish sputum. On physical examination, her oral mucosal leukoplakia was detected, and moist rales and phlegm sounds were heard on lung auscultation. Repeat laboratory tests revealed a WBC count of 11.37 × 10 9 /L, an ANC of 9.34 × 10 9 /L, and a PLT of 152 × 10 9 /L. Her CRP level had increased to 80 mg/L, her PCT level was 0.71 ng/ml, and sputum culture revealed Candida albicans (+ +). The antibiotic coverage was broadened to include cefoperazone sulbactam (2.0 g, ivgtt, q8h) and fluconazole (0.2 g, ivgtt, qd) to cover Pseudomonas aeruginosa and Candida albicans , and methylprednisolone was discontinued. After 7 days of treatment, the patient’s symptoms improved, her oral mucosal leukoplakia subsided, her CRP and PCT levels returned to normal, and a repeat sputum culture was negative. Cefoperazone sulbactam was discontinued, fluconazole administration was switched to capsules (0.2 g, po, qd), non-invasive ventilator therapy was continued, and the patient was prepared for elective discharge. On hospital day 16, the patient developed chills and a high fever (39.2°C), with worsening dyspnoea. Examination revealed bilateral moist rales and marked upper right lung sounds. Laboratory investigations revealed that the WBC count had increased to 17.73 × 10 9 /L, the CRP level was 94 mg/L, and the PCT level was 1.73 ng/ml. ABG analysis revealed an FiO2 of 33.00%, pH of 7.42, pCO2 of 40.3 mmHg, and pO2 of 55.1 mmHg (oxygenation index 167 mmHg). Repeat chest CT revealed a new sizeable consolidation with blurred borders in the upper right lung, a bronchial inflation sign, slightly patchy exudative opacity in the right middle lobe, and a small amount of pleural effusion in the right chest . Imipenem cilastatin (0.5 g, ivgtt, q6h) was empirically used for G-bacilli therapy. The next morning, the patient’s respiratory status worsened, with persistent dyspnea during sitting, slightly blurred consciousness, and coughing up of pale blood-colored sputum. Many bibasilar crackles were heard on lung auscultation. Considering severe nosocomial pneumonia with acute heart failure (PSI score: 160 points, class V; NYHA: cardiac function class IV), we transferred her to the intensive care unit (ICU) for invasive mechanical ventilation. The ICU physician performed endotracheal suction and bedside rapid microscopic detection of fungal fluorescence; fungal spores were positive. Antibiotic therapy was escalated to imipenem cilastatin (0.5 g, ivgtt, q6h) and voriconazole (0.2 g, ivgtt, q12h) to cover G-bacilli and fungi. As her condition became unstable, the patient underwent bedside chest radiography every 2 days; this revealed gradual enlargement of the consolidation in the upper right lung and the development of new patchy exudative opacity in the upper left lung . Her CRP and PCT levels did not improve greatly. Both blood and sputum cultures and serum anti-Lp IgM antibodies were negative. On hospital day 22, bronchoscopy was performed, and orange-colored bronchoalveolar lavage fluid (BALF) was collected at RB2 . mNGS was performed using the PMseq platform, and the results were compared with those reported in the PMDB database. The mNGS results, which were obtained two days later, yielded 23,032 sequence reads for Lp ( Table 1 ). The patient underwent chest CT, which revealed significant progression of the lesions and exudative consolidation in multiple lobes of both lungs . On the basis of the patient’s clinical presentation and mNGS results, she was diagnosed with severe, nosocomial LD. The physician adjusted the antibiotic regimen by discontinuing imipenem cilastatin with voriconazole and starting her on moxifloxacin (0.4 g, ivgtt, qd) in combination with azithromycin (0.5 g, ivgtt, qd) for anti- Legionella therapy. Despite a series of comprehensive treatments, the patient’s condition continued to deteriorate, progressing to multiple organ failure (MOF), upper gastrointestinal bleeding, disseminated intravascular coagulation, and uncorrectable metabolic acidosis. The ICU physicians repeatedly recommended that the patient be transferred to a higher-level hospital for ECMO treatment, but the patient’s family refused. On hospital day 29, the patient’s family decided to abandon treatment. The patient died at home on the following day .
3.941406
0.972656
sec[1]/p[1]
en
0.999994
39975683
https://doi.org/10.3389/fmed.2025.1501192
[ "ivgtt", "lung", "sputum", "chest", "anti", "invasive", "repeat", "antibiotic", "mmhg", "consolidation" ]
[ { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" }, { "code": "MD10", "title": "Abnormal sputum" }, { "code": "MD40.Y", "title": "Other specified clinical findings in specimens from respiratory organs and thorax" }, { "code": "MD40.51", "title": "Positive sputum culture" }, { "code": "MD22", "title": "Haemoptysis" }, { "code": "1B10.0", "title": "Respiratory tuberculosis, confirmed" } ]
=== ICD-11 CODES FOUND === [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung [MD10] Abnormal sputum Definition: This category includes the abnormalities of quantity, colour and odor in sputum which may suggest an aetiology. Patients with chronic bronchitis typically expectorate small quantities of mucoid yellow material. A foul or fetid odor should suggest infection from anaerobic organisms, usually in cases of lung abscess. Occasionally, greatly excessive amounts of sputum or "bronchorrhoea" is associated with bronchioloalveolar carcinoma. Also known as: Abnormal sputum | abnormal sputum examination | Abnormal amount of sputum | excess secretion of sputum | excessive sputum Excludes: blood-stained sputum [MD40.Y] Other specified clinical findings in specimens from respiratory organs and thorax Also known as: Other specified clinical findings in specimens from respiratory organs and thorax | Abnormal findings in bronchial washings | Abnormal findings in nasal secretions | Abnormal findings in pleural fluid | abnormal pleural fluid [MD40.51] Positive sputum culture Also known as: Positive sputum culture [MD22] Haemoptysis Definition: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries. Also known as: Haemoptysis | blood streaked sputum | coughing up blood | Blood-stained sputum | Cough with haemorrhage Includes: Blood-stained sputum | Cough with haemorrhage [1B10.0] Respiratory tuberculosis, confirmed Definition: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough, and sputum production that may be haemorrhagic. Transmission is commonly by inhalation of infected respiratory secretions. Confirmation is by identification of Mycobacterium tuberculosis in clinical samples. Also known as: Respiratory tuberculosis, confirmed | respiratory tuberculosis, with bacteriological or histological confirmation | tuberculosis of chest, with bacteriological or histological confirmation | Tuberculosis of lung, confirmed by sputum microscopy with or without culture | pulmonary tuberculosis confirmed by sputum microscopy with or without culture === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.1] Young syndrome Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections.... --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Pulmonary sporotrichosis Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com... --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --PARENT--> [?] Structural developmental anomalies of the respiratory system --- Walk 5 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --EXCLUDES--> [?] Pneumonitis Def: Pneumonitis is a general term that refers to inflammation of lung tissue. Pneumonitis includes the non-infectious lung diseases that cause inflammation of the interstitium of the lung tissue mainly.... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Congenital pneumonia Def: Congenital pneumonia is an acute respiratory infection contracted prenatally or during the intrapartum period that is caused by a virus, bacteria, or fungi....
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.1] Young syndrome\n Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the respiratory system", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --EXCLUDES--> [?] Pneumonitis\n Def: Pneumonitis is a general term that refers to inflammation of lung tissue. Pneumonitis includes the non-infectious lung diseases that cause inflammation of the interstitium of the lung tissue mainly....", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Congenital pneumonia\n Def: Congenital pneumonia is an acute respiratory infection contracted prenatally or during the intrapartum period that is caused by a virus, bacteria, or fungi...." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
A 16-year-old otherwise healthy male (height: 189.5 cm, weight: 68 kg) was referred to the orthopaedic department because of bilateral knee pain and clunking. These symptoms occurred during running and other forceful movements, were less but not absent with rest, and had been present for more than 1 year. There was no history of trauma. Physiotherapy was reported to be not effective. Other than pain on palpation of the inferior pole of the patella on both sides, the physical examination was unremarkable (i.e., normal gait pattern, normal range of motion of both knees, no signs of hydrops, no ligamentous laxity, no signs of meniscal injury). Radiographs of both knees showed a lytic and round lesion with well-defined margins in the subchondral regions of the superolateral quadrant of both patellae, in keeping with bilateral dorsal patellar defects . Interestingly, radiographs of both knees that were made because of chronic knee pain 9.5 years earlier, at the age of 6.5 years, showed no abnormalities . MRI of both knees was performed for further evaluation and to exclude other causes of knee symptoms, using a 1.5-T system (Ingenia, Philips Healthcare) with a 16-channel knee coil. MRI not only demonstrated the bilateral dorsal patellar defects, but also showed an associated deep slit-like cartilage defect with widespread surrounding bone marrow edema in both patellae . Note that MRI did not show any other causes for the symptoms than the bilateral patellar defects with extensive surrounding bone marrow edema and apparent retropatellar cartilage discontinuties. Because of the usual innocuous nature and clinical course of the dorsal patellar defect, conservative management was chosen (i.e., physiotherapy and instruction to avoid heavy exercise) rather than further invasive (diagnostic or therapeutic) interventions, and the patient was referred back to his general practitioner. The patient returned for a follow-up clinical consultation, radiographic and MRI examinations after 8 months. Radiographs of both knees still showed the dorsal patellar defects, without any obvious changes compared to 8 months earlier . However, MRI of both knees showed a considerable decrease in the amount of surrounding bone marrow edema compared to 8 months earlier . In addition, MRI showed progressive “filling” of the dorsal patellar defects with apparent (onset of) “closure” of the slit-like defects/discontuinities on both retropatellar surfaces compared to 8 months earlier . Importantly, the patient was almost symptom-free. Therefore, the conservative management could be considered successful. Fig. 1 Frontal ( a ) and lateral ( b ) radiographs of both knees demonstrate a lytic and round lesion with well-defined margins in the subchondral regions of the superolateral quadrant of both patellae (arrows) Fig. 2 Frontal ( a ) and lateral ( b ) radiographs of both knees that were made 9.5 years earlier show no abnormalities Fig. 3 MRI of the right knee ( a – e ) and left knee ( f – j ) with sagittal proton-density ( a , f ), sagittal T2-weighted spectral attenuated inversion recovery ( b , g ), sagittal 3D water selective fluid ( c , h ), coronal proton-density ( d , i ), and magnified axial proton-density ( e , j ) slices shown. The lesion in the superolateral quadrant of both patellae, consistent with dorsal patellar defect, is demonstrated (arrows). Note the associated cartilage involvement with a slit-like defect/apparent discontuinity on both retropatellar surfaces ( e , j , arrowheads). Also note the widespread surrounding high T2 signal in both patellae, consistent with bone marrow edema ( b , g ). MRI did not show any other abnormalities in either knee Fig. 4 Eight-month follow-up frontal ( a ) and lateral ( b ) radiographs of both knees still demonstrate the dorsal patellar defects (arrows), without any obvious changes compared to 8 months earlier . However, the patient was almost symptom-free at the time of this radiographic examination Fig. 5 Eight-month follow-up MRI of the right knee ( a – d ) and left knee ( e – h ) with sagittal proton-density ( a , e ), sagittal T2-weighted spectral attenuated inversion recovery ( b , f ), oronal proton-density slices ( c , g ), and magnified axial proton-density views of the patellae ( d , h ) shown. The dorsal patellar defects are still present, but the surrounding bone marrow edema has decreased considerably ( b , f ) compared to 8 months earlier . Only in the left knee some noteworthy bone marrow edema is still seen ( f , arrowhead). Also note progressive “filling” of the dorsal defects with apparent (onset of) “closure” of the slit-like defects/discontuinities on both retropatellar surfaces ( d , h , arrowheads) compared to 8 months earlier . The patient was almost symptom-free at the time of this MRI examination
4.03125
0.977051
sec[1]/p[0]
en
0.999997
26810333
https://doi.org/10.1007/s00256-016-2335-5
[ "both", "knee", "defects", "knees", "patellar", "radiographs", "patellae", "bone", "marrow", "edema" ]
[ { "code": "LB99.6", "title": "Acheiria" }, { "code": "MB51.Z", "title": "Diplegia of upper extremities, unspecified" }, { "code": "LB9A.4", "title": "Apodia" }, { "code": "LB51", "title": "Anorchia or microorchidia" }, { "code": "9D90.2", "title": "Moderate vision impairment" }, { "code": "FA2Z", "title": "Inflammatory arthropathies, unspecified" }, { "code": "NC90.Y", "title": "Other specified superficial injury of knee or lower leg" }, { "code": "FA34.4", "title": "Ankylosis of joint" }, { "code": "FA33.4Z", "title": "Chronic instability of knee, unspecified" }, { "code": "NC90.0", "title": "Abrasion of knee" } ]
=== ICD-11 CODES FOUND === [LB99.6] Acheiria Definition: A condition caused by failure of one or both hands to develop during the antenatal period. Also known as: Acheiria | Congenital absence of hand | agenesis of hand | congenital absence of hand and finger | congenital absence of hand and wrist [MB51.Z] Diplegia of upper extremities, unspecified Also known as: Diplegia of upper extremities, unspecified | Diplegia of upper extremities | paralysis of both upper limbs | both upper extremity paralysis | diplegia of upper limbs [LB9A.4] Apodia Definition: A condition caused by failure of the foot to develop during the antenatal period. Also known as: Apodia | Congenital absence of foot | agenesis of foot | congenital absence of foot or toe | congenital absence of foot or toe, unspecified side [LB51] Anorchia or microorchidia Definition: A disorder affecting males, caused by an abnormality occurring in sex development during the antenatal period. This disorder is characterised by individuals who are born with absence of the testes, or with testes that are deficient in size and function. Confirmation is by physical examination, identification of low testosterone levels but elevated follicle stimulating hormone and luteinizing hormone levels in a blood sample, or imaging. Also known as: Anorchia or microorchidia | Absence or aplasia of testis, unilateral | congenital absence of testis, unilateral | congenital absent testicle | congenital absence of testis [9D90.2] Moderate vision impairment Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision] Includes: visual impairment category 2, in both eyes [FA2Z] Inflammatory arthropathies, unspecified Also known as: Inflammatory arthropathies, unspecified | polyarthritis NOS | inflammatory joint disease NOS | nonpyogenic arthritis NOS | arthritic nodosa [NC90.Y] Other specified superficial injury of knee or lower leg Also known as: Other specified superficial injury of knee or lower leg | Nonthermal blister of other or unspecified parts of lower leg | Nonvenomous insect bite of other or unspecified parts of lower leg | Superficial foreign body in other or unspecified parts of lower leg | Splinter in other or unspecified parts of lower leg [FA34.4] Ankylosis of joint Definition: The term ankylosis denotes restricted movement in the joint, and it can be bony or fibrous. Most cases are caused by trauma, infection, radiotherapy, or severe arthritic condition. Also known as: Ankylosis of joint | ankylosis | ankylosis of joint, site unspecified | frozen joint | fusion of joint Excludes: stiffness of joint without ankylosis | Ankylosis of spinal joint [FA33.4Z] Chronic instability of knee, unspecified Also known as: Chronic instability of knee, unspecified | Chronic instability of knee | instability of knee | old disruption of ligament of knee [NC90.0] Abrasion of knee Also known as: Abrasion of knee === GRAPH WALKS === --- Walk 1 --- [LB99.6] Acheiria Def: A condition caused by failure of one or both hands to develop during the antenatal period.... --PARENT--> [LB99] Reduction defects of upper limb Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB99.0] Amelia of upper limb Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb.... --- Walk 2 --- [LB99.6] Acheiria Def: A condition caused by failure of one or both hands to develop during the antenatal period.... --PARENT--> [LB99] Reduction defects of upper limb Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB99.0] Amelia of upper limb Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb.... --- Walk 3 --- [MB51.Z] Diplegia of upper extremities, unspecified --PARENT--> [MB51] Diplegia of upper extremities Def: This is a loss of motor control in both arms.... --CHILD--> [MB51.0] Flaccid diplegia of upper extremities --- Walk 4 --- [MB51.Z] Diplegia of upper extremities, unspecified --PARENT--> [MB51] Diplegia of upper extremities Def: This is a loss of motor control in both arms.... --PARENT--> [?] Paralytic symptoms --- Walk 5 --- [LB9A.4] Apodia Def: A condition caused by failure of the foot to develop during the antenatal period.... --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB9A.0] Amelia of lower limb --- Walk 6 --- [LB9A.4] Apodia Def: A condition caused by failure of the foot to develop during the antenatal period.... --PARENT--> [LB9A] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --CHILD--> [LB9A.2] Fibular hemimelia Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....
[ "[LB99.6] Acheiria\n Def: A condition caused by failure of one or both hands to develop during the antenatal period....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.0] Amelia of upper limb\n Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb....", "[LB99.6] Acheiria\n Def: A condition caused by failure of one or both hands to develop during the antenatal period....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.0] Amelia of upper limb\n Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb....", "[MB51.Z] Diplegia of upper extremities, unspecified\n --PARENT--> [MB51] Diplegia of upper extremities\n Def: This is a loss of motor control in both arms....\n --CHILD--> [MB51.0] Flaccid diplegia of upper extremities", "[MB51.Z] Diplegia of upper extremities, unspecified\n --PARENT--> [MB51] Diplegia of upper extremities\n Def: This is a loss of motor control in both arms....\n --PARENT--> [?] Paralytic symptoms", "[LB9A.4] Apodia\n Def: A condition caused by failure of the foot to develop during the antenatal period....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.0] Amelia of lower limb", "[LB9A.4] Apodia\n Def: A condition caused by failure of the foot to develop during the antenatal period....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.2] Fibular hemimelia\n Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone...." ]
LB99.6
Acheiria
[ { "from_icd11": "LB99.6", "icd10_code": "Q7131", "icd10_title": "Congenital absence of right hand and finger" }, { "from_icd11": "LB99.6", "icd10_code": "Q7133", "icd10_title": "Congenital absence of hand and finger, bilateral" }, { "from_icd11": "LB99.6", "icd10_code": "Q7130", "icd10_title": "Congenital absence of unspecified hand and finger" }, { "from_icd11": "LB99.6", "icd10_code": "Q713", "icd10_title": "Congenital absence of hand and finger" }, { "from_icd11": "MB51.Z", "icd10_code": "G830", "icd10_title": "Diplegia of upper limbs" }, { "from_icd11": "LB9A.4", "icd10_code": "Q7231", "icd10_title": "Congenital absence of right foot and toe(s)" }, { "from_icd11": "LB9A.4", "icd10_code": "Q7230", "icd10_title": "Congenital absence of unspecified foot and toe(s)" }, { "from_icd11": "LB9A.4", "icd10_code": "Q723", "icd10_title": "Congenital absence of foot and toe(s)" }, { "from_icd11": "LB51", "icd10_code": "Q550", "icd10_title": "Absence and aplasia of testis" }, { "from_icd11": "LB51", "icd10_code": "Q55", "icd10_title": "Other congenital malformations of male genital organs" }, { "from_icd11": "9D90.2", "icd10_code": "H542", "icd10_title": "Low vision, both eyes" }, { "from_icd11": "FA2Z", "icd10_code": "M1389", "icd10_title": "Other specified arthritis, multiple sites" }, { "from_icd11": "FA2Z", "icd10_code": "M1380", "icd10_title": "Other specified arthritis, unspecified site" }, { "from_icd11": "FA2Z", "icd10_code": "M13862", "icd10_title": "Other specified arthritis, left knee" }, { "from_icd11": "FA2Z", "icd10_code": "M13872", "icd10_title": "Other specified arthritis, left ankle and foot" } ]
Q7131
Congenital absence of right hand and finger
A 62-year-old Chinese male patient was admitted to Peking Union Medical College Hospital (PUMCH) complaining of a 6-month history of frontal chronic headache, which used to be alleviated by nonsteroidal anti-inflammatory drugs or rest, from September 2014. The pain was intermittent, pulsatile, and moderate, and occurred about 3 times every month in the previous 5 months. The patient did not seek for medical services until the pain increased in intensity and frequency from the end of February 2015. The results of hormone work-up were uneventful. Brain MRI scan with contrast was performed in the local hospital showing a round-like cystic lesion measuring approximate 20 mm in diameter in sellar region with homogeneous signal characteristics and ring enhancement. The diagnosis of RCC was initially made. However, the patient started to have precipitously worsening conditions including severe frontal pulsatile headache, visual acuity (VA) deficit of the right side, polyuria , polydipsia, and even slight disturbance of consciousness. He was transferred to our hospital by ambulance in the middle of March 2015. The patient did not present with nausea, vomiting, high temperature, and other symptoms related to central nervous system infection. The previous history of paranasal sinus infection or meningitis was negative in our patient. He did not report the regular or previous intake of immunosuppressive drugs. His medical history was otherwise unremarkable. The general physical examination was uneventful. The neurologic examination demonstrated that the patient was awake, alert, and oriented to self, time, and location. The limb muscular strength and tension of our patient were normal. The signs of meningeal irritation were completely negative. Various physiological reflexes existed. The pathological signs were absent. The results of ophthalmologic test indicated mild decline of VA of his right eye and no remarkable loss of the visual field. Preoperatively, VA of the right eye was 0.6. Results of hematologic tests were uneventful. Electrolytes examinations revealed severe hyponatremia (Na: 118 mmol/L; reference range: 135–145 mmol/L). Before surgery, correction of hyponatremia (Na: 147 mmol/L) was done with hypertonic saline. Endocrine evaluations showed hyperprolactinemia and severe panhypopituitarism requiring instant hormone replacement therapy (Table 1 ). MRI demonstrated a sellar and suprasellar lesion with iso-hypointensity, with peripheral enhancement after administration of gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) on T1-weighted images (T1WI) and iso-hyperintensity on T2-weighted images (T2WI) measuring 18 mm × 14 mm × 20 mm. These imaging characteristics were of diagnostic value pointing to pituitary abscess . The patient was diagnosed with pituitary abscess based on the clinical, biochemical, and imaging features. A trans-sphenoidal procedure was performed. In the procedure, purulent materials did not occur as we had expected before the operation. Yellowish-brown homogeneous materials were detected and completely drained out. The cavity was irrigated with saline, and no residual tissues were found. Neither leakage of cerebrospinal fluid (CSF) nor intracranial infection happened during the procedure. RCC was pathologically confirmed . In the postoperative period, cefuroxime was administered intravenously for 3 days. In terms of hormone replacement, the patient was treated with hydrocortisone (100 mg q12 hours) intravenously for 3 days and then prednisone (20 mg q12 hours) orally and levothyroxine (100μg qd). Desmopressin acetate tablets (0.1 mg q12 hours) were taken orally to control diabetes insipidus. Blood sodium remained normal and ranged 140 to 153 mmol/L. The ophthalmologic test was not conducted after surgery because the patient complained of no visual changes. The patient's postoperative course was otherwise uneventful. During a 3-month follow-up of our patient, the intensity of headache alleviated significantly and almost disappeared, and in the meantime the impairment of VA markedly abated as well. However, desmopressin acetate tablets were still needed to control the symptoms of polyuria and polydipsia. Hormone replacement therapy continued. The examination of hormone levels indicated the restoration of pituitary endocrine function with the routine oral intake of levothyroxine (100μg qd) and prednisone (10 mg qd8; 5 mg qd16) tapering to a maintenance dosage (2.5 mg qd8) (Table 1 ). The daily dosage of desmopressin acetate dropped from 0.1 mg q12 hours to 0.05 mg q12 hours, and polyuria was under control . MRI with contrast was also conducted showing no residual or recurrent lesions . During a 12-month follow-up, the quality of life of our patient was further improved with previous routine intake of medicine.
4.070313
0.974121
sec[1]/p[0]
en
0.999998
28272259
https://doi.org/10.1097/MD.0000000000006303
[ "hormone", "hours", "uneventful", "mmol", "headache", "visual", "polyuria", "infection", "intake", "replacement" ]
[ { "code": "5B3Z", "title": "Endocrine diseases, unspecified" }, { "code": "6C4H.1Z", "title": "Harmful pattern of use of non-psychoactive substances, unspecified" }, { "code": "5A61.3", "title": "Growth hormone deficiency" }, { "code": "5A61.0", "title": "Hypopituitarism" }, { "code": "5A81.1", "title": "Testicular hypofunction" }, { "code": "LB13.Y", "title": "Other specified structural developmental anomalies of stomach" }, { "code": "DA40.4", "title": "Hourglass stricture and stenosis of stomach" }, { "code": "JB02.4", "title": "Hypertonic, incoordinate, or prolonged uterine contractions" }, { "code": "GC01.Y", "title": "Other specified disorders of bladder" }, { "code": "8B10.Y", "title": "Other specified transient ischaemic attack" } ]
=== ICD-11 CODES FOUND === [5B3Z] Endocrine diseases, unspecified Also known as: Endocrine diseases, unspecified | endocrine disorder NOS | disorder of endocrine gland | disease of endocrine gland | disorder of endocrine system [6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified Also known as: Harmful pattern of use of non-psychoactive substances, unspecified | Harmful pattern of use of non-psychoactive substances | harmful use of nonprescribed drugs, non-dependence producing | Abuse of antacids | Abuse of herbal or folk remedies [5A61.3] Growth hormone deficiency Definition: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficiency. Includes idiopathic, inborn and acquired forms of growth hormone deficiency. Also known as: Growth hormone deficiency Excludes: Hypopituitarism [5A61.0] Hypopituitarism Definition: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/infarction. Also known as: Hypopituitarism | subpituitarism | hypophyseal dystrophy | hypohypophysism | anterior pituitary insufficiency (in part) Includes: pituitary cachexia | pituitary short stature [5A81.1] Testicular hypofunction Definition: In pre-puberty, a disorder characterised by atrophied testes and sterility, abnormal height and absence of secondary sex characteristics. In post-puberty, a disorder characterised by depressed sexual function, loss of sex drive and sterility, muscle weakness and osteoporosis (due to loss of the androgen anabolic effect). Also known as: Testicular hypofunction | hypofunction testicle | gonadal insufficiency of testis | Testicular hypogonadism NOS | undeveloped testis [LB13.Y] Other specified structural developmental anomalies of stomach Also known as: Other specified structural developmental anomalies of stomach | Congenital megalogastria | congenital gastromegaly | congenital enlarged stomach | Congenital displacement of the stomach [DA40.4] Hourglass stricture and stenosis of stomach Definition: This is a structural change of stomach in which one more or less completely divided into two parts, resembling an hourglass in shape, due to often scarring which complicates chronic gastric ulcer. Also known as: Hourglass stricture and stenosis of stomach | hourglass contraction of stomach | hourglass stenosis of stomach | hourglass stricture of stomach | Bilocular stomach [JB02.4] Hypertonic, incoordinate, or prolonged uterine contractions Definition: A condition affecting pregnant females that is idiopathic. This condition is characterised by uterine dysfunction leading to hypertonic, uncoordinated, and prolonged rhythmic activity of the myometrium during labour. Also known as: Hypertonic, incoordinate, or prolonged uterine contractions | Uterine dystocia NOS | Hypertonic uterus dysfunction complicating delivery | hypertonic uterine activity | hypertonic uterine contraction Excludes: dystocia (fetal)(maternal) NOS [GC01.Y] Other specified disorders of bladder Also known as: Other specified disorders of bladder | Non-neurogenic neurogenic bladder | Occult neuropathic bladder | Hinman syndrome | Hinman-Allen syndrome [8B10.Y] Other specified transient ischaemic attack Also known as: Other specified transient ischaemic attack | Vertebrobasilar artery syndrome | vertebrobasilar arterial insufficiency | vertebrobasilar insufficiency | vertebro-basilar artery syndrome, course of resolution unspecified === GRAPH WALKS === --- Walk 1 --- [5B3Z] Endocrine diseases, unspecified --PARENT--> [?] Endocrine diseases --CHILD--> [?] Other disorders of glucose regulation or pancreatic internal secretion --- Walk 2 --- [5B3Z] Endocrine diseases, unspecified --PARENT--> [?] Endocrine diseases --CHILD--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --- Walk 3 --- [6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified --PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i... --CHILD--> [6C4H.10] Harmful pattern of use of non-psychoactive substances, episodic Def: A pattern of episodic or intermittent use of a non-psychoactive substance that has caused damage to a person’s physical or mental health. The pattern of episodic or intermittent use of the non-psychoa... --- Walk 4 --- [6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified --PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i... --CHILD--> [6C4H.11] Harmful pattern of use of non-psychoactive substances, continuous Def: A pattern of continuous use of a non-psychoactive substance (daily or almost daily) that has caused damage to a person’s physical or mental health. The pattern of continuous use of the non-psychoactiv... --- Walk 5 --- [5A61.3] Growth hormone deficiency Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc... --EXCLUDES--> [?] Hypopituitarism Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in... --CHILD--> [?] Argonz-del Castillo Syndrome --- Walk 6 --- [5A61.3] Growth hormone deficiency Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc... --EXCLUDES--> [?] Hypopituitarism Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in... --CHILD--> [?] Nonacquired hypopituitarism Def: This refers to non-acquired decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain....
[ "[5B3Z] Endocrine diseases, unspecified\n --PARENT--> [?] Endocrine diseases\n --CHILD--> [?] Other disorders of glucose regulation or pancreatic internal secretion", "[5B3Z] Endocrine diseases, unspecified\n --PARENT--> [?] Endocrine diseases\n --CHILD--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....", "[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified\n --PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances\n Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...\n --CHILD--> [6C4H.10] Harmful pattern of use of non-psychoactive substances, episodic\n Def: A pattern of episodic or intermittent use of a non-psychoactive substance that has caused damage to a person’s physical or mental health. The pattern of episodic or intermittent use of the non-psychoa...", "[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified\n --PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances\n Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...\n --CHILD--> [6C4H.11] Harmful pattern of use of non-psychoactive substances, continuous\n Def: A pattern of continuous use of a non-psychoactive substance (daily or almost daily) that has caused damage to a person’s physical or mental health. The pattern of continuous use of the non-psychoactiv...", "[5A61.3] Growth hormone deficiency\n Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...\n --EXCLUDES--> [?] Hypopituitarism\n Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...\n --CHILD--> [?] Argonz-del Castillo Syndrome", "[5A61.3] Growth hormone deficiency\n Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...\n --EXCLUDES--> [?] Hypopituitarism\n Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...\n --CHILD--> [?] Nonacquired hypopituitarism\n Def: This refers to non-acquired decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain...." ]
5B3Z
Endocrine diseases, unspecified
[ { "from_icd11": "5B3Z", "icd10_code": "E342", "icd10_title": "Ectopic hormone secretion, not elsewhere classified" }, { "from_icd11": "5B3Z", "icd10_code": "E348", "icd10_title": "Other specified endocrine disorders" }, { "from_icd11": "5B3Z", "icd10_code": "E349", "icd10_title": "Endocrine disorder, unspecified" }, { "from_icd11": "5B3Z", "icd10_code": "E20-E35", "icd10_title": "" }, { "from_icd11": "5B3Z", "icd10_code": "E34", "icd10_title": "Other endocrine disorders" }, { "from_icd11": "5B3Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5B3Z", "icd10_code": "E351", "icd10_title": "" }, { "from_icd11": "6C4H.1Z", "icd10_code": "F558", "icd10_title": "Abuse of other non-psychoactive substances" }, { "from_icd11": "6C4H.1Z", "icd10_code": "F552", "icd10_title": "Abuse of laxatives" }, { "from_icd11": "6C4H.1Z", "icd10_code": "F553", "icd10_title": "Abuse of steroids or hormones" }, { "from_icd11": "6C4H.1Z", "icd10_code": "F551", "icd10_title": "Abuse of herbal or folk remedies" }, { "from_icd11": "6C4H.1Z", "icd10_code": "F55", "icd10_title": "Abuse of non-psychoactive substances" }, { "from_icd11": "5A61.0", "icd10_code": "E230", "icd10_title": "Hypopituitarism" }, { "from_icd11": "5A61.0", "icd10_code": "Q044", "icd10_title": "Septo-optic dysplasia of brain" }, { "from_icd11": "5A61.0", "icd10_code": "E231", "icd10_title": "Drug-induced hypopituitarism" } ]
E342
Ectopic hormone secretion, not elsewhere classified
A 65-year-old woman presented to our hospital with fever and abdominal pain for 2 days. She had a history of asthma, depression, and irritable bowel syndrome. She had no history of keeping fish or other pets and had never traveled abroad. Upon presentation, her vital signs were as follows: temperature, 37.8 ℃, blood pressure, 103/84 mmHg, pulse rate, 124 beats/min, respiratory rate, 24 breaths/min, and oxygen saturation, 94% on room air. Her abdomen was flat and soft, but tenderness was noted in the right upper abdomen. Blood examination showed the following: leukocytes, 12,000/µL; and C-reactive protein, 37.40 mg/dL (Table 1 ). Contrast-enhanced computed tomography showed gallbladder distention, wall thickening, and inflammation of peri-gallbladder fat . Magnetic resonance cholangiopancreatography did not show gallbladder or common bile duct stones . Based on these tests, a diagnosis of acute cholecystitis with systemic inflammatory response syndrome was made. Our case was classified as moderate acute cholecystitis with marked local inflammatory findings (grade II) per the severity criteria of the Tokyo Guidelines 2018 Acute Cholecystitis . After obtaining blood samples for culture, antibiotic therapy was started, and laparoscopic cholecystectomy was performed. Laparoscopy revealed an enlarged gallbladder; hence, puncture aspiration of bile, and decompression of the gallbladder were performed followed by laparoscopic cholecystectomy. Dark bloody bile was collected and submitted for culture examination. The wall of the removed gallbladder was partially necrotic, and no stones were found in the gallbladder . Histopathological findings showed intense neutrophilic infiltration of all layers of the gallbladder epithelium and necrosis in some layers. At this time, the diagnosis was pyogenic and gangrenous cholecystitis . Postoperatively, she had no complications. Results of blood and bile juice cultures were positive for E. tarda (Table 2 ). Based on the results of the antibiotic sensitivity test, cefmetazole was continued until the 7th postoperative day, and she was discharged home thereafter. After discharge, she continued receiving amoxicillin/clavulanate until postoperative day 15 without any complications . Table 1 The laboratory data Hematology Blood chemistry WBC 12,000/μL TP 6.15 g/dL Neutro 90.5% Albumin 3.78 g/dL Lymph 7.7% BUN 17.8 mg/dL Mono 1.5% Creatinine 0.80 mg/dL Eosino 0.2% Sodium 137 mEq/L Baso 0.1% Potassium 3.7 mEq/L RBC 452 × 10 4 /μL Chloride 99 mEq/L Hemoglobin 13.4 g/dL Calcium 9.1 mg/dL Hematocrit 41.5% Uric acid 4.0 mg/dL Platelet 17.3 × 10 4 /μL AST 28 U/L PT 84.5% ALT 31 U/L ALP 129 U/L γ-GTP 129 U/L LDH 235 U/L T.Bil 2.07 mg/dL D.Bil 1.11 mg/dL CRP 37.40 mg/dL Fig. 1 Contrast-enhanced computed tomography. Image shows gallbladder distention, wall thickening, and pericholecystic inflammation Fig. 2 Magnetic resonance cholangiopancreatography. No gallbladder or common bile duct stones were found Fig. 3 Specimen of surgically removed gallbladder. The gallbladder wall was partially necrotic. No stones were found in the gallbladder Fig. 4 Photomicrograph of hematoxylin and eosin-stained gallbladder specimen. a Image shows full-thickness inflammation with partial degeneration, shedding of the gallbladder epithelium, and necrosis in some layers (magnification, 20 ×). b Image shows intense neutrophilic infiltration of the gallbladder epithelium (magnification, 200 ×) Table 2 Antibiotic susceptibility of E. tarda from blood culture and bile culture Antibiotic Blood culture Bile culture MIC(μg/mL) MIC(μg/mL) GM ≤ 1 S ≤ 1 S ST ≤ 20 S ≤ 20 S AMK ≤ 2 S ≤ 2 S CAZ ≤ 1 S ≤ 1 S CMZ ≤ 1 S 2 S CTM ≤ 8 S ≤ 8 S CTX ≤ 1 S ≤ 1 S FOM ≤ 16 S ≤ 16 S IPM ≤ 0.25 S ≤ 0.25 S ABPC ≤ 2 S ≤ 2 S CFPM ≤ 1 S ≤ 1 S CPDX ≤ 0.25 S 0.5 S CPFX ≤ 0.25 S ≤ 0.25 S AMPC/CVA ≤ 2 S ≤ 2 S LVFX ≤ 0.12 S ≤ 0.12 S MEPM ≤ 0.25 S ≤ 0.25 S MINO ≤ 1 S ≤ 1 S PIPC ≤ 4 S ≤ 4 S Determined based on the 29th edition of Clinical and Laboratory Standards Institute (CLSI) document M100 GM gentamicin, ST sulfamethoxazole–trimethoprim, AMK amikacin, CAZ ceftazidime, CMZ cefmetazole, CTM cefotiam, CTX cefotaxime, FOM fosfomycin, IPM imipenem, ABPC ampicillin, CFPM cefepime, CPDX cefpodoxime, CPFX ciprofloxacin, AMPC/CVA amoxicillin/clavulanate, LVFX levofloxacin, MEPM meropenem, MINO minocycline, PIPC piperacillin, MIC minimum inhibitory concentration, S sensitive Fig. 5 Changes in the number of white blood cells and C-reactive protein levels. Both white blood cell counts and C-reactive protein levels improved following surgery and antibiotic therapy. Cefmetazole was continued until the 7th postoperative day, and amoxicillin/clavulanate was continued until the 15th postoperative day. The patient was discharged on the 7th postoperative day and did not develop any complications
4.035156
0.972656
sec[1]/p[0]
en
0.999998
37872407
https://doi.org/10.1186/s40792-023-01763-z
[ "gallbladder", "blood", "bile", "culture", "antibiotic", "postoperative", "wall", "stones", "cholecystitis", "until" ]
[ { "code": "DC12.Z", "title": "Cholecystitis, unspecified" }, { "code": "DC10.01", "title": "Obstruction of gall bladder" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "ME24.35&XA8KL9", "title": "Perforation of gallbladder" }, { "code": "DC10.2", "title": "Fistula of gallbladder or bile duct" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" } ]
=== ICD-11 CODES FOUND === [DC12.Z] Cholecystitis, unspecified Also known as: Cholecystitis, unspecified | Cholecystitis | gallbladder inflammation [DC10.01] Obstruction of gall bladder Also known as: Obstruction of gall bladder | obstruction of gallbladder | gallbladder obstruction | Constriction of gallbladder | gallbladder constriction [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [DC10.2] Fistula of gallbladder or bile duct Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs. Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood === GRAPH WALKS === --- Walk 1 --- [DC12.Z] Cholecystitis, unspecified --PARENT--> [DC12] Cholecystitis Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders.... --CHILD--> [DC12.Y] Other specified cholecystitis --- Walk 2 --- [DC12.Z] Cholecystitis, unspecified --PARENT--> [DC12] Cholecystitis Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 3 --- [DC10.01] Obstruction of gall bladder --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --CHILD--> [DC10.01] Obstruction of gall bladder --- Walk 4 --- [DC10.01] Obstruction of gall bladder --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile.... --EXCLUDES--> [?] Cholelithiasis Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com... --- Walk 5 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.0] Acquired absence of breast --- Walk 6 --- [QF01.Y] Other specified acquired absence of organs --PARENT--> [QF01] Acquired absence of organs --CHILD--> [QF01.Y] Other specified acquired absence of organs
[ "[DC12.Z] Cholecystitis, unspecified\n --PARENT--> [DC12] Cholecystitis\n Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....\n --CHILD--> [DC12.Y] Other specified cholecystitis", "[DC12.Z] Cholecystitis, unspecified\n --PARENT--> [DC12] Cholecystitis\n Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[DC10.01] Obstruction of gall bladder\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --CHILD--> [DC10.01] Obstruction of gall bladder", "[DC10.01] Obstruction of gall bladder\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.0] Acquired absence of breast", "[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.Y] Other specified acquired absence of organs" ]
DC12.Z
Cholecystitis, unspecified
[ { "from_icd11": "DC12.Z", "icd10_code": "K812", "icd10_title": "Acute cholecystitis with chronic cholecystitis" }, { "from_icd11": "DC12.Z", "icd10_code": "K819", "icd10_title": "Cholecystitis, unspecified" }, { "from_icd11": "DC12.Z", "icd10_code": "K81", "icd10_title": "Cholecystitis" }, { "from_icd11": "DC12.Z", "icd10_code": "K818", "icd10_title": "" }, { "from_icd11": "DC10.01", "icd10_code": "K820", "icd10_title": "Obstruction of gallbladder" }, { "from_icd11": "QF01.Y", "icd10_code": "Z9049", "icd10_title": "Acquired absence of other specified parts of digestive tract" }, { "from_icd11": "DC10.2", "icd10_code": "K833", "icd10_title": "Fistula of bile duct" }, { "from_icd11": "DC10.2", "icd10_code": "K823", "icd10_title": "Fistula of gallbladder" }, { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" } ]
K812
Acute cholecystitis with chronic cholecystitis
During the first admission, the patient’s complaint may be due to improperly treated wounds using topical herbal applications with overlying plastic wrapping by the traditional healer causing infection. The child was first diagnosed with necrotizing fasciitis as he was presented with severe skin and soft tissue infection through the fascial planes with extensive involvement and marked skin necrosis . Referring to the LRINEC (Laboratory Risk Indicator for Necrotizing fasciitis) score, the findings of the white blood cell count (>25,000) and Hemoglobin level (<11 g/dl) result in a total score of 4 (<5) indicating a low risk . However, it is unusual for an infection to spread so rapidly leading to necrosis of the skin and soft tissue. Based on the speed of soft tissue infection and destruction, this appeared to be the fulminant type of necrotizing fasciitis . In this case, the patient suffered greatly from pain and fever, but her consciousness was intact. In order to reduce potential morbidity and mortality, suspecting a severe soft tissue infection as necrotizing fasciitis is recommended as soon as there are skin color changes with demarcation . The surgeon should not wait for all the laboratory results or deterioration of the patient’s condition since this is a potentially lethal soft tissue infection which requires prompt intervention. Just before the debridement the patient’s both lower legs were already blue black, including the feet which were normal before as shown in Fig. 2 . Both dorsalis pedis pulses were absent indicating signs of acute limb ischemia . As a result, the decision swung towards amputation, which the patient’s family refused in favor of a traditional alternative due to financial constraints. The eventual development of bilateral acute limb ischemia leading to auto-amputation of both feet in this patient was also unusual. The ability of the child to endure severe soft tissue infection with loss of both lower limbs without succumbing to sepsis without any antibiotic administration was unexpected. There are several publications from Africa regarding symmetrical bilateral peripheral gangrene due to unknown etiology called Tropical Idiopathic Lower Limb Gangrene . Many of these reported cases exhibited similar findings to this patient. One of the publications reported a patient with sudden onset of leg pain followed by bilateral lower limb gangrene two days after traditional herbal treatment. The patient survived after bilateral below knee amputations . Similar findings are also reported in a case series of peripheral gangrene in African children, involving the application of traditional herbs and leaves on the limbs, without history of major trauma. In the 12 cases reported, seven cases reported normal coagulation tests, whereas the other two cases showed absence of thrombi in the amputated limbs, yet extreme vasospasm was found . These findings were suspected to be linked to alpha receptor stimulating drugs with strong vasospasm effect like ergotamine. Ergot-like alkaloids can be found in many herbs and traditional roots. Even though we were not able to identify the herbs in the patient, based on the clinical findings the possibility is very likely . Most Indonesian traditional herbs contain ergot-like alkaloids . The possibility of extreme vasospasm in this case could explain why dry gangrene occurred after initially presenting with wet gangrene. When the child was first admitted, her WBC was very high. After antibiotic administration, the level decreased on the third day indicating a response to the treatment. However, the low platelet count on day three was worrisome. The tissue necrosis process persisted, indicated by high CRP and high increase of serum transaminase (ALT) levels. The laboratory results in Table 1 showed impairment of the coagulation system indicated by high PTT/APTT levels which dropped to normal levels over a three-day period associated with thrombocytopenia suggesting the possibility that the platelet was depleted due the formation of thrombi . This pathophysiology process was reported by Wakhlu et al. who performed delayed debridement two to four days later. This would result in minimal blood loss; thus, the debridement could be carried out by peeling off the darkened and dry tissue leaving the fresh granulation tissue beneath without the need for anesthesia . This management of necrotizing fasciitis is based on the theory that microthrombi in the subcutaneous vessels automatically barred further in and out flow, thus preventing any further propagation of local or systemic infection. It is possible that in this patient, formed microthrombi prevented the further spread of infection, hence resulting in a dry gangrene leading eventually to a bilateral autoamputation as shown in Fig. 3 , Fig. 4 .
4.199219
0.925293
sec[2]/p[0]
en
0.999997
32416479
https://doi.org/10.1016/j.ijscr.2020.04.062
[ "this", "infection", "tissue", "gangrene", "traditional", "soft", "necrotizing", "fasciitis", "skin", "which" ]
[ { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "code": "1H0Z", "title": "Infection, unspecified" }, { "code": "1G40", "title": "Sepsis without septic shock" }, { "code": "FA10.Z", "title": "Direct infections of joint, unspecified" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" }, { "code": "FB6Z", "title": "Soft tissue disorders, unspecified" }, { "code": "MC85", "title": "Gangrene" }, { "code": "FB56.6", "title": "Other specified soft tissue disorders" }, { "code": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" } ]
=== ICD-11 CODES FOUND === [4A01.03] Transient hypogammaglobulinaemia of infancy Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy] [1H0Z] Infection, unspecified Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS [1G40] Sepsis without septic shock Definition: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Also known as: Sepsis without septic shock | sepsis without septic shock with known organism | Sepsis-associated hypotension | Unspecified sepsis | general septic intoxication Excludes: Septicaemia | Sepsis of fetus or newborn [FA10.Z] Direct infections of joint, unspecified Also known as: Direct infections of joint, unspecified | Direct infections of joint | septic arthritis | pyogenic arthritis | arthritis due to infection [1D9Z] Unspecified viral infection of unspecified site Also known as: Unspecified viral infection of unspecified site | viral infection NOS | viral disorder NOS | disease caused by virus | unspecified viremia [1A40.Z] Infectious gastroenteritis or colitis without specification of infectious agent Also known as: Infectious gastroenteritis or colitis without specification of infectious agent | Gastroenteritis or colitis without specification of infectious agent | diarrhoea and gastroenteritis of presumed infectious origin | diarrhoeal enteritis | GE - [gastroenteritis] [FB6Z] Soft tissue disorders, unspecified Also known as: Soft tissue disorders, unspecified | disease of soft tissue NOS | unspecified soft tissue disorder, site unspecified | disorder of soft tissue | disorder of soft tissue NOS [MC85] Gangrene Definition: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply. Also known as: Gangrene | gangrene NOS | dry gangrene | wet gangrene | ulcerative gangrene Excludes: Pyoderma gangrenosum | Gas gangrene | Polymicrobial necrotising fasciitis [FB56.6] Other specified soft tissue disorders Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease === GRAPH WALKS === --- Walk 1 --- [4A01.03] Transient hypogammaglobulinaemia of infancy --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects... --PARENT--> [4A01] Primary immunodeficiencies due to disorders of adaptive immunity --- Walk 2 --- [4A01.03] Transient hypogammaglobulinaemia of infancy --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects... --CHILD--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells --- Walk 3 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --EXCLUDES--> [?] Infection arising from device, implant or graft, not elsewhere classified --- Walk 4 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] Infections of the fetus or newborn --- Walk 5 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Sepsis of fetus or newborn --EXCLUDES--> [?] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --- Walk 6 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Septicaemia --EXCLUDES--> [?] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....
[ "[4A01.03] Transient hypogammaglobulinaemia of infancy\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --PARENT--> [4A01] Primary immunodeficiencies due to disorders of adaptive immunity", "[4A01.03] Transient hypogammaglobulinaemia of infancy\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --EXCLUDES--> [?] Infection arising from device, implant or graft, not elsewhere classified", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] Infections of the fetus or newborn", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Sepsis of fetus or newborn\n --EXCLUDES--> [?] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Septicaemia\n --EXCLUDES--> [?] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection...." ]
4A01.03
Transient hypogammaglobulinaemia of infancy
[ { "from_icd11": "4A01.03", "icd10_code": "D807", "icd10_title": "Transient hypogammaglobulinemia of infancy" }, { "from_icd11": "1H0Z", "icd10_code": "B999", "icd10_title": "Unspecified infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A312", "icd10_title": "Disseminated mycobacterium avium-intracellulare complex (DMAC)" }, { "from_icd11": "1H0Z", "icd10_code": "B998", "icd10_title": "Other infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A249", "icd10_title": "Melioidosis, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "R6511", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "R6510", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "A318", "icd10_title": "Other mycobacterial infections" }, { "from_icd11": "1H0Z", "icd10_code": "A319", "icd10_title": "Mycobacterial infection, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "B948", "icd10_title": "Sequelae of other specified infectious and parasitic diseases" }, { "from_icd11": "1H0Z", "icd10_code": "B949", "icd10_title": "Sequelae of unspecified infectious and parasitic disease" }, { "from_icd11": "1H0Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "N771", "icd10_title": "Vaginitis, vulvitis and vulvovaginitis in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "I", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B90-B94", "icd10_title": "" } ]
D807
Transient hypogammaglobulinemia of infancy
A 22-month old female patient presented with a combination of severe infections, muscular hypotonia, and anhidrosis in the first year of life (clinical features summarized in Table 1 ). At 7 months of age, the patient was not able to achieve her motor milestones, consistent with congenital muscular hypotonia. The patient developed normally until the age of 5 months , but was admitted to the pediatric intensive care unit and ventilated at 9 months of age as she suffered from frequent recurrent severe bacterial and viral infections, which caused bronchopneumonia, bacteremia, and gastroenteritis . The patient continued to be hospitalized for 6 months, with persistent fever, chronic cough, and respiratory distress needing at least 6 l of oxygen. After 9 months of age, the patient developed severe persistent neutropenia, which was unresponsive to GCSF and has further contributed to frequent infections . Anti-neutrophil antibodies were negative, but the neutropenia responded well to an intravenous immune modulatory dose of immunoglobulin . The patient had gastrointestinal complications such as chronic diarrhea, which was sometimes bloody, and abdominal distention with a picture of frank colitis, resulting in failure to thrive . The patient was initially gaining weight from birth till 6 months of age but started to lose weight after hospital admission and failed to thrive until supported with total parenteral nutrition . In addition, the patient failed the sweat test three times because of anhidrosis and had abnormal teeth with very thin enamel and irregular surface. Her hair was normal with no concerns, but she did have a recurrent erythematous rash that responded only partially to cortisone alone and resolved after applying cortisone and topical antibiotics. Differential lymphocyte counts show normal levels of CD8 + T cells, CD19 + B cells, and NK cells, with slightly increased levels of T h cell (CD4 + ) . Furthermore, there was pronounced increase in the levels of IgG and IgA in the patient . Table 1 Summary of clinical findings in the patient Findings Inheritance Autosomal recessive Type of mutation Missence (c. T376C) Orai1 mutation p.C126R within transmembrane domain 2 of ORAI1 Orai1 expression Normal mRNA and protein levels. ORAI1 PM localization abolished. SOCE SOCE abolished in PMBCs Infections Streptococcus pneumoniae bacteremia; Klebsiella pneumoniae urinary tract infection; Rhinovirus (viral bronchopneumonia); perianal abscess (Pseudomonas from wound culture); Rotavirus gastroenteritis; Rhinovirus and Influenza A virus lower respiratory tract infection; Staphylococcus coagulase negative bacteremia; ESBL Escherichia coli urinary tract infection; Influenza A pneumonitis; Impetigo (methicillin sensitive Staphylococcus aureus from wound culture); Staphylococcus epidermis PICC line infection. Autoimmunity Likely autoimmune neutropenia, as neutropenia improved with IVIG. Lymphocytes Naïve T cells CD45RA + ↓ Lymphocyte function Cytokine production ↓; proliferation in response to stimulation ↓ Antibodies Immunoglobulin level ↑ Myopathy Congenital muscular hypotonia Anhidrosis Anhidrotic ectodermal dysplasia Other complications Chronic diarrhea; failure to thrive; small cysts in pancreas; echogenicity in liver and renal cortex. Outcome Anti-microbial prophylaxis and immunoglobulin replacement therapy; workup for HSCT. Fig. 1 A novel ORAI1 mutation associated with CRAC channelopathy. a Profile of patient body weight with World Health Organization (WHO) weight-for-age percentiles for girls (birth to 24 months) denoted in red. Body weight measurements are indicated as dots. b Neutrophil counts plotted over time. Infections and treatments are indicated above and below the graph respectively. Red dotted lines denote the reference range for neutrophil counts. UTI, urinary tract infection; GMCSF, granulocyte-macrophage colony-stimulating factor; IVIG, intravenous immunoglobulin. c Pedigree of the kindred. d mRNA and protein sequences of the ORAI1 mutation identified in the patient. e Representative traces and summary data of SOCE responses from PBMCs from patient, parent, or healthy donor. PBMCs were incubated in Ca 2+ -free media and treated with the ER ATPase blocker thapsigargin (Tg) to deplete Ca 2+ stores. This is followed by perfusion with Ca 2+ -containing medium (2 mM, 2Ca) to stimulate and quantify SOCE . f Western blot to assess ORAI1 protein levels in PMBCs from patients, patient’s father (parent), and healthy donor (NC). α-Tubulin was used as a loading control. g ORAI1 mRNA expression in the patient, normal control (NC), and a parent. ORAI1 mRNA expression was normalized to house-keeping ribosomal protein RPLP0 expression and shows no difference between the patient, parent, or healthy donor. Mean + SEM, n = 3 technical replicates
4.222656
0.945801
sec[2]/sec[0]/p[0]
en
0.999996
33650027
https://doi.org/10.1007/s10875-021-01004-8
[ "infections", "weight", "infection", "neutropenia", "immunoglobulin", "cells", "mutation", "expression", "mrna", "protein" ]
[ { "code": "1H0Z", "title": "Infection, unspecified" }, { "code": "1G40", "title": "Sepsis without septic shock" }, { "code": "FA10.Z", "title": "Direct infections of joint, unspecified" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" }, { "code": "MG43.5", "title": "Excessive weight loss" }, { "code": "MG43.6", "title": "Excessive weight gain" }, { "code": "MG44.11", "title": "Failure to thrive in infant or child" }, { "code": "5B80.0Z", "title": "Overweight, unspecified" }, { "code": "JA65.2", "title": "Excessive weight gain in pregnancy" } ]
=== ICD-11 CODES FOUND === [1H0Z] Infection, unspecified Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS [1G40] Sepsis without septic shock Definition: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Also known as: Sepsis without septic shock | sepsis without septic shock with known organism | Sepsis-associated hypotension | Unspecified sepsis | general septic intoxication Excludes: Septicaemia | Sepsis of fetus or newborn [FA10.Z] Direct infections of joint, unspecified Also known as: Direct infections of joint, unspecified | Direct infections of joint | septic arthritis | pyogenic arthritis | arthritis due to infection [1D9Z] Unspecified viral infection of unspecified site Also known as: Unspecified viral infection of unspecified site | viral infection NOS | viral disorder NOS | disease caused by virus | unspecified viremia [1A40.Z] Infectious gastroenteritis or colitis without specification of infectious agent Also known as: Infectious gastroenteritis or colitis without specification of infectious agent | Gastroenteritis or colitis without specification of infectious agent | diarrhoea and gastroenteritis of presumed infectious origin | diarrhoeal enteritis | GE - [gastroenteritis] [MG43.5] Excessive weight loss Definition: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health. Also known as: Excessive weight loss | abnormal decrease in weight | abnormal weight loss | unintended weight loss | weight loss NOS [MG43.6] Excessive weight gain Definition: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantity or rate to create risk to the individual’s health. Also known as: Excessive weight gain | abnormal increase in weight | abnormal weight gain | unintended weight gain Excludes: Obesity [MG44.11] Failure to thrive in infant or child Definition: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender. Also known as: Failure to thrive in infant or child | failure to gain weight | failure to thrive NOS | FTT - [failure to thrive] syndrome Excludes: Failure to thrive in newborn | Anorexia Nervosa | Avoidant-restrictive food intake disorder [5B80.0Z] Overweight, unspecified Also known as: Overweight, unspecified | Overweight [JA65.2] Excessive weight gain in pregnancy Definition: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy. Also known as: Excessive weight gain in pregnancy | excessive weight gain in pregnancy, unspecified trimester | maternal obesity syndrome | maternal obesity without hypertension | abnormal weight gain in pregnancy Excludes: Gestational oedema without hypertension === GRAPH WALKS === --- Walk 1 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] Infections of the fetus or newborn --- Walk 2 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --EXCLUDES--> [?] Infection arising from device, implant or graft, not elsewhere classified --- Walk 3 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Sepsis of fetus or newborn --EXCLUDES--> [?] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --- Walk 4 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Septicaemia --EXCLUDES--> [?] Sepsis with septic shock Def: Septic shock is a subset of sepsis in which circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality.... --- Walk 5 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --EXCLUDES--> [?] Reactive arthropathies Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti... --- Walk 6 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --CHILD--> [FA10.0] Bacterial infection of joint
[ "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] Infections of the fetus or newborn", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --EXCLUDES--> [?] Infection arising from device, implant or graft, not elsewhere classified", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Sepsis of fetus or newborn\n --EXCLUDES--> [?] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Septicaemia\n --EXCLUDES--> [?] Sepsis with septic shock\n Def: Septic shock is a subset of sepsis in which circulatory, cellular and metabolic abnormalities are profound enough to substantially increase mortality....", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --EXCLUDES--> [?] Reactive arthropathies\n Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti...", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --CHILD--> [FA10.0] Bacterial infection of joint" ]
1H0Z
Infection, unspecified
[ { "from_icd11": "1H0Z", "icd10_code": "B999", "icd10_title": "Unspecified infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A312", "icd10_title": "Disseminated mycobacterium avium-intracellulare complex (DMAC)" }, { "from_icd11": "1H0Z", "icd10_code": "B998", "icd10_title": "Other infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A249", "icd10_title": "Melioidosis, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "R6511", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "R6510", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "A318", "icd10_title": "Other mycobacterial infections" }, { "from_icd11": "1H0Z", "icd10_code": "A319", "icd10_title": "Mycobacterial infection, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "B948", "icd10_title": "Sequelae of other specified infectious and parasitic diseases" }, { "from_icd11": "1H0Z", "icd10_code": "B949", "icd10_title": "Sequelae of unspecified infectious and parasitic disease" }, { "from_icd11": "1H0Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "N771", "icd10_title": "Vaginitis, vulvitis and vulvovaginitis in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "I", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B90-B94", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B94", "icd10_title": "Sequelae of other and unspecified infectious and parasitic diseases" } ]
B999
Unspecified infectious disease
A 31-year-old African-American man underwent orthotopic liver transplantation 10 years ago for primary sclerosing cholangitis (PSC). He had moderate acute cellular rejection five months after the transplant but had no history of any transplant-related infections. He presented to the emergency department with a one-week history of lower abdominal pain and dysuria. His past medical history was pertinent for ulcerative colitis and type 2 diabetes mellitus. He had been hospitalized multiple times in the past year for abdominal pain. Extensive investigation had shown partial small bowel obstruction caused by intussusception that was treated conservatively, in addition to chronic elevation of total bilirubin, alkaline phosphatase, and transaminases attributed to possible recurrence of PSC in the hepatic graft. At the time of suspicion of possible PSC recurrence, his prednisone dosage had been increased and later tapered when liver function studies improved. He had last been admitted to the hospital 2 weeks earlier for diarrhea and fever, diagnosed with Clostridium difficile infection (CDI), and discharged 10 days prior with oral vancomycin. At the time of current presentation, his immunosuppression regimen included tacrolimus 1 mg twice daily, mycophenolate mofetil 500 mg twice daily, and prednisone 5 mg daily. He reported temporal insertion of indwelling urinary catheters during some of his previous hospital admissions for management of small bowel obstruction. Otherwise, he denied any intravenous (IV) drug use, history of urethral instrumentation, or chronic indwelling urinary catheters. His vital signs on admission revealed blood pressure 134/68 mmHg, heart rate 80 beats per minute, 20 respirations per minute, and temperature 98.5°F. On physical exam, his abdomen was soft with mild tenderness to palpation in the left lower quadrant. Rectal exam revealed a normal-sized, painless prostate with fluctuation at the right base. Laboratory investigation showed white blood cell count of 22,600/ μ L (94% neutrophils, 2% lymphocytes, 1% bands), hemoglobin 12.3 g/dL, and platelet count 309,000/ μ L. Biochemistry tests revealed creatinine 1.2 mg/dL, alanine aminotransferase 199 U/L, aspartate aminotransferase 157 U/L, alkaline phosphatase 719 U/L, and total bilirubin 18.3 mg/dL (direct bilirubin 15.6 mg/dL), which were unchanged compared to previous laboratory results. Human immunodeficiency virus (HIV) antibody was negative. Urinalysis showed 11–20 white blood cells/high power field (HPF), 0–2 red blood cells/HPF, few bacteria, and no casts. Contrast-enhanced computed tomography (CT) of the abdomen and pelvis revealed multiple stable areas of intussusception and a 3.0 cm × 1.9 cm prostatic abscess (Figures 1(a) and 1(b) ). We empirically treated for infection with IV ceftriaxone and vancomycin. MRSA was isolated from both urine (<10,000 CFU/mL) and 2 sets of blood cultures (aerobic and anaerobic bottles) obtained upon admission. Cultures were sensitive to daptomycin, clindamycin, gentamycin, rifampin, tetracycline, levofloxacin, trimethoprim-sulfamethoxazole, and vancomycin (MIC < 0.5). Both transthoracic and transesophageal echocardiography were negative for vegetations. Based on his recent hospitalizations, he was diagnosed with health-care associated MRSA bacteremia. Detailed review of his hospital records revealed that colonization with MRSA had been detected 2 weeks prior in a nasal swab sample and treated accordingly with topical chlorhexidine and mupirocin. A final diagnosis of MRSA prostatic abscess with bacteremia was made. Due to his immunosuppression and bacteremia, it was decided that he was not a candidate for oral antibiotics. IV vancomycin was continued while ceftriaxone was stopped. We opted for conservative management in this case, which showed rapid improvement of symptoms and inflammatory response. Therefore, abscess aspiration was not deemed necessary. We also continued oral vancomycin to complete 14 days of treatment for CDI. The same dosage of immunosuppressant medications was continued, with the exception of tacrolimus, which was held due to acute kidney injury. Leukocytosis resolved at day 3 while symptoms started to improve at day 5. Repeat blood cultures at day 4 were negative. Urine cultures failed to grow any organism at day 11 of active therapy. His creatinine rose to 1.6 mg/dL and IV vancomycin was switched to daptomycin on day 12 of treatment. He was discharged from the hospital at day 22, with instructions to continue daptomycin for a total of 6 weeks of antibiotics. During a follow-up clinic appointment at 8 weeks after completion of antibiotics, his symptoms were resolved, cultures were negative, and repeat CT of the abdomen and pelvis showed complete resolution of the prostatic abscess (Figures 2(a) and 2(b) ).
4.023438
0.977051
sec[1]/p[0]
en
0.999998
25389507
https://doi.org/10.1155/2014/854824
[ "vancomycin", "blood", "cultures", "abscess", "mrsa", "that", "treated", "total", "bilirubin", "oral" ]
[ { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "MG51.20", "title": "Vancomycin resistant Enterococcus" }, { "code": "MG51.01", "title": "Vancomycin resistant Staphylococcus aureus" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "QE00", "title": "Acculturation difficulty" }, { "code": "MD40.51", "title": "Positive sputum culture" } ]
=== ICD-11 CODES FOUND === [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [MG51.20] Vancomycin resistant Enterococcus Also known as: Vancomycin resistant Enterococcus | VRE - [vancomycin-resistant Enterococcus] [MG51.01] Vancomycin resistant Staphylococcus aureus Also known as: Vancomycin resistant Staphylococcus aureus | VRSA [Vancomycin resistant Staphylococcus aureus] [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [QE00] Acculturation difficulty Definition: Problems resulting from the inability to adjust to a different culture or environment. Also known as: Acculturation difficulty | acculturation problem | cultural shock | social migrant difficulty | migration Excludes: Disorders specifically associated with stress [MD40.51] Positive sputum culture Also known as: Positive sputum culture === GRAPH WALKS === --- Walk 1 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Allergic or hypersensitivity conditions Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms. Hypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms... --CHILD--> [?] Allergic or hypersensitivity disorders involving skin or mucous membranes Def: Allergic or hypersensitivity disorders involving the skin and mucous includes a heterogeneous group of disorders involving skin and mucous membranes in which either allergy or hypersensitivity play a ... --- Walk 2 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Disorders due to substance use or addictive behaviours Def: Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or spe... --CHILD--> [?] Disorders due to substance use Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to... --- Walk 3 --- [MG51.20] Vancomycin resistant Enterococcus --PARENT--> [MG51.2] Antibiotic resistant Enterococcus --CHILD--> [MG51.2Y] Enterococcus resistant to other antibiotic --- Walk 4 --- [MG51.20] Vancomycin resistant Enterococcus --PARENT--> [MG51.2] Antibiotic resistant Enterococcus --CHILD--> [MG51.2Y] Enterococcus resistant to other antibiotic --- Walk 5 --- [MG51.01] Vancomycin resistant Staphylococcus aureus --PARENT--> [MG51.0] Antibiotic resistant Staphylococcus aureus --CHILD--> [MG51.01] Vancomycin resistant Staphylococcus aureus --- Walk 6 --- [MG51.01] Vancomycin resistant Staphylococcus aureus --PARENT--> [MG51.0] Antibiotic resistant Staphylococcus aureus --CHILD--> [MG51.00] Methicillin resistant Staphylococcus aureus
[ "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Allergic or hypersensitivity conditions\n Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms.\n\nHypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms...\n --CHILD--> [?] Allergic or hypersensitivity disorders involving skin or mucous membranes\n Def: Allergic or hypersensitivity disorders involving the skin and mucous includes a heterogeneous group of disorders involving skin and mucous membranes in which either allergy or hypersensitivity play a ...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Disorders due to substance use or addictive behaviours\n Def: Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or spe...\n --CHILD--> [?] Disorders due to substance use\n Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to...", "[MG51.20] Vancomycin resistant Enterococcus\n --PARENT--> [MG51.2] Antibiotic resistant Enterococcus\n --CHILD--> [MG51.2Y] Enterococcus resistant to other antibiotic", "[MG51.20] Vancomycin resistant Enterococcus\n --PARENT--> [MG51.2] Antibiotic resistant Enterococcus\n --CHILD--> [MG51.2Y] Enterococcus resistant to other antibiotic", "[MG51.01] Vancomycin resistant Staphylococcus aureus\n --PARENT--> [MG51.0] Antibiotic resistant Staphylococcus aureus\n --CHILD--> [MG51.01] Vancomycin resistant Staphylococcus aureus", "[MG51.01] Vancomycin resistant Staphylococcus aureus\n --PARENT--> [MG51.0] Antibiotic resistant Staphylococcus aureus\n --CHILD--> [MG51.00] Methicillin resistant Staphylococcus aureus" ]
NE60
Harmful effects of drugs, medicaments or biological substances, not elsewhere classified
[ { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A95S", "icd10_title": "Adverse effect of other bacterial vaccines, sequela" }, { "from_icd11": "NE60", "icd10_code": "T50B95A", "icd10_title": "Adverse effect of other viral vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A25A", "icd10_title": "Adverse effect of mixed bacterial vaccines without a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A91A", "icd10_title": "Poisoning by other bacterial vaccines, accidental (unintentional), initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T498X5A", "icd10_title": "Adverse effect of other topical agents, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48905A", "icd10_title": "Adverse effect of unspecified agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48995A", "icd10_title": "Adverse effect of other agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A15A", "icd10_title": "Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50B15A", "icd10_title": "Adverse effect of smallpox vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T416X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T419X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T418X2A", "icd10_title": "" } ]
T50A95A
Adverse effect of other bacterial vaccines, initial encounter
The results of bronchoscopy and a lung lavage test revealed chronic inflammation with fibrosis. The results of lung biopsy were consistent with usual interstitial pneumonitis. Breathing difficulty was alleviated with systemic steroid therapy. During admission, the patient complained of dry mouth and difficulty of swallowing dry food without liquid. Immune serologic tests were performed under suspicion of autoimmune disease. The results of serologic tests were as follows; positive for antinuclear antibody , negative for rheumatoid factor, positive for anti-SSA (Ro) antibody, negative for anti-SSB (La) antibody and positive for anti-Scl 70 antibody. The anti-ds DNA level was 7.64 IU/mL (reference level, <7.0 IU/mL). The secretory function of the salivary gland was considered to be decreased. In a salivary gland scan, the uptake increases in the parotid gland and submandibular gland were relatively normal; however, the ejection fraction of the salivary gland after stimulation decreased by more than the moderate level. Although the results of Schirmer’s test did not satisfy the diagnostic criteria for Sjögren’s syndrome, with the right eye showing a result of 12 mm in 5 min and the left eye showing a result of 7 mm in 5 min, they were found to be lower than the normal range. Other diseases such as hepatitis C, acquired immunodeficiency syndrome, lymphoma and sarcoidosis were excluded by medical history and the results of relevant laboratory tests. Clinical findings including ocular symptom of dry eyes, oral symptom of difficulty in swallowing dry food without liquid, oral sign of abnormal salivary scintigraphy and positive autoantibody of anti-SSA (Ro) antibody were compatible with diagnostic criteria for Sjögren’s syndrome (Table 1 ) . In addition, there were some features of systemic sclerosis (puffy fingers, interstitial lung disease and positive for systemic sclerosis related autoantibody [anti-Scl 70]) according to the revised classification criteria of systemic sclerosis (Table 2 ) . The patient has been followed for the overlap syndrome with Sjögren’s syndrome and systemic sclerosis. Table 1 Diagnostic criteria for Sjögren’s syndrome (American-European Consensus for Sjögren’s syndrome ) Criteria a I. Ocular symptoms (at least one) 1. Dry eyes for at least 3 months 2. A foreign body sensation in the eyes 3. Use of artificial tears three or more times per day II. Oral symptoms (at least one) 1. Dry mouth for at least 3 months 2. Recurrent or persistently swollen salivary glands 3. Need for liquids to swallow dry foods III. Ocular signs (at least one) 1. Abnormal Schimer’s test (5 mm or less in 5 min) 2. Positive vital dye staining (van Bijsterveld score 4 or higher) IV. Histopathology 1. Lip biopsy showing focal lymphocytic sialoadenitis (focus score ≥1 per 4 mm 2 ) V. Oral signs (at least one) 1. Unstimulated whole salivary flow (1.5 ml or less in 15 min) 2. Abnormal parotid sialography 3. Abnormal salivary scintigraphy VI. Autoantibodies (at least one) 1. Anti-SSA (Ro) or anti-SSB (La) or both VII. Exclusion criteria 1. Past head and neck radiation treatment 2. Hepatitis C infection 3. Acquired immunodeficiency syndrome 4. Pre-existing lymphoma 5. Sarcoidosis 6. Graft versus host disease 7. Current use of anticholinergic drugs a For primary Sjögren’s syndrome, (i) any 4 of the 6 criteria, must include either item IV (histopathology) or VI (autoantibodies) or (ii) any 3 of the 4 objective criteria (III, IV, V, VI); for secondary Sjögren’s syndrome, in patients with another well-defined major connective tissue disease, the presence of one symptom (I or II) plus 2 of the 3 objective criteria (III, IV and V) Table 2 Diagnostic criteria for systemic sclerosis (American College of Rheumatology/European League Against Rheumatism criteria for the classification of systemic sclerosis ) Item Sub-items Weight/score a Skin thickening of the fingers of both hands extending proximal to the metacarpophalangeal joints (sufficient criteria) - 9 Skin thickening of the fingers (only count the higher score) Puffy fingers Sclerodactly of the fingers (distal to the metacarpophalangeal joints but proximal to the proximal interphalangeal joints) 2 4 Fingertip lesions (only count the higher score) Distal tip ulcers Fingertip pitting scars 2 3 Telangiectasia - 2 Abnormal nailfold capillaries - 2 Pulmonary arterial hypertension and/or interstitial lung disease (maximum score is 2) Pulmonary arterial hypertension Interstitial lung disease 2 2 Raynaud’s phenomenon - 3 Systemic sclerosis-related autoantibodies Anticentromere Anti-topoisomerase I (anti-Scl 70) Anti-RNA polymerase III 3 a The total score is determined by adding the maximum weight (score) in each category. Patients with a total score of 9 or higher are classified as having definite scleroderma
4.246094
0.907715
sec[1]/sec[8]/p[0]
en
0.999999
27257502
https://doi.org/10.1186/s40557-016-0106-3
[ "criteria", "anti", "score", "systemic", "salivary", "sclerosis", "least", "lung", "antibody", "gland" ]
[ { "code": "2A60.3Z", "title": "Acute myeloid leukaemia, unspecified" }, { "code": "2A60.3Y", "title": "Other specified acute myeloid leukaemia, not elsewhere classified by criteria of other types" }, { "code": "5B7Z", "title": "Unspecified undernutrition" }, { "code": "JA86.Y", "title": "Maternal care for other specified fetal problems" }, { "code": "MB23.1", "title": "Antisocial behaviour" }, { "code": "3B4Z", "title": "Coagulation defects, unspecified" }, { "code": "4A45.Z", "title": "Antiphospholipid syndrome, unspecified" }, { "code": "4A43.Y", "title": "Other specified overlap non-organ specific systemic autoimmune disease" }, { "code": "MB20.1&XC87", "title": "Glasgow Coma Scale, eyes opening, never" }, { "code": "KD30.0", "title": "Birth depression with 5 minute Apgar score 0-3" } ]
=== ICD-11 CODES FOUND === [2A60.3Z] Acute myeloid leukaemia, unspecified Also known as: Acute myeloid leukaemia, unspecified | Acute myeloid leukaemia, not elsewhere classified by criteria of other types | Acute myeloblastic leukaemia without mention of remission | acute myeloblastic leukaemia NOS | Acute myeloid leukaemia, NOS by criteria of other types [2A60.3Y] Other specified acute myeloid leukaemia, not elsewhere classified by criteria of other types Also known as: Other specified acute myeloid leukaemia, not elsewhere classified by criteria of other types | Acute myeloid leukaemia, not elsewhere classified by criteria of other types in complete remission | Acute myeloblastic leukaemia in complete remission | Acute myeloid leukaemia, NOS by criteria of other types in complete remission [5B7Z] Unspecified undernutrition Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome [4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome [KD30.0] Birth depression with 5 minute Apgar score 0-3 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 0-3 === GRAPH WALKS === --- Walk 1 --- [2A60.3Z] Acute myeloid leukaemia, unspecified --PARENT--> [2A60.3] Acute myeloid leukaemia, not elsewhere classified by criteria of other types Def: Acute myeloid leukaemias specified by morphological criteria should only be classified as such, if recurrent genetic abnormalities, prior history of a myelodysplastic syndrome or myelodysplastic/myelo... --EXCLUDES--> [?] Acute myeloid leukaemia with myelodysplasia-related changes Def: An acute myeloid leukaemia with at least 20% blasts in the bone marrow or blood, and either a previous history of myelodysplastic syndrome, multilineage dysplasia or typical myelodysplastic syndrome-r... --- Walk 2 --- [2A60.3Z] Acute myeloid leukaemia, unspecified --PARENT--> [2A60.3] Acute myeloid leukaemia, not elsewhere classified by criteria of other types Def: Acute myeloid leukaemias specified by morphological criteria should only be classified as such, if recurrent genetic abnormalities, prior history of a myelodysplastic syndrome or myelodysplastic/myelo... --CHILD--> [2A60.32] Acute myeloid leukaemia with maturation Def: An acute myeloid leukaemia (AML) characterised by blasts with evidence of maturation to more mature neutrophils.... --- Walk 3 --- [2A60.3Y] Other specified acute myeloid leukaemia, not elsewhere classified by criteria of other types --PARENT--> [2A60.3] Acute myeloid leukaemia, not elsewhere classified by criteria of other types Def: Acute myeloid leukaemias specified by morphological criteria should only be classified as such, if recurrent genetic abnormalities, prior history of a myelodysplastic syndrome or myelodysplastic/myelo... --EXCLUDES--> [?] Therapy-related myeloid neoplasms --- Walk 4 --- [2A60.3Y] Other specified acute myeloid leukaemia, not elsewhere classified by criteria of other types --PARENT--> [2A60.3] Acute myeloid leukaemia, not elsewhere classified by criteria of other types Def: Acute myeloid leukaemias specified by morphological criteria should only be classified as such, if recurrent genetic abnormalities, prior history of a myelodysplastic syndrome or myelodysplastic/myelo... --EXCLUDES--> [?] Acute myeloid leukaemia with recurrent genetic abnormalities --- Walk 5 --- [5B7Z] Unspecified undernutrition --PARENT--> [?] Undernutrition Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c... --EXCLUDES--> [?] Human immunodeficiency virus disease associated with wasting syndrome Def: This is a lentivirus (slowly replicating retrovirus) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which progressive failure of the immune system allows life-threaten... --- Walk 6 --- [5B7Z] Unspecified undernutrition --PARENT--> [?] Undernutrition Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c... --EXCLUDES--> [?] Effects of hunger
[ "[2A60.3Z] Acute myeloid leukaemia, unspecified\n --PARENT--> [2A60.3] Acute myeloid leukaemia, not elsewhere classified by criteria of other types\n Def: Acute myeloid leukaemias specified by morphological criteria should only be classified as such, if recurrent genetic abnormalities, prior history of a myelodysplastic syndrome or myelodysplastic/myelo...\n --EXCLUDES--> [?] Acute myeloid leukaemia with myelodysplasia-related changes\n Def: An acute myeloid leukaemia with at least 20% blasts in the bone marrow or blood, and either a previous history of myelodysplastic syndrome, multilineage dysplasia or typical myelodysplastic syndrome-r...", "[2A60.3Z] Acute myeloid leukaemia, unspecified\n --PARENT--> [2A60.3] Acute myeloid leukaemia, not elsewhere classified by criteria of other types\n Def: Acute myeloid leukaemias specified by morphological criteria should only be classified as such, if recurrent genetic abnormalities, prior history of a myelodysplastic syndrome or myelodysplastic/myelo...\n --CHILD--> [2A60.32] Acute myeloid leukaemia with maturation\n Def: An acute myeloid leukaemia (AML) characterised by blasts with evidence of maturation to more mature neutrophils....", "[2A60.3Y] Other specified acute myeloid leukaemia, not elsewhere classified by criteria of other types\n --PARENT--> [2A60.3] Acute myeloid leukaemia, not elsewhere classified by criteria of other types\n Def: Acute myeloid leukaemias specified by morphological criteria should only be classified as such, if recurrent genetic abnormalities, prior history of a myelodysplastic syndrome or myelodysplastic/myelo...\n --EXCLUDES--> [?] Therapy-related myeloid neoplasms", "[2A60.3Y] Other specified acute myeloid leukaemia, not elsewhere classified by criteria of other types\n --PARENT--> [2A60.3] Acute myeloid leukaemia, not elsewhere classified by criteria of other types\n Def: Acute myeloid leukaemias specified by morphological criteria should only be classified as such, if recurrent genetic abnormalities, prior history of a myelodysplastic syndrome or myelodysplastic/myelo...\n --EXCLUDES--> [?] Acute myeloid leukaemia with recurrent genetic abnormalities", "[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --EXCLUDES--> [?] Human immunodeficiency virus disease associated with wasting syndrome\n Def: This is a lentivirus (slowly replicating retrovirus) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which progressive failure of the immune system allows life-threaten...", "[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --EXCLUDES--> [?] Effects of hunger" ]
2A60.3Z
Acute myeloid leukaemia, unspecified
[ { "from_icd11": "2A60.3Z", "icd10_code": "C9200", "icd10_title": "Acute myeloblastic leukemia, not having achieved remission" }, { "from_icd11": "2A60.3Z", "icd10_code": "C9202", "icd10_title": "Acute myeloblastic leukemia, in relapse" }, { "from_icd11": "2A60.3Z", "icd10_code": "C9201", "icd10_title": "Acute myeloblastic leukemia, in remission" }, { "from_icd11": "2A60.3Z", "icd10_code": "C9290", "icd10_title": "Myeloid leukemia, unspecified, not having achieved remission" }, { "from_icd11": "2A60.3Z", "icd10_code": "C9291", "icd10_title": "Myeloid leukemia, unspecified in remission" }, { "from_icd11": "2A60.3Z", "icd10_code": "C920", "icd10_title": "Acute myeloblastic leukemia" }, { "from_icd11": "2A60.3Z", "icd10_code": "C929", "icd10_title": "Myeloid leukemia, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E43", "icd10_title": "Unspecified severe protein-calorie malnutrition" }, { "from_icd11": "5B7Z", "icd10_code": "E538", "icd10_title": "Deficiency of other specified B group vitamins" }, { "from_icd11": "5B7Z", "icd10_code": "E569", "icd10_title": "Vitamin deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E638", "icd10_title": "Other specified nutritional deficiencies" }, { "from_icd11": "5B7Z", "icd10_code": "E639", "icd10_title": "Nutritional deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E41", "icd10_title": "Nutritional marasmus" }, { "from_icd11": "5B7Z", "icd10_code": "E539", "icd10_title": "Vitamin B deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E568", "icd10_title": "Deficiency of other vitamins" } ]
C9200
Acute myeloblastic leukemia, not having achieved remission
A 78-year-old male patient with dyspnoea classified as New York Heart Association functional class III and peripheral oedema presented to our clinic with severe mitral regurgitation (MR) and moderate tricuspid regurgitation (TR). The patient underwent coronary artery bypass graft (CABG) surgery at the age of 55 years [left internal mammary artery—first marginal, right internal mammary artery–left anterior descending artery (LAD), vein graft—right coronary artery (RCA)] due to a severe coronary three-vessel disease with chronic total occlusion of the RCA, severe stenosis of the circumflex artery, and severe stenosis of the LAD with stenting of the left main in 2001 due to functional occluded bypasses to the LAD without any acute myocardial infarction. Furthermore, permanent atrial fibrillation, chronic renal disease stage III, type 2 diabetes mellitus, and a combined post- and pre-capillary pulmonary hypertension (mean pulmonary artery pressure 35 mmHg, pulmonary wedge pressure 24 mmHg, cardiac output 2.9 L/min, pulmonary vascular resistance 3.8 Wood units were derived from right heart catheterization) were documented. Coronary angiography excluded a progression of the coronary artery disease. The electrocardiogram showed previously known atrial fibrillation with regular ventricular response. Echocardiography confirmed a severe, extremely eccentric predominantly secondary MR [2D-effective regurgitation orifice area (EROA) 0.46 cm 2 , regurgitation volume 67 mL, vena contracta (VC) biplane 10 mm, mitral valve area of 4.8 cm 2 , mean pressure gradient was 1.5 mmHg] due to a dilation of the mitral valve annulus (intercommissural diameter was 36 mm) and an asymmetric tethering with a short posterior mitral leaflet of 5 mm length and a moderate-severe TR. Left ventricular ejection fraction was 52%, and N-terminal pro b-type natriuretic peptide (NT-proBNP) was elevated at 1901 ng/L. Before treatment, patient was on novel oral anticoagulant, betablocker, angiotensin receptor blocker, mineralocorticoid receptor antagonist, sodium-glucose transport 2-inhibitor, loop diuretics, and a distinct diabetic therapy. The EuroSCORE II was 10.4% and the STS score 16.7%. The interdisciplinary Heart Team decided for a TMVI procedure with a Cardiovalve prosthesis due to the fact of a high-risk patient for a re-operation (after prior CABG surgery), known pulmonary hypertension, and no need for a coronary bypass surgery. Mitral valve transcatheter edge-to-edge repair (M-TEER) was also not a good option due to the short and tethered posterior mitral valve leaflet. In addition, the possibility of a mitral valve replacement within the AHEAD study was another fact for the decision of treatment. The anchoring mechanism is a clamping of the valve leaflets with ventricular legs and an atrial flange to anchor from the atrial side . A computer tomography (CT) scan was done for sizing of the mitral valve annulus. CT evaluation included also the neo-left ventricular outflow tract (LVOT) narrowing and the access venous vessel. After approval of the independent clinical screening committee and patient informed consent, a Cardiovalve prosthesis (size M) was implanted via a transfemoral–transseptal access. Surgical cut-down was recommended in the first cases regarding safety issues due to the 37 Fr sheath size. After performing a transseptal puncture as posterior and superior as possible, a pre-dilation of the septum with a 10 × 40 mm peripheral transluminal angioplasty balloon (Admiral; Medtronic, Germany) was done. Thereafter, a steerable sheath (8 Fr) and a pigtail catheter were used for crossing of the mitral valve. The pigtail catheter was exchanged for a stiff wire (Lunderquist; Cook Medical, Ireland). Over this wire, a floating manoeuvre using a Reliant balloon (Medtronic, Germany) to ensure a free positioning without any interaction with the cords was performed. Thereafter, the delivery system was advanced into the left atrium and centred with respect to the mitral annulus, the ventricular grasping legs were opened, dived into the left ventricle, and afterwards retracted . After confirmation that all ventricular legs grasped the leaflets, the atrial flange was opened followed by releasing of the ventricular part of the system . Echocardiography showed a perfect result with only trace paravalvular MR and a mean gradient of 4.5 mmHg. There was no relevant LVOT gradient after the procedure (mean LVOT 1.6 mmHg). The right heart catheter measurement revealed no relevant left-to-right atrial shunt (Qp:Qs = 1.1), and the shunt was kept open. Patient was extubated right after the procedure and discharged to a rehab clinic on Day 11. For prevention of a thrombus, oral anticoagulation with warfarin was administered with an international normalized ratio (INR) of 2.5–3.5.
4.113281
0.967285
sec[1]/sec[0]/p[0]
en
0.999996
39045523
https://doi.org/10.1093/ehjcr/ytae336
[ "mitral", "artery", "valve", "ventricular", "coronary", "atrial", "pulmonary", "mmhg", "heart", "regurgitation" ]
[ { "code": "BB60.Z", "title": "Mitral valve stenosis, unspecified" }, { "code": "LA89.2", "title": "Mitral atresia" }, { "code": "BB6Z", "title": "Mitral valve disease, unspecified" }, { "code": "LA87.11", "title": "Congenital mitral valvar stenosis" }, { "code": "LA87.10", "title": "Congenital mitral regurgitation" }, { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "BD52", "title": "Certain specified disorders of arteries or arterioles" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "BD52.2", "title": "Stricture of artery" }, { "code": "BD40.Z", "title": "Atherosclerotic chronic arterial occlusive disease, unspecified" } ]
=== ICD-11 CODES FOUND === [BB60.Z] Mitral valve stenosis, unspecified Also known as: Mitral valve stenosis, unspecified | Mitral valve stenosis | MS - [mitral stenosis] | mitral stenosis | mitral valvular stricture [LA89.2] Mitral atresia Definition: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve. Also known as: Mitral atresia | Mitral atresia with absent atrioventricular connection | absent left atrioventricular connection or junction | absent left atrioventricular connection in laevocardia | mitral atresia with absent valvar annulus [BB6Z] Mitral valve disease, unspecified Also known as: Mitral valve disease, unspecified | noninfective endocarditis of mitral valve | rheumatic heart disease of mitral valve, unspecified | mitral valvulopathy | mitral valve cardiopathy [LA87.11] Congenital mitral valvar stenosis Definition: A congenital cardiovascular malformation of the mitral valve in which there is narrowing or stricture of the valvar orifice (obstruction to flow). Also known as: Congenital mitral valvar stenosis | Duroziez disease | congenital mitral stenosis | congenital stenosis of mitral valve | congenital mitral valve stricture [LA87.10] Congenital mitral regurgitation Definition: A congenital cardiovascular finding in which there is backward flow through the mitral valve. Also known as: Congenital mitral regurgitation | congenital insufficiency of mitral valve | congenital mitral insufficiency | congenital mitral valve incompetence | congenital mitral valve insufficiency [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [BD52] Certain specified disorders of arteries or arterioles Also known as: Certain specified disorders of arteries or arterioles | Aortic dilatation - joint hypermobility - arterial tortuosity | Generalised arterial calcification of infancy | Median arcuate ligament syndrome | Aortic root abscess Excludes: collagen (vascular) diseases | Hypersensitivity angiitis | Acute arterial occlusion [BD52.3] Rupture of artery Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula Excludes: traumatic rupture of artery - see injury of blood vessel by body region [BD52.2] Stricture of artery Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery [BD40.Z] Atherosclerotic chronic arterial occlusive disease, unspecified Also known as: Atherosclerotic chronic arterial occlusive disease, unspecified | Atherosclerotic chronic arterial occlusive disease | arteriosclerosis, NOS | generalised atherosclerosis | atherosclerosis NOS === GRAPH WALKS === --- Walk 1 --- [BB60.Z] Mitral valve stenosis, unspecified --PARENT--> [BB60] Mitral valve stenosis --EXCLUDES--> [?] Mitral valve stenosis with insufficiency Def: This is a valvular heart disease characterised by the narrowing of the orifice of the mitral valve of the heart, with regurgitation.... --- Walk 2 --- [BB60.Z] Mitral valve stenosis, unspecified --PARENT--> [BB60] Mitral valve stenosis --CHILD--> [BB60.1] Nonrheumatic mitral valve stenosis Def: Mitral stenosis is narrowing of the passage through the mitral valve due to fibrosis, and calcinosis in the leaflets and chordal areas. The most common reason of mitral stenosis is rheumatic fever. Ex... --- Walk 3 --- [LA89.2] Mitral atresia Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve.... --PARENT--> [LA89] Functionally univentricular heart Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ... --CHILD--> [LA89.0] Double inlet atrioventricular connection Def: A congenital cardiovascular malformation with a univentricular atrioventricular connection wherein both atria connect to one ventricle either via two separate atrioventricular valves or a common atrio... --- Walk 4 --- [LA89.2] Mitral atresia Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve.... --PARENT--> [LA89] Functionally univentricular heart Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ... --CHILD--> [LA89.2] Mitral atresia Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve.... --- Walk 5 --- [BB6Z] Mitral valve disease, unspecified --PARENT--> [?] Mitral valve disease Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i... --PARENT--> [?] Heart valve diseases --- Walk 6 --- [BB6Z] Mitral valve disease, unspecified --PARENT--> [?] Mitral valve disease Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i... --EXCLUDES--> [?] Congenital anomaly of mitral valve Def: A congenital cardiac malformation in which there is an abnormality of the mitral valve....
[ "[BB60.Z] Mitral valve stenosis, unspecified\n --PARENT--> [BB60] Mitral valve stenosis\n --EXCLUDES--> [?] Mitral valve stenosis with insufficiency\n Def: This is a valvular heart disease characterised by the narrowing of the orifice of the mitral valve of the heart, with regurgitation....", "[BB60.Z] Mitral valve stenosis, unspecified\n --PARENT--> [BB60] Mitral valve stenosis\n --CHILD--> [BB60.1] Nonrheumatic mitral valve stenosis\n Def: Mitral stenosis is narrowing of the passage through the mitral valve due to fibrosis, and calcinosis in the leaflets and chordal areas.\nThe most common reason of mitral stenosis is rheumatic fever. Ex...", "[LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --CHILD--> [LA89.0] Double inlet atrioventricular connection\n Def: A congenital cardiovascular malformation with a univentricular atrioventricular connection wherein both atria connect to one ventricle either via two separate atrioventricular valves or a common atrio...", "[LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --CHILD--> [LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....", "[BB6Z] Mitral valve disease, unspecified\n --PARENT--> [?] Mitral valve disease\n Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i...\n --PARENT--> [?] Heart valve diseases", "[BB6Z] Mitral valve disease, unspecified\n --PARENT--> [?] Mitral valve disease\n Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i...\n --EXCLUDES--> [?] Congenital anomaly of mitral valve\n Def: A congenital cardiac malformation in which there is an abnormality of the mitral valve...." ]
BB60.Z
Mitral valve stenosis, unspecified
[ { "from_icd11": "BB60.Z", "icd10_code": "I050", "icd10_title": "Rheumatic mitral stenosis" }, { "from_icd11": "BB60.Z", "icd10_code": "I342", "icd10_title": "Nonrheumatic mitral (valve) stenosis" }, { "from_icd11": "LA89.2", "icd10_code": "Q232", "icd10_title": "Congenital mitral stenosis" }, { "from_icd11": "BB6Z", "icd10_code": "I059", "icd10_title": "Rheumatic mitral valve disease, unspecified" }, { "from_icd11": "BB6Z", "icd10_code": "I058", "icd10_title": "Other rheumatic mitral valve diseases" }, { "from_icd11": "BB6Z", "icd10_code": "I348", "icd10_title": "Other nonrheumatic mitral valve disorders" }, { "from_icd11": "BB6Z", "icd10_code": "I349", "icd10_title": "Nonrheumatic mitral valve disorder, unspecified" }, { "from_icd11": "BB6Z", "icd10_code": "I05-I09", "icd10_title": "" }, { "from_icd11": "BB6Z", "icd10_code": "I05", "icd10_title": "Rheumatic mitral valve diseases" }, { "from_icd11": "BB6Z", "icd10_code": "I390", "icd10_title": "" }, { "from_icd11": "BB6Z", "icd10_code": "I34", "icd10_title": "Nonrheumatic mitral valve disorders" }, { "from_icd11": "LA87.10", "icd10_code": "Q233", "icd10_title": "Congenital mitral insufficiency" }, { "from_icd11": "BD5Z", "icd10_code": "I7389", "icd10_title": "Other specified peripheral vascular diseases" }, { "from_icd11": "BD5Z", "icd10_code": "I7419", "icd10_title": "Embolism and thrombosis of other parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7411", "icd10_title": "Embolism and thrombosis of thoracic aorta" } ]
I050
Rheumatic mitral stenosis
For the left side, we decided to access the sinus using a lateral window as the area of deficient bone was much larger in size and more complex in shape. We also decided to approach this area from the palate, as the defect was closer to the palate and required much less bone removal as a buccal approach. Most importantly, we were already familiar with the anatomical structures on the lower medial wall of the sinus in the access area as we visualized this area during the first graft surgery and CT scans showed no signs of larger intraosseous vasculature in the area. Given this specific case, and knowledge of the vascular anatomy of the maxillary sinus in the surgical area , we felt that our approach would not invade the zone of risk for bleeding complications. We performed the surgery similar to a conventional lateral window sinus augmentation surgery using piezosurgery and a buccal approach, except from the palatal side of the alveolar ridge and staying clear of the greater palatine neurovascular bundle . Here, we created a mucoperiosteal flap with vertical release at no. 13 . Using a piezotome and piezosurgery inserts (Piezotome 2, Acteon North America, Mount Laurel, NJ, USA), we created a rectangular window over the bony defect, avoiding any vascular structures . Using piezosurgery inserts and hydraulic pressure (IntraLift Kit, Acteon North America, Mount Laurel, NJ, USA), we carefully removed the Schneiderian membrane from the finger-like defect . We then placed a root-form 4.7 mm × 10 mm implant according to standard protocol and achieved good primary stability in excess of 30 Ncm. We placed a strip of resorbable collagen tape over any exposed Schneiderian membrane, grafted the site with 1.2 ml cortical particulate allograft (LifeNet Health, Virginia Beach, WA, USA) and placed a resorbable collagen membrane (ConFORM, ACE Surgical Supply, Brockton, MA, USA) over the palatal access window . We then covered the implant and graft with the palatal flap and sutured it with PTFE 3-0 (Cytoplast, Osteogenics Biomedical, Lubbock, TX, USA) continuous and horizontal mattress sutures . A postoperative radiograph showed good containment of the graft material . Fig. 8 Blood supply of the sinus. There are three areas in the sinus where blood vessels may be encountered during sinus augmentation procedures for implants. On the inflection point between hard palate and alveolar ridge in the posterior maxilla, the greater palatine neurovascular bundle is located embedded in soft tissue. This inflection point is matched in the internal sinus anatomy and presents a landmark that can be palpated with sinus curettes during sinus membrane elevation or seen on cone beam CT images in this patient. It is important to avoid instrumenting the area above this inflection point as branches of the lateral posterior nasal arteries may be encountered superior to this area. Injuring these blood vessels can lead to significant sinus bleeding that is difficult to stop without sinus tamponade. Often on cone beam CT images, we see a small blood vessel channel midway within the lateral wall of the sinus, which likely is the posterior superior alveolar artery and vein. This and the interior medial wall sinus inflection point can serve as anatomic landmark to delineate a risk zone superior to it and to limit sinus augmentation inferior to it Fig. 9 Schematic diagram of palatal approach sinus augmentation. The diagram shows the location of the lateral window, avoiding the thick grafted bone on the buccal, and the greater palatal neurovascular bundle Fig. 10 Palatal approach lateral window sinus augmentation. This photographic series shows the surgical procedure that augmented bone and allowed implant placement at the no. 14 site. a Preoperative view prior to infiltration anesthesia. b Full-thickness midcrestal incision with palatal release and flap elevation. This was aided by a small bony ridge that separated the alveolar crest from the soft tissue area containing the greater palatine neurovascular bundle. c Sinus window created with piezosurgery. d–f With gentle piezocision and water pressure, the finger-like membrane is slowly mobilized and collapsed towards the remainder of the sinus cavity. The overlying bone serves to form a new floor covering the base of the finger-like cavity. f Conventional implant placement using osteotomy drills. g Any exposed sinus membrane is covered with collagen tape. h Particulate mineralized allograft is placed into the newly created space. i A resorbable collagen membrane is placed over the access window. j Palatal tissue is sutured over implant and grafted site with mattress sutures. k Postoperative radiograph taken immediately after surgery shows cloud of particulate grafted bone around implant, suggesting good bone graft containment
4.097656
0.826172
sec[1]/p[5]
en
0.999997
28105590
https://doi.org/10.1186/s40729-017-0065-7
[ "sinus", "this", "area", "window", "palatal", "bone", "membrane", "approach", "implant", "using" ]
[ { "code": "CA0A.Z", "title": "Chronic rhinosinusitis, unspecified" }, { "code": "CA0Y&XA3523", "title": "Nasal sinus obstruction" }, { "code": "CA0J.Y", "title": "Other specified nasal polyp" }, { "code": "LB03.Y", "title": "Other specified structural developmental anomalies of umbilical cord" }, { "code": "DA09.61", "title": "Periapical abscess with sinus" }, { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "code": "QF29", "title": "Difficulty or need for assistance with major areas of life" }, { "code": "EH40.1Y", "title": "Other specified infantile napkin dermatoses" }, { "code": "GA90", "title": "Hyperplasia of prostate" }, { "code": "2B66.Z", "title": "Malignant neoplasms of other or unspecified parts of mouth, unspecified" } ]
=== ICD-11 CODES FOUND === [CA0A.Z] Chronic rhinosinusitis, unspecified Also known as: Chronic rhinosinusitis, unspecified | Chronic rhinosinusitis | Chronic sinusitis | chronic sinusitis NOS | unspecified sinusitis [CA0J.Y] Other specified nasal polyp Also known as: Other specified nasal polyp | Polyp of nasal cavity | Polyp of the nasopharynx | nasopharyngeal polyp | Polyp of adenoid tissue [LB03.Y] Other specified structural developmental anomalies of umbilical cord Also known as: Other specified structural developmental anomalies of umbilical cord | Umbilical cord calcifications | Omphalomesenteric duct remnants or cysts | Vitelline duct remnants and cysts | Persistent omphalomesenteric duct [DA09.61] Periapical abscess with sinus Also known as: Periapical abscess with sinus | Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus | periapical abscess fistula Includes: Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus [4A01.03] Transient hypogammaglobulinaemia of infancy Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy] [QF29] Difficulty or need for assistance with major areas of life Also known as: Difficulty or need for assistance with major areas of life | difficulty with major areas of life | need for assistance with major areas of life | Difficulty or need for assistance with education | Difficulty or needs for assistance with work and economic life [EH40.1Y] Other specified infantile napkin dermatoses Also known as: Other specified infantile napkin dermatoses | Infections of the napkin area [GA90] Hyperplasia of prostate Definition: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urinary urgency, nocturia, weak urine stream, straining while urinating, incomplete bladder emptying during urination, or increased frequency of urinary tract infection. Also known as: Hyperplasia of prostate | Adenofibromatous hypertrophy of prostate | benign prostatic hyperplasia | prostate hyperplasia | prostatic area hypertrophy Includes: Adenofibromatous hypertrophy of prostate Excludes: Benign neoplasms of prostate [2B66.Z] Malignant neoplasms of other or unspecified parts of mouth, unspecified Also known as: Malignant neoplasms of other or unspecified parts of mouth, unspecified | Malignant neoplasms of other or unspecified parts of mouth | cancer of buccal mucosa | cancer of cheek mucosa | internal cheek cancer === GRAPH WALKS === --- Walk 1 --- [CA0A.Z] Chronic rhinosinusitis, unspecified --PARENT--> [CA0A] Chronic rhinosinusitis Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d... --CHILD--> [CA0A.Z] Chronic rhinosinusitis, unspecified --- Walk 2 --- [CA0A.Z] Chronic rhinosinusitis, unspecified --PARENT--> [CA0A] Chronic rhinosinusitis Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d... --CHILD--> [CA0A.0] Samter syndrome Def: Samter syndrome is composed of asthma, acetylsalicylic acid (aspirin®™) intolerance, nasal polyps and chronic rhinosinusitis.... --- Walk 3 --- [CA0J.Y] Other specified nasal polyp --PARENT--> [CA0J] Nasal polyp Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,... --PARENT--> [?] Upper respiratory tract disorders Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ... --- Walk 4 --- [CA0J.Y] Other specified nasal polyp --PARENT--> [CA0J] Nasal polyp Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,... --CHILD--> [CA0J.0] Polypoid sinus degeneration Def: Also referred to as Woakes' syndrome or ethmoiditis. Woakes' syndrome is characterised by severe recurrent nasal polyps, often without eosinophils on histological examination and with broadening of th... --- Walk 5 --- [LB03.Y] Other specified structural developmental anomalies of umbilical cord --PARENT--> [LB03] Structural developmental anomalies of umbilical cord Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period.... --RELATED_TO--> [?] Umbilical cord haemangioma Def: Tumour composed of thin walled blood vessels lined by endothelium present within the cord.... --- Walk 6 --- [LB03.Y] Other specified structural developmental anomalies of umbilical cord --PARENT--> [LB03] Structural developmental anomalies of umbilical cord Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period.... --RELATED_TO--> [?] Fetus or newborn affected by short umbilical cord Def: An umbilical cord < 2 SD in length below mean for the gestational age. At term, this is < 35 cm. Often associated with fetal hypokinesia...
[ "[CA0A.Z] Chronic rhinosinusitis, unspecified\n --PARENT--> [CA0A] Chronic rhinosinusitis\n Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...\n --CHILD--> [CA0A.Z] Chronic rhinosinusitis, unspecified", "[CA0A.Z] Chronic rhinosinusitis, unspecified\n --PARENT--> [CA0A] Chronic rhinosinusitis\n Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...\n --CHILD--> [CA0A.0] Samter syndrome\n Def: Samter syndrome is composed of asthma, acetylsalicylic acid (aspirin®™) intolerance, nasal polyps and chronic rhinosinusitis....", "[CA0J.Y] Other specified nasal polyp\n --PARENT--> [CA0J] Nasal polyp\n Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...", "[CA0J.Y] Other specified nasal polyp\n --PARENT--> [CA0J] Nasal polyp\n Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...\n --CHILD--> [CA0J.0] Polypoid sinus degeneration\n Def: Also referred to as Woakes' syndrome or ethmoiditis. Woakes' syndrome is characterised by severe recurrent nasal polyps, often without eosinophils on histological examination and with broadening of th...", "[LB03.Y] Other specified structural developmental anomalies of umbilical cord\n --PARENT--> [LB03] Structural developmental anomalies of umbilical cord\n Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period....\n --RELATED_TO--> [?] Umbilical cord haemangioma\n Def: Tumour composed of thin walled blood vessels lined by endothelium present within the cord....", "[LB03.Y] Other specified structural developmental anomalies of umbilical cord\n --PARENT--> [LB03] Structural developmental anomalies of umbilical cord\n Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period....\n --RELATED_TO--> [?] Fetus or newborn affected by short umbilical cord\n Def: An umbilical cord < 2 SD in length below mean for the gestational age. At term, this is < 35 cm. Often associated with fetal hypokinesia..." ]
CA0A.Z
Chronic rhinosinusitis, unspecified
[ { "from_icd11": "CA0A.Z", "icd10_code": "J329", "icd10_title": "Chronic sinusitis, unspecified" }, { "from_icd11": "CA0A.Z", "icd10_code": "J324", "icd10_title": "Chronic pansinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J320", "icd10_title": "Chronic maxillary sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J322", "icd10_title": "Chronic ethmoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J323", "icd10_title": "Chronic sphenoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J328", "icd10_title": "Other chronic sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J321", "icd10_title": "Chronic frontal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J30-J39", "icd10_title": "" }, { "from_icd11": "CA0A.Z", "icd10_code": "J32", "icd10_title": "Chronic sinusitis" }, { "from_icd11": "DA09.61", "icd10_code": "K046", "icd10_title": "Periapical abscess with sinus" }, { "from_icd11": "4A01.03", "icd10_code": "D807", "icd10_title": "Transient hypogammaglobulinemia of infancy" }, { "from_icd11": "QF29", "icd10_code": "Z742", "icd10_title": "Need for assistance at home and no other household member able to render care" }, { "from_icd11": "GA90", "icd10_code": "N402", "icd10_title": "Nodular prostate without lower urinary tract symptoms" }, { "from_icd11": "GA90", "icd10_code": "N403", "icd10_title": "Nodular prostate with lower urinary tract symptoms" }, { "from_icd11": "GA90", "icd10_code": "N400", "icd10_title": "Benign prostatic hyperplasia without lower urinary tract symptoms" } ]
J329
Chronic sinusitis, unspecified
Abdominal contrast-enhanced CT revealed a mass of 36 mm in diameter at the tail of the remnant pancreas, with an adjacent mass of 15 mm . These two masses were almost clear and round and appeared to be protruding from the tail of the pancreas. Furthermore, these masses revealed ring-enhanced features, and the inner part showed no contrast effect, as if it were a necrotic tissue. The boundary between the tumor and the left diaphragm was unclear, suggesting invasion of the tumor. Although no dilatation of the main pancreatic duct or swelling the surrounding lymph node was observed, the larger tumor was enlarged compared with 1 month before , and had not been recognized 6 months previously . However, the diameter of the smaller tumor had not changed for 3 years . These masses showed low signal intensity on T1-weighted MRI , heterogeneous high intensity on T2-weighted MRI , and high signal intensity in diffusion-weighted imaging (DWI) , and the apparent diffusion coefficient (ADC) value revealed low signal intensity . Whole-body FDG-PET showed abnormal uptake in the two tumors , and the standardized uptake value maximum was 13.1, with the delayed scan showing 17.4. No other abnormal uptake suggestive of distant metastasis, lymph node metastasis, or dissemination was observed. Examinations of the pancreatic juice cytology, EUS, and endoscopic retrograde cholangiopancreatography were difficult to perform because the patient had undergone total gastrectomy and pancreatoduodenectomy with gastrointestinal reconstruction. Finally, these tumors were diagnosed as suspected anaplastic pancreatic cancer or benign cystic tumor. In this case, during two previous surgeries for advanced gastric cancer and carcinoma of the ampulla of Vater, regional lymph node dissection was performed. In addition, because the tumors were located at the end of the pancreas tail, a sufficient surgical margin was considered to be easily obtained. On the basis of these findings, although there was a possibility of malignant disease, we conducted a partial resection of the remnant pancreas with concomitant resection of the left diaphragm as a diagnostic therapy to preserve pancreatic functions. In fact, intraoperative ultrasound examination revealed that a surgical margin of 20 mm from the tumor to the stump could be obtained, and histopathological examination of intraoperative frozen sections showed negative findings at the pancreatic stump. Macroscopically, the cystic lesion was 9 mm in diameter and was filled with white-yellowish material in the pancreatic tissue . The other mass was 23 mm in diameter and presented intervening pancreatic tissue. In the former, histopathological examination revealed squamous epithelium on a background of cysts with proliferated lymphoid tissue . In the latter, neutrophil infiltration, lymphocytes, and collagen fibers were observed; thus, it was suggested that there was acute exacerbation of chronic inflammation. The histopathological diagnosis was an LEC with chronic abscess in the pancreas. Although tight adhesion was intraoperatively observed between the tumors of the pancreatic tail and the left diaphragm, which was suspected to be invasion of cancer to the diaphragm, histopathological examination demonstrated that the tumors were LEC with an adjacent abscess with tight adhesion to the left diaphragm. Fig. 1 Contrast-enhanced computed tomography (CT) findings. CT showed a relatively clear, round, ring-enhanced tumor of 15 mm in diameter (white arrow) and an adjacent tumor of 35 mm in size (yellow arrow) ( a ). The larger tumor was enlarged compared with 1 month before ( b ) and had not been recognized 6 months previously ( c ). The smaller tumor had not changed from 3 years previously ( d ) Fig. 2 Magnetic resonance imaging findings. Magnetic resonance imaging revealed both the larger (yellow arrow) and smaller (white arrow) tumors as having low signal intensity on T1-weighted MRI ( a ), heterogeneous high intensity on T2-weighted MRI ( b ), and high signal intensity in diffusion-weighted imaging ( c ), and the apparent diffusion coefficient value revealed low signal intensity ( d ) Fig. 3 Fluorodeoxyglucose-positron emission tomography findings. The tumors were visualized as masses with a standardized uptake value maximum of 17.4 (white arrow) Fig. 4 Cross sections of the resected specimen. The cystic lesion of 23 mm in diameter was filled with white-yellowish material in the pancreatic tissue (yellow arrow). The other white solid mass of 9 mm in diameter was present with intervening pancreatic tissue (white arrow) Fig. 5 Pathological findings. Squamous epithelium on a background of cysts with proliferated lymphoid tissue was identified ( a ). Infiltration of neutrophils into the stratified squamous epithelium was evident ( b )
4.175781
0.943359
sec[1]/p[1]
en
0.999997
33914178
https://doi.org/10.1186/s40792-021-01191-x
[ "tumor", "pancreatic", "intensity", "diameter", "tissue", "tumors", "white", "arrow", "signal", "weighted" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "DC3Z", "title": "Diseases of pancreas, unspecified" }, { "code": "DC3Y", "title": "Other specified diseases of pancreas" }, { "code": "LB21.3", "title": "Agenesis-aplasia of pancreas" }, { "code": "LB21.Z", "title": "Structural developmental anomalies of pancreas, unspecified" }, { "code": "DC35.0", "title": "Atrophy of pancreas" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [DC3Z] Diseases of pancreas, unspecified Also known as: Diseases of pancreas, unspecified [DC3Y] Other specified diseases of pancreas Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis [LB21.3] Agenesis-aplasia of pancreas Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas. Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas [LB21.Z] Structural developmental anomalies of pancreas, unspecified Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas [DC35.0] Atrophy of pancreas Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --PARENT--> [02] Neoplasms Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair.... --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --CHILD--> [?] Generalised lymph node enlargement --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fat pad Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied.... --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --PARENT--> [02] Neoplasms Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair.... --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --CHILD--> [?] Generalised lymph node enlargement", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fat pad\n Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied....", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 74-year-old Caucasian immunocompetent man was admitted with an anamnesis of just 24 hours with evolving headache, fever, and confusion. The patient was known for having an uncomplicated essential hypertension treated with amlodipine; epilepsy treated with lamotrigine and no convulsions for many years; no previous hospital admissions. He was fit and physically active as a hobby farmer and as an active mountain walker. At the time of admission he had a Glasgow Coma Scale (GCS) score of 14 points, temperature of 40 degrees Celsius, normal vital parameters, petechia on both legs, and neck stiffness. He had no focal neurological deficits and no convulsions. Blood chemistry showed leukocytes of 14.1 × 10 9 /L, neutrophils of 12.2 × 10 9 /L, creatinine of 119 micromol/L, INR of 1.2, blood glucose of 7.7 mmol/L, and a C-reactive protein (CRP) of 131 mg/L (reference value: <3 mg/L). A spinal tap showed turbid CSF with pleocytosis of 1877 × 10 6 /L, 78% of neutrophils, CSF protein of 1.9 g/L, CSF glucose of 3.7 mmol/L, and CSF lactate of 5.2 mmol/L (reference value: 0.9–2.8 micromol/L). Gram staining of the CSF was negative for bacteria. After the spinal tap the patient was started promptly on treatment with intravenous dexamethasone 10 mg four times a day for 4 days and with intravenous ceftriaxone 4 g once daily, according to our guidelines in 2011 for empirical treatment of bacterial meningitis in patients with penicillin allergy. According to our guidelines patients without penicillin allergy should be treated with combination antibiotic treatment of ceftriaxone and benzylpenicillin or ampicillin (as coverage for possible Listeria meningitis). During the first day of admission the GCS score fell to under 12 points and a CT of the brain was performed with no signs of hydrocephalus or other complications to bacterial meningitis . Because neither the CSF nor the blood cultures showed any growth on the second day of admission, CSF was sent to the National Reference Laboratory of Microbiology in Copenhagen, Denmark (Statens Serum Institut), for extensive polymerase chain reaction (PCR) analyses for bacterial and viral pathogens. These PCR examinations of the CSF from the day of admission were negative for herpes simplex virus, varicella zoster virus, Cytomegalovirus, Epstein-Barr virus, Enterovirus, and Mycoplasma pneumoniae , specific PCR for Streptococcus pneumoniae , specific PCR for Neisseria meningitidis , and a broad range 16sRNA PCR for bacterial DNA. A urine sample was also negative for pneumococcal urine antigen. At the same time treatment was intensified with intravenous aciclovir 750 mg three times a day. On the third and fourth day of admission the patient seemed to improve a little bit clinically, with rising GCS score to 14, falling levels of CRP, but still with temperature over 40 degrees Celsius despite maximum dose of antipyretic paracetamol (4 g/day). On the fifth day of admission his clinical state deteriorated with falling GCS score under 10 and eye deviation to the left side but otherwise without neurological deficits. A new CT of the brain on the fifth day of admission now showed development of a communicating hydrocephalus . The patient was changed from ceftriaxone to intravenous meropenem 2 g three times daily on the indication of clinical failure on ceftriaxone treatment. The patient was transferred with ambulance airplane from the Faroe Islands to Copenhagen, Denmark, where an external ventricular catheter was inserted the same evening. CSF from this catheter showed fast growth of LM with normal resistance patterns and as expected resistance to cephalosporins. The Listeria strain was typed at the Faroese Food Security Agency as LM serotype 1/2a. After the identification of LM in the CSF, aciclovir was discontinued, and the patient was treated with meropenem for 6 weeks. A small brain abscess formation in relation to the external ventricular catheter was the reason for the long meropenem treatment. This small brain abscess formation was interpreted as a complication to the external ventricular catheter treatment. The patient was treated at the intensive care unit (ICU) for 5 weeks, four of these weeks on ventilator. During the stay at the ICU the patient had to have inserted external ventricular catheter three times. When the antibiotic treatment finished, the patient had severe neurological sequelae with tetraparesis, convulsions, and very low cognitive functions. A control CT of the brain 7 months after admission showed severe sequelae in the brain structure . The patient was admitted to a normal medical ward for one whole year, before being sent to a nursing home, but died shortly after. There was no indication of how the patient was infected with LM and no food investigation was done relating to this case.
4.144531
0.961914
sec[1]/p[0]
en
0.999998
26697245
https://doi.org/10.1155/2015/248302
[ "brain", "treated", "catheter", "score", "intravenous", "times", "ceftriaxone", "bacterial", "ventricular", "convulsions" ]
[ { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "LA05.Z", "title": "Cerebral structural developmental anomalies, unspecified" }, { "code": "1D00.Z", "title": "Infectious encephalitis, unspecified" }, { "code": "LA00.0Z", "title": "Anencephaly, unspecified" }, { "code": "NA07.3Y", "title": "Other specified diffuse brain injury" }, { "code": "QB62.Z", "title": "Attention to artificial openings, unspecified" }, { "code": "QB30.5", "title": "Fitting or adjustment of urinary device" }, { "code": "PK93.10", "title": "Gastroenterology or urology devices associated with injury or harm, urinary catheter" }, { "code": "PK90.1", "title": "Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices" }, { "code": "PK91.2Y", "title": "Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" } ]
=== ICD-11 CODES FOUND === [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [LA05.Z] Cerebral structural developmental anomalies, unspecified Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS [1D00.Z] Infectious encephalitis, unspecified Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation [LA00.0Z] Anencephaly, unspecified Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence [NA07.3Y] Other specified diffuse brain injury Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion [QB62.Z] Attention to artificial openings, unspecified Also known as: Attention to artificial openings, unspecified | Attention to artificial openings | toilet or cleansing of artificial opening | removal of catheter | passage of sounds or bougies [QB30.5] Fitting or adjustment of urinary device Also known as: Fitting or adjustment of urinary device | change of indwelling catheter | Removal of indwelling urinary catheter | removal of urinary catheter | removal of indwelling catheter [PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter Also known as: Gastroenterology or urology devices associated with injury or harm, urinary catheter | Gastroenterology or urology devices associated with adverse incidents, Foley catheter | Gastroenterology or urology devices associated with adverse incidents, indwelling urinary catheter | Mechanical complication of urinary catheter | Mechanical complication of urinary indwelling catheter Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [PK90.1] Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices Definition: An anaesthesiology device was involved in an adverse incident that occurred in a therapeutic (nonsurgical) and rehabilitative task Also known as: Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices | Anaesthesiology devices associated with injury or harm, spinal catheter | Mechanical complication of spinal catheter | Anaesthesiology devices associated with injury or harm, epidural catheter | Anaesthesiology devices associated with injury or harm, endotracheal tube Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Cardiovascular devices associated with injury or harm, conduits | Mechanical complication of other cardiac and vascular devices and implants | Mechanical complication of artificial heart | Mechanical complication of vascular balloon implant or device === GRAPH WALKS === --- Walk 1 --- [8E7Y] Other specified diseases of the nervous system --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --RELATED_TO--> [?] Structural developmental anomalies of the nervous system Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period.... --- Walk 2 --- [8E7Y] Other specified diseases of the nervous system --PARENT--> [08] Diseases of the nervous system Def: This is a group of conditions characterised as being in or associated with the nervous system.... --CHILD--> [?] Disorders with neurocognitive impairment as a major feature --- Walk 3 --- [LA05.Z] Cerebral structural developmental anomalies, unspecified --PARENT--> [LA05] Cerebral structural developmental anomalies Def: Any condition caused by failure of the brain to correctly develop during the antenatal period.... --EXCLUDES--> [?] Encephalocele --- Walk 4 --- [LA05.Z] Cerebral structural developmental anomalies, unspecified --PARENT--> [LA05] Cerebral structural developmental anomalies Def: Any condition caused by failure of the brain to correctly develop during the antenatal period.... --CHILD--> [LA05.2] Holoprosencephaly Def: Holoprosencephaly is a brain malformation resulting from incomplete cleavage of the prosencephalon, occurring between the 18th and the 28th day of gestation and affecting both the forebrain and the fa... --- Walk 5 --- [1D00.Z] Infectious encephalitis, unspecified --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified Def: A disease of the brain, caused by an infection.... --CHILD--> [1D00.0] Bacterial encephalitis --- Walk 6 --- [1D00.Z] Infectious encephalitis, unspecified --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified Def: A disease of the brain, caused by an infection.... --CHILD--> [1D00.1] Fungal encephalitis
[ "[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --RELATED_TO--> [?] Structural developmental anomalies of the nervous system\n Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period....", "[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --CHILD--> [?] Disorders with neurocognitive impairment as a major feature", "[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --EXCLUDES--> [?] Encephalocele", "[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --CHILD--> [LA05.2] Holoprosencephaly\n Def: Holoprosencephaly is a brain malformation resulting from incomplete cleavage of the prosencephalon, occurring between the 18th and the 28th day of gestation and affecting both the forebrain and the fa...", "[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.0] Bacterial encephalitis", "[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.1] Fungal encephalitis" ]
8E7Y
Other specified diseases of the nervous system
[ { "from_icd11": "LA05.Z", "icd10_code": "Q048", "icd10_title": "Other specified congenital malformations of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q043", "icd10_title": "Other reduction deformities of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q049", "icd10_title": "Congenital malformation of brain, unspecified" }, { "from_icd11": "LA05.Z", "icd10_code": "Q04", "icd10_title": "Other congenital malformations of brain" }, { "from_icd11": "1D00.Z", "icd10_code": "G0490", "icd10_title": "Encephalitis and encephalomyelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0491", "icd10_title": "Myelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0430", "icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0431", "icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0439", "icd10_title": "Other acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G0489", "icd10_title": "Other myelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G04", "icd10_title": "Encephalitis, myelitis and encephalomyelitis" }, { "from_icd11": "1D00.Z", "icd10_code": "G048", "icd10_title": "Other encephalitis, myelitis and encephalomyelitis" }, { "from_icd11": "LA00.0Z", "icd10_code": "Q000", "icd10_title": "Anencephaly" }, { "from_icd11": "QB62.Z", "icd10_code": "Z436", "icd10_title": "Encounter for attention to other artificial openings of urinary tract" } ]
Q048
Other specified congenital malformations of brain
A 72-year-old Chinese male patient who presented with progressively worsening cough and sputum for approximately 3 months and poor appetite and fatigue for approximately 2 months was admitted to the hospital on May 8, 2020. The patient was a smoker of 40 years with an 80-pack per year history and had a background of coronary atherosclerotic heart disease and hypertension. Computed tomography (CT) showed mediastinal nodules in the posterior segment of the left superior lobe, measuring 22 × 24*28.1 mm in size, multiple small nodules in the bilateral lung fields, and subcutaneous adipose soft tissue density nodules on the left chest wall . Head magnetic resonance imaging scan demonstrated the brain metastases. The left chest wall nodules of the patient were not excluded from metastasis. The pathological diagnosis was confirmed by ultrasound-guided surgery of the left chest wall, and the result was lung adenocarcinoma . Molecular genetic analysis revealed an EGFR mutation L858R in exon 21. Consequently received stage IV (T2NxM1) adenocarcinoma of the left upper lung lobe with a complicated chest wall and brain metastasis diagnosis. Twenty days later, first-line treatment with osimertinib was initiated using a standard dose of 80 mg/day. He initially experienced partial remission of NSCLC for 6 weeks without evidence of gastrointestinal, cutaneous, or cardiac side effects. However, 8 weeks after starting the medication, he started coughing up the phlegm and experienced shortness while exerting himself. Ten weeks after beginning the medicine, the patient was readmitted to the same hospital because the dyspnea and fever symptoms worsened. Computed tomography revealed interstitial lung fibrosis changes in both lungs and pulmonary infiltrates . After symptomatic treatment failed, the patient was admitted to our hospital for further treatment. Supplemental oxygen was administered because of severe dyspnea. Physical examination revealed the following vital signs: heart rate, 116 bpm; blood pressure, 98/66 mm Hg; O 2 saturation, 92% while the patient was breathing oxygen, breath rate 33 per minute, and a temperature of 36.3 °C. Bilateral inspiratory crackles were observed in the lower lung field. The arterial blood gas showed a PH of 7.44 (reference range, 7.35–7.45), partial pressure of carbon dioxide of 31.8 mm Hg (reference range, 35–45 mm Hg), and partial pressure of oxygen of 76 mm Hg (reference range, 80–100 mm Hg). Blood work showed remarkably elevated inflammatory parameters (CRP 293.18 mg/dL [standard < 0.5 mg/dL], PCT 0.364 ng/mL, leucocytes 9.34 G/L). D-dimer 1.1 μg/mL. Screening for general bacterial culture, acid-fast Bacillus smear, and culture yielded negative results. No viral or fungal infections were observed. Transbronchial biopsy for histopathological evaluation could not be performed because of the poor performance status. The patient’s medical history was unremarkable, with no history of interstitial lung disease, asthma, COPD, or pulmonary embolism. Furthermore, in addition to osimertinib, no medication was administered in the preceding 10 weeks. We considered that the patient had severe osimertinib-induced pneumonitis. Osimertinib was discontinued, and prednisolone 160 mg/day was prescribed, along with supplemental oxygen and wide-spectrum antibiotics (piperacillin, tazocine, and batavidin combined with moxifloxacin). However, the symptoms did not resolve, and impaired oxygenation persisted over the subsequent 4 days in parallel with persistent pulmonary infiltrates, requiring mechanical ventilation. However, the patient and his family refused mechanical ventilation. On day 5 of hospitalization, rapid aggravation of symptoms of dyspnea was observed; peripheral capillary oxygen saturation was below 80%; the sound of breathing in the left upper lung disappeared; chest radiography was performed immediately, which revealed a left-sided pneumothorax ; and a closed thoracic drainage tube was placed, but his dyspnea did not improve. The patient then underwent endotracheal intubation, assisted ventilation, and continued morphine sedation. The patient’s vital signs were relatively stable. On the seventh day of hospitalization, a right-sided pneumothorax was observed . A closed thoracic drainage tube was then placed on the right side. Unfortunately, the patient’s general condition deteriorated in the following days, and progressive dyspnea, respiratory failure, and heart failure developed. After 16 days of anti-infection treatment with high-dose methylprednisolone, mechanical ventilation, and supportive care, the patient with severe pneumothorax died of multiple organ failure. At the request of his family, no autopsies were performed. A timeline of the medical history of the patients in our study is presented in Figure 2 .
4.007813
0.977051
sec[1]/p[0]
en
0.999997
38241563
https://doi.org/10.1097/MD.0000000000036994
[ "lung", "chest", "dyspnea", "oxygen", "nodules", "wall", "osimertinib", "ventilation", "heart", "partial" ]
[ { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" }, { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB27", "title": "Pleural effusion" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "NA80.Y&XJ1C6", "title": "Thoracic haematoma" } ]
=== ICD-11 CODES FOUND === [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB27] Pleural effusion Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate Includes: Pleurisy with effusion Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Pulmonary sporotrichosis Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com... --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --- Walk 5 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --CHILD--> [CA40.0] Bacterial pneumonia Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --CHILD--> [CA40.0] Bacterial pneumonia\n Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o..." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
A 54-year-old female with a right temporal WHO II meningioma was referred to our institute. She was refractory to conventional treatment with surgery (thrice) and radiotherapy (seven times). She suffered from focal seizures with sensory onset and impaired awareness 5x/day and every 2–3 months had a more severe focal seizure with impaired awareness, repeatedly leading to a status epilepticus. During multidisciplinary tumour board, the patients were considered irresectable by the neurosurgeon. The radiation oncologist had reached the maximum acceptable dose on surrounding healthy tissues; thus, additional external stereotactic radiation therapy was considered too risky. As meningioma is known for their SSTR2a overexpression, a 68 Ga-DOTATOC PET/CT was performed to explore the option for PRRT . On imaging the tumour showed high SSTR2a expression, thus patients started with PRRT. She received 7.4 GBq 177 Lu-HA-DOTATATE intravenously in February 2018 according to standard PRRT protocol for neuroendocrine tumours, with one night hospital admission according to local radiation safety regulations . Post-treatment imaging obtained 24 h after the first cycle showed very low uptake in the tumour . Estimated absorbed dose was approximately 4,6 Gy (with the assumption of a residence time of 25.7 h) . Four weeks after the treatment she had no clinical, biochemical or haematological toxicities. In stereotactic radiation therapy, a mean tumour absorbed dose of at least 50 Gy is pursued ; thus, intravenous PRRT was considered to result in a too low mean tumour dose. To increase tumour uptake of the radiopharmaceutical, we injected 7.4 GBq via a microcatheter placed selectively in the right external carotid artery via a femoral approach, after obtaining informed consent. Figure 2 B shows the selective injection position in the right external carotid artery and middle meningeal artery. Thirty minutes prior to injection of the radiopharmaceutical, intravenous amino-acid infusion was started according to standard protocol for the duration of 4 h . Via the microcatheter, the radiopharmaceutical was administered in 5 min with no additional side effects. On the post-treatment scan 24 h later, tumour uptake increased 11-fold , resulting in an estimated absorbed dose of 51 Gy. Four weeks after treatment, she experienced no side effects besides some local hair loss. We repeated the intra-arterial administration twice, aiming for a total > 150 Gy tumour absorbed dose. Two months after her fourth cycle (once intravenous and thrice intra-arterial, mean treatment interval 7 weeks; cumulative administered activity amounted to 29.6 GBq, estimated absorbed dose 154 Gy), her PET/CT showed significant decrease in SSTR2 expression and a partial response on MRI . Additionally, the evaluation MRI showed central necrosis of the meningioma and decreased diffusion restriction. Apart from limited localized hair loss after the second treatment, she experienced no treatment-related toxicities. More importantly, 3 months after her treatment regimen, her severe seizures have been absent since start of PRRT and her focal sensory-onset seizures decreased in frequency to 3–4x/week. Ten months after treatment, the frequency of the focal sensory-onset seizures was stable, her severe seizures were still absent, and the tumour remained in a partial response on MRI. Fig. 1 A Pre-treatment gallium-68-DOTATOC PET/CT showing high somatostatin receptor expression in the right temporal meningioma and physiological expression in the pituitary gland. B + C Pre-treatment gadolinium enhanced T1 MRI sequence showing a homogeneously enhancing solid lesion. D Post-treatment gallium-68-DOTATOC PET/CT showed 79% decrease in SSTR2 expression. E + F Gadolinium enhanced T1 MRI sequence showed a partial response of the right temporal meningioma, − 38% in volume and − 24% in longest diameter, and additionally central necrosis of the tumour can be acknowledged on the coronal reconstruction ( F ) and reduction in enhancement of tumour deposits in the old resection cavity ( F ) Fig. 2 A Post-treatment lutetium-177-HA-DOTATATE scan after intravenous administration showing vague uptake of the radiopharmaceutical in the meningioma. B + C Anterior and lateral digital subtraction angiography of the selective injection position in the right external carotid artery, middle meningeal artery, just proximal of the origin of the parotid artery. A tumour blush can be acknowledged (white arrows). Because an additional tumour feeding branch was originated from the parotid artery, this treatment position was chosen. D After intra-arterial administration, remarkable increase in radiopharmaceutical uptake is seen on the post-treatment lutetium-177-HA-DOTATATE scan and at quantification an 11-fold increase is measured
4.113281
0.956543
sec[1]/p[0]
en
0.999996
31187231
https://doi.org/10.1007/s00270-019-02262-1
[ "tumour", "artery", "meningioma", "seizures", "prrt", "expression", "uptake", "absorbed", "radiopharmaceutical", "radiation" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "BD52", "title": "Certain specified disorders of arteries or arterioles" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "BD52.2", "title": "Stricture of artery" }, { "code": "BD40.Z", "title": "Atherosclerotic chronic arterial occlusive disease, unspecified" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [BD52] Certain specified disorders of arteries or arterioles Also known as: Certain specified disorders of arteries or arterioles | Aortic dilatation - joint hypermobility - arterial tortuosity | Generalised arterial calcification of infancy | Median arcuate ligament syndrome | Aortic root abscess Excludes: collagen (vascular) diseases | Hypersensitivity angiitis | Acute arterial occlusion [BD52.3] Rupture of artery Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula Excludes: traumatic rupture of artery - see injury of blood vessel by body region [BD52.2] Stricture of artery Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery [BD40.Z] Atherosclerotic chronic arterial occlusive disease, unspecified Also known as: Atherosclerotic chronic arterial occlusive disease, unspecified | Atherosclerotic chronic arterial occlusive disease | arteriosclerosis, NOS | generalised atherosclerosis | atherosclerosis NOS === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
After withdrawal of the eSheath from the left femoral artery, a significant stenosis was seen in the TAVR primary access artery, which was successfully treated with balloon angioplasty using the same balloon . All other accesses were closed without complications, and the TAVR secondary access was closed with a 6-F Angio-seal VIP (Terumo, New Jersey, USA). All the steps are summarized in the step-by-step . Figure 6 Vascular access management, procedural and follow-up results. (a) Angiography of the main transcatheter aortic valve replacement access via the cross-over balloon showing significant residual stenosis after vascular closure devices were closed. (b) Result after balloon angioplasty using the same premounted over-the-wire balloon from the contralateral femoral artery. (c–e) Postprocedural TEEevaluation showing: c – good valves position and function with no mechanical obstruction of the LVOT; d – mean mitral valve gradient of 5 mmHg; e – mean aortic valve gradient of 12 mmHg. (f) One-month follow-up transthoracic echocardiogram still showing no signs of LVOT obstruction. Abbreviations: LVOT, left ventricule outflow tract; TEE, transesophageal echocardiography. Table 1 Step-by-step guidance on performing a fully percutaneous transfemoral simultaneous transcatheter valve replacement (STVR) for native aortic regurgitation and mitral stenosis Main steps Step-by-step description Remarks 1. Vascular accesses . I. Primary venous access (TMVR) – Right femoral vein (6-Fr). II. Secondary arterial access – Right femoral artery (6-Fr) and cross-over technique to the left femoral artery. III. Primary arterial access (TAVR), contralateral left femoral artery (6-Fr, then upgrade for 9-Fr). IV. Half heparinization. Ultrasound-guided vascular access. 300-cm GRAND SLAM® and a modified mammary catheter. Ultrasound- and cross-over-guided vascular access with preclosure technique. 2. TMVR setting . I. Exchange venous access introducer for the VersaCross RF® system. - With the VersaCross Pigtail RF® wire II. Perform transeptal puncture. III. Advance and leave in place the introducer and wire into the LA. IV. Full heparinization TEE-guided transeptal puncture: inferoposterior puncture. If no pericardial effusion. 3. TAVR procedure . I. As per manufacturer recommendations, with an oversize of 20% and be ready to adjust while deploying under rapid pacing. II. Leave the TAVR wire in the LV. III. Leave the TAVR device introducer in place. To secure LV access during and after the TMVR procedure. 4. TMVR procedure . I. Exchange the VersaCross RF® introducer for an Agilis® NxT Steerable Introducer. II. Deliver TMVR wire into the LV through a pigtail catheter. III. Exchange Agilis® NxT Steerable Introducer for a GORE® DrySeal Flex (26-Fr). IV. Mitral valve and interatrial septum predilatation. V. TMVR valve delivery and deployment under rapid pacing. VI. Withdrawal of TMVR delivery system. Under 3D to ensure safe passage into the LV. 14-16 mm balloon. Be prepared for THV postdilation. TEE evaluation, including LVOT obstruction and IASD. 5. Vascular closure . I. Withdrawal and closure of primary venous access. II. Withdrawal and closure of primary arterial access with cross-over technique. - 1:1 balloon size selection for the left arterial iliac artery. III. Withdraw and closure of TAVR secondary access. Abbreviations: IASD, iatrogenic atrial septal defect; LA, left atrium; LV, left ventricle; LVOT, left ventricle outflow tract; TAVR, transcatheter aortic valve replacement; TMVR, transcatheter mitral valve replacement; TEE, transesophageal echocardiogram. Figure 7 Simultaneous Transcatheter aortic and mitral native valve replacement (STVR). After setting vascular accesses (main TAVR-main access into the left femoral artery, main TMVR-main access into the right femoral vein and secondary TAVR access into the right femoral artery) and after giving half-dose heparin, the first STVR procedural step (1) is performing the TEE-guided transeptal puncture and then complete the heparin dose. Leaving the transeptal puncture system in place, the pre-TAVR aortogram is performed (2) to finally deploy the aortic THV (3) while holding the LV wire into the LV after the aortic THV deployment. Under TEE guidance, the native mitral valve is crossed (4) and access into the LV is secured with the upwardly directed curve of the LV wire. The mitral valve and then interatrial septum predilation (5) are performed. Then, the mitral THV slow deployment (6) is performed. Both valves are deployed under rapid pacing using the LV wire. Abbreviations: LV, left vetnricle; STVR, simultaneous transcatheter valve replacement; TAVR, transcatheter aortic valve replacement; TEE, transesophageal echocardiography; THV, transcatheter heart valve; TMVR, transcatheter mitral valve replacement.
4.148438
0.441162
sec[3]/sec[4]/p[0]
en
0.999997
PMC11294837
https://doi.org/10.1016/j.shj.2024.100295
[ "access", "valve", "tavr", "tmvr", "femoral", "artery", "transcatheter", "mitral", "aortic", "replacement" ]
[ { "code": "QD70.6", "title": "Problems associated with inadequate access to electricity" }, { "code": "QB30.3", "title": "Adjustment or management of vascular access device" }, { "code": "QB50.Y", "title": "Presence of other specified cardiac or vascular implants or grafts" }, { "code": "NE81.2Y", "title": "Other specified surgical site infection" }, { "code": "QB30.Y", "title": "Fitting, adjustment or management of other specified implanted devices" }, { "code": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" }, { "code": "BC00", "title": "Multiple valve disease" }, { "code": "BB9Z", "title": "Pulmonary valve disease, unspecified" }, { "code": "BB6Z", "title": "Mitral valve disease, unspecified" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, unspecified" } ]
=== ICD-11 CODES FOUND === [QD70.6] Problems associated with inadequate access to electricity Definition: Inadequate power that may restrict healthy living. Also known as: Problems associated with inadequate access to electricity [QB30.3] Adjustment or management of vascular access device Also known as: Adjustment or management of vascular access device [QB50.Y] Presence of other specified cardiac or vascular implants or grafts Also known as: Presence of other specified cardiac or vascular implants or grafts | Presence of artificial heart | Presence of intravascular prosthesis, not elsewhere classified | Status following peripheral angioplasty NOS | Presence of vascular implant or access port device [NE81.2Y] Other specified surgical site infection Also known as: Other specified surgical site infection | Local complication at access site of cardiac catheterisation | Postprocedural abscess | Postprocedural stitch abscess [QB30.Y] Fitting, adjustment or management of other specified implanted devices Also known as: Fitting, adjustment or management of other specified implanted devices | Fitting or adjustment of ileostomy or other intestinal appliances | fitting of ileostomy device | Fitting or adjustment of colostomy | fitting of colostomy belt [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease [BC00] Multiple valve disease Also known as: Multiple valve disease | Multiple valve disease of unspecified origin | multiple valvular cardiac dysfunction | multivalvular cardiac dysfunction | Disorders of both mitral and aortic valves [BB9Z] Pulmonary valve disease, unspecified Also known as: Pulmonary valve disease, unspecified | rheumatic heart disease of pulmonary valve, unspecified | chronic rheumatic pulmonary valve endocarditis | chronic rheumatic pulmonary valvular endocarditis | rheumatic disease of pulmonary valve [BB6Z] Mitral valve disease, unspecified Also known as: Mitral valve disease, unspecified | noninfective endocarditis of mitral valve | rheumatic heart disease of mitral valve, unspecified | mitral valvulopathy | mitral valve cardiopathy [LA8Z] Structural developmental anomaly of heart or great vessels, unspecified Also known as: Structural developmental anomaly of heart or great vessels, unspecified | Heart malformations | Cardiac malformations | congenital anomaly of heart | congenital heart disease === GRAPH WALKS === --- Walk 1 --- [QD70.6] Problems associated with inadequate access to electricity Def: Inadequate power that may restrict healthy living.... --PARENT--> [QD70] Problems associated with the natural environment or human-made changes to the environment --RELATED_TO--> [?] Problems associated with inadequate drinking-water --- Walk 2 --- [QD70.6] Problems associated with inadequate access to electricity Def: Inadequate power that may restrict healthy living.... --PARENT--> [QD70] Problems associated with the natural environment or human-made changes to the environment --CHILD--> [QD70.0] Problems associated with exposure to noise --- Walk 3 --- [QB30.3] Adjustment or management of vascular access device --PARENT--> [QB30] Adjustment or management of implanted devices --CHILD--> [QB30.0] Adjustment or management of implanted hearing device --- Walk 4 --- [QB30.3] Adjustment or management of vascular access device --PARENT--> [QB30] Adjustment or management of implanted devices --CHILD--> [QB30.0] Adjustment or management of implanted hearing device --- Walk 5 --- [QB50.Y] Presence of other specified cardiac or vascular implants or grafts --PARENT--> [QB50] Presence of cardiac or vascular implants or grafts --CHILD--> [QB50.2] Presence of prosthetic heart valve --- Walk 6 --- [QB50.Y] Presence of other specified cardiac or vascular implants or grafts --PARENT--> [QB50] Presence of cardiac or vascular implants or grafts --CHILD--> [QB50.0] Presence of electronic cardiac devices
[ "[QD70.6] Problems associated with inadequate access to electricity\n Def: Inadequate power that may restrict healthy living....\n --PARENT--> [QD70] Problems associated with the natural environment or human-made changes to the environment\n --RELATED_TO--> [?] Problems associated with inadequate drinking-water", "[QD70.6] Problems associated with inadequate access to electricity\n Def: Inadequate power that may restrict healthy living....\n --PARENT--> [QD70] Problems associated with the natural environment or human-made changes to the environment\n --CHILD--> [QD70.0] Problems associated with exposure to noise", "[QB30.3] Adjustment or management of vascular access device\n --PARENT--> [QB30] Adjustment or management of implanted devices\n --CHILD--> [QB30.0] Adjustment or management of implanted hearing device", "[QB30.3] Adjustment or management of vascular access device\n --PARENT--> [QB30] Adjustment or management of implanted devices\n --CHILD--> [QB30.0] Adjustment or management of implanted hearing device", "[QB50.Y] Presence of other specified cardiac or vascular implants or grafts\n --PARENT--> [QB50] Presence of cardiac or vascular implants or grafts\n --CHILD--> [QB50.2] Presence of prosthetic heart valve", "[QB50.Y] Presence of other specified cardiac or vascular implants or grafts\n --PARENT--> [QB50] Presence of cardiac or vascular implants or grafts\n --CHILD--> [QB50.0] Presence of electronic cardiac devices" ]
QD70.6
Problems associated with inadequate access to electricity
[ { "from_icd11": "QB30.3", "icd10_code": "Z452", "icd10_title": "Encounter for adjustment and management of vascular access device" }, { "from_icd11": "GB61.Z", "icd10_code": "N183", "icd10_title": "Chronic kidney disease, stage 3 (moderate)" }, { "from_icd11": "GB61.Z", "icd10_code": "N189", "icd10_title": "Chronic kidney disease, unspecified" }, { "from_icd11": "GB61.Z", "icd10_code": "N250", "icd10_title": "Renal osteodystrophy" }, { "from_icd11": "GB61.Z", "icd10_code": "N18", "icd10_title": "Chronic kidney disease (CKD)" }, { "from_icd11": "BC00", "icd10_code": "I081", "icd10_title": "Rheumatic disorders of both mitral and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I080", "icd10_title": "Rheumatic disorders of both mitral and aortic valves" }, { "from_icd11": "BC00", "icd10_code": "I082", "icd10_title": "Rheumatic disorders of both aortic and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I083", "icd10_title": "Combined rheumatic disorders of mitral, aortic and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I088", "icd10_title": "Other rheumatic multiple valve diseases" }, { "from_icd11": "BC00", "icd10_code": "I089", "icd10_title": "Rheumatic multiple valve disease, unspecified" }, { "from_icd11": "BC00", "icd10_code": "I05-I09", "icd10_title": "" }, { "from_icd11": "BC00", "icd10_code": "I08", "icd10_title": "Multiple valve diseases" }, { "from_icd11": "BC00", "icd10_code": "I34", "icd10_title": "Nonrheumatic mitral valve disorders" }, { "from_icd11": "BC00", "icd10_code": "I35", "icd10_title": "Nonrheumatic aortic valve disorders" } ]
Z452
Encounter for adjustment and management of vascular access device
The subacromial suture scar was erythematous at the first session (day 0), presumably due to inflammation at the site of the surgical scar and periphery of the scar . Erythema was observed at the site of the surgical scar at the eighth treatment session (127 days after the start of treatment); however, it had almost disappeared in the surrounding area . The subclavian suture scar was 7.8 cm long and 0.9 cm wide at the first session (day 0); in contrast, it was 6.8 cm long and 0.4 cm wide at the eighth session (day 127 from the start of treatment) . The axillary suture scar at the first session (day 0) showed a similar erythematous appearance, presumably due to inflammation at the site of the surgical scar and the surrounding areas . Erythema was observed at the site of the surgical scar at the eighth session (day 127 from the start of treatment); however, it had completely disappeared in the area surrounding the scar . The axillary suture scar was 2.9 cm long and 0.3 cm wide at the first session (day 0). In contrast, it was 1.8 cm long and 0.2 cm wide at the eighth session (day 127 from the start of treatment) . The pain score decreased from 8.3 to 6.7 from the first to the third session (day 41 from the start of treatment), indicating that the cold sensation and pain in the subacromial surgical scar area and the stiffness of the subacromial surgical scar area was relieved. However, the surgical scar had to be covered and strong muscle tension on the right side of the back and hips and axillary stiffness were present. In addition, the pain in the surgical scar interfered with the daily life activities, requiring regular use of analgesics and weekly nerve block injections . Although the pain in the subclavian surgical scar was reduced, the pain at the site of the sentinel node biopsy, which had been the most painful site, increased. Similarly, the pain in the sternocleidomastoid muscle decreased; however, the pain in the chest and pectoralis major muscles, which were not noticeable earlier, increased. The pain score decreased from 6.7 to 4.8 from the third (41 days after the start of treatment) to the sixth session (83 days after the start of treatment) , and the patient was rarely disturbed by surgical scar pain. The axillary pain was relieved, and an improvement in the mobility of the area was also observed. The use of analgesics was reduced by 93% compared with the first treatment, and block injections were no longer necessary . However, an increase in pain in the latissimus dorsi, serratus anterior, and erector spinae muscles below the elbow was observed during inclement weather and loading on the operative side, particularly when carrying heavy loads. The frequency of clenching increased owing to pain, and pain expansion was observed in the temporal and sternocleidomastoid muscles. The pain score decreased from 4.8 to 0.4 from the sixth (83 days after the start of treatment) to the eighth session (127 days after the first treatment) . The disability in daily life due to pain at the surgical scar was resolved, and relaxation of muscle tension around the suture scar was observed. Furthermore, the tendency to roll the right shoulder and the habit of stretching movements that occurred during pain almost disappeared. No analgesic medications or block injections were administered . No significant adverse events were observed during the treatment. Fig. 1 Changes in suture scar after basalt stone treatment and placenta extract application. a Schematic diagram of the length and width of the right subclavian surgical scar. b Suture scar area (left) at the first treatment session (day 1); suture scar area (right) at treatment 8 (day 127). c Changes in the length of the suture scar during the treatment period. d Changes in the width after removal of the suture scar during the treatment period. Suture length and width in cm Fig. 2 Changes in axillary suture scar caused by right axillary sentinel lymph node biopsy after basalt stone treatment and placenta extract application. a Schematic diagram of the length and width of the axillary surgical scar. b Axillary suture scar (left) at the first treatment session (day 1); axillary suture scar area (right) at the first eighth session (day 127). c Changes in the suture scar length during the treatment period. d Changes in the width of the suture scar during the treatment period. Suture length and width are expressed in cm Fig. 3 Changes in pain score after basalt stone treatment and placenta extract application. a Changes in the pain score from at the first treatment session (day 1) to the at the eighth treatment session (day 127). b Changes in the frequency of analgesic medication and block injection use from at the first treatment session (day 1) to the eighth treatment session (day 127)
4.140625
0.906738
sec[1]/p[4]
en
0.999994
38105259
https://doi.org/10.1186/s13256-023-04264-7
[ "scar", "session", "pain", "suture", "axillary", "changes", "eighth", "start", "area", "site" ]
[ { "code": "EH94", "title": "Scar of skin, not elsewhere classified" }, { "code": "FB32.Y", "title": "Other specified disorders of muscles" }, { "code": "EE60.1", "title": "Hypertrophic scar" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "9A77.Y", "title": "Other specified corneal scars or opacities" }, { "code": "QB9Y", "title": "Other specified contact with health services for nonsurgical interventions not involving devices" }, { "code": "QB96", "title": "Contact with health services for radiotherapy session" }, { "code": "QB97", "title": "Contact with health services for chemotherapy session for neoplasm" }, { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" } ]
=== ICD-11 CODES FOUND === [EH94] Scar of skin, not elsewhere classified Also known as: Scar of skin, not elsewhere classified | adherent scar of skin | cicatrix NOS | scar NOS | disfigurement due to scar [FB32.Y] Other specified disorders of muscles Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia [EE60.1] Hypertrophic scar Definition: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, they do not expand beyond the boundary of the initial injury or inflammation and may undergo spontaneous resolution. Also known as: Hypertrophic scar | hypertrophic scarring [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [9A77.Y] Other specified corneal scars or opacities Also known as: Other specified corneal scars or opacities | Corneal infiltrate or haze | Surgically-induced corneal haze | Argentous corneal deposits | Corneal deposits in metabolic disorders [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices Also known as: Other specified contact with health services for nonsurgical interventions not involving devices | Chemotherapy other than for neoplasm | admission for chemotherapy administration other than for neoplasm | chemotherapy regimen other than for neoplasm | drug therapy other than for neoplasm [QB96] Contact with health services for radiotherapy session Also known as: Contact with health services for radiotherapy session | admission for radiotherapy [QB97] Contact with health services for chemotherapy session for neoplasm Also known as: Contact with health services for chemotherapy session for neoplasm | antineoplastic chemotherapy regimen | cancer chemotherapy regimen | maintenance chemotherapy for neoplasm | neoplasm chemotherapy [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders === GRAPH WALKS === --- Walk 1 --- [EH94] Scar of skin, not elsewhere classified --PARENT--> [?] Skin disorders provoked by external factors Def: A large group of skin disorders due to exposure of the skin to various external physical, chemical or environmental insults including chemical irritants and allergens, poisons, pressure, cold, heat, s... --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and... --- Walk 2 --- [EH94] Scar of skin, not elsewhere classified --PARENT--> [?] Skin disorders provoked by external factors Def: A large group of skin disorders due to exposure of the skin to various external physical, chemical or environmental insults including chemical irritants and allergens, poisons, pressure, cold, heat, s... --RELATED_TO--> [?] Hand and arm vibration syndrome Def: Hand Transmitted Vibration is mechanical vibration arising from powered processes or tools which enters the body at the fingers or the palm of the hands. As a consequence of this exposure some people ... --- Walk 3 --- [FB32.Y] Other specified disorders of muscles --PARENT--> [FB32] Certain specified disorders of muscle Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category.... --CHILD--> [FB32.2] Ischaemic infarction of muscle --- Walk 4 --- [FB32.Y] Other specified disorders of muscles --PARENT--> [FB32] Certain specified disorders of muscle Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category.... --RELATED_TO--> [?] Drug-induced myopathy Def: Myopathy caused by drugs that ranges from mild myalgias with or without mild weakness to chronic myopathy with severe weakness, to massive rhabdomyolysis with acute renal failure. It could be due to s... --- Walk 5 --- [EE60.1] Hypertrophic scar Def: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, the... --RELATED_TO--> [?] Hypertrophic surgical scar Def: An elevated surgical scar containing an excess of fibrous tissue which, in contrast to a keloidal scar, does tend to flatten with time.... --PARENT--> [?] Hypertrophic scar Def: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, the... --- Walk 6 --- [EE60.1] Hypertrophic scar Def: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, the... --RELATED_TO--> [?] Hypertrophic surgical scar Def: An elevated surgical scar containing an excess of fibrous tissue which, in contrast to a keloidal scar, does tend to flatten with time.... --PARENT--> [?] Hypertrophic scar Def: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, the...
[ "[EH94] Scar of skin, not elsewhere classified\n --PARENT--> [?] Skin disorders provoked by external factors\n Def: A large group of skin disorders due to exposure of the skin to various external physical, chemical or environmental insults including chemical irritants and allergens, poisons, pressure, cold, heat, s...\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...", "[EH94] Scar of skin, not elsewhere classified\n --PARENT--> [?] Skin disorders provoked by external factors\n Def: A large group of skin disorders due to exposure of the skin to various external physical, chemical or environmental insults including chemical irritants and allergens, poisons, pressure, cold, heat, s...\n --RELATED_TO--> [?] Hand and arm vibration syndrome\n Def: Hand Transmitted Vibration is mechanical vibration arising from powered processes or tools which enters the body at the fingers or the palm of the hands. As a consequence of this exposure some people ...", "[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --CHILD--> [FB32.2] Ischaemic infarction of muscle", "[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --RELATED_TO--> [?] Drug-induced myopathy\n Def: Myopathy caused by drugs that ranges from mild myalgias with or without mild weakness to chronic myopathy with severe weakness, to massive rhabdomyolysis with acute renal failure. It could be due to s...", "[EE60.1] Hypertrophic scar\n Def: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, the...\n --RELATED_TO--> [?] Hypertrophic surgical scar\n Def: An elevated surgical scar containing an excess of fibrous tissue which, in contrast to a keloidal scar, does tend to flatten with time....\n --PARENT--> [?] Hypertrophic scar\n Def: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, the...", "[EE60.1] Hypertrophic scar\n Def: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, the...\n --RELATED_TO--> [?] Hypertrophic surgical scar\n Def: An elevated surgical scar containing an excess of fibrous tissue which, in contrast to a keloidal scar, does tend to flatten with time....\n --PARENT--> [?] Hypertrophic scar\n Def: Hypertrophic scars result from the production of excessive amounts of collagen in the dermis during connective tissue repair following inflammation, injury or surgery. In contrast to keloid scars, the..." ]
EH94
Scar of skin, not elsewhere classified
[ { "from_icd11": "EH94", "icd10_code": "L905", "icd10_title": "Scar conditions and fibrosis of skin" }, { "from_icd11": "EH94", "icd10_code": "T009", "icd10_title": "" }, { "from_icd11": "FB32.Y", "icd10_code": "M6281", "icd10_title": "Muscle weakness (generalized)" }, { "from_icd11": "EE60.1", "icd10_code": "L910", "icd10_title": "Hypertrophic scar" }, { "from_icd11": "QB9Y", "icd10_code": "Z5181", "icd10_title": "Encounter for therapeutic drug level monitoring" }, { "from_icd11": "QB96", "icd10_code": "Z510", "icd10_title": "Encounter for antineoplastic radiation therapy" }, { "from_icd11": "QB96", "icd10_code": "Z51", "icd10_title": "Encounter for other aftercare and medical care" }, { "from_icd11": "QB97", "icd10_code": "Z5111", "icd10_title": "Encounter for antineoplastic chemotherapy" }, { "from_icd11": "QB97", "icd10_code": "Z5112", "icd10_title": "Encounter for antineoplastic immunotherapy" }, { "from_icd11": "QB97", "icd10_code": "Z511", "icd10_title": "Encounter for antineoplastic chemotherapy and immunotherapy" }, { "from_icd11": "MG3Z", "icd10_code": "R52", "icd10_title": "Pain, unspecified" }, { "from_icd11": "MG3Z", "icd10_code": "R529", "icd10_title": "" } ]
L905
Scar conditions and fibrosis of skin
A 71-year-old female who had been undergoing oral treatment for diabetes with canagliflozin 100 mg/day, metformin 1,000 mg/day, and saxagliptin 5 mg/day noticed general malaise a month before her emergency department (ED) visit to Kurume University Hospital Advanced Emergency Medical Service Center. Two weeks before her ED visit, her oral intake decreased because of reduced appetite, but oral medications continued at their initial dose. The day prior to her ED visit, her malaise worsened, and she developed nausea and abdominal pain. She consulted a local doctor where it was discovered that she had notable metabolic acidosis (pH, 6.860; CO 2 , 8 mmHg, HCO 3 , − 1.0 mEq/L; base excess measurement, below sensitivity); hence, she was urgently transferred to our facility. Her vital signs on admission were as follows: body temperature, 35.0 °C; pulse, 118/min; respiratory rate, 28/min; and blood pressure, 111/75 mmHg. The findings on consultation were notable dryness inside the oral cavity and a cold sensation on distal regions of the limbs. Auscultation of the chest revealed no significant findings, but there was mild tenderness in the lower abdominal region. The blood tests at the time of ED evaluation are shown in Table 1 . Blood gases demonstrated notable metabolic acidosis (pH, 6.89; CO 2 , 11.4 mmHg; H CO 3 , 1.9 mEq/L; base excess, − 31.3 mmol/L), but the increase in lactic acid was mild at 3.3 mmol/L, and blood sugar was mildly elevated at 259 mg/dL. Although hyperkalemia was observed accompanying the acidosis, no significant kidney function impairment was observed. We considered a diagnosis of lactic acidosis secondary to metformin, but the patient had not recently been exposed to a contrast agent and the lactate was only mildly elevated, making this diagnosis less likely. Since point-of-care urine testing showed strongly positive urinary ketones and glucose, and plasma 3-hydroxybutyric acid (> 10,000 μmol/L) was also markedly high, DKA was suspected even though there was minimal hyperglycemia. As treatment for DKA, an injection of 0.45% sodium chloride was given as an intravenous drip at 800 mL/h. Blood sugar dropped down to 180 mg/dL after using two units of short-acting insulin; hence, insulin was not used continuously. Since hypoglycemia was a concern, an intravenous drip of glucose was started, and around 6 units/day of insulin was used as appropriate while blood sugar was monitored. Notable acidosis continued after starting treatment, and tachypnea and nausea were not tolerable; sodium bicarbonate was given as an intravenous drip. Although conservative treatments were continued, control of the severe ketoacidosis (pH, 7.18; CO 2 , 13.5 mmHg; HCO 3 , 5.0 mEq /L; base excess, − 22.3 mmol/L; 3-hydroxybutyric acid, 9,253 μmol/L) was difficult; thus, from day 2 after hospital admission, continuous renal replacement therapy (CRRT) was started. The acidosis improved because of CRRT over 3 days. The follow-up progress is shown in Table 2 . Hyperketonemia reduced notably after a few days, but urinary sugar continued to rise. Osmotic diuresis set in with urinary glucose as the cause and polyurea was observed; thus, fluid replacement was carried out using Ringer’s solution based on the movement of the urinary sugar. Urinary sugar turned negative on day 16 after admission, and as her overall condition was good, she was discharged on day 18 after admission. Table 1 Laboratory data on admission Biochemical analysis Blood gas analysis Reference range Biochemistry Reference range pH 6.828 7.380–7.460 BUN 18 mg/dL 8–20 mg/dL PaCO 2 11.4 mmHg 32.0–46.0 mmHg Cre 2.02 mg/dL 0.65–1.07 mg/dL PaO 2 176.0 mmHg 74.0–109.0 mmHg Na 143 mEq/L 138–145 mEq/L HCO 3 − 1.9 mmol/L 21.0–29.0 mmol/L K 4.6 mEq/L 3.6–4.8 mEq/L BE − 31.3 mmol/L − 2.0–2.0 mmol/L Cl 107 mEq/L 101–108 mEq/L Lactate 3.3 mmol/L 0.44–2.13 mmol/L CRP 5.78 mg/dL ≤ 0.14 mg/dL Urinalysis HbA1c 6.7% 4.9–6.0% Glucose 4 + 3-hydroxybutyric acid > 10,000 μmol/L < 74 μmol/L Ketone 3+ Abbreviations: pH power of hydrogen, PaO 2 partial pressure of arterial oxygen, PaCO 2 partial pressure of arterial carbon dioxide, HCO 3 hydrogen carbonate, BE base excess, BUN blood urea nitrogen, Cre creatinine, Na sodium, K potassium, Cl chloride, CRP C-reactive protein, HbA1c glycated hemoglobin Table 2 Initial and follow-up laboratory findings Parameter Initial After 3 days After 6 days After 9 days After 12 days After 16 days Arterial pH [7.380–7.460 mmHg] 6.828 7.406 7.484 7.456 Serum bicabonate [21.0–29.0 mmol/L] 1.9 17.4 27.0 26.1 Serum 3-hydroxybutyric acid [< 74 μmol/L] > 100,000 2695 782 333 156 79 Serum lactate [0.44–2.13 mmol/L] 3.3 0.7 0.5 0.5 Urine volume [mL/day] 6400 5380 3750 2010 1950 890 Urine sugar [< 85 mg/day] 73,107 92,966 71,636 44,700 19,390 0 Abbreviation: pH Power of hydrogen
4.011719
0.973145
sec[1]/p[0]
en
0.999997
31969112
https://doi.org/10.1186/s12245-020-0261-8
[ "mmol", "mmhg", "blood", "sugar", "acidosis", "acid", "urinary", "oral", "notable", "base" ]
[ { "code": "GB42.1", "title": "Albuminuria, Grade A3" }, { "code": "GB42.0", "title": "Albuminuria, Grade A2" }, { "code": "MA18.0Y", "title": "Other specified elevated blood glucose level" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "MF93", "title": "Glycosuria" }, { "code": "5A41", "title": "Hypoglycaemia without associated diabetes" } ]
=== ICD-11 CODES FOUND === [GB42.1] Albuminuria, Grade A3 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy [GB42.0] Albuminuria, Grade A2 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine [MA18.0Y] Other specified elevated blood glucose level Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [MF93] Glycosuria Also known as: Glycosuria | glucosuria | sugar in urine | urinary sugar [5A41] Hypoglycaemia without associated diabetes Also known as: Hypoglycaemia without associated diabetes | low blood sugar | hypoglycaemia NOS | spontaneous hypoglycaemia | nondiabetic hypoglycaemia Excludes: Hypoglycaemia in the context of diabetes mellitus === GRAPH WALKS === --- Walk 1 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --PARENT--> [?] Glomerular diseases Def: Any disease characterised by pathological changes to the glomerulus.... --- Walk 2 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Proteinuria Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc... --- Walk 3 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Proteinuria Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc... --- Walk 4 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --PARENT--> [MA18] Certain clinical findings of blood chemistry --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --EXCLUDES--> [?] Syndrome of infant of mother with gestational diabetes Def: Describes the range of effects on the infant born to a woman with gestational diabetes (onset or first recognition of carbohydrate intolerance of variable severity in pregnancy). Common neonatal effec...
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --PARENT--> [?] Glomerular diseases\n Def: Any disease characterised by pathological changes to the glomerulus....", "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Proteinuria\n Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Proteinuria\n Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --PARENT--> [MA18] Certain clinical findings of blood chemistry", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --EXCLUDES--> [?] Syndrome of infant of mother with gestational diabetes\n Def: Describes the range of effects on the infant born to a woman with gestational diabetes (onset or first recognition of carbohydrate intolerance of variable severity in pregnancy). Common neonatal effec..." ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
For the dynamic part of the investigation, patient positioning was adapted according to the findings of the previous spinal MRI; prone when a ventral osteodiscogenic microspur was suspected, or lateral decubitus when a ruptured spinal nerve root diverticulum was the presumed source of the leakage. In both positions, the head was tilted upwards and supported with a foam wedge to prevent excessive flow of contrast agent into the intracranial subarachnoid space. Lateral projection was used in patients in the prone position and anteroposterior projection in patients in lateral decubitus, which provided optimal conditions for identifying the leakage point when contrast spillage occurs perpendicularly to the incidental X‑ray beam. The patient’s feet were secured to the table using adjustable straps to prevent sliding (Foot Holder, 74 29 830, Siemens Healthcare, Erlangen, Germany) and both arms were extended above the head. The table was progressively tilted into the Trendelenburg position (approximately 30–45°) to facilitate intrathecal caudocranial flow of the injected contrast medium . During tilting, pulsed fluoroscopy was performed with optimized collimation. The default frame rate was 7.5 f/s, and the detector was slowly moved in a cranial direction following the leading edge of the contrast medium along the ventral or lateral margin of the thecal sac. Fluoroscopic sequences were intermittently stored. The level at which contrast material first exited the intrathecal compartment and started filling the epidural space was defined as the level of leakage. As soon as spillage occurred one single-shot image was acquired. . When the leakage point was not identified during the first run, the table was tilted back to the reverse Trendelenburg position for 3 min to allow gravity-dependent layering of contrast medium in the dependent portion of the thecal sac. Before performing a second run and tilting the table back to the Trendelenburg position, patient positioning, collimation and zoom were adjusted. Fig. 2 A patient with a suspected ventral spinal CSF leak, in the prone decubitus position. a The patient’s feet are secured to the table using adjustable straps and both arms are extended above the head. The head is tilted upwards and supported with a foam wedge to prevent excessive flow of contrast material into the intracranial subarachnoid space. Lateral projection is used. The inlay in the upper left corner shows intradural contrast media (in blue) outlining the myelon. b The table is progressively tilted into the Trendelenburg position. The inlay in the upper left corner shows leakage of contrast medium into the ventral epidural space. c Illustration of the progressive tilting of the table and cranial movement of the detector following the leading edge of the contrast material. d For better image quality at the cervicothoracic junction, the left arm is placed alongside the body and the X‑ray tube is slightly rotated to a right oblique view Fig. 3 A patient with suspected leakage from the nerve root sleeve diverticulum, in the lateral decubitus position. a The patient’s feet are secured to the table using adjustable straps and both arms are positioned in front of the chest. The head is tilted upwards and supported with a foam wedge to prevent excessive flow of contrast material into the intracranial subarachnoid space. The inlay in the upper left corner shows intradural contrast media (in blue) outlining the myelon. b The table is progressively tilted into the Trendelenburg position. The inlay in the upper left corner shows leakage of contrast media into the lateral epidural space. c Illustration of the progressive tilting of the table and cranial movement of the detector following the leading edge of the contrast material. d Illustration showing the cranial movement of the detector following the leading edge of the contrast medium Fig. 4 Middle-aged patient with sudden onset of orthostatic headache. a Heavily T2 weighted sagittal MRI with visible cerebrospinal fluid in the ventral epidural space, and the dura mater ( arrow ). b – d Dynamic myelography with contrast medium leaking into the ventral epidural space ( arrow ). e Postmyelography CT demonstrating a ventral microspur ( arrow ) at the corresponding level leading to a dural breach Fig. 5 Middle-aged female with occipital headache and vertigo she had been suffering for 1 year. Dynamic myelography in right decubitus with progressive tilt of the table with time course from a – d , total time: 14 s. b Filling of the nerve root diverticulum with contrast medium. c Contrast medium leaking into the epidural space adjacent to the diverticulum with progressive extension more cranially ( black arrows ). d Final image demonstrating contrast media distribution in the epidural space
4.089844
0.436279
sec[1]/sec[0]/p[3]
en
0.999998
32845353
https://doi.org/10.1007/s00062-020-00943-w
[ "contrast", "space", "position", "medium", "leakage", "tilted", "epidural", "decubitus", "head", "trendelenburg" ]
[ { "code": "9D43", "title": "Impairment of contrast vision" }, { "code": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" }, { "code": "QD71.1", "title": "Inadequate housing" }, { "code": "PA50.Z", "title": "Unintentional air or space transport injury event, unspecified" }, { "code": "AB32.0", "title": "Persistent Postural-Perceptual Dizziness" }, { "code": "DA0E.3", "title": "Anomalies of tooth position" }, { "code": "NC90.Z", "title": "Superficial injury of knee or lower leg, unspecified" } ]
=== ICD-11 CODES FOUND === [9D43] Impairment of contrast vision Definition: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces. Peak Contrast sensitivity refers to the smallest differences that are discernible for large stimuli. For smaller objects, such as those involved in many Activities of Daily Living, contrast sensitivity interacts with visual acuity and visual field. Better contrast makes smaller details visible. The visual field is larger for stronger stimuli. Also known as: Impairment of contrast vision | Moderate impairment of contrast vision | Profound impairment of contrast vision [QA00.6Y] Other specified examination of eyes or vision Also known as: Other specified examination of eyes or vision | No Impairment of Contrast vision | Normal colour vision | No Impairment of Dark adaptation | No diplopia [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics [QD71.1] Inadequate housing Also known as: Inadequate housing | lack of adequate housing | problem with inadequate housing | restriction of housing space | unsatisfactory surroundings Excludes: Problems associated with the natural environment or human-made changes to the environment [PA50.Z] Unintentional air or space transport injury event, unspecified Also known as: Unintentional air or space transport injury event, unspecified | Unintentional air or space transport injury event | Air and space transport accidents | Air transport accident NOS | Aircraft accident NOS [AB32.0] Persistent Postural-Perceptual Dizziness Definition: Persistent non-vertiginous dizziness, unsteadiness, or both lasting three months or more. Symptoms are present most days, often increasing throughout the day, but may wax and wane. Momentary flares may occur spontaneously or with sudden movement. Affected individuals feel worst when upright, exposed to moving or complex visual stimuli, and during active or passive head motion. These situations may not be equally provocative. Typically, the disorder follows occurrences of acute or episodic vestib Also known as: Persistent Postural-Perceptual Dizziness | Chronic subjective dizziness | Phobic postural vertigo | Visual vertigo | Space and motion discomfort [DA0E.3] Anomalies of tooth position Definition: Dental anomalies are craniofacial abnormalities of form, function, or position of the teeth, bones, and tissues of the jaw and mouth. Anomalies of tooth position can be classified in ectopic, transmigration, transposition, rotation. Also known as: Anomalies of tooth position | Diastema of teeth | abnormal spacing of tooth or teeth | Crowding of tooth or teeth | Distomolar causing crowding Includes: Diastema of teeth [NC90.Z] Superficial injury of knee or lower leg, unspecified Also known as: Superficial injury of knee or lower leg, unspecified | Superficial injury of knee or lower leg | Superficial injury of knee | Superficial injury of popliteal space === GRAPH WALKS === --- Walk 1 --- [9D43] Impairment of contrast vision Def: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces. Peak Contrast sensitivity refers to the smallest differences that are discernible ... --PARENT--> [?] Impairment of visual functions --CHILD--> [9D42] Patterns of visual field impairment Def: Patterns of visual field impairment are often indicative for certain disease conditions.... --- Walk 2 --- [9D43] Impairment of contrast vision Def: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces. Peak Contrast sensitivity refers to the smallest differences that are discernible ... --PARENT--> [?] Impairment of visual functions --RELATED_TO--> [?] Polyopia Def: Monocular diplopia and polyopia are usually a refractive phenomenon.... --- Walk 3 --- [QA00.6Y] Other specified examination of eyes or vision --PARENT--> [QA00.6] Examination of eyes or vision --EXCLUDES--> [?] Examination for driving license --- Walk 4 --- [QA00.6Y] Other specified examination of eyes or vision --PARENT--> [QA00.6] Examination of eyes or vision --EXCLUDES--> [?] Examination for driving license --- Walk 5 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Alcohol intoxication Def: Alcohol intoxication is a clinically significant transient condition that develops during or shortly after the consumption of alcohol that is characterised by disturbances in consciousness, cognition,... --CHILD--> [?] Mild alcohol intoxication Def: Mild alcohol intoxication is a clinically significant transient condition that develops during or shortly after the administration of alcohol that is characterised by detectable impairment in areas of... --- Walk 6 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Allergic or hypersensitivity conditions Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms. Hypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms... --CHILD--> [?] Allergic or hypersensitivity disorders involving the respiratory tract Def: Allergic or hypersensitivity disorders involving the respiratory tract includes several clinically different conditions that can be considered as hypersensitivity disorders of the upper and lower resp...
[ "[9D43] Impairment of contrast vision\n Def: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces.\n\nPeak Contrast sensitivity refers to the smallest differences that are discernible ...\n --PARENT--> [?] Impairment of visual functions\n --CHILD--> [9D42] Patterns of visual field impairment\n Def: Patterns of visual field impairment are often indicative for certain disease conditions....", "[9D43] Impairment of contrast vision\n Def: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces.\n\nPeak Contrast sensitivity refers to the smallest differences that are discernible ...\n --PARENT--> [?] Impairment of visual functions\n --RELATED_TO--> [?] Polyopia\n Def: Monocular diplopia and polyopia are usually a refractive phenomenon....", "[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --EXCLUDES--> [?] Examination for driving license", "[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --EXCLUDES--> [?] Examination for driving license", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Alcohol intoxication\n Def: Alcohol intoxication is a clinically significant transient condition that develops during or shortly after the consumption of alcohol that is characterised by disturbances in consciousness, cognition,...\n --CHILD--> [?] Mild alcohol intoxication\n Def: Mild alcohol intoxication is a clinically significant transient condition that develops during or shortly after the administration of alcohol that is characterised by detectable impairment in areas of...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Allergic or hypersensitivity conditions\n Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms.\n\nHypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms...\n --CHILD--> [?] Allergic or hypersensitivity disorders involving the respiratory tract\n Def: Allergic or hypersensitivity disorders involving the respiratory tract includes several clinically different conditions that can be considered as hypersensitivity disorders of the upper and lower resp..." ]
9D43
Impairment of contrast vision
[ { "from_icd11": "9D43", "icd10_code": "H538", "icd10_title": "Other visual disturbances" }, { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A95S", "icd10_title": "Adverse effect of other bacterial vaccines, sequela" }, { "from_icd11": "NE60", "icd10_code": "T50B95A", "icd10_title": "Adverse effect of other viral vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A25A", "icd10_title": "Adverse effect of mixed bacterial vaccines without a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A91A", "icd10_title": "Poisoning by other bacterial vaccines, accidental (unintentional), initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T498X5A", "icd10_title": "Adverse effect of other topical agents, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48905A", "icd10_title": "Adverse effect of unspecified agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48995A", "icd10_title": "Adverse effect of other agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A15A", "icd10_title": "Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50B15A", "icd10_title": "Adverse effect of smallpox vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T416X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T419X3A", "icd10_title": "" } ]
H538
Other visual disturbances
In our case, the patient belonged to a subtropical region of South Asia and presented with altered mental status, seizure, and low Glasgow Coma Scale score, which were indicative of neurological involvement. This was supported by a CT scan showing bilateral thalamic and cerebellar infarcts due to possible brain edema, possibly indicating cerebellitis and dengue encephalitis. Myocarditis and cardiac dysfunction are rare but recognized complications of dengue fever. Earlier studies have reported on these complications, but did not specify which serotype was most commonly associated with them. More recent studies, however, have suggested that dengue virus serotype 2 (DENV-2) may be particularly implicated in causing myocardial dysfunction in children. Cardiac complications of dengue fever tend to manifest early in the disease course, and common electrocardiographic changes include T-wave inversion. These findings have been described in the literature previously . In the current case, our patient was suspected to have myocarditis, which was later confirmed by the presence of a raised Troponin I level and a low ejection fraction on echocardiography. Acute kidney injury (AKI) is a significant complication that can occur in patients with dengue fever, particularly in those who are hospitalized for extended periods of time. The etiology of AKI in dengue fever is not fully understood, but proposed mechanisms include rhabdomyolysis, hemodynamic instability, acute glomerular injury, and hemolysis, all of which can lead to tubular necrosis, thrombotic microangiopathy, and acute glomerulopathy. Unfortunately, patients with dengue fever who develop renal complications such as AKI have a higher mortality rate. There are currently no specific recommendations for the treatment of AKI in dengue patients, and treatment typically involves conventional renal replacement therapy . Dengue fever can affect the liver, which is the most commonly affected organ in patients with this infection. Liver involvement can range from mild elevation of hepatic transaminases to severe acute liver failure. The mechanisms behind liver injury in dengue fever are not fully understood, but may include hypoxic liver injury due to shock, direct virological attack on hepatocytes, and immunological damage to the liver. The management of acute liver injury in dengue fever can be challenging, as there are few guidelines available on the best approach. In the past, some studies have suggested that the use of NAC as an antidote for acetaminophen toxicity may be beneficial in the management of acute liver failure in dengue fever, as it has been associated with reduced mortality and high transplant-free survival, particularly when used in the early stages of the disease . In our case, the administration of NAC was based on evidence from a recent meta-analysis conducted by Walayat et al. , which highlighted the significant improvement in overall survival associated with NAC, even in cases of non-acetaminophen-related acute liver failure . The underlying pathophysiology of dengue fever involves a complex interplay between the virus and host-specific factors. The dengue virus replicates inside host cells, triggering the release of immune-mediated destruction and cytokines. While there is increased vascular permeability, plasma leakage is typically confined to the pleural and peritoneal cavities and does not result in generalized edema. The development of hemorrhagic diathesis is thought to be caused by liver damage that leads to decreased secretion of coagulative factors and albumin. The virus also replicates in the adrenal gland, contributing to sodium loss and hypotension. The presence of petechiae, which are small red or purple spots on the skin, is likely due to capillary fragility, thrombocytopenia, and cytokines that disrupt vascular integrity . In dengue infection, both thrombosis and brain edema are potential mechanisms underlying the vascular involvement observed in cerebellitis and dengue encephalitis. Thrombosis can occur due to endothelial dysfunction and increased vascular permeability, leading to impaired blood flow and infarction in cerebral blood vessels. Meanwhile, the inflammatory response triggered by dengue fever can cause brain edema through the release of cytokines and immune mediators, resulting in increased blood–brain barrier permeability and fluid accumulation in the brain tissue. Brain edema can subsequently compress surrounding vessels and compromise blood flow, potentially leading to ischemic events and infarction . It is evident from the CT images that the patient in our case most probably had ischemic changes due to brain edema that resolved in the subsequent days as evident in follow-up recovery brain CT scan which shows no residual findings.
4.382813
0.712402
sec[2]/p[1]
en
0.999995
PMC10351108
https://doi.org/10.1186/s41182-023-00530-y
[ "dengue", "fever", "liver", "which", "brain", "that", "edema", "injury", "complications", "virus" ]
[ { "code": "1D2Z", "title": "Dengue fever, unspecified" }, { "code": "1D22", "title": "Severe dengue" }, { "code": "1D21", "title": "Dengue with warning signs" }, { "code": "1D20", "title": "Dengue without warning signs" }, { "code": "QA08.5", "title": "Special screening examination for other viral diseases" }, { "code": "MG26", "title": "Fever of other or unknown origin" }, { "code": "1D81.Z", "title": "Infectious mononucleosis, unspecified" }, { "code": "1B99", "title": "Pasteurellosis" }, { "code": "4A60.0", "title": "Familial Mediterranean fever" }, { "code": "JB40.0", "title": "Puerperal sepsis" } ]
=== ICD-11 CODES FOUND === [1D2Z] Dengue fever, unspecified Also known as: Dengue fever, unspecified | breakbone fever | classical dengue | classical dengue fever | dandy fever [1D22] Severe dengue Definition: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. severe organ involvement: Liver AST or ALT ≥ 1000, CNS: impaired consciousness, involvement of other organs, as myocarditis or nephritis. Also known as: Severe dengue | Severe dengue haemorrhagic fever | Severe dengue fever | dengue shock syndrome | Encephalitis due to Dengue fever [1D21] Dengue with warning signs Definition: Clinical warning signs are: abdominal pain or tenderness, mucosal bleeding, lethargy and/or restlessness, rapid decrease in platelet count, increase in haematocrit. Other signs can include: persistent vomiting, visible fluid accumulation, liver enlargement more than 2 cm. Also known as: Dengue with warning signs | Bangkok haemorrhagic fever | Singapore haemorrhagic fever | Thailand haemorrhagic fever | Southeast Asia haemorrhagic fever [1D20] Dengue without warning signs Also known as: Dengue without warning signs | Dengue fever without warning signs | Dengue haemorrhagic fever Grade 1 | Dengue haemorrhagic fever without warning signs Includes: Dengue haemorrhagic fever Grade 1 | Dengue fever without warning signs | Dengue haemorrhagic fever without warning signs [QA08.5] Special screening examination for other viral diseases Also known as: Special screening examination for other viral diseases | Measles screening | Poliomyelitis screening | Rubella screening | Screening for Dengue fever Includes: Screening for COVID-19 Excludes: Viral intestinal infections | Special screening examination for infections with a predominantly sexual mode of transmission | Special screening examination for human immunodeficiency virus [MG26] Fever of other or unknown origin Definition: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process. Also known as: Fever of other or unknown origin | febrile | febris | fever | feverish Excludes: fever of unknown origin in newborn | Malignant hyperthermia due to anaesthesia [1D81.Z] Infectious mononucleosis, unspecified Also known as: Infectious mononucleosis, unspecified | Infectious mononucleosis | Glandular fever | Gammaherpesviral mononucleosis | kissing disease [1B99] Pasteurellosis Definition: A disease caused by an infection with the gram-negative bacteria Pasteurella. This disease is characterised by local cellulitis and may lead to other clinical signs depending on the route of infection. Transmission is commonly by direct contact through the bite, scratch, or lick from an infected animal, inhalation of infected respiratory secretions, or ingestion of contaminated meat. Confirmation is by identification of Pasteurella from the affected individual. Also known as: Pasteurellosis | pasteurella infection | shipping fever | transport fever [4A60.0] Familial Mediterranean fever Definition: FMF is an autoinflammatory disease associated with mutations in pyrin resulting in enhanced IL1 beta production. This results in clinical attacks of inflammation in the form of fever and serositis in the form of peritoneal, pleural or synovial inflammation along with increased acute phase reactants. Also known as: Familial Mediterranean fever | Periodic disease | FMF - [familial mediterranean fever] | periodic fever | periodic polyserositis [JB40.0] Puerperal sepsis Also known as: Puerperal sepsis | puerperal fever | postpartum sepsis | generalised puerperal infection | major puerperal infection Excludes: Obstetric pyaemic or septic embolism | sepsis during labour === GRAPH WALKS === --- Walk 1 --- [1D2Z] Dengue fever, unspecified --PARENT--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --CHILD--> [1D20] Dengue without warning signs --- Walk 2 --- [1D2Z] Dengue fever, unspecified --PARENT--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --- Walk 3 --- [1D22] Severe dengue Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se... --PARENT--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --CHILD--> [1D21] Dengue with warning signs Def: Clinical warning signs are: abdominal pain or tenderness, mucosal bleeding, lethargy and/or restlessness, rapid decrease in platelet count, increase in haematocrit. Other signs can include: persistent... --- Walk 4 --- [1D22] Severe dengue Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se... --PARENT--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --- Walk 5 --- [1D21] Dengue with warning signs Def: Clinical warning signs are: abdominal pain or tenderness, mucosal bleeding, lethargy and/or restlessness, rapid decrease in platelet count, increase in haematocrit. Other signs can include: persistent... --PARENT--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --CHILD--> [1D22] Severe dengue Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se... --- Walk 6 --- [1D21] Dengue with warning signs Def: Clinical warning signs are: abdominal pain or tenderness, mucosal bleeding, lethargy and/or restlessness, rapid decrease in platelet count, increase in haematocrit. Other signs can include: persistent... --PARENT--> [?] Dengue Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti... --CHILD--> [1D22] Severe dengue Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se...
[ "[1D2Z] Dengue fever, unspecified\n --PARENT--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...\n --CHILD--> [1D20] Dengue without warning signs", "[1D2Z] Dengue fever, unspecified\n --PARENT--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....", "[1D22] Severe dengue\n Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se...\n --PARENT--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...\n --CHILD--> [1D21] Dengue with warning signs\n Def: Clinical warning signs are: abdominal pain or tenderness, mucosal bleeding, lethargy and/or restlessness, rapid decrease in platelet count, increase in haematocrit. Other signs can include: persistent...", "[1D22] Severe dengue\n Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se...\n --PARENT--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....", "[1D21] Dengue with warning signs\n Def: Clinical warning signs are: abdominal pain or tenderness, mucosal bleeding, lethargy and/or restlessness, rapid decrease in platelet count, increase in haematocrit. Other signs can include: persistent...\n --PARENT--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...\n --CHILD--> [1D22] Severe dengue\n Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se...", "[1D21] Dengue with warning signs\n Def: Clinical warning signs are: abdominal pain or tenderness, mucosal bleeding, lethargy and/or restlessness, rapid decrease in platelet count, increase in haematocrit. Other signs can include: persistent...\n --PARENT--> [?] Dengue\n Def: Dengue is a viral disease transmitted by the bite of a mosquito infected by dengue viruses. It is one disease entity with different clinical presentations and often with unpredictable clinical evoluti...\n --CHILD--> [1D22] Severe dengue\n Def: Clinical signs include: 1. Severe plasma leakage leading to shock (dengue shock syndrome - DSS) and/or fluid accumulation with respiratory distress; 2. severe bleeding as evaluated by clinician, 3. se..." ]
1D2Z
Dengue fever, unspecified
[ { "from_icd11": "1D2Z", "icd10_code": "A97", "icd10_title": "" }, { "from_icd11": "1D2Z", "icd10_code": "A979", "icd10_title": "" }, { "from_icd11": "1D22", "icd10_code": "A972", "icd10_title": "" }, { "from_icd11": "1D21", "icd10_code": "A971", "icd10_title": "" }, { "from_icd11": "1D20", "icd10_code": "A970", "icd10_title": "" }, { "from_icd11": "QA08.5", "icd10_code": "Z1159", "icd10_title": "Encounter for screening for other viral diseases" }, { "from_icd11": "QA08.5", "icd10_code": "Z1151", "icd10_title": "Encounter for screening for human papillomavirus (HPV)" }, { "from_icd11": "QA08.5", "icd10_code": "Z115", "icd10_title": "Encounter for screening for other viral diseases" }, { "from_icd11": "MG26", "icd10_code": "R5081", "icd10_title": "Fever presenting with conditions classified elsewhere" }, { "from_icd11": "MG26", "icd10_code": "R5084", "icd10_title": "Febrile nonhemolytic transfusion reaction" }, { "from_icd11": "MG26", "icd10_code": "R5082", "icd10_title": "Postprocedural fever" }, { "from_icd11": "MG26", "icd10_code": "R5083", "icd10_title": "Postvaccination fever" }, { "from_icd11": "MG26", "icd10_code": "R509", "icd10_title": "Fever, unspecified" }, { "from_icd11": "MG26", "icd10_code": "R502", "icd10_title": "Drug induced fever" }, { "from_icd11": "MG26", "icd10_code": "R50", "icd10_title": "Fever of other and unknown origin" } ]
A97
The infant underwent phototherapy to address the jaundice when her bilirubin levels reached 15 mg/dL. Additionally, she received oral ursodeoxycholic acid (20 mg/kg/dose, twice a day) and probiotics to aid in gut regulation. Despite these interventions, the ursodeoxycholic acid demonstrated suboptimal efficacy in mitigating the abdominal distension, which did, however, gradually resolve following hepatic supportive and symptomatic treatments, with no recurrence of this symptom. Nonetheless, the direct bilirubin fraction exhibited a persistent increasing trend. Half a month postadmission, a liver stiffness measurement highlighted an average value of approximately 3.1 KPa, compared with normal liver stiffness values typically ranging between 2.0 and 2.5 KPa, pointing to alterations in liver consistency. Our decision not to utilize a gene panel specifically designed for neonatal cholestasis was based on the unique clinical manifestations and biochemical profile observed in this case, which suggested a broader spectrum of potential genetic disorders beyond the usual scope of cholestasis-related genes. Concurrently, blood tandem mass spectrometry for metabolic disorder screening revealed elevated levels of phenylalanine, necessitating further in-depth investigations via a trio whole-exome sequencing test. The test methods were as follows: (1) Mutation screening: Initially, with informed consent from the infant’s family, 2 mL of peripheral blood was drawn from the infant and her parents for high-throughput trio whole-exome sequencing. The inability to obtain samples from the infant’s elder brother posed a limitation in our study. This method comprehensively sequenced all protein-coding regions of a genome, furnishing exhaustive information on potential genetic mutations. (2) Genetic data analysis: After sequencing, we subjected the resultant data to an integrative, in-depth analysis, cross-referencing multiple databases and combining molecular biology annotations, genetic interpretations, and clinical characteristics, facilitated by a precision diagnostic cloud platform system designed for genetic disorders. Employing specialized genetic data analysis algorithms and adhering to the ACMG grading system, we classified hundreds of thousands of genetic variations. (3) Verification of suspected pathogenic mutations: Post high-throughput sequencing, we conducted PCR amplification on selected candidate loci with suspected pathogenic variations. These were then subject to Sanger sequencing, using the ABI3730 sequencer, a revered method in mutation confirmation. Sequence analysis software was employed to interpret the results meticulously, confirming or ruling out pathogenic mutations. (4) Decision against invasive procedures: Crucially, our decision to prioritize genetic testing over cholangiography during the infant’s hospital stay was significantly influenced by specific clinical and radiological observations. The infant’s bowel movements were regular and lacked any signs of obstructive pathology, and the radiological findings did not indicate typical structural anomalies associated with cholestatic diseases. This clinical presentation, coupled with the distinctive radiological profile, suggested a metabolic or genetic etiology rather than a structural biliary disorder, thus steering our diagnostic approach toward genetic testing, which provided a noninvasive yet comprehensive method to explore potential hereditary or metabolic causes. Prior to the establishment of a definitive diagnosis, extensive screenings, including tests for common hereditary metabolic diseases such as PKU, were conducted. These tests confirmed the exclusion of these conditions as causal factors in the patient’s presentation. Moreover, we chose not to perform a liver biopsy despite the rare pathological findings of melanin deposits in newborn liver cells, considering it unnecessary in the face of advancing genetic testing technologies, which are progressively becoming more pivotal in diagnoses, negating the indispensability of liver biopsy as a sole diagnostic modality. Upon receiving the consequential genetic test results and a thorough assessment of the infant’s condition, the medical team decided to discharge the patient. In the subsequent postdischarge phase, the medical strategy involved the prescription of a regimen of phenobarbital (3.5 mg/kg/dose, twice a day) for 2 weeks, manifesting improved efficacy compared with the initial treatment, before its orderly discontinuation. To date, meticulous regular follow-ups with the patient have been sustained, ensuring close monitoring of her progress and prompt addressing of any emergent concerns or anomalies in her health status, underscoring the importance of continual surveillance in managing such conditions.
4.3125
0.519043
sec[2]/p[2]
en
0.999999
38277553
https://doi.org/10.1097/MD.0000000000036991
[ "genetic", "liver", "sequencing", "these", "which", "this", "metabolic", "decision", "potential", "method" ]
[ { "code": "LD27.6Z", "title": "Genetic lipodystrophy, unspecified" }, { "code": "8E02.Z", "title": "Creutzfeldt-Jakob disease, unspecified" }, { "code": "EC20", "title": "Genetic disorders of keratinisation" }, { "code": "AB56", "title": "Hereditary hearing loss" }, { "code": "EC10", "title": "Genetic syndromes with poikiloderma" }, { "code": "DB9Z", "title": "Diseases of liver, unspecified" }, { "code": "DB97.Z", "title": "Inflammatory liver disease, unspecified" }, { "code": "DB99.7", "title": "Hepatic failure without mention whether acute or chronic" }, { "code": "LB20.0Y", "title": "Other specified structural developmental anomalies of liver" }, { "code": "LB20.0Z", "title": "Structural developmental anomalies of liver, unspecified" } ]
=== ICD-11 CODES FOUND === [LD27.6Z] Genetic lipodystrophy, unspecified Also known as: Genetic lipodystrophy, unspecified | Genetic lipodystrophy | Hereditary lipodystrophy | Lipodystrophy due to peptidic growth factors deficiency | Hoepffner-Dreyer-Reimers syndrome [8E02.Z] Creutzfeldt-Jakob disease, unspecified Also known as: Creutzfeldt-Jakob disease, unspecified | Genetic prion diseases [EC20] Genetic disorders of keratinisation Definition: Heritable disorders characterised by abnormal epidermal keratinization. They include the ichthyoses and palmoplantar keratodermas. Also known as: Genetic disorders of keratinisation [AB56] Hereditary hearing loss Also known as: Hereditary hearing loss | genetic hearing loss | hereditary deafness Excludes: Congenital hearing impairment | Acquired hearing impairment [EC10] Genetic syndromes with poikiloderma Definition: Hereditary syndromes in which poikiloderma (cutaneous pigmentation, atrophy and telangiectasia) is a conspicuous feature. Also known as: Genetic syndromes with poikiloderma | Poikiloderma with neutropaenia | Poikiloderma with neutropaenia, Clericuzio type | Hereditary sclerosing poikiloderma | Hereditary sclerosing poikiloderma (MIM 173700) [DB9Z] Diseases of liver, unspecified Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy [DB97.Z] Inflammatory liver disease, unspecified Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS [DB99.7] Hepatic failure without mention whether acute or chronic Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS [LB20.0Y] Other specified structural developmental anomalies of liver Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity [LB20.0Z] Structural developmental anomalies of liver, unspecified Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver === GRAPH WALKS === --- Walk 1 --- [LD27.6Z] Genetic lipodystrophy, unspecified --PARENT--> [LD27.6] Genetic lipodystrophy Def: Genetic lipodystrophies represent a heterogeneous group of rare diseases characterised by a generalised or localised loss of body fat (lipoatrophy).... --RELATED_TO--> [?] Familial partial lipodystrophy --- Walk 2 --- [LD27.6Z] Genetic lipodystrophy, unspecified --PARENT--> [LD27.6] Genetic lipodystrophy Def: Genetic lipodystrophies represent a heterogeneous group of rare diseases characterised by a generalised or localised loss of body fat (lipoatrophy).... --CHILD--> [LD27.60] Congenital generalised lipodystrophy --- Walk 3 --- [8E02.Z] Creutzfeldt-Jakob disease, unspecified --PARENT--> [8E02] Genetic prion diseases Def: Genetic prion disease generally manifests with cognitive difficulties, ataxia, and myoclonus (abrupt jerking movements of muscle groups and/or entire limbs). The order of appearance and/or predominanc... --CHILD--> [8E02.0] Genetic Creutzfeldt-Jakob disease Def: A disease of the brain, that is associated with a prion. This disease is characterised by neurological deficits, and is fatal. Confirmation is by pathological examination of the brain.... --- Walk 4 --- [8E02.Z] Creutzfeldt-Jakob disease, unspecified --PARENT--> [8E02] Genetic prion diseases Def: Genetic prion disease generally manifests with cognitive difficulties, ataxia, and myoclonus (abrupt jerking movements of muscle groups and/or entire limbs). The order of appearance and/or predominanc... --CHILD--> [8E02.0] Genetic Creutzfeldt-Jakob disease Def: A disease of the brain, that is associated with a prion. This disease is characterised by neurological deficits, and is fatal. Confirmation is by pathological examination of the brain.... --- Walk 5 --- [EC20] Genetic disorders of keratinisation Def: Heritable disorders characterised by abnormal epidermal keratinization. They include the ichthyoses and palmoplantar keratodermas.... --RELATED_TO--> [?] Syndromic ichthyosis Def: Hereditary disorders in which ichthyosis is associated with significant other abnormalities.... --CHILD--> [?] Autosomal ichthyosis syndromes with neurological manifestations Def: Hereditary autosomal disorders in which ichthyosis and neurological abnormalities are prominent features.... --- Walk 6 --- [EC20] Genetic disorders of keratinisation Def: Heritable disorders characterised by abnormal epidermal keratinization. They include the ichthyoses and palmoplantar keratodermas.... --RELATED_TO--> [?] Syndromic ichthyosis Def: Hereditary disorders in which ichthyosis is associated with significant other abnormalities.... --CHILD--> [?] Autosomal ichthyosis syndromes with hair abnormalities Def: Hereditary autosomal disorders in which ichthyosis and hair abnormalities are prominent features....
[ "[LD27.6Z] Genetic lipodystrophy, unspecified\n --PARENT--> [LD27.6] Genetic lipodystrophy\n Def: Genetic lipodystrophies represent a heterogeneous group of rare diseases characterised by a generalised or localised loss of body fat (lipoatrophy)....\n --RELATED_TO--> [?] Familial partial lipodystrophy", "[LD27.6Z] Genetic lipodystrophy, unspecified\n --PARENT--> [LD27.6] Genetic lipodystrophy\n Def: Genetic lipodystrophies represent a heterogeneous group of rare diseases characterised by a generalised or localised loss of body fat (lipoatrophy)....\n --CHILD--> [LD27.60] Congenital generalised lipodystrophy", "[8E02.Z] Creutzfeldt-Jakob disease, unspecified\n --PARENT--> [8E02] Genetic prion diseases\n Def: Genetic prion disease generally manifests with cognitive difficulties, ataxia, and myoclonus (abrupt jerking movements of muscle groups and/or entire limbs). The order of appearance and/or predominanc...\n --CHILD--> [8E02.0] Genetic Creutzfeldt-Jakob disease\n Def: A disease of the brain, that is associated with a prion. This disease is characterised by neurological deficits, and is fatal. Confirmation is by pathological examination of the brain....", "[8E02.Z] Creutzfeldt-Jakob disease, unspecified\n --PARENT--> [8E02] Genetic prion diseases\n Def: Genetic prion disease generally manifests with cognitive difficulties, ataxia, and myoclonus (abrupt jerking movements of muscle groups and/or entire limbs). The order of appearance and/or predominanc...\n --CHILD--> [8E02.0] Genetic Creutzfeldt-Jakob disease\n Def: A disease of the brain, that is associated with a prion. This disease is characterised by neurological deficits, and is fatal. Confirmation is by pathological examination of the brain....", "[EC20] Genetic disorders of keratinisation\n Def: Heritable disorders characterised by abnormal epidermal keratinization. They include the ichthyoses and palmoplantar keratodermas....\n --RELATED_TO--> [?] Syndromic ichthyosis\n Def: Hereditary disorders in which ichthyosis is associated with significant other abnormalities....\n --CHILD--> [?] Autosomal ichthyosis syndromes with neurological manifestations\n Def: Hereditary autosomal disorders in which ichthyosis and neurological abnormalities are prominent features....", "[EC20] Genetic disorders of keratinisation\n Def: Heritable disorders characterised by abnormal epidermal keratinization. They include the ichthyoses and palmoplantar keratodermas....\n --RELATED_TO--> [?] Syndromic ichthyosis\n Def: Hereditary disorders in which ichthyosis is associated with significant other abnormalities....\n --CHILD--> [?] Autosomal ichthyosis syndromes with hair abnormalities\n Def: Hereditary autosomal disorders in which ichthyosis and hair abnormalities are prominent features...." ]
LD27.6Z
Genetic lipodystrophy, unspecified
[ { "from_icd11": "LD27.6Z", "icd10_code": "E881", "icd10_title": "Lipodystrophy, not elsewhere classified" }, { "from_icd11": "EC20", "icd10_code": "Q809", "icd10_title": "Congenital ichthyosis, unspecified" }, { "from_icd11": "EC20", "icd10_code": "L998", "icd10_title": "" }, { "from_icd11": "EC20", "icd10_code": "Q80-Q89", "icd10_title": "" }, { "from_icd11": "EC20", "icd10_code": "Q80", "icd10_title": "Congenital ichthyosis" }, { "from_icd11": "EC20", "icd10_code": "Q808", "icd10_title": "Other congenital ichthyosis" }, { "from_icd11": "EC10", "icd10_code": "Q828", "icd10_title": "Other specified congenital malformations of skin" }, { "from_icd11": "DB9Z", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB9Z", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K769", "icd10_title": "Liver disease, unspecified" }, { "from_icd11": "DB9Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "DB9Z", "icd10_code": "K762", "icd10_title": "Central hemorrhagic necrosis of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K70-K77", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K778", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K72", "icd10_title": "Hepatic failure, not elsewhere classified" } ]
E881
Lipodystrophy, not elsewhere classified
A 44-year-old man (height 168 cm, weight 88.5 kg) was admitted to the emergency department of our hospital with chest pain persisting for 8 h. He had a history of hypertension but did not take medication regularly. His vital signs upon admission included a right arm blood pressure of 138/77 mmHg, a pulse of 70 beats/min, a respiratory rate of 18 breaths/min, and an oxygen saturation (SpO2) of 97%. A 12-lead electrocardiogram revealed ST-segment depression in the II, III, and aVF leads. Myocardial enzyme levels were significantly elevated, including CK-MB at 182 ng/ml (0–6 ng/ml) and troponin at 24.54 ng/ml (0–0.08 ng/ml). A pre-operative computed tomography angiogram (CTA) of the entire aorta, coronary artery and supra-aortic vessels revealed ATAAD with a rupture located in the ascending aorta . The dissection flap extended from the ascending aorta to bilateral common iliac artery, right external iliac artery and left internal iliac artery. Celiac trunk artery, superior mesenteric artery, bilateral renal artery and most of intercostal arteries originate from the true lumen, while the inferior mesenteric artery originate from the false lumen. Eccentric thickening of the wall of the proximal segment of the right coronary artery and the proximal segment of the left ventricular posterior branch was observed. A small aneurysm was noted in the M2 segment of the left middle cerebral artery, and the lumen of the right anterior cerebral artery appeared slender. Pre-operative echocardiography revealed coordinated movement of the left and right ventricles with normal contraction amplitude and a left ventricular ejection fraction (LVEF) of 59%. Emergency physicians diagnosed ATAAD with AMI, and emergency surgery was planned in collaboration with the cardiovascular surgery team. For the surgery performed via median sternotomy, cardiopulmonary bypass (CPB) was established through the axillary artery, femoral artery, and right atrium. The ascending aorta was clamped proximal to the brachiocephalic artery and opened to inspect the coronary ostial lesions. A cold blood cardioplegic solution was perfused through the coronary ostium, and no intimal tear was found. The heart was covered with ice. The dissected aorta was resected, intima and media of the aorta were resected, the false lumen blood clots were cleared, and a large epicardial hematoma on the right ventricular surface was explored. Sequential coronary artery bypass grafting (CABG) was performed using a saphenous vein graft from the left ventricular posterior branch (PL) to the posterior descending branch (PDA). Proximal aortic reconstruction was performed using the adventitial inversion technique. Circulatory arrest was initiated at a bladder temperature of 28℃ with bilateral-anterograde cerebral perfusion. A 30-mm self-expandable elephant trunk stent graft was inserted into the true lumen of the descending aorta, and aortic arch reconstruction was performed using a 30-mm four-branched arch graft. When the heart resumed beating and body temperature normalized, intraoperative transesophageal echocardiography revealed decreased left heart function with an LVEF of 32%, the patients have evidence of cardiogenic shock (systemic systolic pressure <90, urine output <30 ml/hour, lactate >2), necessitating the initiation of ECMO through the axillary artery and femoral vein (rotation speed: 2,500 R/min, flow rate: 3.360 L/min). The right coronary saphenous vein graft flow was 58 ml/min, and the pulsatility index was 2.0 by transit time flow measurement (TTFM). The CPB duration was 337 min, aortic cross-clamping time was 153 min, and the circulatory arrest time was 19 min. ECMO was discontinued on post-operative day 3, and the patient was extubated on day 7. The patient spent 18 days in intensive care and 24 days in the hospital. Echocardiography at discharge revealed hypokinesis of the middle and the lower segments of the right ventricle and lower posterior wall of the left ventricle, with an LVEF of 55%. Ultrasound at discharge revealed venous thrombosis in the bilateral lower limbs and right upper limbs. The CTA revealed bilateral scattered pulmonary embolism with an unobstructed artificial vessel and a well-dilated elephant trunk stent without internal leakage. The false lumens distal to the stent had thrombosed. At 2 years and 6 months of follow-up, the patient exhibited normal heart function and could perform normal daily activities. Recent echocardiography revealed normal left and right ventricular wall movements, with an LVEF of 63%. Recent CTA revealed an unobstructed great saphenous vein graft, occlusion of the left ventricular posterior branch, unobstructed artificial vessels, a well-attached elephant trunk stent to the aortic wall, thrombosis and occlusion of the false lumen .
4.007813
0.973145
sec[1]/sec[0]/p[0]
en
0.999995
PMC11825745
https://doi.org/10.3389/fcvm.2025.1463764
[ "artery", "aorta", "coronary", "lumen", "ventricular", "aortic", "graft", "segment", "trunk", "false" ]
[ { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "BD52", "title": "Certain specified disorders of arteries or arterioles" }, { "code": "BD52.3", "title": "Rupture of artery" }, { "code": "BD52.2", "title": "Stricture of artery" }, { "code": "BD40.Z", "title": "Atherosclerotic chronic arterial occlusive disease, unspecified" }, { "code": "LA8A.3", "title": "Congenital supravalvar aortic stenosis" }, { "code": "BD40.1", "title": "Atherosclerosis of aorta" }, { "code": "BB71.Z", "title": "Aortic valve insufficiency, unspecified" }, { "code": "LA8B.2Y", "title": "Other specified congenital anomaly of aorta or its branches" }, { "code": "BA8Z", "title": "Diseases of coronary artery, unspecified" } ]
=== ICD-11 CODES FOUND === [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [BD52] Certain specified disorders of arteries or arterioles Also known as: Certain specified disorders of arteries or arterioles | Aortic dilatation - joint hypermobility - arterial tortuosity | Generalised arterial calcification of infancy | Median arcuate ligament syndrome | Aortic root abscess Excludes: collagen (vascular) diseases | Hypersensitivity angiitis | Acute arterial occlusion [BD52.3] Rupture of artery Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula Excludes: traumatic rupture of artery - see injury of blood vessel by body region [BD52.2] Stricture of artery Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery [BD40.Z] Atherosclerotic chronic arterial occlusive disease, unspecified Also known as: Atherosclerotic chronic arterial occlusive disease, unspecified | Atherosclerotic chronic arterial occlusive disease | arteriosclerosis, NOS | generalised atherosclerosis | atherosclerosis NOS [LA8A.3] Congenital supravalvar aortic stenosis Definition: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalvar aortic stenosis' is described as three forms: an hourglass deformity, a fibrous membrane, and a diffuse narrowing of the ascending aorta. Supravalvar aortic stenosis may involve the coronary artery ostia, and the aortic leaflets may be tethered. The coronary arteries can become tortuous and dilate Also known as: Congenital supravalvar aortic stenosis | stenosis of aorta | supravalvular aortic stenosis | stricture of aorta | congenital narrowed aorta Excludes: Congenital aortic valvar stenosis [BD40.1] Atherosclerosis of aorta Also known as: Atherosclerosis of aorta | aorta atheroma | aorta calcification | aorta arteriosclerosis | aortic degeneration [BB71.Z] Aortic valve insufficiency, unspecified Also known as: Aortic valve insufficiency, unspecified | Aortic valve insufficiency | aortic insufficiency | aortic valve incompetency | AI - [aortic incompetence] [LA8B.2Y] Other specified congenital anomaly of aorta or its branches Also known as: Other specified congenital anomaly of aorta or its branches | Congenital anomaly of ascending aorta | Hypoplasia of ascending aorta | Congenital ascending aorta aneurysm or dilation | congenital ascending aortic aneurysm or dilation [BA8Z] Diseases of coronary artery, unspecified Also known as: Diseases of coronary artery, unspecified | coronary artery insufficiency | coronary artery heart disease | CAD - [coronary artery disease] | coronary artery disorder === GRAPH WALKS === --- Walk 1 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [BD30] Acute arterial occlusion --- Walk 2 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [?] Chronic arterial occlusive disease --- Walk 3 --- [BD52] Certain specified disorders of arteries or arterioles --CHILD--> [BD52.0] Segmental arterial mediolysis Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys... --PARENT--> [BD52] Certain specified disorders of arteries or arterioles --- Walk 4 --- [BD52] Certain specified disorders of arteries or arterioles --CHILD--> [BD52.2] Stricture of artery --PARENT--> [BD52] Certain specified disorders of arteries or arterioles --- Walk 5 --- [BD52.3] Rupture of artery --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes Def: !markdown In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre... --CHILD--> [?] Injuries to the neck --- Walk 6 --- [BD52.3] Rupture of artery --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes Def: !markdown In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre... --EXCLUDES--> [?] Pathological fracture
[ "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD30] Acute arterial occlusion", "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [?] Chronic arterial occlusive disease", "[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.0] Segmental arterial mediolysis\n Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys...\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles", "[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.2] Stricture of artery\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles", "[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --CHILD--> [?] Injuries to the neck", "[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --EXCLUDES--> [?] Pathological fracture" ]
BD5Z
Diseases of arteries or arterioles, unspecified
[ { "from_icd11": "BD5Z", "icd10_code": "I7389", "icd10_title": "Other specified peripheral vascular diseases" }, { "from_icd11": "BD5Z", "icd10_code": "I7419", "icd10_title": "Embolism and thrombosis of other parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7411", "icd10_title": "Embolism and thrombosis of thoracic aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7410", "icd10_title": "Embolism and thrombosis of unspecified parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7381", "icd10_title": "Erythromelalgia" }, { "from_icd11": "BD5Z", "icd10_code": "I745", "icd10_title": "Embolism and thrombosis of iliac artery" }, { "from_icd11": "BD5Z", "icd10_code": "I789", "icd10_title": "Disease of capillaries, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I748", "icd10_title": "Embolism and thrombosis of other arteries" }, { "from_icd11": "BD5Z", "icd10_code": "I749", "icd10_title": "Embolism and thrombosis of unspecified artery" }, { "from_icd11": "BD5Z", "icd10_code": "I781", "icd10_title": "Nevus, non-neoplastic" }, { "from_icd11": "BD5Z", "icd10_code": "I788", "icd10_title": "Other diseases of capillaries" }, { "from_icd11": "BD5Z", "icd10_code": "I744", "icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified" }, { "from_icd11": "BD5Z", "icd10_code": "I70-I79", "icd10_title": "" }, { "from_icd11": "BD5Z", "icd10_code": "I74", "icd10_title": "Arterial embolism and thrombosis" }, { "from_icd11": "BD5Z", "icd10_code": "I73", "icd10_title": "Other peripheral vascular diseases" } ]
I7389
Other specified peripheral vascular diseases
A 67-year-old male patient developed left pelvic pain without obvious cause in January 2017. The patient went to hospital, and yet no obvious abnormality was found in the anterolateral radiographs of the pelvis. The doctor in that hospital suggested further examination to exclude the possibility of lumbar disc herniation, but the patient did not follow his advice. In March 2018, the pain in the left pelvis and left lower limb aggravated so much as to cripple the patient. Magnetic resonance imaging (MRI) in other hospitals suggested that the left pelvis was occupied, and malignant tumor was considered. To check out the diagnosis and seek treatment, he went to our hospital in March 2019. SPECT/CT imaging of the whole body suggested: 1) abnormal concentration of imaging agent was distributed in the left iliac bone and the left part of T12 vertebrae, and bone destruction was observed in the corresponding parts; 2) abnormal concentration of imaging agent was observed in the left iliac crest near the symphysis pubis, lateral to the 8th spine of the right posterior rib, and in the lower segment of the right humerus; there is possibility of bone metastasis tumor, which need further diagnosis. Ultrasound-guided puncture biopsy of the left iliac crest was thus sent for pathology analysis. Under microscope, thyroid follicles of different sizes were observed, with mild atypia and mild morphology ; dense and crowded glands with active hyperplasia and mild atypia were observed, with a few ground-glass nuclei seen and no nuclear sulcus, no sand bodies, and no papilla observed . Bone metastasis of thyroid follicular carcinoma was thus considered. Reviewing the patient’s past medical history, we found the patient admitted to our hospital 5 years ago due to right neck mass. He underwent thyroid doppler ultrasound examination , which showed: There was a solid nodule in the right lobe of the thyroid gland, about 30mm×28mm in size, with clear boundary, solid interior and irregular anechoic area; short strip-shaped strong echo could be seen around the nodules, and abundant blood flow signals could be seen in and around the nodules. Clinical conclusion suggested the strong possibility of nodular goiter accompanied by adenomatoid hyperplasia, and the to-be-determined possibility of follicular tumor. Total thyroidectomy on the right side + subtotal thyroidectomy on the left side + lymph node dissection on the right side of the neck were thus performed. The pathological diagnosis showed the nodule to be adenoma, which did not suggest malignancy. Immunohistochemistry: Ki67 (1%+), Galectin-3(+), MC (+ +), CK19 (+ +). Molecular pathology: no mutation of BRAF gene V600E was detected. Nodular goiter (left thyroid gland) with adenomatous hyperplasia, accompanied by cystic changes. Clinical considerations: The right thyroid mass 3 years ago may be follicular carcinoma (pathologically misdiagnosed as a benign nodule), and this bone metastasis was caused by the gradual increase of hemorrhagic metastasis. After MDT consultation, it was deemed necessary to further resect the left residual thyroid gland. Therefore, the patient was transferred to the Department of Tumor Surgery of our hospital for left residual thyroid lobectomy. Postoperative pathology: nodular goitre (left thyroid lobule), no signs of malignant tumor. To further confirm the diagnosis, the original pathology of the patient’s right thyroid in 2014 was reviewed . It said: At low magnification, the tumor was characterized by a follicular neoplasm with a thick fibrous capsule surrounding it; thyroid follicles of different sizes can be seen in the capsule; some thyroid follicles were similar to fetal thyroid follicles during embryonic development; the cells were densely crowded, thyroid glia was found in the follicles, some glia were concentrated, and absorption vacuoles were formed in the follicular epithelium; Right in the upper side of the view, the tumor was seen to invade the capsule and protrude out of it, creating what was called a “mushroom-like appearance”. The tumor invaded the vasculature and formed intracavascular tumor thrombus. At high magnification, the nuclei of the tumor were found slightly enlarged; nucleoli were seen in a few tumor cells; the nuclei were sparse; no ground-glass nuclei, no nuclear groove, no nuclear overlap, and no mitotic images were observed; in some areas, the cytoplasm of tumor cells was eosinophilic; fibrous hyperplasia was seen in the tumor stroma and separated the tumor into nodular structures; the surrounding thyroid tissue was nodular goiter. Based on two thyroid surgeries, imaging tests, and the histopathological characteristics of thyroid follicular carcinoma, the final diagnosis of right thyroid follicular carcinoma with pelvic metastasis was made.
3.931641
0.983398
sec[0]/p[0]
en
0.999997
PMC10235689
https://doi.org/10.3389/fonc.2023.1048485
[ "thyroid", "tumor", "follicular", "imaging", "bone", "metastasis", "follicles", "nodular", "suggested", "possibility" ]
[ { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" } ]
=== ICD-11 CODES FOUND === [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS === GRAPH WALKS === --- Walk 1 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.2] Autoimmune thyroiditis Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies.... --- Walk 2 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.2] Autoimmune thyroiditis Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies.... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A01] Nontoxic goitre Def: Enlargement of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis... --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A00] Hypothyroidism --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --RELATED_TO--> [?] Postpartum thyroiditis Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.2] Autoimmune thyroiditis\n Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies....", "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.2] Autoimmune thyroiditis\n Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies....", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A01] Nontoxic goitre\n Def: Enlargement of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis...", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A00] Hypothyroidism", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth...." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
Our experience reports the case of a 41-year-old male patient who presented to our outpatient department for severe back pain. The patient had been emergently treated with a zone-2 TEVAR with distal PETTICOAT (provisional extension to induce complete attachment) limited to the thoracic region for complicated Type-IIIB aortic dissection performed due to a worsening of pleural effusion and to a not responding arterial hypertensive state. The left subclavian artery was neither revascularized nor occluded at the origin. The intervention was complicated by left cerebral ischemia; the stroke resulted in a right hemisyndrome with mild walking impairment. Patient followed a neurological rehabilitation program both in hospital and after discharge. A 2-month computed tomography (CT) scan observed a Type-IC endoleak and complete reperfusion of the false lumen from distal reentry tear with enlargement of the false lumen associated with intermittent pain. The subsequent treatment entailed a stent–graft extension from the previous TEVAR to just above the celiac trunk origin followed, 2 weeks after, by embolization of the origin of the left subclavian artery and occlusion of the distal false lumen with a candy plug version II. 2 3 The immediate postoperative course was characterized by a postimplant syndrome treated with steroids. Nonetheless, a few months after these procedures, the patient returned with worsening back pain that was hardly responding to any common pain killers. Repeated hospitalizations and complete vascular and neurological evaluations did not show any technical and anatomical issues to justify the recurrent pain. Follow-up CT scans, performed to rule out an aortic etiology of the pain, revealed a progressive complete thrombosis of the false lumen with progressive shrinkage of its portion in the thoracic region and stable transaortic diameter in the abdominal region with the residual dissection . The patient was referred for algological therapy with a mild regression of the visual analogue scale (VAS) from 8 to 6. After 18 months, since the first procedure, the patient was under transdermal oxycodone treatment. A Short Form 12 Health Survey Scale (SF-12) was administered underlying severe physical and social impairment because of back pain and drug therapy. During a new hospitalization, in our hospital, new angio-magnetic resonance imaging (MRI), electroencephalogram, electroneuromyography, and somatosensorial-evoked response tests excluded any neurologic defects. Lung and pleural evaluations showed normal results. In the end, despite the technical success, the aortic nature of the pain was suspected and zooming the bulk of endovascular material inside the thoracic aorta as a trigger for complex regional pain syndrome (CRPS). 4 5 Therefore, the candy plug removal was considered to reduce the radial force working inside the aorta. The patient was approached in two stages. First, a left carotid subclavian artery bypass was performed to increase the collateral network inflow considering that preoperative MRI and CT scan failed to detect patent intercostal arteries arising from the stent–grafted region. Ten days after cervical bypass, a semiconservative open conversion was performed through a left thoracoabdominal incision in the eighth intercostal space; the progressive shrinkage of the thoracic false lumen allowed treating the patient as a Type-IV thoracoabdominal aortic aneurysm (TAAA). Cerebrospinal fluid drainage and permissive hypothermia (lower rectal temperature of 33°C) combined with the previous left subclavian artery revascularization were employed as adjuncts for spinal cord protection. The thoracoabdominal aorta was prepared from approximately 10 cm above the aortic hiatus down to the aortoiliac bifurcation. Before opening the aorta, the region where “candy plug” imprinting the aortic adventitia was evident ( Video 1 ; available in the online version). “Candy plug” bulged out from the aortic false lumen through a 10-cm long longitudinal incision ( Video 1 ; available in the online version). After aortic cross-clamping, the false lumen was longitudinally opened, the candy plug was removed , and the true lumen endograft was partially resected to both perform the proximal anastomosis in a dissection-healed thoracic region and resect the residual and aneurysmal abdominal aorta. Visceral and renal protection was obtained with local hypothermic perfusion with 4°C Mannitol and Ringer Lactate solution. 2 3 Proximal aortic graft was sutured end to end with the endograft and distally a beveled anastomosis, including visceral and renal vessels, was performed. 3 Recovery was uneventful, and patient was discharged on postoperative day 15. After 4 months, the patient reported VAS 2 with no need of opiates as painkiller.
3.998047
0.978516
sec[1]/p[0]
en
0.999997
34644804
https://doi.org/10.1055/s-0041-1730007
[ "pain", "aortic", "lumen", "false", "region", "thoracic", "candy", "plug", "aorta", "complete" ]
[ { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" }, { "code": "FB56.2", "title": "Myalgia" }, { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "LA8A.3", "title": "Congenital supravalvar aortic stenosis" }, { "code": "BD40.1", "title": "Atherosclerosis of aorta" }, { "code": "BB71.Z", "title": "Aortic valve insufficiency, unspecified" }, { "code": "LA8B.2Y", "title": "Other specified congenital anomaly of aorta or its branches" } ]
=== ICD-11 CODES FOUND === [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [LA8A.3] Congenital supravalvar aortic stenosis Definition: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalvar aortic stenosis' is described as three forms: an hourglass deformity, a fibrous membrane, and a diffuse narrowing of the ascending aorta. Supravalvar aortic stenosis may involve the coronary artery ostia, and the aortic leaflets may be tethered. The coronary arteries can become tortuous and dilate Also known as: Congenital supravalvar aortic stenosis | stenosis of aorta | supravalvular aortic stenosis | stricture of aorta | congenital narrowed aorta Excludes: Congenital aortic valvar stenosis [BD40.1] Atherosclerosis of aorta Also known as: Atherosclerosis of aorta | aorta atheroma | aorta calcification | aorta arteriosclerosis | aortic degeneration [BB71.Z] Aortic valve insufficiency, unspecified Also known as: Aortic valve insufficiency, unspecified | Aortic valve insufficiency | aortic insufficiency | aortic valve incompetency | AI - [aortic incompetence] [LA8B.2Y] Other specified congenital anomaly of aorta or its branches Also known as: Other specified congenital anomaly of aorta or its branches | Congenital anomaly of ascending aorta | Hypoplasia of ascending aorta | Congenital ascending aorta aneurysm or dilation | congenital ascending aortic aneurysm or dilation === GRAPH WALKS === --- Walk 1 --- [MG3Z] Pain, unspecified --PARENT--> [?] Pain --CHILD--> [MG30] Chronic pain Def: Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Chronic pain is pain that persists or recurs for longer t... --- Walk 2 --- [MG3Z] Pain, unspecified --PARENT--> [?] Pain --CHILD--> [MG3Z] Pain, unspecified --- Walk 3 --- [8E43.Z] Pain disorders, unspecified --PARENT--> [8E43] Pain disorders --CHILD--> [8E43.0] Neuropathic pain Def: Neuropathic pain is described as electric, burning, or shock like, caused by metabolic, nutritional, infectious, genetic, autoimmune, and/or vasculitic processes. The pain may occur spontaneously, wit... --- Walk 4 --- [8E43.Z] Pain disorders, unspecified --PARENT--> [8E43] Pain disorders --EXCLUDES--> [?] Chronic neuropathic pain Def: Chronic neuropathic pain is chronic pain caused by a lesion or disease of the somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful stimulus (hyper... --- Walk 5 --- [MG31.Z] Acute pain, unspecified --PARENT--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --PARENT--> [?] Pain --- Walk 6 --- [MG31.Z] Acute pain, unspecified --PARENT--> [MG31] Acute pain Def: Pain with a duration of less than 3 months. This code should be used only when there is no further specification of site.... --CHILD--> [MG31.0] Acute pain in the face, not elsewhere classified
[ "[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --CHILD--> [MG30] Chronic pain\n Def: Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Chronic pain is pain that persists or recurs for longer t...", "[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --CHILD--> [MG3Z] Pain, unspecified", "[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --CHILD--> [8E43.0] Neuropathic pain\n Def: Neuropathic pain is described as electric, burning, or shock like, caused by metabolic, nutritional, infectious, genetic, autoimmune, and/or vasculitic processes. The pain may occur spontaneously, wit...", "[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --EXCLUDES--> [?] Chronic neuropathic pain\n Def: Chronic neuropathic pain is chronic pain caused by a lesion or disease of the somatosensory nervous system. The pain may be spontaneous or evoked, as an increased response to a painful stimulus (hyper...", "[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --PARENT--> [?] Pain", "[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --CHILD--> [MG31.0] Acute pain in the face, not elsewhere classified" ]
MG3Z
Pain, unspecified
[ { "from_icd11": "MG3Z", "icd10_code": "R52", "icd10_title": "Pain, unspecified" }, { "from_icd11": "MG3Z", "icd10_code": "R529", "icd10_title": "" }, { "from_icd11": "MG31.Z", "icd10_code": "R520", "icd10_title": "" }, { "from_icd11": "MG30.Z", "icd10_code": "R521", "icd10_title": "" }, { "from_icd11": "MG30.Z", "icd10_code": "R522", "icd10_title": "" }, { "from_icd11": "FB56.2", "icd10_code": "M7918", "icd10_title": "Myalgia, other site" }, { "from_icd11": "FB56.2", "icd10_code": "M7910", "icd10_title": "Myalgia, unspecified site" }, { "from_icd11": "FB56.2", "icd10_code": "M7912", "icd10_title": "Myalgia of auxiliary muscles, head and neck" }, { "from_icd11": "FB56.2", "icd10_code": "M791", "icd10_title": "Myalgia" }, { "from_icd11": "BD5Z", "icd10_code": "I7389", "icd10_title": "Other specified peripheral vascular diseases" }, { "from_icd11": "BD5Z", "icd10_code": "I7419", "icd10_title": "Embolism and thrombosis of other parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7411", "icd10_title": "Embolism and thrombosis of thoracic aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7410", "icd10_title": "Embolism and thrombosis of unspecified parts of aorta" }, { "from_icd11": "BD5Z", "icd10_code": "I7381", "icd10_title": "Erythromelalgia" }, { "from_icd11": "BD5Z", "icd10_code": "I745", "icd10_title": "Embolism and thrombosis of iliac artery" } ]
R52
Pain, unspecified
Here we describe, to our knowledge, the first case of retinal vasculopathy and MAS parallel in SLE flare, treated concomitantly with intravitreal anti-VEGF, laser photocoag-ulation and RTX with a good response. Establishing the diagnosis of MAS in SLE is challenging due to overlapping clinical features (splenomegaly, hepatomegaly, and lymphadenopathy) and laboratory findings (cytopenias) of SLE and MAS. The fact that both conditions mimic each other can lead to a delay in diagnosis and treatment. Hemophagocytosis was not found in the bone marrow aspirate of our patient, but we made the diagnosis of MAS in SLE-flare because our patient fulfilled the currently available criteria for both primary HLH and secondary HLH/MAS . The criteria for MAS in the adult SLE population are not yet developed, so other criteria could be used for the establishment of the diagnosis . Other MAS-specific laboratory parameters found were elevated ferritin, triglyceride, d-dimers, AST, ALT, and LDH, as well as decreased albumin and fibrinogen, and these parameters, particularly hyperferritinemia, should lead rheumatologists to confirm or rule out MAS . A delayed diagnosis of MAS due to the absence of hemophagocytosis in the bone marrow aspirate can lead to a fatal outcome, so it is necessary to start treatment even though only a suspicion of MAS was made. Macrophage activation syndrome is considered a rheumatological emergency and a lethal complication of SLE. Recent studies showed that MAS in the adult SLE population carried a better prognosis than other secondary HLH, with mortality between 5% and 35% . High mortality is a consequence of insufficiently early recognition of the clinical syndrome, the severity of the disease itself, and the lack of treatment recommendations . Because of the rare occurrence of MAS in the adult SLE population and other rheumatological diseases, management, and treatment recommendations for MAS in adults with rheumatological conditions are not yet developed. Treatment of MAS is so far based on a rheumatologist’s individual assessment of the patient’s illness, previously reported case reports and expert opinions, and the hematological HLH-2004 protocol with dexamethasone, cyclosporine, and etoposide, which can be considered in selected cases . Based on the treatment of our patient, but also on previously reported case reports and small clinical studies, our opinion is that the treatment of MAS in SLE should be individually tailored to each patient depending on which target organ (kidney, brain, lungs, eyes, etc.) is affected in parallel by SLE and how severe and life-threatening this comorbidity is. High-dose glucocorticoids present fundamental therapy, and other immunosuppressants, such as MMF, cyclophosphamide, RTX, anti-TNF-alfa, anakinra, canakinumab, immunoglobulins, and plasma exchange are added in cases of severe organ-threatening or refractory disease . In the beginning, our patient had retinopathy with preserved visual acuity in parallel with MAS. Because of previously published cases and small studies of patients with SLE and MAS and patients with SLE and RV, we first opted for high-dose corticosteroid therapy, which resulted in immediate clinical and laboratory response, and concurrent MMF as an immunosuppressant and glucocorticoid-sparing drug . Despite this therapy, the patient had an SLE flare with the possibility of MAS recurrence, significant worsening of RV, and a threatening exacerbation which tends to affect the macula. The treatment of lupus retinopathy depends on the severity of the disease, and the visual outcome was usually better in those with cotton-wool spots than in severe retinal vaso-occlusive disease . Bevacizumab should be considered in severe vaso-occlusive retinopathy, as in our patient. In addition, vitrectomy and retinal photocoagulation can be performed in selected cases to halt neovascularization and prevent aggravation of visual loss . Intraocular therapy in our patient with BEV and laser photocoagulation halted the further progression of retinal damage and preserved visual acuity. Due to SLE flare and RV despite MMF, we decided on a second immunosuppressant RTX in parallel with BEV and laser photocoagulation. We opted for RTX because it has been successfully used for the treatment of MAS and/or RV within SLE . Cyclophosphamide could also be the therapy of choice, but our patient refused it due to unacceptable side effects. After 12 months of RTX therapy, our patient doesn’t have active retinal disease or lupus. According to some authors, retinal vasculitis is a sign of severe SLE disease activity . Our case suggests that all patients with severe SLE disease activity should be carefully evaluated for ocular manifestations and clinical features and laboratory parameters of MAS.
4.273438
0.890625
sec[2]/p[0]
en
0.999997
PMC9916420
https://doi.org/10.3390/ijms24032594
[ "retinal", "parallel", "flare", "laboratory", "that", "because", "which", "cases", "visual", "laser" ]
[ { "code": "9B7Z", "title": "Disorders of the retina, unspecified" }, { "code": "9B74.Z", "title": "Retinal vascular occlusions, unspecified" }, { "code": "9B73.4", "title": "Retinal breaks without detachment" }, { "code": "9B78.9", "title": "Retinal atrophy" }, { "code": "9B7Y", "title": "Other specified disorders of the retina" }, { "code": "LA8Y", "title": "Other specified structural developmental anomaly of heart or great vessels" }, { "code": "LA85.Y", "title": "Other specified congenital anomaly of an atrioventricular or ventriculo-arterial connection" }, { "code": "BD74.0", "title": "Uncomplicated lower limb venous hypertension" }, { "code": "EF20.2", "title": "Lower limb venous telangiectases" }, { "code": "EA90.1", "title": "Guttate psoriasis" } ]
=== ICD-11 CODES FOUND === [9B7Z] Disorders of the retina, unspecified Also known as: Disorders of the retina, unspecified | retinal disease | retinal lesion NOS [9B74.Z] Retinal vascular occlusions, unspecified Also known as: Retinal vascular occlusions, unspecified | Retinal vascular occlusions | occlusion of retinal vessels | retinal obstruction [9B73.4] Retinal breaks without detachment Also known as: Retinal breaks without detachment | Retinal break NOS | ruptured retina | Horseshoe tear of retina without detachment | Round hole of retina without detachment Includes: Horseshoe tear of retina without detachment | Round hole of retina without detachment Excludes: Chorioretinal scars after surgery for detachment | peripheral retinal degeneration without break [9B78.9] Retinal atrophy Definition: This is a group of genetic diseases and is characterised by the bilateral degeneration of the retina, causing progressive vision loss culminating in blindness. Also known as: Retinal atrophy | atrophic retina [9B7Y] Other specified disorders of the retina Also known as: Other specified disorders of the retina | Åland Island eye disease | Cone dystrophy with supernormal rod response | Familial retinal arterial macroaneurysm | IRVAN syndrome [LA8Y] Other specified structural developmental anomaly of heart or great vessels Also known as: Other specified structural developmental anomaly of heart or great vessels | Congenital anomaly of position or spatial relationships of thoraco-abdominal organs | Usual atrial arrangement | atrial situs solitus | Abnormal atrial arrangement [LA85.Y] Other specified congenital anomaly of an atrioventricular or ventriculo-arterial connection Also known as: Other specified congenital anomaly of an atrioventricular or ventriculo-arterial connection | Concordant atrioventricular connections | Normal atrioventricular connections | Atrioventricular concordance | Concordant ventriculo-arterial connections [BD74.0] Uncomplicated lower limb venous hypertension Definition: The presence of lower limb venous incompetence or hypertension as may be manifest by the presence of haemosiderin pigmentation of the skin, telangiectasia or finely dilated superficial veins. Also known as: Uncomplicated lower limb venous hypertension | Lower limb haemosiderosis due to venous insufficiency | Lower limb haemosiderosis secondary to venous insufficiency | Lower limb superficial venous ectasia | Venous flare [EF20.2] Lower limb venous telangiectases Definition: Finely dilated superficial veins of lower limbs resulting from chronic venous hypertension. Also known as: Lower limb venous telangiectases | Lower limb venous flares | Lower limb spider veins | Reticular leg veins [EA90.1] Guttate psoriasis Definition: An acute, usually widespread eruption of small (<1cm) papules of psoriasis associated in a majority of cases with preceding streptococcal infection, particularly tonsillitis and streptococcal sore throat. This form of psoriasis is seen typically in children and young adults. If untreated it tends to resolve over a period of four to six months. Also known as: Guttate psoriasis | Psoriasis guttata | Acute guttate psoriasis | Guttate flare of plaque psoriasis === GRAPH WALKS === --- Walk 1 --- [9B7Z] Disorders of the retina, unspecified --PARENT--> [?] Disorders of the retina --RELATED_TO--> [?] Certain congenital malformations of posterior segment of eye --- Walk 2 --- [9B7Z] Disorders of the retina, unspecified --PARENT--> [?] Disorders of the retina --RELATED_TO--> [?] Certain congenital malformations of posterior segment of eye --- Walk 3 --- [9B74.Z] Retinal vascular occlusions, unspecified --PARENT--> [9B74] Retinal vascular occlusions Def: These are obstruction or closure of retinal vascular structures.... --CHILD--> [9B74.1] Retinal venous occlusions --- Walk 4 --- [9B74.Z] Retinal vascular occlusions, unspecified --PARENT--> [9B74] Retinal vascular occlusions Def: These are obstruction or closure of retinal vascular structures.... --CHILD--> [9B74.1] Retinal venous occlusions --- Walk 5 --- [9B73.4] Retinal breaks without detachment --EXCLUDES--> [?] Peripheral retinal degeneration --EXCLUDES--> [?] Retinal breaks without detachment --- Walk 6 --- [9B73.4] Retinal breaks without detachment --EXCLUDES--> [?] Peripheral retinal degeneration --CHILD--> [?] Paving stone degeneration of retina
[ "[9B7Z] Disorders of the retina, unspecified\n --PARENT--> [?] Disorders of the retina\n --RELATED_TO--> [?] Certain congenital malformations of posterior segment of eye", "[9B7Z] Disorders of the retina, unspecified\n --PARENT--> [?] Disorders of the retina\n --RELATED_TO--> [?] Certain congenital malformations of posterior segment of eye", "[9B74.Z] Retinal vascular occlusions, unspecified\n --PARENT--> [9B74] Retinal vascular occlusions\n Def: These are obstruction or closure of retinal vascular structures....\n --CHILD--> [9B74.1] Retinal venous occlusions", "[9B74.Z] Retinal vascular occlusions, unspecified\n --PARENT--> [9B74] Retinal vascular occlusions\n Def: These are obstruction or closure of retinal vascular structures....\n --CHILD--> [9B74.1] Retinal venous occlusions", "[9B73.4] Retinal breaks without detachment\n --EXCLUDES--> [?] Peripheral retinal degeneration\n --EXCLUDES--> [?] Retinal breaks without detachment", "[9B73.4] Retinal breaks without detachment\n --EXCLUDES--> [?] Peripheral retinal degeneration\n --CHILD--> [?] Paving stone degeneration of retina" ]
9B7Z
Disorders of the retina, unspecified
[ { "from_icd11": "9B7Z", "icd10_code": "H30-H36", "icd10_title": "" }, { "from_icd11": "9B7Z", "icd10_code": "H32", "icd10_title": "Chorioretinal disorders in diseases classified elsewhere" }, { "from_icd11": "9B7Z", "icd10_code": "H320", "icd10_title": "" }, { "from_icd11": "9B7Z", "icd10_code": "H328", "icd10_title": "" }, { "from_icd11": "9B74.Z", "icd10_code": "H348192", "icd10_title": "Central retinal vein occlusion, unspecified eye, stable" }, { "from_icd11": "9B74.Z", "icd10_code": "H348310", "icd10_title": "Tributary (branch) retinal vein occlusion, right eye, with macular edema" }, { "from_icd11": "9B74.Z", "icd10_code": "H348112", "icd10_title": "Central retinal vein occlusion, right eye, stable" }, { "from_icd11": "9B74.Z", "icd10_code": "H348122", "icd10_title": "Central retinal vein occlusion, left eye, stable" }, { "from_icd11": "9B74.Z", "icd10_code": "H34819", "icd10_title": "Central retinal vein occlusion, unspecified eye" }, { "from_icd11": "9B74.Z", "icd10_code": "H348392", "icd10_title": "Tributary (branch) retinal vein occlusion, unspecified eye, stable" }, { "from_icd11": "9B74.Z", "icd10_code": "H34812", "icd10_title": "Central retinal vein occlusion, left eye" }, { "from_icd11": "9B74.Z", "icd10_code": "H34813", "icd10_title": "Central retinal vein occlusion, bilateral" }, { "from_icd11": "9B74.Z", "icd10_code": "H348120", "icd10_title": "Central retinal vein occlusion, left eye, with macular edema" }, { "from_icd11": "9B74.Z", "icd10_code": "H348320", "icd10_title": "Tributary (branch) retinal vein occlusion, left eye, with macular edema" }, { "from_icd11": "9B74.Z", "icd10_code": "H34811", "icd10_title": "Central retinal vein occlusion, right eye" } ]
H30-H36
The proband was the second child of unrelated parents with no remarkable medical history. The paternal grandfather had a history of simple, uncomplicated febrile seizures in infancy. The pregnancy and delivery were unremarkable, and the patients’ neurodevelopmental milestones were in the normal range. However, the mother described the appearance of sleep disorders at the age of 10 months that increased the sleep onset latency and nocturnal awakenings and ceased with co-sleeping. Not until the age of 6 could he sleep alone. The patient began school at the age of 3, but separation anxiety was severe and interfered with his learning. He was also described as a solitary child without other signs suggestive of an autism spectrum disorder. Between 19 months and 6 years of age, he experienced 7 typical febrile seizures. At 7 years of age, a global cognitive assessment revealed a heterogeneous profile with verbal intellectual quotient (IQ) of 78, perceptive IQ of 71 and speed processing index of 59. These results should, however, be interpreted with caution given the level of anxiety. At the age of 8, sodium valproate (400 mg per day, blood concentration: 52.4 mg/l) was introduced because of the occurrence of two spontaneous generalized tonic-clonic seizures with generalized spike-wave discharges upon interictal electroencephalography recording. Sodium valproate led to full seizure control. At the age of 9, anxiety escalation was noted, with death worries, iterative questioning, restlessness and panic attacks. At the age of 10, emotional withdrawal emerged, along with a flat affect, suicidal thoughts, irrelevant talk, delusions and paranoid ideation, with no recurrence of seizures. Confusion and disorganization were also noted. He began to talk and giggle with self. Eventually, the occurrence of daily auditory and visual hallucinations led to the patient’s hospitalization. The diagnosis of childhood onset schizophrenia (DSM V) was then evoked. This uncommon and severe phenotype associated with visual hallucinations led to further investigations. Brain magnetic resonance imaging was unremarkable. Wakefulness electroencephalography showed a normal background and some bilateral spike-wave discharges that did not explain the psychosis features and lacked contemporary clinical manifestation. Ammonemia, urinary organic acids, plasmatic amino acids, exchangeable copper, lysosphingolipids and oxysterols were in the normal ranges. A comparative genomic hybridization array (180 K, Agilent, Santa Clara, CA, USA) and quantitative polymerase chain reaction revealed an 867-kb 16p13.3 duplication inherited from the patient’s mother, which was interpreted as a variant of unknown significance (arr [hg19] 16p13.13p13.12(12,008,151-12,875,277) × 3 mat). The patient was given risperidone (1,5 mg per day), which led to a clinical improvement allowing hospital discharge. At the age of 11, an explosive relapse of epilepsy occurred with daily seizures of various types: absences, myoclonic fits, tonic and tonicoclonic seizures. No contemporary increase in behavioral disorders was noted. An electroencephalogram disclosed slow background activity, with bilateral diffuse spikes and waves predominating in the frontal area. Several tonic seizures were recorded. A photoparoxysmal response was recorded on electroencephalogram with photic stimulation. Progressive but significant improvement of epilepsy was obtained with lamotrigine (250 mg per day) in addition to valproic acid . The epilepsy phenotype, close to Lennox-Gastaut syndrome, led to the sequencing of a 93-gene panel for monogenic epileptic disorders. Capture was performed with the SeqCap EZ kit (Roche, Madison, WI, USA) and sequencing on a NextSeq500 (Illumina, San Diego, CA, USA). Gene panel sequencing disclosed the presence of a heterozygous transition in CHD2 that was predicted to produce a premature stop codon, p.. This transition had not been reported previously in patients or in database of control individuals (gnomAD). Sanger sequencing from the patient and his parents confirmed the presence of the variant and indicated its de novo occurrence. The present truncating variation likely brought on non-mediated decay (NMD) so that no protein could be produced. Fig. 1 a Detail of the patient’s CGH array analysis showing a 16p13.3 interstitial duplication (867-kb). b qPCR ratios confirmed the duplication and showed its maternal inheritance Fig. 2 Representation of CHD2 variant adapted from the DECIPHER browser. The heterozygous transition in CHD2 is predicted to produce a premature stop codon, p., which likely brings on non-mediated decay (NMD) so that no protein could be produced Fig. 3 CHD2 variant validated by Sanger sequencing. The variant was found in the patient but was absent in both parents
4.257813
0.938477
sec[1]/p[0]
en
0.999998
31914951
https://doi.org/10.1186/s12881-019-0946-0
[ "seizures", "that", "variant", "sequencing", "parents", "sleep", "disorders", "anxiety", "occurrence", "tonic" ]
[ { "code": "8A68.Z", "title": "Type of seizure, unspecified" }, { "code": "8A6Z", "title": "Epilepsy or seizures, unspecified" }, { "code": "8A63.Y", "title": "Seizure due to other acute cause" }, { "code": "8A67", "title": "Acute repetitive seizures" }, { "code": "8A68.Y", "title": "Other specified type of seizure" }, { "code": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" } ]
=== ICD-11 CODES FOUND === [8A68.Z] Type of seizure, unspecified Also known as: Type of seizure, unspecified | Types of seizures | uncontrolled seizures | Seizure NOS | fits NOS [8A6Z] Epilepsy or seizures, unspecified Also known as: Epilepsy or seizures, unspecified | Cerebral seizures | Seizure disorder | seizure disorder, so described | epilepsy NOS [8A63.Y] Seizure due to other acute cause Also known as: Seizure due to other acute cause | Seizures due to immune disorders | Seizures due to medications | Toxic syndrome with generalised seizures, drug related | Acute seizures due to central nervous system infections or infestations [8A67] Acute repetitive seizures Definition: Acute repetitive seizures are multiple seizures, with a distinct time of onset, with recovery between each seizure, occurring within 24 hours in adults, or 12 hours in children. Also known as: Acute repetitive seizures | complex partial status epilepticus | Cluster seizures | Serial seizures | Recurrent seizures [8A68.Y] Other specified type of seizure Also known as: Other specified type of seizure | Absence episode | Absence seizure episode | Pseudotetanus | Clonic seizure disorder [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS === GRAPH WALKS === --- Walk 1 --- [8A68.Z] Type of seizure, unspecified --PARENT--> [8A68] Types of seizures --EXCLUDES--> [?] Neonatal seizures Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn.... --- Walk 2 --- [8A68.Z] Type of seizure, unspecified --PARENT--> [8A68] Types of seizures --EXCLUDES--> [?] Neonatal seizures Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn.... --- Walk 3 --- [8A6Z] Epilepsy or seizures, unspecified --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --RELATED_TO--> [?] Neonatal seizures Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn.... --- Walk 4 --- [8A6Z] Epilepsy or seizures, unspecified --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --CHILD--> [8A62] Epileptic encephalopathies Def: Epilepsies for which no clear etiology can be detected or occurring at the presence of two or more static structural or metabolic conditions increasing the risk for epileptic seizures. The epileptic a... --- Walk 5 --- [8A63.Y] Seizure due to other acute cause --PARENT--> [8A63] Seizure due to acute causes Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult.... --CHILD--> [8A63.Y] Seizure due to other acute cause --- Walk 6 --- [8A63.Y] Seizure due to other acute cause --PARENT--> [8A63] Seizure due to acute causes Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult.... --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....
[ "[8A68.Z] Type of seizure, unspecified\n --PARENT--> [8A68] Types of seizures\n --EXCLUDES--> [?] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....", "[8A68.Z] Type of seizure, unspecified\n --PARENT--> [8A68] Types of seizures\n --EXCLUDES--> [?] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....", "[8A6Z] Epilepsy or seizures, unspecified\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....\n --RELATED_TO--> [?] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....", "[8A6Z] Epilepsy or seizures, unspecified\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....\n --CHILD--> [8A62] Epileptic encephalopathies\n Def: Epilepsies for which no clear etiology can be detected or occurring at the presence of two or more static structural or metabolic conditions increasing the risk for epileptic seizures. The epileptic a...", "[8A63.Y] Seizure due to other acute cause\n --PARENT--> [8A63] Seizure due to acute causes\n Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult....\n --CHILD--> [8A63.Y] Seizure due to other acute cause", "[8A63.Y] Seizure due to other acute cause\n --PARENT--> [8A63] Seizure due to acute causes\n Def: A clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult....\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart...." ]
8A68.Z
Type of seizure, unspecified
[ { "from_icd11": "8A68.Z", "icd10_code": "R561", "icd10_title": "Post traumatic seizures" }, { "from_icd11": "8A68.Z", "icd10_code": "R569", "icd10_title": "Unspecified convulsions" }, { "from_icd11": "8A68.Z", "icd10_code": "R56", "icd10_title": "Convulsions, not elsewhere classified" }, { "from_icd11": "8A68.Z", "icd10_code": "R568", "icd10_title": "" }, { "from_icd11": "8A6Z", "icd10_code": "G40A09", "icd10_title": "Absence epileptic syndrome, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40B09", "icd10_title": "Juvenile myoclonic epilepsy, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40B19", "icd10_title": "Juvenile myoclonic epilepsy, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A19", "icd10_title": "Absence epileptic syndrome, intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A11", "icd10_title": "Absence epileptic syndrome, intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40A01", "icd10_title": "Absence epileptic syndrome, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40409", "icd10_title": "Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40802", "icd10_title": "Other epilepsy, not intractable, without status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40801", "icd10_title": "Other epilepsy, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G40901", "icd10_title": "Epilepsy, unspecified, not intractable, with status epilepticus" }, { "from_icd11": "8A6Z", "icd10_code": "G4089", "icd10_title": "Other seizures" } ]
R561
Post traumatic seizures
On hospital days 2–4 (illness days 8–10), the patient’s vital signs remained largely stable. She reported that her cough and sore throat were worse than before, accompanied by chest pain and a small amount of sputum. Intermittent fever and sore throat were still reported . Supportive treatment was performed at this stage, and methylprednisolone sodium succinate 40 mg QD intravenously was given to inhibit lung inflammation. During this period, we found that the patient developed melena in the morning, indicating that we should be aware of the possibility of upper gastrointestinal bleeding. The patient was treated with pantoprazole for acid suppression. Ambroxol (30 mg BID intravenously), limonene, and pinene enteric soft capsules (0.3 g TID peros) were used to expel sputum. Laboratory results on hospital days 1–3 (illness days 7–9) reflected leukopenia, neutropenia, lymphopenia, and reduced hematocrit. Additionally, elevated levels of lactate dehydrogenase and C-reactive protein were observed (Table 1 ). According to the suggestion of The Diagnosis and Treatment of Pneumonitis with COVID-19 Infection (DTPI) published by National Health Commission of the PRC, we generally monitor the patient’s blood oxygen saturation and oxygenation index closely. When the patient’s blood oxygen saturation is below 93%, respiratory support is given. This patient has not reached the point where tracheal intubation is required, so respiratory support was not given to this patient. Fig. 2 Clinical symptoms and treatments from January 9 to January 30, 2020 Table 1 Clinical Laboratory Results Measure Reference range 16 17 18 19 20 21 22 23 24 26 29 30 White-cell count (10 9 /L) 4–10 2.45 a 2.29 a 2.2 a 6.15 8.56 9.73 9.33 4.82 4.3 4.21 6.88 6.12 Red-cell count (10 12 /L) 3.5–5.5 3.96 3.8 4.4 3.96 4.11 4.1 4.18 3.99 4.07 4.1 3.43 a 3.6 Absolute neutrophil count (10 9 /L) 2–7 1.75 a 1.44 a 1.45 a 5.34 7.97 b 9.21 b 8.59 b 4.08 2.92 2.32 4.7 3.86 Absolute lymphocyte count (10 9 /L) 0.8–4 0.6 a 0.73 a 0.69 a 0.62 a 0.45 a 0.32 a 0.43 a 0.49 a 0.92 a 1.39 a 1.48 a 1.6 a Platelet count (10 9 /L) 100–300 145 139 181 203 231 290 326 b 326 b 358 b 342 b 325 b 358 b Hemoglobin (g/L) 110–160 110 106 a 122 108 a 114 113 114 110 111 111 94 a 100 a Hematocrit (%) 37–54 34.4 a 32.8 a 38.1 34.1 a 35.1 a 35.1 a 35.8 a 34 a 35.1 a 35.6 a 30.1 a 31.4 a Potassium (mmol/L) 3.5–5.5 4.09 – 3.71 3.7 3.3 a 4.06 3.69 3.77 4.12 3.72 4.08 4.12 Sodium (mmol/L) 133–149 134.4 – 135.2 134 136.3 134.7 139.5 137.7 134.2 135.8 135.8 135.6 Chloride (mmol/L) 95–110 99.8 – 101.9 101 101.6 102.3 101.9 103.2 100 102.1 102.5 103.8 Calcium (mmol/L) 1.05–1.35 – – 1.19 1.21 1.19 1.18 1.21 1.22 1.19 1.2 1.25 1.2 Alanine aminotransferase (U/L) 0–42 16.2 20.6 23.88 21.84 21.31 18.94 26.12 21.81 16.74 22.37 19.54 19.18 Aspartate aminotransferase (U/L) 0–37 35.6 43.4 b 37.4 b 27.47 22.7 19.44 17.51 16.3 11.27 15.91 14.04 18.88 Total bilirubin (μmol/L) 3.4–20.5 5.2 4.6 5.94 5.3 6.23 7.83 13.41 13.54 10.98 5.32 5.43 5.03 Total protein (g/L) 60–83 58.9 a 58.5 a 63.17 56 a 59.3 a 67.79 64.42 58.2 a 58.51 a 57.99 a 55.43 a 62.03 Albumin (g/L) 35–55 35.4 35.8 37.6 33.51 a 33.38 a 34.56 a 32.88 a 28.08 a 28.73 a 34.33 a 31.67 a 34.79 a Blood urea nitrogen 2.86–8.2 2.5 a 2.47 a 3.85 4.32 4.61 5.99 13.29 b 10.29 b 8.05 6.63 5.45 4.21 Creatinine (μmol/L) 19.8–87.1 63.8 65.6 49.85 52.44 51.73 55.2 98.25 b 77.66 82.63 52.08 48.85 57.25 Uric acid (μmol/L) 149–430 247 196 236.6 206.6 192.9 196 343.6 188.8 125.4 a 88.1 a 135.2 a 116.7 a Creatine kinase (U/L) 10–190 160.3 – 149.2 96.7 60 43 19.2 16.6 14.7 19.1 26 34.1 Creatine kinase-MB (U/L) 0–24 35.2 b 17.2 19.4 18.2 17.8 28.6 b 6.9 12.8 5.4 3.9 5.4 4.7 Lactate dehydrogenase (U/L) 80–245 306 b 282 b 286.3 b 275.9 b 280.1 b 266.4 b 218.9 176.8 150.8 128.6 139.9 168.5 Venous lactate (mg/L) 120–160 – – – – 705.2 b 295.8 b 831.3 b 902.3 b 812 b 838.4 b 880.1 b 803.7 b C-reactive protein (mg/L) 0–8 19.7 b 18.8 b 17.05 b 16.07 b 55.42 b 43.19 b 22.71 b 12.61 b 6.49 3.72 – 10.37 b Partial pressure of carbon dioxide (mmHg) 35–45 31.8 a – 24.8 a 28.1 a 36.1 27.5 a 39.4 38.7 43.1 38.8 33.5 a 27.1 a Partial pressure of oxygen (mmHg) 80–100 78.8 a – 119.2 b 116.8 b 56.8 a 78.2 a 77.2 a 61.9 a 97.9 74.6 a 89.5 102.5 b PaO 2 /FiO 2 (mmHg) 400–500 272 a – 411 403 172 a 270 a 234 a 188 a 316 a 241 a 309 a 353 a Blood oxygen saturation (%) 91.9–99.9 96.6 – 98.6 98.6 92 96.5 96.4 93.3 97.7 95.8 97.6 98.2 Carbon dioxide (mmol/L) 24–32 – – 18.6 a 21.9 a 28.6 21.1 a 31.5 29.3 31.5 29.2 27.5 22.2 a Procalcitonin (ng/ml) 0–0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 D-Dimer (μg/ml) 0–1 0.28 0.31 0.35 0.38 0.47 0.63 0.61 0.66 0.54 0.43 0.45 0.55 a The value in the patient was below normal b The value in the patient was above normal
4.003906
0.935059
sec[1]/p[1]
en
0.999996
33176693
https://doi.org/10.1186/s12879-020-05545-y
[ "count", "mmol", "this", "blood", "oxygen", "that", "lactate", "protein", "saturation", "mmhg" ]
[ { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" }, { "code": "3B64.Z", "title": "Thrombocytopenia, unspecified" }, { "code": "4B0Z", "title": "Immune system disorders involving white cell lineages, unspecified" }, { "code": "4B03.Z", "title": "Eosinophilia, unspecified" }, { "code": "4B00.1Z", "title": "Neutrophilia, unspecified" }, { "code": "GB42.1", "title": "Albuminuria, Grade A3" }, { "code": "GB42.0", "title": "Albuminuria, Grade A2" }, { "code": "MA18.0Y", "title": "Other specified elevated blood glucose level" }, { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" } ]
=== ICD-11 CODES FOUND === [3B63.1Z] Acquired thrombocytosis, unspecified Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia [3B64.Z] Thrombocytopenia, unspecified Also known as: Thrombocytopenia, unspecified | Thrombocytopenia | low platelet count | low platelets | decreased platelets [4B0Z] Immune system disorders involving white cell lineages, unspecified Also known as: Immune system disorders involving white cell lineages, unspecified [4B03.Z] Eosinophilia, unspecified Also known as: Eosinophilia, unspecified | Eosinophilia | Disorders with increased eosinophil counts | Idiopathic hypereosinophilic syndrome [4B00.1Z] Neutrophilia, unspecified Also known as: Neutrophilia, unspecified | Neutrophilia | Disorders with increased neutrophil counts [GB42.1] Albuminuria, Grade A3 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy [GB42.0] Albuminuria, Grade A2 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine [MA18.0Y] Other specified elevated blood glucose level Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified [4A01.03] Transient hypogammaglobulinaemia of infancy Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy] [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS === GRAPH WALKS === --- Walk 1 --- [3B63.1Z] Acquired thrombocytosis, unspecified --PARENT--> [3B63.1] Acquired thrombocytosis Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte... --CHILD--> [3B63.1Z] Acquired thrombocytosis, unspecified --- Walk 2 --- [3B63.1Z] Acquired thrombocytosis, unspecified --PARENT--> [3B63.1] Acquired thrombocytosis Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte... --CHILD--> [3B63.1Z] Acquired thrombocytosis, unspecified --- Walk 3 --- [3B64.Z] Thrombocytopenia, unspecified --PARENT--> [3B64] Thrombocytopenia Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate... --CHILD--> [3B64.Z] Thrombocytopenia, unspecified --- Walk 4 --- [3B64.Z] Thrombocytopenia, unspecified --PARENT--> [3B64] Thrombocytopenia Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate... --RELATED_TO--> [?] Isolated thrombocytopenia --- Walk 5 --- [4B0Z] Immune system disorders involving white cell lineages, unspecified --PARENT--> [?] Immune system disorders involving white cell lineages --RELATED_TO--> [?] Defects in the complement system --- Walk 6 --- [4B0Z] Immune system disorders involving white cell lineages, unspecified --PARENT--> [?] Immune system disorders involving white cell lineages --CHILD--> [4B02] Eosinopenia
[ "[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --CHILD--> [3B63.1Z] Acquired thrombocytosis, unspecified", "[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --CHILD--> [3B63.1Z] Acquired thrombocytosis, unspecified", "[3B64.Z] Thrombocytopenia, unspecified\n --PARENT--> [3B64] Thrombocytopenia\n Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate...\n --CHILD--> [3B64.Z] Thrombocytopenia, unspecified", "[3B64.Z] Thrombocytopenia, unspecified\n --PARENT--> [3B64] Thrombocytopenia\n Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate...\n --RELATED_TO--> [?] Isolated thrombocytopenia", "[4B0Z] Immune system disorders involving white cell lineages, unspecified\n --PARENT--> [?] Immune system disorders involving white cell lineages\n --RELATED_TO--> [?] Defects in the complement system", "[4B0Z] Immune system disorders involving white cell lineages, unspecified\n --PARENT--> [?] Immune system disorders involving white cell lineages\n --CHILD--> [4B02] Eosinopenia" ]
3B63.1Z
Acquired thrombocytosis, unspecified
[ { "from_icd11": "3B63.1Z", "icd10_code": "D473", "icd10_title": "Essential (hemorrhagic) thrombocythemia" }, { "from_icd11": "3B64.Z", "icd10_code": "D6942", "icd10_title": "Congenital and hereditary thrombocytopenia purpura" }, { "from_icd11": "3B64.Z", "icd10_code": "D6941", "icd10_title": "Evans syndrome" }, { "from_icd11": "3B64.Z", "icd10_code": "D6949", "icd10_title": "Other primary thrombocytopenia" }, { "from_icd11": "3B64.Z", "icd10_code": "D696", "icd10_title": "Thrombocytopenia, unspecified" }, { "from_icd11": "3B64.Z", "icd10_code": "D69", "icd10_title": "Purpura and other hemorrhagic conditions" }, { "from_icd11": "3B64.Z", "icd10_code": "D694", "icd10_title": "Other primary thrombocytopenia" }, { "from_icd11": "4B0Z", "icd10_code": "D72829", "icd10_title": "Elevated white blood cell count, unspecified" }, { "from_icd11": "4B0Z", "icd10_code": "D72819", "icd10_title": "Decreased white blood cell count, unspecified" }, { "from_icd11": "4B0Z", "icd10_code": "D72818", "icd10_title": "Other decreased white blood cell count" }, { "from_icd11": "4B0Z", "icd10_code": "D72828", "icd10_title": "Other elevated white blood cell count" }, { "from_icd11": "4B0Z", "icd10_code": "D72823", "icd10_title": "Leukemoid reaction" }, { "from_icd11": "4B0Z", "icd10_code": "D72821", "icd10_title": "Monocytosis (symptomatic)" }, { "from_icd11": "4B0Z", "icd10_code": "D72825", "icd10_title": "Bandemia" }, { "from_icd11": "4B0Z", "icd10_code": "D72810", "icd10_title": "Lymphocytopenia" } ]
D473
Essential (hemorrhagic) thrombocythemia
The patient was a 76-year-old woman who experienced menopause for >20 years, without vaginal bleeding or other discomfort after menopause. Two weeks earlier, she experienced abdominal distension with difficulty in urination and defecation without obvious causes. On March 23, 2022, an abdominal ultrasonogram obtained outside the hospital showed an anterior uterus measuring 36 mm × 24 mm × 32 mm, endothelial thickness of 2 mm, cervical length of 25 mm, unequal echoes in the pelvic cavity, which measured 116 mm × 101 mm, unclear border, pelvic-free echogenic area of 110 mm × 96 mm, and the pelvic abdominal cavity in the echogenic area, with a depth of approximately 150 mm. The patient complained of abdominal distension, urinary difficulties, constipation, no abdominal pain, no irregular vaginal bleeding, and no increase in vaginal secretions. Therefore, she was admitted to our hospital as an emergency case for further investigation into the nature of the pelvic mass, as a malignant ovarian tumor was suspected. Physical examination revealed the following: bilateral adnexa not obvious to touch, pelvis could be touched a size of about 7 cm mass, activity check, no pressure pain. On admission, pelvic computed tomography (CT) showed a round, huge mass in the pelvic cavity, approximately 120 mm × 122 mm × 98 mm in size, with clear borders and uneven density. Low-density cystic necrosis was found inside. The CT value of the solid component of the lesion during plain scan was 24 HU. After enhancement, it appeared uneven. There was uniform, mild-to-moderate enhancement. The CT values in the arterial phase and venous phase were approximately 42 HU and 51 HU respectively. There was no obvious enhancement in the cystic necrosis area. It implied that the possible malignant pelvic tumor from the ovary may be an abdominopelvic cavity with a large amount of fluid or a small ascending colon diverticulum . Enhanced magnetic resonance imaging (MRI) showed a huge mixed signal mass in the pelvic cavity. T1WI showed slightly low signal, T2WI showed obviously high and low mixed signal, T1WI-fs showed low mixed signal, T2WI-fs showed high and low mixed signal, and DWI (b=800) showed uneven signal. High signal, ADC value was about 1167×10 -6 mm 2 /s; the size of the lesion was about 120 mm×122 mm×98 mm, with clear boundary and smooth edge, and the lesion was unevenly enhanced after enhancement. The left ovary was unclearly displayed, and the uterus was compressed. There was no obvious thickening of the endometrium. The signal was uniform, the junction zone was clear, and the muscle layer signal was uneven. There was no obvious enhancement of the endometrium and myometrium after enhancement. The cervical parenchyma showed multiple, abnormal, and round signal shadows of varying sizes, with low signal on T1WI and high signal on T2WI, and with clear boundaries and uniform signals. No obvious enhancement was seen after enhancement. The bladder was poorly filled and a urinary catheter was visible in the cavity. A large amount of fluid accumulation was seen in the abdominal and pelvic cavity. It revealed a huge malignant pelvic space, possibly originating from the ovary, a large amount of fluid in the abdominopelvic cavity, and multiple nasal cysts in the cervix . The preliminary diagnoses were ovarian malignancy and pelvic-abdominal effusion. Laboratory tests revealed the following: CA125 level: 16.73 U/ml, CA199 level: <2 U/ml, and CEA level: 2.82 ng/ml, all of which were normal. However, human epididymis protein 4 (HE4) level was 283.5 pmol/L, which was higher than the normal level. The patient underwent surgery on March 31st, and the patient intraoperative observation revealed a large amount of bloody ascites in the pelvic and abdominal cavity. A huge mass of about 12×11×10 cm, was seen in the right appendage, originating from the right ovary. The surface of the tumor was smooth without rupture, and no obvious tumor was found on the surface. The uterus was slightly smaller, about 4×3×2 cm, with a regular outline. There was dense adhesion between the bladder and the lower segment of the uterus. No obvious abnormality was found in the left appendage. The greater omentum was thickened and had a hard texture. The cancer had metastasized. The greater omentum was thickened in a pie shape, measuring about 13×12×6 cm. The surface of the liver was detected. Miliary metastasis was detected. The stomach and pelvic intestines had smooth serosal surfaces, the posterior leaf of the left broad ligament showed flaky thickening and frizzy peritoneal surfaces, and the rest of the pelvic and abdominal peritoneum was smooth. Based on the above intraoperative observations, the International Federation of Gynecology and Obstetrics stage of the patient was IIIc T3cNxM0.
3.988281
0.979004
sec[1]/sec[0]/p[0]
en
0.999998
PMC10618416
https://doi.org/10.3389/fonc.2023.1278300
[ "pelvic", "signal", "abdominal", "cavity", "obvious", "enhancement", "about", "uterus", "tumor", "huge" ]
[ { "code": "FC00.3", "title": "Acquired deformity of pelvis" }, { "code": "GA34.Y", "title": "Other specified female pelvic pain associated with genital organs or menstrual cycle" }, { "code": "LB30.7", "title": "Ectopic or pelvic kidney" }, { "code": "MD82", "title": "Intra-abdominal or pelvic swelling, mass or lump" }, { "code": "GA05.Z", "title": "Female pelvic inflammatory diseases, unspecified" }, { "code": "5A00.01", "title": "Permanent congenital hypothyroidism without goitre" }, { "code": "4A00.2", "title": "Genetic susceptibility to particular pathogens" }, { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" } ]
=== ICD-11 CODES FOUND === [FC00.3] Acquired deformity of pelvis Also known as: Acquired deformity of pelvis | deformity of pelvis | pelvic deformity | ischium deformity | ilium deformity Excludes: Maternal care for disproportion | Obstructed labour due to maternal pelvic abnormality | Obstructed labour due to deformed pelvis [GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle Also known as: Other specified female pelvic pain associated with genital organs or menstrual cycle | Pelvic congestion syndrome | Pelvic varicosities | Female frozen pelvis | Female intrapelvic haemorrhage [LB30.7] Ectopic or pelvic kidney Definition: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones Also known as: Ectopic or pelvic kidney | Congenital displaced kidney | congenital misplaced kidney | congenital malposition of kidney | congenital prolapsed kidney Includes: Congenital displaced kidney | Malrotation of kidney [MD82] Intra-abdominal or pelvic swelling, mass or lump Definition: This refers to the presence of abdominal or pelvic wall swelling, mass or tumour in the abdominal and pelvic regions. These mass or tumours can be recognised by visual examination and/or palpation. Also known as: Intra-abdominal or pelvic swelling, mass or lump | Abdominal mass without further specification | mass in abdomen | intra-abdominal lump | intra-abdominal mass Excludes: Abdominal distension | Ascites [GA05.Z] Female pelvic inflammatory diseases, unspecified Also known as: Female pelvic inflammatory diseases, unspecified | Female pelvic inflammatory diseases | PID - [pelvic inflammatory disease] | pelvic inflammatory disease NOS | Parametritis [5A00.01] Permanent congenital hypothyroidism without goitre Definition: This is a permanent congenital state in which the thyroid gland does not make enough thyroid hormone. This diagnosis is without swelling of the thyroid gland. Also known as: Permanent congenital hypothyroidism without goitre | congenital hypothyroidism without goitre | aplasia of thyroid | congenital subthyroidism | congenital thyroid aplasia [4A00.2] Genetic susceptibility to particular pathogens Also known as: Genetic susceptibility to particular pathogens | Idiopathic CD4 lymphocytopenia | Immunodeficiency due to interleukin-1 receptor-associated kinase-4 deficiency | IRAK4 - [interleukin-1 receptor-associated kinase-4 deficiency] | Lung fibrosis - immunodeficiency - gonadal dysgenesis [MD81.3] Acute abdomen Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain [JA01.0] Abdominal pregnancy Definition: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy. Also known as: Abdominal pregnancy | abdomen pregnancy | intraperitoneal pregnancy Excludes: Maternal care for viable fetus in abdominal pregnancy | Delivery of viable fetus in abdominal pregnancy [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS === GRAPH WALKS === --- Walk 1 --- [FC00.3] Acquired deformity of pelvis --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ... --CHILD--> [?] Obstructed labour due to pelvic inlet contraction --- Walk 2 --- [FC00.3] Acquired deformity of pelvis --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ... --CHILD--> [?] Obstructed labour due to generally contracted pelvis --- Walk 3 --- [GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle.... --EXCLUDES--> [?] Chronic secondary visceral pain Def: Chronic visceral pain is persistent or recurrent pain originating from internal organs of the head/neck region and of the thoracic, abdominal and pelvic cavities. The visceral etiology of the pain sho... --- Walk 4 --- [GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle.... --EXCLUDES--> [?] Chronic primary visceral pain Def: Chronic primary visceral pain is chronic pain localized in the thoracic, abdominal or pelvic region, and is associated with significant emotional distress or functional disability. The distinct anatom... --- Walk 5 --- [LB30.7] Ectopic or pelvic kidney Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones... --PARENT--> [LB30] Structural developmental anomalies of kidneys Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period.... --CHILD--> [LB30.1] Renal dysplasia Def: A condition characterised by abnormal development of one or both kidneys.... --- Walk 6 --- [LB30.7] Ectopic or pelvic kidney Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones... --PARENT--> [LB30] Structural developmental anomalies of kidneys Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period.... --CHILD--> [LB30.0] Renal agenesis or other reduction defects of kidney Def: A series of conditions resulting in reduced kidney function including a congenital absence of both kidneys...
[ "[FC00.3] Acquired deformity of pelvis\n --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality\n Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ...\n --CHILD--> [?] Obstructed labour due to pelvic inlet contraction", "[FC00.3] Acquired deformity of pelvis\n --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality\n Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ...\n --CHILD--> [?] Obstructed labour due to generally contracted pelvis", "[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle\n --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle\n Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle....\n --EXCLUDES--> [?] Chronic secondary visceral pain\n Def: Chronic visceral pain is persistent or recurrent pain originating from internal organs of the head/neck region and of the thoracic, abdominal and pelvic cavities. The visceral etiology of the pain sho...", "[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle\n --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle\n Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle....\n --EXCLUDES--> [?] Chronic primary visceral pain\n Def: Chronic primary visceral pain is chronic pain localized in the thoracic, abdominal or pelvic region, and is associated with significant emotional distress or functional disability. The distinct anatom...", "[LB30.7] Ectopic or pelvic kidney\n Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones...\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --CHILD--> [LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....", "[LB30.7] Ectopic or pelvic kidney\n Def: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones...\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --CHILD--> [LB30.0] Renal agenesis or other reduction defects of kidney\n Def: A series of conditions resulting in reduced kidney function including a congenital absence of both kidneys..." ]
FC00.3
Acquired deformity of pelvis
[ { "from_icd11": "FC00.3", "icd10_code": "M955", "icd10_title": "Acquired deformity of pelvis" }, { "from_icd11": "LB30.7", "icd10_code": "Q632", "icd10_title": "Ectopic kidney" }, { "from_icd11": "LB30.7", "icd10_code": "Q63", "icd10_title": "Other congenital malformations of kidney" }, { "from_icd11": "MD82", "icd10_code": "R1900", "icd10_title": "Intra-abdominal and pelvic swelling, mass and lump, unspecified site" }, { "from_icd11": "MD82", "icd10_code": "R1909", "icd10_title": "Other intra-abdominal and pelvic swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1902", "icd10_title": "Left upper quadrant abdominal swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1904", "icd10_title": "Left lower quadrant abdominal swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1903", "icd10_title": "Right lower quadrant abdominal swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1901", "icd10_title": "Right upper quadrant abdominal swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1907", "icd10_title": "Generalized intra-abdominal and pelvic swelling, mass and lump" }, { "from_icd11": "MD82", "icd10_code": "R1906", "icd10_title": "Epigastric swelling, mass or lump" }, { "from_icd11": "MD82", "icd10_code": "R190", "icd10_title": "Intra-abdominal and pelvic swelling, mass and lump" }, { "from_icd11": "GA05.Z", "icd10_code": "N739", "icd10_title": "Female pelvic inflammatory disease, unspecified" }, { "from_icd11": "GA05.Z", "icd10_code": "N738", "icd10_title": "Other specified female pelvic inflammatory diseases" }, { "from_icd11": "GA05.Z", "icd10_code": "N74", "icd10_title": "Female pelvic inflammatory disorders in diseases classified elsewhere" } ]
M955
Acquired deformity of pelvis
A 56-year-old female with a history of metastatic breast adenocarcinoma, on fulvestrant (estrogen receptors blocker) and palbociclib (cyclin-dependent kinases inhibitor), presented to the emergency department with nausea, vomiting, abdominal pain, and jaundice. Her vital signs showed temperature of 37.0°C (reference range: 36.5°C-37.3°C), heart rate of 85 beats per minute (reference range: 60-100 beats per minute), respiratory rate of 16 breaths per minute (reference range: 12-18 breaths per minute), blood pressure of 135/85 mmHg (reference range: 90/60-120/80 mmHg), and oxygen saturation level of 95% on ambient air (reference range: 95%-100%). The physical examination was notable for jaundice in the skin and scleral icterus. Additionally, there was tenderness in the right upper quadrant and epigastric region, accompanied by a positive Murphy's sign. Admission labs are included in Table 1 and were significant for elevated total bilirubin, direct bilirubin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). The CT scan of the abdomen with contrast, performed upon admission, demonstrated evidence of cholelithiasis accompanied by gallbladder wall thickening and adjacent edema, suggesting acute cholecystitis. However, no intrahepatic or extrahepatic biliary dilatation was noticed on the CT scan . The liver was unremarkable, and the biliary tree exhibited a standard caliber. In light of the imaging findings consistent with acute cholecystitis and to exclude the possibility of choledocholithiasis, a magnetic resonance cholangiopancreatography (MRCP) and hepatobiliary iminodiacetic acid scan (HIDA scan) were conducted. The results of the MRCP and HIDA scan were deemed unremarkable . Since imaging studies ruled out the presence of choledocholithiasis and calculous cholecystitis, endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy were not indicated. The patient's symptoms were minimally managed with conservative treatments, including antiemetics and analgesics. Her direct bilirubin levels continued to uptrend and reached 14.3 mg/dl on day five of admission. However, her ALP, ALT, and AST were stable, with minimal to no change at that time (Table 1 ). A comprehensive viral hepatitis panel was conducted to assess the etiology of the cholestatic liver injury, which included testing for hepatitis B surface antigen (HBsAg), hepatitis B core antigen (HBcAg), hepatitis A antibody (anti-HAV), and hepatitis C antibody (anti-HCV). Serological tests for cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were also performed. In parallel, an autoimmune panel was obtained, comprising anti-nuclear antibodies (ANA), antimitochondrial antibodies (AMA), and anti-smooth muscle antibodies (ASMA). The results from these assessments were all negative. An ultrasound-guided two-core liver biopsy was performed on day six of admission due to an unexplained increase in direct bilirubin to 15.8 mg/dL . She was also noted to have a small amount of ascites and required diagnostic ultrasound-guided paracentesis, which was performed by the Interventional radiology team in the right lower quadrant. Ascitic fluid analysis was significant for SAAG >1.1 g/dL and ascitic protein <3 g/dL, suggestive of portal hypertension etiology. Ascitic fluid cytology revealed no malignant cells, as immunohistochemistry staining for BerEP4, MOC31, estrogen receptor, progesterone receptor, GATA3, and mammaglobin was negative. The paracentesis was complicated by hemorrhagic shock due to bleeding from the right superficial circumflex iliac artery, which triggered disseminated intravascular coagulation (DIC). She required angiogram embolization by interventional radiology (IR), intensive care unit (ICU) transfer, blood transfusion, and vasopressors. She was not a surgical candidate, as any surgical intervention would have caused massive bleeding and death. She passed away on day seven of admission. Eventually, the liver biopsy confirmed poorly differentiated metastatic lobular breast carcinoma. Both core biopsies demonstrated diffuse sinusoidal infiltrate of poorly differentiated tumor cells, with intracytoplasmic features consistent with lobular carcinoma metastasis. Iron stains revealed a focal presence of scant iron. No abnormal PAS-positive material was identified within the hepatocytes on PAS stain, with or without diastase digestion. Trichrome and reticulin stains showed fibrosis associated with tumor metastasis . It is noteworthy that a FDG PET scan conducted one month before admission revealed lytic bone lesions; however, the remainder of her body imaging appeared relatively unremarkable. The imaging indicated hepatomegaly, but no focal lesions were identified, and the gallbladder also appeared normal.
4.089844
0.970703
sec[1]/p[0]
en
0.999996
40291193
https://doi.org/10.7759/cureus.81368
[ "scan", "reference", "range", "hepatitis", "minute", "bilirubin", "liver", "imaging", "anti", "direct" ]
[ { "code": "MB71.Y", "title": "Other specified clinical findings on diagnostic imaging of central nervous system" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "JA66.3", "title": "Abnormal ultrasonic finding on antenatal screening of mother" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" }, { "code": "6B22.Z", "title": "Olfactory reference disorder, unspecified" }, { "code": "MB26.03", "title": "Delusion of reference" }, { "code": "6B22.1", "title": "Olfactory reference disorder with poor to absent insight" }, { "code": "4B00.0Z", "title": "Neutropaenia, unspecified" }, { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" } ]
=== ICD-11 CODES FOUND === [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system Also known as: Other specified clinical findings on diagnostic imaging of central nervous system | Epidural haemorrhage, localised, no generalised mass effect or midline shift | Epidural haemorrhage, confined to a small region in relation to a fracture | Epidural haemorrhage, size less than 1 x 1 x 1 cm, not in relation to a fracture | Epidural haemorrhage, mass effect or midline shift less than 0.5 cm [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Definition: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother. Also known as: Abnormal ultrasonic finding on antenatal screening of mother | antenatal ultrasound scan abnormal [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics [6B22.Z] Olfactory reference disorder, unspecified Also known as: Olfactory reference disorder, unspecified | Olfactory reference disorder | Delusions of malodour [MB26.03] Delusion of reference Definition: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature. Also known as: Delusion of reference [6B22.1] Olfactory reference disorder with poor to absent insight Definition: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative explanation for their experience. The lack of insight exhibited by the individual does not vary markedly as a function of anxiety level. Also known as: Olfactory reference disorder with poor to absent insight [4B00.0Z] Neutropaenia, unspecified Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range [3B63.1Z] Acquired thrombocytosis, unspecified Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia === GRAPH WALKS === --- Walk 1 --- [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system --PARENT--> [MB71] Clinical findings on diagnostic imaging of central nervous system Def: Clinical findings on diagnostic imaging of central nervous system is findings on diagnostic imaging of the brain or the spinal cord which don't appear in normal status of the body. Diagnostic imaging ... --CHILD--> [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system --- Walk 2 --- [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system --PARENT--> [MB71] Clinical findings on diagnostic imaging of central nervous system Def: Clinical findings on diagnostic imaging of central nervous system is findings on diagnostic imaging of the brain or the spinal cord which don't appear in normal status of the body. Diagnostic imaging ... --CHILD--> [MB71.0] Intracranial space-occupying lesion --- Walk 3 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --PARENT--> [?] Harmful effects of substances --PARENT--> [22] Injury, poisoning or certain other consequences of external causes Def: !markdown In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre... --- Walk 4 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Disorders due to substance use or addictive behaviours Def: Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or spe... --CHILD--> [?] Disorders due to substance use Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to... --- Walk 5 --- [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Def: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother.... --PARENT--> [JA66] Clinical findings on antenatal screening of mother Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother.... --CHILD--> [JA66.1] Abnormal biochemical finding on antenatal screening of mother Def: A sign characterised by an abnormality detected by biochemistry during an antenatal screening of the mother.... --- Walk 6 --- [JA66.3] Abnormal ultrasonic finding on antenatal screening of mother Def: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother.... --PARENT--> [JA66] Clinical findings on antenatal screening of mother Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother.... --EXCLUDES--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...
[ "[MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system\n --PARENT--> [MB71] Clinical findings on diagnostic imaging of central nervous system\n Def: Clinical findings on diagnostic imaging of central nervous system is findings on diagnostic imaging of the brain or the spinal cord which don't appear in normal status of the body. Diagnostic imaging ...\n --CHILD--> [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system", "[MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system\n --PARENT--> [MB71] Clinical findings on diagnostic imaging of central nervous system\n Def: Clinical findings on diagnostic imaging of central nervous system is findings on diagnostic imaging of the brain or the spinal cord which don't appear in normal status of the body. Diagnostic imaging ...\n --CHILD--> [MB71.0] Intracranial space-occupying lesion", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --PARENT--> [?] Harmful effects of substances\n --PARENT--> [22] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Disorders due to substance use or addictive behaviours\n Def: Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or spe...\n --CHILD--> [?] Disorders due to substance use\n Def: Disorders due to substance use include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to...", "[JA66.3] Abnormal ultrasonic finding on antenatal screening of mother\n Def: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother....\n --PARENT--> [JA66] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....\n --CHILD--> [JA66.1] Abnormal biochemical finding on antenatal screening of mother\n Def: A sign characterised by an abnormality detected by biochemistry during an antenatal screening of the mother....", "[JA66.3] Abnormal ultrasonic finding on antenatal screening of mother\n Def: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother....\n --PARENT--> [JA66] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....\n --EXCLUDES--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems\n Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del..." ]
MB71.Y
Other specified clinical findings on diagnostic imaging of central nervous system
[ { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A95S", "icd10_title": "Adverse effect of other bacterial vaccines, sequela" }, { "from_icd11": "NE60", "icd10_code": "T50B95A", "icd10_title": "Adverse effect of other viral vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A25A", "icd10_title": "Adverse effect of mixed bacterial vaccines without a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A91A", "icd10_title": "Poisoning by other bacterial vaccines, accidental (unintentional), initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T498X5A", "icd10_title": "Adverse effect of other topical agents, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48905A", "icd10_title": "Adverse effect of unspecified agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48995A", "icd10_title": "Adverse effect of other agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A15A", "icd10_title": "Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50B15A", "icd10_title": "Adverse effect of smallpox vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T416X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T419X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T418X2A", "icd10_title": "" } ]
T50A95A
Adverse effect of other bacterial vaccines, initial encounter
A 75-year-old man presented with fever and right chest pain. The blood biochemical tests showed the following: lactate dehydrogenase (LDH), 251 IU/L; alkaline phosphatase (ALP), 469 IU/L; gamma-glutamyl transferase (γ-GTP), 125 IU/L; creatinine (Cre) 1.43 mg/dL; C-reactive protein (CRP) 3.04 mg/dL; squamous cell carcinoma-related antigen (SCC), 1.8 ng/mL; nerve specific enolase (NSE), 21.6 ng/mL; soluble interleukin-2 receptor (SIL-2R), 614 U/mL. Computed tomography (CT) showed a huge 10-cm mass under the right diaphragm . This well-circumscribed and smooth-marginated tumor showed minor enhancement in the lower density areas close to the fat and showed a gradual, heterogeneous mild enhancement of tumor and liver margins. The main feeder for the tumor is the right inferior phrenic artery, and this tumor was supposed to be a sarcomatoid malignancy originating from the diaphragm rather than a benign disease such as schwannoma on CT. No findings were suggesting obvious pulmonary invasion. Magnetic resonance imaging (MRI) demonstrated heterogeneous high signal intensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI) . Contrast-enhanced MRI showed gradual heterogeneous enhancement similar to CT findings. Findings of extrahepatic development were also obtained, but the possibility of adhesion to the liver was suspected. Fluorodeoxyglucose-positron emission tomography (FDG-PET) revealed abnormal uptake in the tumor with a maximal standardized uptake value (SUVmax) of 4.6 . The uptake was not so high, and a myxoid type sarcoma, such as myxoid liposarcoma, or benign tumor was considered. Although a definitive diagnosis could not be achieved, we scheduled a diaphragmatic resection for suspicion of benign tumors of the diaphragm, such as mucous-type sarcoma or schwannoma. However, we performed extended right posterior segmentectomy with combined resection of the diaphragm, because separation of the tumor from the liver was not possible and the tumor was close to the posterior Glisson’s pedicles and segment 8 dorsal Glisson’s pedicles . The total operation time was 8 h 10 m, and the total blood loss was 1459 mL. Although the major diameter of the diaphragmatic defect was 12 cm, simple closure was possible . The patient’s postoperative course was uneventful, and he was discharged 14 days after surgery. Pathological findings showed that the mass was located just below the hepatic capsule/intraparenchymal space and was adherent to the diaphragm, but there was no continuity with the diaphragm . Mitosis was unremarkable, about 0–1 cells/10 HPF. The morphology suggested low-grade mesenchymal tumors such as solitary fibrous tumor (SFT) and perivascular epithelioid cell tumor (PEComa) , but immunostaining was negative for these tumors, making the diagnosis difficult . We diagnosed the tumor as a spindle cell tumor with smooth muscle differentiation because of the positive results of myosin markers such as αSMA, desmin, and h-caldesmon, although some areas with high proliferative activity were observed. 1 year has passed since the surgery with no recurrence. Fig. 1 Contrast-enhanced computed tomography (CT), contrast-enhanced magnetic resonance imaging (MRI), and positron emission tomography (PET). a , b CT shows a well-circumscribed and smooth-marginated, huge 10-cm mass under the right diaphragm. The main feeder for the tumor is the right inferior phrenic artery. c MRI demonstrates heterogeneous high signal intensity on T2WI. d PET revealed abnormal uptake in the tumor with a SUVmax of 4.6 Fig. 2 Surgical procedure. a Separation of the tumor from the liver was not possible. b , c Combined resection of the diaphragm was performed. d By clamping A5, we found the boundary between S5 and S6. e We performed extended right posterior segmentectomy (S6, 7, 8dors resection). f simple closure of the diaphragm was possible Fig.3 Macroscopic of the resected specimen. A well-circumscribed nodular tumor of 11 × 10 × 8.5 cm in size was located just below the hepatic capsule/intraparenchymal space and was adherent to the diaphragm, but there was no continuity with the diaphragm Fig. 4 Microscopic findings of the tumor. Hematoxylin and eosin staining. a Section shows a proliferation of anaplastic cells with clear cytoplasm and round heteroplasm. Map-like necrotic foci are seen in some areas. b Some areas contain fat droplets and exhibit lipomatous features. Mitotic figures are rarely seen. c Bundled proliferation of spindle-shaped cells is seen in some tumors. d Myxoid or microcystic changes of the stroma and hemangiopericytomatous vessels are also seen Fig. 5 Immunohistochemistry. a , c , d The tumor cells are negative for CD34, HMB45, Melan A. b , e The tumor cells are positive for α-SMA, glypican-3. f Ki-67 index is 10% (hot spot)
4.019531
0.977051
sec[1]/p[0]
en
0.999995
36117227
https://doi.org/10.1186/s40792-022-01530-6
[ "tumor", "diaphragm", "cells", "tomography", "areas", "heterogeneous", "liver", "uptake", "resection", "tumors" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "CB23", "title": "Disorders of diaphragm" }, { "code": "LB00.1", "title": "Absence of diaphragm" }, { "code": "NB32.Y&XA2JL0", "title": "Laceration of diaphragm" }, { "code": "LB00.Y", "title": "Other specified structural developmental anomalies of diaphragm" }, { "code": "DC51.1&XA2JL0", "title": "Adhesion of diaphragm" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [CB23] Disorders of diaphragm Definition: This category includes the abnormalities of diaphragmatic position or motion (paralysis, relaxation, and acquired deformity) and the inflammation of the diaphragm, but neoplasms of the diaphragm, congenital malformation of diaphragm, and diaphragmatic hernias are included in other categories. Also known as: Disorders of diaphragm | diaphragmatic disorder | disease of diaphragm | disorder of diaphragm | Acquired diaphragmatic deformity Excludes: Congenital diaphragmatic hernia | Structural developmental anomalies of diaphragm [LB00.1] Absence of diaphragm Also known as: Absence of diaphragm | diaphragm agenesis [LB00.Y] Other specified structural developmental anomalies of diaphragm Also known as: Other specified structural developmental anomalies of diaphragm | Eventration of diaphragm | diaphragm elevation | high diaphragm | Oesophageal hiatus hypertrophy === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F92] Neoplasms of unknown behaviour of skin --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fatty apron --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --PARENT--> [02] Neoplasms Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fatty apron", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair...." ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
The patient underwent the first computed tomography (CT) and magnetic resonance imaging (MRI) examination in our hospital. The CT scans of the head, chest, abdomen and pelvis revealed bilateral nodules of soft tissue near the cavernous sinus; multiple nodules in the lungs, one in the right lower lobe and the rest in the basal segment; and bone destruction and soft tissue tumours of the L2 vertebral body and the left side of the accessory area . Lumbar-enhanced MRI showed flattening of the L2 vertebral body and bone destruction in the left part of the vertebral body and the vertebral arch adnexa. A local irregular soft tissue lesion of the lumbar spine with hyposignal intensity in T1 imaging and slight hyposignal intensity in T2 imaging was observed . The mass protruded into the spinal canal, and adjacent to the vertebral body, the left psoas major muscle was significantly shifted. However, the boundary with the psoas major muscle was clear. There was mild atrophy and intermediate enhancement of the psoas major muscle on the left side compared to the right side . Head MRI revealed bilateral nodular soft tissue signal lesions near the cavernous sinus . Head-enhanced CT also showed tumour masses with significant enhancement . The patient underwent L2 vertebral tumour biopsy under the guidance of C-Arm x-ray, and the pathological results were spindle cell soft tissue tumours. The cells were arranged in bundles, cell atypia was not obvious, inflammatory cells were rare, and the tumour invaded the vertebra. On the basis of these findings and immunohistochemistry findings, low-grade myogenic or inflammatory myofibroblastic tumours were considered. The patient was given cyclophosphamide, doxorubicin and vincristine (CAV) chemotherapy, considering the malignant transformation and metastasis of the tumour. After three chemotherapy treatments in June, July and August 2020, the symptoms were not relieved, and the masses were not reduced. Considering that the tumours were not sensitive to chemotherapy, it was decided to remove the tumour in the lumbar spine and adnexa area. In August 2020, the patient underwent anterior and posterior lumbar mass resection, fusion bone grafting and internal fixation under general anaesthesia. The patient reported that the symptoms of recurrent bilateral pain in the hip joint had eased after the surgery. Pathological results revealed EBV-SMT in the lumbar spine. The tumour cells were mildly atypical, with no clear mitosis, a low Ki67 proliferation index, no obvious neoplastic necrosis, visible bone destruction, and highly differentiated morphology. In situ hybridization showed EBV-encoded small RNA (EBER) positivity. Immunohistochemistry for smooth muscle actin confirmed the smooth muscle nature of the tumours in the lumbar mass . Considering that EBV-SMTs are generally associated with immunodeficiency and EBV infection, we performed EBV antibody, EBV DNA, lymphocyte subset, and genetic tests. With the EB -VCA-lgG>750U/ml(reference:0∼20 U/ml), EB-NA-IgG 48.8U/ml (reference:0∼20 U/ml), the EBV antibody test indicated previous EBV infection. The EBV DNA test detected 6.38 × 10 2 copies/ml. The lymphocyte subset test results showed the following: CD4 + T% 23.97% (reference: 31.7%∼47%), CD8 + T% 18.3% (reference: 13%∼39%), percentage of total T lymphocytes 49.6% (reference: 63.2%∼77.8%), CD4 + T 516/µl (reference: 646∼1,515/µl), CD8 + T 396/µl (reference: 220∼1,129/µl), and absolute number of total T lymphocytes 1,030/µl (reference: 1,239∼2,611/µl), which suggests the possibility of immunodeficiency disease o·r malignancy, etc. We found a novel mutation in the ITK gene [c.725_730delAGAGTA (p. K242_S243del), located on chromosome 5]; the clinical significance of the pathogenicity of the variant is unknown; and the deletion mutation in this gene has not yet been reported. The child was homozygous for this mutation, and the mother and father were both heterozygous for this mutation . In April 2021, the child was treated again for pulmonary infection, and right intrabronchial mass resection was performed in our hospital under fibre bronchoscopy in May 2021. A pathological analysis of the resected bronchial mass suggested that it was a spindle cell tumour, and on the basis of the pathological findings and medical history, EBV-SMT was confirmed. In situ hybridization detected EBER positivity. Immunohistochemistry for smooth muscle actin confirmed the smooth muscle nature of the tumours in the bronchial masses . The EBV DNA test detected 2.5 × 10 2 copies/ml. There was no recurrence or metastasis in the lumbar tumour and no significant change in the other lesions more than two years after surgery. The patient had intermittent headaches, and her hip pain disappeared. The patient's follow-up remains ongoing .
4.074219
0.974121
sec[1]/p[2]
en
0.999997
PMC10350626
https://doi.org/10.3389/fped.2023.1189219
[ "tumour", "reference", "lumbar", "muscle", "tumours", "vertebral", "soft", "tissue", "bone", "body" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "6B22.Z", "title": "Olfactory reference disorder, unspecified" }, { "code": "MB26.03", "title": "Delusion of reference" }, { "code": "6B22.1", "title": "Olfactory reference disorder with poor to absent insight" }, { "code": "4B00.0Z", "title": "Neutropaenia, unspecified" }, { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [6B22.Z] Olfactory reference disorder, unspecified Also known as: Olfactory reference disorder, unspecified | Olfactory reference disorder | Delusions of malodour [MB26.03] Delusion of reference Definition: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature. Also known as: Delusion of reference [6B22.1] Olfactory reference disorder with poor to absent insight Definition: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative explanation for their experience. The lack of insight exhibited by the individual does not vary markedly as a function of anxiety level. Also known as: Olfactory reference disorder with poor to absent insight [4B00.0Z] Neutropaenia, unspecified Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range [3B63.1Z] Acquired thrombocytosis, unspecified Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 74-year-old man presented with a left lung nodule and left adrenal tumor based on computed tomography (CT) and was referred to us. He had a history of emphysema, pneumoconiosis, and chronic bronchitis. He had a history of smoking with a Brinkman index of 750. Serum tumor markers including carcinoembryonic antigen, cytokeratin 19 fragment, and pro-gastrin-releasing peptide were within the normal ranges. Chest and abdominal CT showed a well-circumscribed, 1.6-cm mass in the S6 segment of the left lower lobe and a 3.5-cm mass in the left adrenal gland. Positron emission tomography (PET)-CT imaging revealed 18 F-fluorodeoxyglucose (FDG) accumulation of a maximum standardized uptake value (SUV max) of 3.88 and 6.14 in the lung nodule and adrenal mass, respectively. We suspected clinical T1bN0M1b, stage IVB lung cancer of the left lower lobe and performed bronchoscopy. We performed left adrenalectomy to obtain a definitive diagnosis. Operation time and blood loss were 115 min and 56 ml, respectively. The left adrenal tumor was gray-white with a clear border of 3.5 cm consisting of solid, proliferative, short spindle cells without clear differentiation . Since a part of the tumor showed slight epithelial differentiation and most immunohistological epithelial markers were positive, metastatic cancer was considered. Immunohistochemical staining was positive for AE1/AE3, CAM5.2, epithelial membrane antigen (EMA), and vimentin but negative for thyroid transcription factor-1 (TTF-1), smooth muscle actin (SMA), desmin, and PE-10. Although it was TTF-1 negative and the lung lesion could not be determined as the primary lesion, there was a high possibility of metastasis of the primary PPC. CT after left adrenalectomy showed spontaneous regression of the lung lesion . Therefore, the possibility of inflammatory changes in S6 lung nodules could not be ruled out. Moreover, the possibility of cTXN0M1b, stage IVA lung cancer of unknown origin remained. Subsequently, chemotherapy with cisplatin and docetaxel was administered according to adjuvant chemotherapy of non-small cell carcinoma regimen. Finally, two courses of chemotherapy were administered. Chemotherapy was discontinued after two courses at the patient’s request due to nausea. After chemotherapy, the lung lesions became linear and nearly disappeared . Since lung lesions re-enlarged 11 months after adrenalectomy , PET-CT was performed that showed an FDG accumulation with SUV max of 2.72 in the lung nodule. Eventually, the pulmonary nodule was determined to be the primary lesion, and we decided to resect it for definitive diagnosis. In the respiratory function test immediately before the operation, both the forced expiratory volume in 1 s (1.24 l) and the forced expiratory volume 1 s percent (40.5%) were low. Due to high emphysema and poor lung function, we proposed a partial resection, and the patient agreed. Therefore, partial resection of the left lower lobe was performed. Operation time and blood loss were 60 min and 1 ml, respectively. Macroscopically, a solid white tumor with a clear border of 1.4 cm was observed . Histologically, there was no clear keratinization, inter-tissue bridge, or ductal structure, and the findings were similar to those of adrenal tumors . Immunohistochemical staining was positive for AE1/AE3, CAM5.2, EMA, and vimentin, and negative for TTF-1, SMA, desmin, and PE-10. The diagnosis was consistent with the primary lesions of adrenal tumors. Thus, three courses of chemotherapy with cisplatin and docetaxel were administered. There was no recurrence for 4 years and 3 months since the last treatment, and the patient was followed up at another hospital. After 8 years and 4 months since the lung resection, endocrine therapy was administered for the diagnosis of advanced prostate cancer. However, no recurrence of PPC was observed. Fig. 1 Computed tomography (CT). a Chest CT showed a well-circumscribed, 1.6-cm mass in the S6 segment of the left lower lobe. b CT performed before chemotherapy and 2 months after left adrenalectomy showed spontaneous regression of lung lesions. c After chemotherapy, the lung lesions became linear and nearly disappeared. d Lung lesions re-enlarged 11 months after adrenalectomy Fig. 2 Pathological findings. a Macroscopic findings of the adrenal tumor: the tumor was a 3.5-cm gray-white tumor with a clear border. b Microscopic findings of the adrenal tumor: the tumor consisted of solid, proliferative, short, spindle cells without clear differentiation. c Macroscopic findings of the lung tumor: the tumor was a 1.4-cm, solid, white tumor with a clear border. d Microscopic findings of the lung tumor: there was no clear keratinization, inter-tissue bridge, or ductal structure, and the findings were similar to those of adrenal tumors
4.03125
0.977051
sec[1]/p[0]
en
0.999997
31993853
https://doi.org/10.1186/s40792-020-0794-3
[ "lung", "tumor", "adrenal", "clear", "chemotherapy", "lesions", "adrenalectomy", "nodule", "lobe", "cancer" ]
[ { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" } ]
=== ICD-11 CODES FOUND === [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Pulmonary sporotrichosis Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com... --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- Walk 5 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --CHILD--> [CA40.2] Fungal pneumonia
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --CHILD--> [CA40.2] Fungal pneumonia" ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
First, to confirm the diagnosis and develop an operation plan, a core needle biopsy was performed at our hospital. Based on the findings of the preoperative examination, including the biopsy results, the preoperative diagnosis was suspected hepatocellular carcinoma. The Child–Pugh score was 8 (albumin, 3; prothrombin time, 2; bilirubin, 1; ascites, 1; and encephalopathy, 1), and the indocyanine green retention rate (ICG-R15) was 2.9%. On enhanced CT just before the operation, the tumor was 8.7 × 10.4 × 13.1 cm in size, showing marked growth within a one-month period. We planned to perform elective surgical resection by laparotomy. At the operation, a large mass was located in the central portion of liver with no findings of peritoneal dissemination or intra-abdominal metastasis. The tumor involved liver segments 4, 5 and 8; however, the dorsal portion of segment 8 had been spared. The tumor did not actually invade Glisson’s sheath at the liver hilum, and the distance between the tumor and the umbilical portion of portal vein was 1 cm. After removing the gallbladder, hepatic parenchymal transection was performed with a water-jet hybrid knife (erbe JET2 ® ; Erbe Elektromedizin GmbH, Tubingen, Germany) using the Pringle maneuver while confirming the tumor location using intraoperative ultrasonography. The dorsal portion of Segment 8 was successfully preserved. The blood supply of the area was confirmed by intraoperative ultrasonography after resection. Finally, the tumor was resected en bloc with a margin. The operative time was 521 min, and the blood loss was 490 ml. He was transferred to the previous hospital on postoperative day 12. Macroscopic findings showed a yellowish white, solid tumor of 10 × 9 cm in size with hemorrhage and necrosis . Although the tumor was well-circumscribed macroscopically, in a histopathological examination, the tumor cells showed an infiltrative growth pattern and vascular invasion was observed . The tumor was composed of polygonal or oval-shaped cells arranged around blood vessels , spindle cells arranged in fascicles , and round epithelioid cells with clear cytoplasm . Tumor cells showed a high nuclear grade and multinucleated giant cells were also noted . Mitotic figures were easily recognized; the mitotic activity was 30/50 hpf, including abnormal mitosis . Immunohistochemistry revealed that some cells were positive for α-SMA and melan A, while approximately 50% of cells were positive for HMB-45 . These histopathological findings, along with immunoreactivity with melanocytic markers, were consistent with a diagnosis of perivascular epithelioid cell tumor. The diagnosis was also confirmed by a central review committee in the Japan Children’s Cancer Group (JCCG). After discharge from our hospital, he was followed up at another hospital. In the 6th month after the initial surgery, he complained of shoulder pain. MRI showed dumbbell-like shaped tumor at the 2nd thoracic vertebrae, which was confirmed to be bone metastasis of PEComa by biopsy. After reducing the tumor size by chemotherapy (including ifosfamide and doxorubicin), vertebrectomy was performed. Postoperatively he suffered from cerebrospinal fluid leakage and meningitis, which were treated by vancomycin. Additional therapy was judged to be unnecessary because no viable cells were found in the specimen. At two years from the relapse, in a regular follow-up visit, thoracoabdominal CT showed a 10-cm solid mass occupying the pelvis and a 15-mm nodule in the middle lobe of the right lung. The pelvic tumor was extirpated by laparotomy, while a nodule in right lung was removed in a thoracoscopic procedure. A pathological examination revealed that both lesions were PEComa, and genetic alteration of the TSC2 gene was identified in tumor cells. At four months after second relapse, pelvic metastasis appeared again. Since the third relapse, he has been carefully treated with a mammalian target of rapamycin (mTOR) inhibitor. Fig. 4 Histopathological findings (macroscopic). A yellowish white, solid 10 × 9-cm tumor is seen, showing hemorrhaging and necrosis Fig. 5 Histopathological findings (microscopic). The tumor shows an infiltrative growth pattern ( a ) and vascular invasion is also noted ( b ). The tumor is composed of polygonal or oval-shaped cells arranged around blood vessels ( c ), spindle cells arranged in fascicles ( d ), and round epithelioid cells with clear cytoplasm ( e ). Multinucleated giant cells are also noted ( f , highlighted with yellow arrows). Mitotic figure was easily recognized, including abnormal mitosis ( f , highlighted with a red arrow) Fig. 6 Immunohistochemical findings. Immunohistochemistry showed α-SMA ( a ) and melan A ( c ) were positive in some cells, while HMB-45 ( b ) was positive in about 50% of cells
4.164063
0.940918
sec[1]/p[3]
en
0.999997
34542724
https://doi.org/10.1186/s40792-021-01300-w
[ "tumor", "cells", "including", "portion", "while", "blood", "histopathological", "arranged", "biopsy", "growth" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "9A96.3", "title": "Primary anterior uveitis" }, { "code": "3A61.Z", "title": "Acquired pure red cell aplasia, unspecified" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine [5C56.20] Mucolipidosis Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2 Excludes: Sialidosis (mucolipidosis type 1) [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] [9A96.3] Primary anterior uveitis Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid. Also known as: Primary anterior uveitis | anterior chamber cell [3A61.Z] Acquired pure red cell aplasia, unspecified Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --EXCLUDES--> [?] Nonspecific mesenteric lymphadenitis --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --EXCLUDES--> [?] Chronic lymphadenitis --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --PARENT--> [02] Neoplasms Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --EXCLUDES--> [?] Nonspecific mesenteric lymphadenitis", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --EXCLUDES--> [?] Chronic lymphadenitis", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair...." ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 50 year-old woman was admitted in our hospital for abdominal pain and massive vaginal haemorrhage. She was at day 9 post-partum, following a non-complicated elective caesarean section after unsuccessful birth induction. This event occurred after a 41 weeks normal gestation resulting from oocyte donation for infertility due to physiological ovarian aging. At admission, blood pressure was maintained at 129/91 mmHg despite massive bleeding. Haemoglobin was 93 g/L with a normal thrombocyte count. She rapidly underwent two uterine curettages followed by embolization of uterine arteries. Treatment also included amines, oxytocine, sulprostone, 2 g of tranexamic acid (TXA), 5 units of packed red blood cells (RBC), 1 unit of platelets, 2 units of frozen plasma and 2 g of fibrinogen for consumption coagulopathy. At Intensive Care Unit admission, serum creatinine was increased to 116 μmol/L and platelet count was decreased to 102 G/L. Due to persistent uncontrolled bleeding, she underwent total hysterectomy, with the administration of 7 additional RBCs and 500 mcg of TXA. Total blood loss was estimated to 2700 mL. Anatomopathological analysis of surgical tissues excluded signs of endometritis. In the recovery room, she developed symptomatic high blood pressure associated with blurred vision, dizziness, headache and hyperreflexia necessitating intravenous labetalol. Despite bleeding control and coagulation markers’ normalization, haemoglobin, platelet count and kidney function continued to worsen, subsequently leading to AKI stage 3 associated with dysmorphic microhematuria and proteinuria up to 2 g/day with the need of replacement therapy. Blood tests showed numerous schizocytes (49‰) with undetectable haptoglobin (< 0.1 g/L) and massive lactate dehydrogenase levels, clearly defining signs of TMA. Disseminated intravascular coagulation was reasonably ruled out due to a normal fibrinogen level. ADAMTS-13 activity was normal at 38%, although the essay was performed just after the administration of the 2 initial fresh frozen plasma packs. C3 was reduced to 0.63 g/L with markedly increased serum sC5b-9 and Bb factors, respectively to 637 ng/ml (normal range 127–303 ng/mL) and 5.95 μg/mL (normal range < 1.65 μg/mL). Moreover, a serum C3 splitting activity was found giving rise to C3c. Factor H (FH) was normal and Factor I (FI) was slightly but not significantly reduced to 36.2 μg/mL (normal range 38–58 μg/mL), probably due to consumption. No anti-FH antibody was detected (Table 1 ). The marked activation of complement alternative and terminal pathways prompted us to start anti-C5 therapy, i.e. intravenous eculizumab 900 mg, once weekly, with the required antibiotic prophylaxis and meningococcal vaccination. Interestingly, sC5b-9 normalized within 12 h after the first dose of eculizumab, factor Bb and C3 after seven days, platelet count after nine days and haptoglobin after 3 weeks. The clinical picture improved rapidly with blood pressure control after 48 h and diuresis resumed after three days. Weekly eculizumab was continued aiming a CH50 below 10%. The patient received a total of six doses of eculizumab over two months, until haemodialysis could be discontinued . Using Next-Generation Sequencing, no complement genetic abnormality in favour of p-aHUS was detected. Two years after admission, the patient was doing well. Serum creatinine was 82 μmol/l, corresponding to an estimated GFR of 71 ml/min/1.73 m 2 (CKD-EPI Cystatine C), without proteinuria nor haematuria. Table 1 Functional and genetic complement analysis at admission and during follow-up Day 0 Day+ 1 Day+ 5 Day+ 8 2nd week After 9 months C3 (normal value 0.76–1.46 g/L) 0.62 (↓) – – 1.04 1.08 – C4 (n.v. 0.1–0.4 g/L) 0.07 (↓) – – 0.16 0.18 – CH50 (n.v. 70–140%) 61 (↓) – 1 (↓) 13 (↓) 2 (↓) 74 MBL (n.v. > 49%) 0 (↓) – 5(↓) 3 (↓) 0 (↓) – AP50 (n.v. > 71%) 44 (↓) – 2(↓) 6 (↓) 1 (↓) 76 C5b-9 (n.v. 127–303 ng/mL) 637 (↑) 296 245 225.6 – 71 (↓) Bb factor (n.v. < 1.65 μg/mL) 5.95 (↑) – 2.43 (↑) 1.45 0.98 0.78 H factor (n.v. 400–800 μg/mL) 723 – 700 – 803 – I factor (n.v. 38–58 μg/mL) 36.2 – 48.5 – 45.8 – B factor (n.v. 213–622 μg/mL) 308.4 – – – – – Anti-factor H (n.v. < 30 AU/mL) < 3.9 – – – – – C3 conversion present – – – – absent No genetic abnormality was found in these complement and coagulation genes: ADAMTS13, C3, MCP, CFB, CFD, CFH, CFHR1, CFHR2, CFHR3, CFHR4, CFHR5, CFI, CFP, HOXA2, MMACHC, THBD Fig. 1 Laboratory and clinical evolution from admission to the end of eculizumab administration. Normal values of creatinine, hemoglobin, LDH and thrombocytes are specified in the figure but also represented by transparent rectangles with the same colors of lines. Eculizumab administration are represented with thick blue arrows. HBP = high blood pressure controlled by therapy
4.148438
0.970703
sec[1]/p[0]
en
0.999998
34229609
https://doi.org/10.1186/s12882-021-02456-1
[ "factor", "blood", "eculizumab", "pressure", "count", "serum", "administration", "complement", "massive", "bleeding" ]
[ { "code": "3B14.0", "title": "Hereditary deficiency of factor I" }, { "code": "3B14.Z", "title": "Other inherited coagulation factor deficiency with bleeding tendency, unspecified" }, { "code": "3B14.1", "title": "Hereditary factor X deficiency" }, { "code": "3B11.Z", "title": "Hereditary factor IX deficiency, unspecified" }, { "code": "PB6Z", "title": "Unspecified unintentional cause of morbidity or mortality" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" } ]
=== ICD-11 CODES FOUND === [3B14.0] Hereditary deficiency of factor I Definition: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen. Afibrinogenaemia (complete absence of fibrinogen) and hypofibrinogenaemia (reduced plasma fibrinogen concentration) correspond to quantitative anomalies of fibrinogen while dysfibrinogenaemia corresponds to a functional anomaly of fibrinogen. Hypo- and dysfibrinogenaemia may be frequently combined Also known as: Hereditary deficiency of factor I | Deficiency of factor 1 | Hereditary fibrinogen deficiency | Deficiency of fibrinogen | congenital fibrinogenopenia [3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified Also known as: Other inherited coagulation factor deficiency with bleeding tendency, unspecified | Other inherited coagulation factor deficiency with bleeding tendency | Hereditary factor V deficiency | Proaccelerin deficiency | Owren disease [3B14.1] Hereditary factor X deficiency Definition: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms. Also known as: Hereditary factor X deficiency | Congenital Stuart factor deficiency | Stuart-Prower factor deficiency | Deficiency of factor X | congenital factor x deficiency [3B11.Z] Hereditary factor IX deficiency, unspecified Also known as: Hereditary factor IX deficiency, unspecified | Hereditary factor IX deficiency | factor 9 deficiency | factor IX deficiency | hereditary factor IX deficiency disease [PB6Z] Unspecified unintentional cause of morbidity or mortality Also known as: Unspecified unintentional cause of morbidity or mortality | Exposure to unspecified factor | Exposure to unspecified factor causing fracture | Exposure to unspecified factor causing other and unspecified injury | accidental cause NOS [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood === GRAPH WALKS === --- Walk 1 --- [3B14.0] Hereditary deficiency of factor I Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen.... --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui... --CHILD--> [3B14.0] Hereditary deficiency of factor I Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen.... --- Walk 2 --- [3B14.0] Hereditary deficiency of factor I Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen.... --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui... --PARENT--> [?] Congenital or constitutional haemorrhagic condition Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo... --- Walk 3 --- [3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui... --CHILD--> [3B14.1] Hereditary factor X deficiency Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms.... --- Walk 4 --- [3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui... --CHILD--> [3B14.0] Hereditary deficiency of factor I Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen.... --- Walk 5 --- [3B14.1] Hereditary factor X deficiency Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms.... --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui... --CHILD--> [3B14.1] Hereditary factor X deficiency Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms.... --- Walk 6 --- [3B14.1] Hereditary factor X deficiency Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms.... --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui... --PARENT--> [?] Congenital or constitutional haemorrhagic condition Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo...
[ "[3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --CHILD--> [3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....", "[3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --PARENT--> [?] Congenital or constitutional haemorrhagic condition\n Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo...", "[3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --CHILD--> [3B14.1] Hereditary factor X deficiency\n Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms....", "[3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --CHILD--> [3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....", "[3B14.1] Hereditary factor X deficiency\n Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms....\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --CHILD--> [3B14.1] Hereditary factor X deficiency\n Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms....", "[3B14.1] Hereditary factor X deficiency\n Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms....\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --PARENT--> [?] Congenital or constitutional haemorrhagic condition\n Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo..." ]
3B14.0
Hereditary deficiency of factor I
[ { "from_icd11": "3B14.0", "icd10_code": "D682", "icd10_title": "Hereditary deficiency of other clotting factors" }, { "from_icd11": "3B11.Z", "icd10_code": "D67", "icd10_title": "Hereditary factor IX deficiency" }, { "from_icd11": "PB6Z", "icd10_code": "W312XXA", "icd10_title": "Contact with powered woodworking and forming machines, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W311XXA", "icd10_title": "Contact with metalworking machines, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W3189XA", "icd10_title": "Contact with other specified machinery, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W319XXS", "icd10_title": "Contact with unspecified machinery, sequela" }, { "from_icd11": "PB6Z", "icd10_code": "W3182XA", "icd10_title": "Contact with other commercial machinery, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W3182XS", "icd10_title": "Contact with other commercial machinery, sequela" }, { "from_icd11": "PB6Z", "icd10_code": "W3089XA", "icd10_title": "Contact with other specified agricultural machinery, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W309XXS", "icd10_title": "Contact with unspecified agricultural machinery, sequela" }, { "from_icd11": "PB6Z", "icd10_code": "W3089XS", "icd10_title": "Contact with other specified agricultural machinery, sequela" }, { "from_icd11": "PB6Z", "icd10_code": "W310XXA", "icd10_title": "Contact with mining and earth-drilling machinery, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W3183XA", "icd10_title": "Contact with special construction vehicle in stationary use, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W3183XD", "icd10_title": "Contact with special construction vehicle in stationary use, subsequent encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W319XXA", "icd10_title": "Contact with unspecified machinery, initial encounter" } ]
D682
Hereditary deficiency of other clotting factors
In their paper “Hyperpituitarism beginning in infancy, the Alton giant”, published in 1932, the physicians Louis Henry Behrens and David Preswick Barr of the St. Louis Barnes Hospital report on a remarkable case of acromegalic gigantism which started to develop between ages 1 and 2 years old . The patient, Robert Pershing Wadlow , was born on February 22, 1918 in Alton, IL, USA and at the time of the case report he had been followed up between the ages 11 years & 11 months and 13 years & 6 months old. During this short period his height increased from 208 to 221.5 cm. . The publication does not mention sensory deficits, nor ulcers, or healing problems of the lower extremities in this young man with gigantism. Robert Wadlow would continue to grow to finally become the tallest man ever with a final height of 272 cm. (8′ 11.1″) [ 2 – 9 ]. His maximum weight was 215.9 kg. He died on 15 July 1940 at the age of 22 years & 5 months. His untimely death occurred due to an infected abrasion on his ankle caused by a leg brace that was required because of peroneal nerve paralysis (drop foot) leading to cellulitis and bacteremia. In that era the first antibiotic, penicillin, was not yet readily available; indeed the first British patient was treated with penicillin on February 12, 1941, after which it was also introduced in the United States . Being the private patient of the surgeon Franklin E Walton , Robert Wadlow was admitted several times at Barnes Hospital in St Louis, MO, USA for foot infections. The hospital records mention four hospital admissions starting in 1931. From 13 to 23 October 1931, he was hospitalized because of cellulitis of the left foot, following an injury, for which he underwent incision and drainage. He was readmitted from 21 June to 2 July 1932 because of an infection of the big toe of the left foot and again in 1932 from 18 to 23 October for another infection of the same toe and a fracture of the left 2nd metatarsal bone after an injury. Finally, an abscess was incised and drained. The hospital files report on another hospital admission from 24 March 1935 to 4 May 1935 because of an ulcer of the big toe of the right foot and cellulitis. At that time he was 17 years old and his height at admission was 244 cm. He weighed 149 kg., although his previously reported weight was 170 kg. It was suggested that because of a diminished food intake/loss of appetite he had lost weight before and during hospital admissions. At a certain stage the diagnosis of “hypophysial cachexia, Simmonds’ disease” was considered. Robert Wadlow was only treated with desiccated thyroid hormone. Hydrocortisone/cortisol was not available at the time; the US chemist Edward Calvin Kendall was isolating compound E (later renamed cortisone), which was subsequently synthetized in 1946 . In 1948, the first patient with rheumatoid arthritis was treated with cortisone by the US rheumatologist Philip Showalter Hench . During hospitalization, Robert Wadlow was also under the continuous care of Dr Barr. Already in October 1932, it was reported that reflexes in the lower extremity were “difficult to obtain”. In 1935, vibratory, temperature and pain sensation in the feet, ankles and lower legs were reduced and reflexes were absent . Because of multiple joint problems in the legs and pelvis in combination with muscle weakness, his leg movements became progressively impaired. In the last years of his life, Robert Wadlow had to use one or two canes for assistance in walking. In pictures and short movies, genu valga (knock knees) are apparent with swollen knee and ankle joints and markedly deformed feet . It should be noted that diabetes mellitus, or impaired glucose tolerance was absent. In 1977, the Endocrinologist William Hamilton Daughaday , from the Department of Medicine, Washington University School of Medicine at St. Louis, MO, retrospectively reported on these findings . Daughaday also suggested that, based on the hospital records, Robert Wadlow developed carpal tunnel syndrome leading to difficulties holding a pen or pencil . Fig. 1 Schematic recording of the “cutaneous sensations” of the American acromegalic giant Robert Wadlow dating 25 March 1935—age 17 years & 1 month (height 244 cm., weight 170 kg.)—demonstrating sensory defects in the lower legs. Picture from the Barnes hospital, St. Louis, MO hospital medical file—private collection Warren A. Raymond Fig. 2 Photograph of the American acromegalic giant Robert Wadlow dating 19 October 1936—age 18 years & 8 months (height 255.9 cm., weight 197.7 kg.)—showing deformities of both legs (genu valga), knees and feet. Photograph from the private collection of Warren A. Raymond. The bottom part of this photograph, only showing the legs, was also reproduced in the paper by Daughaday, et al.
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0.955078
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0.999997
37270760
https://doi.org/10.1007/s11102-023-01325-4
[ "robert", "wadlow", "that", "because", "louis", "height", "weight", "foot", "legs", "which" ]
[ { "code": "LD2F.1Y", "title": "Other specified syndromes with multiple structural anomalies, not of environmental origin" }, { "code": "LD20.1", "title": "Syndromes with lissencephaly as a major feature" }, { "code": "JA83.0", "title": "Maternal care for disproportion due to deformity of maternal pelvic bones" }, { "code": "JB05.0", "title": "Obstructed labour due to deformed pelvis" }, { "code": "8A80.Z", "title": "Migraine, unspecified" }, { "code": "QA76", "title": "Medication or substance that is known to be an allergen without injury or harm" }, { "code": "PL13.6", "title": "Medication or substance that is known to be an allergen, as mode of injury or harm" }, { "code": "9C40.A0", "title": "Papilloedema" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" }, { "code": "QC10", "title": "Procedure not carried out because of contraindication" } ]
=== ICD-11 CODES FOUND === [LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin Also known as: Other specified syndromes with multiple structural anomalies, not of environmental origin | 46,XX disorder of sex development - anorectal anomalies | 46,XX DSD - anorectal anomalies | Aarskog-Scott syndrome | Aarskog syndrome [LD20.1] Syndromes with lissencephaly as a major feature Definition: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) associated with abnormal organisation of the cortical layers as a result of neuronal migration defects during embryogenesis. Children with lissencephaly have feeding and swallowing problems, muscle tone anomalies (early hypotonia and subsequently limb hypertonia), seizures (in particular, infantile spas Also known as: Syndromes with lissencephaly as a major feature | Pachygyria | Agyria | Classic lissencephaly | Lissencephaly type 1 Includes: Agyria | Pachygyria [JA83.0] Maternal care for disproportion due to deformity of maternal pelvic bones Also known as: Maternal care for disproportion due to deformity of maternal pelvic bones | Pelvic deformity causing disproportion NOS | pelvis deformity with fetopelvic disproportion | pelvis deformity with disproportion | Maternal care for anthropoid pelvis with disproportion [JB05.0] Obstructed labour due to deformed pelvis Also known as: Obstructed labour due to deformed pelvis | labour and delivery affected by deformed pelvis | pelvic deformity with disproportion, causing obstructed labour | pelvis deformity with disproportion, causing obstructed labour | Cretin pelvis with disproportion, causing obstructed labour [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine [QA76] Medication or substance that is known to be an allergen without injury or harm Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm. Also known as: Medication or substance that is known to be an allergen without injury or harm Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance [9C40.A0] Papilloedema Definition: Optic disc swelling that results from increased intracranial pressure Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure Includes: Optic disc swelling that results from increased intracranial pressure [PA6Z] Unintentional fall from unspecified height Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS [QC10] Procedure not carried out because of contraindication Also known as: Procedure not carried out because of contraindication | intervention not carried out because of contraindication | Procedure cancelled due to contraindication === GRAPH WALKS === --- Walk 1 --- [LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin --PARENT--> [LD2F.1] Syndromes with multiple structural anomalies, not of environmental origin --CHILD--> [LD2F.12] Sirenomelia Def: Sirenomelia is a rare lethal malformation characterised by severe anomalies of the caudal part of the fetus that include a single lower limb, with various degrees of involvement ranging from single to... --- Walk 2 --- [LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin --PARENT--> [LD2F.1] Syndromes with multiple structural anomalies, not of environmental origin --RELATED_TO--> [?] Waardenburg-Shah syndrome Def: In this syndrome the phenotype includes not only the classical features of Waardenburg syndrome but also Hirschsprung disease. It may be caused by mutations in SOX10, EDN3 or EDNRB genes.... --- Walk 3 --- [LD20.1] Syndromes with lissencephaly as a major feature Def: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) asso... --PARENT--> [LD20] Syndromes with central nervous system anomalies as a major feature --CHILD--> [LD20.1] Syndromes with lissencephaly as a major feature Def: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) asso... --- Walk 4 --- [LD20.1] Syndromes with lissencephaly as a major feature Def: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) asso... --PARENT--> [LD20] Syndromes with central nervous system anomalies as a major feature --CHILD--> [LD20.0] Syndromes with cerebellar anomalies as a major feature --- Walk 5 --- [JA83.0] Maternal care for disproportion due to deformity of maternal pelvic bones --PARENT--> [JA83] Maternal care for disproportion Def: A condition characterised by the provision of health interventions to the mother due to the situation in which the head or body of the fetus is too large to fit through the pelvis of the mother.... --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ... --- Walk 6 --- [JA83.0] Maternal care for disproportion due to deformity of maternal pelvic bones --PARENT--> [JA83] Maternal care for disproportion Def: A condition characterised by the provision of health interventions to the mother due to the situation in which the head or body of the fetus is too large to fit through the pelvis of the mother.... --EXCLUDES--> [?] Obstructed labour due to other causes Def: Any other condition characterised by the inability of the presenting part of the fetus to progress into the birth canal for any reason....
[ "[LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin\n --PARENT--> [LD2F.1] Syndromes with multiple structural anomalies, not of environmental origin\n --CHILD--> [LD2F.12] Sirenomelia\n Def: Sirenomelia is a rare lethal malformation characterised by severe anomalies of the caudal part of the fetus that include a single lower limb, with various degrees of involvement ranging from single to...", "[LD2F.1Y] Other specified syndromes with multiple structural anomalies, not of environmental origin\n --PARENT--> [LD2F.1] Syndromes with multiple structural anomalies, not of environmental origin\n --RELATED_TO--> [?] Waardenburg-Shah syndrome\n Def: In this syndrome the phenotype includes not only the classical features of Waardenburg syndrome but also Hirschsprung disease. It may be caused by mutations in SOX10, EDN3 or EDNRB genes....", "[LD20.1] Syndromes with lissencephaly as a major feature\n Def: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) asso...\n --PARENT--> [LD20] Syndromes with central nervous system anomalies as a major feature\n --CHILD--> [LD20.1] Syndromes with lissencephaly as a major feature\n Def: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) asso...", "[LD20.1] Syndromes with lissencephaly as a major feature\n Def: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) asso...\n --PARENT--> [LD20] Syndromes with central nervous system anomalies as a major feature\n --CHILD--> [LD20.0] Syndromes with cerebellar anomalies as a major feature", "[JA83.0] Maternal care for disproportion due to deformity of maternal pelvic bones\n --PARENT--> [JA83] Maternal care for disproportion\n Def: A condition characterised by the provision of health interventions to the mother due to the situation in which the head or body of the fetus is too large to fit through the pelvis of the mother....\n --EXCLUDES--> [?] Obstructed labour due to maternal pelvic abnormality\n Def: Obstructed labour means that, in spite of strong contractions of the uterus, the fetus cannot descend through the pelvis because there is an insurmountable barrier preventing its descent. Obstruction ...", "[JA83.0] Maternal care for disproportion due to deformity of maternal pelvic bones\n --PARENT--> [JA83] Maternal care for disproportion\n Def: A condition characterised by the provision of health interventions to the mother due to the situation in which the head or body of the fetus is too large to fit through the pelvis of the mother....\n --EXCLUDES--> [?] Obstructed labour due to other causes\n Def: Any other condition characterised by the inability of the presenting part of the fetus to progress into the birth canal for any reason...." ]
LD2F.1Y
Other specified syndromes with multiple structural anomalies, not of environmental origin
[ { "from_icd11": "LD20.1", "icd10_code": "Q043", "icd10_title": "Other reduction deformities of brain" }, { "from_icd11": "JA83.0", "icd10_code": "O330", "icd10_title": "Maternal care for disproportion due to deformity of maternal pelvic bones" }, { "from_icd11": "8A80.Z", "icd10_code": "G43B0", "icd10_title": "Ophthalmoplegic migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43409", "icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A0", "icd10_title": "Cyclical vomiting, in migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43D0", "icd10_title": "Abdominal migraine, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43709", "icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43A1", "icd10_title": "Cyclical vomiting, in migraine, intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43509", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43719", "icd10_title": "Chronic migraine without aura, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43501", "icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43C0", "icd10_title": "Periodic headache syndromes in child or adult, not intractable" }, { "from_icd11": "8A80.Z", "icd10_code": "G43401", "icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43419", "icd10_title": "Hemiplegic migraine, intractable, without status migrainosus" }, { "from_icd11": "8A80.Z", "icd10_code": "G43B1", "icd10_title": "Ophthalmoplegic migraine, intractable" } ]
Q043
Other reduction deformities of brain
A 60‐year‐old Japanese male patient without any past medical history presented with dyspnea for 5 days in June 2019 (before the COVID‐19 outbreak). He had no history of cigarette smoking, alcohol consumption, or sick contacts. He had a frequent cough, tachypnea (40 breaths per minute), low‐grade fever (37.2°C), and hypoxemia (PaO 2 , 50.2 mm Hg on room air). He did not have wheezes or lung crackles and abnormal heart sounds on auscultation. Edema, skin rash, muscle weakness, myalgia, and arthralgia were absent. Blood tests revealed leukocytosis (10,300 cells/μl with 76% neutrophils, 2.0% eosinophils, and 14.0% lymphocytes) with high C‐reactive protein levels (5.27 mg/dl). He had normal liver and renal function tests (aspartate aminotransferase 25 IU/L, normal <38 IU/L; alanine aminotransferase 30 IU/L, normal <40 IU/L; blood urea nitrogen 13.6 mg/dl, normal <20 mg/dl; and creatinine 1.04 mg/dl, normal <1.10 mg/dl) and no elevation of creatinine kinase (155 IU/L, normal <170 IU/L). Autoimmune screening did not identify any abnormalities, including anticyclic citrullinated peptide, anti‐nuclear antibodies, anti‐double‐stranded DNA antibodies, anti‐proteinase 3 (PR3) antibodies, anti‐myeloperoxidase (MPO) antibodies, anti‐Scl‐70 antibodies, anti‐Sjögren's syndrome‐related antigen A (SSA/Ro52) antibodies, anti‐aminoacyl‐transfer RNA synthetase (ARS) antibodies, anti‐Jo‐1 antibodies, and anti‐melanoma differentiation‐associated gene 5 (MDA5) antibodies. Chest X‐ray and computed tomography (CT) scan showed diffuse ground‐glass opacification and consolidation in bilateral lung fields . On the day of admission, the patient's condition deteriorated rapidly and he received noninvasive intermittent positive pressure ventilation (NPPV). The diagnosis of rapidly progressive interstitial lung disease with autoimmune disorders, such as severe inflammatory myopathy‐related interstitial lung disease, could not be ruled out. Based on the diagnosis of ARDS of unknown etiology (PaO 2 /FiO 2 235 with a positive end‐expiratory pressure of 5 cmH 2 O), high‐dose intravenous (IV) methylprednisolone therapy was initiated. Empiric antibiotics (IV piperacillin‐tazobactam and levofloxacin) were also given, although blood culture and urinary pneumococcal and Legionella antigen tests were negative. After 3 days of steroid pulse therapy, the patient improved dramatically and was weaned from NPPV and, thereafter, from oxygen support. The dose of IV methylprednisolone was reduced to half every 3 days and later it was switched to oral prednisolone (60 mg/day), which was also gradually reduced. Chest CT scan taken on the 13th day of admission revealed almost complete disappearance of abnormal shadows from the lung field . He was discharged without dyspnea on the 26th day of admission. The steroid was tapered down gradually and discontinued 7 months after discharge. Although the patient had been asymptomatic for a while, he had a relapse of dyspnea in 10 months later after the first onset of ARDS. Upon the second admission, he had hypoxemia (PaO 2 64 mm Hg) on O 2 5L/min via face mask and started receiving NPPV therapy. Chest CT scan showed a mixture of diffuse ground‐glass opacification and consolidation similar to roentgenological patterns observed previously . The findings of physical examination and blood tests were not significantly different from the previous admission except that he had grasping pain in both thighs, proximal muscle weakness in extremities, and elevation of serum creatinine kinase . He had no skin eruptions, such as nail‐bed telangiectasia, heliotrope rash, Gottron's papules, Raynaud's phenomenon, and hyperkeratotic lesions on his fingers (mechanic's hands). The short‐tau inversion recovery sequence (STIR) of magnetic resonance imaging (MRI) showed inflammatory changes in both hamstring muscles . However, the Euroline myositis line blot assay showed negative results for either myositis‐specific antibodies (Jo‐1, PL‐7, PL‐12, EJ, SRP, Mi‐2, MDA5, and TIF1‐γ) or myositis‐associated antibodies (Ku, PM‐Scl100, Scl‐70, and SSA/Ro52). From these findings, the diagnosis of ARDS that relapsed along with an initial manifestation of seronegative PM was made. After 3 days of high‐dose (1,000 mg daily) IV methylprednisolone therapy, the patient's dyspnea and muscle weakness improved dramatically and NPPV therapy was discontinued. Additionally, the diffuse abnormal shadows on the chest CT scan and the high signal on STIR MRI of the hamstring muscles disappeared. The dose of IV methylprednisolone was gradually reduced to 40 mg/day prednisolone, when the patient was discharged without respiratory and muscular symptoms on the 26th day of the second admission . The steroid was tapered down gradually and discontinued 6 months after discharge.
4.03125
0.975586
sec[1]/p[0]
en
0.999996
34925833
https://doi.org/10.1002/ccr3.5147
[ "antibodies", "anti", "lung", "dyspnea", "blood", "chest", "scan", "nppv", "methylprednisolone", "gradually" ]
[ { "code": "JA86.Y", "title": "Maternal care for other specified fetal problems" }, { "code": "MA14.14", "title": "Anti-nuclear antibody positive" }, { "code": "MA14.13", "title": "Anti-nuclear antibody negative" }, { "code": "JA86.0", "title": "Maternal care for red cell antibodies" }, { "code": "MA14.1C", "title": "Raised antibody titre" }, { "code": "MB23.1", "title": "Antisocial behaviour" }, { "code": "3B4Z", "title": "Coagulation defects, unspecified" }, { "code": "4A45.Z", "title": "Antiphospholipid syndrome, unspecified" }, { "code": "4A43.Y", "title": "Other specified overlap non-organ specific systemic autoimmune disease" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" } ]
=== ICD-11 CODES FOUND === [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MA14.14] Anti-nuclear antibody positive Also known as: Anti-nuclear antibody positive | ANA - [anti-nuclear antibody] positive [MA14.13] Anti-nuclear antibody negative Also known as: Anti-nuclear antibody negative | ANA - [anti-nuclear antibody] negative [JA86.0] Maternal care for red cell antibodies Definition: Maternal care for rhesus or other isoimmunization Also known as: Maternal care for red cell antibodies | Maternal care for rhesus isoimmunization | Rh factor immunization affecting management of pregnancy | Rh incompatibility | Rh incompatibility with hydrops fetalis [MA14.1C] Raised antibody titre Also known as: Raised antibody titre | antibody titre above reference range | high antibody titre | increased antibody titre Excludes: isoimmunization, in pregnancy affecting fetus or newborn [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome [4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum === GRAPH WALKS === --- Walk 1 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --CHILD--> [JA86.1] Maternal care for hydrops fetalis --- Walk 2 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --EXCLUDES--> [?] Labour or delivery complicated by fetal distress --- Walk 3 --- [MA14.14] Anti-nuclear antibody positive --PARENT--> [MA14.1] Certain specified immunological findings --CHILD--> [MA14.12] Anticitrullinated protein antibody positive --- Walk 4 --- [MA14.14] Anti-nuclear antibody positive --PARENT--> [MA14.1] Certain specified immunological findings --CHILD--> [MA14.12] Anticitrullinated protein antibody positive --- Walk 5 --- [MA14.13] Anti-nuclear antibody negative --PARENT--> [MA14.1] Certain specified immunological findings --CHILD--> [MA14.11] Anticitrullinated protein antibody negative --- Walk 6 --- [MA14.13] Anti-nuclear antibody negative --PARENT--> [MA14.1] Certain specified immunological findings --PARENT--> [MA14] Immunological findings in blood, blood-forming organs, or the immune system
[ "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --CHILD--> [JA86.1] Maternal care for hydrops fetalis", "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Labour or delivery complicated by fetal distress", "[MA14.14] Anti-nuclear antibody positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.12] Anticitrullinated protein antibody positive", "[MA14.14] Anti-nuclear antibody positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.12] Anticitrullinated protein antibody positive", "[MA14.13] Anti-nuclear antibody negative\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.11] Anticitrullinated protein antibody negative", "[MA14.13] Anti-nuclear antibody negative\n --PARENT--> [MA14.1] Certain specified immunological findings\n --PARENT--> [MA14] Immunological findings in blood, blood-forming organs, or the immune system" ]
JA86.Y
Maternal care for other specified fetal problems
[ { "from_icd11": "JA86.Y", "icd10_code": "O26841 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26843 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26849 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O3680X0 ", "icd10_title": "" }, { "from_icd11": "JA86.0", "icd10_code": "O360930", "icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360920", "icd10_title": "Maternal care for other rhesus isoimmunization, second trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360130", "icd10_title": "Maternal care for anti-D [Rh] antibodies, third trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360932", "icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, fetus 2" }, { "from_icd11": "JA86.0", "icd10_code": "O360922", "icd10_title": "Maternal care for other rhesus isoimmunization, second trimester, fetus 2" }, { "from_icd11": "JA86.0", "icd10_code": "O360990", "icd10_title": "Maternal care for other rhesus isoimmunization, unspecified trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360110", "icd10_title": "Maternal care for anti-D [Rh] antibodies, first trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360120", "icd10_title": "Maternal care for anti-D [Rh] antibodies, second trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360910", "icd10_title": "Maternal care for other rhesus isoimmunization, first trimester, not applicable or unspecified" }, { "from_icd11": "JA86.0", "icd10_code": "O360", "icd10_title": "Maternal care for rhesus isoimmunization" }, { "from_icd11": "MA14.1C", "icd10_code": "R760", "icd10_title": "Raised antibody titer" } ]
O26841
A 65-year-old male farmer was admitted to the dermatology department of Lishui Central Hospital in April 2016 with the chief complaint of erythema, pruritus, and ulceration of the perianal skin combined with cough, which lasted for 1 year. One year ago, patient had perianal erythema, accompanied by pruritus, ulceration, exudation, and pain. Further questioning revealed that the patient had been coughing several times a day. The patient occasionally had white sputum, without any hemoptysis, chest pain, low grade fever, night sweats, or any other discomfort. The patient had applied a variety of ointments for external use, without improvement. The erythema gradually expanded, affecting half of the hip on both sides of the crissum; an ulcer developed at the center of the erythema. Past medical history included hepatitis B for more than 10 years, and hypertension for about 3 years. The patient had surgical history of cholecystectomy at 39 years of age and denied previous history of TB, tumor, being engaged in risky sexual behaviors, or similar family history. Physical examinations included body temperature of 36.9°C, blood pressure 133/86 mm Hg, pulse rate 86 beats/min, breathing 20 times/min, double pulmonary breath sounded rough without obvious rales. Physical examination by specialist showed a large erythematous plaque of about 20 cm × 15 cm around the anus, skin ulcers could be seen nearly 4 cm range at the perianal area, and the base could be seen with fresh granulation, and few purulent secretions . Blood routine test, liver and kidney function tests, treponema pallidum particle agglutination assay (TPPA), toluidine red unheated serum test (TRUST), combined detection of human immunodeficiency virus (HIV) antibodies, and HIV antigens were all negative or within normal ranges. The detection and screening of alpha-fetoprotein (AFP) tumor marker, carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), total prostate specific antigen (TPSA), and free prostate-specific antigen (FPSA) were all normal. Blood sedimentation rate was 50.0 mm/h, TB DNA was positive, and TB antibody was positive. Acid-fast bacillus detection in sputum samples was ++++. Histological examination of perianal skin showed an ulcerative and necrotic area in the perianal skin, and peripheral epidermis had keratosis and hyperkeratosis. The stratum spinosum was proliferated, accompanied by intercellular edema. The whole dermis had epithelial-like cell mass, Langerhans giant cells could be seen, a large number of infiltrating lymphocytes were observed, and anti-acid staining was positive. Pathological diagnosis demonstrated (perianal skin) necrotic granulomatous lesions (TB). Special staining demonstrated acid-fast bacilli using acid-fast staining, periodic acid-Schiff stain (PAS) was negative (−), silver hexosamine stain was negative (−) . Chest computed tomography (CT) scan showed symmetrical thorax, trachea moved to the right, and double lung marking increased and disordered. Diffuse nodular, flocculent, and striped high-density shadow could be seen in both the lungs, the edges were blurred, and the density was uneven. The partial lung tissues in both the upper lungs were consolidated and the cavity was formed. Hilus of the lung and mediastinal lymph nodes were not enlarged. The shape of the heart was not abnormal. There was no pleural effusion in the bilateral pleural cavity. Intrahepatic bile duct showed dilatation. Chest CT scan showed secondary pulmonary TB with cavitation in both upper lobes, and part of the right upper lung was damaged . The results of abdominal enhanced CT showed intrahepatic bile duct dilatation and pneumobilia, gallbladder was not shown; splenomegaly, and multiple renal cysts in both the kidneys; possibility of duodenal descending diverticulum, and a little pneumatosis as a partial small intestinal obstruction. Admitting diagnosis showed perianal ulcerative skin TB, secondary bilateral pulmonary TB with possible cavity formation in the 2 upper lungs, TB bacillus was positive (+) in sputum smear. The patient was transferred to the infectious disease department for treatment, and was given with regular anti-TB treatment, which included isoniazid tablets 0.1 g/time, 3 times/day; rifampicin capsules 0.45 g/time, 1 time/day; ethambutol tablets 0.75 g/time, 1 time/day; pyrazinamide tablets 0.75 g/time, 2 times/day. The patient was discharged after 8 days of hospital treatment. M. tuberculosis in sputum smear was negative (−) at the time of discharge. Flushing and exudation of perianal skin were better than before. The patient was recommended to take regular anti-TB drugs for 6 months after discharge. After 6 months of discharge, the patient was followed up through telephone and replied that the ulcer had healed.
4.015625
0.976074
sec[1]/p[0]
en
0.999997
29851791
https://doi.org/10.1097/MD.0000000000010836
[ "perianal", "skin", "time", "both", "acid", "erythema", "times", "sputum", "antigen", "lung" ]
[ { "code": "DB50.1", "title": "Anal fistula" }, { "code": "DB61", "title": "Perianal venous thrombosis" }, { "code": "EG60", "title": "Anal pruritus" }, { "code": "1A95.0", "title": "Anal warts" }, { "code": "DB6Z", "title": "Haemorrhoids or perianal venous conditions, unspecified" }, { "code": "ME67", "title": "Skin disorder of uncertain or unspecified nature" }, { "code": "ME66.Y", "title": "Other specified skin changes" }, { "code": "EM0Y", "title": "Other specified diseases of the skin" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "ME66.1", "title": "Changes in skin texture" } ]
=== ICD-11 CODES FOUND === [DB50.1] Anal fistula Definition: Anal fistula is an abnormal communication, hollow tract lined with granulation tissue connecting the primary opening inside the anal canal to a secondary opening in the perineal skin. They are usually associated with anorectal abscesses, and they are thought to be a chronic condition after an abscess evacuation. Also known as: Anal fistula | Allingham ulcer | perianal fistula | fistula in ano [DB61] Perianal venous thrombosis Definition: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions are thrombi lying within the thin-walled vessels of the external anal plexus. Also known as: Perianal venous thrombosis | thrombosed external pile | anal thrombosis | Perianal haematoma (nontraumatic) | perianal thrombosis Includes: perianal thrombosis | Perianal haematoma (nontraumatic) [EG60] Anal pruritus Definition: Anal pruritus is irritation of the skin at the anal margin and surrounding perianal skin which results in the desire to scratch. Also known as: Anal pruritus | Pruritus ani | Perianal itching [1A95.0] Anal warts Definition: Infection of the anus or perianal skin by human papillomavirus (HPV). Although the majority of such infections are sexually transmitted and caused by HPV subtypes responsible for genital warts, autoinoculation from common warts, especially on the hands in children, may also cause perianal warts. Also known as: Anal warts | Condylomata acuminata of anus | HPV - [Human papillomavirus] infection of anus | Condyloma acuminatum of anus | Perianal warts Includes: Condylomata acuminata of anus [DB6Z] Haemorrhoids or perianal venous conditions, unspecified Also known as: Haemorrhoids or perianal venous conditions, unspecified | varicose veins of anus and rectum [ME67] Skin disorder of uncertain or unspecified nature Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question. Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS [ME66.Y] Other specified skin changes Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta [EM0Y] Other specified diseases of the skin Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [ME66.1] Changes in skin texture Definition: Alterations in skin texture of unspecified cause. Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis === GRAPH WALKS === --- Walk 1 --- [DB50.1] Anal fistula Def: Anal fistula is an abnormal communication, hollow tract lined with granulation tissue connecting the primary opening inside the anal canal to a secondary opening in the perineal skin. They are usually... --PARENT--> [DB50] Fissure or fistula of anal regions Def: Anal fissure and fistula are the common disorders of anal regions. An anal fissure is a superficial linear tear in the anoderm that is distal to the dentate line. An anal fistula is an inflammatory tr... --CHILD--> [DB50.1] Anal fistula Def: Anal fistula is an abnormal communication, hollow tract lined with granulation tissue connecting the primary opening inside the anal canal to a secondary opening in the perineal skin. They are usually... --- Walk 2 --- [DB50.1] Anal fistula Def: Anal fistula is an abnormal communication, hollow tract lined with granulation tissue connecting the primary opening inside the anal canal to a secondary opening in the perineal skin. They are usually... --PARENT--> [DB50] Fissure or fistula of anal regions Def: Anal fissure and fistula are the common disorders of anal regions. An anal fissure is a superficial linear tear in the anoderm that is distal to the dentate line. An anal fistula is an inflammatory tr... --CHILD--> [DB50.0] Anal fissure Def: An anal fissure is a linear break or tear in the mucosa that lines the anal canal. It may occur when hard or large stools are passed after defecation and typically cause pain and bright red anal bleed... --- Walk 3 --- [DB61] Perianal venous thrombosis Def: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions... --PARENT--> [?] Haemorrhoids or perianal venous conditions Def: Haemorrhoids are anatomical structures of swollen veins of the rectal plexus in the walls of the anal canal and/or under the skin around the anus. The term haemorrhoids is usually related to the sympt... --CHILD--> [DB61] Perianal venous thrombosis Def: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions... --- Walk 4 --- [DB61] Perianal venous thrombosis Def: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions... --PARENT--> [?] Haemorrhoids or perianal venous conditions Def: Haemorrhoids are anatomical structures of swollen veins of the rectal plexus in the walls of the anal canal and/or under the skin around the anus. The term haemorrhoids is usually related to the sympt... --CHILD--> [DB61] Perianal venous thrombosis Def: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions... --- Walk 5 --- [EG60] Anal pruritus Def: Anal pruritus is irritation of the skin at the anal margin and surrounding perianal skin which results in the desire to scratch.... --PARENT--> [?] Dermatoses of the anus, perianal area or perineum Def: Disorders affecting the skin of and surrounding the anus including the intergluteal cleft and genitocrural folds.... --CHILD--> [EG60] Anal pruritus Def: Anal pruritus is irritation of the skin at the anal margin and surrounding perianal skin which results in the desire to scratch.... --- Walk 6 --- [EG60] Anal pruritus Def: Anal pruritus is irritation of the skin at the anal margin and surrounding perianal skin which results in the desire to scratch.... --PARENT--> [?] Dermatoses of the anus, perianal area or perineum Def: Disorders affecting the skin of and surrounding the anus including the intergluteal cleft and genitocrural folds.... --RELATED_TO--> [?] Perianal lichen simplex Def: Circumscribed pruritic lichenification of perianal localisation....
[ "[DB50.1] Anal fistula\n Def: Anal fistula is an abnormal communication, hollow tract lined with granulation tissue connecting the primary opening inside the anal canal to a secondary opening in the perineal skin. They are usually...\n --PARENT--> [DB50] Fissure or fistula of anal regions\n Def: Anal fissure and fistula are the common disorders of anal regions. An anal fissure is a superficial linear tear in the anoderm that is distal to the dentate line. An anal fistula is an inflammatory tr...\n --CHILD--> [DB50.1] Anal fistula\n Def: Anal fistula is an abnormal communication, hollow tract lined with granulation tissue connecting the primary opening inside the anal canal to a secondary opening in the perineal skin. They are usually...", "[DB50.1] Anal fistula\n Def: Anal fistula is an abnormal communication, hollow tract lined with granulation tissue connecting the primary opening inside the anal canal to a secondary opening in the perineal skin. They are usually...\n --PARENT--> [DB50] Fissure or fistula of anal regions\n Def: Anal fissure and fistula are the common disorders of anal regions. An anal fissure is a superficial linear tear in the anoderm that is distal to the dentate line. An anal fistula is an inflammatory tr...\n --CHILD--> [DB50.0] Anal fissure\n Def: An anal fissure is a linear break or tear in the mucosa that lines the anal canal. It may occur when hard or large stools are passed after defecation and typically cause pain and bright red anal bleed...", "[DB61] Perianal venous thrombosis\n Def: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions...\n --PARENT--> [?] Haemorrhoids or perianal venous conditions\n Def: Haemorrhoids are anatomical structures of swollen veins of the rectal plexus in the walls of the anal canal and/or under the skin around the anus. The term haemorrhoids is usually related to the sympt...\n --CHILD--> [DB61] Perianal venous thrombosis\n Def: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions...", "[DB61] Perianal venous thrombosis\n Def: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions...\n --PARENT--> [?] Haemorrhoids or perianal venous conditions\n Def: Haemorrhoids are anatomical structures of swollen veins of the rectal plexus in the walls of the anal canal and/or under the skin around the anus. The term haemorrhoids is usually related to the sympt...\n --CHILD--> [DB61] Perianal venous thrombosis\n Def: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions...", "[EG60] Anal pruritus\n Def: Anal pruritus is irritation of the skin at the anal margin and surrounding perianal skin which results in the desire to scratch....\n --PARENT--> [?] Dermatoses of the anus, perianal area or perineum\n Def: Disorders affecting the skin of and surrounding the anus including the intergluteal cleft and genitocrural folds....\n --CHILD--> [EG60] Anal pruritus\n Def: Anal pruritus is irritation of the skin at the anal margin and surrounding perianal skin which results in the desire to scratch....", "[EG60] Anal pruritus\n Def: Anal pruritus is irritation of the skin at the anal margin and surrounding perianal skin which results in the desire to scratch....\n --PARENT--> [?] Dermatoses of the anus, perianal area or perineum\n Def: Disorders affecting the skin of and surrounding the anus including the intergluteal cleft and genitocrural folds....\n --RELATED_TO--> [?] Perianal lichen simplex\n Def: Circumscribed pruritic lichenification of perianal localisation...." ]
DB50.1
Anal fistula
[ { "from_icd11": "DB50.1", "icd10_code": "K603", "icd10_title": "Anal fistula" }, { "from_icd11": "DB61", "icd10_code": "K645", "icd10_title": "Perianal venous thrombosis" }, { "from_icd11": "EG60", "icd10_code": "L290", "icd10_title": "Pruritus ani" }, { "from_icd11": "DB6Z", "icd10_code": "K649", "icd10_title": "Unspecified hemorrhoids" }, { "from_icd11": "DB6Z", "icd10_code": "K55-K64", "icd10_title": "" }, { "from_icd11": "DB6Z", "icd10_code": "K64", "icd10_title": "Hemorrhoids and perianal venous thrombosis" }, { "from_icd11": "ME67", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "ME66.Y", "icd10_code": "L578", "icd10_title": "Other skin changes due to chronic exposure to nonionizing radiation" }, { "from_icd11": "EM0Y", "icd10_code": "L918", "icd10_title": "Other hypertrophic disorders of the skin" }, { "from_icd11": "EM0Y", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "ME66.1", "icd10_code": "R234", "icd10_title": "Changes in skin texture" } ]
K603
Anal fistula
A 54-year-old male was referred to the Rheumatology Division of Fornaroli Hospital from the Infective Department. In February 2014, he was admitted to hospital because of interstitial lung disease of uncertain origin accompanied by fever with shiver, dry cough, and chest pain. Chest X-ray showed a right subclavicle interstitial consolidation. A lung/abdominal CT (Computerized Tomography) with contrast enhancement showed an interstitial consolidation with centrilobular branching linear structures with bronchial dilatation and multifocal areas of ground-glass attenuation at the right superior and medium lobe of lung in the posterior segment. There were pleura's thickening at the lingula and fibrotic lines with consolidation at the left superior lobe of lung in the anterior segment, also. Moreover, there were some mediastinic bilateral lymphadenopathies . Laboratory tests showed ESR 28 mm/h (cut-off value ≤10 mm/h) and C-reactive protein 6.66 mg/dL (range of normality: 0–5). Antinuclear antibodies (ANA), cryoglobulin, extractable nuclear antibodies (ENAs), anti-DNA native antibodies, antiphospholipid antibodies, and antineutrophil cytoplasmic antibody (ANCA) were negative. Complementemia (C3, C4) was at range of normality. Rheumatoid factor (RF) was 24 UI/mL (range of normality <12) and anti-cyclic citrullinated peptide (anti-CCP) antibodies were 17 UA/mL (range of normality <5). Serum angiotensin-converting enzyme (ACE) levels were normal. Quantiferon-TB Gold was negative. Microbial agents were excluded (serology for Legionella , Streptococcus pneumoniae , Mycoplasma pneumoniae , and Chlamydia was negative). A restrictive defect on functional lung exams was excluded and diffusion capacity of the lung for carbon monoxide (DLCO) was normal. Smoking history was absent. A lung bronchoscopy with a bronchoalveolar lavage (BAL) was made. Bacterial BAL fluid cultures were negative. Culture and genome for Koch's bacillus were negative. BAL cytology excluded monoclonality disorders and showed increased numbers of neutrophils and eosinophils. Lung CT showed multifocal areas of ground-glass and we hypothesized a rheumatologic versus infective interstitial lung disease. So, lung biopsy was not performed in this patient because we think that it was excessive forasmuch as BAL was performed (including cultures and cytology) which supported inflammatory diagnosis. A positron emission tomography-computed tomography ( 18 F-FDG PET/CT) showed an elevated glucometabolic activity at bilaterally axillary lymphadenopathies and at level of pulmonary consolidation seen at HR-CT; these abnormalities were hypothesized to inflammatory nature and possible rheumatic disease (such as vasculitis). Heart ultrasound, nailfold videocapillaroscopy, and superior abdomen ultrasound did not show abnormalities. After some weeks, painful swelling of right knee appeared. Doppler ultrasound (US) of low limbs excluded deep venous thrombosis. He received a large spectrum antibiotic therapy (before, at home he had assumed oral levofloxacin therapy and later oral amoxicillin clavulanate; during the recovery he received oral doxicilin and azithromycin at standard dosage) with reduction of fever but persistence of lung abnormities to radiologic exams. So, It was started a steroid therapy ex adiuvantibus with a clinical subjective improvement. In the suspect of rheumatologic disease patient was assigned to our division. During rheumatologic recovery painful swelling of right wrist, knee, and ankle appeared. We made an ultrasound (US) echographic of the lung . Commercially available echographic equipment with a 7.5 MHz linear probe was used (Mylab25, Esaote, Genoa, Italy). US of right lung, at the fifth posterior intercostal space, showed the presence of Ultrasound Lung Comets (ULCs) (as echographic sign of interstitial lung involvement). On the basis of clinical features and laboratory/functional/radiologic tests we made a diagnosis of NSIP in RA seropositive for RF. We started immunosuppressive therapy with intravenous cyclophosphamide 1 gr every 28 days for a cumulative dose of 6 gr associated with steroid tapering therapy. We observed any adverse events during treatment with cyclophosphamide. At the end of intravenous infusion of cyclophosphamide, a lung high-resolution CT was performed. It showed a significant improvement of interstitial lung disease with disappearance of multifocal areas of ground-glass attenuation and consolidations . Also ultrasound evaluation at the end of therapy showed complete resolution of ULCs . So we decided to stop other infusions of cyclophosphamide and to start treatment with methotrexate 10 mg/weekly for arthralgia of right wrist as well as maintenance therapy associated with low dose of steroids (prednisone 5 mg/day tapering).
4.097656
0.971191
sec[1]/p[0]
en
0.999997
26240772
https://doi.org/10.1155/2015/107275
[ "lung", "interstitial", "ultrasound", "antibodies", "consolidation", "range", "normality", "excluded", "cyclophosphamide", "tomography" ]
[ { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" }, { "code": "JA01.Y", "title": "Other specified ectopic pregnancy" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "9A7Y", "title": "Other specified disorders of the cornea" }, { "code": "CB0Z", "title": "Respiratory diseases principally affecting the lung interstitium, unspecified" }, { "code": "CB03.4", "title": "Idiopathic pulmonary fibrosis" } ]
=== ICD-11 CODES FOUND === [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung [JA01.Y] Other specified ectopic pregnancy Also known as: Other specified ectopic pregnancy | Cornual gestation or pregnancy | cornual gestation | cornual pregnancy | Cervical pregnancy [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [9A7Y] Other specified disorders of the cornea Also known as: Other specified disorders of the cornea | Secondary disorders of sclera or cornea | Disorders of sclera and cornea in diseases classified elsewhere | Secondary keratitis or keratoconjunctivitis | Keratitis and keratoconjunctivitis in other diseases classified elsewhere [CB0Z] Respiratory diseases principally affecting the lung interstitium, unspecified Also known as: Respiratory diseases principally affecting the lung interstitium, unspecified | interstitial lung disease NOS | diffuse parenchymal lung diseases [CB03.4] Idiopathic pulmonary fibrosis Definition: Idiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia (pneumonitis) of unknown cause, occurring primarily in older adults, limited to the lungs, and associated with the histopathologic and/or radiologic pattern of UIP. The definition of IPF requires the exclusion of other forms of interstitial pneumonia (pneumonitis) including other idiopathic interstitial pneumonias (pneumonitis) and Interstitial Lung Disease (ILD) associated Also known as: Idiopathic pulmonary fibrosis | interstitial pulmonary fibrosis | IPF - [Idiopathic pulmonary fibrosis] | idiopathic lung fibrosis | fibrosing lung disease === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Pulmonary sporotrichosis Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com... --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.0] Ciliary dyskinesia Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l... --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- Walk 5 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --CHILD--> [CA40.1] Viral pneumonia Def: A disease of the pulmonary system, caused by an infection with a viral source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhalation... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Congenital pneumonia Def: Congenital pneumonia is an acute respiratory infection contracted prenatally or during the intrapartum period that is caused by a virus, bacteria, or fungi....
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.0] Ciliary dyskinesia\n Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --CHILD--> [CA40.1] Viral pneumonia\n Def: A disease of the pulmonary system, caused by an infection with a viral source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhalation...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Congenital pneumonia\n Def: Congenital pneumonia is an acute respiratory infection contracted prenatally or during the intrapartum period that is caused by a virus, bacteria, or fungi...." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
A 66-year-old Chinese male patient with a history of hypertension for more than 20 years was admitted to hospital due to unstable angina. He didn’t have any history of neurologic illnesses or allergies, as well as any other heart disease besides coronary artery disease. In addition, he had a family history of hypertension. Physical examination on admission showed that his heart rate was 62 beats per minute, blood pressure was 130/80 mmHg, body mass index was 21.13 kg/m 2 and the other findings were normal. A 12-lead Electrocardiogram (ECG) demonstrated sinus rhythm, with no ischemic ST/T abnormalities. Troponin I, B-type natriuretic peptide (BNP), blood glucose as well as lipid panel were within normal limits. The patient’s baseline estimated glomerular filtration rate (eGFR) was 93 mL/min/BSAc. The coronary angiography demonstrated a bifurcation lesion in left main (LM), left anterior descending (LAD) and left circumflex (LCX) coronary artery . The jailed balloon technique was used to prevent acute LCX occlusion at the time of LM-LAD drug-eluting stents implantation. After the procedure, no significant residual stenosis was observed from LM to LAD and TIMI 3 blood flow was acquired in LCX . The procedure lasted fifty-four minutes, and a total of 80 ml of non-ionic, low-osmolar, iodine-based contrast media (iopromide; Ultravist 370, Bayer Healthcare) was used. The patient returned to the ward with clear consciousness and no chest pain. Physical examination showed the heart rate was 74 beats per minute, blood pressure was 161/89 mmHg. A 12-lead ECG revealed the height of T wave was a little increased in leads I and aVL compared with the previous ECG, and the patient was given continuous ECG monitoring and tirofiban pumping. About 2 h after the procedure, the patient lost his consciousness suddenly and suffered from a status epilepticus. His bilateral pupils were generally equal in size and round, and the light reflection was sensitive. Bilateral Babinski and Chaddock signs were positive, but no neck stiffness was observed. His Glasgow Coma Scale was 8/15. A 12-lead ECG showed mild ST-segment elevation in leads I and aVL, together with ST-segment depression and T wave inversion in leads II, III and aVF. Continuous ECG monitoring did not find any malignant arrhythmias. And echocardiography confirmed no cardiac tamponade. His plasma glucose and electrolyte levels were maintained normal. Midazolam (10 mg, i.v.) was used to the patient for keeping sedation. Then, emergency re-angiography revealed TIMI 1–2 blood flow in LCX . Percutaneous transluminal coronary angioplasty (PTCA) was performed immediately and the TIMI 2–3 blood flow was restored . About 60 ml iopromide was utilized this time. A 12-lead ECG after PTCA revealed a significant decrease in elevated ST-segment in leads I and aVL. The patient was still in the state of status epilepticus and unconsciousness. Emergency non-contrast brain CT examination 3 h after first surgery was subsequently performed to exclude intracranial hemorrhage or ischemic stroke and revealed no obvious abnormalities. However, typical cortical and subarachnoid enhancement as well as prolonged retention of contrast media in the middle cerebral artery were observed one hour later after PTCA . Therefore, CIE was suspected, and the patient was given intravenous hydration to accelerate contrast media excretion, midazolam 1 mg per hour to treat epilepsy, mannitol 125 mL to dehydrate and reduce intracranial pressure. About 3 h later (6 h after the first surgery), the patient suddenly regained his consciousness, the seizures ceased, and all pathological normalized. Repeat non-contrast CT-brain was conducted 42 h after the first surgery, which showed resolution of the cortical and subarachnoid enhancement . Furthermore, there was no residual retention of contrast media in the middle cerebral artery. During the following 6 months, the patient did not experience any neurological symptoms. Fig. 1 First intervention and emergency intervention. a Coronary angiography demonstrated a bifurcation lesion in LM, LAD and LCX (red arrow). b No significant residual stenosis was observed from LM to LAD after LM-LAD drug-eluting stent implantation. c Emergency re-angiography revealed TIMI 1–2 blood flow in LCX (red arrow). d TIMI 2–3 blood flow was restored in LCX after percutaneous transluminal coronary angioplasty. LM, left main. LAD, left anterior descending. LCX, left circumflex Fig. 2 First and second non-contrast CT scans of brain. a Typical cortical and subarachnoid enhancement as well as prolonged retention of contrast media in the middle cerebral artery were observed in non-contrast CT scan (red arrow). b Non-contrast CT scan 36 h later showed resolution of the cortical and subarachnoid enhancement
3.9375
0.978516
sec[1]/p[0]
en
0.999996
37259072
https://doi.org/10.1186/s12872-023-03288-7
[ "contrast", "blood", "coronary", "artery", "timi", "flow", "media", "well", "lead", "angiography" ]
[ { "code": "9D43", "title": "Impairment of contrast vision" }, { "code": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" } ]
=== ICD-11 CODES FOUND === [9D43] Impairment of contrast vision Definition: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces. Peak Contrast sensitivity refers to the smallest differences that are discernible for large stimuli. For smaller objects, such as those involved in many Activities of Daily Living, contrast sensitivity interacts with visual acuity and visual field. Better contrast makes smaller details visible. The visual field is larger for stronger stimuli. Also known as: Impairment of contrast vision | Moderate impairment of contrast vision | Profound impairment of contrast vision [QA00.6Y] Other specified examination of eyes or vision Also known as: Other specified examination of eyes or vision | No Impairment of Contrast vision | Normal colour vision | No Impairment of Dark adaptation | No diplopia [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood === GRAPH WALKS === --- Walk 1 --- [9D43] Impairment of contrast vision Def: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces. Peak Contrast sensitivity refers to the smallest differences that are discernible ... --PARENT--> [?] Impairment of visual functions --RELATED_TO--> [?] Polyopia Def: Monocular diplopia and polyopia are usually a refractive phenomenon.... --- Walk 2 --- [9D43] Impairment of contrast vision Def: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces. Peak Contrast sensitivity refers to the smallest differences that are discernible ... --PARENT--> [?] Impairment of visual functions --RELATED_TO--> [?] Polyopia Def: Monocular diplopia and polyopia are usually a refractive phenomenon.... --- Walk 3 --- [QA00.6Y] Other specified examination of eyes or vision --PARENT--> [QA00.6] Examination of eyes or vision --CHILD--> [QA00.6Y] Other specified examination of eyes or vision --- Walk 4 --- [QA00.6Y] Other specified examination of eyes or vision --PARENT--> [QA00.6] Examination of eyes or vision --CHILD--> [QA00.6Y] Other specified examination of eyes or vision --- Walk 5 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Allergic or hypersensitivity conditions Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms. Hypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms... --CHILD--> [?] Allergic or hypersensitivity disorders involving skin or mucous membranes Def: Allergic or hypersensitivity disorders involving the skin and mucous includes a heterogeneous group of disorders involving skin and mucous membranes in which either allergy or hypersensitivity play a ... --- Walk 6 --- [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified --EXCLUDES--> [?] Allergic or hypersensitivity conditions Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms. Hypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms... --CHILD--> [?] Allergic or hypersensitivity disorders involving skin or mucous membranes Def: Allergic or hypersensitivity disorders involving the skin and mucous includes a heterogeneous group of disorders involving skin and mucous membranes in which either allergy or hypersensitivity play a ...
[ "[9D43] Impairment of contrast vision\n Def: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces.\n\nPeak Contrast sensitivity refers to the smallest differences that are discernible ...\n --PARENT--> [?] Impairment of visual functions\n --RELATED_TO--> [?] Polyopia\n Def: Monocular diplopia and polyopia are usually a refractive phenomenon....", "[9D43] Impairment of contrast vision\n Def: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces.\n\nPeak Contrast sensitivity refers to the smallest differences that are discernible ...\n --PARENT--> [?] Impairment of visual functions\n --RELATED_TO--> [?] Polyopia\n Def: Monocular diplopia and polyopia are usually a refractive phenomenon....", "[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --CHILD--> [QA00.6Y] Other specified examination of eyes or vision", "[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --CHILD--> [QA00.6Y] Other specified examination of eyes or vision", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Allergic or hypersensitivity conditions\n Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms.\n\nHypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms...\n --CHILD--> [?] Allergic or hypersensitivity disorders involving skin or mucous membranes\n Def: Allergic or hypersensitivity disorders involving the skin and mucous includes a heterogeneous group of disorders involving skin and mucous membranes in which either allergy or hypersensitivity play a ...", "[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Allergic or hypersensitivity conditions\n Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms.\n\nHypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms...\n --CHILD--> [?] Allergic or hypersensitivity disorders involving skin or mucous membranes\n Def: Allergic or hypersensitivity disorders involving the skin and mucous includes a heterogeneous group of disorders involving skin and mucous membranes in which either allergy or hypersensitivity play a ..." ]
9D43
Impairment of contrast vision
[ { "from_icd11": "9D43", "icd10_code": "H538", "icd10_title": "Other visual disturbances" }, { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A95S", "icd10_title": "Adverse effect of other bacterial vaccines, sequela" }, { "from_icd11": "NE60", "icd10_code": "T50B95A", "icd10_title": "Adverse effect of other viral vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A25A", "icd10_title": "Adverse effect of mixed bacterial vaccines without a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A91A", "icd10_title": "Poisoning by other bacterial vaccines, accidental (unintentional), initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T498X5A", "icd10_title": "Adverse effect of other topical agents, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48905A", "icd10_title": "Adverse effect of unspecified agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T48995A", "icd10_title": "Adverse effect of other agents primarily acting on the respiratory system, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50A15A", "icd10_title": "Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50B15A", "icd10_title": "Adverse effect of smallpox vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T416X3A", "icd10_title": "" }, { "from_icd11": "NE60", "icd10_code": "T419X3A", "icd10_title": "" } ]
H538
Other visual disturbances
Patient 2 The second patient is a 54-year-old woman who initially presented with fatigue. She also noticed an unusual swelling of her right calf. She visited her primary care physician and underwent a workup to look for causes of her pronounced malaise. A mild anemia (Hbg 10.5 g/dL) was noted but the patient's other blood counts were normal. Fatigue workup also included negative tests for Lyme disease and influenza. Later that month, she was admitted to her local hospital with abdominal pain and diarrhea. She was diagnosed with an ileitis and tests for C. difficile were negative. She was noted to have a significant leukocytosis (WBC 18,000/ μ L) with left shift (72% neutrophils, 13% bands), continued anemia (Hbg 9.1 g/dL), and Plts 325,000/ μ L. After 4-5 days of empiric metronidazole therapy, the patient was discharged with improved abdominal pain. The patient was readmitted shortly thereafter, however, with a swollen and erythematous left elbow. An incision and drainage at the site of the elbow erythema was performed, but all cultures were negative and the joint itself was not infected. The patient was treated with IV antibiotics for cellulitis and discharged on oral antibiotics. Her primary care physician examined her twice during the following week, both times with a swollen, painful right thigh. Doppler ultrasound showed no evidence of DVT. Several days later, her right thigh became warm and erythematous. CBC demonstrated a WBC count of 46,000/ μ L with increased bands but no blasts, Hgb 9.7 g/dL, Plts 190,000/ μ L. She was readmitted to the hospital with a diagnosis of cellulitis. In addition, she was experiencing significant diarrhea and had developed frank anasarca. She was transferred to the medicine service at our institution two months after her initial presentation, with ongoing anasarca, right leg pain and swelling, intermittent fevers, and failure to thrive. MRI of her right leg showed changes consistent with pyomyositis. The patient's leg was therefore drained but cultures were negative and she was ultimately converted from intravenous to oral antibiotics. Laboratory studies were notable for a ferritin that was markedly elevated (6,165 ng/mL), consistent with an inflammatory syndrome. The patient's anasarca initially progressed, with albumin below the detectable limits of the assay. Nephrotic syndrome was ruled out and the diagnosis of protein losing enteropathy was entertained, but colonoscopy and esophagogastroduodenoscopy (EGD) did not support this. Left-shifted leukocytosis, anemia, and thrombocytopenia persisted during her hospitalization. A bone marrow biopsy was performed which showed a markedly hypercellular marrow (>90%) with significant myeloid hyperplasia, hypersegmented neutrophils, erythroid hypoplasia, and megakaryocytic dysplasia. The differential diagnosis was felt to include a reactive process in the setting of the patient's worsening overall condition versus a myeloproliferative neoplasm. The significant megakaryocytic atypia was felt to favor a hematopoetic neoplasm, and the possibility of primary myelofibrosis was raised because of significant reticulin fibrosis that was seen. Cytogenetics were normal and RT-PCR for BCR-ABL and Jak2 V617F from the peripheral blood was negative. In the setting of ongoing anasarca and hypoalbuminemia with no clear underlying cause, an empiric course of high-dose steroids was started following the completion of the bone marrow biopsy. With steroids, the patient's anasarca and hypoalbuminemia gradually improved, and she was discharged to a rehabilitation facility. Steroids were gradually tapered to 15 mg daily over the course of the next three months. Routine CBC three months after discharge then surprisingly demonstrated a WBC count of >40,000/ μ L with 50% myeloblasts detected by flow cytometry. Subsequent bone marrow biopsy confirmed the diagnosis of AML, WHO category acute panmyelosis with myelofibrosis. Cytogenetics were normal but the patient expressed an FLT3 internal tandem duplication mutation. She was treated with mitoxantrone, etoposide, and cytarabine chemotherapy and achieved complete remission. Steroids were tapered to off. With successful treatment of her leukemia, the patient returned to excellent functional status. Unfortunately, her leukemia relapsed shortly prior to planned admission for allogeneic stem cell transplant. She was refractory to salvage chemotherapy but did achieve a complete remission without platelet recovery after 40 days of therapy with a novel FLT3 inhibitor and was able to undergo fully myeloablative allogeneic stem cell transplant from her HLA identical brother. However, the patient relapsed with high WBC count on day +80 after transplant and expired 30 days later with complications from progressive AML.
3.857422
0.982422
sec[1]/p[1]
en
0.999995
22928125
https://doi.org/10.1155/2012/582950
[ "anasarca", "marrow", "steroids", "anemia", "that", "pain", "discharged", "antibiotics", "count", "bone" ]
[ { "code": "MG29.1", "title": "Generalised oedema" }, { "code": "CB01", "title": "Pulmonary oedema" }, { "code": "5B7Z", "title": "Unspecified undernutrition" }, { "code": "BD10", "title": "Congestive heart failure" }, { "code": "KC41.1", "title": "Hydrops fetalis not due to haemolytic disease" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "3A70.Z", "title": "Aplastic anaemia, unspecified" }, { "code": "3C0Y", "title": "Other specified diseases of the blood or blood-forming organs" }, { "code": "3A70.12", "title": "Idiopathic aplastic anaemia" }, { "code": "NE84", "title": "Failure or rejection of transplanted organs or tissues" } ]
=== ICD-11 CODES FOUND === [MG29.1] Generalised oedema Also known as: Generalised oedema | anasarca [CB01] Pulmonary oedema Definition: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe. Also known as: Pulmonary oedema | oedema lung | pulmonary oedema NOS | lung anasarca | lung congestion Includes: Acute pulmonary oedema | Chronic pulmonary oedema Excludes: Pulmonary oedema due to chemicals, gases, fumes or vapours | Pulmonary oedema with mention of heart disease NOS or heart failure [5B7Z] Unspecified undernutrition Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS [BD10] Congestive heart failure Definition: A clinical syndrome characterised by abnormalities of ventricular function and neurohormonal regulation which are accompanied by effort intolerance and fluid retention. Also known as: Congestive heart failure | Congestive heart disease | CCF - [congestive cardiac failure] | CHF - [congestive heart failure] | congestive cardiac diseases Includes: Congestive heart disease [KC41.1] Hydrops fetalis not due to haemolytic disease Definition: A fetal condition characterised by an accumulation of fluid or oedema in at least two fetal compartments, including subcutaneous compartments, the pleura, the pericardium, or the abdomen that is not due to the breakdown of red blood cells. Also known as: Hydrops fetalis not due to haemolytic disease | hydrops baby NOS | Hydrops fetalis NOS | hydrops in fetus or newborn | nonimmune hydrops fetalis [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [3A70.Z] Aplastic anaemia, unspecified Also known as: Aplastic anaemia, unspecified | Aplastic anaemia | erythroid aplasia | AA - [aplastic anaemia] | haematopoietic aplasia [3C0Y] Other specified diseases of the blood or blood-forming organs Also known as: Other specified diseases of the blood or blood-forming organs | Congenital anomaly blood or lymph other | Blood dyscrasia | blood dyscrasia NOS | Bone marrow hyperplasia [3A70.12] Idiopathic aplastic anaemia Also known as: Idiopathic aplastic anaemia | Idiopathic bone marrow failure | idiopathic aplastic anaemia NOS [NE84] Failure or rejection of transplanted organs or tissues Also known as: Failure or rejection of transplanted organs or tissues | organ transplant rejection | transplant failure | transplant rejection | Bone-marrow transplant rejection === GRAPH WALKS === --- Walk 1 --- [MG29.1] Generalised oedema --CHILD--> [MG29.10] Oedema due to increased capillary pressure Def: Increased capillary pressure increases the leakage of fluid from the vascular compartment to the interstitial tissues, resulting in oedema. Causes include impaired or obstructed venous return (fluid o... --PARENT--> [MG29.1] Generalised oedema --- Walk 2 --- [MG29.1] Generalised oedema --PARENT--> [MG29] Oedema Def: Abnormal fluid accumulation in tissues or body cavities not coded elsewhere.... --EXCLUDES--> [?] Pulmonary oedema Def: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.... --- Walk 3 --- [CB01] Pulmonary oedema Def: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.... --PARENT--> [?] Respiratory diseases principally affecting the lung interstitium --CHILD--> [CB01] Pulmonary oedema Def: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.... --- Walk 4 --- [CB01] Pulmonary oedema Def: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.... --EXCLUDES--> [?] Pulmonary oedema due to chemicals, gases, fumes or vapours --CHILD--> [?] Acute chemical pulmonary oedema --- Walk 5 --- [5B7Z] Unspecified undernutrition --PARENT--> [?] Undernutrition Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c... --RELATED_TO--> [?] Undernutrition-dehydration cataract Def: This is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. This diagnosis is with dehydration cataract.... --- Walk 6 --- [5B7Z] Unspecified undernutrition --PARENT--> [?] Undernutrition Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c... --RELATED_TO--> [?] Undernutrition-dehydration cataract Def: This is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. This diagnosis is with dehydration cataract....
[ "[MG29.1] Generalised oedema\n --CHILD--> [MG29.10] Oedema due to increased capillary pressure\n Def: Increased capillary pressure increases the leakage of fluid from the vascular compartment to the interstitial tissues, resulting in oedema. Causes include impaired or obstructed venous return (fluid o...\n --PARENT--> [MG29.1] Generalised oedema", "[MG29.1] Generalised oedema\n --PARENT--> [MG29] Oedema\n Def: Abnormal fluid accumulation in tissues or body cavities not coded elsewhere....\n --EXCLUDES--> [?] Pulmonary oedema\n Def: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe....", "[CB01] Pulmonary oedema\n Def: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe....\n --PARENT--> [?] Respiratory diseases principally affecting the lung interstitium\n --CHILD--> [CB01] Pulmonary oedema\n Def: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe....", "[CB01] Pulmonary oedema\n Def: Pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe....\n --EXCLUDES--> [?] Pulmonary oedema due to chemicals, gases, fumes or vapours\n --CHILD--> [?] Acute chemical pulmonary oedema", "[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --RELATED_TO--> [?] Undernutrition-dehydration cataract\n Def: This is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. This diagnosis is with dehydration cataract....", "[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --RELATED_TO--> [?] Undernutrition-dehydration cataract\n Def: This is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. This diagnosis is with dehydration cataract...." ]
MG29.1
Generalised oedema
[ { "from_icd11": "MG29.1", "icd10_code": "R601", "icd10_title": "Generalized edema" }, { "from_icd11": "CB01", "icd10_code": "J811", "icd10_title": "Chronic pulmonary edema" }, { "from_icd11": "CB01", "icd10_code": "J810", "icd10_title": "Acute pulmonary edema" }, { "from_icd11": "CB01", "icd10_code": "J81", "icd10_title": "Pulmonary edema" }, { "from_icd11": "5B7Z", "icd10_code": "E43", "icd10_title": "Unspecified severe protein-calorie malnutrition" }, { "from_icd11": "5B7Z", "icd10_code": "E538", "icd10_title": "Deficiency of other specified B group vitamins" }, { "from_icd11": "5B7Z", "icd10_code": "E569", "icd10_title": "Vitamin deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E638", "icd10_title": "Other specified nutritional deficiencies" }, { "from_icd11": "5B7Z", "icd10_code": "E639", "icd10_title": "Nutritional deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E41", "icd10_title": "Nutritional marasmus" }, { "from_icd11": "5B7Z", "icd10_code": "E539", "icd10_title": "Vitamin B deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E568", "icd10_title": "Deficiency of other vitamins" }, { "from_icd11": "5B7Z", "icd10_code": "E649", "icd10_title": "Sequelae of unspecified nutritional deficiency" }, { "from_icd11": "5B7Z", "icd10_code": "E618", "icd10_title": "Deficiency of other specified nutrient elements" }, { "from_icd11": "5B7Z", "icd10_code": "E40-E46", "icd10_title": "" } ]
R601
Generalized edema
A 55-year-old woman without relevant medical history was referred to our burn center with 35% total body surface area full thickness thermal burns (third degree) from flames on her lower limbs, hands and face (UBS 110, ABSI 9) . The burns on her right ankle and foot and left knee seemed to be deeper (fourth degree). Initial surgical treatment occurred 2 h after the burns (Day 0) and included releasing incisions from knee to toes in both her lower limbs. The initial dressing was composed of silver sulfadiazine 1% and general resuscitation included fluid resuscitation and invasive monitoring. Then, three surgical procedures were required to excise the devitalized tissues, including muscles and tendons of both lower limbs. Thighs and upper third of her legs were covered with skin autografts. Tibia and fibula were exposed on the right limb. Toes were amputated through the metatarso-phalangeal joints. Ankle, mediotarsal and tarso-metatarsal capsules were burnt, some joints were open and vasculo-nervous pedicle was at high risk of exposure. Consequently, the lower extremity required covering with vascularized tissues. Local pedicled flap was not an option for the ankle and foot; therefore, we opted for a latissimus dorsi musculo-cutaneous flap with vertical skin paddle (4 × 20 cm) centered on the main perforator of the anterior branch of the thoraco-dorsal pedicle, identified with an echo-doppler. The flap was performed on day 27 post-burn. On the pre-operative CT-angiogram of the lower limb, we noticed that the anterior tibial artery was thrombosed just at the second third of the leg. The posterior tibial pedicle was preserved to ensure the vascularization of the remaining tissues of the foot. The thoraco-dorsal pedicle was end-to-end anastomosed to the anterior tibial artery. The anastomoses were difficult to perform because inflammatory tissues, full of oedema, surrounded the vessels. The skin paddle of the latissimus dorsi flap was originally intended for flap monitoring . The free flap was a success, and 3 weeks later, the right limb was almost totally covered either with skin graft or with the flap. Nevertheless, the left patellar tendon was still exposed and needed to be covered with a flap . The options discussed were to perform a pedicled flap, to perform a second free flap or to recycle tissues from the previous flap. We performed a vascular mapping of the flap with the use of an echo-doppler. The main pedicle of the flap was divided into two branches. The skin paddle was vascularized by this anterior branch from which a main perforator was identified. The choice between a musculo-cutaneous flap and a perforator flap was discussed. As a cross-leg had to be performed, the risks of rupture due to excessive tension or of thrombosis due to desiccation of the perforator were considered as too high. Consequently, a musculo-cutaneous cross-leg flap was harvested from the previous flap. The flap was partially raised from the right limb including the anterior branch of the thoraco-dorsal pedicle and a cross leg was performed to cover the left patellar tendon. Both legs were immobilized together using an external fixation . The donor site was covered with a skin graft. After a period of 3 weeks, the skin paddle was progressively cut from the previous flap after partial occlusion clamps were tested. One week later, the patient was discharged to a rehabilitation center for further treatment. The wounds were completely healed 9 weeks after the burns. At 6 months post-burns, the patient was able to walk and left the rehabilitation centre . Fig. 1 Appearance of a 55-year-old woman patient's right ( a ) and left ( b ) legs with full thickness burns at admission, before the releasing incisions were performed Fig. 2 Appearence of lower right extremity of a 55-year-old woman burn patient after debridment of necrotic tissues. Tibia and fibula were exposed. Ankle, mediotarsal, and tarso-metatarsal capsules were burnt and some joints were open Fig. 3 Appearence of lower right extremity of a 55-year-old woman burn patient after a free latissimus dorsi musculo-cutaneous flap with vertical skin paddle was performed to cover dorsal foot and ankle Fig. 4 Appearence of lower limbs of a 55-year-old woman burn patient with exposure of left patellar tendon and superior third of the tibia requiring coverage with a flap Fig. 5 Appearance of both legs of a 55-year-old woman burn patient after a pedicled flap was raised from the previous free flap; ( a ) a cross leg transferred to cover the left patellar tendon and ( b ) both legs were immobilized together using an external fixation (Hoffmann apparatus) Fig. 6 Appearance of a 55-year-old woman burn patient's legs at 6 months post-surgery, after the patient left the rehabilitation centre
4.042969
0.97168
sec[1]/p[0]
en
0.999999
30009190
https://doi.org/10.1186/s41038-018-0107-2
[ "flap", "skin", "burn", "burns", "tissues", "legs", "pedicle", "ankle", "both", "paddle" ]
[ { "code": "EM0Y", "title": "Other specified diseases of the skin" }, { "code": "EL51", "title": "Cutaneous flap necrosis" }, { "code": "EL52", "title": "Myocutaneous flap necrosis" }, { "code": "ME67", "title": "Skin disorder of uncertain or unspecified nature" }, { "code": "ME66.Y", "title": "Other specified skin changes" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "ME66.1", "title": "Changes in skin texture" }, { "code": "NE2Z", "title": "Burns, unspecified" }, { "code": "NE11", "title": "Burn of unspecified body region" }, { "code": "PB1Z", "title": "Unintentional exposure to unspecified thermal mechanism" } ]
=== ICD-11 CODES FOUND === [EM0Y] Other specified diseases of the skin Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures [EL51] Cutaneous flap necrosis Definition: Necrosis of surgical skin flap Also known as: Cutaneous flap necrosis | Cutaneous flap necrosis, partial | Cutaneous flap necrosis, total [EL52] Myocutaneous flap necrosis Definition: Necrosis of a surgical flap containing both skin and muscle Also known as: Myocutaneous flap necrosis | Myocutaneous flap necrosis, partial | Myocutaneous flap necrosis, total [ME67] Skin disorder of uncertain or unspecified nature Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question. Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS [ME66.Y] Other specified skin changes Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [ME66.1] Changes in skin texture Definition: Alterations in skin texture of unspecified cause. Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis [NE2Z] Burns, unspecified Also known as: Burns, unspecified | Scald | burns from friction | burns from hot air and hot gases | burns from hot objects [NE11] Burn of unspecified body region Also known as: Burn of unspecified body region | burn and corrosion, body region unspecified | burn NOS | Corrosion of unspecified body region, unspecified degree | corrode [PB1Z] Unintentional exposure to unspecified thermal mechanism Also known as: Unintentional exposure to unspecified thermal mechanism | thermal injuries and inhalation of products of combustion | Exposure to unspecified smoke, fire and flames | burning NOS | fire === GRAPH WALKS === --- Walk 1 --- [EM0Y] Other specified diseases of the skin --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and... --RELATED_TO--> [?] Haematoma of surgical wound of skin Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis... --- Walk 2 --- [EM0Y] Other specified diseases of the skin --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and... --CHILD--> [?] Inflammatory dermatoses Def: A large group of skin disorders in which inflammation plays an important role.... --- Walk 3 --- [EL51] Cutaneous flap necrosis Def: Necrosis of surgical skin flap... --PARENT--> [?] Postprocedural disorders of the skin Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions.... --CHILD--> [EL50] Unsatisfactory surgical scar of skin Def: A surgical skin scar with a poor functional or cosmetic outcome.... --- Walk 4 --- [EL51] Cutaneous flap necrosis Def: Necrosis of surgical skin flap... --PARENT--> [?] Postprocedural disorders of the skin Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions.... --CHILD--> [EL51] Cutaneous flap necrosis Def: Necrosis of surgical skin flap... --- Walk 5 --- [EL52] Myocutaneous flap necrosis Def: Necrosis of a surgical flap containing both skin and muscle... --PARENT--> [?] Postprocedural disorders of the skin Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions.... --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and... --- Walk 6 --- [EL52] Myocutaneous flap necrosis Def: Necrosis of a surgical flap containing both skin and muscle... --PARENT--> [?] Postprocedural disorders of the skin Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions.... --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...
[ "[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Haematoma of surgical wound of skin\n Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis...", "[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --CHILD--> [?] Inflammatory dermatoses\n Def: A large group of skin disorders in which inflammation plays an important role....", "[EL51] Cutaneous flap necrosis\n Def: Necrosis of surgical skin flap...\n --PARENT--> [?] Postprocedural disorders of the skin\n Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions....\n --CHILD--> [EL50] Unsatisfactory surgical scar of skin\n Def: A surgical skin scar with a poor functional or cosmetic outcome....", "[EL51] Cutaneous flap necrosis\n Def: Necrosis of surgical skin flap...\n --PARENT--> [?] Postprocedural disorders of the skin\n Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions....\n --CHILD--> [EL51] Cutaneous flap necrosis\n Def: Necrosis of surgical skin flap...", "[EL52] Myocutaneous flap necrosis\n Def: Necrosis of a surgical flap containing both skin and muscle...\n --PARENT--> [?] Postprocedural disorders of the skin\n Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions....\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...", "[EL52] Myocutaneous flap necrosis\n Def: Necrosis of a surgical flap containing both skin and muscle...\n --PARENT--> [?] Postprocedural disorders of the skin\n Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions....\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and..." ]
EM0Y
Other specified diseases of the skin
[ { "from_icd11": "EM0Y", "icd10_code": "L918", "icd10_title": "Other hypertrophic disorders of the skin" }, { "from_icd11": "EM0Y", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "EL51", "icd10_code": "T85898A", "icd10_title": "Other specified complication of other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T8586XA", "icd10_title": "" }, { "from_icd11": "EL51", "icd10_code": "T85868A", "icd10_title": "Thrombosis due to other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85848A", "icd10_title": "Pain due to other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85858A", "icd10_title": "Stenosis due to other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85840A", "icd10_title": "Pain due to nervous system prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85868D", "icd10_title": "Thrombosis due to other internal prosthetic devices, implants and grafts, subsequent encounter" }, { "from_icd11": "EL51", "icd10_code": "T85838A", "icd10_title": "Hemorrhage due to other internal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T85890A", "icd10_title": "Other specified complication of nervous system prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "EL51", "icd10_code": "T8589XA", "icd10_title": "" }, { "from_icd11": "EL51", "icd10_code": "T8584XA", "icd10_title": "" }, { "from_icd11": "EL51", "icd10_code": "T8583XA", "icd10_title": "" }, { "from_icd11": "EL51", "icd10_code": "T85818A", "icd10_title": "Embolism due to other internal prosthetic devices, implants and grafts, initial encounter" } ]
L918
Other hypertrophic disorders of the skin
The TLH procedure was carried out according to our previous literature . Thus, bowel preparation was performed by the administration of oral laxatives 3 days prior to surgery and rectal enemas were administered every 8 h before surgery over the previous 24 h. The surgery was performed under general anesthesia with the patient in the lithotomic position. Urinary catheterization was performed and a nasogastric tube was inserted due to the risk of gastric distention and perforation. We used the ClearView Uterine Manipulator-7 cm (Ethicon Endo-Surgery, Cincinnati, USA) to allow for better manipulation of the uterus. A 12-mm trocar was placed by open procedure just below the xiphoid process and a pneumoperitoneum of 10–14 mmHg was created in a neutral position (a supine position where the patient’s spinal column is aligned with legs parallel to the operatory room bed that is inclined of 0 degree) and maintained throughout the surgery. Intra-abdominal visualization was achieved using a 10 mm, 0° telescope (Karl Storz, Tuttlingen, Germany). Two 5-mm trocars were inserted in the hypochondrium lateral to the rectus abdominis muscle, and a third 12-mm trocar at the umbilicus. The surgical table was placed in Trendelenburg position, modulating the angle in accordance with the anesthesiologist’s requirements at various stages of the operation. The first stage of the surgery involved coagulation and transection of the round ligament. We continued the dissection anteriorly from the round ligaments up to the vesico-uterine peritoneal fold to find the correct plane. Then, the utero-ovarian vessels were coagulated and transected. These procedures were performed using Ligasure (Tyco Healthcare; AutoSuture Co., U.S. Surgical Corp., Norwalk, CT). At this time, another 5 mm trocar was inserted in the suprapubic position and the telescope was inserted into the umbilical trocar. Using the uterine manipulator, the uterus was pushed cephalad to recreate the “traction-counter traction” of the lower uterine segment with the help of lateral laparoscopic instruments used for leverage. This elevates the uterine arteries along the lower cervix, and positions them away from the ureters. A bladder flap was incised and the anterior cervical fascia exposed for dissection of the cervix below the cervico-vaginal margin using monopolar forceps. Then, we completed the opening of the posterior leaf of broad ligaments to better expose the uterosacral ligaments. The uterine arteries were skeletonized with the BiClamp LAP forceps (ERBE GmbH, Tubingen, Germany) and monopolar forceps and we then coagulated them with the BiClamp and made the final section with the monopolar forceps. The uterine arteries were pushed downward to expose the cardinal ligament. Then, the cardinal fibers were incised posteriorly to the uterosacral ligaments, and inferiorly, identifying the lowest limit of dissection as the cervico-vaginal margin using Ligasure. The cervico-vaginal margin was laparoscopically visualized and “palpated” with the laparoscopic instruments; the vagina was incised with monopolar scissors at the precise margin of the cervix. Completion of the colpotomy was performed with Ligasure. After the dissection of the cervix, a Foley catheter was placed into the vagina to avoid pneumoperitoneum loss. The vaginal cuff was laparoscopically sutured with the V-Loc wound closure device (Covidien-Medtronic, Minneapolis, MN, USA); we were careful to include the pubocervical vaginal mucosa and uterosacral ligament in the suture to avoid vaginal prolapse. After the extrafascial hysterectomy, the intact uterus was retrieved from the abdominal cavity through a very low transverse laparotomic incision of about 10 cm to limit operating time, using a wound protector/retractor to protect the incision site, and morcellated with a cold blade scalpel externally to prevent spillage. At the end of the surgery, after the closure of the accessory laparotomy, we laparoscopically checked carefully the abdominal cavity and repeatedly washed it thoroughly . There were no complications; the operating time was approximately 220 min. Intraoperative blood loss was about 50 ml subsequent to a small uterus lesion resulting from the introduction of the first lateral trocar. The final weight of the removed uterus was 5320 g , and the findings of the pathologic examination were consistent with a benign fibroid uterus. The patient was discharged from the hospital on postoperative day 3 in very good condition. The patient follow-up after surgery did not reported any complication connected with the procedure. Fig. 3 a Viewing from above of the abdomen with highlighted ( black circle ) the contour of the large uterus; ( b ) Skin incisions at the end after closure Fig. 4 Uterus after morcellation
4.097656
0.645996
sec[1]/sec[0]/p[0]
en
0.999997
28472966
https://doi.org/10.1186/s12893-017-0248-4
[ "uterus", "uterine", "using", "vaginal", "position", "trocar", "dissection", "ligaments", "cervix", "margin" ]
[ { "code": "GA1Z&XA99N3", "title": "Noninflammatory disorders of uterus, except cervix" }, { "code": "GA01.Z", "title": "Inflammatory disorders of the uterus, except cervix, unspecified" }, { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" }, { "code": "NB92.6", "title": "Injury of uterus" }, { "code": "GC04.1Y", "title": "Other specified fistulae involving female genital tract" }, { "code": "QE11.Z", "title": "Hazardous drug use, unspecified" }, { "code": "6C4Z", "title": "Disorders due to substance use, unspecified" }, { "code": "QE11.3", "title": "Hazardous use of cocaine" }, { "code": "QE11.2", "title": "Hazardous use of sedatives, hypnotics or anxiolytics" }, { "code": "QE11.1", "title": "Hazardous use of cannabis" } ]
=== ICD-11 CODES FOUND === [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified Also known as: Inflammatory disorders of the uterus, except cervix, unspecified | Inflammatory disorders of the uterus, except cervix | inflammatory disease of the uterus | uterine inflammatory disease | uterus inflammation [GA16.Y] Other specified acquired abnormalities of uterus, except cervix Also known as: Other specified acquired abnormalities of uterus, except cervix | Polyp of corpus uteri | intrauterine polyp | polyp of body of uterus | polyp of uterus [NB92.6] Injury of uterus Also known as: Injury of uterus | uterine injury | intrauterine injury NOS | Injury of uterus without open wound into cavity | Injury of uterus with open wound into cavity [GC04.1Y] Other specified fistulae involving female genital tract Also known as: Other specified fistulae involving female genital tract | Other female intestinal-genital tract fistulae | Intestinouterine fistula | enterouterine fistula | Cervicosigmoidal fistula [QE11.Z] Hazardous drug use, unspecified Also known as: Hazardous drug use, unspecified | Hazardous drug use | chronic drug use NOS | chronic IV substance use | drug use nos [6C4Z] Disorders due to substance use, unspecified Also known as: Disorders due to substance use, unspecified | Disorders due to substance abuse | drug use disorder | Bad trips due to drugs [QE11.3] Hazardous use of cocaine Definition: A pattern of cocaine use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of cocaine use, from the amount used on a given occasion, from risky behaviours associated with cocaine use or the context of use, from a harmful route of administration, or from a combination of these. The risk may be related to short-term eff Also known as: Hazardous use of cocaine | cocaine use | intravenous cocaine use | Hazardous use of crack cocaine | crack cocaine use Excludes: Disorders due to use of cocaine [QE11.2] Hazardous use of sedatives, hypnotics or anxiolytics Definition: A pattern of use of sedatives, hypnotics or anxiolytics that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of use of sedatives, hypnotics or anxiolytics, from the amount used on a given occasion, from risky behaviours associated with use of sedatives, hypnotics or anxiolytics or the context of use, from a harmful route Also known as: Hazardous use of sedatives, hypnotics or anxiolytics | Hazardous use of anxiolytics | Hazardous use of hypnotics | hypnotic use | Hazardous use of sedatives Excludes: Disorders due to use of sedatives, hypnotics or anxiolytics [QE11.1] Hazardous use of cannabis Definition: A pattern of cannabis use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals. The increased risk may be from the frequency of cannabis use, from the amount used on a given occasion, from risky behaviours associated with cannabis use or the context of use, from a harmful route of administration, or from a combination of these. The risk may be related to short-term Also known as: Hazardous use of cannabis | marijuana use | cannabis use Excludes: Disorders due to use of cannabis === GRAPH WALKS === --- Walk 1 --- [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i... --CHILD--> [GA01.Y] Other specified inflammatory disorders of the uterus, except cervix --- Walk 2 --- [GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i... --CHILD--> [GA01.0] Acute inflammatory disease of uterus --- Walk 3 --- [GA16.Y] Other specified acquired abnormalities of uterus, except cervix --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix).... --CHILD--> [GA16.0] Endometrial glandular hyperplasia Def: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometr... --- Walk 4 --- [GA16.Y] Other specified acquired abnormalities of uterus, except cervix --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix).... --RELATED_TO--> [?] Caesarean scar defect of uterus Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar... --- Walk 5 --- [NB92.6] Injury of uterus --PARENT--> [NB92] Injury of urinary or pelvic organs --RELATED_TO--> [?] Female Genital Mutilation Def: A condition caused by procedures or other interventions for non-medical purposes. This condition is characterised by the partial or total removal of the external female genitalia or other injury to th... --- Walk 6 --- [NB92.6] Injury of uterus --PARENT--> [NB92] Injury of urinary or pelvic organs --RELATED_TO--> [?] Female Genital Mutilation Def: A condition caused by procedures or other interventions for non-medical purposes. This condition is characterised by the partial or total removal of the external female genitalia or other injury to th...
[ "[GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified\n --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix\n Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i...\n --CHILD--> [GA01.Y] Other specified inflammatory disorders of the uterus, except cervix", "[GA01.Z] Inflammatory disorders of the uterus, except cervix, unspecified\n --PARENT--> [GA01] Inflammatory disorders of the uterus, except cervix\n Def: A spectrum of inflammations involving the Uterus and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Such inflammation can lead to functional i...\n --CHILD--> [GA01.0] Acute inflammatory disease of uterus", "[GA16.Y] Other specified acquired abnormalities of uterus, except cervix\n --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix\n Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....\n --CHILD--> [GA16.0] Endometrial glandular hyperplasia\n Def: A condition of the uterus, caused by chronic, excess oestrogen stimulation due to obesity, anovulation, or oestrogen therapy. This condition is characterised by excessive proliferation of the endometr...", "[GA16.Y] Other specified acquired abnormalities of uterus, except cervix\n --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix\n Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....\n --RELATED_TO--> [?] Caesarean scar defect of uterus\n Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar...", "[NB92.6] Injury of uterus\n --PARENT--> [NB92] Injury of urinary or pelvic organs\n --RELATED_TO--> [?] Female Genital Mutilation\n Def: A condition caused by procedures or other interventions for non-medical purposes. This condition is characterised by the partial or total removal of the external female genitalia or other injury to th...", "[NB92.6] Injury of uterus\n --PARENT--> [NB92] Injury of urinary or pelvic organs\n --RELATED_TO--> [?] Female Genital Mutilation\n Def: A condition caused by procedures or other interventions for non-medical purposes. This condition is characterised by the partial or total removal of the external female genitalia or other injury to th..." ]
GA1Z&XA99N3
Noninflammatory disorders of uterus, except cervix
[ { "from_icd11": "GA01.Z", "icd10_code": "N719", "icd10_title": "Inflammatory disease of uterus, unspecified" }, { "from_icd11": "GA01.Z", "icd10_code": "N71", "icd10_title": "Inflammatory disease of uterus, except cervix" }, { "from_icd11": "NB92.6", "icd10_code": "S3763XA", "icd10_title": "Laceration of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S3769XA", "icd10_title": "Other injury of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S3760XA", "icd10_title": "Unspecified injury of uterus, initial encounter" }, { "from_icd11": "NB92.6", "icd10_code": "S376", "icd10_title": "Injury of uterus" }, { "from_icd11": "QE11.Z", "icd10_code": "Z722", "icd10_title": "" }, { "from_icd11": "6C4Z", "icd10_code": "F1910", "icd10_title": "Other psychoactive substance abuse, uncomplicated" }, { "from_icd11": "6C4Z", "icd10_code": "F1911", "icd10_title": "Other psychoactive substance abuse, in remission" }, { "from_icd11": "6C4Z", "icd10_code": "F19129", "icd10_title": "Other psychoactive substance abuse with intoxication, unspecified" }, { "from_icd11": "6C4Z", "icd10_code": "F19121", "icd10_title": "Other psychoactive substance abuse with intoxication delirium" }, { "from_icd11": "6C4Z", "icd10_code": "F1920", "icd10_title": "Other psychoactive substance dependence, uncomplicated" }, { "from_icd11": "6C4Z", "icd10_code": "F19239", "icd10_title": "Other psychoactive substance dependence with withdrawal, unspecified" }, { "from_icd11": "6C4Z", "icd10_code": "F1914", "icd10_title": "Other psychoactive substance abuse with psychoactive substance-induced mood disorder" }, { "from_icd11": "6C4Z", "icd10_code": "F1921", "icd10_title": "Other psychoactive substance dependence, in remission" } ]
N719
Inflammatory disease of uterus, unspecified
A boy aged 6 years and 5 months (client 1) has delayed psychomotor development, including speech development. Based on the psychological examination with the WISC III intellectual test, it was found that his overall performance was in the upper range of mild mental retardation. The verbal component of his intellect was in the range of mild to moderate mental retardation. With proper guidance and provision of a sufficient amount of stimuli in a reasonable measure, it is possible to move into the zone of light mental retardation or into the border zone. In client 1, an overall delay was noticeable for his age. Verbal expression was not developed. Monosyllabic expression in the form of interjections prevailed. Client 1 showed an effort to communicate using gestures and facial expressions. He was spontaneous, proactive, and natural in his communication. He showed limitations in his gross motor skills, especially when walking up and down stairs. He played more in parallel with other children. Except for the verbal component, he was in the border zone between mild and moderate mental functional diversity. There were uneven fluctuations between subtests. Special pedagogical examination: the examination was focused on logopaedic diagnosis. The diagnosis was focused on the assessment of four language levels. All four planes were disrupted, in this case. In the case of the pragmatic level, client 1’s unintelligible speech was noticeable. Client 1’s effort was evident, but if the other person did not understand him, the tension increased. He responded adequately to questions. The lexical–semantic level did not correspond to client 1’s age. Insufficient vocabulary, both active and passive, was evident. However, his speech understanding was not impaired. He used his own jargon, onomatopoeia, and gestures to communicate. The phonetic–phonological level was incomprehensible. He showed no interest in preschool tasks, refused to count, and managed to match colours passively. He made only brief eye contact. This was an overall slower psychomotor development. The entrance examination using the WeeFIM test gave the following results: (self-service) food: level 5—needs supervision; personal hygiene: level 3—moderate assistance; bath and shower: level 1—full assistance; dressing the upper half of the body: level 3—moderate assistance; dressing the lower half of the body: level 4—maximum assistance; toilet use: level 4—maximum assistance; control of urination and defecation: level 3—moderate assistance; (functional mobility) transfers: level 7—complete independence; transfer to the toilet: level 7—complete independence; transfer to bath: level 4—minimal assistance; walking: level 4—moderate assistance; stairs: level 5—supervision; (cognitive abilities) understanding: level 3—moderate assistance; expression: level 2—maximum assistance; social interaction: level 2—maximum assistance; problem solving: level 2—maximum assistance; memory: level 4—minimal assistance. Out of 126 possible points, the client received 66 points in testing. A girl aged 13 years and 4 months (client 2) has a combined functional diversity—hypotonia, hyperkinetic disorder with manifestations of anxiety, and unevenly distributed mental abilities in the range of moderate mental retardation. A phoniatric examination (a hearing examination) was requested at the foster mother’s request. The motivation for the request was client 2’s reduced response to speech at a distance of 4 m. The investigation was focused on the availability of otoacoustic emissions (AOE). The phoniatrist performed an auditory test—an examination of the search reaction, which showed that client 2 reacted bilaterally to weak stimulus intensity, at least from a distance of 2 to 3 m. A pro-master navigator at frequencies of 0.5–4 kHz was chosen to determine the availability of otoacoustic emissions. The resulting audiogram showed that client 2’s hearing was in the normal hearing range. A psychological examination, making use of the WISC III test, confirmed that client 2 was at the upper limit of moderate mental retardation. It also showed that a girl with a combined functional diversity requires a higher level of special educational needs. The verbal component of her intellect was in the middle zone of moderate mental retardation. Weaknesses in both fine and gross motor skills were also found, along with delayed graphomotor development and reduced visual discrimination. A special pedagogical examination showed that client 2 had slightly impaired coordination of movements in the area of gross motor skills, while in the area of fine motor skills she needed a little help when handling small objects, and in the area of tactile perception without visual support, there were significant deficiencies.
3.96875
0.932129
sec[1]/p[1]
en
0.999997
PMC9739072
https://doi.org/10.3390/ijerph192315474
[ "client", "assistance", "mental", "that", "retardation", "maximum", "development", "speech", "range", "verbal" ]
[ { "code": "QF2Z", "title": "Difficulty or need for assistance with unspecified activity" }, { "code": "QF22", "title": "Difficulty or need for assistance with communication" }, { "code": "QF25", "title": "Difficulty or need for assistance with relationships" }, { "code": "QF23", "title": "Difficulty or need for assistance with mobility" }, { "code": "QF20", "title": "Difficulty or need for assistance with learning" }, { "code": "6E8Z", "title": "Mental, behavioural or neurodevelopmental disorders, unspecified" }, { "code": "6A00.Z", "title": "Disorders of intellectual development, unspecified" }, { "code": "6E6Z", "title": "Secondary mental or behavioural syndrome, unspecified" }, { "code": "MB21.4", "title": "Disorientation" }, { "code": "6A2Z", "title": "Schizophrenia or other primary psychotic disorders, unspecified" } ]
=== ICD-11 CODES FOUND === [QF2Z] Difficulty or need for assistance with unspecified activity Also known as: Difficulty or need for assistance with unspecified activity | need for assistance with activities | dependence on care provider | difficulty with activities [QF22] Difficulty or need for assistance with communication Also known as: Difficulty or need for assistance with communication | communication difficulty | need for assistance with communication [QF25] Difficulty or need for assistance with relationships Also known as: Difficulty or need for assistance with relationships | difficulty with relationships | need for assistance with relationships | Difficulty or need for assistance with family relationships | Difficulty or need for assistance with formal relationships [QF23] Difficulty or need for assistance with mobility Also known as: Difficulty or need for assistance with mobility | difficulty with mobility | need for assistance due to reduced mobility | need for assistance with mobility | problem with impaired mobility Excludes: Abnormalities of gait or mobility [QF20] Difficulty or need for assistance with learning Also known as: Difficulty or need for assistance with learning | need for assistance with learning | learning difficulty [6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified Also known as: Mental, behavioural or neurodevelopmental disorders, unspecified | Psychiatric disorder | mental disease NOS | mental disorder NOS | mental illness [6A00.Z] Disorders of intellectual development, unspecified Also known as: Disorders of intellectual development, unspecified | Disorders of intellectual development | Mental retardation | Intellectual developmental disorder | Intellectual disability [6E6Z] Secondary mental or behavioural syndrome, unspecified Also known as: Secondary mental or behavioural syndrome, unspecified | organic mental disorders | Secondary mental and behavioural disorders | Mental or behavioural syndromes due to health conditions not classified under mental or behavioural disorders [MB21.4] Disorientation Definition: Impairment in or loss of awareness of the position of the self in relation to place, time, situation, or other persons. In severe cases, the sense of personal identity may also be lost. Also known as: Disorientation | mental confusion NOS [6A2Z] Schizophrenia or other primary psychotic disorders, unspecified Also known as: Schizophrenia or other primary psychotic disorders, unspecified | Unspecified nonorganic psychosis | nonorganic psychosis | confusional psychosis | atypical psychosis === GRAPH WALKS === --- Walk 1 --- [QF2Z] Difficulty or need for assistance with unspecified activity --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF22] Difficulty or need for assistance with communication --- Walk 2 --- [QF2Z] Difficulty or need for assistance with unspecified activity --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF22] Difficulty or need for assistance with communication --- Walk 3 --- [QF22] Difficulty or need for assistance with communication --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --EXCLUDES--> [?] Dependence on enabling machines or devices --- Walk 4 --- [QF22] Difficulty or need for assistance with communication --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --EXCLUDES--> [?] Dependence on enabling machines or devices --- Walk 5 --- [QF25] Difficulty or need for assistance with relationships --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --EXCLUDES--> [?] Dependence on enabling machines or devices --- Walk 6 --- [QF25] Difficulty or need for assistance with relationships --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF22] Difficulty or need for assistance with communication
[ "[QF2Z] Difficulty or need for assistance with unspecified activity\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF22] Difficulty or need for assistance with communication", "[QF2Z] Difficulty or need for assistance with unspecified activity\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF22] Difficulty or need for assistance with communication", "[QF22] Difficulty or need for assistance with communication\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --EXCLUDES--> [?] Dependence on enabling machines or devices", "[QF22] Difficulty or need for assistance with communication\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --EXCLUDES--> [?] Dependence on enabling machines or devices", "[QF25] Difficulty or need for assistance with relationships\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --EXCLUDES--> [?] Dependence on enabling machines or devices", "[QF25] Difficulty or need for assistance with relationships\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF22] Difficulty or need for assistance with communication" ]
QF2Z
Difficulty or need for assistance with unspecified activity
[ { "from_icd11": "QF2Z", "icd10_code": "Z7389", "icd10_title": "Other problems related to life management difficulty" }, { "from_icd11": "QF2Z", "icd10_code": "Z7382", "icd10_title": "Dual sensory impairment" }, { "from_icd11": "QF2Z", "icd10_code": "Z742", "icd10_title": "Need for assistance at home and no other household member able to render care" }, { "from_icd11": "QF2Z", "icd10_code": "Z602", "icd10_title": "Problems related to living alone" }, { "from_icd11": "QF2Z", "icd10_code": "Z748", "icd10_title": "Other problems related to care provider dependency" }, { "from_icd11": "QF2Z", "icd10_code": "Z73", "icd10_title": "Problems related to life management difficulty" }, { "from_icd11": "QF2Z", "icd10_code": "Z738", "icd10_title": "Other problems related to life management difficulty" }, { "from_icd11": "QF2Z", "icd10_code": "Z739", "icd10_title": "Problem related to life management difficulty, unspecified" }, { "from_icd11": "QF2Z", "icd10_code": "Z74", "icd10_title": "Problems related to care provider dependency" }, { "from_icd11": "QF2Z", "icd10_code": "Z749", "icd10_title": "Problem related to care provider dependency, unspecified" }, { "from_icd11": "QF23", "icd10_code": "Z7401", "icd10_title": "Bed confinement status" }, { "from_icd11": "QF23", "icd10_code": "Z7409", "icd10_title": "Other reduced mobility" }, { "from_icd11": "QF23", "icd10_code": "Z740", "icd10_title": "Reduced mobility" }, { "from_icd11": "6E8Z", "icd10_code": "F99", "icd10_title": "Mental disorder, not otherwise specified" }, { "from_icd11": "6E8Z", "icd10_code": "F488", "icd10_title": "Other specified nonpsychotic mental disorders" } ]
Z7389
Other problems related to life management difficulty
A 54-year-old female patient was admitted to the hospital for 14 days, complaining of fever, headache, nausea, and vomiting. The temperature at the time of admission was 38.5°C. History taking revealed that the patient had undergone a lumbar puncture some days ago in a hospital. The lumbar pressure was 120 mmH 2 O, white blood cell count was 281×106/L, the cerebrospinal fluid protein was 1139 mg/L, cerebrospinal fluid glucose 2.50 mmol/L, and cerebrospinal fluid chloride was 117.8 mmol/L ( Table 1 ). The lady tested positive for serum tuberculosis infection T cell, and a diagnosis of tuberculous meningitis was made. The patient experienced intermittent limb twitching daily to the present admission, accompanied by loss of consciousness. In addition, the patient confessed to having a history of “diabetes” for about half a month. Physical examination was conducted upon admission. The patient had a positive result for the neck resistance test, and the head MRI showed lacunar infarction in the left basal ganglia. A Chest CT scan revealed multiple nodules in both lungs . Organ function tests relating to the liver and kidney returned typical results. The sodium and chloride ion levels were 124.4mmol/L and 92.2mmol/L, respectively. Both HIV antibody and syphilis monitoring tests were negative. A diagnosis of tuberculous meningitis was made, and the patient was given antituberculosis drug therapy comprising isoniazid, rifampicin, and pyrazinamide. Re-examining the lumbar puncture on the second day of admission showed a lumbar pressure of 150 mmH 2 O, white blood cell count was 44×106/L, the cerebrospinal fluid protein was 636 mg/L, cerebrospinal fluid glucose was 5.84 mmol/L, and cerebrospinal fluid chloride was 111.8 mmol/L ( Table 1 ). Cerebrospinal fluid cytology was suggestive of mixed cell response. No abnormalities were seen regarding cryptococcal capsular antigen and acid-fast staining tests, cerebrospinal fluid mNGS (metagenomics next generation sequencing), culture and Gene Xpert MTB/RIF. Similarly, there were no pathogenic microorganisms found in the cerebrospinal fluid. The EEG results showed slowed brain wave frequencies during the awake period, and moderately slow waves (3-5 Hz) appeared intermittently in each lead. After instituting anti-tuberculosis treatment, the clinical symptoms improved rapidly; the headache resolved, but nausea and vomiting occasionally occurred . One week after admission, the lumbar puncture was repeated, giving the following results: lumbar pressure was 75 mmH 2 O, white blood cell count was 42×10 6 /L, cerebrospinal fluid protein was 651 mg/L, cerebrospinal fluid glucose was 6.30 mmol/L, and cerebrospinal fluid chloride was 110.9 mmol/L ( Table 1 ). Re-examination of the cerebrospinal fluid mNGS found no pathogenic microorganisms. Two weeks after admission, the patient had no headache and was discharged from the hospital on oral antituberculosis drugs. However, one week after being discharged from the hospital, the patient was re-admitted to the hospital, complaining of persistent nausea and vomiting. A re-examination of the lumbar puncture showed that the pressure was 100 mmH 2 O, the number of white blood cells was 23×10 6 /L, cerebrospinal fluid protein 504 mg/L, and cerebrospinal fluid chloride was 108.1mmol/L. Blood sodium and chloride ions was 128.5 mmol/L and 90.9 mmol/L, respectively ( Table 1 ). A re-examination of the head MRI showed no typical APS imaging features . The serum AQP4 antibody test (Cytometric Bead Array method) was 1:100, while the fundus examination, visual examination, evoked potential, and spinal cord magnetic resonance was negative. Besides, anti-MOG, anti-GFAP, anti-NMDA, anti-IgG4 antibodies, and autoantibodies were all negative, leading to a definite diagnosis of NMOSD. At the same time, antituberculosis drugs were discontinued. After instituting pulse therapy using 1000 mg of methylprednisolone, nausea and vomiting reduced rapidly. Six days later, the patient was discharged on oral treatment with prednisone. Three months later, the patient’s clinical symptoms did not recur. In addition, five months later, the patient developed blurred vision in one eye during the follow-up. VEP showed prolonged P100 latency and decreased P100 amplitude. The visual field test indicated a superior and temporal visual field defect, AQP4-Ab testing was reviewed, which titer was 1:10. Lumbar pressure 90 mmH 2 O, white blood cell count was 1×10 7 /L, cerebrospinal fluid protein was 312 mg/L, cerebrospinal fluid glucose 6.10 mmol/L, and cerebrospinal fluid chloride was 124.7mmol/L. Therefore, the possibility of optic neuritis was clinically considered, and mycophenolate mofetil was given. The patient’s vision recovered rapidly in a short time after the treatment.
4.015625
0.978516
sec[1]/p[0]
en
0.999997
PMC9585379
https://doi.org/10.3389/fimmu.2022.938492
[ "cerebrospinal", "fluid", "mmol", "lumbar", "chloride", "blood", "cell", "pressure", "white", "protein" ]
[ { "code": "1D01.Z", "title": "Infectious meningitis, unspecified" }, { "code": "8A40.Z", "title": "Multiple sclerosis, unspecified" }, { "code": "MB70.Z", "title": "Clinical findings in cerebrospinal fluid, unspecified" }, { "code": "8D43.0Z", "title": "Encephalopathy due to toxicity, unspecified" }, { "code": "8D65", "title": "Cerebrospinal fluid fistula" }, { "code": "FA36.Z", "title": "Effusion of joint, unspecified" }, { "code": "5C70.0", "title": "Dehydration" }, { "code": "5C78", "title": "Fluid overload" }, { "code": "MG29.Z", "title": "Oedema, unspecified" }, { "code": "ME04.Z", "title": "Ascites, unspecified" } ]
=== ICD-11 CODES FOUND === [1D01.Z] Infectious meningitis, unspecified Also known as: Infectious meningitis, unspecified | Infectious meningitis, not elsewhere classified | acute meningomyelitis | septic meningitis NOS | infectious meningitis NEC [8A40.Z] Multiple sclerosis, unspecified Also known as: Multiple sclerosis, unspecified | Multiple sclerosis | cerebrospinal sclerosis | disseminated sclerosis | generalised multiple sclerosis [MB70.Z] Clinical findings in cerebrospinal fluid, unspecified Also known as: Clinical findings in cerebrospinal fluid, unspecified | Clinical findings in cerebrospinal fluid | cerebrospinal fluid abnormality | nonspecific abnormal findings in cerebrospinal fluid [8D43.0Z] Encephalopathy due to toxicity, unspecified Also known as: Encephalopathy due to toxicity, unspecified | Encephalopathy due to toxicity | toxic encephalopathy | toxic brain fever | toxic brain inflammation [8D65] Cerebrospinal fluid fistula Definition: Cerebrospinal fluid fistula is a condition in which the cerebrospinal fluid (CSF) held in and around the human brain and spinal cord leaks out of the surrounding protective sac, the dura, for no apparent reason or due to several pathological processes. Also known as: Cerebrospinal fluid fistula | Cranial cerebrospinal fluid fistula | Cranial cerebrospinal fluid fistula due to injuries to the head | Cranial cerebrospinal fluid fistula due to surgery or lumbar puncture | Cranial cerebrospinal fluid fistula due to tumour invasion [FA36.Z] Effusion of joint, unspecified Also known as: Effusion of joint, unspecified | Effusion of joint | effusion into joint | effusion of joint, site unspecified | hydrarthrosis [5C70.0] Dehydration Definition: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water intake. Also known as: Dehydration | fluid depletion | anhydration | anhydremia | fluid volume deficit [5C78] Fluid overload Definition: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compartment occurs due to an increase in total body sodium content and a consequent increase in extracellular body water. The mechanism usually stems from compromised regulatory mechanisms for sodium handling as seen in congestive heart failure (CHF), kidney failure, and liver failure. It may also be cause Also known as: Fluid overload | fluid excess | fluid volume excess | hypervolemia | volume excess [MG29.Z] Oedema, unspecified Also known as: Oedema, unspecified | Oedema | dropsy | hydrops | Fluid retention NOS [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS === GRAPH WALKS === --- Walk 1 --- [1D01.Z] Infectious meningitis, unspecified --PARENT--> [1D01] Infectious meningitis, not elsewhere classified Def: A disease of the meninges, caused by an infection.... --CHILD--> [1D01.2] Parasitic or protozoal meningitis --- Walk 2 --- [1D01.Z] Infectious meningitis, unspecified --PARENT--> [1D01] Infectious meningitis, not elsewhere classified Def: A disease of the meninges, caused by an infection.... --PARENT--> [?] Non-viral and unspecified infections of the central nervous system Def: Any condition of the nervous system, caused by an infection with a bacterial, fungal, parasitic or unspecified source.... --- Walk 3 --- [8A40.Z] Multiple sclerosis, unspecified --PARENT--> [8A40] Multiple sclerosis Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre... --CHILD--> [8A40.2] Secondary progressive multiple sclerosis --- Walk 4 --- [8A40.Z] Multiple sclerosis, unspecified --PARENT--> [8A40] Multiple sclerosis Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre... --PARENT--> [?] Multiple sclerosis or other white matter disorders Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission.... --- Walk 5 --- [MB70.Z] Clinical findings in cerebrospinal fluid, unspecified --PARENT--> [MB70] Clinical findings in cerebrospinal fluid --CHILD--> [MB70.1] Abnormal level of hormones in cerebrospinal fluid --- Walk 6 --- [MB70.Z] Clinical findings in cerebrospinal fluid, unspecified --PARENT--> [MB70] Clinical findings in cerebrospinal fluid --CHILD--> [MB70.1] Abnormal level of hormones in cerebrospinal fluid
[ "[1D01.Z] Infectious meningitis, unspecified\n --PARENT--> [1D01] Infectious meningitis, not elsewhere classified\n Def: A disease of the meninges, caused by an infection....\n --CHILD--> [1D01.2] Parasitic or protozoal meningitis", "[1D01.Z] Infectious meningitis, unspecified\n --PARENT--> [1D01] Infectious meningitis, not elsewhere classified\n Def: A disease of the meninges, caused by an infection....\n --PARENT--> [?] Non-viral and unspecified infections of the central nervous system\n Def: Any condition of the nervous system, caused by an infection with a bacterial, fungal, parasitic or unspecified source....", "[8A40.Z] Multiple sclerosis, unspecified\n --PARENT--> [8A40] Multiple sclerosis\n Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre...\n --CHILD--> [8A40.2] Secondary progressive multiple sclerosis", "[8A40.Z] Multiple sclerosis, unspecified\n --PARENT--> [8A40] Multiple sclerosis\n Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre...\n --PARENT--> [?] Multiple sclerosis or other white matter disorders\n Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission....", "[MB70.Z] Clinical findings in cerebrospinal fluid, unspecified\n --PARENT--> [MB70] Clinical findings in cerebrospinal fluid\n --CHILD--> [MB70.1] Abnormal level of hormones in cerebrospinal fluid", "[MB70.Z] Clinical findings in cerebrospinal fluid, unspecified\n --PARENT--> [MB70] Clinical findings in cerebrospinal fluid\n --CHILD--> [MB70.1] Abnormal level of hormones in cerebrospinal fluid" ]
1D01.Z
Infectious meningitis, unspecified
[ { "from_icd11": "1D01.Z", "icd10_code": "G02", "icd10_title": "Meningitis in other infectious and parasitic diseases classified elsewhere" }, { "from_icd11": "1D01.Z", "icd10_code": "G028", "icd10_title": "" }, { "from_icd11": "8A40.Z", "icd10_code": "G35", "icd10_title": "Multiple sclerosis" }, { "from_icd11": "8A40.Z", "icd10_code": "G370", "icd10_title": "Diffuse sclerosis of central nervous system" }, { "from_icd11": "8A40.Z", "icd10_code": "G375", "icd10_title": "Concentric sclerosis [Balo] of central nervous system" }, { "from_icd11": "MB70.Z", "icd10_code": "R839", "icd10_title": "Unspecified abnormal finding in cerebrospinal fluid" }, { "from_icd11": "MB70.Z", "icd10_code": "R83-R89", "icd10_title": "" }, { "from_icd11": "MB70.Z", "icd10_code": "R83", "icd10_title": "Abnormal findings in cerebrospinal fluid" }, { "from_icd11": "8D43.0Z", "icd10_code": "G92", "icd10_title": "Toxic encephalopathy" }, { "from_icd11": "8D65", "icd10_code": "G960", "icd10_title": "Cerebrospinal fluid leak" }, { "from_icd11": "8D65", "icd10_code": "G970", "icd10_title": "Cerebrospinal fluid leak from spinal puncture" }, { "from_icd11": "8D65", "icd10_code": "G96", "icd10_title": "Other disorders of central nervous system" }, { "from_icd11": "FA36.Z", "icd10_code": "M25471", "icd10_title": "Effusion, right ankle" }, { "from_icd11": "FA36.Z", "icd10_code": "M25461", "icd10_title": "Effusion, right knee" }, { "from_icd11": "FA36.Z", "icd10_code": "M25462", "icd10_title": "Effusion, left knee" } ]
G02
Meningitis in other infectious and parasitic diseases classified elsewhere
This case report represents a patient with metastatic melanoma of unknown primary with durable response by conventional chemotherapy and palliative radiation. When comparing prognosis, MUP tends to have a better prognosis than MKP as reported in previous studies [ 2 , 4 – 6 , 8 , 12 ]. The aforementioned hypotheses of unknown primary including an immunological response that leads to spontaneous regression of primary tumor, unrecognized primary tumor, and the occurrence of malignant ectopic nevus cells in the lymph node itself can be considered the etiology of MUP in this patient, who denied previous removal of cutaneous lesion . The data from Dana-Farber Institute reported that the nodal-only metastasis was an independent favorable prognostic factor of MUP compared to metastasis at other sites . This patient had nodal-only metastasis, which explains that this is a favorable clinical feature. The survival outcome of metastatic melanoma according to the molecular alteration was reported in many literatures. For Asian population, the study reported by Kong et al. showed that KIT mutation was an independent prognostic factor for a shorter survival compared to KIT wild type (30 versus 58 months). Another study by Si et al. reported that BRAF and NRAS mutation was associated with worse overall survival compared to wild-type melanoma (33 versus 53 months). Regarding the effect of palliative chemotherapy, the recent studies showed that the response rate was 10–30% consistent with the response rate of this patient. After completion of chemotherapy, the tumors still had a detectable size as same as previous, but after regular visits, the tumors gradually decreased in size based on the interval CT scan. The possibility of clinical response from the conventional chemotherapy can be explained by the genomic profile. The correlation of somatic mutations with the clinical outcome of melanoma patients treated with carboplatin/paclitaxel either with or without sorafenib was reported by Melissa et al. The patients harboring BRAF mutation and wild type seemed to have longer survival than those harboring NRAS mutation (15.6 versus 5.6 months) in a chemotherapy arm . Another study from Jilaveanu et al. reported the association between marker expression and response to sorafenib plus chemotherapy. This study revealed that the patients with high VEGFR-R2/low ERK1/2 expression correlated with a higher response rate compared to those with low VEGFR-R2/high ERK1/2. However, we could not demonstrate the molecular alteration in our patient due to the unaffordable cost of testing at the time of diagnosis and the poor quality of the 5-year archival specimen. In addition to the chemotherapy treatment, the tumors outside the radiation field also decreased in size which could be either the effect of chemotherapy or the abscopal effect of radiation . This late-response phenomenon could be the effect of the immune response rather than of the chemotherapy itself. According to the effect of radiotherapy, irradiation can induce the host antitumor immune response resulting in the late response after treatment as presented in this case . The hypotheses of presentation of vitiligo concomitant with melanoma by the process of autoimmune-related vitiligo were published in many literatures. The several data-reported specific antigens of melanoma such as TRP1 and TRP2 that were shared by normal melanocytes caused immune response to both melanoma and normal melanocytes [ 20 – 22 ]. In addition, some preclinical evidence supported the role of CD8 T-cell-mediated melanoma in vitiligo. The result from an ex vivo study demonstrated that melanoma cells can be killed by CD8 T-cells taken from a vitiligo lesion and T-cells taken from melanoma that caused apoptosis of melanocytes . Moreover, the report from Becker et al. showed the clonotypically identical T-cell infiltration within the melanoma and vitiligo lesion. All those theories can explain the correlation between melanoma and vitiligo. The evidence supports that the presence of vitiligo may be a favorable prognostic factor for survival theoretically due to the immune mechanism responsible for melanocytic proliferation causing depigmentation of skin and spontaneous regression of primary melanoma which were reported [ 26 – 28 ]. One of the studies reported by Nordlund et al. showed that a 10-year survival rate among patients with nonmetastatic melanoma with vitiligo was 49%. This patient who has vitiligo may benefit from this mechanism in terms of disease control. This patient had a tumor response along with vitiligo later after the complete treatment which was probably from the effect of the immune process. The molecular basis in this patient was not yet known to be a prognostic marker for survival.
4.292969
0.741699
sec[2]/p[1]
en
0.999996
29955408
https://doi.org/10.1155/2018/7289896
[ "melanoma", "response", "this", "that", "vitiligo", "chemotherapy", "survival", "effect", "immune", "cells" ]
[ { "code": "2C30.Z", "title": "Melanoma of skin, unspecified" }, { "code": "2B70.Y&XH4846", "title": "Melanoma of oesophagus" }, { "code": "2C30.Y", "title": "Other specified melanoma of skin" }, { "code": "2D0Y&XA4MT3", "title": "Melanoma of uvea" }, { "code": "2D04", "title": "Malignant neoplasm of orbit" }, { "code": "MB20.1", "title": "Coma" }, { "code": "4B4Z", "title": "Diseases of the immune system, unspecified" }, { "code": "MG46", "title": "Systemic inflammatory response syndrome of noninfectious origin" }, { "code": "MB72", "title": "Results of function studies of the nervous system" }, { "code": "MC81.0", "title": "Tachycardia, unspecified" } ]
=== ICD-11 CODES FOUND === [2C30.Z] Melanoma of skin, unspecified Also known as: Melanoma of skin, unspecified | Melanoma of skin | Malignant melanoma of skin | cutaneous melanoma | melanoma NOS [2C30.Y] Other specified melanoma of skin Also known as: Other specified melanoma of skin | Naevoid melanoma, primary | Spitzoid malignant melanoma | Naevoid malignant melanoma | Small cell melanoma [2D04] Malignant neoplasm of orbit Definition: A primary or metastatic malignant neoplasm involving the orbit. Also known as: Malignant neoplasm of orbit | orbital cancer | primary malignant neoplasm of orbit | intraorbital cancer | Malignant neuroepithelial tumours of orbit Excludes: Benign neoplasm of orbital bone | malignant neoplasm of orbital bone [MB20.1] Coma Definition: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Motor responses to noxious stimulation are limited to reflexive behaviour. Etiologies include but are not limited to traumatic, anoxic, infectious, neoplastic, vascular, inflammatory and metabolic brain injuries. Also known as: Coma | comatose | exanimation | Coma, NOS | Unconsciousness, NOS Excludes: Diabetic coma | Hepatic coma | Neonatal coma [4B4Z] Diseases of the immune system, unspecified Also known as: Diseases of the immune system, unspecified | immunological defect NOS | immunity disorder NOS | immune mechanism disorder NOS | immune compromised NOS [MG46] Systemic inflammatory response syndrome of noninfectious origin Also known as: Systemic inflammatory response syndrome of noninfectious origin | systemic inflammatory response syndrome NOS | SIRS -[systemic inflammatory response syndrome] of noninfectious origin | SIRS NOS -[systemic inflammatory response syndrome not otherwise specified] Excludes: Systemic inflammatory response syndrome of infectious origin [MB72] Results of function studies of the nervous system Also known as: Results of function studies of the nervous system | Abnormal results of function studies of central nervous system | abnormal central nervous system function studies | Abnormal brain function studies | Abnormal EEG - [electroencephalogram] [MC81.0] Tachycardia, unspecified Also known as: Tachycardia, unspecified | heart rate fast | rapid heart | Rapid heart beat | increased heart rate === GRAPH WALKS === --- Walk 1 --- [2C30.Z] Melanoma of skin, unspecified --PARENT--> [2C30] Melanoma of skin Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni... --EXCLUDES--> [?] Melanoma of vulva --- Walk 2 --- [2C30.Z] Melanoma of skin, unspecified --PARENT--> [2C30] Melanoma of skin Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni... --EXCLUDES--> [?] Melanoma of vulva --- Walk 3 --- [2C30.Y] Other specified melanoma of skin --PARENT--> [2C30] Melanoma of skin Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni... --EXCLUDES--> [?] Melanoma of penis --- Walk 4 --- [2C30.Y] Other specified melanoma of skin --PARENT--> [2C30] Melanoma of skin Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni... --EXCLUDES--> [?] Melanoma of penis --- Walk 5 --- [2D04] Malignant neoplasm of orbit Def: A primary or metastatic malignant neoplasm involving the orbit.... --EXCLUDES--> [?] Malignant mesenchymal neoplasms Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn... --CHILD--> [?] Osteosarcoma, primary site Def: A usually aggressive malignant bone-forming mesenchymal tumour, predominantly affecting adolescents and young adults. It usually involves bones and less frequently extraosseous sites. It often involve... --- Walk 6 --- [2D04] Malignant neoplasm of orbit Def: A primary or metastatic malignant neoplasm involving the orbit.... --EXCLUDES--> [?] Malignant mesenchymal neoplasms Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn... --CHILD--> [?] Chondrosarcoma, primary site
[ "[2C30.Z] Melanoma of skin, unspecified\n --PARENT--> [2C30] Melanoma of skin\n Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...\n --EXCLUDES--> [?] Melanoma of vulva", "[2C30.Z] Melanoma of skin, unspecified\n --PARENT--> [2C30] Melanoma of skin\n Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...\n --EXCLUDES--> [?] Melanoma of vulva", "[2C30.Y] Other specified melanoma of skin\n --PARENT--> [2C30] Melanoma of skin\n Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...\n --EXCLUDES--> [?] Melanoma of penis", "[2C30.Y] Other specified melanoma of skin\n --PARENT--> [2C30] Melanoma of skin\n Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...\n --EXCLUDES--> [?] Melanoma of penis", "[2D04] Malignant neoplasm of orbit\n Def: A primary or metastatic malignant neoplasm involving the orbit....\n --EXCLUDES--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...\n --CHILD--> [?] Osteosarcoma, primary site\n Def: A usually aggressive malignant bone-forming mesenchymal tumour, predominantly affecting adolescents and young adults. It usually involves bones and less frequently extraosseous sites. It often involve...", "[2D04] Malignant neoplasm of orbit\n Def: A primary or metastatic malignant neoplasm involving the orbit....\n --EXCLUDES--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...\n --CHILD--> [?] Chondrosarcoma, primary site" ]
2C30.Z
Melanoma of skin, unspecified
[ { "from_icd11": "2C30.Z", "icd10_code": "C4359", "icd10_title": "Malignant melanoma of other part of trunk" }, { "from_icd11": "2C30.Z", "icd10_code": "C4372", "icd10_title": "Malignant melanoma of left lower limb, including hip" }, { "from_icd11": "2C30.Z", "icd10_code": "C4339", "icd10_title": "Malignant melanoma of other parts of face" }, { "from_icd11": "2C30.Z", "icd10_code": "C4331", "icd10_title": "Malignant melanoma of nose" }, { "from_icd11": "2C30.Z", "icd10_code": "C4371", "icd10_title": "Malignant melanoma of right lower limb, including hip" }, { "from_icd11": "2C30.Z", "icd10_code": "C4352", "icd10_title": "Malignant melanoma of skin of breast" }, { "from_icd11": "2C30.Z", "icd10_code": "C4322", "icd10_title": "Malignant melanoma of left ear and external auricular canal" }, { "from_icd11": "2C30.Z", "icd10_code": "C4362", "icd10_title": "Malignant melanoma of left upper limb, including shoulder" }, { "from_icd11": "2C30.Z", "icd10_code": "C43112", "icd10_title": "Malignant melanoma of right lower eyelid, including canthus" }, { "from_icd11": "2C30.Z", "icd10_code": "C4330", "icd10_title": "Malignant melanoma of unspecified part of face" }, { "from_icd11": "2C30.Z", "icd10_code": "C4351", "icd10_title": "Malignant melanoma of anal skin" }, { "from_icd11": "2C30.Z", "icd10_code": "C4370", "icd10_title": "Malignant melanoma of unspecified lower limb, including hip" }, { "from_icd11": "2C30.Z", "icd10_code": "C4360", "icd10_title": "Malignant melanoma of unspecified upper limb, including shoulder" }, { "from_icd11": "2C30.Z", "icd10_code": "C4320", "icd10_title": "Malignant melanoma of unspecified ear and external auricular canal" }, { "from_icd11": "2C30.Z", "icd10_code": "C439", "icd10_title": "Malignant melanoma of skin, unspecified" } ]
C4359
Malignant melanoma of other part of trunk
A 48-year-old female was admitted to the authors’ department for episodic loss of consciousness with twitching of extremities for 5 hours. The patient was admitted to the hospital 5 hours ago; loss of consciousness occurred during mealtime, accompanied by limb twitching, limb tonicity, manifested by double eye hanging, double upper limb flexion, accompanied by lip cyanosis, no foaming at the mouth, diarrhea, no tongue bite, recurrent symptoms, consciousness did not return during the convulsions, cranial Computed tomography showed that the right temporal lobe deep hypodense foci, bilateral posterior horn of the ventricle, occipital, parietal cortex patchy hypodense shadow, considered persistent epilepsy. The patient was given mechanical ventilation, midazolam, and sodium valproate to control epilepsy, and dopamine treatment for low blood pressure. Physical examination revealed a sedative state, bilateral pupil equal circle, diameter about 2 mm, slow to light reflex, bilateral facial lines symmetrical, bilateral limb tendon reflex decreased, bilateral pathological signs negative, other physical examination did not cooperate. Previous medical history revealed 10 years of history of epilepsy, irregular oral drugs, 10 years of history of diabetes, irregular oral drugs, history of hearing loss, and unknown etiology. His brother died after being diagnosed with “epilepsy” at the age of 2, the cause of which is unknown. Brain magnetic fluid-attenuated inversion recovery showed symmetrical lesions in the bilateral parietal lobe with high signal intensity at the edge and high signal intensity in the bilateral occipital lobe, paraventricular white matter, corona radiata, and the center of semiovale . Electroencephalography showed that 6 to 7 Hz low to medium amplitude theta waves and theta rhythm in the whole conduction in the quiet closed-eye state, interspersed with a small amount of low amplitude fast waves, poor left-right symmetry, poor regulation, and amplitude modulation, and incompatibility between open and closed eyes. In the monitoring, the whole conduction frequency was slowed down, and the low to medium wave amplitude sharp waves in the frontal poles and frontal leads emanated from the right frontal area asynchronously. No clinical seizures were observed during the monitoring . The electromyography of the needle pole showed that there was no obvious myogenic or neurogenic electromyogram change in the examined muscle, and the conduction velocity of the bilateral median nerve, bilateral tibial nerve, and right common peroneal nerve slowed down, the sensory conduction sensory nerve action potential of bilateral median nerve was not elicited, the amplitude of sensory nerve action potential wave of sensory nerve decreased, the latency of F wave of the motor nerve was normal, the amplitude of F wave of tibial nerve decreased, and the latency of H reflex of the tibial nerve was normal. No abnormality was found in cardiac ultrasound and electrocardiogram. The pressure of the cerebrospinal fluid is normal, with cerebrospinal fluid leukocytes of 3 × 10 6 /L (reference range: <8 × 10 6 /L), an elevated lactic acid (8.30 mmol/L), a normal adenosine dehydrogenase (0.77 U/L), an normal protein (0.28 g/L), and normal glucose (2.96 mmol/L). Virus encephalitis was also initially considered because of the symptoms of epilepsy. However, the analysis of cerebrospinal fluid metagenomic next-generation sequencing did not detect virus sequence numbers. Her cerebrospinal fluid and serum oligoclonal bands are negative. The results of macroeconomic deoxyribonucleic acid (DNA) and RNA detection of pathogenic microorganisms in cerebrospinal fluid were negative. Autoimmune antibodies, including anti-N-methyl-D-aspartate, anti-glial fibrillary acidic protein, anti-α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid 1, anti-α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid 2, anti-gamma-aminobutyric acidβ, leucine-rich glioma-inactivated 1, anti-contactin-associated protein-like 2, anti-glutamic acid decarboxylase 65-kilodalton isoform were negative in cerebrospinal fluid and serum. Blood routine test showed that hemoglobin decreased (90 g/L), creatine kinase was 1258 U/L, creatine kinase isoenzyme was 40.2 U/L, pituitary function showed hypothyroidism, insulin-like growth factor decreased, glycosylated hemoglobin was 11.7%, blood lactic acid was 5.81 mmol/L, homocysteine was 20.998 µmol/L. The antibody against paraneoplastic neurological syndrome was negative. Autoimmune thyroid antibody, antinuclear antibody spectrum, antineutrophil cytoplasmic antibodies, anti-double-stranded DNA antibody, anticardiolipin antibody, immunoglobulin, anti-streptococcal hemolysin, compliment, and tumor markers were not significantly abnormal.
4.152344
0.970703
sec[1]/p[0]
en
0.999997
PMC10158904
https://doi.org/10.1097/MD.0000000000033725
[ "nerve", "anti", "fluid", "amplitude", "cerebrospinal", "acid", "epilepsy", "antibody", "limb", "that" ]
[ { "code": "8C1Z", "title": "Mononeuropathy of unspecified site" }, { "code": "ND56.4", "title": "Injury of nerve of unspecified body region" }, { "code": "8B80", "title": "Disorders of olfactory nerve" }, { "code": "8C0Z", "title": "Polyneuropathy, unspecified" }, { "code": "9C40.Z", "title": "Disorder of the optic nerve, unspecified" }, { "code": "JA86.Y", "title": "Maternal care for other specified fetal problems" }, { "code": "MB23.1", "title": "Antisocial behaviour" }, { "code": "3B4Z", "title": "Coagulation defects, unspecified" }, { "code": "4A45.Z", "title": "Antiphospholipid syndrome, unspecified" }, { "code": "4A43.Y", "title": "Other specified overlap non-organ specific systemic autoimmune disease" } ]
=== ICD-11 CODES FOUND === [8C1Z] Mononeuropathy of unspecified site Also known as: Mononeuropathy of unspecified site | inflammation of nerve NOS | nerve condition NOS | neuritis NOS | nerve disease NOS [ND56.4] Injury of nerve of unspecified body region Also known as: Injury of nerve of unspecified body region | injuries to nerves, nerve plexuses and roots | injury to nerves, unspecified site | nerve damage NOS | Injury of nerve NOS Excludes: multiple injuries of nerves NOS [8B80] Disorders of olfactory nerve Also known as: Disorders of olfactory nerve | disorders of olfactory [1st] nerve | disorders of the first nerve | first cranial nerve disorder | disease of first cranial nerve Includes: Disorder of 1st cranial nerve Excludes: Idiopathic anosmia | Idiopathic parosmia [8C0Z] Polyneuropathy, unspecified Also known as: Polyneuropathy, unspecified | multiple neuropathy | peripheral neuropathy NOS | peripheral polyneuropathy | multiple peripheral neuritis [9C40.Z] Disorder of the optic nerve, unspecified Also known as: Disorder of the optic nerve, unspecified | Disorder of the optic nerve | disease of optic cranial nerve | disease of optic nerve | disease of second cranial nerve [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome [4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome === GRAPH WALKS === --- Walk 1 --- [8C1Z] Mononeuropathy of unspecified site --PARENT--> [?] Mononeuropathy --CHILD--> [8C10] Mononeuropathies of upper limb Def: Damage to a single nerve or nerve group of the upper limb (not including central nervous structures such as the brain, brainstem or spinal cord), resulting in a loss of movement, sensation and/or auto... --- Walk 2 --- [8C1Z] Mononeuropathy of unspecified site --PARENT--> [?] Mononeuropathy --CHILD--> [8C10] Mononeuropathies of upper limb Def: Damage to a single nerve or nerve group of the upper limb (not including central nervous structures such as the brain, brainstem or spinal cord), resulting in a loss of movement, sensation and/or auto... --- Walk 3 --- [ND56.4] Injury of nerve of unspecified body region --EXCLUDES--> [?] Injuries of nerves involving multiple body regions --PARENT--> [?] Other injuries involving multiple body regions, not elsewhere classified --- Walk 4 --- [ND56.4] Injury of nerve of unspecified body region --EXCLUDES--> [?] Injuries of nerves involving multiple body regions --EXCLUDES--> [?] Injuries of nerves and spinal cord involving other multiple body regions --- Walk 5 --- [8B80] Disorders of olfactory nerve --EXCLUDES--> [?] Anosmia --PARENT--> [?] Disturbances of smell or taste Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste.... --- Walk 6 --- [8B80] Disorders of olfactory nerve --EXCLUDES--> [?] Parosmia --PARENT--> [?] Disturbances of smell or taste Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....
[ "[8C1Z] Mononeuropathy of unspecified site\n --PARENT--> [?] Mononeuropathy\n --CHILD--> [8C10] Mononeuropathies of upper limb\n Def: Damage to a single nerve or nerve group of the upper limb (not including central nervous structures such as the brain, brainstem or spinal cord), resulting in a loss of movement, sensation and/or auto...", "[8C1Z] Mononeuropathy of unspecified site\n --PARENT--> [?] Mononeuropathy\n --CHILD--> [8C10] Mononeuropathies of upper limb\n Def: Damage to a single nerve or nerve group of the upper limb (not including central nervous structures such as the brain, brainstem or spinal cord), resulting in a loss of movement, sensation and/or auto...", "[ND56.4] Injury of nerve of unspecified body region\n --EXCLUDES--> [?] Injuries of nerves involving multiple body regions\n --PARENT--> [?] Other injuries involving multiple body regions, not elsewhere classified", "[ND56.4] Injury of nerve of unspecified body region\n --EXCLUDES--> [?] Injuries of nerves involving multiple body regions\n --EXCLUDES--> [?] Injuries of nerves and spinal cord involving other multiple body regions", "[8B80] Disorders of olfactory nerve\n --EXCLUDES--> [?] Anosmia\n --PARENT--> [?] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....", "[8B80] Disorders of olfactory nerve\n --EXCLUDES--> [?] Parosmia\n --PARENT--> [?] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste...." ]
8C1Z
Mononeuropathy of unspecified site
[ { "from_icd11": "8C1Z", "icd10_code": "G59", "icd10_title": "Mononeuropathy in diseases classified elsewhere" }, { "from_icd11": "8C1Z", "icd10_code": "G598", "icd10_title": "" }, { "from_icd11": "ND56.4", "icd10_code": "T144", "icd10_title": "" }, { "from_icd11": "8B80", "icd10_code": "G520", "icd10_title": "Disorders of olfactory nerve" }, { "from_icd11": "8C0Z", "icd10_code": "G629", "icd10_title": "Polyneuropathy, unspecified" }, { "from_icd11": "8C0Z", "icd10_code": "G53", "icd10_title": "Cranial nerve disorders in diseases classified elsewhere" }, { "from_icd11": "8C0Z", "icd10_code": "G538", "icd10_title": "" }, { "from_icd11": "9C40.Z", "icd10_code": "H47012", "icd10_title": "Ischemic optic neuropathy, left eye" }, { "from_icd11": "9C40.Z", "icd10_code": "H47099", "icd10_title": "Other disorders of optic nerve, not elsewhere classified, unspecified eye" }, { "from_icd11": "9C40.Z", "icd10_code": "H47091", "icd10_title": "Other disorders of optic nerve, not elsewhere classified, right eye" }, { "from_icd11": "9C40.Z", "icd10_code": "H47093", "icd10_title": "Other disorders of optic nerve, not elsewhere classified, bilateral" }, { "from_icd11": "9C40.Z", "icd10_code": "H47019", "icd10_title": "Ischemic optic neuropathy, unspecified eye" }, { "from_icd11": "9C40.Z", "icd10_code": "H47013", "icd10_title": "Ischemic optic neuropathy, bilateral" }, { "from_icd11": "9C40.Z", "icd10_code": "H47011", "icd10_title": "Ischemic optic neuropathy, right eye" }, { "from_icd11": "9C40.Z", "icd10_code": "H47021", "icd10_title": "Hemorrhage in optic nerve sheath, right eye" } ]
G59
Mononeuropathy in diseases classified elsewhere
Two affected sisters were born at term to healthy first-cousin parents from Saudi Arabia. The pregnancy with Patient 1 was complicated by gestational diabetes. Muscular hypotonia was noted at birth. Feeding problems became apparent during the newborn period. She suffered from recurrent aspiration pneumonia and dysphagia from the first month of life, requiring gavage feeding from 1 year of age. Motor development was severely delayed, and the patient did not achieve early developmental milestones such as head control, rolling over, and crawling (Table 1 ). A physical examination at age 3 years revealed a high palate, myopathic facies, severe distal muscle weakness, generalized amyotrophy, bilateral ankle flexion contractures , and severe global developmental delay. Patient 1 was unable to stand, sit, eat, or drink without support at age 3 years. Her speech was limited to repeating single words in Arabic and German. Neurometabolic screening tests (tandem mass spectrometry of amino and organic acids, lactate, ammonia) and first-line genetic analyses (karyotyping, muscular dystrophy gene panel) were inconclusive. Serum CPK levels were normal. Cranial MRI revealed a diffuse T 2 -hyperintensity, predominantly affecting the subcortical white matter. Structural abnormalities were ruled out. MR spectroscopy was normal. A muscle biopsy was not performed. The younger sister of the patient (Patient 2) presented in a similar way but was more severely affected at the age of 2 years. Table 1 Genetic and clinical features of our patients with SPTBN4 variants. Symptoms are encoded according to Human Phenotype Ontology (HPO) . Characteristics and symptoms HPO Pat 1, Fam A (this report) Pat 2, Fam A (this report) Pat 3, Fam B (this report) Pat 4, Fam C (this report) Pat 5, Fam D (this report) Mutation in SPTBN4 c.3375_3393del p. c.3375_3393del p. c.737G>C p.(Arg246Pro) c.1247del p.(Leu417Tyrfs*5) c.1149dup p.(Asn384Glnfs*17) / g.(?_41,001,394)_(41,011,375_?)del ACMG variant classification PVS1 PVS1 PM2 PVS1 PVS1 Ethnicity Saudi Arabia Saudi Arabia Afghanistan Iran (Kurdish) Chile (Latin American) Gender Female Female Female Female Female Consanguinity Y Y Y Y N Zygosity Hom Hom Hom Hom Comp Het Head Myopathic facies HP:0002058 Y Y Y Y Y Poor head control HP:0002421 Y Y Y Y Y High palate HP:0000218 Y Y Y Y N Sensorineural hearing impairment HP:0000407 N (clinically) N (clinically) Y N (clinically) Y Absent brainstem auditory responses HP:0004463 ND ND Y ND N Scoliosis HP:0002650 N N N Y Y Respiratory and chest Recurrent infections due to aspiration HP:0004891 Y Y Y Y Y Gastronintestinal Feeding difficulties HP:0011968 Y Y Y Y Y Poor suck HP:0002033 Y Y Y Y Y Dysphagia HP:0002015 Y Y Y Y Y Gastroesophageal reflux HP:0002020 U U Y Y Y Gastrostomy tube feeding in infancy HP:0011471 Y Y Y N Y Skeletal Ankle contracture HP:0006466 N N N Y Y Neurologic Neonatal hypotonia HP:0001319 Y Y Y Y Y Generalized hypotonia HP:0001290 Y Y Y Y Y Generalized muscle atrophy HP:0009055 Y Y N Y Y Distal limb muscle atrophy HP:0003693 Y Y N Y Y Choreoathetoid movements HP:0001266 N N Y N N Abnormality of the cerebral white matter HP:0002500 Y ND N ND N Demyelinating peripheral neuropathy HP:0003448 N N N N N Peripheral axonal neuropathy HP:0003477 N N N N Y Type 1 muscle fiber atrophy HP:0011807 ND ND Y ND Y Type 2 muscle fiber atrophy HP:0003554 ND ND N ND Y Areflexia HP:0001284 Y Y N Y Y Delayed gross motor development HP:0002194 Y Y Y Y Y Horizontal nystagmus HP:0000666 N N Y Y N EEG abnormality HP:0002353 ND ND Y ND Y Absent speech HP:0001344 Y Y Y Y Y Prenatal manifestation Premature birth (<37 weeks of gestation) HP:0001622 N N N N N Fig. 1 Clinical images of the patients and family trees. A Patient 2 (II.2) from Family A at age 2.5 years. B Note the tented upper lip vermillion, her mask-like facies, and the high palate. C Pedigree of Family A. D Patient 3 (II.2) from Family B at age 5. Note the lack of head control, choreoathetoid arm movements, and muscular hypotonia causing slip through when held in vertical position under the armpits. E Pedigree of Family B. F , G Patient 4 (II.2) from Family C at age 4 years. Note severe dystrophy due to feeding difficulties and unavailability of gastric tube feeding, myopathic facies, and severe muscle weakness with frog-leg posture. Her brother (II.1) passed away from aspiration pneumonia and had a similar phenotype. H Pedigree of Family C. I , J Patient 5 from Family D, I shows the severe muscle hypotonia, J depicts the same patient at 6 years not able to stand independently. K Pedigree of Family D. L EEG from Patient 5 at age 6 years shows generalized epileptic activity. No clinical seizures were observed in a 24-h video EEG recording. The parents had never observed any type of fits or seizures.
4.203125
0.564941
sec[2]/sec[0]/sec[0]/p[0]
en
0.999997
33772159
https://doi.org/10.1038/s41431-021-00846-5
[ "family", "muscle", "feeding", "hypotonia", "this", "head", "facies", "atrophy", "pedigree", "saudi" ]
[ { "code": "QE70.Z", "title": "Problems related to primary support group, including family circumstances, unspecified" }, { "code": "8C74.1Z", "title": "Periodic paralysis, unspecified" }, { "code": "2B90.Y", "title": "Other specified malignant neoplasms of colon" }, { "code": "EE61", "title": "Superficial fibromatoses" }, { "code": "9B70", "title": "Inherited retinal dystrophies" }, { "code": "FB3Z", "title": "Disorders of muscles, unspecified" }, { "code": "FB32.Y", "title": "Other specified disorders of muscles" }, { "code": "8C70.Z", "title": "Muscular dystrophy, unspecified" }, { "code": "FB32.2Z", "title": "Ischaemic infarction of muscle, unspecified" }, { "code": "FB56.2", "title": "Myalgia" } ]
=== ICD-11 CODES FOUND === [QE70.Z] Problems related to primary support group, including family circumstances, unspecified Also known as: Problems related to primary support group, including family circumstances, unspecified | Problems related to primary support group, including family circumstances | family problem | problem related to primary support group | Problem related to gambling in the family [8C74.1Z] Periodic paralysis, unspecified Also known as: Periodic paralysis, unspecified | Periodic paralysis | Westphal disease | periodic myotonia | myoplegic dystrophy [2B90.Y] Other specified malignant neoplasms of colon Also known as: Other specified malignant neoplasms of colon | Neuroendocrine neoplasm of colon | Colon endocrine neoplasm | Neuroendocrine carcinoma of colon | NEC - [neuroendocrine carcinoma] of colon [EE61] Superficial fibromatoses Also known as: Superficial fibromatoses | Pachydermodactyly | Camptodactyly or streblodactyly | Familial camptodactyly | Sporadic camptodactyly [9B70] Inherited retinal dystrophies Also known as: Inherited retinal dystrophies | hereditary retinal dystrophies | Amaurosis - hypertrichosis | Autosomal dominant late-onset retinal degeneration | Bothnia retinal dystrophy Includes: Leber congenital amaurosis | Stargardt disease | Vitreoretinal dystrophy [FB3Z] Disorders of muscles, unspecified Also known as: Disorders of muscles, unspecified | disorder of muscle, unspecified | muscle disease | muscular disease | muscular disorder [FB32.Y] Other specified disorders of muscles Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia [8C70.Z] Muscular dystrophy, unspecified Also known as: Muscular dystrophy, unspecified | Muscular dystrophy | Gower's muscular dystrophy | progressive musclular dystrophy | pseudohypertrophic atrophy [FB32.2Z] Ischaemic infarction of muscle, unspecified Also known as: Ischaemic infarction of muscle, unspecified | Ischaemic infarction of muscle | muscle infarction [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain === GRAPH WALKS === --- Walk 1 --- [QE70.Z] Problems related to primary support group, including family circumstances, unspecified --PARENT--> [QE70] Problems related to primary support group, including family circumstances --CHILD--> [QE70.2] Dependent relative needing care at home --- Walk 2 --- [QE70.Z] Problems related to primary support group, including family circumstances, unspecified --PARENT--> [QE70] Problems related to primary support group, including family circumstances --EXCLUDES--> [?] Problems associated with upbringing --- Walk 3 --- [8C74.1Z] Periodic paralysis, unspecified --PARENT--> [8C74.1] Periodic paralysis Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or... --CHILD--> [8C74.11] Hyperkalaemic periodic paralysis Def: Hyperkalaemic periodic paralysis (HyperPP) is a muscle disorder characterised by episodic attacks of muscle weakness associated with an increase in serum potassium concentration.... --- Walk 4 --- [8C74.1Z] Periodic paralysis, unspecified --PARENT--> [8C74.1] Periodic paralysis Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or... --CHILD--> [8C74.1Y] Other specified periodic paralysis --- Walk 5 --- [2B90.Y] Other specified malignant neoplasms of colon --PARENT--> [2B90] Malignant neoplasms of colon Def: Primary malignant neoplasms arising in the colon.... --RELATED_TO--> [?] Gastrointestinal stromal tumour of colon Def: This is a malignant mesenchymal tumour that arises from cells lining the large intestine. It is generally immunohitochemically positive for KIT (CD117), phenotypically paralleling Cajal-cell different... --- Walk 6 --- [2B90.Y] Other specified malignant neoplasms of colon --PARENT--> [2B90] Malignant neoplasms of colon Def: Primary malignant neoplasms arising in the colon.... --CHILD--> [2B90.1] Malignant neoplasm of descending colon and splenic flexure of colon
[ "[QE70.Z] Problems related to primary support group, including family circumstances, unspecified\n --PARENT--> [QE70] Problems related to primary support group, including family circumstances\n --CHILD--> [QE70.2] Dependent relative needing care at home", "[QE70.Z] Problems related to primary support group, including family circumstances, unspecified\n --PARENT--> [QE70] Problems related to primary support group, including family circumstances\n --EXCLUDES--> [?] Problems associated with upbringing", "[8C74.1Z] Periodic paralysis, unspecified\n --PARENT--> [8C74.1] Periodic paralysis\n Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or...\n --CHILD--> [8C74.11] Hyperkalaemic periodic paralysis\n Def: Hyperkalaemic periodic paralysis (HyperPP) is a muscle disorder characterised by episodic attacks of muscle weakness associated with an increase in serum potassium concentration....", "[8C74.1Z] Periodic paralysis, unspecified\n --PARENT--> [8C74.1] Periodic paralysis\n Def: Rare group of neuromuscular disorders that are associated with defects in ion channels. Characterized by intermittent episodes of severe weakness of the limbs usually after heavy exercise, fasting, or...\n --CHILD--> [8C74.1Y] Other specified periodic paralysis", "[2B90.Y] Other specified malignant neoplasms of colon\n --PARENT--> [2B90] Malignant neoplasms of colon\n Def: Primary malignant neoplasms arising in the colon....\n --RELATED_TO--> [?] Gastrointestinal stromal tumour of colon\n Def: This is a malignant mesenchymal tumour that arises from cells lining the large intestine. It is generally immunohitochemically positive for KIT (CD117), phenotypically paralleling Cajal-cell different...", "[2B90.Y] Other specified malignant neoplasms of colon\n --PARENT--> [2B90] Malignant neoplasms of colon\n Def: Primary malignant neoplasms arising in the colon....\n --CHILD--> [2B90.1] Malignant neoplasm of descending colon and splenic flexure of colon" ]
QE70.Z
Problems related to primary support group, including family circumstances, unspecified
[ { "from_icd11": "QE70.Z", "icd10_code": "Z6379", "icd10_title": "Other stressful life events affecting family and household" }, { "from_icd11": "QE70.Z", "icd10_code": "Z6372", "icd10_title": "Alcoholism and drug addiction in family" }, { "from_icd11": "QE70.Z", "icd10_code": "Z638", "icd10_title": "Other specified problems related to primary support group" }, { "from_icd11": "QE70.Z", "icd10_code": "Z639", "icd10_title": "Problem related to primary support group, unspecified" }, { "from_icd11": "QE70.Z", "icd10_code": "Z637", "icd10_title": "Other stressful life events affecting family and household" }, { "from_icd11": "8C74.1Z", "icd10_code": "G723", "icd10_title": "Periodic paralysis" }, { "from_icd11": "EE61", "icd10_code": "F54", "icd10_title": "Psychological and behavioral factors associated with disorders or diseases classified elsewhere" }, { "from_icd11": "9B70", "icd10_code": "H3552", "icd10_title": "Pigmentary retinal dystrophy" }, { "from_icd11": "9B70", "icd10_code": "H3550", "icd10_title": "Unspecified hereditary retinal dystrophy" }, { "from_icd11": "9B70", "icd10_code": "H3553", "icd10_title": "Other dystrophies primarily involving the sensory retina" }, { "from_icd11": "9B70", "icd10_code": "H3554", "icd10_title": "Dystrophies primarily involving the retinal pigment epithelium" }, { "from_icd11": "9B70", "icd10_code": "H355", "icd10_title": "Hereditary retinal dystrophy" }, { "from_icd11": "FB3Z", "icd10_code": "M60831", "icd10_title": "Other myositis, right forearm" }, { "from_icd11": "FB3Z", "icd10_code": "M60869", "icd10_title": "Other myositis, unspecified lower leg" }, { "from_icd11": "FB3Z", "icd10_code": "M60811", "icd10_title": "Other myositis, right shoulder" } ]
Z6379
Other stressful life events affecting family and household
Knee radiographs showed diffuse osteopenia, marked fraying and widening of the distal femoral and proximal tibial/fibular metaphyses as shown in Fig. 1 a, c, Fig. 2 a and c. The Vitamin D, 25-OH levels in Twin A and Twin B were low at 17.5 nmol/L and 15 nmol/L respectively. They both had elevated parathyroid hormone (PTH) levels of 47.3 pmol/L and 36.6 pmol/L respectively, low phosphorus, and appropriately elevated Vitamin D, 1,25-Dihydroxy levels of 235.2 pmol/L and 256.8 pmol/L (98 pg/mL and 107 pg/mL respectively). Alkaline phosphatase levels were elevated at 1137 and 1640 U/L respectively. Bone specific alkaline phosphatase levels were elevated at 241.4 μg/L and 405 μg/L respectively (reference range 25.4–124 μg/L). Vitamin D 2 50,000 IU weekly was initiated. Both twins developed hypocalcemia after initiation of Vitamin D supplements. Serum total calcium levels decreased from 2.18 mmol/L to 1.95 mmol/L and 2.08 mmol/L to 1.65 mmol/L respectively. Activated Vitamin D (calcitriol) was initiated for hypocalcemia and then discontinued when serum total calcium levels and PTH levels were improving and urinary calcium excretion was noted to trend up, although still within the normal range. Details of the treatment regimen are shown in Table 1 . Fig. 1 Twin A knee radiographs. AP view ( a ) before treatment ( b ) after treatment. Lateral view ( c ) before treatment and ( d ) after treatment. a and c show diffuse osteopenia, fraying and widening of metaphyses. b and d demonstrate improvement in rickets Fig. 2 Twin B knee radiographs. AP view ( a ) before treatment ( b ) after treatment. Lateral view ( c ) before treatment and ( d ) after treatment. a and c show diffuse osteopenia, fraying and widening of metaphyses. b and d demonstrate improvement in rickets Table 1 Metabolic bone labs and treatment regimens in Twin A and B (Conventional unit values are represented in parentheses) Time Twin Vitamin D, 25-Hydroxy: 75–250 nmol/L (30–100 ng/mL) Total Calcium, serum: 2.13–2.65 mmol/L (8.5–10.6 mg/dL) Phosphorus: 1.45–2.16 Mmol/L (4.5–6.7 mg/dL) PTH, intact 1.6–6.9 pmol/L (15–65 pg/mL) Alkaline Phosphatase 104–345 U/L Treatment comments Day 0 A 17.5 (7) 2.18 (8.7) 0.77 (2.4) 47.3 (446) 964 Started Ergocalciferol 50,000 IU weekly and Calcium carbonate (Ca carb) elemental Ca at 50 mg/kg/day B 15 (6) 2.08 (8.3) 0.74 (2.3) 36.6 (345) 1367 Day 5 A 1.95 (7.8) 0.90 (2.8) 40.4 (381) 599 Started Calcitriol 0.2 mcg bid due to drop in serum total calcium levels and elevated PTH levels. Increased Ca carb to 100 mg/kg/day. Started sodium phosphate 2 mmol.kg/day. B 1.65 (6.6) 0.94 (2.9) 51.8 (488) 923 Day 7 A 2.10 (8.4) 0.94 (2.9) 46.3 (436) 610 Increased Calcitriol dose to 0.4 mcg bid due to persistent hypocalcemia (Twin A ionized Ca 0.99 and Twin B iCa 0.92. (normal 1.14–1.40 mmol/L), further increase in PTH levels. Urine Ca/Creatinine ratio: Twin A- 0.08; Twin B- 0.1 (normal 0.6) B 1.78 (7.1) 1.10 (3.4) 65.6 (618) 1014 Day 10 A 2.2 (8.8) 0.77 (2.4) 39.5 (372) 692 Decreased Calcitriol to 0.4 mcg qd and discontinued Sodium phosphate. (serum phos trending down due to additional phos possibly stimulating FGF23 and further exacerbating phosphaturia. Underlying issue for low phos is secondary hyperparathyroidism from Vitamin D deficiency) B 1.93 (7.7) 0.87 (2.7) 48.8 (460) 1113 Week 3 A 2.38 (9.5) 0.68 (2.1) 33.1 (312) 878 Discontinued Calcitriol as serum total calcium levels and PTH were improving. Increased Ergocalciferol to 50,000 IU two times/week as PTH still elevated after 3 doses of Vitamin D 2 . Decreased Calcium carb to 50 mg/kg/day. Discharged to home. B 2.33 (9.3) 0.84 (2.6) 36.2 (341) 1759 Week 5 A 15 (6) 2.50 (10) 0.61 (1.9) 12.3 (116) 755 Twins were readmitted for G tube placement and liver biopsy. They missed Ergocalciferol doses at home. Increased Ergocalciferol to 50,000 IU three times/week Restarted Calcitriol at 0.1 mcg bid. Discharged after 1 week. B < 12.5 (< 5) 2.35 (9.4) 0.58 (1.8) 26.8 (253) 1367 Week 10 A 22.5 (9) 2.68 (10.7) 1.74 (5.4) 6.6 (62) 743 Twins were seen outpatient and decreased Calcitriol to 0.1 mcg qd. Family adherent to Vitamin D therapy. Week 12: Internal biliary diversion surgery was performed. B 25 (10) 2.53 (10.1) 1.39 (4.3) 10.5 (99) 849 Week 14 A 32.5 (13) 2.70 (10.8) 1.91 (5.9) 1.4 (13) 341 Discontinued Calcitriol and decreased Ca to 30 mg/kg/day. Continued Ergocalciferol 50,000 IU three times/week. Urine Ca/Creat: Twin A- 0.21; Twin B 0.26 B 40 (16) 2.85 (11.4) 1.81 (5.6) 2.0 (19) 333 Week 15 A 2.55 (10.2) 1.74 (5.4) 2.9 (27) 287 Switched to Ergocalciferol 16,000 IU daily and continued Ca carb at 30 mg/kg/day for 2 weeks following which they were switched to maintenance dose of Vitamin D 3 2000 IU daily and 25-OH Vitamin D levels were monitored. B 2.53 (10.1) 1.94 (6) 3.6 (34) 302
4.214844
0.609863
sec[1]/p[2]
en
0.999998
32508937
https://doi.org/10.1186/s13633-020-00079-1
[ "twin", "vitamin", "calcium", "mmol", "calcitriol", "respectively", "serum", "ergocalciferol", "pmol", "total" ]
[ { "code": "JA80.0", "title": "Twin pregnancy" }, { "code": "LD2G", "title": "Conjoined twins" }, { "code": "JA8A.0", "title": "Placental transfusion syndromes" }, { "code": "QA47.3Z", "title": "Twin, born in hospital, unspecified" }, { "code": "QA47.5", "title": "Twin, unspecified as to place of birth" }, { "code": "5B7Z", "title": "Unspecified undernutrition" }, { "code": "5B90.Z", "title": "Unspecified vitamin excesses" }, { "code": "5B55.Z", "title": "Vitamin A deficiency, unspecified" }, { "code": "6C4H.1Z", "title": "Harmful pattern of use of non-psychoactive substances, unspecified" }, { "code": "5B90.Y", "title": "Other specified vitamin excess" } ]
=== ICD-11 CODES FOUND === [JA80.0] Twin pregnancy Also known as: Twin pregnancy | twin complicating pregnancy [LD2G] Conjoined twins Definition: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth. Also known as: Conjoined twins | siamese twin | twin fusion | Thoracopagus | thorax-joined twins [JA8A.0] Placental transfusion syndromes Also known as: Placental transfusion syndromes | placental transfusion | placenta transfusion syndrome | Twin to twin transfusion syndrome | Feto-fetal transfusion syndrome [QA47.3Z] Twin, born in hospital, unspecified Also known as: Twin, born in hospital, unspecified | Twin, born in hospital | twin liveborn infant born in hospital | newborn twin, born in hospital [QA47.5] Twin, unspecified as to place of birth Also known as: Twin, unspecified as to place of birth | liveborn twin infant NOS | newborn twin NOS [5B7Z] Unspecified undernutrition Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS [5B90.Z] Unspecified vitamin excesses Also known as: Unspecified vitamin excesses | Vitamin excesses [5B55.Z] Vitamin A deficiency, unspecified Also known as: Vitamin A deficiency, unspecified | Vitamin A deficiency | Hypovitaminosis A [6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified Also known as: Harmful pattern of use of non-psychoactive substances, unspecified | Harmful pattern of use of non-psychoactive substances | harmful use of nonprescribed drugs, non-dependence producing | Abuse of antacids | Abuse of herbal or folk remedies [5B90.Y] Other specified vitamin excess Also known as: Other specified vitamin excess === GRAPH WALKS === --- Walk 1 --- [JA80.0] Twin pregnancy --PARENT--> [JA80] Maternal care related to multiple gestation --EXCLUDES--> [?] Maternal care related to complications specific to multiple gestation --- Walk 2 --- [JA80.0] Twin pregnancy --PARENT--> [JA80] Maternal care related to multiple gestation --EXCLUDES--> [?] Maternal care related to complications specific to multiple gestation --- Walk 3 --- [LD2G] Conjoined twins Def: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth.... --PARENT--> [?] Multiple developmental anomalies or syndromes Def: Complex developmental anomalies involving more than one body system... --CHILD--> [LD21] Syndromes with eye anomalies as a major feature Def: Any syndrome caused by failure of one or both eyes to correctly develop during the antenatal period.... --- Walk 4 --- [LD2G] Conjoined twins Def: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth.... --PARENT--> [?] Multiple developmental anomalies or syndromes Def: Complex developmental anomalies involving more than one body system... --CHILD--> [LD22] Syndromes with dental anomalies as a major feature --- Walk 5 --- [JA8A.0] Placental transfusion syndromes --PARENT--> [JA8A] Maternal care related to placental disorders --EXCLUDES--> [?] Maternal care related to placenta praevia or low lying placenta Def: A placenta that is implanted over or very near the internal cervical os--total, partial, marginal, low-lying placenta... --- Walk 6 --- [JA8A.0] Placental transfusion syndromes --PARENT--> [JA8A] Maternal care related to placental disorders --CHILD--> [JA8A.0] Placental transfusion syndromes
[ "[JA80.0] Twin pregnancy\n --PARENT--> [JA80] Maternal care related to multiple gestation\n --EXCLUDES--> [?] Maternal care related to complications specific to multiple gestation", "[JA80.0] Twin pregnancy\n --PARENT--> [JA80] Maternal care related to multiple gestation\n --EXCLUDES--> [?] Maternal care related to complications specific to multiple gestation", "[LD2G] Conjoined twins\n Def: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth....\n --PARENT--> [?] Multiple developmental anomalies or syndromes\n Def: Complex developmental anomalies involving more than one body system...\n --CHILD--> [LD21] Syndromes with eye anomalies as a major feature\n Def: Any syndrome caused by failure of one or both eyes to correctly develop during the antenatal period....", "[LD2G] Conjoined twins\n Def: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth....\n --PARENT--> [?] Multiple developmental anomalies or syndromes\n Def: Complex developmental anomalies involving more than one body system...\n --CHILD--> [LD22] Syndromes with dental anomalies as a major feature", "[JA8A.0] Placental transfusion syndromes\n --PARENT--> [JA8A] Maternal care related to placental disorders\n --EXCLUDES--> [?] Maternal care related to placenta praevia or low lying placenta\n Def: A placenta that is implanted over or very near the internal cervical os--total, partial, marginal, low-lying placenta...", "[JA8A.0] Placental transfusion syndromes\n --PARENT--> [JA8A] Maternal care related to placental disorders\n --CHILD--> [JA8A.0] Placental transfusion syndromes" ]
JA80.0
Twin pregnancy
[ { "from_icd11": "JA80.0", "icd10_code": "O30043", "icd10_title": "Twin pregnancy, dichorionic/diamniotic, third trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30042", "icd10_title": "Twin pregnancy, dichorionic/diamniotic, second trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30013", "icd10_title": "Twin pregnancy, monochorionic/monoamniotic, third trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30032", "icd10_title": "Twin pregnancy, monochorionic/diamniotic, second trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30033", "icd10_title": "Twin pregnancy, monochorionic/diamniotic, third trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30002", "icd10_title": "Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, second trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30041", "icd10_title": "Twin pregnancy, dichorionic/diamniotic, first trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30001", "icd10_title": "Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30093", "icd10_title": "Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, third trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30003", "icd10_title": "Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30049", "icd10_title": "Twin pregnancy, dichorionic/diamniotic, unspecified trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30039", "icd10_title": "Twin pregnancy, monochorionic/diamniotic, unspecified trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30009", "icd10_title": "Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30099", "icd10_title": "Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, unspecified trimester" }, { "from_icd11": "JA80.0", "icd10_code": "O30019", "icd10_title": "Twin pregnancy, monochorionic/monoamniotic, unspecified trimester" } ]
O30043
Twin pregnancy, dichorionic/diamniotic, third trimester
Considering the lung metastasis and the large right lobe tumor invading the right portal vein, chemotherapy was selected over primary surgery. Lenvatinib (12 mg/day) was applied for two weeks with an anti-HB agent (tenofovir alafenamide). Re-evaluation with contrast-enhanced CT after 2 weeks of lenvatinib administration showed tumor necrosis, the reduction of tumor vascularity, slight shrinkage of pulmonary nodules, and a little extension of portal vein invasion . Grade 2 hypertension was observed 7 days after the initiation of lenvatinib therapy. Levels of AFP and PIVKA-II sharply decreased . From the findings of the portal vein invasion, we were concerned about the possible extension of the invasion to the contralateral branch and then loss of the chance of hepatectomy. Therefore, we decided to do portal vein transection and continue further lenvatinib therapy after that. Even at this moment, the estimated liver remnant volume was not enough (estimated liver remnant volume: 482 mL, 40.3% of total liver volume), and we were reluctant to do an extended right hepatectomy. He underwent a right portal vein transection after 1-week withdrawal from lenvatinib intending for the enlargement of the left lobe while more lenvatinib therapy were added . The laparotomy revealed invasion to the right diaphragm. Enhanced abdominal CT showed left lobe hypertrophy and progression of tumor necrosis 1 month after the transection of the right portal vein . Estimated liver remnant volume after extended right hepatectomy was 42.1% of total liver volume. Although estimated liver volume showed only a slight increase, we decided to perform the operation not to lose the chance of conversion hepatectomy. He underwent an extended right hepatectomy with partial resection of the left medial segment and a part of the right diaphragm 2 months after the initial right portal vein transection . The resected tumor was 5.2 × 3.6 cm in size, and the pathological diagnosis was moderately differentiated hepatocellular carcinoma (pT4pN0M0 pStage IVA, vp3, vv0, b0, p0 UICC 8th) . Intraoperative irrigation cytology was negative, and the resected diaphragm and tumor of right portal vein showed necrotic changes of the carcinoma as well as the absence of viable carcinoma. Non-cancerous liver tissues were noted to be A1F2 based on New Inuyama Classification . The level of AFP and PIVKA-II returned to normal values after the hepatectomy. Although lenvatinib was resumed 1 month after the second operation, he developed grade 2 thrombocytopenia 2 weeks after resumption. This adverse event prompted the halting of lenvatinib administration 1 week after its reduction . Platelet count recovered immediately after halting of lenvatinib. Even after discontinuation of lenvatinib, AFP and PIVKA-II remained within the normal range . Chest CT showed a decrease in size of the nodules after 3 months and subsequent disappearance 6 months (data not shown) after hepatectomy. At 9 months after the hepatectomy and 1 year after diagnosis, the patient is doing well with no tumor recurrence. Fig. 3 Abdominal enhanced CT findings in the course. a – c After two weeks of lenvatinib administration before the portal vein transection. CT showed reduction of tumor vascularity (yellow arrow), and extension of portal vein invasion (red arrowhead), as well as tumor necrosis (red arrowhead). d , e One month after the right portal vein transection. Absent flow in the right portal vein (yellow arrow), enlargement of the left lateral segment (red arrowhead), and progression of tumor necrosis (blue arrowhead) Fig. 4 Perioperative changes in AFP and PIVKA-II levels. Levels of AFP and PIVKA-II sharply decreased with lenvatinib administration and returned to normal values after the hepatectomy. AFP and PIVKA-II remained within the normal range after discontinuation of lenvatinib Fig. 5 Surgical images. a The operation of right portal vein transection. Light blue arrows show the stumps of right portal vein. Red arrow shows the stump of cystic artery. Yellow arrow shows the stump of cystic duct. b The operation of conversion hepatectomy. Light blue arrow shows portal vein. Yellow arrow shows common bile duct. Green arrow heads show cutting surface of partial resection of the left medial segment Fig. 6 Pathological findings. a Cut surface of the formalin-fixed liver with solid masses in the right lobe. The part surrounded red circle included viable carcinoma. b Hematoxylin and eosin (HE) staining showing viable cancer cells in the liver tumor. Magnification, ×100. Scale bar: 200 μm. c HE staining showing necrosis of the tumor. Magnification, ×40. Scale bar: 500 μm. d HE staining showing tumor necrosis of portal vein invasion without viable cancer cells. Magnification, ×40. Scale bar: 500 μm
4.019531
0.964844
sec[1]/p[1]
en
0.999997
33301055
https://doi.org/10.1186/s40792-020-01078-3
[ "portal", "vein", "tumor", "lenvatinib", "hepatectomy", "liver", "transection", "arrow", "necrosis", "invasion" ]
[ { "code": "DB98.3", "title": "Portal vein thrombosis" }, { "code": "DB98.7Z", "title": "Portal hypertension, unspecified" }, { "code": "NB90.4Y&XA1E17", "title": "Portal venous laceration" }, { "code": "LA90.21", "title": "Congenital portosystemic shunt" }, { "code": "DB98.7Y", "title": "Other specified portal hypertension" }, { "code": "BD7Z", "title": "Diseases of veins, unspecified" }, { "code": "MC88", "title": "Prominent veins" }, { "code": "BD7Y", "title": "Other specified diseases of veins" }, { "code": "BD75.Y", "title": "Venous varicosities of other specified sites" }, { "code": "BD73.2Z", "title": "Systemic vein obstruction, unspecified" } ]
=== ICD-11 CODES FOUND === [DB98.3] Portal vein thrombosis Definition: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion. Also known as: Portal vein thrombosis | Phlebitis of portal vein | deep vein thrombosis of portal vein | portal thrombosis | PVT - [portal vein thrombosis] Includes: Phlebitis of portal vein [DB98.7Z] Portal hypertension, unspecified Also known as: Portal hypertension, unspecified | Portal hypertension | PHT - [portal hypertension] | Portal HTN [LA90.21] Congenital portosystemic shunt Also known as: Congenital portosystemic shunt | anomalous pulmonary venous drainage to hepatic veins | anomaly of portal vein connection | portal vein deformity | portal vein anomaly [DB98.7Y] Other specified portal hypertension Also known as: Other specified portal hypertension | Banti syndrome | Banti spleen | fibrocongestive splenomegaly | congestive splenomegaly [BD7Z] Diseases of veins, unspecified Also known as: Diseases of veins, unspecified [MC88] Prominent veins Also known as: Prominent veins [BD7Y] Other specified diseases of veins Also known as: Other specified diseases of veins [BD75.Y] Venous varicosities of other specified sites Also known as: Venous varicosities of other specified sites | Caput medusae | Jugular venous aneurysm | jugular vein aneurysm | Orbital varices [BD73.2Z] Systemic vein obstruction, unspecified Also known as: Systemic vein obstruction, unspecified | Systemic vein obstruction === GRAPH WALKS === --- Walk 1 --- [DB98.3] Portal vein thrombosis Def: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion.... --PARENT--> [DB98] Vascular disorders of the liver Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein.... --CHILD--> [DB98.2] Nodular regenerative hyperplasia of liver Def: Nodular regenerative hyperplasia of the liver is a rare disorder characterised by diffuse micronodular transformation of the hepatic parenchyma without fibrous septa between the nodules.... --- Walk 2 --- [DB98.3] Portal vein thrombosis Def: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion.... --PARENT--> [DB98] Vascular disorders of the liver Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein.... --CHILD--> [DB98.1] Peliosis hepatis --- Walk 3 --- [DB98.7Z] Portal hypertension, unspecified --PARENT--> [DB98.7] Portal hypertension Def: Portal hypertension is abnormal increase of portal vein pressure, which induces development of collateral vessels of portal vein including oesophageal and cardiac varices. It also contributes to devel... --PARENT--> [DB98] Vascular disorders of the liver Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein.... --- Walk 4 --- [DB98.7Z] Portal hypertension, unspecified --PARENT--> [DB98.7] Portal hypertension Def: Portal hypertension is abnormal increase of portal vein pressure, which induces development of collateral vessels of portal vein including oesophageal and cardiac varices. It also contributes to devel... --CHILD--> [DB98.70] Idiopathic portal hypertension --- Walk 5 --- [LA90.21] Congenital portosystemic shunt --PARENT--> [LA90.2] Peripheral venous malformations --RELATED_TO--> [?] Blue rubber bleb naevus syndrome Def: Blue rubber bleb nevus (BRBNS) is a rare vascular malformation disorder with cutaneous and visceral lesions frequently associated with serious, potentially fatal bleeding and anaemia. Multifocal venou... --- Walk 6 --- [LA90.21] Congenital portosystemic shunt --PARENT--> [LA90.2] Peripheral venous malformations --RELATED_TO--> [?] Developmental venous malformations involving the skin Def: Certain genetically-determined syndromes presenting with venous anomalies in the skin...
[ "[DB98.3] Portal vein thrombosis\n Def: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion....\n --PARENT--> [DB98] Vascular disorders of the liver\n Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein....\n --CHILD--> [DB98.2] Nodular regenerative hyperplasia of liver\n Def: Nodular regenerative hyperplasia of the liver is a rare disorder characterised by diffuse micronodular transformation of the hepatic parenchyma without fibrous septa between the nodules....", "[DB98.3] Portal vein thrombosis\n Def: Portal vein thrombosis is a condition where the portal vein and/or its branches are obstructed, mainly by a blood clot or malignant tumour invasion....\n --PARENT--> [DB98] Vascular disorders of the liver\n Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein....\n --CHILD--> [DB98.1] Peliosis hepatis", "[DB98.7Z] Portal hypertension, unspecified\n --PARENT--> [DB98.7] Portal hypertension\n Def: Portal hypertension is abnormal increase of portal vein pressure, which induces development of collateral vessels of portal vein including oesophageal and cardiac varices. It also contributes to devel...\n --PARENT--> [DB98] Vascular disorders of the liver\n Def: Vascular disorders of the liver are conditions where the hepatic blood flow is deranged due to damage, malformation and obstruction of hepatic artery, portal vein and hepatic vein....", "[DB98.7Z] Portal hypertension, unspecified\n --PARENT--> [DB98.7] Portal hypertension\n Def: Portal hypertension is abnormal increase of portal vein pressure, which induces development of collateral vessels of portal vein including oesophageal and cardiac varices. It also contributes to devel...\n --CHILD--> [DB98.70] Idiopathic portal hypertension", "[LA90.21] Congenital portosystemic shunt\n --PARENT--> [LA90.2] Peripheral venous malformations\n --RELATED_TO--> [?] Blue rubber bleb naevus syndrome\n Def: Blue rubber bleb nevus (BRBNS) is a rare vascular malformation disorder with cutaneous and visceral lesions frequently associated with serious, potentially fatal bleeding and anaemia. Multifocal venou...", "[LA90.21] Congenital portosystemic shunt\n --PARENT--> [LA90.2] Peripheral venous malformations\n --RELATED_TO--> [?] Developmental venous malformations involving the skin\n Def: Certain genetically-determined syndromes presenting with venous anomalies in the skin..." ]
DB98.3
Portal vein thrombosis
[ { "from_icd11": "DB98.3", "icd10_code": "I81", "icd10_title": "Portal vein thrombosis" }, { "from_icd11": "DB98.7Z", "icd10_code": "K766", "icd10_title": "Portal hypertension" }, { "from_icd11": "LA90.21", "icd10_code": "Q265", "icd10_title": "Anomalous portal venous connection" }, { "from_icd11": "BD7Z", "icd10_code": "I82412", "icd10_title": "Acute embolism and thrombosis of left femoral vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82621", "icd10_title": "Acute embolism and thrombosis of deep veins of right upper extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82432", "icd10_title": "Acute embolism and thrombosis of left popliteal vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82C11", "icd10_title": "Acute embolism and thrombosis of right internal jugular vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82441", "icd10_title": "Acute embolism and thrombosis of right tibial vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82422", "icd10_title": "Acute embolism and thrombosis of left iliac vein" }, { "from_icd11": "BD7Z", "icd10_code": "I82622", "icd10_title": "Acute embolism and thrombosis of deep veins of left upper extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I824Z1", "icd10_title": "Acute embolism and thrombosis of unspecified deep veins of right distal lower extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82401", "icd10_title": "Acute embolism and thrombosis of unspecified deep veins of right lower extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I824Z2", "icd10_title": "Acute embolism and thrombosis of unspecified deep veins of left distal lower extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82612", "icd10_title": "Acute embolism and thrombosis of superficial veins of left upper extremity" }, { "from_icd11": "BD7Z", "icd10_code": "I82721", "icd10_title": "Chronic embolism and thrombosis of deep veins of right upper extremity" } ]
I81
Portal vein thrombosis
At the time of discharge from AB-LT (Table 1 ), the child actively assisted with bilateral knee extension on command 75% of the time in supported squat position. There was a change from initial hyporeflexive response to hyperreflexive response of her left leg and from absent to hyporeflexive response on right leg. The Segmental Assessment of Trunk Control (SATCo) , a standardized measure to assess trunk control without compensation, was first conducted during AB-LT session 23. Initially, she demonstrated appropriate kinematics during testing with arms supported on table, score of 2/20 (Head Control). She continued to improve trunk control across reassessments (Table 2 ). By discharge, she was able to maintain appropriate alignment of her previously kyphotic trunk position with support decreased to low ribs, 12/20 SATCo (Lower Thoracic Control), prop ring-sitting for 60 s, and was able to sit with one arm support, initiating trunk rotation to interact with her environment. In less kyphotic, upright sitting, the child’s breathing appeared automatic, unnoticeable, and void of chest raising or accessory muscle activity. She had also begun to lift her arms during short-sitting and could bimanually stack blocks without support from a ring-sitting position as well as rotate to pick up a bucket beside her with both hands and place it on her other side. Her pelvis was only slightly tilted posteriorly, and her trunk held upright with a flat back . Improved trunk control allowed her to use her arms and hands to play. Therapists observed the mother bringing her child to therapy holding her with one arm while her child sat upright on her hip. Using this new ability to hold her upright, the child now could sit independently while having a haircut instead of her mother holding her . By discharge the child could also independently roll, come to long-sit, drag crawl, and scoot backwards in prone. Dependent wheeled mobility changed from full recline in the Kid Kart to less reclined position and the headrest was removed. While initially fully dependent, she was discharged home able to propel and steer a manual wheelchair with pelvic positioning device at a household level . She was discharged home in a custom manual wheelchair with pelvic positioning device only. Table 1 Comparison of medical status and function prior to AB-LT and during/post AB-LT. Comparison of outcomes: prior to activity-based locomotor training (AB-LT) and during/post-AB-LT Prior to AB-LT During and post-AB-LT Duration 2.5 years 8 months Mobility status Dependent—-power chair/kid kart Independent—-manual wheelchair Functional skills Unable to roll, sit, come to sit, stand or walk Able to independently roll, come to sit, and sit while using arms Medical status Pneumonia ×2 No pneumonia (up to 3 years post AB-LT) Hospitalized ×2 Hospitalization ×1 (Atelectasis; 3 months post initiation of AB-LT) Daily use of percussion vest No required use of percussion vest Number of treatment sessions ~350 sessions 144 sessions AB-LT activity-based locomotor training. Table 2 Trunk control: progression of outcomes from initial evaluation through discharge during activity-based locomotor training (AB-LT). Trunk control and sitting progression of outcomes Months of AB-LT Session number Outcome measure SATCo Timed sit 0 0 NT Incapable of sitting with or without arm support 1 23 2/20 Requires arm support to sit 2 42 8/20 Requires support to sit 4 70 8/20 Requires support to sit 6 98 11/20 Starts to lift one arm during unsupported sitting 8 144 12/20 Able to sit unsupported for 30 s Segmental Assessment of Trunk Control (SATCo) incrementally measures uncompensated trunk control with a maximum score of 20/20 representing ability to sit without external manual support while maintaining appropriate kinematics/alignment without compensation during testing of static, active, and reactive control. Timed sit measures sitting endurance without regard to alignment or kinematics. Fig. 5 Short-sitting posture. Sitting posture at initial evaluation ( a ) and at discharge evaluation ( b ). At initial evaluation, child requires therapist assistance to sit, cannot sit independently even with arm support, and sits with flexed trunk, posterior pelvic tilt, and weight distributed to right side. a At discharge evaluation, child can short-sit without support by therapist and stand-by guarding only, uses minimal arm support, trunk is upright, and extended. Fig. 6 Improved quality of life and participation. a For the first time since injury, child was able to sit in a Barbie car for a haircut instead of having to be held in her mother’s lap. b , c She participated in numerous sports such as basketball and tennis from manual wheelchair. d She enjoyed fishing with her parents in the community.
4.0625
0.864746
sec[1]/sec[0]/p[7]
en
0.999997
32157078
https://doi.org/10.1038/s41394-020-0261-1
[ "trunk", "control", "support", "sitting", "without", "able", "upright", "while", "manual", "position" ]
[ { "code": "ND51.Y", "title": "Other specified injuries of spine or trunk, level unspecified" }, { "code": "ND35", "title": "Traumatic amputations involving multiple body regions" }, { "code": "ND5Z", "title": "Injuries to unspecified part of trunk, limb or body region, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "ND33", "title": "Dislocations, strains or sprains involving multiple body regions" }, { "code": "6C01.Z", "title": "Encopresis, unspecified" }, { "code": "6C00.Z", "title": "Enuresis, unspecified" }, { "code": "MF50.2Z", "title": "Urinary incontinence, unspecified" }, { "code": "5A14", "title": "Diabetes mellitus, type unspecified" }, { "code": "6C0Z", "title": "Elimination disorders, unspecified" } ]
=== ICD-11 CODES FOUND === [ND51.Y] Other specified injuries of spine or trunk, level unspecified Also known as: Other specified injuries of spine or trunk, level unspecified | Superficial injury of trunk, level unspecified | multiple superficial injuries of trunk | Abrasion of trunk, level unspecified | Contusion of trunk, level unspecified [ND35] Traumatic amputations involving multiple body regions Also known as: Traumatic amputations involving multiple body regions | avulsion involving multiple body regions | Traumatic amputation of both hands | Traumatic amputation of one hand and other arm, any level, except hand | traumatic amputation of upper limb and other hand Includes: avulsion involving multiple body regions Excludes: traumatic amputation of leg NOS | traumatic amputation of arm NOS | Open wounds involving multiple body regions [ND5Z] Injuries to unspecified part of trunk, limb or body region, unspecified Also known as: Injuries to unspecified part of trunk, limb or body region, unspecified | body trunk trauma | Unspecified injury of trunk, level unspecified | torso wound NOS | truncal injury [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [ND33] Dislocations, strains or sprains involving multiple body regions Also known as: Dislocations, strains or sprains involving multiple body regions | Dislocations, strains or sprains involving head with neck | Dislocations, sprains and strains of sites classifiable as head or neck level | Multiple dislocations of head and neck | Multiple sprains of head and neck [6C01.Z] Encopresis, unspecified Also known as: Encopresis, unspecified | Encopresis | Problems of bowel control | encopresis of nonorganic origin | faecal incontinence of nonorganic origin [6C00.Z] Enuresis, unspecified Also known as: Enuresis, unspecified | Enuresis | Functional enuresis | Problems of bladder control | enuresis NOS [MF50.2Z] Urinary incontinence, unspecified Also known as: Urinary incontinence, unspecified | Urinary incontinence | urinary incontinence, NOS | bladder incontinence NOS | absence of bladder continence [5A14] Diabetes mellitus, type unspecified Also known as: Diabetes mellitus, type unspecified | diabetes NOS | DM - [diabetes mellitus] NOS | severe diabetes mellitus | sudden-onset diabetes mellitus Excludes: Idiopathic Type 1 diabetes mellitus | Type 2 diabetes mellitus | Diabetes mellitus, other specified type [6C0Z] Elimination disorders, unspecified Also known as: Elimination disorders, unspecified | Problems of bowel or bladder control === GRAPH WALKS === --- Walk 1 --- [ND51.Y] Other specified injuries of spine or trunk, level unspecified --PARENT--> [ND51] Other injuries of spine or trunk, level unspecified --EXCLUDES--> [?] Crushing injuries involving multiple body regions --- Walk 2 --- [ND51.Y] Other specified injuries of spine or trunk, level unspecified --PARENT--> [ND51] Other injuries of spine or trunk, level unspecified --EXCLUDES--> [?] Crushing injuries involving multiple body regions --- Walk 3 --- [ND35] Traumatic amputations involving multiple body regions --EXCLUDES--> [?] Other injuries of leg, level unspecified --PARENT--> [?] Injuries to unspecified part of trunk, limb or body region --- Walk 4 --- [ND35] Traumatic amputations involving multiple body regions --EXCLUDES--> [?] Open wounds involving multiple body regions --EXCLUDES--> [?] Traumatic amputations involving multiple body regions --- Walk 5 --- [ND5Z] Injuries to unspecified part of trunk, limb or body region, unspecified --PARENT--> [?] Injuries to unspecified part of trunk, limb or body region --EXCLUDES--> [?] Injuries involving multiple body regions --- Walk 6 --- [ND5Z] Injuries to unspecified part of trunk, limb or body region, unspecified --PARENT--> [?] Injuries to unspecified part of trunk, limb or body region --EXCLUDES--> [?] Burns Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...
[ "[ND51.Y] Other specified injuries of spine or trunk, level unspecified\n --PARENT--> [ND51] Other injuries of spine or trunk, level unspecified\n --EXCLUDES--> [?] Crushing injuries involving multiple body regions", "[ND51.Y] Other specified injuries of spine or trunk, level unspecified\n --PARENT--> [ND51] Other injuries of spine or trunk, level unspecified\n --EXCLUDES--> [?] Crushing injuries involving multiple body regions", "[ND35] Traumatic amputations involving multiple body regions\n --EXCLUDES--> [?] Other injuries of leg, level unspecified\n --PARENT--> [?] Injuries to unspecified part of trunk, limb or body region", "[ND35] Traumatic amputations involving multiple body regions\n --EXCLUDES--> [?] Open wounds involving multiple body regions\n --EXCLUDES--> [?] Traumatic amputations involving multiple body regions", "[ND5Z] Injuries to unspecified part of trunk, limb or body region, unspecified\n --PARENT--> [?] Injuries to unspecified part of trunk, limb or body region\n --EXCLUDES--> [?] Injuries involving multiple body regions", "[ND5Z] Injuries to unspecified part of trunk, limb or body region, unspecified\n --PARENT--> [?] Injuries to unspecified part of trunk, limb or body region\n --EXCLUDES--> [?] Burns\n Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute..." ]
ND51.Y
Other specified injuries of spine or trunk, level unspecified
[ { "from_icd11": "ND51.Y", "icd10_code": "S30860A", "icd10_title": "Insect bite (nonvenomous) of lower back and pelvis, initial encounter" }, { "from_icd11": "ND51.Y", "icd10_code": "S30861A", "icd10_title": "Insect bite (nonvenomous) of abdominal wall, initial encounter" }, { "from_icd11": "ND35", "icd10_code": "T05", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T050", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T051", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T052", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T053", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T054", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T055", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T056", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T058", "icd10_title": "" }, { "from_icd11": "ND35", "icd10_code": "T059", "icd10_title": "" }, { "from_icd11": "ND5Z", "icd10_code": "T08-T14", "icd10_title": "" }, { "from_icd11": "ND5Z", "icd10_code": "T119", "icd10_title": "" }, { "from_icd11": "ND5Z", "icd10_code": "T139", "icd10_title": "" } ]
S30860A
Insect bite (nonvenomous) of lower back and pelvis, initial encounter
On physical examination, the patient temperature was 38.2°C, heart rate was 92/bpm, respiratory rate was 20 breaths/min, blood pressure was 115/79 mm Hg. The patient had clear consciousness, and a soybean-sized lymph node was palpable on the right side of the neck, which was moderate in quality, mobile, and non-tender. Breathing was slightly coarse in both lungs, and moist and dry rales, as well as pleural friction rub sounds, were not audible in both lungs. Cardiac and abdominal examination of the patient was unremarkable. There was no swelling or pain in the joints of the body, and no edema in the limbs. After admission, the blood work showed the following: white blood cells, 9.18*10 9 /L; hemoglobin, 92.8 g/L; mean corpuscular volume, 59.38; mean corpuscular hemoglobin, 19.54. Her urine routine, stool routine, and blood biochemistry tests were unremarkable. The pathogenic smears and cultures of sputum, peripheral blood, bone marrow, and CSF were all negative. Tumor markers in patients’ serum were all negative. The electrocardiogram was within the normal range and the cardiac ultrasound did not show any abnormalities. Superficial B ultrasound revealed a 1.2 * 1.0 cm lymph node detected in the right neck, and pathological biopsy of the lymph nodes revealed no neoplastic lesions. Chest CT examination on admission revealed a few exudative lesions in both lungs. Positron emission tomography-CT examination revealed: Inflammatory hyperplasia of multiple systemic lymph nodes (bilateral neck areas I, II, and V, bilateral axillae, mediastinum, bilateral hilum, and bilateral groin). Slight inflammation in both lungs. Bone marrow with increased glucose metabolism, which was likely reactive changes. A bone marrow biopsy showed that proliferation of the bone marrow was active, and abnormal cells were not detected. The patient was diagnosed with fever of unknown origin (lung infection?) and received anti-infective therapy with large encirclement of anti-bacterial, antifungal and empirical anti-tuberculosis successively during hospitalization in the Department of Infectious Diseases. Yet her condition continues to progress. During the treatment, the patient complained of swelling, pain, and stiffness in many joints and particularly the metacarpophalangeal and proximal interphalangeal hand joints, wrists, ankles, elbows, and knee joints. Autoantibody test showed the following: ANA, + (1:320); RF, +; Anti-CCP, +; Anti-ENA, −; Anti-dsDNA, −; Antiphospholipid antibodies, −; C3/C4, −. X-ray examination revealed osteoporosis of both hands and minimal soft tissue swelling around the proximal interphalangeal joints of both hands and the first metacarpophalangeal joint of the right hand. Joint ultrasonography examination revealed thickening of the synovium of both wrists and a small amount of blood flow signal. The patient was diagnosed with definite RA and transferred to our department on October 21, 2022 for continued treatment. She was treated with glucocorticoids (GC, 40 mg qd) and methotrexate (MTX, 10 mg qw) with a slight decrease in peak body temperature, but still had recurrent fever. On November 03, 2022, the patient presented with worsening condition, characterized by severe cough with chest tightness, progressive worsening of anasarca , increased pleural effusion and decreased blood pressure, with a minimum blood pressure of 84/44 mm Hg. Dynamic reexamination showed a significant increase in white blood cell count, high-sensitivity C-reactive protein and ferritin levels, and a progressive decrease in albumin levels . Inflammatory factor test results suggested significantly increased levels of IL-1β, IL-6, IL-8, IL-10, TNF-α, and INF-α . A repeat chest CT revealed progressive ground-glass lesions in both lungs and bilateral pleural effusion. We summarized a series of patient case characteristics and reviewed a case series that fulfills the criteria for hyperferritinemic syndrome and CLS reported in the literature. The patient was eventually diagnosed with RA combined with hyperferritinemic syndrome and CLS. Then she received GC (160 mg qd) combined with intravenous immunoglobulin (IVIG, 20 g/d, for 3 days). After treatment, her temperature gradually decreased, but still fluctuated. We considered that the patient also had an overwhelming proinflammatory cytokine storm, so she received a strong anti-inflammatory treatment with tocilizumab (TCZ) (400 mg qm). The patient symptoms and follow-up chest CT showed significant improvement following treatment . Subsequently, the patient returned regularly, and the GC dose was gradually reduced to discontinuation according to the criteria. Following up to now, the patient was taking MTX (15 mg qw) and TCZ (400 mg qm) continuously and the disease was in sustained remission.
3.880859
0.980957
sec[1]/p[2]
en
0.999997
PMC11081611
https://doi.org/10.1097/MD.0000000000038104
[ "blood", "both", "anti", "lungs", "joints", "lymph", "bone", "marrow", "chest", "temperature" ]
[ { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "LB99.6", "title": "Acheiria" }, { "code": "MB51.Z", "title": "Diplegia of upper extremities, unspecified" }, { "code": "LB9A.4", "title": "Apodia" }, { "code": "LB51", "title": "Anorchia or microorchidia" }, { "code": "9D90.2", "title": "Moderate vision impairment" } ]
=== ICD-11 CODES FOUND === [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood [LB99.6] Acheiria Definition: A condition caused by failure of one or both hands to develop during the antenatal period. Also known as: Acheiria | Congenital absence of hand | agenesis of hand | congenital absence of hand and finger | congenital absence of hand and wrist [MB51.Z] Diplegia of upper extremities, unspecified Also known as: Diplegia of upper extremities, unspecified | Diplegia of upper extremities | paralysis of both upper limbs | both upper extremity paralysis | diplegia of upper limbs [LB9A.4] Apodia Definition: A condition caused by failure of the foot to develop during the antenatal period. Also known as: Apodia | Congenital absence of foot | agenesis of foot | congenital absence of foot or toe | congenital absence of foot or toe, unspecified side [LB51] Anorchia or microorchidia Definition: A disorder affecting males, caused by an abnormality occurring in sex development during the antenatal period. This disorder is characterised by individuals who are born with absence of the testes, or with testes that are deficient in size and function. Confirmation is by physical examination, identification of low testosterone levels but elevated follicle stimulating hormone and luteinizing hormone levels in a blood sample, or imaging. Also known as: Anorchia or microorchidia | Absence or aplasia of testis, unilateral | congenital absence of testis, unilateral | congenital absent testicle | congenital absence of testis [9D90.2] Moderate vision impairment Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision] Includes: visual impairment category 2, in both eyes === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Certain conditions originating in the perinatal period Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later.... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] Diseases of spleen --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.4Z] Haematuria, unspecified --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Certain conditions originating in the perinatal period\n Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Diseases of spleen", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] Haematuria, unspecified", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
Because a liver tumor located in segment 2 with PVTT in P2 is thought to readily metastasize through the portal venous flow to segments 3 and 4, left hepatectomy is the first choice of treatment. Left lateral sectionectomy is the second choice because the tumor was close to the left hepatic vein. However, in patients with liver cirrhosis, the left lateral section hypertrophies, and left hepatectomy or left lateral sectionectomy are sometimes not feasible because of decreased liver functional reserve and the relatively large volume of the left hemiliver or left lateral section . In our case, the left hemiliver and left lateral section became large (45% and 41% of the total liver, respectively) and the ICG-R15 level was relatively high (24%). And we judged preoperatively that we can exfoliate the tumor from the left hepatic vein. Therefore, anatomical liver segmentectomy 2 rather than left hepatectomy or left lateral sectionectomy was selected because it optimizes the balance between oncological requirements and the need to spare functioning liver parenchyma. Although preoperative surgical planning was evaluated by two-dimensional CT in our case, we think that three-dimensional CT computer-assisted preoperative surgical planning may be helpful for anatomical liver segmentectomy 2 . In anatomical segmentectomy 2, transection of the glissonean pedicle that feeds segment 2 and intraoperative ultrasound-guided blunt compression of the segment 2 portal branch have been reported; however, these techniques are not suitable in liver cancer patients with PVTT in the root of P2, including our patient. In such cases, complete removal of PVTT is extremely important to prevent early tumor recurrence; therefore, after A2, A3, P2, and umbilical and transverse portions of the left portal vein were separated, the liver was dissected, and PVTT was removed under direct vision. It is easy to ligate and divide the origin of P2 before liver transection; however, we think that it is safer and more certain to incise the origin of P2 and suture the stump of P2 after liver transection than before liver transection. This separation method could be adapted for segmentectomy 3 and segmentectomy 3 and 4 . Although several reports have demonstrated the feasibility and safety of laparoscopic anatomic resection based on three-dimensional CT images recently, we performed anatomical liver segmentectomy 2 by open surgery because laparoscopic approach to hepatic tumors remains a challenge, and the patient in present report underwent upper abdominal surgeries (splenectomy, partial gastrectomy, and cholecystectomy). Left hemihepatic vascular occlusion, limited to 30 min followed by 5 min of perfusion, is useful to prevent blood loss originating from hepatic inflow ; however, it is difficult to control retrograde bleeding from the left hepatic vein using this maneuver. Selective hepatic vascular exclusion (SHVE), which combines inflow vascular occlusion (Pringle maneuver) with extrahepatic control of the major hepatic veins, overcomes the drawbacks of backflow bleeding of the Pringle maneuver . In segmentectomy 2 or 3, modified selective hepatic vascular exclusion (m-SHVE), which combines extrahepatic control of the middle and left hepatic veins with left hemihepatic inflow occlusion, is sufficient to reduce both backflow and inflow bleeding. In our case, this m-SHVE procedure contributed to reduce bleeding during liver dissection and was not associated with hemodynamic changes. SHVE has been used in major liver resections to control intraoperative bleeding ; however, this technique has not been reported and studied in anatomical liver segmentectomy 2, to our knowledge. Furthermore, although it is reported in previous publications that SHVE entails Pringle maneuver and extrahepaic clamping of major hepatic veins , m-SHVE which entails not Pringle maneuver but hemihepatic inflow occlusion has not been reported. Therefore, anatomical liver segmentectomy 2 with m-SHVE is the novel technique. We think that this m-SHVE is the effective technique in anatomical liver segmentectomy 2 and can be adapted also for anatomical liver segmentectomy 3. Intraabdominal adhesion resulting from previous surgery was very severe, and then, about 120 min were required and blood loss was about 400 ml during exfoliation of this adhesion. Therefore, we think that the operative time (419 min) and the amount of blood loss (939 ml) in our case seem in the tolerance. The liver transection time was relatively longer because of the hard texture of liver parenchyma resulting from liver cirrhosis. Because postoperative liver function was adequate in our case, anatomical segmentectomy 2 is feasible to preserve remnant liver function in selected patients with liver cirrhosis.
4.296875
0.661621
sec[2]/p[1]
en
0.999998
22273493
https://doi.org/10.1186/1477-7819-10-22
[ "liver", "segmentectomy", "hepatic", "anatomical", "shve", "because", "that", "this", "however", "transection" ]
[ { "code": "DB9Z", "title": "Diseases of liver, unspecified" }, { "code": "DB97.Z", "title": "Inflammatory liver disease, unspecified" }, { "code": "DB99.7", "title": "Hepatic failure without mention whether acute or chronic" }, { "code": "LB20.0Y", "title": "Other specified structural developmental anomalies of liver" }, { "code": "LB20.0Z", "title": "Structural developmental anomalies of liver, unspecified" }, { "code": "DA20.Z", "title": "Acquired anatomical alterations of the oesophagus, unspecified" }, { "code": "DA40.Z", "title": "Acquired anatomical alterations of the stomach, unspecified" }, { "code": "DA50.Z", "title": "Acquired anatomical alterations of the duodenum, unspecified" }, { "code": "DB31.Z", "title": "Acquired anatomical alterations of large intestine, unspecified" }, { "code": "DA20.Y", "title": "Other specified acquired anatomical alterations of the oesophagus" } ]
=== ICD-11 CODES FOUND === [DB9Z] Diseases of liver, unspecified Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy [DB97.Z] Inflammatory liver disease, unspecified Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS [DB99.7] Hepatic failure without mention whether acute or chronic Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS [LB20.0Y] Other specified structural developmental anomalies of liver Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity [LB20.0Z] Structural developmental anomalies of liver, unspecified Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver [DA20.Z] Acquired anatomical alterations of the oesophagus, unspecified Also known as: Acquired anatomical alterations of the oesophagus, unspecified | Acquired anatomical alterations of the oesophagus [DA40.Z] Acquired anatomical alterations of the stomach, unspecified Also known as: Acquired anatomical alterations of the stomach, unspecified | Acquired anatomical alterations of the stomach [DA50.Z] Acquired anatomical alterations of the duodenum, unspecified Also known as: Acquired anatomical alterations of the duodenum, unspecified | Acquired anatomical alterations of the duodenum [DB31.Z] Acquired anatomical alterations of large intestine, unspecified Also known as: Acquired anatomical alterations of large intestine, unspecified | Other acquired anatomical alterations of large intestine [DA20.Y] Other specified acquired anatomical alterations of the oesophagus Also known as: Other specified acquired anatomical alterations of the oesophagus | Acquired fistula of oesophagus === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --RELATED_TO--> [?] Metabolic or transporter liver disease --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --CHILD--> [DB91] Acute or subacute hepatic failure Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases.... --- Walk 3 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --CHILD--> [DB97.2] Chronic hepatitis, not elsewhere classified --- Walk 4 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --CHILD--> [DB97.2] Chronic hepatitis, not elsewhere classified --- Walk 5 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --EXCLUDES--> [?] Hepatic vein thrombosis Def: Venous thrombosis within the hepatic vein.... --- Walk 6 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --EXCLUDES--> [?] Hepatic vein thrombosis Def: Venous thrombosis within the hepatic vein....
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Metabolic or transporter liver disease", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --CHILD--> [DB91] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.2] Chronic hepatitis, not elsewhere classified", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.2] Chronic hepatitis, not elsewhere classified", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --EXCLUDES--> [?] Hepatic vein thrombosis\n Def: Venous thrombosis within the hepatic vein....", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --EXCLUDES--> [?] Hepatic vein thrombosis\n Def: Venous thrombosis within the hepatic vein...." ]
DB9Z
Diseases of liver, unspecified
[ { "from_icd11": "DB9Z", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB9Z", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K769", "icd10_title": "Liver disease, unspecified" }, { "from_icd11": "DB9Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "DB9Z", "icd10_code": "K762", "icd10_title": "Central hemorrhagic necrosis of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K70-K77", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K778", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K72", "icd10_title": "Hepatic failure, not elsewhere classified" }, { "from_icd11": "DB9Z", "icd10_code": "K76", "icd10_title": "Other diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K768", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB97.Z", "icd10_code": "K7581", "icd10_title": "Nonalcoholic steatohepatitis (NASH)" }, { "from_icd11": "DB97.Z", "icd10_code": "K7589", "icd10_title": "Other specified inflammatory liver diseases" }, { "from_icd11": "DB97.Z", "icd10_code": "K759", "icd10_title": "Inflammatory liver disease, unspecified" }, { "from_icd11": "DB97.Z", "icd10_code": "K752", "icd10_title": "Nonspecific reactive hepatitis" }, { "from_icd11": "DB97.Z", "icd10_code": "K75", "icd10_title": "Other inflammatory liver diseases" } ]
K7681
Hepatopulmonary syndrome
Cases of complete torsion with absent flow in affected testis are usually diagnosed without difficulty by sonography . In late-phase torsion (greater than 24 h), in addition to lack of color flow within the testis, a “halo sign” consisting of a rim of increased pudendal flow surrounding the testis is present . In both situations, the epididymis is also frequently enlarged and avascular . Epididymitis is the most common entity confused with testicular torsion, and a study of relevant malpractice claims found that in 61% of these cases, torsion was misdiagnosed as epididymitis . In case of partial or intermittent torsion with recurrent episodes of testicular pain, sonographic examinations can be difficult and ambiguous: testicular flow may still be present but decreased in comparison to the contralateral side or flow may be apparently symmetrical with the contralateral side . If the flow is markedly decreased compared to the asymptomatic side, testicular torsion is a more likely diagnosis. If the decrease in flow is subtle, a conclusive diagnosis from sonography is more difficult. In cases with complete torsion and near-symmetrical flow, a high degree of suspicion is necessary for accurate diagnosis . In addition, flow might be maintained within the epididymis, which is often enlarged and therefore not infrequently results in an erroneous diagnosis of epididymitis. If spontaneous detorsion has occurred, the symptoms resolve and the resultant hyperemia and enlargement of the epididymis and testis can result in the erroneous diagnosis of epididymo-orchitis. Systematic high-resolution sonography of the cord can significantly influence surgical management . The sonographic findings depend not only upon the degree of spermatic cord rotation and the length of time of the torsion, but also upon how tightly the cord is twisted . Fig. 9 Partial torsion in a 13-year-old boy who presented with a 2-week history of intermittent left testicular pain and swelling. a Transverse power Doppler US image of both testes shows bilateral preserved flow with a slightly globular-appearing left testis. b Gray-scale longitudinal US image of the left testis and epididymis shows an enlarged left epididymal-cord complex and surrounding small hydrocele. The boy was discharged with a diagnosis of epididymitis because of the long confounding duration of symptoms and presence of intratesticular flow. c Color and pulsed Doppler US image of the left testis at initial presentation shows preserved intrinsic flow with normal arterial waveform. d Follow-up exam after 3 weeks demonstrates abnormally dampened left testicular flow and waveforms. e Color Doppler US image of left testis during at follow-up for persistent pain shows interval significantly enlarged left testis with decreased vascularity and a focal hypovascular parenchymal area concerning for infarct in the setting of incomplete torsion. He underwent left detorsion with bilateral orchiopexy Fig. 10 Complete torsion with preserved flow. a Transverse color Doppler US image of both testes in a 13-year-old boy with 8 h of right-side acute pain shows oblique lie and globular enlargement of the right testis with preserved flow and surrounding small reactive hydrocele. There is a linear transducer artifact at mid-testis level. b Longitudinal color Doppler US image of the right testis shows a globular testis with intratesticular flow. During surgery, complete torsion was diagnosed with a 360° twist and bilateral bell clapper deformity. c Transverse gray-scale image of both testes in a 15-year-old boy with acute right testicular pain shows horizontal lie of the right testis. The asymptomatic left testis incidentally demonstrates a medially directed mediastinum testis and trace fluid in the tunica vaginalis. d Transverse color Doppler US image demonstrates preserved intratesticular flow thought to be symmetrical. Complete torsion of the right testis was diagnosed at surgery, and bilateral orchiopexy was performed post detorsion Fig. 11 Bilateral partial torsion in a 15-year-old boy who presented with acute left testicular pain. a Color Doppler US image of the upper left scrotal sac shows an enlarged epididymal-cord complex with flow within, and surrounding complex hydrocele with mobile echoes. b, c Preserved slightly asymmetrical — left ( b ) less than right ( c ) — intratesticular flow and symmetrical waveforms are appreciated. The enlarged epididymal-cord complex was confused for epididymitis. d Follow-up exam after 4 months for recurrent testicular pain, now on the right side, shows an enlarged epididymal-cord complex in the right scrotum. Bilateral partial torsion (270° twist on the right side and 90° twist on the left side) and bilateral bell clapper anomaly were detected at orchiopexy
4.359375
0.424805
sec[0]/sec[3]/p[4]
en
0.999997
29468365
https://doi.org/10.1007/s00247-018-4093-0
[ "flow", "testis", "torsion", "testicular", "color", "enlarged", "pain", "side", "cord", "doppler" ]
[ { "code": "GA20.50", "title": "Heavy menstrual bleeding" }, { "code": "BA40.Y", "title": "Other specified angina pectoris" }, { "code": "LA8B.Y", "title": "Other specified congenital anomaly of great arteries including arterial duct" }, { "code": "GC01.0", "title": "Bladder neck obstruction" }, { "code": "DA40.0", "title": "Gastric outlet obstruction" }, { "code": "GB0Y&XA4947", "title": "Disease or disorder of testis, unspecified" }, { "code": "GB02.1&XA4947", "title": "Inflammation of testis" }, { "code": "LB51", "title": "Anorchia or microorchidia" }, { "code": "GB03", "title": "Atrophy of testis" }, { "code": "2F97&XA4947", "title": "Neoplasms of unknown behaviour of testis" } ]
=== ICD-11 CODES FOUND === [GA20.50] Heavy menstrual bleeding Definition: Menstruation with heavy (> 80 ml) volume of monthly blood loss Also known as: Heavy menstrual bleeding | menstruation excessive | Heavy menstrual bleeding caused by bleeding disorders | Excessive menstruation with regular cycle | excessive menses [BA40.Y] Other specified angina pectoris Also known as: Other specified angina pectoris | Atypical angina | Angina of effort | angina pectoris of effort | Coronary slow flow syndrome [LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct Also known as: Other specified congenital anomaly of great arteries including arterial duct | Congenital arterial duct anomaly | Congenital ductus arteriosus anomaly | ductus arteriosus deformity | Ductus arteriosus agenesis [GC01.0] Bladder neck obstruction Definition: A condition of the bladder, caused by congenital or acquired abnormalities that impair the muscles that connect the bladder to the urethra. This condition is characterised by obstruction of the bladder neck and constricted opening during urination. This condition may also present with pelvic pain, pollakiuria, incontinence, or incomplete bladder emptying. Confirmation is by video urodynamics to observe the obstruction as the bladder fills and voids. Also known as: Bladder neck obstruction | bladder outlet obstruction | obstruction of bladder neck or vesicourethral orifice | vesicourethral orifice obstruction | BNO - [bladder neck obstruction] Includes: Acquired bladder neck stenosis [DA40.0] Gastric outlet obstruction Definition: Gastric outlet obstruction is a disorder characterised by epigastric abdominal pain and postprandial vomiting due to mechanical obstruction mostly at the level of the pylorus. Also known as: Gastric outlet obstruction | Adult hypertrophic pyloric stenosis | gastric outflow obstruction | hypertrophic pylorus stenosis | hypertrophic pylorus stricture [LB51] Anorchia or microorchidia Definition: A disorder affecting males, caused by an abnormality occurring in sex development during the antenatal period. This disorder is characterised by individuals who are born with absence of the testes, or with testes that are deficient in size and function. Confirmation is by physical examination, identification of low testosterone levels but elevated follicle stimulating hormone and luteinizing hormone levels in a blood sample, or imaging. Also known as: Anorchia or microorchidia | Absence or aplasia of testis, unilateral | congenital absence of testis, unilateral | congenital absent testicle | congenital absence of testis [GB03] Atrophy of testis Definition: A condition of the testis, caused by apoptosis of the cells due to diminished cellular proliferation, decreased cellular volume, decreased function, ischemia, malnutrition, disease, infection, mutation, or hormonal changes. This condition is characterised by a partial or complete decrease in size and function of the testis tissue. Also known as: Atrophy of testis | atrophic testicle | atrophy of testicle | testicular atrophy === GRAPH WALKS === --- Walk 1 --- [GA20.50] Heavy menstrual bleeding Def: Menstruation with heavy (> 80 ml) volume of monthly blood loss... --PARENT--> [GA20.5] Abnormal volume of uterine bleeding --CHILD--> [GA20.50] Heavy menstrual bleeding Def: Menstruation with heavy (> 80 ml) volume of monthly blood loss... --- Walk 2 --- [GA20.50] Heavy menstrual bleeding Def: Menstruation with heavy (> 80 ml) volume of monthly blood loss... --PARENT--> [GA20.5] Abnormal volume of uterine bleeding --CHILD--> [GA20.51] Light menstrual bleeding Def: Menstruation with light (< 5 ml) volume of monthly blood loss... --- Walk 3 --- [BA40.Y] Other specified angina pectoris --PARENT--> [BA40] Angina pectoris --CHILD--> [BA40.0] Unstable angina --- Walk 4 --- [BA40.Y] Other specified angina pectoris --PARENT--> [BA40] Angina pectoris --EXCLUDES--> [?] Otocephaly Def: Malplacement of the external ears with or without fusion microstomia, and persistence of the buccopharyngeal membrane likely being secondary effects of absence or hypoplasia of the mandibular arch.... --- Walk 5 --- [LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct --PARENT--> [LA8B] Congenital anomaly of great arteries including arterial duct Def: A congenital cardiovascular malformation of the great arteries (aorta, pulmonary trunk [main pulmonary artery], branch pulmonary arteries) or the arterial duct (ductus arteriosus).... --CHILD--> [LA8B.0] Congenital aortopulmonary window Def: A congenital cardiovascular malformation in which there is side-to-side continuity of the lumens of the ascending aorta and pulmonary trunk in association with separate aortic and pulmonary valves or ... --- Walk 6 --- [LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct --PARENT--> [LA8B] Congenital anomaly of great arteries including arterial duct Def: A congenital cardiovascular malformation of the great arteries (aorta, pulmonary trunk [main pulmonary artery], branch pulmonary arteries) or the arterial duct (ductus arteriosus).... --EXCLUDES--> [?] Common arterial trunk Def: A congenital cardiovascular malformation in which a single arterial trunk arises from the heart, giving origin sequentially to the coronary arteries, one or more pulmonary arteries, and the systemic a...
[ "[GA20.50] Heavy menstrual bleeding\n Def: Menstruation with heavy (> 80 ml) volume of monthly blood loss...\n --PARENT--> [GA20.5] Abnormal volume of uterine bleeding\n --CHILD--> [GA20.50] Heavy menstrual bleeding\n Def: Menstruation with heavy (> 80 ml) volume of monthly blood loss...", "[GA20.50] Heavy menstrual bleeding\n Def: Menstruation with heavy (> 80 ml) volume of monthly blood loss...\n --PARENT--> [GA20.5] Abnormal volume of uterine bleeding\n --CHILD--> [GA20.51] Light menstrual bleeding\n Def: Menstruation with light (< 5 ml) volume of monthly blood loss...", "[BA40.Y] Other specified angina pectoris\n --PARENT--> [BA40] Angina pectoris\n --CHILD--> [BA40.0] Unstable angina", "[BA40.Y] Other specified angina pectoris\n --PARENT--> [BA40] Angina pectoris\n --EXCLUDES--> [?] Otocephaly\n Def: Malplacement of the external ears with or without fusion microstomia, and persistence of the buccopharyngeal membrane likely being secondary effects of absence or hypoplasia of the mandibular arch....", "[LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct\n --PARENT--> [LA8B] Congenital anomaly of great arteries including arterial duct\n Def: A congenital cardiovascular malformation of the great arteries (aorta, pulmonary trunk [main pulmonary artery], branch pulmonary arteries) or the arterial duct (ductus arteriosus)....\n --CHILD--> [LA8B.0] Congenital aortopulmonary window\n Def: A congenital cardiovascular malformation in which there is side-to-side continuity of the lumens of the ascending aorta and pulmonary trunk in association with separate aortic and pulmonary valves or ...", "[LA8B.Y] Other specified congenital anomaly of great arteries including arterial duct\n --PARENT--> [LA8B] Congenital anomaly of great arteries including arterial duct\n Def: A congenital cardiovascular malformation of the great arteries (aorta, pulmonary trunk [main pulmonary artery], branch pulmonary arteries) or the arterial duct (ductus arteriosus)....\n --EXCLUDES--> [?] Common arterial trunk\n Def: A congenital cardiovascular malformation in which a single arterial trunk arises from the heart, giving origin sequentially to the coronary arteries, one or more pulmonary arteries, and the systemic a..." ]
GA20.50
Heavy menstrual bleeding
[ { "from_icd11": "GC01.0", "icd10_code": "N320", "icd10_title": "Bladder-neck obstruction" }, { "from_icd11": "DA40.0", "icd10_code": "K311", "icd10_title": "Adult hypertrophic pyloric stenosis" }, { "from_icd11": "LB51", "icd10_code": "Q550", "icd10_title": "Absence and aplasia of testis" }, { "from_icd11": "LB51", "icd10_code": "Q55", "icd10_title": "Other congenital malformations of male genital organs" }, { "from_icd11": "GB03", "icd10_code": "N503", "icd10_title": "Cyst of epididymis" }, { "from_icd11": "GB03", "icd10_code": "N500", "icd10_title": "Atrophy of testis" }, { "from_icd11": "GB03", "icd10_code": "N50", "icd10_title": "Other and unspecified disorders of male genital organs" }, { "from_icd11": "2F97&XA4947", "icd10_code": "D401", "icd10_title": "Neoplasm of uncertain behavior of testis" } ]
N320
Bladder-neck obstruction
There were 3 cases of adverse effects probably caused by medical glue, which all affected the injection side of the superficial eyelid lesions, and not limited to the surgical field. The 1st patient was treated in the early years. At that time, the injected medical glue was not removed. Regular follow-up in one month after the surgery showed round skin ulcer, and solidified medical glue as a foreign body was removed with tweezers. Immediate surgical exploration was performed to remove other medical glue, and the skin healed well in the end . Another patient suffered from a mass lesion on the left upper eyelid and near the supraorbital ridge. The lesion was as big as a walnut and had ill-defined border, pulsatile, and audible wind-blowing murmur in the blood vessel. Computed tomography angiography (CTA) examination confirmed an abnormally expanded blood vessel mass above the left orbit, supplied by the left superficial temporal artery, temporal artery and arteria angularis. Pre-surgical examination showed the malformed blood vessels were adjacent to orbicularis oculi muscle and frontalis. During surgery the supplying blood vessels were ligated at first and then medical glue was injected into the lesion. The malformed blood vessels were treated in this way one by one. After removed all the malformed blood vessels, we carefully inspected the surgical field and cleaned every piece of medical glue to make sure that no glue residue before suturing of the incision. Pathological diagnosis showed arteriovenous malformation. When the suture removed at one week after the surgery, there was a palpable solid nodule with the size of a rice grain on the upper eyelid, and a 0.5 cm palpable strip of solid nodule under the temporal skin with mild congestion. Visual image is not available unfortunately. On the follow up visit 3 months after the surgery, the solid nodule had softened and the patient stopped following up . In the third case of subcutaneous venous malformation, a suture was made after confirming that there was no residual glue. Two weeks after the surgery there was one solid nodule and mild congestion around but not in the surgical field. Nine months after the surgery during a phone call follow up, the nodule had softened but was still palpable, and the skin color was normal . Fig. 3 The 1st case with local skin adverse effect a Appearance before operation showed the purple obscure boundary lesion in the right nasal and inferior fornical conjunctiva and two spheroid masses under the skin of the inner canthus. Medical glue was injected into the two vascular malformation masses under the skin of the inner canthus via an incision made on the conjunctiva. The glue was not removed and the patient was discharged in stable condition one week after surgery. b The appearance of the lesion one month following the surgery showed two round skin ulcers on the nasal side, with 4 mm in diameter, and white swelling elevated margin. c Two residues of medical glue were removed from the ulcers; d local skin scar healing after debridement and suture Fig. 4 The 2nd case of local skin adverse effect A Three-dimensional computed tomographic(CT) angiography showed an abnormally expanded blood vessel mass (white arrow) in the soft tissue above the left orbit, supplied by the left superficial temporal artery, temporal artery (white arrow with dark outline) and arteria angularis (black arrow). The malformed blood vessel was not adjacent to the eyeball. B . CT imaging showed subcutaneous soft tissue mass in the upper left eyelid and forehead. C . Enhanced CT scan showed the vessel mass significantly heterogenous contrast enhancement. D . Surgical debulking was performed via a skin incision below the supraorbital ridge. White arrow indicates the solidified vascular malformation after medical glue injection. Black arrow indicates the exposed frontal bone after complete resection of the malformed blood vessel. E . CT scan showed the skin in the lateral-superior region of left orbit was slightly thickened at three months after surgery. Comparison of the pre-operation imaging the malformed blood vessel lesion was absent Fig. 5 The 3rd case of local adverse effect to the skin. a . Appearance showed that the left nasal upper eyelid was slightly elevated. The border of the mass was drawn after putting pressure on the neck. b . CT coronal scanning showed an interior-superior homogenous mass in the left orbit (white arrow with dark outline). c . The gross specimen of vascular malformation solidified after medical glue injection. d . Follow-up two weeks after the surgery showed skin color change on the left forehead (white arrow), slightly congested, with an ill-defined border, and a hard nodule in the middle of the upper eyelid (black arrow)
4.054688
0.937012
sec[2]/sec[3]/p[1]
en
0.999997
30572848
https://doi.org/10.1186/s12886-018-1002-0
[ "skin", "glue", "blood", "arrow", "vessel", "eyelid", "lesion", "malformed", "nodule", "white" ]
[ { "code": "ME67", "title": "Skin disorder of uncertain or unspecified nature" }, { "code": "ME66.Y", "title": "Other specified skin changes" }, { "code": "EM0Y", "title": "Other specified diseases of the skin" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "ME66.1", "title": "Changes in skin texture" }, { "code": "AA82", "title": "Chronic serous or mucoid otitis media" }, { "code": "6C4B.2Z", "title": "Volatile inhalant dependence, unspecified" }, { "code": "PB36", "title": "Unintentional exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source" }, { "code": "PD05", "title": "Intentional self-harm by exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source" }, { "code": "PH56", "title": "Exposure to or harmful effects of undetermined intent of other or unspecified substances chiefly nonmedicinal as to source" } ]
=== ICD-11 CODES FOUND === [ME67] Skin disorder of uncertain or unspecified nature Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question. Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS [ME66.Y] Other specified skin changes Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta [EM0Y] Other specified diseases of the skin Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [ME66.1] Changes in skin texture Definition: Alterations in skin texture of unspecified cause. Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis [AA82] Chronic serous or mucoid otitis media Definition: Chronic serous or mucoid otitis media is probably the most common form of sub-acute middle ear disease found in the developed world. It typically lingers following otitis media, when the fluid in the ear, formed by the infection, does not clear spontaneously. The tympanic membrane is intact but the middle ear is liquid- fluid filled. This presumably puts the middle ear at risk for further infection and often worsens hearing by about 30 dB. This is most frequently found in children and can interf Also known as: Chronic serous or mucoid otitis media | Chronic serous or mucoid otitis media with transudative | Chronic serous or mucoid otitis media with exudative | Chronic serous or mucoid otitis media with effusion | Seromucinous otitis media [6C4B.2Z] Volatile inhalant dependence, unspecified Also known as: Volatile inhalant dependence, unspecified | Volatile inhalant dependence | Volatile inhalant addiction | Glue sniffing dependence | glue sniffing addiction [PB36] Unintentional exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source Also known as: Unintentional exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source | Unintentional exposure to or harmful effects of other or unspecified gases, fumes or vapours | Unintentional exposure to or harmful effects of nitrogen oxides | Unintentional exposure to or harmful effects of sulfur dioxide | Unintentional exposure to or harmful effects of formaldehyde [PD05] Intentional self-harm by exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source Also known as: Intentional self-harm by exposure to or harmful effects of other or unspecified substances chiefly nonmedicinal as to source | intentional self-poisoning by exposure to or harmful effects of other and unspecified chemicals and noxious substances | intentional overdose of other and unspecified chemicals and noxious substances | Intentional self-harm by exposure to or harmful effects of other gases, fumes or vapours | Intentional self-harm by exposure to or harmful effects of nitrogen oxides [PH56] Exposure to or harmful effects of undetermined intent of other or unspecified substances chiefly nonmedicinal as to source Also known as: Exposure to or harmful effects of undetermined intent of other or unspecified substances chiefly nonmedicinal as to source | Exposure to or harmful effects of undetermined intent of other gases, fumes or vapours | Exposure to or harmful effects of undetermined intent of nitrogen oxides | Exposure to or harmful effects of undetermined intent of sulfur dioxide | Exposure to or harmful effects of undetermined intent of formaldehyde === GRAPH WALKS === --- Walk 1 --- [ME67] Skin disorder of uncertain or unspecified nature Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --CHILD--> [ME62] Acute skin eruption of uncertain or unspecified nature Def: A provisional diagnosis for an acute skin eruption of less than six weeks' duration of unknown, uncertain or unspecified nature.... --- Walk 2 --- [ME67] Skin disorder of uncertain or unspecified nature Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --CHILD--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --- Walk 3 --- [ME66.Y] Other specified skin changes --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs Def: Other specified skin changes which cannot be more precisely defined.... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --- Walk 4 --- [ME66.Y] Other specified skin changes --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs Def: Other specified skin changes which cannot be more precisely defined.... --RELATED_TO--> [?] Abnormal skin pigmentation Def: Abnormal skin pigmentation without specification of type or cause.... --- Walk 5 --- [EM0Y] Other specified diseases of the skin --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and... --CHILD--> [?] Inflammatory dermatoses Def: A large group of skin disorders in which inflammation plays an important role.... --- Walk 6 --- [EM0Y] Other specified diseases of the skin --PARENT--> [14] Diseases of the skin Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and... --RELATED_TO--> [?] Neonatal phototherapy burn Def: Burn resulting from phototherapy administered to neonate, usually for the treatment of neonatal jaundice....
[ "[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME62] Acute skin eruption of uncertain or unspecified nature\n Def: A provisional diagnosis for an acute skin eruption of less than six weeks' duration of unknown, uncertain or unspecified nature....", "[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...", "[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....", "[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --RELATED_TO--> [?] Abnormal skin pigmentation\n Def: Abnormal skin pigmentation without specification of type or cause....", "[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --CHILD--> [?] Inflammatory dermatoses\n Def: A large group of skin disorders in which inflammation plays an important role....", "[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Neonatal phototherapy burn\n Def: Burn resulting from phototherapy administered to neonate, usually for the treatment of neonatal jaundice...." ]
ME67
Skin disorder of uncertain or unspecified nature
[ { "from_icd11": "ME67", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "ME66.Y", "icd10_code": "L578", "icd10_title": "Other skin changes due to chronic exposure to nonionizing radiation" }, { "from_icd11": "EM0Y", "icd10_code": "L918", "icd10_title": "Other hypertrophic disorders of the skin" }, { "from_icd11": "EM0Y", "icd10_code": "L988", "icd10_title": "Other specified disorders of the skin and subcutaneous tissue" }, { "from_icd11": "ME66.1", "icd10_code": "R234", "icd10_title": "Changes in skin texture" }, { "from_icd11": "AA82", "icd10_code": "H6520", "icd10_title": "Chronic serous otitis media, unspecified ear" }, { "from_icd11": "AA82", "icd10_code": "H652", "icd10_title": "Chronic serous otitis media" }, { "from_icd11": "AA82", "icd10_code": "H653", "icd10_title": "Chronic mucoid otitis media" }, { "from_icd11": "6C4B.2Z", "icd10_code": "F18259", "icd10_title": "Inhalant dependence with inhalant-induced psychotic disorder, unspecified" }, { "from_icd11": "6C4B.2Z", "icd10_code": "F18280", "icd10_title": "Inhalant dependence with inhalant-induced anxiety disorder" }, { "from_icd11": "6C4B.2Z", "icd10_code": "F18288", "icd10_title": "Inhalant dependence with other inhalant-induced disorder" }, { "from_icd11": "6C4B.2Z", "icd10_code": "F182", "icd10_title": "Inhalant dependence" }, { "from_icd11": "PB36", "icd10_code": "X49", "icd10_title": "" }, { "from_icd11": "PD05", "icd10_code": "X69", "icd10_title": "" }, { "from_icd11": "PH56", "icd10_code": "Y19", "icd10_title": "" } ]
L989
Disorder of the skin and subcutaneous tissue, unspecified
Case History 2 Twenty year old female who was asymptomatic till four months back, went to her doctor with recurrent episodes of persistently left sided headache of four months duration, subsiding with analgesics. It was not associated with any sensory or motor complaints and there was no history of early morning headache. Two months after the onset of headache she developed generalised tonic-clonic seizures, while watching television. CT head showed isodense to hypodense non-enhancing lesion with peripheral hypodense zone in the upper posterior part of the left temporal lobe and adjacent parietal lobe with minimal mass effect . A differential diagnosis of low grade glioma/granuloma/focal infarction/resolving hematoma was considered. MRI showed hypodense lesion in T1 weighted images and hyperdense lesion in T2 weighted images in left temporal lobe which supported the diagnosis of low grade glioma . Then patient was referred form the local hospital for surgery to another higher centre. Prior to surgery at the higher centre she underwent a repeat MRI which showed focal gyral hyperintensity in the region of left posterior temporal gyrus on T1 weighted images. Corresponding areas showed signal intensification on T2 weighted images. Hyperintensity was noted also along the course of vein of Labbe in F1 3D images suggesting vein of Labbe thrombosis . MR venogram subsequently confirmed the cortical vein thrombosis. She was further evaluated at the higher centre, the physical examination was unremarkable according to them except for the pallor. The Hb was 9.2 gm/dL, with macrocytosis (MCV110fl), MCH 33.8 and MCHC 36, TLC and DLC was normal with mild thrombocytosis (5.1 lakh/cmm) RDW of 18%, with a normal ESR and reticulocyte count (0.6). ANA, Anti-DS DNA, Anti-phospholipid antibody were negative. The CSF study showed opening pressure of 110 mmof CSF with total of 2 cells/cmm which were lymphocytes and the protein was 41 mg/dL with sugar of 70 mg/dL (corresponding blood sugar of 99 mg/dL). The ECG and chest skiagram were normal as well as the 2D echocardiogram. Sleep EEG showed mild degree of focal nonspecific electrophysiological abnormalities over the left posterior temporal region. No epileptiform abnormalities seen. The striking abnormality was the serum homocysteine of 65 micro mol/L (normal 5–15 micromol/l). She was treated with antiepileptics and was supplemented with folate for the macrocytic anemia and for hyperhomocysteinemia. Vitamin B12 was not supplemented adequately from that centre. She was referred to us for evaluation of anemia and the pro-coagulant state. A detailed review of history showed that she was on a strict vegetarian diet with no consumption of egg or dairy products. The vegetarian diet she took was erratic and totally unbalanced without adequate intake green leafy vegetables. She was moderately built and nourished with mild pallor, and striking premature greying of the hair and knuckle hyper-pigmentation. She had by then features suggestive of mild Subacute combined degeneration of spinal cord as evidenced by Romberg's sign positivity. Folate supplementation alone which she received prior to coming to our centre, in the presence of severe Vitamin B12 deficiency might have precipitated the neurological signs. Thus a clinical diagnosis of vitamin B12 deficiency was made. The following investigation were done: Peripheral smear showed moderate anisopoikilocytosis with normochromic normocytic cells, macroovalocytes, tear drop cells and a few microcytes suggestive of dimorphic anemia. Serum vitamin B12 was 293 pg/mL (211–911 pg/mL) and the serum ferritin was decreased. Peripheral smear report and lower limit of vitamin B12 in spite of partial supplementation earlier, supported the diagnosis of vitamin B12 deficiency with iron deficiency. Hyperhomocysteinemia was secondary to B12 deficiency which resulted in hypercoagulable state. Patient was treated with vitamin B12 and folate and she improved dramatically over the next few weeks. Currently she is asymptomatic and is adhering to balanced diet and is not on anticoagulants for the last two years. Thanks to the preoperative diagnosis of cortical venous thrombosis by the good radiologist which saved her and her family from the agony of an unwanted surgery and its complications. This case history illustrates that if we do not elicit the dietary history and if we fail to notice the physical signs of B12 deficiency it will prolong the agony even after the diagnosis of CVT is made. It also tells that the thrombus may not be demonstrable in major sinuses at the time of evaluation. Therefore, clinical suspicion, proper clinical evaluation, supporting investigations, and clinical judgment should be the most important in arriving at the conclusions.
3.964844
0.98291
sec[5]/p[2]
en
0.999998
22567255
https://doi.org/10.1155/2012/210676
[ "vitamin", "which", "deficiency", "centre", "temporal", "weighted", "that", "headache", "hypodense", "lesion" ]
[ { "code": "5B7Z", "title": "Unspecified undernutrition" }, { "code": "5B90.Z", "title": "Unspecified vitamin excesses" }, { "code": "5B55.Z", "title": "Vitamin A deficiency, unspecified" }, { "code": "6C4H.1Z", "title": "Harmful pattern of use of non-psychoactive substances, unspecified" }, { "code": "5B90.Y", "title": "Other specified vitamin excess" }, { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "8A44.3", "title": "Certain specified leukodystrophies" }, { "code": "BE2Z", "title": "Diseases of the circulatory system, unspecified" } ]
=== ICD-11 CODES FOUND === [5B7Z] Unspecified undernutrition Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS [5B90.Z] Unspecified vitamin excesses Also known as: Unspecified vitamin excesses | Vitamin excesses [5B55.Z] Vitamin A deficiency, unspecified Also known as: Vitamin A deficiency, unspecified | Vitamin A deficiency | Hypovitaminosis A [6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified Also known as: Harmful pattern of use of non-psychoactive substances, unspecified | Harmful pattern of use of non-psychoactive substances | harmful use of nonprescribed drugs, non-dependence producing | Abuse of antacids | Abuse of herbal or folk remedies [5B90.Y] Other specified vitamin excess Also known as: Other specified vitamin excess [BD50.41] Abdominal aortic aneurysm with rupture Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA [EK91] Dermatoses which may presage cutaneous lymphoma Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature. Also known as: Dermatoses which may presage cutaneous lymphoma [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [8A44.3] Certain specified leukodystrophies Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome [BE2Z] Diseases of the circulatory system, unspecified Also known as: Diseases of the circulatory system, unspecified | circulatory disease NOS | cardiovascular disease NOS | cardiovascular system disease NOS | CVS - [cardiovascular system] disease === GRAPH WALKS === --- Walk 1 --- [5B7Z] Unspecified undernutrition --PARENT--> [?] Undernutrition Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c... --EXCLUDES--> [?] Intestinal malabsorption Def: Intestinal malabsorption (syndrome) occurs due to pathological interference with the normal physiological sequence of digestion (intraluminal process), absorption (mucosal process), and transport (pos... --- Walk 2 --- [5B7Z] Unspecified undernutrition --PARENT--> [?] Undernutrition Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c... --RELATED_TO--> [?] Undernutrition-dehydration cataract Def: This is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. This diagnosis is with dehydration cataract.... --- Walk 3 --- [5B90.Z] Unspecified vitamin excesses --PARENT--> [5B90] Vitamin excesses --CHILD--> [5B90.2] Hypervitaminosis D Def: Hypervitaminosis D is secondary to excessive intake of vitamin D. It can occur with long-term high intake or with a substantial, acute ingestion. Excess amounts result in abnormally high concentration... --- Walk 4 --- [5B90.Z] Unspecified vitamin excesses --PARENT--> [5B90] Vitamin excesses --CHILD--> [5B90.0] Hypervitaminosis A Def: Because vitamin A is fat soluble and can be stored, primarily in the liver, routine consumption of large amounts of vitamin A over a period of time can result in toxic symptoms, including liver damage... --- Walk 5 --- [5B55.Z] Vitamin A deficiency, unspecified --PARENT--> [5B55] Vitamin A deficiency Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ... --CHILD--> [5B55.0] Vitamin A deficiency with night blindness Def: Night blindness (poor adaptation to darkness) is generally the earliest manifestation of vitamin A deficiency. In mild cases, night blindness is apparent only after photic stress. Affected children no... --- Walk 6 --- [5B55.Z] Vitamin A deficiency, unspecified --PARENT--> [5B55] Vitamin A deficiency Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ... --CHILD--> [5B55.0] Vitamin A deficiency with night blindness Def: Night blindness (poor adaptation to darkness) is generally the earliest manifestation of vitamin A deficiency. In mild cases, night blindness is apparent only after photic stress. Affected children no...
[ "[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --EXCLUDES--> [?] Intestinal malabsorption\n Def: Intestinal malabsorption (syndrome) occurs due to pathological interference with the normal physiological sequence of digestion (intraluminal process), absorption (mucosal process), and transport (pos...", "[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --RELATED_TO--> [?] Undernutrition-dehydration cataract\n Def: This is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. This diagnosis is with dehydration cataract....", "[5B90.Z] Unspecified vitamin excesses\n --PARENT--> [5B90] Vitamin excesses\n --CHILD--> [5B90.2] Hypervitaminosis D\n Def: Hypervitaminosis D is secondary to excessive intake of vitamin D. It can occur with long-term high intake or with a substantial, acute ingestion. Excess amounts result in abnormally high concentration...", "[5B90.Z] Unspecified vitamin excesses\n --PARENT--> [5B90] Vitamin excesses\n --CHILD--> [5B90.0] Hypervitaminosis A\n Def: Because vitamin A is fat soluble and can be stored, primarily in the liver, routine consumption of large amounts of vitamin A over a period of time can result in toxic symptoms, including liver damage...", "[5B55.Z] Vitamin A deficiency, unspecified\n --PARENT--> [5B55] Vitamin A deficiency\n Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...\n --CHILD--> [5B55.0] Vitamin A deficiency with night blindness\n Def: Night blindness (poor adaptation to darkness) is generally the earliest manifestation of vitamin A deficiency. In mild cases, night blindness is apparent only after photic stress. Affected children no...", "[5B55.Z] Vitamin A deficiency, unspecified\n --PARENT--> [5B55] Vitamin A deficiency\n Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...\n --CHILD--> [5B55.0] Vitamin A deficiency with night blindness\n Def: Night blindness (poor adaptation to darkness) is generally the earliest manifestation of vitamin A deficiency. In mild cases, night blindness is apparent only after photic stress. Affected children no..." ]
5B7Z
Unspecified undernutrition
[ { "from_icd11": "5B7Z", "icd10_code": "E43", "icd10_title": "Unspecified severe protein-calorie malnutrition" }, { "from_icd11": "5B7Z", "icd10_code": "E538", "icd10_title": "Deficiency of other specified B group vitamins" }, { "from_icd11": "5B7Z", "icd10_code": "E569", "icd10_title": "Vitamin deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E638", "icd10_title": "Other specified nutritional deficiencies" }, { "from_icd11": "5B7Z", "icd10_code": "E639", "icd10_title": "Nutritional deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E41", "icd10_title": "Nutritional marasmus" }, { "from_icd11": "5B7Z", "icd10_code": "E539", "icd10_title": "Vitamin B deficiency, unspecified" }, { "from_icd11": "5B7Z", "icd10_code": "E568", "icd10_title": "Deficiency of other vitamins" }, { "from_icd11": "5B7Z", "icd10_code": "E649", "icd10_title": "Sequelae of unspecified nutritional deficiency" }, { "from_icd11": "5B7Z", "icd10_code": "E618", "icd10_title": "Deficiency of other specified nutrient elements" }, { "from_icd11": "5B7Z", "icd10_code": "E40-E46", "icd10_title": "" }, { "from_icd11": "5B7Z", "icd10_code": "E50-E64", "icd10_title": "" }, { "from_icd11": "5B7Z", "icd10_code": "E53", "icd10_title": "Deficiency of other B group vitamins" }, { "from_icd11": "5B7Z", "icd10_code": "E56", "icd10_title": "Other vitamin deficiencies" }, { "from_icd11": "5B7Z", "icd10_code": "E61", "icd10_title": "Deficiency of other nutrient elements" } ]
E43
Unspecified severe protein-calorie malnutrition
The female patient was the second child of a non-consanguineous Han Chinese couple. The mother previously had four episodes of spontaneous abortion during the first trimester due to lack of mixed lymphocyte reaction blocking antibodies. Through paternal lymphocyte immunotherapy, the mother successfully gave birth to the proband and her older brother. Fetal ultrasound scans of the proband showed fetal liver was normal. She was born at the gestational age of 39 weeks by cesarean section, with a birth weight of 3.15 kg. She presented at the age of 3 months and 14 days with bronchopneumonia, during the course of which elevated alanine aminotransferase (101 U/L, normal: 0-40 U/L) and aspartate aminotransferase (135 U/L, normal: 0-40 U/L) were noted. Initial abdominal ultrasound revealed hepatomegaly (the liver enlarged 2 cm below the costal margin). As the elevated liver enzymes and hepatomegaly persisted after recovery of bronchopneumonia, the child was transferred to another hospital for further treatment. Fasting hypertriglyceridemia was noted at presentation and throughout the follow-up period (range 4.39-10.94 mmol/L, normal: 0.56-1.7 mmol/L). Gamma-glutamyltranspeptidase and total bile acids were 265 IU/L (normal: 7-50 IU/L) and 18.2 μmol/L (normal: 0-10 μmol/L), respectively. However, total cholesterol, lipoprotein, bilirubin, alpha-fetoprotein and synthetic liver function (coagulation studies and albumin) were within normal limits. Abdominal CT scan showed a severely enlarged liver accompanied with fatty change, which had diffusely decreased density. Viral serological markers (hepatotrophic viruses, Epstein-Barr virus, cytomegalovirus, and HIV), toxoplasma, thyroid function tests, creatine phosphokinase, glucose, ceruloplasmin, blood routine tests, urine routine tests, blood lactate, blood ammonia, carbonyldiamide, creatinine, uric acid, urine organic acids, autoimmune serology, immunoglobulin levels, and echocardiogram were unremarkable. At this point, due to the combination of hypertriglyceridemia, hepatomegaly, and elevated liver transaminases, the working diagnosis was inclined to inherited metabolic liver disease. Thus, the whole blood samples from the family were sent to Precision MD (Beijing, China) for panel sequencing to screen 4503 genes using the customized xGen Inherited Diseases Panel. She took “Compound Glycyrrhizin” during this hospitalization. However, the levels of triglyceride and liver enzymes were not decreased. She was referred to the center for pediatric liver diseases in our hospital at 6.5 months of age for percutaneous liver biopsy. Since then, she did not receive any treatment. At the last evaluation at the age of 1 year and 3 months, the child still presented with hepatomegaly, hypertriglyceridemia, and moderately elevated transaminases, while maintaining a normal growth and psychomotor development. The detailed clinical characteristics of the proband are shown in Table 1 . The patient’s parents and older brother were asymptomatic. The liver functions of the mother and older brother were normal. However, alanine aminotransferase (59 IU/L, normal: 0-40 IU/L), gamma-glutamyl transpeptidase (62 IU/L, normal: 7-50 IU/L), total cholesterol (5.87 mmol/L, normal: 3.1-5.2 mmol/L) and triglyceride (3.5 mmol/L, normal: 0.56-1.7 mmol/L) were mildly elevated in the father. In addition, the father was morbidly obese (body mass index 31.3 kg/m 2 , normal: 18.5-23.9 kg/m 2 ). Table 1 Clinical and laboratory findings of the patient Personal history Presenting age (months) 3.5 Age at last following up (months) 15 Gravidity (G) and Parity (P) G6P2 Gestation (weeks) 39 Birth weight (g) 3150 Birth history cesarean section Physical examination at 6.5 months old Head circumference (cm) 42.0 Chest circumference (cm) 43.0 Height (cm) 63.0 Weight (kg) 6.8 Temperature (°C) 37.0 Heart rate (beats per minute) 126 Respiration rate (times per minute) 28 Hepatomegaly Yes Splenomegaly No Biochemical examination Albumin (g/L) 45.1-50.8 Alanine aminotransferase (IU/L) 68-110 Aspartate aminotransferase (IU/L) 108-186 Gammaglutamyl-transpeptidase (IU/L) 233-482 Direct bilirubin (umol/L) 1.0-2.3 Total bilirubin (umol/L) 2.4-9.4 Total bile acid (umol/L) 9.0-19.8 Alpha fetal protein (ng/mL) 53 Triglyceride (mmol/L) 4.18-10.94 Total cholesterol (mmol/L) 2.36-4.35 Glucose (mmol/L) 4.2-5.7 Coagulation test D-dimer (mg/L) 0.27-1.18 Activated partial thromboplastin time (s) 25.0-33.3 Thrombin time (s) 19.4-19.9 Prothrombin time (s) 11.0-13.3 Fibrinogen (g/L) 1.84-1.93 Blood routine examination Hemoglobin (g/L) 95.0-101.0 Red blood cell count (per liter) 4.91-5.24 × 10 12 White blood cell count (per liter) 7.7-11 × 10 9 Lymphocytes (%) 65.0-75.0 Neutrophils (%) 16.8-22.0 Platelets count (per liter) 568-782 × 10 9
4.195313
0.955566
sec[1]/sec[0]/p[0]
en
0.999998
29940878
https://doi.org/10.1186/s12876-018-0827-6
[ "liver", "mmol", "blood", "total", "aminotransferase", "hepatomegaly", "birth", "mother", "proband", "older" ]
[ { "code": "DB9Z", "title": "Diseases of liver, unspecified" }, { "code": "DB97.Z", "title": "Inflammatory liver disease, unspecified" }, { "code": "DB99.7", "title": "Hepatic failure without mention whether acute or chronic" }, { "code": "LB20.0Y", "title": "Other specified structural developmental anomalies of liver" }, { "code": "LB20.0Z", "title": "Structural developmental anomalies of liver, unspecified" }, { "code": "GB42.1", "title": "Albuminuria, Grade A3" }, { "code": "GB42.0", "title": "Albuminuria, Grade A2" }, { "code": "MA18.0Y", "title": "Other specified elevated blood glucose level" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" } ]
=== ICD-11 CODES FOUND === [DB9Z] Diseases of liver, unspecified Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy [DB97.Z] Inflammatory liver disease, unspecified Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS [DB99.7] Hepatic failure without mention whether acute or chronic Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS [LB20.0Y] Other specified structural developmental anomalies of liver Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity [LB20.0Z] Structural developmental anomalies of liver, unspecified Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver [GB42.1] Albuminuria, Grade A3 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy [GB42.0] Albuminuria, Grade A2 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine [MA18.0Y] Other specified elevated blood glucose level Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --RELATED_TO--> [?] Structural developmental anomalies of liver --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --CHILD--> [DB90] Infectious liver disease --- Walk 3 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --CHILD--> [DB97.1] Hepatic berylliosis --- Walk 4 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --CHILD--> [DB97.1] Hepatic berylliosis --- Walk 5 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --CHILD--> [DB99.2] Hepatorenal syndrome --- Walk 6 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --EXCLUDES--> [?] Hepatic vein thrombosis Def: Venous thrombosis within the hepatic vein....
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Structural developmental anomalies of liver", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --CHILD--> [DB90] Infectious liver disease", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.1] Hepatic berylliosis", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.1] Hepatic berylliosis", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --CHILD--> [DB99.2] Hepatorenal syndrome", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --EXCLUDES--> [?] Hepatic vein thrombosis\n Def: Venous thrombosis within the hepatic vein...." ]
DB9Z
Diseases of liver, unspecified
[ { "from_icd11": "DB9Z", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB9Z", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K769", "icd10_title": "Liver disease, unspecified" }, { "from_icd11": "DB9Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "DB9Z", "icd10_code": "K762", "icd10_title": "Central hemorrhagic necrosis of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K70-K77", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K778", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K72", "icd10_title": "Hepatic failure, not elsewhere classified" }, { "from_icd11": "DB9Z", "icd10_code": "K76", "icd10_title": "Other diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K768", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB97.Z", "icd10_code": "K7581", "icd10_title": "Nonalcoholic steatohepatitis (NASH)" }, { "from_icd11": "DB97.Z", "icd10_code": "K7589", "icd10_title": "Other specified inflammatory liver diseases" }, { "from_icd11": "DB97.Z", "icd10_code": "K759", "icd10_title": "Inflammatory liver disease, unspecified" }, { "from_icd11": "DB97.Z", "icd10_code": "K752", "icd10_title": "Nonspecific reactive hepatitis" }, { "from_icd11": "DB97.Z", "icd10_code": "K75", "icd10_title": "Other inflammatory liver diseases" } ]
K7681
Hepatopulmonary syndrome
A 37 year old female presented to her primary care physician with nonspecific abdominal pain. She underwent CT imaging that revealed bilateral ovarian masses and ascites. Preoperative CA125 was the only tumor marker examined and it was within normal limits. A presumptive diagnosis of ovarian cancer was made and she underwent exploratory laparotomy which revealed macroscopic peritoneal metastases to ovaries, omentum and pelvic peritoneum. At that time total abdominal hysterectomy, bilateral salpingoopherectomy, pelvic lymph node sampling, partial omentectomy, appendectomy and evacuation of mucinous ascites was performed. Final pathology revealed low grade mucinous adenocarcinoma in all specimens, arising from an appendiceal primary. The patient received no additional therapy and was followed clinically. She developed recurrent abdominal pain approximately 2 years later. Computed tomography (CT) scan revealed progressive nodularity in the mesentery and peritoneal surfaces consistent with recurrent disease. This was further evaluated with a laparoscopy, which revealed mucinous tumor implants along the anterior abdominal wall, right retroperitoneum, diaphragm, and remaining omentum . At this time, the patient was referred to the University of Cincinnati for consideration of cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion. The patient's past medical history was significant only for a seizure disorder which was managed by anticonvulsant medication and an implanted vagus nerve stimulator. Preoperative CA19-9 was elevated at 59, while CEA and CA-125 were normal. The patient was felt to be an appropriate candidate and underwent exploration. At surgery, extensive disease was noted over the peritoneal surfaces. A complete cytoreduction was achieved requiring, right colectomy, splenectomy, cholecystectomy, omentectomy, and perionectomies of the diaphragms, anterior abdominal wall, and pelvis. Tumor nodules were excised from the small bowel and large bowel mesentery. The cytoreductive portion of the operation was completed in approximately 210 minutes. Per our current practice protocol, a 90 minute perfusion was performed using an inflow temperature of 44°C, with peritoneal surface temperatures averaging 40.5–41.5°C. Intraperitoneal temperatures were measured via four temperature probes, one within the liver parenchyma, and three within separate quadrants of the peritoneum. Core temperature was recorded via the bladder and esophageal temperature probes. Per our standard protocol, the carrier solution was peritoneal dialysis fluid (2.5%). The patient's maximum recorded core body temperature during the procedure was 38.7°C and the maximum recorded liver temperature was 38.8°C. Mitomycin C was delivered using a total dose of 10 mg/L perfusate, delivered in divided doses of 7 mg/L at initiation and redosed after 45 minutes at 3 mg/L. A total dose of 45 mg was delivered in this patient. During the operation, the patient had no significant electrolyte abnormalities aside from the expected glucose elevation seen during the perfusion period. The maximum serum glucose was 355 mg/dL and the lowest serum sodium was 135. The operation was generally uneventful; no blood transfusions were required and the patient was transferred to the ICU in stable condition. Postoperatively, all serum electrolytes were normal and albumin was 3.4 mg/dl compared with 4.3 mg/dl, preoperatively. The patient was easily arousable and followed commands appropriately. However, approximately 4 hrs later, the patient complained of headache and right eye pain. Her headache was treated with analgesics, however 3 hours later, she was found to be tachypenic, bradycardic, and hypotensive, and was unresponsive with fixed, dilated pupils. She was emergently intubated and resuscitated. After approximately 15 minutes, she regained consciousness, and responded appropriately to commands. Her pupils returned to 3 mm and because reactive. Neurology was consulted and she was loaded with Dilantin due to her history of seizure disorder. An urgent CT scan was ordered. On route to the CT scanner, she once again became bradycardic and hypotensive with fixed, dilated pupils. The CT scan revealed diffuse cerebral edema . ICP monitoring revealed pressures of 70–90 mmHg. Mannitol was used in an attempt to lower intracranial pressure without success. EEG was consistent with diffuse brain dysfunction. A brain death protocol revealed that she had suffered brain death and care was subsequently withdrawn. At autopsy, diffuse cerebral edema with tonsillar herniation was noted . No pathologic findings were present to indicate the cause of the cerebral edema. The final pathology on all resected specimens reconfirmed the diagnosis of mucinous adenocarcinoma .
4.082031
0.953613
sec[1]/p[0]
en
0.999997
17137499
https://doi.org/10.1186/1477-7819-4-85
[ "temperature", "abdominal", "peritoneal", "mucinous", "approximately", "pain", "that", "tumor", "within", "which" ]
[ { "code": "MG26", "title": "Fever of other or unknown origin" }, { "code": "NF03.Z", "title": "Unspecified effects of reduced temperature" }, { "code": "ME65.0", "title": "Burning of skin" }, { "code": "NF03.Y", "title": "Other specified effects of reduced temperature" }, { "code": "QD84.Y", "title": "Other specified occupational exposure to risk-factors" }, { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "NB51.0&XA3KX0", "title": "Laceration without foreign body of abdominal wall" }, { "code": "NB9Y", "title": "Other specified injuries to the abdomen, lower back, lumbar spine or pelvis" } ]
=== ICD-11 CODES FOUND === [MG26] Fever of other or unknown origin Definition: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process. Also known as: Fever of other or unknown origin | febrile | febris | fever | feverish Excludes: fever of unknown origin in newborn | Malignant hyperthermia due to anaesthesia [NF03.Z] Unspecified effects of reduced temperature Also known as: Unspecified effects of reduced temperature | Other effects of reduced temperature | adverse effect of cold | cold effects | exposure to cold [ME65.0] Burning of skin Definition: A burning sensation in the skin which usually arises without obvious explanation. Also known as: Burning of skin | Burning sensation | Disturbance in temperature sense [NF03.Y] Other specified effects of reduced temperature Also known as: Other specified effects of reduced temperature | Chapping of skin | Exhaustion from cold [QD84.Y] Other specified occupational exposure to risk-factors Also known as: Other specified occupational exposure to risk-factors | Occupational exposure to noise | Occupational exposure to radiation | Occupational exposure to air contaminants other than dust | Occupational exposure to tobacco smoke [MD81.3] Acute abdomen Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain [JA01.0] Abdominal pregnancy Definition: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy. Also known as: Abdominal pregnancy | abdomen pregnancy | intraperitoneal pregnancy Excludes: Maternal care for viable fetus in abdominal pregnancy | Delivery of viable fetus in abdominal pregnancy [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS [NB9Y] Other specified injuries to the abdomen, lower back, lumbar spine or pelvis Also known as: Other specified injuries to the abdomen, lower back, lumbar spine or pelvis | Abdominal wall trauma | Injury of pelvic floor | pelvic floor blunt injury | pelvic floor blunt trauma === GRAPH WALKS === --- Walk 1 --- [MG26] Fever of other or unknown origin Def: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process.... --RELATED_TO--> [?] Pyrexia of unknown origin following delivery --PARENT--> [?] Infections in the puerperium --- Walk 2 --- [MG26] Fever of other or unknown origin Def: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process.... --RELATED_TO--> [?] Pyrexia of unknown origin following delivery --EXCLUDES--> [?] Pyrexia during labour, not elsewhere classified Def: A complication characterised by maternal fever during labour, and not elsewhere classified.... --- Walk 3 --- [NF03.Z] Unspecified effects of reduced temperature --PARENT--> [NF03] Other effects of reduced temperature --CHILD--> [NF03.Y] Other specified effects of reduced temperature --- Walk 4 --- [NF03.Z] Unspecified effects of reduced temperature --PARENT--> [NF03] Other effects of reduced temperature --CHILD--> [NF03.0] Chilblains Def: Chilblains are the result of cold-induced damage principally to the microvasculature of acral skin in susceptible individuals. They are commonest in the winter months in cold, damp climates. They pres... --- Walk 5 --- [ME65.0] Burning of skin Def: A burning sensation in the skin which usually arises without obvious explanation.... --PARENT--> [ME65] Disturbances of skin sensation of unspecified aetiology Def: A group of cutaneous symptoms for which it is frequently impossible to identify a precise cause.... --RELATED_TO--> [?] Tactile hallucinations Def: Hallucinations involving the perception of being touched (e.g., feeling like bugs are crawling on the skin, pins being stuck into one's finger) that are not restricted to the period of awakening or th... --- Walk 6 --- [ME65.0] Burning of skin Def: A burning sensation in the skin which usually arises without obvious explanation.... --PARENT--> [ME65] Disturbances of skin sensation of unspecified aetiology Def: A group of cutaneous symptoms for which it is frequently impossible to identify a precise cause.... --CHILD--> [ME65.1] Itching of skin Def: The sensation of itch in the skin. For persistent itch of unknown cause the term "Pruritus of unknown cause" should be used....
[ "[MG26] Fever of other or unknown origin\n Def: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process....\n --RELATED_TO--> [?] Pyrexia of unknown origin following delivery\n --PARENT--> [?] Infections in the puerperium", "[MG26] Fever of other or unknown origin\n Def: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process....\n --RELATED_TO--> [?] Pyrexia of unknown origin following delivery\n --EXCLUDES--> [?] Pyrexia during labour, not elsewhere classified\n Def: A complication characterised by maternal fever during labour, and not elsewhere classified....", "[NF03.Z] Unspecified effects of reduced temperature\n --PARENT--> [NF03] Other effects of reduced temperature\n --CHILD--> [NF03.Y] Other specified effects of reduced temperature", "[NF03.Z] Unspecified effects of reduced temperature\n --PARENT--> [NF03] Other effects of reduced temperature\n --CHILD--> [NF03.0] Chilblains\n Def: Chilblains are the result of cold-induced damage principally to the microvasculature of acral skin in susceptible individuals. They are commonest in the winter months in cold, damp climates. They pres...", "[ME65.0] Burning of skin\n Def: A burning sensation in the skin which usually arises without obvious explanation....\n --PARENT--> [ME65] Disturbances of skin sensation of unspecified aetiology\n Def: A group of cutaneous symptoms for which it is frequently impossible to identify a precise cause....\n --RELATED_TO--> [?] Tactile hallucinations\n Def: Hallucinations involving the perception of being touched (e.g., feeling like bugs are crawling on the skin, pins being stuck into one's finger) that are not restricted to the period of awakening or th...", "[ME65.0] Burning of skin\n Def: A burning sensation in the skin which usually arises without obvious explanation....\n --PARENT--> [ME65] Disturbances of skin sensation of unspecified aetiology\n Def: A group of cutaneous symptoms for which it is frequently impossible to identify a precise cause....\n --CHILD--> [ME65.1] Itching of skin\n Def: The sensation of itch in the skin. For persistent itch of unknown cause the term \"Pruritus of unknown cause\" should be used...." ]
MG26
Fever of other or unknown origin
[ { "from_icd11": "MG26", "icd10_code": "R5081", "icd10_title": "Fever presenting with conditions classified elsewhere" }, { "from_icd11": "MG26", "icd10_code": "R5084", "icd10_title": "Febrile nonhemolytic transfusion reaction" }, { "from_icd11": "MG26", "icd10_code": "R5082", "icd10_title": "Postprocedural fever" }, { "from_icd11": "MG26", "icd10_code": "R5083", "icd10_title": "Postvaccination fever" }, { "from_icd11": "MG26", "icd10_code": "R509", "icd10_title": "Fever, unspecified" }, { "from_icd11": "MG26", "icd10_code": "R502", "icd10_title": "Drug induced fever" }, { "from_icd11": "MG26", "icd10_code": "R50", "icd10_title": "Fever of other and unknown origin" }, { "from_icd11": "MG26", "icd10_code": "R508", "icd10_title": "Other specified fever" }, { "from_icd11": "NF03.Z", "icd10_code": "T699XXA", "icd10_title": "Effect of reduced temperature, unspecified, initial encounter" }, { "from_icd11": "NF03.Z", "icd10_code": "T699XXS", "icd10_title": "Effect of reduced temperature, unspecified, sequela" }, { "from_icd11": "NF03.Z", "icd10_code": "T698XXA", "icd10_title": "Other specified effects of reduced temperature, initial encounter" }, { "from_icd11": "NF03.Z", "icd10_code": "T69", "icd10_title": "Other effects of reduced temperature" }, { "from_icd11": "NF03.Z", "icd10_code": "T698", "icd10_title": "Other specified effects of reduced temperature" }, { "from_icd11": "NF03.Z", "icd10_code": "T699", "icd10_title": "Effect of reduced temperature, unspecified" }, { "from_icd11": "MD81.3", "icd10_code": "R100", "icd10_title": "Acute abdomen" } ]
R5081
Fever presenting with conditions classified elsewhere
In 2004, a series of four cases diagnosed in the Messina province (Sicily, Italy) between December 1997 and May 2001 were reported . Case 1 was a 14-year-old, female, domestic short-haired (DSH) cat admitted for dyspnoea, lethargy, anorexia and weight loss. Pale mucous membranes, dehydration, dermatologic lesions on the head (a small crusty ulcer and a hemorrhagic bulla), and uveitis sequela were observed at physical examination. Amastigotes were detected at cytological evaluation of skin lesions and the cat was antibody positive to L. infantum (IFAT titre: 640). Additional investigations detected feline immunodeficiency virus (FIV) antibody positivity, azotemic chronic kidney disease (CKD), pancytopenia, hyperproteinemia and hyperglobulinemia with monoclonal hypergammaglobulinemia, bronchopneumonia and pyothorax, and the cat died 35 days later. The age of case 2 was unknown and it was a rescued adult long-haired cat admitted for systemic lymph node enlargement. Uveitis sequela was observed at ophthalmologic examination. Complete blood count, biochemical profile and urinalysis were within reference range apart from hyperproteinemia and hyperglobulinemia with monoclonal hypergammaglobulinemia and the cat was FIV antibody and feline leukaemia virus (FeLV) antigen negative. Amastigotes were seen at cytological evaluation of lymph nodes and the diagnosis was confirmed by antibody detection (IFAT titre: 640), positive culture and conventional PCR from lymph nodes. Anti- Leishmania oral treatment was started with fluconazole (5 mg/kg q24 h for 2 months) and it was ineffective as well as the subsequent combination of metronidazole (25 mg/kg) and spiramycin (150,000 IU/kg) q24 h for 35 days and afterwards itraconazole (50 mg q24 h for 2 months). After that no anti- Leishmania treatment was given. Chronic kidney disease was evidenced 5 months after the diagnosis of leishmaniosis and it progressively worsened associated with severe weight loss and non-regenerative anemia. Twenty-two months later, the diagnosis euthanasia was performed and, at that time, lymph node enlargement was no longer detected, hypergammaglobulinemia was reduced but alfa-globulin fraction was increased and anti- L. infantum IFAT titre was 320. Case 3 was a 6-year-old, DSH, male cat presented with a single enlarged lymph node. Conventional PCR and culture from the enlarged lymph node were both positive and anti- L. infantum IFAT titre was 1280. A cutaneous hemorrhagic bulla was observed on the pinna margin as well as chorioretinitis. The cat was positive for anti-FIV antibodies and hyperproteinemia, hyperglobulinemia and monoclonal hypergammaglobulinemia were detected. Complete blood count, biochemical profile and urinalysis were in the reference range and the owner did not comply with therapy. Three years later urinary abnormalities suggestive of CKD were found and 5 years after the diagnosis of leishmaniosis the owner reported anorexia and episodes of seizure. A cardiac arrhythmia was diagnosed but the owner refused further investigations and asked for euthanasia. The initial clinical findings persisted during the 5 year period of follow up and, at the time of euthanasia, anti- L. infantum IFAT titre was 640 and lymph node was found Leishmania positive at cytological and PCR investigations. Case 4 was a 10-year-old, DSH, female cat admitted for lethargy, anorexia and severe weight loss. Pale mucous membranes, systemic lymph node enlargement, alopecia, hepatomegaly and acute uveitis were observed at physical examination. The cat was found positive for anti-FIV antibodies and pancytopenia, hyperproteinemia, hyperglobulinemia and monoclonal hypergammaglobulinemia were detected. Lymph nodes were found positive to L. infantum by cytological evaluation, PCR and culture. Anti- Leishmania antibodies were detected by IFAT (titre: 640). The cat was treated with allopurinol (20 mg/kg q24 h) and erythropoietin was added during the first two months and human recombinant interferon-alpha was given for 6 months. In a few weeks there was a clinical improvement and in few months was clinically cured. Allopurinol was stopped after 15 months of therapy when anti- Leishmania antibodies were <80 and PCR was negative. However, a few months later, there was a clinical recurrence associated with antibody positivity and positive culture from lymph node. These four cats were tested, apart for FIV and FeLV infections, also for antibodies against feline coronavirus (FCoV), Bartonella henselae and Toxoplasma gondii . Anti-FCoV antibodies were detected only in case 2 but with a low IFAT titre (25). Case 2 and case 3 were both IgG positive for B. henselae (IFAT titre: 256). Case 1 (titre: 100), case 2 (titre: 400) and case 4 were found IgG positive for T. gondii .
4.121094
0.722168
sec[2]/sec[1]/sec[1]/sec[0]/p[5]
en
0.999997
33800782
https://doi.org/10.3390/pathogens10030307
[ "titre", "lymph", "anti", "ifat", "node", "antibodies", "antibody", "infantum", "hypergammaglobulinemia", "leishmania" ]
[ { "code": "MA14.1C", "title": "Raised antibody titre" }, { "code": "BD9Z", "title": "Disorders of lymphatic vessels or lymph nodes, unspecified" }, { "code": "BD90.Z", "title": "Lymphadenitis, unspecified" }, { "code": "BD90.Y", "title": "Other specified lymphadenitis" }, { "code": "BD9Y", "title": "Other specified disorders of lymphatic vessels or lymph nodes" }, { "code": "MA01.Z", "title": "Enlarged lymph nodes, unspecified" }, { "code": "JA86.Y", "title": "Maternal care for other specified fetal problems" }, { "code": "MB23.1", "title": "Antisocial behaviour" }, { "code": "3B4Z", "title": "Coagulation defects, unspecified" }, { "code": "4A45.Z", "title": "Antiphospholipid syndrome, unspecified" } ]
=== ICD-11 CODES FOUND === [MA14.1C] Raised antibody titre Also known as: Raised antibody titre | antibody titre above reference range | high antibody titre | increased antibody titre Excludes: isoimmunization, in pregnancy affecting fetus or newborn [BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified Also known as: Disorders of lymphatic vessels or lymph nodes, unspecified | Lymphatic system disorders | lymph disease NOS | lymph gland disease | Lymphatic system disease NOS [BD90.Z] Lymphadenitis, unspecified Also known as: Lymphadenitis, unspecified | Lymphadenitis | adenitis NOS | inflammation of gland | lymphatic gland inflammation [BD90.Y] Other specified lymphadenitis Also known as: Other specified lymphadenitis | Dermatopathic lymphadenopathy | lipomelanotic reticulosis | Infective inguinal bubo | bubo [BD9Y] Other specified disorders of lymphatic vessels or lymph nodes Also known as: Other specified disorders of lymphatic vessels or lymph nodes | Chylous cyst | Mesentery chylous cyst | Peritoneum chylous cyst | Lymphocele [MA01.Z] Enlarged lymph nodes, unspecified Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy [JA86.Y] Maternal care for other specified fetal problems Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS [MB23.1] Antisocial behaviour Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated. Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [4A45.Z] Antiphospholipid syndrome, unspecified Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome === GRAPH WALKS === --- Walk 1 --- [MA14.1C] Raised antibody titre --EXCLUDES--> [?] Haemolytic disease of fetus or newborn Def: A paediatric alloimmune condition characterised by the break-down of red blood cells by IgG antibodies which are transmitted from mother to child via the placenta.... --CHILD--> [?] Rh isoimmunization of fetus or newborn Def: A condition characterised by the transmission of antibodies from a mother to the child via the placenta against the Rhesus factor of blood. Such antibodies were developed in a Rhesus factor negative m... --- Walk 2 --- [MA14.1C] Raised antibody titre --EXCLUDES--> [?] Haemolytic disease of fetus or newborn Def: A paediatric alloimmune condition characterised by the break-down of red blood cells by IgG antibodies which are transmitted from mother to child via the placenta.... --CHILD--> [?] ABO isoimmunization of fetus or newborn Def: A condition of the newborn characterized by the destruction of red blood cells initiated by the transmission of anti-A or anti-B antibodies from a mother to the child via the placenta against A or B a... --- Walk 3 --- [BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes.... --CHILD--> [BD91] Lymphangitis Def: Lymphangitis is an inflammation of lymphatic vessels. It is most often caused by infection from bacteria, virus or fungus or infiltration by cancer cells.... --- Walk 4 --- [BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes.... --CHILD--> [BD91] Lymphangitis Def: Lymphangitis is an inflammation of lymphatic vessels. It is most often caused by infection from bacteria, virus or fungus or infiltration by cancer cells.... --- Walk 5 --- [BD90.Z] Lymphadenitis, unspecified --PARENT--> [BD90] Lymphadenitis --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --- Walk 6 --- [BD90.Z] Lymphadenitis, unspecified --PARENT--> [BD90] Lymphadenitis --CHILD--> [BD90.1] Nonspecific mesenteric lymphadenitis
[ "[MA14.1C] Raised antibody titre\n --EXCLUDES--> [?] Haemolytic disease of fetus or newborn\n Def: A paediatric alloimmune condition characterised by the break-down of red blood cells by IgG antibodies which are transmitted from mother to child via the placenta....\n --CHILD--> [?] Rh isoimmunization of fetus or newborn\n Def: A condition characterised by the transmission of antibodies from a mother to the child via the placenta against the Rhesus factor of blood. Such antibodies were developed in a Rhesus factor negative m...", "[MA14.1C] Raised antibody titre\n --EXCLUDES--> [?] Haemolytic disease of fetus or newborn\n Def: A paediatric alloimmune condition characterised by the break-down of red blood cells by IgG antibodies which are transmitted from mother to child via the placenta....\n --CHILD--> [?] ABO isoimmunization of fetus or newborn\n Def: A condition of the newborn characterized by the destruction of red blood cells initiated by the transmission of anti-A or anti-B antibodies from a mother to the child via the placenta against A or B a...", "[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --CHILD--> [BD91] Lymphangitis\n Def: Lymphangitis is an inflammation of lymphatic vessels. It is most often caused by infection from bacteria, virus or fungus or infiltration by cancer cells....", "[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --CHILD--> [BD91] Lymphangitis\n Def: Lymphangitis is an inflammation of lymphatic vessels. It is most often caused by infection from bacteria, virus or fungus or infiltration by cancer cells....", "[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....", "[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.1] Nonspecific mesenteric lymphadenitis" ]
MA14.1C
Raised antibody titre
[ { "from_icd11": "MA14.1C", "icd10_code": "R760", "icd10_title": "Raised antibody titer" }, { "from_icd11": "BD9Z", "icd10_code": "I898", "icd10_title": "Other specified noninfective disorders of lymphatic vessels and lymph nodes" }, { "from_icd11": "BD9Z", "icd10_code": "I899", "icd10_title": "Noninfective disorder of lymphatic vessels and lymph nodes, unspecified" }, { "from_icd11": "BD9Z", "icd10_code": "I89", "icd10_title": "Other noninfective disorders of lymphatic vessels and lymph nodes" }, { "from_icd11": "BD90.Z", "icd10_code": "I889", "icd10_title": "Nonspecific lymphadenitis, unspecified" }, { "from_icd11": "BD90.Z", "icd10_code": "I88", "icd10_title": "Nonspecific lymphadenitis" }, { "from_icd11": "BD90.Z", "icd10_code": "I888", "icd10_title": "Other nonspecific lymphadenitis" }, { "from_icd11": "BD90.Z", "icd10_code": "L00-L08", "icd10_title": "" }, { "from_icd11": "MA01.Z", "icd10_code": "R599", "icd10_title": "Enlarged lymph nodes, unspecified" }, { "from_icd11": "MA01.Z", "icd10_code": "R59", "icd10_title": "Enlarged lymph nodes" }, { "from_icd11": "JA86.Y", "icd10_code": "O26841 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26843 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26849 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O3680X0 ", "icd10_title": "" }, { "from_icd11": "3B4Z", "icd10_code": "D688", "icd10_title": "Other specified coagulation defects" } ]
R760
Raised antibody titer
The patient was a 58-year-old male who consulted a local physician due to dysphagia and weight loss over the past 6 months. An esophagogastroduodenoscopy (EGDs) revealed a submucosal tumor from cervical to upper thoracic esophagus, leading to a referral to the Department of Gastroenterology at Kurume University. His medical history included bronchial asthma, for which he was receiving inhalation therapy. He occasionally consumed alcohol and had no smoking history. Blood tests showed no elevation of tumor markers. Upper gastrointestinal fluoroscopy revealed a 5.7-cm tumor spanning from the cervical to the upper thoracic esophagus with a smooth mucosal surface and no mediastinal shift . A cervico-thoraco-abdominal contrast-enhanced CT scan revealed a uniformly enhanced 5 × 3.5 × 5.4 cm tumor without with no evidence of invasion to other organs nor enlarged surrounding lymph nodes enlargement . An endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) of tumor was performed , and immunohistochemistry results CD34 ( −), c-kit ( −), desmin ( −), and S100 ( +) confirmed a benign esophageal schwannoma. He was referred to our department for surgical intervention. Considering the tumor size and location, we decided to perform enucleation of tumor using both thoracoscopic and cervical approaches. Under general anesthesia, the patient was first immobilized in the prone position, with port placements similar to those use of esophageal cancer procedures, specifically (1) air seal port at the right sixth intercostal space on subscapular angle, (2) 12-mm port at the right ninth intercostal space on scapular line, (3) 12-mm port at the right eighth intercostal space on mid-axilla line, (4) 5-mm port at the right seventh intercostal space on posterior-axilla line, (5) 5-mm port at the right fifth intercostal space on posterior-axilla line, and (6) 12-mm port at the right third intercostal space on mid-axilla line. No apparent invasion was observed after circumferential dissection of the caudal side of the tumor and its separation from surrounding organs . The tumor extended to the upper thoracic esophagus. We performed dissection as much as possible toward the side of the cervical esophagus under thoracic procedures. After changing the patient’s position from prone to supine, a collar-shaped skin incision was performed on the neck. The cervical esophagus was identified from the left side, and after confirming the presence of the left recurrent laryngeal nerve, periesophageal dissection was performed. To acquire clear view of operation field, the right sternocleidomastoid muscle was dissected from the sternum. After confirming the right recurrent laryngeal nerve, the esophagus was taped above and below the tumor, and the muscular layer was incised to enucleate the tumor. After enucleate tumor, dissected muscular layer was sutured with 3–0 absorbable sutures; however, a 1-cm muscular layer defect remained. Intraoperative endoscopy suggested that further muscular layer suture would result in stenosis of the cervical esophagus. Therefore, we decided to perform a right sternocleidomastoid muscle flap to repair muscular layer and to prevent stenosis of the cervical esophagus . The operation time was 4 h and 29 min (53 min for thoracic procedures), and blood loss was 60 ml. The excised specimen was 6 × 5.2 × 4.2 cm . The postoperative course was uneventful, and fluoroscopy on postoperative day 8 confirmed no anastomotic leakage or stenosis. Oral intake was started on day 9. The patient had an uneventful recovery and was discharged in good condition on the 22nd postoperative day. There were no symptoms of stenosis after discharge and no recurrence 2 years after surgery . Fig. 1 Upper gastrointestinal fluoroscopy revealed a 5.7-cm tumor spanning from the cervical to the upper thoracic esophagus with a smooth mucosal surface Fig. 2 A contrast-enhanced CT scan revealed a uniformly enhanced 5 × 3.5 × 5.4 cm tumor without invasion to other organs or enlarged surrounding lymph nodes Fig. 3 EGD findings: a submucosal tumor with a smooth surface was found 22 cm from the incisors. The oral esophagus did not dilate Fig. 4 Operative findings: the tumor extended to the cervical from the upper thoracic esophagus. It was difficult to dissect the cranial side of the tumor Fig. 5 Operative finding: 1-cm muscular defect was observed. The fault was covered with a right sternocleidomastoid muscle flap Fig. 6 The resected specimen was yellow, hard, and elastic and measured 6 × 5.2 × 4.2 cm Fig. 7 Immunohistochemistry results CD34 ( −), c-kit ( −), desmin ( −), and S100 ( +) confirmed a benign esophageal schwannoma Fig. 8 After the surgery, an endoscopy conducted 2 years later showed no signs of narrowing or ischemic changes
3.96875
0.976074
sec[1]/p[0]
en
0.999995
PMC11533642
https://doi.org/10.1186/s44215-024-00171-5
[ "tumor", "esophagus", "cervical", "thoracic", "port", "intercostal", "space", "muscular", "line", "layer" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "DA2Z", "title": "Diseases of oesophagus, unspecified" }, { "code": "DA24.Z", "title": "Oesophagitis, unspecified" }, { "code": "DA20.0", "title": "Oesophageal obstruction" }, { "code": "DA25.Z", "title": "Oesophageal ulcer, unspecified" }, { "code": "LB12.Y", "title": "Other specified structural developmental anomalies of oesophagus" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [DA2Z] Diseases of oesophagus, unspecified Also known as: Diseases of oesophagus, unspecified | disease of oesophagus | disorder of oesophagus | oesophageal disease | oesophageal disorder [DA24.Z] Oesophagitis, unspecified Also known as: Oesophagitis, unspecified | Oesophagitis | inflammation of oesophagus | oesophagitis NOS | oesophageal inflammation [DA20.0] Oesophageal obstruction Definition: Hindrance of the passage of luminal contents in the oesophagus. Obstruction of oesophagus can be partial or complete, and caused by intrinsic or extrinsic factors. Also known as: Oesophageal obstruction | obstruction of oesophagus | oesophageal narrowing | obstructed oesophagus | Stricture of oesophagus Excludes: Congenital stenosis or stricture of oesophagus | Anatomical alteration due to gastro-oesophageal reflux disease | Neoplasms of the oesophagus [DA25.Z] Oesophageal ulcer, unspecified Also known as: Oesophageal ulcer, unspecified | Oesophageal ulcer | Ulcer of oesophagus | ulcer of oesophagus NOS | OU - [oesophageal ulcer] [LB12.Y] Other specified structural developmental anomalies of oesophagus Also known as: Other specified structural developmental anomalies of oesophagus | Absence of oesophagus | Agenesis of oesophagus | Congenital displacement of oesophagus | Duplication of oesophagus === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Breast lump or mass female --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fat pad Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied.... --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fat pad\n Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied....", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
The initial approach to ventilator settings is low tidal volume (VT) (6 ml/kg) and low PEEP (5 mmHg), to minimize expiratory air leak . The limited available clinical literature supports a plateau pressure (Ppl) less than 26 cmH for optimal compliance and gas exchange . If we are not able to achieve the desired VT and Ppl, the switching to pressure-controlled mode with the same target Ppl has been shown to improve ventilation and reduce peak airway pressure . In patients with refractory respiratory acidosis, persistently elevated peak airway pressure, or oxygenation difficulties, salvage modes include high-frequency ventilation (HFV) . Some studies have found that in some cases of tracheobronchial lesion in otherwise healthy lungs, HFV improves oxygenation at lower mean airway pressures than conventional mechanical ventilation . The advantage of this method of ventilation is that it can allow effective gas transport without high airway pressure or depression of hemodynamic function and thus avoiding barotrauma or decreased cardiac output . In our case series, we have approached the ventilation problems in case 1 by carrying out the procedure in spontaneous breathing, in case 2 by using a low Peep (5 mmHg), and in case 3 by the complete exclusion of bronchial lesion and one lung ventilation. The ventilation problem is strictly correlated to the airway management problem during the procedures. The limited available clinical literature supports that ventilation and airway management should prevent damage to the uninjured trachea, ensure adequate ventilation of the patient through the operative procedure, and finally facilitate the surgical repair of the affected bronchus . The limited available clinical literature supports that the spontaneous breathing in the case of conservative treatment of tracheal rupture is associated with the best outcome . So we have decided to conduct the case in LMA and in spontaneous breathing. When the spontaneous breathing is not possible, the airway management should aim to bridge the tracheal rupture with the tip and the cuff of the tube. The optimal method for protecting the repair is extubation, since spontaneous respiration places the least strain on the airways. Nevertheless, most multisystem trauma patients must remain intubated postoperatively. The limited available clinical literature supports the using of the lowest VT possible, the maintenance of Ppl under 26 mmHg, and considering modes that encourage spontaneous respirations during, such as intermittent mandatory ventilation (IMV) during postoperative ventilator management . In case 3, we decided to perform tracheostomy on the patient because we need to awaken her and to recover the spontaneous breathing but we did not consider the extubation safe. The flexible videolaryngoscopy, in fact, confirmed edema and hyperemia of the larynx, glottis, and subglottic region. Most of the literature on airway management deals with airway management in case of tracheal rupture and or conservative treatment or thoracotomy . Also, the jet ventilation has been tried especially in this kind of treatment . The innovative approach of the endoscopic treatment of tracheal rupture with fibrin glue has driven us to study these different kinds of airway management basing on the literature published. In case 3, we did not decide to use the double-lumen tube because of the size and location of rupture and so we chose a 5.5 size-reinforced endotracheal tube modifying the suggestions by Marquette . It should be better to use total intravenous anesthesia involving the use of analgesics, hypnotics, and anti-secretory agents as volatile anesthetic delivery cannot be guaranteed. The use of local anesthesia by topical lidocaine and inhalational techniques could precipitate coughing and so they should be avoided . The use of propofol/fentanyl to conduct anesthesia in spontaneous breathing was also described in another case report in a patient with tracheal dehiscence post-tracheal resection surgery. Kim et al. used a low-dose propofol infusion (25–50 μg/kg/min) and intermittent small bolus of fentanyl (25 μg) . The low doses of propofol and fentanyl do not inhibit hypoxic pulmonary vasoconstriction . An alternative as intravenous anesthetic agents should be ketamine and dexmedetomidine. Ketamine provides intense analgesia from the blockade of NMDA ( N -methyl- d -aspartate) receptors with preservation of spontaneous breathing. The problem of its use in this setting is the increasing oral and airway secretions due to ketamine itself. There are recently several manuscript published on the use of dexmedetomidine in operative setting, but dexmedetomidine may be associated with hypotension and bradycardia and appropriate caution should be used .
4.140625
0.631348
sec[4]/p[5]
en
0.999994
30574292
https://doi.org/10.1186/s13741-018-0111-x
[ "ventilation", "airway", "spontaneous", "breathing", "literature", "tracheal", "pressure", "that", "rupture", "limited" ]
[ { "code": "MD11.Y", "title": "Other specified abnormalities of breathing" }, { "code": "MD11.7", "title": "Hyperventilation" }, { "code": "PK81.0", "title": "Ventilation associated with injury or harm in therapeutic use" }, { "code": "QB41", "title": "Dependence on respirator" }, { "code": "CA70.7", "title": "Air conditioner or humidifier lung" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "CA22.Z", "title": "Chronic obstructive pulmonary disease, unspecified" }, { "code": "7A41", "title": "Obstructive sleep apnoea" }, { "code": "CB60", "title": "Tracheostomy malfunction" }, { "code": "MD2Z", "title": "Haemorrhage from respiratory passages, unspecified" } ]
=== ICD-11 CODES FOUND === [MD11.Y] Other specified abnormalities of breathing Also known as: Other specified abnormalities of breathing | Bradypnoea | Choking sensation | Hypoventilation | hypoventilation syndrome NOS [MD11.7] Hyperventilation Definition: Hyperventilation refers to an increase in the rate of alveolar ventilation that is excessive for the rate of metabolic carbon dioxide production, resulting in a decrease in arterial PCO2 to below the normal range of 37 to 43 mm Hg. Hyperventilation should be distinguished from tachypnoea, an increase in respiratory frequency, and from hyperpnea, an increase in minute volume of ventilation. Also known as: Hyperventilation | hyperventilating | overbreathing | HV - [hyperventilation] | increased respiratory rate [PK81.0] Ventilation associated with injury or harm in therapeutic use Also known as: Ventilation associated with injury or harm in therapeutic use | complication during or following ventilation | Ventilator associated pneumonia | VAP - [ventilator associated pneumonia] | respirator associated pneumonia Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm [QB41] Dependence on respirator Also known as: Dependence on respirator | dependence on iron lung | dependence on respiratory ventilator [CA70.7] Air conditioner or humidifier lung Definition: A form of the sick building syndrome caused by organisms that contaminate humidifiers and the piping of air conditioner ducts. The air conditioner blows cold air containing spores of the organisms throughout the building. Also known as: Air conditioner or humidifier lung | air conditioner lung | air humidifier pneumonitis | humidifier lung | sauna takers lung [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [CA22.Z] Chronic obstructive pulmonary disease, unspecified Also known as: Chronic obstructive pulmonary disease, unspecified | Chronic obstructive pulmonary disease | COPD - [chronic obstructive pulmonary disease] | COAD - [chronic obstructive airways disease] | COLD - [chronic obstructive lung disease] [7A41] Obstructive sleep apnoea Definition: Obstructive sleep apnoea is characterised by repetitive episodes of apnoea or hypopnea that are caused by upper airway obstruction occurring during sleep. These events often result in reductions in blood oxygen saturation and are usually terminated by brief arousals from sleep. Excessive sleepiness is a major presenting complaint in many but not all cases. Reports of insomnia, poor sleep quality, and fatigue are also common. Upper airway resistance syndrome shares the same pathophysiology and sh Also known as: Obstructive sleep apnoea | obstructive sleep apnoea syndrome | obstructive sleep apnoea, adult | OSA - [obstructive sleep apnoea] | obstructive sleep apnoea, paediatric Excludes: Obstructive neonatal apnoea [CB60] Tracheostomy malfunction Also known as: Tracheostomy malfunction | tracheostomy dysfunction | status of malfunctioning tracheostomy | functional disturbance of tracheostomy | tracheostomy complications [MD2Z] Haemorrhage from respiratory passages, unspecified Also known as: Haemorrhage from respiratory passages, unspecified | haemorrhage from respiratory tract | respiratory system haemorrhage | airway haemorrhage NOS === GRAPH WALKS === --- Walk 1 --- [MD11.Y] Other specified abnormalities of breathing --PARENT--> [MD11] Abnormalities of breathing Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing.... --CHILD--> [MD11.2] Ataxic breathing Def: An irregular breathing pattern that usually progresses to complete apnoea.... --- Walk 2 --- [MD11.Y] Other specified abnormalities of breathing --PARENT--> [MD11] Abnormalities of breathing Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing.... --CHILD--> [MD11.1] Asphyxia Def: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all... --- Walk 3 --- [MD11.7] Hyperventilation Def: Hyperventilation refers to an increase in the rate of alveolar ventilation that is excessive for the rate of metabolic carbon dioxide production, resulting in a decrease in arterial PCO2 to below the ... --PARENT--> [MD11] Abnormalities of breathing Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing.... --CHILD--> [MD11.1] Asphyxia Def: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all... --- Walk 4 --- [MD11.7] Hyperventilation Def: Hyperventilation refers to an increase in the rate of alveolar ventilation that is excessive for the rate of metabolic carbon dioxide production, resulting in a decrease in arterial PCO2 to below the ... --PARENT--> [MD11] Abnormalities of breathing Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing.... --CHILD--> [MD11.0] Apnoea --- Walk 5 --- [PK81.0] Ventilation associated with injury or harm in therapeutic use --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm --- Walk 6 --- [PK81.0] Ventilation associated with injury or harm in therapeutic use --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm --CHILD--> [?] Failure of sterile precautions without injury or harm Def: Standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient, without documented injury or harm....
[ "[MD11.Y] Other specified abnormalities of breathing\n --PARENT--> [MD11] Abnormalities of breathing\n Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing....\n --CHILD--> [MD11.2] Ataxic breathing\n Def: An irregular breathing pattern that usually progresses to complete apnoea....", "[MD11.Y] Other specified abnormalities of breathing\n --PARENT--> [MD11] Abnormalities of breathing\n Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing....\n --CHILD--> [MD11.1] Asphyxia\n Def: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all...", "[MD11.7] Hyperventilation\n Def: Hyperventilation refers to an increase in the rate of alveolar ventilation that is excessive for the rate of metabolic carbon dioxide production, resulting in a decrease in arterial PCO2 to below the ...\n --PARENT--> [MD11] Abnormalities of breathing\n Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing....\n --CHILD--> [MD11.1] Asphyxia\n Def: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all...", "[MD11.7] Hyperventilation\n Def: Hyperventilation refers to an increase in the rate of alveolar ventilation that is excessive for the rate of metabolic carbon dioxide production, resulting in a decrease in arterial PCO2 to below the ...\n --PARENT--> [MD11] Abnormalities of breathing\n Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing....\n --CHILD--> [MD11.0] Apnoea", "[PK81.0] Ventilation associated with injury or harm in therapeutic use\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm\n --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm", "[PK81.0] Ventilation associated with injury or harm in therapeutic use\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm\n --CHILD--> [?] Failure of sterile precautions without injury or harm\n Def: Standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient, without documented injury or harm...." ]
MD11.Y
Other specified abnormalities of breathing
[ { "from_icd11": "MD11.7", "icd10_code": "R064", "icd10_title": "Hyperventilation" }, { "from_icd11": "QB41", "icd10_code": "Z9911", "icd10_title": "Dependence on respirator [ventilator] status" }, { "from_icd11": "QB41", "icd10_code": "Z991", "icd10_title": "Dependence on respirator" }, { "from_icd11": "CA70.7", "icd10_code": "J677", "icd10_title": "Air conditioner and humidifier lung" }, { "from_icd11": "CA22.Z", "icd10_code": "J449", "icd10_title": "Chronic obstructive pulmonary disease, unspecified" }, { "from_icd11": "CA22.Z", "icd10_code": "J440", "icd10_title": "Chronic obstructive pulmonary disease with (acute) lower respiratory infection" }, { "from_icd11": "CA22.Z", "icd10_code": "J44", "icd10_title": "Other chronic obstructive pulmonary disease" }, { "from_icd11": "CA22.Z", "icd10_code": "J448", "icd10_title": "" }, { "from_icd11": "7A41", "icd10_code": "G4733", "icd10_title": "Obstructive sleep apnea (adult) (pediatric)" }, { "from_icd11": "7A41", "icd10_code": "G4730", "icd10_title": "Sleep apnea, unspecified" }, { "from_icd11": "CB60", "icd10_code": "J9503", "icd10_title": "Malfunction of tracheostomy stoma" }, { "from_icd11": "CB60", "icd10_code": "J9501", "icd10_title": "Hemorrhage from tracheostomy stoma" }, { "from_icd11": "CB60", "icd10_code": "J9502", "icd10_title": "Infection of tracheostomy stoma" }, { "from_icd11": "CB60", "icd10_code": "J9509", "icd10_title": "Other tracheostomy complication" }, { "from_icd11": "CB60", "icd10_code": "J9504", "icd10_title": "Tracheo-esophageal fistula following tracheostomy" } ]
R064
Hyperventilation
An 83-year-old woman (height, 1.55 m; weight, 31.9 kg; body surface area, 1.2 m 2 ) was referred to our hospital with symptomatic severe aortic stenosis. Her medical history included hypertension, osteoporosis, and microscopic polyangiitis. She was receiving monthly intravenous cyclophosphamide pulse therapy and 20 mg of oral prednisolone. Transthoracic echocardiography revealed a heavily calcified bicuspid aortic valve with fusion of the right and left coronary cusps, an aortic valve area of 0.45 cm 2 , and a peak velocity of 5.1 m/s. Computed tomography revealed an annular plane area of 509 mm 2 with nodular calcifications in the left ventricular outflow tract (LVOT) . Severely calcified bicuspid valve leaflets and nodular calcifications in the LVOT are risk factors for TAVI-related complications. However, conventional surgical AVR was not considered feasible in this patient because of her advanced age, moderate surgical risk (STS operative mortality score: 5.54%), and frailty (Clinical Frailty Scale : 5). Regarding the device selection, the use of self-expandable valve may help mitigate the risk of annular rupture. However, significant calcification could potentially distort the valve opening, leading to insufficient function and unacceptable aortic valve regurgitation. We anticipated that the use of an underfilled balloon dilatation could avoid the risk of annular rupture due to the use of a balloon-expandable valve. Ultimately, we planned to perform transfemoral TAVI using a 26 mm SAPIEN 3 Ultra RESILIA valve (Edwards Lifesciences, Irvine, CA, USA) with a 1 mL underfilled dilation. During the procedure, the valve was implanted using slow and careful dilation to minimize the risk of aortic root complications. However, soon after valve implantation, transesophageal echocardiography revealed pericardial effusion, and the hemodynamic status of the patient deteriorated rapidly. Prompt pericardial drainage was performed via a subxiphoid skin incision and femoro-femoral extracorporeal membrane oxygenation (ECMO) was initiated within 10 min of effusion detection. The hemorrhage was uncontrollable, and we therefore converted to open-heart surgery. A median sternotomy was performed, allowing the detection of a pulsatile hemorrhage in the anterior region of the sinus of Valsalva, indicating aortic rupture. Under aortic cross-clamping, the ascending aorta was opened, and a meticulous inspection of the aortic root was conducted. The valve had been implanted in the anterior commissural side of the annulus, and mechanical stress from the expanding valve had torn the anterior commissure. The valve was easily removed using two peans compressing and deforming the stent cage. After valve explantation, a 5 mm tear was observed just below the anterior commissure . After removing the native valve leaflets, the severely damaged Valsalva sinus wall and aortic annulus were resected, leaving the bilateral coronary ostia intact. The resected area was reconstructed using a bovine pericardium patch with a 2–0 pledgeted mattress suture and 4–0 polypropylene running suture . A 19 mm INSPIRIS RESILIA aortic valve (Edwards Lifesciences) was then implanted in the supra-annular position with 2–0 pledgeted valve sutures placed in a non-everting fashion in the native aortic annulus and a transmural outside-in fashion in the patch region . The patient was weaned smoothly from cardiopulmonary bypass. Aortic cross-clamp and cardiopulmonary bypass times were 135 and 190 min, respectively. Although the patient experienced some postoperative rehabilitation difficulties, she was successfully transferred to another hospital 60 days after surgery without complications and is currently doing well as an outpatient. Fig. 1 A Computed tomography scan shows severely calcified bicuspid aortic valve. B Measurements of the annular plane indicated an annular area of 509 mm 2 and an annular perimeter of 83.3 mm. C Measurements of the leaflet plane. A 26 mm SAPIEN3 valve was expected to be positioned as shown in the figure Fig. 2 Intraoperative findings of the anterior portion of the sinus of Valsalva. A A 5 mm tear is observed from the outside of the sinus of Valsalva (white arrow). B The anterior commissure was torn due to the dilation of the implanted valve (white arrow), resulting in aortic root rupture Fig. 3 Schematic illustrations of aortic root repair. A After removing the native aortic valve, a part of the annulus was unintentionally damaged due to aggressive debridement (white arrow). B The injured annulus was reconstructed using bovine pericardium, and a new valve was subsequently positioned and secured with sutures placed in a non-everting fashion in the native aortic annulus and in a transmural outside-in fashion in the patch region
4.011719
0.970215
sec[1]/p[0]
en
0.999998
PMC11533707
https://doi.org/10.1186/s44215-024-00172-4
[ "valve", "aortic", "annular", "annulus", "area", "risk", "using", "rupture", "implanted", "root" ]
[ { "code": "GB61.Z", "title": "Chronic kidney disease, stage unspecified" }, { "code": "BC00", "title": "Multiple valve disease" }, { "code": "BB9Z", "title": "Pulmonary valve disease, unspecified" }, { "code": "BB6Z", "title": "Mitral valve disease, unspecified" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, unspecified" }, { "code": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "LA8A.3", "title": "Congenital supravalvar aortic stenosis" }, { "code": "BD40.1", "title": "Atherosclerosis of aorta" }, { "code": "BB71.Z", "title": "Aortic valve insufficiency, unspecified" }, { "code": "LA8B.2Y", "title": "Other specified congenital anomaly of aorta or its branches" } ]
=== ICD-11 CODES FOUND === [GB61.Z] Chronic kidney disease, stage unspecified Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease [BC00] Multiple valve disease Also known as: Multiple valve disease | Multiple valve disease of unspecified origin | multiple valvular cardiac dysfunction | multivalvular cardiac dysfunction | Disorders of both mitral and aortic valves [BB9Z] Pulmonary valve disease, unspecified Also known as: Pulmonary valve disease, unspecified | rheumatic heart disease of pulmonary valve, unspecified | chronic rheumatic pulmonary valve endocarditis | chronic rheumatic pulmonary valvular endocarditis | rheumatic disease of pulmonary valve [BB6Z] Mitral valve disease, unspecified Also known as: Mitral valve disease, unspecified | noninfective endocarditis of mitral valve | rheumatic heart disease of mitral valve, unspecified | mitral valvulopathy | mitral valve cardiopathy [LA8Z] Structural developmental anomaly of heart or great vessels, unspecified Also known as: Structural developmental anomaly of heart or great vessels, unspecified | Heart malformations | Cardiac malformations | congenital anomaly of heart | congenital heart disease [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [LA8A.3] Congenital supravalvar aortic stenosis Definition: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalvar aortic stenosis' is described as three forms: an hourglass deformity, a fibrous membrane, and a diffuse narrowing of the ascending aorta. Supravalvar aortic stenosis may involve the coronary artery ostia, and the aortic leaflets may be tethered. The coronary arteries can become tortuous and dilate Also known as: Congenital supravalvar aortic stenosis | stenosis of aorta | supravalvular aortic stenosis | stricture of aorta | congenital narrowed aorta Excludes: Congenital aortic valvar stenosis [BD40.1] Atherosclerosis of aorta Also known as: Atherosclerosis of aorta | aorta atheroma | aorta calcification | aorta arteriosclerosis | aortic degeneration [BB71.Z] Aortic valve insufficiency, unspecified Also known as: Aortic valve insufficiency, unspecified | Aortic valve insufficiency | aortic insufficiency | aortic valve incompetency | AI - [aortic incompetence] [LA8B.2Y] Other specified congenital anomaly of aorta or its branches Also known as: Other specified congenital anomaly of aorta or its branches | Congenital anomaly of ascending aorta | Hypoplasia of ascending aorta | Congenital ascending aorta aneurysm or dilation | congenital ascending aortic aneurysm or dilation === GRAPH WALKS === --- Walk 1 --- [GB61.Z] Chronic kidney disease, stage unspecified --PARENT--> [GB61] Chronic kidney disease Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist... --PARENT--> [?] Kidney failure Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ... --- Walk 2 --- [GB61.Z] Chronic kidney disease, stage unspecified --PARENT--> [GB61] Chronic kidney disease Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist... --CHILD--> [GB61.1] Chronic kidney disease, stage 2 Def: Kidney damage and GFR 60-89 ml/min/1.73m²... --- Walk 3 --- [BC00] Multiple valve disease --PARENT--> [?] Heart valve diseases --CHILD--> [?] Aortic valve disease --- Walk 4 --- [BC00] Multiple valve disease --PARENT--> [?] Heart valve diseases --EXCLUDES--> [?] Atypical truncal valve Def: A congenital cardiovascular malformation in which the truncal valve does not have the usual morphological or functional attributes at birth.... --- Walk 5 --- [BB9Z] Pulmonary valve disease, unspecified --PARENT--> [?] Pulmonary valve disease --CHILD--> [BB90] Pulmonary valve stenosis Def: Pulmonary valve stenosis is an obstruction at the level of pulmonary valve which impedes the outflow of blood from right ventricle to pulmonary artery.... --- Walk 6 --- [BB9Z] Pulmonary valve disease, unspecified --PARENT--> [?] Pulmonary valve disease --EXCLUDES--> [?] Congenital anomaly of pulmonary valve Def: A congenital malformation of the heart where the pulmonary valve is abnormal....
[ "[GB61.Z] Chronic kidney disease, stage unspecified\n --PARENT--> [GB61] Chronic kidney disease\n Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...", "[GB61.Z] Chronic kidney disease, stage unspecified\n --PARENT--> [GB61] Chronic kidney disease\n Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...\n --CHILD--> [GB61.1] Chronic kidney disease, stage 2\n Def: Kidney damage and GFR 60-89 ml/min/1.73m²...", "[BC00] Multiple valve disease\n --PARENT--> [?] Heart valve diseases\n --CHILD--> [?] Aortic valve disease", "[BC00] Multiple valve disease\n --PARENT--> [?] Heart valve diseases\n --EXCLUDES--> [?] Atypical truncal valve\n Def: A congenital cardiovascular malformation in which the truncal valve does not have the usual morphological or functional attributes at birth....", "[BB9Z] Pulmonary valve disease, unspecified\n --PARENT--> [?] Pulmonary valve disease\n --CHILD--> [BB90] Pulmonary valve stenosis\n Def: Pulmonary valve stenosis is an obstruction at the level of pulmonary valve which impedes the outflow of blood from right ventricle to pulmonary artery....", "[BB9Z] Pulmonary valve disease, unspecified\n --PARENT--> [?] Pulmonary valve disease\n --EXCLUDES--> [?] Congenital anomaly of pulmonary valve\n Def: A congenital malformation of the heart where the pulmonary valve is abnormal...." ]
GB61.Z
Chronic kidney disease, stage unspecified
[ { "from_icd11": "GB61.Z", "icd10_code": "N183", "icd10_title": "Chronic kidney disease, stage 3 (moderate)" }, { "from_icd11": "GB61.Z", "icd10_code": "N189", "icd10_title": "Chronic kidney disease, unspecified" }, { "from_icd11": "GB61.Z", "icd10_code": "N250", "icd10_title": "Renal osteodystrophy" }, { "from_icd11": "GB61.Z", "icd10_code": "N18", "icd10_title": "Chronic kidney disease (CKD)" }, { "from_icd11": "BC00", "icd10_code": "I081", "icd10_title": "Rheumatic disorders of both mitral and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I080", "icd10_title": "Rheumatic disorders of both mitral and aortic valves" }, { "from_icd11": "BC00", "icd10_code": "I082", "icd10_title": "Rheumatic disorders of both aortic and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I083", "icd10_title": "Combined rheumatic disorders of mitral, aortic and tricuspid valves" }, { "from_icd11": "BC00", "icd10_code": "I088", "icd10_title": "Other rheumatic multiple valve diseases" }, { "from_icd11": "BC00", "icd10_code": "I089", "icd10_title": "Rheumatic multiple valve disease, unspecified" }, { "from_icd11": "BC00", "icd10_code": "I05-I09", "icd10_title": "" }, { "from_icd11": "BC00", "icd10_code": "I08", "icd10_title": "Multiple valve diseases" }, { "from_icd11": "BC00", "icd10_code": "I34", "icd10_title": "Nonrheumatic mitral valve disorders" }, { "from_icd11": "BC00", "icd10_code": "I35", "icd10_title": "Nonrheumatic aortic valve disorders" }, { "from_icd11": "BC00", "icd10_code": "I36", "icd10_title": "Nonrheumatic tricuspid valve disorders" } ]
N183
Chronic kidney disease, stage 3 (moderate)
The patient was fitted for a brachial plexus block at the cervical paravertebral approach. In the radiology department; she was placed on her right side, and a blockade on the left side of the neck was performed under aseptic conditions by an experienced orthopaedic surgeon following confirmatory X-ray. Standard monitoring was applied, including electrocardiography (ECG), pulse oximetry, and blood pressure measurement. After a thorough infiltration of the subcutaneous tissue with 0.5% bupivacaine hydrochloride solution, an 18-gauge Whitacre-tip spinal needle was used to perform the cervical paravertebral block at the C6 level. The posterior approach was chosen to avoid puncturing blood vessels, and primarily, to reach the sensory fibers of the roots. The needle was introduced at the apex of the V-shaped space formed by the trapezius and levator scapulae muscles 6 cm laterally from the spinous process. Sustaining a slightly anterior, medial, and caudal direction, the needle progressed until contact with the transverse process of C6 at a depth of 5 cm from the skin. Following a negative blood aspiration test, 0.5% bupivacaine was injected in incremental doses over several minutes to a total of 10 mL. Two minutes later, the patient began to exhibit paraesthesia in the arms and became confused, then apnoeic and unresponsive. Pulseless cardiac electrical activity with sinus bradycardia developed. Cardiopulmonary resuscitation (CPR) was initiated using chest compressions and bag-mask ventilation. The patient underwent endotracheal intubation when a resuscitation team arrived. The return of spontaneous circulation was achieved after four minutes. Arterial blood pressure was measured at 60⁄40 mmHg with a sinus rhythm at 125 beats per minute. Using a portable ventilator and observing vital signs on the monitor, the patient was transported to the intensive care unit (ICU), and volume control mandatory ventilation was then performed. With a presumptive diagnosis of bupivacaine systemic toxicity, a 100 mL bolus of Lipofundin 20% (B. Braun, Melsungen AG, Germany) was administered, followed by subsequent continuous infusion of 400 mL over 30 minutes. CPR was resumed with monophasic defibrillation 360J without delay when ventricular fibrillation occurred 23 minutes after the first cardiopulmonary collapse. Uninterrupted chest compressions were performed except during the assessment of cardiac rhythm and the defibrillation attempt. Repeated defibrillation attempts were required ten times for sustained ventricular fibrillation. Adrenaline 1 mg was administered every 4-5 min. for a total dose of 10 mg. Amiodarone 300 mg was given after three defibrillation attempts with an additional 150 mg later on. After 47 minutes of CPR, the patient returned to spontaneous circulation, and the sinus rhythm was restored. We observed that the patient was making purposeful movements and opened her eyes while cardiac arrest persisted. When spontaneous circulation returned, ECG demonstrated ST depression in leads I, II, aVL, and V2-V6. Noradrenaline was administered continuously to maintain haemodynamic stability at a maximal dose of 0.3 μg/kg/min. The patient was sedated with midazolam (1 mg/h) and fentanyl (0.16 mg/h) infusion to an appropriate level of consciousness (Richmond Agitation Sedation Scale up to -3). A transthoracic echocardiogram showed an absence of abnormal motions in the heart wall, an ejection fraction of 40%, and minor dilatation of all chambers with regurgitation through the mitral and tricuspid valves. Blood test results shortly after the return of spontaneous circulation were abnormal, showing high sensitivity troponin I 31,004.9 ng/L [normal range < 2 ng/L], D-dimer 35,500 μg/mL [normal range < 200 μg/L], urea 9.49 mmol/L [normal range 2.10-8.30 mmol/L], lactate 12.9 mmol/L [normal range 0.5–1.6 mmol/L], serum creatinine 127 μmol/L [normal range 44-106 μmol/L], and glucose 21.63 mmol/L [normal range 3.9-5.8 mmol/L]. The next morning, haemodynamic stability was achieved, and high sensitivity troponin I was 18,748.6 ng/L. The patient had full consciousness and was subsequently disconnected from the ventilator and extubated. Non-oliguric acute kidney injury developed, serum creatinine increased up to 402 μmol/L with urea to 21.17 mmol/L, and continuous furosemide infusion was required. Six days later, the patient was transferred from the ICU to the ward at the orthopaedic department. The patient had complaints of dizziness, decreased hearing, and pain in the chest wall but did not sustain any significant neurological or cardiovascular deficits. Serum urea and creatinine values returned to normal ranges on seventh day. After an additional two weeks of observation, the patient was discharged from the hospital.
3.923828
0.95459
sec[1]/p[1]
en
0.999998
31934640
https://doi.org/10.1515/med-2019-0112
[ "mmol", "minutes", "range", "blood", "spontaneous", "circulation", "defibrillation", "bupivacaine", "needle", "cardiac" ]
[ { "code": "GB42.1", "title": "Albuminuria, Grade A3" }, { "code": "GB42.0", "title": "Albuminuria, Grade A2" }, { "code": "MA18.0Y", "title": "Other specified elevated blood glucose level" }, { "code": "ED5Y", "title": "Other specified disorders of epidermal keratinisation" }, { "code": "KD30.0", "title": "Birth depression with 5 minute Apgar score 0-3" }, { "code": "KD30.1", "title": "Birth depression with 5 minute Apgar score 4-6" }, { "code": "KB21.0", "title": "Severe birth asphyxia" }, { "code": "KB21.1", "title": "Mild and moderate birth asphyxia" }, { "code": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "4B00.0Z", "title": "Neutropaenia, unspecified" } ]
=== ICD-11 CODES FOUND === [GB42.1] Albuminuria, Grade A3 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy [GB42.0] Albuminuria, Grade A2 Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid. Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine [MA18.0Y] Other specified elevated blood glucose level Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified [ED5Y] Other specified disorders of epidermal keratinisation Also known as: Other specified disorders of epidermal keratinisation | Follicular digitate keratoses | Lichen spinulosus | Keratosis spinulosa | Keratosis circumscripta [KD30.0] Birth depression with 5 minute Apgar score 0-3 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 0-3 [KD30.1] Birth depression with 5 minute Apgar score 4-6 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 4-6 [KB21.0] Severe birth asphyxia Definition: Pulse less than 100 per minute at birth and falling or steady, respiration absent or gasping, colour poor, tone absent. Also known as: Severe birth asphyxia | severe perinatal hypoxia | asphyxia pallida of newborn | Asphyxia with 5-minute Apgar score 0-3 | newborn severe asphyxia [KB21.1] Mild and moderate birth asphyxia Definition: Normal respiration not established within one minute, but heart rate 100 or above, some muscle tone present, some response to stimulation. Also known as: Mild and moderate birth asphyxia | asphyxia livida of newborn | Asphyxia with 5-minute Apgar score 4-7 | Blue asphyxia [QA00.6Y] Other specified examination of eyes or vision Also known as: Other specified examination of eyes or vision | No Impairment of Contrast vision | Normal colour vision | No Impairment of Dark adaptation | No diplopia [4B00.0Z] Neutropaenia, unspecified Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range === GRAPH WALKS === --- Walk 1 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Proteinuria Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc... --- Walk 2 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --CHILD--> [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --- Walk 3 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --CHILD--> [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --- Walk 4 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --EXCLUDES--> [?] Postprocedural hypoinsulinaemia Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus.... --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --CHILD--> [MA18.0Y] Other specified elevated blood glucose level
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Proteinuria\n Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...", "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --CHILD--> [GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --CHILD--> [GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --EXCLUDES--> [?] Postprocedural hypoinsulinaemia\n Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus....", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --CHILD--> [MA18.0Y] Other specified elevated blood glucose level" ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "KD30.0", "icd10_code": "P210", "icd10_title": "" }, { "from_icd11": "KD30.1", "icd10_code": "P211", "icd10_title": "" } ]
P210
Homeopathy is a therapeutic clinical medical method based on the application of the law of similars (like cures), morbid individuality (all human beings get sick in different ways, even if we have the same disease), single medication (each homeopathic medicine is unique and produces characteristic symptoms and clinical signs), and minimum dose , which allows the establishment of correct treatment, capable of achieving a gentle, effective and lasting cure. Here, we present a case of refractory depression, together with its respective homeopathic treatment, based on the previously mentioned principles. Since the age of 5, the patient had constantly resorted to antidepressants and psychotherapy, with continuous relapses. At the age of 18, she was about to be admitted to the psychiatric hospital. The aggravation in her depression seems to have been precipitated by the disappointment of her romantic love. Interestingly, the patient responded surprisingly well to treatment with Staphisagria , N. vomica , A. album , and L. trigonocephalus in parallel with allopathic treatment and had a good evolution; she presented significant improvements, which led to the decrease and cessation of the doses of conventional treatments and the total reestablishment of her depressive state. Staphisagria is a medicine used in homeopathy mainly for the treatment of nervous disorders aggravated by anger or repressed indignation. Being one of the main symptoms of the indignation presented by the patient after her love break-up, its use was preferred over Natrum muriaticum , which presents repressed anger to a greater degree. Studies in albino rats showed Staphisagria 30CH as an antidepressant . Staphisagria contains flavonoids such as astragalin, which increase sleep rate and sleep time and decrease sleep latency in combination with sodium pentobarbital . Rutin and isoquercitrin are active constituents of Staphisagria, with antidepressant activity ; rutin also decreases some symptoms of chronic stress such as anxiety and improves cognition and locomotor and muscle coordination skills. N. vomica acts mainly on the cerebrospinal nervous system. Our patient presented a marked tendency to violence and irritability. Therefore, she was prescribed N. vomica . In a study, N. vomica and L. trigonocephalus reduced depression, anxiety, and insomnia in climacteric women . The administration of N. vomica 30CH improves the quality and quantity of sleep in individuals with a history of coffee-induced insomnia , it was also demonstrated that N. vomica (6CH, 12CH, and 30CH), significantly attenuates cognitive impairment and anxiety, in mice that exhibited its anxiolytic potential . N. vomica contains strychnine, in this regard it was found that neurons in the lateral/basolateral amygdala express functional strychnine-sensitive glycine receptors, thus microinjection of strychnine directly into the basolateral amygdala reduces anxiety-like behavior in rats . A. album is especially useful in patients who present fear of death or anxiety about the future, in this case, the patient showed these mental symptoms triggered by the suicide of her friend. Adler et al. reported the effective use of individualized homeopathic treatment, which included A. album in Q potencies for moderate to severe depression with results similar to those reported for fluoxetine . Post-trauma anxiety was also effectively treated with A. album . L. trigonocephalus is one of the drugs prescribed in patients showing jealousy with a tendency to aggressiveness; in this case, the patient presented intense jealousy from the beginning of treatment, which was not resolved with the treatment with N. vomica. However, treatment with L. trigonocephalus significantly improved this aspect and her emotional well-being. With respect to the time and benefits of the use of homeopathic treatment in this study, physical and emotional improvements were detected from five days of treatment, using 200CH doses, in accordance with other studies that used 200CH doses for the treatment of depression for six weeks ; although in these studies potentiation of the treatment was not applied as in the present study. It is also important to mention that the uses of 30C and Q potencies have been successfully employed for the treatment of depression and their use depends on the characteristics of each case. This study has several limitations including sample size, lack of placebo, and follow-up period. However, it gives enough evidence for future well-designed randomized controlled studies to further evaluate the efficacy, effectiveness, and safety of homeopathic treatment alone or in combination with conventional medicine on patients with TRD, separating them from patients with other types of depression.
4.34375
0.891113
sec[2]/p[0]
en
0.999998
34737912
https://doi.org/10.7759/cureus.18444
[ "vomica", "depression", "which", "anxiety", "this", "homeopathic", "staphisagria", "that", "album", "trigonocephalus" ]
[ { "code": "6A7Z", "title": "Depressive disorders, unspecified" }, { "code": "6A72", "title": "Dysthymic disorder" }, { "code": "KD30.Z", "title": "Birth depression, unspecified" }, { "code": "6A7Y", "title": "Other specified depressive disorders" }, { "code": "6E20", "title": "Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic symptoms" }, { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "8A44.3", "title": "Certain specified leukodystrophies" }, { "code": "MB24.3", "title": "Anxiety" } ]
=== ICD-11 CODES FOUND === [6A7Z] Depressive disorders, unspecified Also known as: Depressive disorders, unspecified | depression NOS | depressive disorder NOS | depressed NOS [6A72] Dysthymic disorder Definition: Dysthymic disorder is characterised by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifest as pervasive irritability. The depressed mood is accompanied by additional symptoms such as markedly diminished interest or pleasure in activities, reduced concentration and attention or indecisiveness, low self-worth or excessive or inappropriate guilt, hopelessness about the future, disturbed sl Also known as: Dysthymic disorder | Dysthymia | chronic depressive disorder | chronic depression | depressive personality Includes: Dysthymia Excludes: anxiety depression (mild or not persistent) [KD30.Z] Birth depression, unspecified Also known as: Birth depression, unspecified | Birth depression [6A7Y] Other specified depressive disorders Also known as: Other specified depressive disorders [6E20] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic symptoms Definition: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, most commonly depressive symptoms. The syndrome does not include delusions, hallucinations, or other psychotic symptoms. If the symptoms meet the diagnostic requirements for a specific mental disorder, that diagnosis should also be assigned. This designation should not be used to describe mild and transient depressive symptoms that do Also known as: Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic symptoms | mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic features | Postpartum depression NOS | postnatal depression NOS | puerperal depression NOS [BD50.41] Abdominal aortic aneurysm with rupture Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA [EK91] Dermatoses which may presage cutaneous lymphoma Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature. Also known as: Dermatoses which may presage cutaneous lymphoma [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [8A44.3] Certain specified leukodystrophies Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome [MB24.3] Anxiety Definition: Apprehensiveness or anticipation of future danger or misfortune accompanied by a feeling of worry, distress, or somatic symptoms of tension. The focus of anticipated danger may be internal or external. Also known as: Anxiety | Nervous tension | nervous | Nervousness | nervous irritation Includes: Nervous tension === GRAPH WALKS === --- Walk 1 --- [6A7Z] Depressive disorders, unspecified --PARENT--> [?] Depressive disorders Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ... --CHILD--> [6A72] Dysthymic disorder Def: Dysthymic disorder is characterised by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifes... --- Walk 2 --- [6A7Z] Depressive disorders, unspecified --PARENT--> [?] Depressive disorders Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ... --CHILD--> [6A71] Recurrent depressive disorder Def: Recurrent depressive disorder is characterised by a history of at least two depressive episodes separated by at least several months without significant mood disturbance. A depressive episode is chara... --- Walk 3 --- [6A72] Dysthymic disorder Def: Dysthymic disorder is characterised by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifes... --EXCLUDES--> [?] Mixed depressive and anxiety disorder Def: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or ma... --PARENT--> [?] Depressive disorders Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ... --- Walk 4 --- [6A72] Dysthymic disorder Def: Dysthymic disorder is characterised by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifes... --EXCLUDES--> [?] Mixed depressive and anxiety disorder Def: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or ma... --PARENT--> [?] Depressive disorders Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ... --- Walk 5 --- [KD30.Z] Birth depression, unspecified --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.1] Birth depression with 5 minute Apgar score 4-6 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.... --- Walk 6 --- [KD30.Z] Birth depression, unspecified --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.0] Birth depression with 5 minute Apgar score 0-3 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth....
[ "[6A7Z] Depressive disorders, unspecified\n --PARENT--> [?] Depressive disorders\n Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ...\n --CHILD--> [6A72] Dysthymic disorder\n Def: Dysthymic disorder is characterised by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifes...", "[6A7Z] Depressive disorders, unspecified\n --PARENT--> [?] Depressive disorders\n Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ...\n --CHILD--> [6A71] Recurrent depressive disorder\n Def: Recurrent depressive disorder is characterised by a history of at least two depressive episodes separated by at least several months without significant mood disturbance. A depressive episode is chara...", "[6A72] Dysthymic disorder\n Def: Dysthymic disorder is characterised by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifes...\n --EXCLUDES--> [?] Mixed depressive and anxiety disorder\n Def: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or ma...\n --PARENT--> [?] Depressive disorders\n Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ...", "[6A72] Dysthymic disorder\n Def: Dysthymic disorder is characterised by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifes...\n --EXCLUDES--> [?] Mixed depressive and anxiety disorder\n Def: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or ma...\n --PARENT--> [?] Depressive disorders\n Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ...", "[KD30.Z] Birth depression, unspecified\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.1] Birth depression with 5 minute Apgar score 4-6\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth....", "[KD30.Z] Birth depression, unspecified\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.0] Birth depression with 5 minute Apgar score 0-3\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth...." ]
6A7Z
Depressive disorders, unspecified
[ { "from_icd11": "6A7Z", "icd10_code": "F3289", "icd10_title": "Other specified depressive episodes" }, { "from_icd11": "6A7Z", "icd10_code": "F3281", "icd10_title": "Premenstrual dysphoric disorder" }, { "from_icd11": "6A7Z", "icd10_code": "F329", "icd10_title": "Major depressive disorder, single episode, unspecified" }, { "from_icd11": "6A7Z", "icd10_code": "F328", "icd10_title": "Other depressive episodes" }, { "from_icd11": "6A72", "icd10_code": "F341", "icd10_title": "Dysthymic disorder" }, { "from_icd11": "6E20", "icd10_code": "F53", "icd10_title": "Mental and behavioral disorders associated with the puerperium, not elsewhere classified" }, { "from_icd11": "BD50.41", "icd10_code": "I713", "icd10_title": "Abdominal aortic aneurysm, ruptured" }, { "from_icd11": "EK91", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MH12.1", "icd10_code": "R961", "icd10_title": "" }, { "from_icd11": "MB24.3", "icd10_code": "R450", "icd10_title": "Nervousness" } ]
F3289
Other specified depressive episodes
A 24-year-old female was admitted for a 1-year history of cough and sputum production and a 3-day history of fever. She had been diagnosed with HIV infection 10 years prior, and prescribed anti-retroviral therapy medications (ART; Rilpivirine 25 mg once/day, Lamivudine 300 mg/ Abacavir 600 mg once/day, Raltegravir 400 mg twice/day), but had poor adherence due to gastrointestinal troubles. Her CD4 T-cell count 3 months before admission was 15 cells/mm 3 , and her viral load had not been suppressed for several years. On admission, her temperature was 37 °C, respiratory rate was 20 breaths per minute, pulse was 108 beats per minute, and blood pressure was 102/74 mmHg. Auscultation of her lungs revealed coarse breath sounds with crackles in the bilateral lower lung fields. A complete blood cell count and blood chemistry on admission revealed a white blood cell count of 4,240/mm 3 (neutrophils, 88.5 %; lymphocytes, 6.1 %), hemoglobin level of 13.0 g/dL, and platelet count of 66,000/mm 3 . Arterial blood gas analysis measured while breathing room air showed an arterial oxygen partial pressure (PaO 2 ) of 74.2 mmHg, arterial carbon dioxide partial pressure (PaCO 2 ) of 37.4 mmHg, and oxygen (O 2 ) saturation of 95.3 %. Quantitative real-time polymerase chain reaction showed a HIV viral load of 851,000 copies/mL, and the patient’s CD4 T cell count was 5 cells/mm 3 . Chest radiography on admission revealed diffuse bilateral reticular infiltrates in bilateral lung fields . A high resolution computed tomography (CT) scan showed tiny centrilobular nodules with a tree-in-bud pattern in both lungs . To evaluate the possibility of community-acquired bacterial pneumonia, a urine Streptococcus pneumoniae antigen (Ag) test, sputum Legionella pneumophila polymerase chain reaction (PCR) test, and sputum and blood cultures were done. All results were negative. Viral pneumonia was also considered and PCR tests were performed to detect adenovirus, respiratory syncytial virus, influenza viruses A and B, coronavirus, and parainfluenza virus, but all results were negative. Pneumocystis jirovecii PCR, Aspergillus galactomannan Ag assay, and cryptococcal Ag test results were also negative. We considered cytomegalovirus (CMV) pneumonitis, and CMV quantitative PCR revealed 13,650 copies/mL. However, the patient’s clinical symptoms and chest x-ray improved without any treatment for CMV. Miliary tuberculosis was initially suspected, and anti-retroviral agents (elvitegravir 150 mg, cobicistat 288.5 mg, emtricitabine 200 mg, tenofovir 300 mg) and anti-tuberculosis medication were administered. At the same time, ceftriaxone 2 g once daily and clarithromycin 500 mg twice daily were administered, as the clinicians were unable to rule out concurrent bacterial infection. On the 7th day of hospitalization, the patient’s chest x-ray showed rapid improvement. The patient did not present with any symptoms suggestive of inflammatory connective tissue diseases, such as arthralgia or dry eyes, and had no exposure history to irradiation or fumes, which are known to cause inflammatory injury to the lungs. Contrary to the clinicians’ initial suspicion of miliary tuberculosis, results of an interferon γ releasing assay (IGRA), sputum acid-fast bacilli (AFB) stain, and tuberculosis PCR were negative. Overall, the etiology remained unknown, so on the 8th day of admission, we performed video-assisted thoracoscopic surgery (VATS) to determine the cause of the patient’s diffuse lung infiltration. Microscopic examination showed patchy fibroblastic plugs in the bronchioles and alveolar ducts, consistent with BOOP, while tissue AFB stain and tuberculosis PCR tests were negative . Anti-tuberculosis medications and ceftriaxone were discontinued, and oral clarithromycin 500 mg twice a day was continued. Follow-up chest radiography and clinical symptoms of cough and sputum production improved prior to discharge . Five months after discharge, the patient was asymptomatic with a normal chest x-ray. Furthermore, as the patient’s adherence to ART improved, her CD4 T-cell count rose to 181 cells/mm 3 . Clarithromycin was discontinued at that time and the patient is currently receiving regular outpatient follow-up. Fig. 1 Chest radiography on admission. Diffuse bilateral reticular infiltrates in the bilateral lung fields were present Fig. 2 High resolution computed tomography (CT) scan showing tiny centrilobular nodules with a tree-in-bud pattern in both lungs Fig. 3 Microscopic examination of the lung tissue at x100 magnification after H&E staining. Patchy fibroblastic plugs in the bronchioles and alveolar ducts were observed, consistent with BOOP Fig. 4 Chest X-ray on the 15 th day of admission. Note resolution of the diffuse bilateral reticular infiltrates
4.066406
0.975586
sec[1]/p[0]
en
0.999995
26201392
https://doi.org/10.1186/s12879-015-1025-6
[ "chest", "count", "blood", "tuberculosis", "sputum", "cell", "lung", "anti", "lungs", "twice" ]
[ { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB27", "title": "Pleural effusion" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "NA80.Y&XJ1C6", "title": "Thoracic haematoma" }, { "code": "3B63.1Z", "title": "Acquired thrombocytosis, unspecified" }, { "code": "3B64.Z", "title": "Thrombocytopenia, unspecified" }, { "code": "4B0Z", "title": "Immune system disorders involving white cell lineages, unspecified" }, { "code": "4B03.Z", "title": "Eosinophilia, unspecified" }, { "code": "4B00.1Z", "title": "Neutrophilia, unspecified" } ]
=== ICD-11 CODES FOUND === [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB27] Pleural effusion Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate Includes: Pleurisy with effusion Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure [3B63.1Z] Acquired thrombocytosis, unspecified Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia [3B64.Z] Thrombocytopenia, unspecified Also known as: Thrombocytopenia, unspecified | Thrombocytopenia | low platelet count | low platelets | decreased platelets [4B0Z] Immune system disorders involving white cell lineages, unspecified Also known as: Immune system disorders involving white cell lineages, unspecified [4B03.Z] Eosinophilia, unspecified Also known as: Eosinophilia, unspecified | Eosinophilia | Disorders with increased eosinophil counts | Idiopathic hypereosinophilic syndrome [4B00.1Z] Neutrophilia, unspecified Also known as: Neutrophilia, unspecified | Neutrophilia | Disorders with increased neutrophil counts === GRAPH WALKS === --- Walk 1 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --EXCLUDES--> [?] Developmental anomalies Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period.... --- Walk 2 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --RELATED_TO--> [?] Sleep-related breathing disorders Def: Sleep related breathing disorders are characterised by abnormalities of respiration during sleep. In some of these disorders, respiration is also abnormal during wakefulness. The disorders are grouped... --- Walk 3 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --PARENT--> [?] Pleural, diaphragm or mediastinal disorders Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin... --CHILD--> [CB20] Pleural plaque Def: Deposits of hyalinized collagen fibres in the parietal pleura that result from chronic inflammation. Most commonly associated with past exposure to asbestos, typically becoming visible years after inh... --- Walk 4 --- [CB27] Pleural effusion Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.... --EXCLUDES--> [?] Pleurisy Def: Pleurisy or Pleuritis is the medical term for inflammation of the pleura. The most common cause of pleuritis is infection, but it can also be caused by lupus, rheumatoid arthritis, and certain medicin... --CHILD--> [?] Chronic pleurisy --- Walk 5 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --PARENT--> [?] Lung infections Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source.... --CHILD--> [CA41] Acute bronchiolitis Def: An acute disease of the bronchioles, commonly caused by an infection with a bacteria or viral source. This disease is characterised by inflammation of the bronchioles and coryza. This disease presents... --- Walk 6 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with... --PARENT--> [?] Tuberculosis of the respiratory system Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....
[ "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --EXCLUDES--> [?] Developmental anomalies\n Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....", "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --RELATED_TO--> [?] Sleep-related breathing disorders\n Def: Sleep related breathing disorders are characterised by abnormalities of respiration during sleep. In some of these disorders, respiration is also abnormal during wakefulness. The disorders are grouped...", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --PARENT--> [?] Pleural, diaphragm or mediastinal disorders\n Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin...\n --CHILD--> [CB20] Pleural plaque\n Def: Deposits of hyalinized collagen fibres in the parietal pleura that result from chronic inflammation. Most commonly associated with past exposure to asbestos, typically becoming visible years after inh...", "[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Pleurisy\n Def: Pleurisy or Pleuritis is the medical term for inflammation of the pleura. The most common cause of pleuritis is infection, but it can also be caused by lupus, rheumatoid arthritis, and certain medicin...\n --CHILD--> [?] Chronic pleurisy", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --PARENT--> [?] Lung infections\n Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source....\n --CHILD--> [CA41] Acute bronchiolitis\n Def: An acute disease of the bronchioles, commonly caused by an infection with a bacteria or viral source. This disease is characterised by inflammation of the bronchioles and coryza. This disease presents...", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...\n --PARENT--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M...." ]
CB7Z
Diseases of the respiratory system, unspecified
[ { "from_icd11": "CB7Z", "icd10_code": "J989", "icd10_title": "Respiratory disorder, unspecified" }, { "from_icd11": "CB7Z", "icd10_code": "X", "icd10_title": "" }, { "from_icd11": "CB7Z", "icd10_code": "J09-J18", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J910", "icd10_title": "Malignant pleural effusion" }, { "from_icd11": "CB27", "icd10_code": "J918", "icd10_title": "Pleural effusion in other conditions classified elsewhere" }, { "from_icd11": "CB27", "icd10_code": "J90", "icd10_title": "Pleural effusion, not elsewhere classified" }, { "from_icd11": "CB27", "icd10_code": "J90-J94", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J91", "icd10_title": "Pleural effusion in conditions classified elsewhere" }, { "from_icd11": "CA44", "icd10_code": "J869", "icd10_title": "Pyothorax without fistula" }, { "from_icd11": "CA44", "icd10_code": "J860", "icd10_title": "Pyothorax with fistula" }, { "from_icd11": "CA44", "icd10_code": "J85-J86", "icd10_title": "" }, { "from_icd11": "CA44", "icd10_code": "J86", "icd10_title": "Pyothorax" }, { "from_icd11": "MD30.Z", "icd10_code": "R0781", "icd10_title": "Pleurodynia" }, { "from_icd11": "MD30.Z", "icd10_code": "R0782", "icd10_title": "Intercostal pain" }, { "from_icd11": "MD30.Z", "icd10_code": "R079", "icd10_title": "Chest pain, unspecified" } ]
J989
Respiratory disorder, unspecified
A 39‐year‐old man presented to our outpatient clinic to undergo ICL implantation surgery. He had no history of systemic or ocular diseases other than refractive error. His preoperative uncorrected visual acuity (UCVA) was 20/500 in each eye, while his distance‐corrected visual acuity (DCVA) was 20/13 (S, −7.00; Cyl, −1.75 × 20°) in the right eye and 20/13 (S, −6.25; Cyl, −2.5 × 10°) in the left eye. The intraocular pressure (IOP) was 16 and 15 mm Hg, and the corneal endothelial cell density was 3118 and 3318 cells/mm 2 in the patient's right and left eyes, respectively. In the right and left eye, respectively, the pupil sizes were 8 and 8 mm in a dark examination room, and 5.7 and 5.8 mm in a bright examination room; the anterior chamber depths (from the corneal endothelium to the anterior lens capsule) were 3.58 and 3.55 mm, the white‐to‐white (WTW) diameters were 11.4 and 11.4 mm, the sulcus‐to‐sulcus (STS) distances were 11.7 and 11.68 mm, and the corneal thicknesses was 539 and 528 μm. Two months before the toric ICL (TICL) implantation surgery, laser iridotomy was performed in both eyes. Based on the calculations of the TICL software (STAAR Surgical Company, Monrovia, CA, USA), we chose the TICMV4 model, with a power of −13.5 + 3.5 × 89° in the right eye and −13.5 + 2.5 × 101° in the left eye, and a diameter of 12.6 mm in both eyes. The TICLs were implanted without any complications at 16° and 0° anticlockwise from the horizontal meridian in the right and left eyes, respectively. In both eyes, the 3‐month postoperative UCVA was 20/10; the DCVA was also 20/10 (S, +1.00; Cyl, −0.50 × 135° in the right eye and S, +0.50; Cyl. −0.50 × 20° in the left eye). The IOP was 12 and 13 mm Hg, respectively, and the corneal endothelial cell density 3 months after surgery was 3125 and 3086 cells/mm 2 . The central vault, which is the distance between the TICL and crystalline lens, was 0.9 and 1.05 mm 3 months after surgery. Although the central vault was high, we followed it without surgical interventions because the angle was open and there were no complications such as IOP rise, iris contact with the corneal endothelium, or pigment dispersion syndrome. Eleven months after the initial ICL implantation surgery, the patient developed blurred vision in his right eye after being struck by another player's hand during a futsal match. The patient presented to the outpatient clinic the day after the injury. The UCVA in his right eye was 20/13, while the DCVA was 20/13 (S, +1.25; Cyl, −0.50 × 130°). Slit‐lamp examination revealed mild inflammation in the anterior chamber, and both the superior and inferior temporal haptics of the ICL were dislodged into the anterior chamber and entrapped within the pupil, without touching the corneal endothelium . We performed repositioning surgery on the same day. After filling the anterior chamber with viscoelastic material, we used the ICL manipulator from the preexisting wound to reposition the ICL behind the iris. The patient used 1.5% levofloxacin, 0.1% bromfenac sodium hydrate, and 0.1% betamethasone ophthalmic solutions for 1 week after the operation. One month after the repositioning surgery, his UCVA was 20/13 and his DCVA was 20/13 (S, +0.75; Cyl, −0.75 × 135°). The blurred vision in his right eye was resolved. The IOP in the affected eye was 13 mm Hg; the corneal endothelial cell density was 3001 cells/mm 2 , and the vault distance was 0.82 mm. No complications such as iris damage, cataract formation, or ICL rotation were noted. Two years and 2 months after the initial TICL implantation surgery, the patient again developed blurred vision in his right eye after being struck by another player's foot during a futsal match. The UCVA in his right eye was 20/17, and the DCVA was 20/17 (S, +0.75; Cyl, −0.75 × 135°). We observed mild inflammation in the anterior chamber, and the inferonasal haptic of the ICL was dislodged into the anterior chamber and entrapped within the pupil, without touching the corneal endothelium . We performed repositioning surgery the next day. The patient used 1.5% levofloxacin, 0.1% bromfenac sodium hydrate, and 0.1% fluorometholone ophthalmic solutions for 1 month after the operation. One month after surgery, his UCVA was 20/10, while his DCVA was 20/10 (S, +0.50; Cyl, −0.50 × 105°). The IOP was 17 mm Hg, the corneal endothelial cell density was 3050 cells/mm 2 , and the vault distance was 0.79 mm. No complications associated with the repositioning surgery or trauma were observed. We observed pigment deposition on the posterior surface of the ICL after the surgery, but the amount of the pigment had not changed 1 year after injury. We explained to the patient the risk of ICL prolapse during futsal at night, advising him to use protective glasses.
4.132813
0.943359
sec[1]/p[0]
en
0.999997
30997050
https://doi.org/10.1002/ccr3.2055
[ "corneal", "ucva", "dcva", "chamber", "eyes", "implantation", "distance", "endothelial", "cell", "cells" ]
[ { "code": "9A7Z", "title": "Disorders of the cornea, unspecified" }, { "code": "9A71", "title": "Infectious keratitis" }, { "code": "9A76", "title": "Corneal ulcer" }, { "code": "9A78.4", "title": "Corneal degeneration" }, { "code": "9A70.Z", "title": "Hereditary corneal dystrophies, unspecified" }, { "code": "9A8Z", "title": "Disorders of the anterior chamber, unspecified" }, { "code": "9A96.3", "title": "Primary anterior uveitis" }, { "code": "9A90.0", "title": "Disorders of chamber angle" }, { "code": "9A8Y", "title": "Other specified disorders of the anterior chamber" }, { "code": "9A80", "title": "Hyphaema" } ]
=== ICD-11 CODES FOUND === [9A7Z] Disorders of the cornea, unspecified Also known as: Disorders of the cornea, unspecified | corneal disease | disease of cornea | keratopathy [9A71] Infectious keratitis Also known as: Infectious keratitis | corneal inflammation | Bacterial keratitis | Fungal keratitis | fungal infection of cornea [9A76] Corneal ulcer Definition: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection. Also known as: Corneal ulcer | cornea ulcer | ulcerative keratitis | corneal ulcer NOS | Central corneal ulcer Includes: Central corneal ulcer | Ring corneal ulcer | Corneal ulcer with hypopyon [9A78.4] Corneal degeneration Also known as: Corneal degeneration | degenerative corneal opacity | Pellucid marginal degeneration | Arcus senilis | gerontoxon Includes: Arcus senilis Excludes: Mooren ulcer [9A70.Z] Hereditary corneal dystrophies, unspecified Also known as: Hereditary corneal dystrophies, unspecified | Hereditary corneal dystrophies | hereditary corneal dystrophy | corneal dystrophy NOS | familial hereditary corneal degeneration [9A8Z] Disorders of the anterior chamber, unspecified Also known as: Disorders of the anterior chamber, unspecified [9A96.3] Primary anterior uveitis Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid. Also known as: Primary anterior uveitis | anterior chamber cell [9A90.0] Disorders of chamber angle Definition: This refers to the change of tissue to a lower or less functionally active form, of the fluid-filled space inside the eye between the iris and the cornea's innermost surface, the endothelium. Also known as: Disorders of chamber angle [9A8Y] Other specified disorders of the anterior chamber Also known as: Other specified disorders of the anterior chamber [9A80] Hyphaema Also known as: Hyphaema | blood in anterior chamber | haemorrhage of anterior chamber of eye | hyphaemia | anterior chamber haemorrhage Excludes: traumatic hyphaema === GRAPH WALKS === --- Walk 1 --- [9A7Z] Disorders of the cornea, unspecified --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --CHILD--> [9A71] Infectious keratitis --- Walk 2 --- [9A7Z] Disorders of the cornea, unspecified --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --CHILD--> [9A70] Hereditary corneal dystrophies Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ... --- Walk 3 --- [9A71] Infectious keratitis --RELATED_TO--> [?] Herpes simplex keratitis Def: This is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct... --CHILD--> [?] Neurotrophic keratopathy --- Walk 4 --- [9A71] Infectious keratitis --RELATED_TO--> [?] Herpes simplex keratitis Def: This is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct... --CHILD--> [?] Infectious epithelial keratitis --- Walk 5 --- [9A76] Corneal ulcer Def: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection.... --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --CHILD--> [9A71] Infectious keratitis --- Walk 6 --- [9A76] Corneal ulcer Def: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection.... --PARENT--> [?] Disorders of the cornea Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc... --CHILD--> [9A70] Hereditary corneal dystrophies Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ...
[ "[9A7Z] Disorders of the cornea, unspecified\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --CHILD--> [9A71] Infectious keratitis", "[9A7Z] Disorders of the cornea, unspecified\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --CHILD--> [9A70] Hereditary corneal dystrophies\n Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ...", "[9A71] Infectious keratitis\n --RELATED_TO--> [?] Herpes simplex keratitis\n Def: This is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct...\n --CHILD--> [?] Neurotrophic keratopathy", "[9A71] Infectious keratitis\n --RELATED_TO--> [?] Herpes simplex keratitis\n Def: This is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct...\n --CHILD--> [?] Infectious epithelial keratitis", "[9A76] Corneal ulcer\n Def: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection....\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --CHILD--> [9A71] Infectious keratitis", "[9A76] Corneal ulcer\n Def: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue. It is often caused by bacterial, fungal, or viral infection....\n --PARENT--> [?] Disorders of the cornea\n Def: This refers to disorders of the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea, with the anterior chamber and lens, refracts light, with the cornea acc...\n --CHILD--> [9A70] Hereditary corneal dystrophies\n Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ..." ]
9A7Z
Disorders of the cornea, unspecified
[ { "from_icd11": "9A7Z", "icd10_code": "H16203", "icd10_title": "Unspecified keratoconjunctivitis, bilateral" }, { "from_icd11": "9A7Z", "icd10_code": "H16229", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16231", "icd10_title": "Neurotrophic keratoconjunctivitis, right eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16213", "icd10_title": "Exposure keratoconjunctivitis, bilateral" }, { "from_icd11": "9A7Z", "icd10_code": "H16209", "icd10_title": "Unspecified keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16221", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, right eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16222", "icd10_title": "Keratoconjunctivitis sicca, not specified as Sjogren's, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16202", "icd10_title": "Unspecified keratoconjunctivitis, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16299", "icd10_title": "Other keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16292", "icd10_title": "Other keratoconjunctivitis, left eye" }, { "from_icd11": "9A7Z", "icd10_code": "H16219", "icd10_title": "Exposure keratoconjunctivitis, unspecified eye" }, { "from_icd11": "9A7Z", "icd10_code": "H169", "icd10_title": "Unspecified keratitis" }, { "from_icd11": "9A7Z", "icd10_code": "H189", "icd10_title": "Unspecified disorder of cornea" }, { "from_icd11": "9A7Z", "icd10_code": "H168", "icd10_title": "Other keratitis" }, { "from_icd11": "9A7Z", "icd10_code": "H162", "icd10_title": "Keratoconjunctivitis" } ]
H16203
Unspecified keratoconjunctivitis, bilateral
A 20-year-old woman with no medical history was referred to our hospital for evaluation and treatment of a 3-month history of worsening pain in the left ankle. Physical examination revealed no remarkable findings except tenderness on the anterior aspect of her left ankle. All laboratory data were within the reference ranges. Radiographs showed multiple discontiguous osteolytic lesions in the bones of the left lower extremity (femur, patella, tibia, and talus) . The spotty lytic lesions were ill-circumscribed and lacked marginal sclerosis. Some were accompanied by thinning and ballooning of the bone cortexes . The lesion at the distal end of the tibia extended beyond the epiphyseal plate and eroded the subchondral bone; this lesion was considered to be the cause of her ankle pain. On ankle magnetic resonance imaging, the spotty lesions showed isointensity to the muscles on T1-weighted images , mild hyperintensity on T2-weighted images, and homogeneous enhancement by gadolinium administration . On fluorodeoxyglucose positron emission tomography (FDG-PET), all of the intraosseous spotty lesions in the left lower extremity were FDG-avid with a maximum standardized uptake value (SUV) of 15.95; no such lesions were present in the soft tissues . Based on the findings from the imaging studies, the differential diagnoses of the multiple bone lesions included bone metastasis, hematological malignancies such as malignant lymphoma and multiple myeloma, and vascular tumors. Curettage of the lesion in the distal tibia and artificial bone grafting were performed for pain relief and histological diagnosis. While waiting for the definitive diagnosis, progressive bone absorption at all of the lesions and worsening lower limb pain occurred over 1 month . The preliminary pathology report suggested a non-hematological neoplasm composed of spindle cells and osteoclast-like giant cells, which led to a clinical diagnosis of bone metastases from a solid cancer despite the fact that no lesion suspicious of primary cancer was present. Based on the clinical diagnosis of bone metastasis, monthly administration of denosumab (120 mg) was initiated. The final pathological report demonstrated proliferation of spindle cells and epithelioid cells with eosinophilic cytoplasm. The tumor cells were immunohistochemically positive for keratin (AE1/AE3), CD31, ERG, and FOSB , which led to the diagnosis of PMHE. Because her limb pain gradually improved after denosumab administration, the monthly denosumab treatment was continued. After 1 year of denosumab treatment, the drug was administered at longer intervals of up to 6 months. The drug was discontinued 4 years after its initiation. Although the spotty lesions remained, a plain radiograph showed no increase in the size of the lesions or the surrounding marked marginal scleroses . On FDG-PET, the lesions showed clearly decreased SUVs . Because denosumab treatment led to dramatic symptom improvement, the patient did not agree to undergo a second-look biopsy or curettage of the remaining lesions at the time of denosumab discontinuation. The patient developed no signs of new lesions or distant metastasis and agreed to continue undergoing active surveillance. Fig. 1 Imaging findings at presentation. a and b Plain X-ray findings. Multifocal ill-circumscribed lytic lesions were seen in the left femur, patella, tibia, and talus. c and d Sagittal magnetic resonance imaging findings of the left ankle. The multifocal lesions showed c homogeneous low intensity on T1-weighted images and d homogeneous enhancement after gadolinium administration. e-i Fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography showed multifocal FDG-avid lesions in the bones of the left lower extremity with a maximum standardized uptake value of 15.95. No lesions were found in the soft tissue. j and k Rapid progression after curettage and artificial bone grafting of the lesion at the distal end of the left tibia was observed. Each ill-circumscribed lytic lesion in the left extremity increased in size over 1 month Fig. 2 Pathological findings. a and b Hematoxylin–eosin staining showed proliferation of spindle and epithelioid cells with eosinophilic cytoplasm, which was compatible with the diagnosis of pseudomyogenic hemangioendothelioma. c and d Immunohistochemical studies showed that the tumor cells were positive for ERG and FOSB Fig. 3 Imaging findings 4 years following denosumab treatment. a and b Plain radiographs showed shrinkage of the lesions with striking marginal sclerosis. c-g Fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography showed that each lesion had become less FDG-avid with a maximum standardized uptake value of 2.6 and was accompanied by remarkable sclerotic bone
4.070313
0.974121
sec[1]/p[0]
en
0.999997
31481040
https://doi.org/10.1186/s12885-019-6072-8
[ "lesions", "bone", "lesion", "cells", "denosumab", "pain", "ankle", "tibia", "imaging", "tomography" ]
[ { "code": "FA5Z", "title": "Arthropathies, unspecified" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" } ]
=== ICD-11 CODES FOUND === [FA5Z] Arthropathies, unspecified Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Osteoarthritis Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art... --- Walk 2 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Inflammatory arthropathies --- Walk 3 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ... --- Walk 4 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --EXCLUDES--> [?] Endocrine, nutritional or metabolic diseases Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases.... --- Walk 5 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --CHILD--> [ME60.2] Ulcer of skin of uncertain nature Def: This denotes the presence of a skin ulcer but uncertainty as to its nature. No inference as to whether the ulcer might be of serious significance (e.g. suspected skin cancer) is made.... --- Walk 6 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --CHILD--> [ME60.0] Skin lesion of uncertain nature Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made....
[ "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Osteoarthritis\n Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art...", "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Inflammatory arthropathies", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --EXCLUDES--> [?] Endocrine, nutritional or metabolic diseases\n Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases....", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --CHILD--> [ME60.2] Ulcer of skin of uncertain nature\n Def: This denotes the presence of a skin ulcer but uncertainty as to its nature. No inference as to whether the ulcer might be of serious significance (e.g. suspected skin cancer) is made....", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --CHILD--> [ME60.0] Skin lesion of uncertain nature\n Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made...." ]
FA5Z
Arthropathies, unspecified
[ { "from_icd11": "FA5Z", "icd10_code": "M00-M25", "icd10_title": "" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "ME60.Z", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MD41", "icd10_code": "R911", "icd10_title": "Solitary pulmonary nodule" }, { "from_icd11": "MD41", "icd10_code": "R91", "icd10_title": "Abnormal findings on diagnostic imaging of lung" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" } ]
M00-M25
A 48-year-old Sinhalese man with myasthenia gravis was presented to the department of radiology of a tertiary care hospital for upper gastrointestinal (GI) contrast study, for further evaluation of progressive dysphagia. Myasthenia gravis was diagnosed in May 2016 and he underwent thymectomy in November 2016 for thymic hyperplasia. From the point of diagnosis, he had two episodes of myasthenic crisis, precipitated by lower respiratory tract infections that required mechanical ventilatory support. Thereafter, he was on regular pyridostigmine, 50 mg/6 hourly, mycophenolate mofetil (MMF) 500 mg twice daily, and orally administered prednisolone therapy. He was able to perform his daily routines of life with negligible support. Meanwhile, he developed progressive dysphagia for solids initially and then for liquids for a 3-month duration. He was evaluated by a neurologist and referred to the surgical team for upper GI endoscopy. Since that was also uneventful, he was referred to our radiology unit for a contrast study. On admission to the radiology unit, he had normal respiratory parameters and his limb muscle power was grade 5/5. Due to the possible risk of aspiration, 10 ml of iohexol (Omnipaque™) was given under fluoroscopy guidance. As the contrast material had directly entered his right main bronchus, the procedure was abandoned and he was transferred to the accident and emergency treatment unit (ETU). Although he was able to maintain his air oxygen saturation above 90% with high flow oxygen via non-rebreather mask, effort of breathing drastically dropped 45 minutes after admission to the ETU including dropping of respiratory rate to 10 breaths per minute. Despite continuous treatment with nebulized salbutamol and intravenously administered metronidazole 500 mg stat dose, he eventually required endotracheal intubation with 3 mg midazolam and 10 mg atracurium administered intravenously. There was a drooping of eyelids, but it was very difficult to assess limb muscle power before intubation. According to the clinical scenario, the diagnosis of respiratory distress due to contrast aspiration was made and he was transferred to the ICU. Following admission, the diagnosis was questioned as there were no significant chest X-ray (CXR) abnormalities to cause the high degree of respiratory distress, except right apical segment collapse. He was then evaluated by a neurologist and the diagnosis was revised to myasthenic crisis, possibly due to aspiration pneumonitis caused by aspiration of contrast. Hence, intravenously administered immunoglobulin 20 g daily for 5 days was commenced with an increased dose of pyridostigmine 60 mg 6 hourly, MMF 750 mg twice daily, and prednisolone 40 mg daily. Although there was no clinical, microbiological, or serological evidence of infection, considering the high possibility of potential development of sepsis, intravenously administered ceftriaxone 1 g 8 hourly was initiated. In addition, there were no electrolyte abnormalities acting as a precipitant of myasthenic crisis. Mechanical ventilation was continued in a synchronized intermittent mandatory mode with fraction of inspired oxygen (FiO 2 ) of 50%, positive end-expiratory pressure (PEEP) of 5 cmH 2 O, and pressure support 10 cmH 2 O. Respiratory support was gradually reduced over 72-hour period as there was remarkable improvement in his respiratory mechanics with the treatment. Meanwhile, there was a sudden de-saturation with evidence of subcutaneous emphysema on the right side of his neck and a subsequent CXR revealed complete collapse of his left lung, a hyperinflated right lung with slightly increased translucency on same side, with right-sided subcutaneous air . CXR findings raised the suspicion of right-sided pneumothorax. Since the cause of subcutaneous emphysema was occult in the CXR, non-contrast computed tomography (NCCT) of his chest was done and revealed total left lung collapse with ipsilateral mediastinal shift and left loculated pneumothorax. Subsequent bronchoscopy was negative. However, with regular chest physiotherapy, lung collapse improved. He was then gradually weaned off the ventilator and transferred to the general medical ward for continuation of care. Following an 18-day hospital stay, he was successfully discharged from the hospital with a tailing off dose of prednisolone. However, due to the high possibility of aspiration, he was advised to keep the nasogastric tube. Two weeks following discharge, during the first clinic visit, he was ambulant showing an improvement in swallowing. The nasogastric tube was removed and regular follow-up was planned. Fig. 1 Chest X-ray anteroposterior view showing complete left lung collapse and hyperinflated right lung with right-sided subcutaneous emphysema
3.90625
0.977539
sec[1]/p[0]
en
0.999995
31146780
https://doi.org/10.1186/s13256-019-2114-8
[ "respiratory", "contrast", "lung", "daily", "aspiration", "collapse", "support", "intravenously", "chest", "subcutaneous" ]
[ { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "CB41.2Z", "title": "Respiratory failure, unspecified" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "MD11.Y", "title": "Other specified abnormalities of breathing" }, { "code": "9D43", "title": "Impairment of contrast vision" }, { "code": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" } ]
=== ICD-11 CODES FOUND === [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [CB41.2Z] Respiratory failure, unspecified Also known as: Respiratory failure, unspecified | Respiratory failure, unspecified as acute or chronic | respiration failure | respiratory failure NOS | respiration failed [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [MD11.Y] Other specified abnormalities of breathing Also known as: Other specified abnormalities of breathing | Bradypnoea | Choking sensation | Hypoventilation | hypoventilation syndrome NOS [9D43] Impairment of contrast vision Definition: Contrast sensitivity refers to the ability to distinguish small differences in brightness between adjacent surfaces. Peak Contrast sensitivity refers to the smallest differences that are discernible for large stimuli. For smaller objects, such as those involved in many Activities of Daily Living, contrast sensitivity interacts with visual acuity and visual field. Better contrast makes smaller details visible. The visual field is larger for stronger stimuli. Also known as: Impairment of contrast vision | Moderate impairment of contrast vision | Profound impairment of contrast vision [QA00.6Y] Other specified examination of eyes or vision Also known as: Other specified examination of eyes or vision | No Impairment of Contrast vision | Normal colour vision | No Impairment of Dark adaptation | No diplopia [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics === GRAPH WALKS === --- Walk 1 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --CHILD--> [?] Lung infections Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source.... --- Walk 2 --- [CB7Z] Diseases of the respiratory system, unspecified --PARENT--> [12] Diseases of the respiratory system --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics --- Walk 3 --- [CB41] Respiratory failure Def: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both.... --EXCLUDES--> [?] Respiratory arrest Def: Arrest of spontaneous breathing.... --CHILD--> [?] Respiratory arrest of newborn --- Walk 4 --- [CB41] Respiratory failure Def: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both.... --EXCLUDES--> [?] Acute respiratory distress syndrome Def: Acute respiratory distress syndrome ("ARDS") is a life-threatening inflammation with oedema in the lungs which leads to severe respiratory failure. ARDS is a clinical syndrome of lung injury with hypo... --CHILD--> [?] Respiratory distress syndrome of newborn Def: Respiratory distress syndrome (RDS) is an acute illness, usually of preterm infants, due to pulmonary surfactant deficiency, developing within 4-6 hours of birth, and is characterised by respiratory d... --- Walk 5 --- [CB41.2Z] Respiratory failure, unspecified --PARENT--> [CB41.2] Respiratory failure, unspecified as acute or chronic Def: This is inadequate gas exchange by the respiratory system, with the result that levels of arterial oxygen, carbon dioxide or both cannot be maintained within their normal ranges, unspecified as acute ... --CHILD--> [CB41.2Z] Respiratory failure, unspecified --- Walk 6 --- [CB41.2Z] Respiratory failure, unspecified --PARENT--> [CB41.2] Respiratory failure, unspecified as acute or chronic Def: This is inadequate gas exchange by the respiratory system, with the result that levels of arterial oxygen, carbon dioxide or both cannot be maintained within their normal ranges, unspecified as acute ... --PARENT--> [CB41] Respiratory failure Def: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both....
[ "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --CHILD--> [?] Lung infections\n Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source....", "[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics", "[CB41] Respiratory failure\n Def: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both....\n --EXCLUDES--> [?] Respiratory arrest\n Def: Arrest of spontaneous breathing....\n --CHILD--> [?] Respiratory arrest of newborn", "[CB41] Respiratory failure\n Def: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both....\n --EXCLUDES--> [?] Acute respiratory distress syndrome\n Def: Acute respiratory distress syndrome (\"ARDS\") is a life-threatening inflammation with oedema in the lungs which leads to severe respiratory failure. ARDS is a clinical syndrome of lung injury with hypo...\n --CHILD--> [?] Respiratory distress syndrome of newborn\n Def: Respiratory distress syndrome (RDS) is an acute illness, usually of preterm infants, due to pulmonary surfactant deficiency, developing within 4-6 hours of birth, and is characterised by respiratory d...", "[CB41.2Z] Respiratory failure, unspecified\n --PARENT--> [CB41.2] Respiratory failure, unspecified as acute or chronic\n Def: This is inadequate gas exchange by the respiratory system, with the result that levels of arterial oxygen, carbon dioxide or both cannot be maintained within their normal ranges, unspecified as acute ...\n --CHILD--> [CB41.2Z] Respiratory failure, unspecified", "[CB41.2Z] Respiratory failure, unspecified\n --PARENT--> [CB41.2] Respiratory failure, unspecified as acute or chronic\n Def: This is inadequate gas exchange by the respiratory system, with the result that levels of arterial oxygen, carbon dioxide or both cannot be maintained within their normal ranges, unspecified as acute ...\n --PARENT--> [CB41] Respiratory failure\n Def: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both...." ]
CB7Z
Diseases of the respiratory system, unspecified
[ { "from_icd11": "CB7Z", "icd10_code": "J989", "icd10_title": "Respiratory disorder, unspecified" }, { "from_icd11": "CB7Z", "icd10_code": "X", "icd10_title": "" }, { "from_icd11": "CB7Z", "icd10_code": "J09-J18", "icd10_title": "" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J96", "icd10_title": "Respiratory failure, not elsewhere classified" }, { "from_icd11": "CB41.2Z", "icd10_code": "J9691", "icd10_title": "Respiratory failure, unspecified with hypoxia" }, { "from_icd11": "CB41.2Z", "icd10_code": "J9690", "icd10_title": "Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia" }, { "from_icd11": "CB41.2Z", "icd10_code": "J9692", "icd10_title": "Respiratory failure, unspecified with hypercapnia" }, { "from_icd11": "CB41.2Z", "icd10_code": "J9621", "icd10_title": "Acute and chronic respiratory failure with hypoxia" }, { "from_icd11": "CB41.2Z", "icd10_code": "J969", "icd10_title": "Respiratory failure, unspecified" }, { "from_icd11": "9D43", "icd10_code": "H538", "icd10_title": "Other visual disturbances" }, { "from_icd11": "NE60", "icd10_code": "T50A95A", "icd10_title": "Adverse effect of other bacterial vaccines, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z15A", "icd10_title": "Adverse effect of immunoglobulin, initial encounter" }, { "from_icd11": "NE60", "icd10_code": "T50Z95A", "icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter" } ]
J989
Respiratory disorder, unspecified
A 37-year-old woman was hospitalized after an occupying lung lesion and an enlarged right supraclavicular lymph node were discovered. A computed tomography (CT) scan revealed several lymph node metastases in the right supraclavicular area, mediastinum, and lung, in addition to a mass in the upper lobe of the right lung, right pleural metastasis and multiple nodules in both lungs, with a high probability of inflammatory lesions combined with some metastases . There were no lesions seen on the brain’s magnetic resonance imaging (MRI). No bone metastases were detected by bone imaging. A right supraclavicular lymph node biopsy revealed adenocarcinoma and CK7(+), TTF-1(+), and P40(−) immunohistochemistry results were consistent with adenocarcinoma of pulmonary origin . The patient was found to have T4N3M1a stage IVa lung adenocarcinoma. Amplification refractory mutation system PCR (ARMS-PCR) genetic testing suggested EGFR exon 19 deletion, with no detectable aberrant changes in the ALK, ROS1, KRAS, BRAF, RET, NRAS, PIK3CA, and HER2 genes. We advocated that the patient engaged in a clinical trial using both gefitinib and anlotinib, but for a variety of reasons, the patient opted not to do so. However, the patient requested anlotinib therapy; icotinib 125 mg tid and anlotinib 8 mg qd were chosen as the patient’s initial treatment regimen. According to the response evaluation criteria for solid tumors (RECIST v1.1), significant lung tumor lesions decreased and developed cavity-like alterations after 5 months of therapy, demonstrating partial response (PR) . Additionally, there was a decline in the serum tumor biomarkers CA199, CA153, CA125, and CEA. The upper lobe of the right lung had a noticeably larger tumor lesion on 5 January 2021, which was classified as progressing disease (PD) using the RECIST v1.1 assessment criteria . The patient underwent CT-guided biopsy of lung lesions by puncture on 8 January 2021. Immunohistochemistry showed adenocarcinoma, TTF-1 (+), CK7 (+), P40 (−), and Ki67 (+20%). Further blood and tumor specimens from the patient were subjected to next-generation sequencing (NGS) testing, showing EGFR exon 19 deletion with an abundance of 2.4% in tumor specimens and TP53 exon 8 mutation with an abundance of 0.9% in tumor specimens. Programmed cell death-Ligand protein 1(PD-L1) expression was also examined, and the result suggested that the PD-L1 tumor cell proportion score (TPS) was <1%. The patient opted to participate in a clinical study as the second line of treatment, receiving three cycles of KN046 (a bispecific antibody inhibitor of PD-L1 and CTLA-4) with pemetrexed 800 mg/d1 and carboplatin 750 mg/d1, with an effectiveness rating of SD on CT scan . Unfortunately, the patient subsequently ceased the treatment because of grade 3 hepatitis brought on by immunotherapy. Forty days after discontinuation of the regimen, the patient was evaluated as PD , with a significant increase in serum tumor biomarkers. After that, the patient underwent fiberoptic bronchoscopy, and further lung lesions were sampled. Repeated NGS analysis of the patient’s blood and tumor samples revealed an EGFR exon 19 deletion with an abundance of 41.9% in tumor specimens, suggesting a potential re-sensitization to EGFR-TKI. Because immune checkpoint inhibitors interact with EGFR-TKI to produce serious adverse effects, we restarted EGFR-TKI therapy after 3 months of discontinuation of immune checkpoint inhibitors based on the elution time of the immune checkpoint inhibitors. Third-line therapy involved the use of afatinib 40 mg every day in conjunction with docetaxel 110 mg every 3 weeks . On CT, the patient was assessed for a partial response after two cycles of therapy , with no drug-related adverse events and a decrease in serum tumor biomarkers once again. On 15 August 2022, the patient underwent a CT examination which revealed a significant re-enlargement of the tumour and was considered to be drug resistant again, getting a progression free survival (PFS) of 14 months . A repeat CT-guided puncture biopsy of the lung lesion and repeat NGS testing of the patient’s blood and tumor specimen suggested the presence of a T790M mutation in exon 20 of EGFR . The patient is currently being treated with osimertinib (Osimertinib, a third-generation EGFR-TKI that targets EGFR mutations and T790M-resistant mutations and inhibits tyrosine kinase phosphorylation by creating a covalent bond with the C797 residue at the ATP binding site of EGFR mutations and T790M mutations, acting as a tumor suppressor). On 11 March 2023, the patient underwent a CT examination that revealed a significant shrinking of the tumor, considered to be a partial response. The timeline of the treatment of the patient is presented in Figure 4 .
4.1875
0.95459
sec[1]/p[0]
en
0.999996
PMC10339383
https://doi.org/10.3389/fmed.2023.1168220
[ "tumor", "egfr", "lung", "lesions", "exon", "that", "adenocarcinoma", "response", "specimens", "mutations" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "GB61.1", "title": "Chronic kidney disease, stage 2" }, { "code": "GB61.5", "title": "Chronic kidney disease, stage 5" }, { "code": "GB61.4", "title": "Chronic kidney disease, stage 4" }, { "code": "GB61.3", "title": "Chronic kidney disease, stage 3b" }, { "code": "GB61.0", "title": "Chronic kidney disease, stage 1" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [GB61.1] Chronic kidney disease, stage 2 Definition: Kidney damage and GFR 60-89 ml/min/1.73m² Also known as: Chronic kidney disease, stage 2 | kidney damage and mild decrease in GFR | chronic renal failure, stage 2 | CKD - [chronic kidney disease] stage 2 | kidney damage and mild decrease in eGFR - [estimated glomerular filtration rate] Includes: chronic renal failure, stage 2 [GB61.5] Chronic kidney disease, stage 5 Definition: Kidney failure, GFR < 15 ml/min/1.73m² Also known as: Chronic kidney disease, stage 5 | chronic renal failure, stage 5 | CKD - [chronic kidney disease] stage 5 | end stage kidney failure | end stage renal failure Includes: chronic renal failure, stage 5 [GB61.4] Chronic kidney disease, stage 4 Definition: GFR (15-29 ml/min/1.73m²) Also known as: Chronic kidney disease, stage 4 | severe decrease in GFR | chronic renal failure, stage 4 | CKD - [chronic kidney disease] stage 4 | eGFR - [estimated glomerular filtration rate] 15-29 ml/min/1.73m² Includes: chronic renal failure, stage 4 [GB61.3] Chronic kidney disease, stage 3b Definition: GFR 30-44 ml/min/1.73m² Also known as: Chronic kidney disease, stage 3b | chronic renal failure, stage 3b | CKD - [chronic kidney disease] stage 3b | eGFR - [estimated glomerular filtration rate] 30-44 ml/min/1.73m² Includes: chronic renal failure, stage 3b [GB61.0] Chronic kidney disease, stage 1 Definition: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²) Also known as: Chronic kidney disease, stage 1 | chronic renal failure, stage 1 | CKD - [chronic kidney disease] stage 1 | normal or increased eGFR (>90 ml/min/1.73m²) Includes: chronic renal failure, stage 1 === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fatty apron --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --EXCLUDES--> [?] Lymphadenitis --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fatty apron", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --EXCLUDES--> [?] Lymphadenitis", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
The patient was born at normal term and good newborn mensuration to unrelated parents from North African origin. She was the last child of three siblings. Her two brothers have been monitored for asthma. No family history of genetic disorders or young death has been reported. The first year of life was characterized by repeated urinary tract infections (three episodes of pyelonephritis), resulting in the discovery of urinary tract malformation (duplication of left ureter), resulting in a solitary functional kidney and vesicoureteral reflux requiring a pyeloureteral nephrectomy before the age of 1 year. She also presented with recurrent ear infections (otitis media) and three episodes of pneumonia with gastroesophageal reflux. Tympanocentesis (tympanic membranes incision) was performed because of recurrent otitis media and otorrhea at the age of 2 years. An adenoidectomy was also performed at this age. Intravenous immunoglobulin (Ig) replacement therapy was started at the age of 3 years as increased IgM associated with decreased IgG and normal IgA serum levels were detected ( Table 1 ). Although under Ig replacement therapy the patient continued to suffer from recurrent (chronic) otitis media associated with Streptococcus haemolyticus A and Staphylococcus infections. She also suffered from a Staphylococcus aureus Meti S infection causing sepsis at the age of 11.5 years. The patient developed progressive neurodevelopmental disorders with delayed acquisition of walking at 24 months of life, delayed language development, and becoming unintelligible after 4 years old. In parallel, she presented with growth disorders evolving regularly on +0.5 SD for weight and −1 SD for height until the age of 1 year. Then, a break in the stature curve appeared until −3 SD at the age of 3 years, associated with a rapid onset of obesity, becoming severe from age of 6 years. Clinical examination revealed morphologic abnormalities including hypertelorism, strabismic amblyopia, large philtrum, genu valgum and adipomastia, and symptoms of lymphoproliferation presenting as hepatosplenomegaly associated with upper centimetric lymphadenopathies. Lymphoproliferation symptoms disappeared at the age of 7 years. Vascular malformation with carotid stenosis and moyamoya was found using cerebral magnetic resonance imaging. Over the years, the patient developed behavior disorders requiring neuroleptic medicines, pedopsychiatric monitoring and institutionalization, sleep apnea syndrome requiring an equipment with non-invasive nocturnal ventilation, and hyperandrogenia with primitive amenorrhea or polycystic ovary syndrome. The etiologic investigation including karyotypic, array comparative genomic hybridization, and genetic analysis was negative. Panel sequencing of genes implicated in intellectual deficiencies identified a non-described de novo heterozygous non-sense mutation of RAI1 gene c.2701A>T p.Lys901 * not found in the two parents' blood tests, responsible for an SMS. However, the whole phenotype could not be explained by this syndrome, and an inborn error of immunity was suspected because of the infection history, the hypogammaglobulinemia and immune phenotyping of the patient indicating B-cell lymphopenia associated with an increased frequency of transitional B cells, a decreased frequency of naive (CD45RA + ) and recent thymic emigrants (CD45RA + CD31 + ) CD4 and naive (CD45RA + CCR7 + ) CD8 T-cell subsets, increased frequency of CD8 (CCR7 − CD 45 RA − and CCR7 − CD 45 RA + ) T-cell subsets, and an inverted CD4/CD8 T-cell ratio ( Table 1 ). Whole-exome sequencing of DNA from the patient and both parents was performed on a research basis. Filtering of annotated variants after a strict de novo genetic model confirmed the non-sense mutation of RAI1 and showed another de novo variant (2 nucleotide deletion) located within the intronic splice region (splice donor site) of the PIK3R1 gene at position GRCh37/hg19; chr5: 67589664; c.1425+3delGA, giving evidence for an APDS2. Analysis of patients' derived T-cell blast mRNA indicated exon skipping of coding exon11 . Increased phosphorylation of AKT/protein kinase B at position Ser473 was observed in patients' T-cell blasts vs. healthy control T-cell blasts . Treatment with a p110 δ-specific inhibitor abrogated those differences, indicating that increased PI3K δ-signaling at basal level was responsible for the high level of AKT phosphorylation at Ser473 . Together, our functional analysis demonstrated that the de novo c.1425+3delGA mutation causes exon skipping of exon 11 and subsequent activation of PI3K δ-signaling in lymphocytes. Since the discovery of APDS2, administration of immunomodulatory agents such as rapamycin and p110δ-specific inhibitor has been under consideration.
4.089844
0.977539
sec[1]/p[0]
en
0.999999
34249818
https://doi.org/10.3389/fped.2021.688022
[ "cell", "associated", "disorders", "novo", "parents", "three", "genetic", "infections", "requiring", "recurrent" ]
[ { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "9A96.3", "title": "Primary anterior uveitis" }, { "code": "3A61.Z", "title": "Acquired pure red cell aplasia, unspecified" }, { "code": "MB25.02", "title": "Disorganised thinking" }, { "code": "LD2F.11", "title": "VATER association" }, { "code": "5A61.0", "title": "Hypopituitarism" }, { "code": "FB1Z", "title": "Conditions associated with the spine, unspecified" }, { "code": "QE5Z", "title": "Problems associated with relationships, unspecified" } ]
=== ICD-11 CODES FOUND === [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine [5C56.20] Mucolipidosis Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2 Excludes: Sialidosis (mucolipidosis type 1) [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] [9A96.3] Primary anterior uveitis Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid. Also known as: Primary anterior uveitis | anterior chamber cell [3A61.Z] Acquired pure red cell aplasia, unspecified Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia [MB25.02] Disorganised thinking Definition: A disturbance in the associative thought process typically manifested in speech in which the person shifts suddenly from one topic to another that is unrelated or minimally related to the first. The individual gives no indication of being aware of the disconnectedness or illogicality of their thinking. Also known as: Disorganised thinking | thought derailment | loose associations | disorganised speech [LD2F.11] VATER association Definition: VACTERL/VATER is an association of congenital malformations typically characterised by the presence of at least three of the following: vertebral defects, anal atresia, cardiac defects, tracheo-oesophageal fistula, renal anomalies, and limb abnormalities. Also known as: VATER association | VACTERL association [5A61.0] Hypopituitarism Definition: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/infarction. Also known as: Hypopituitarism | subpituitarism | hypophyseal dystrophy | hypohypophysism | anterior pituitary insufficiency (in part) Includes: pituitary cachexia | pituitary short stature [FB1Z] Conditions associated with the spine, unspecified Also known as: Conditions associated with the spine, unspecified | dorsopathies | disorder of spine | spinal disorder [QE5Z] Problems associated with relationships, unspecified Also known as: Problems associated with relationships, unspecified === GRAPH WALKS === --- Walk 1 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --CHILD--> [MF90] Acetonuria Def: Acetonuria is a medical condition in which acetone is present in the urine.... --- Walk 2 --- [MF9Y] Other specified clinical findings on examination of urine, without diagnosis --PARENT--> [?] Clinical findings on examination of urine, without diagnosis --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system --- Walk 3 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Wolman disease Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir... --PARENT--> [?] Lysosomal acid lipase deficiency Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater... --- Walk 4 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Mucolipidosis type 4 Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu... --PARENT--> [?] Mucolipidosis --- Walk 5 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da... --- Walk 6 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF90] Acetonuria\n Def: Acetonuria is a medical condition in which acetone is present in the urine....", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] Lysosomal acid lipase deficiency\n Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Mucolipidosis", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy\n Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da...", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy" ]
MF9Y
Other specified clinical findings on examination of urine, without diagnosis
[ { "from_icd11": "3A51.1", "icd10_code": "D571", "icd10_title": "Sickle-cell disease without crisis" }, { "from_icd11": "3A61.Z", "icd10_code": "D609", "icd10_title": "Acquired pure red cell aplasia, unspecified" }, { "from_icd11": "3A61.Z", "icd10_code": "D608", "icd10_title": "Other acquired pure red cell aplasias" }, { "from_icd11": "3A61.Z", "icd10_code": "D60", "icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]" }, { "from_icd11": "MB25.02", "icd10_code": "R4689", "icd10_title": "Other symptoms and signs involving appearance and behavior" }, { "from_icd11": "MB25.02", "icd10_code": "R4681", "icd10_title": "Obsessive-compulsive behavior" }, { "from_icd11": "MB25.02", "icd10_code": "R468", "icd10_title": "Other symptoms and signs involving appearance and behavior" }, { "from_icd11": "LD2F.11", "icd10_code": "Q872", "icd10_title": "Congenital malformation syndromes predominantly involving limbs" }, { "from_icd11": "5A61.0", "icd10_code": "E230", "icd10_title": "Hypopituitarism" }, { "from_icd11": "5A61.0", "icd10_code": "Q044", "icd10_title": "Septo-optic dysplasia of brain" }, { "from_icd11": "5A61.0", "icd10_code": "E231", "icd10_title": "Drug-induced hypopituitarism" }, { "from_icd11": "FB1Z", "icd10_code": "M435X2", "icd10_title": "Other recurrent vertebral dislocation, cervical region" }, { "from_icd11": "FB1Z", "icd10_code": "M438X4", "icd10_title": "Other specified deforming dorsopathies, thoracic region" }, { "from_icd11": "FB1Z", "icd10_code": "M4324", "icd10_title": "Fusion of spine, thoracic region" }, { "from_icd11": "FB1Z", "icd10_code": "M4325", "icd10_title": "Fusion of spine, thoracolumbar region" } ]
D571
Sickle-cell disease without crisis
A 75-year-old man was diagnosed with gastric cancer through a medical check-up and was referred to our department. The patient had no subjective symptoms or remarkable past medical history. The tumor marker carbohydrate antigen 19-9 (CA19-9) was elevated, with a value of 231.5 U/ml . Upper endoscopy demonstrated a 5-cm circumferential ulcerated lesion at the cardia . Biopsy showed a poorly differentiated tubular adenocarcinoma. Computed tomography (CT) showed a wall thickening of the lesser curvature side of the upper gastric body . The patient underwent laparoscopic total gastrectomy with lymph node dissection, and the pathological diagnosis was consistent with a moderately differentiated tubular adenocarcinoma, pathological stage T4aN1M0, and IIIA according to the UICC classification . The postoperative course was unremarkable, and the patient was discharged. He refused adjuvant chemotherapy and was under close observation. The patient was regularly followed up with laboratory tests and imaging studies. Twenty-three months after the primary gastrectomy, a CT scan revealed an irregular mass near the port site wounds . The mass continued growing over time, and port site recurrence was suspected. The CA19-9 level increased to 142.2 U/ml . The patient underwent mass resection, and the pathological diagnosis was consistent with metastatic adenocarcinoma in the subcutaneous tissue at the port site . In the operative findings, there were no ascites and disseminated nodules in the abdominal cavity. Macroscopic findings of the resected specimen revealed that the center of the tumor was not in the peritoneum, but the abdominal wall. Therefore, it was considered to be a PSM rather than peritoneal dissemination. Thirteen months after the second surgery, CT revealed an enhanced mass in the abdominal wall. Furthermore, PET-CT showed an elevated uptake in the rectus abdominis muscle and a SUV of 3.1 . Fine-needle aspiration biopsy of the lesion detected malignant cells with suspected metastatic adenocarcinoma. The CA19-9 level was elevated to 53.6 U/ml again . The patient underwent mass resection again. The mass had macroscopically infiltrated into the rectus abdominis muscle . Similar to the first recurrence, there were no ascites or disseminated nodules in the abdominal cavity. The pathological diagnosis was identical to that of a gastric metastatic adenocarcinoma in the rectus abdominis muscle . After thirty-five months from the third surgery, CT revealed a mass in the left gluteal region. PET-CT revealed a 35-mm mass in the lateral subcutaneous area of the left iliocostalis lumborum muscle, which showed an elevated SUV of 9.6 . Percutaneous biopsy of the lesion revealed a metastatic adenocarcinoma, and the CA19-9 level was 111 U/ml . Another mass resection procedure was performed, and the pathological diagnosis was consistent with subcutaneous metastasis from the gastric adenocarcinoma . Since tumor cells were present at the resection margin, additional radiation therapy was performed. After each recurrence, the patient did not undergo adjuvant chemotherapy. The patient has survived 78 months after primary gastrectomy. Fig. 1 Serum carbohydrate antigen 19-9 (CA19-9) level after the primary operation. Serum CA19-9 level increased according to each relapse of gastric cancer. It responded to each surgical treatment Fig. 2 Computed tomography (CT) scan and pathological findings of the primary gastric cancer. a Upper endoscopy demonstrated circumferential ulcerated lesion at the cardia. b CT scan showing wall thickening at the lesser curvature side of the upper gastric body. c Pathological examination reveals a moderately differentiated adenocarcinoma Fig. 3 Computed tomography (CT) scan and pathological findings of the first recurrence. a CT scan shows an enhanced mass in the median line of abdominal wall. b Macroscopic findings show a white nodular lesion in the peritoneum. c Pathological examination reveals an adenocarcinoma consistent with metastatic tumor from gastric cancer Fig. 4 Computed tomography (CT) scan and pathological findings of the second recurrence. a Positron emission tomography (PET)/CT scan showing an elevated fluorodeoxyglucose (FDG) intake in the left rectus abdominis muscle. b Macroscopic findings showing a white nodular lesion in the skeletal muscle. c Pathological examination revealing an adenocarcinoma consistent with metastatic tumor from gastric cancer Fig. 5 Computed tomography (CT) scan and pathological findings of the third recurrence. a Positron emission tomography (PET)/CT scan shows an elevated FDG intake in the lateral area of the left iliocostalis lumborum muscle. b Pathological examination reveals an adenocarcinoma consistent with metastatic tumor from gastric cancer
3.947266
0.97998
sec[1]/p[0]
en
0.999997
34013476
https://doi.org/10.1186/s40792-021-01202-x
[ "pathological", "adenocarcinoma", "gastric", "scan", "tomography", "metastatic", "muscle", "cancer", "tumor", "lesion" ]
[ { "code": "5C64.5", "title": "Disorders of calcium metabolism" }, { "code": "JA04", "title": "Blighted ovum or nonhydatidiform mole" }, { "code": "GB06.1", "title": "Priapism" }, { "code": "6C71", "title": "Kleptomania" }, { "code": "6D10.Z", "title": "Personality disorder, severity unspecified" }, { "code": "2D40", "title": "Adenocarcinoma of unspecified site" }, { "code": "2C0Y", "title": "Other specified malignant neoplasms of intestine" }, { "code": "2C25.0", "title": "Adenocarcinoma of bronchus or lung" }, { "code": "2C94.0", "title": "Adenocarcinoma of urinary bladder" }, { "code": "2B70.0Z", "title": "Adenocarcinoma of oesophagus, unspecified" } ]
=== ICD-11 CODES FOUND === [5C64.5] Disorders of calcium metabolism Definition: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important consequences for health. Also known as: Disorders of calcium metabolism | Calcinosis | general calcification | heterotopic calcification | metastatic calcification Excludes: Hyperparathyroidism | Chondrocalcinosis [JA04] Blighted ovum or nonhydatidiform mole Definition: A condition caused by genetic abnormality, abnormal cell division, or poor quality ovum or sperm. This condition is characterised by a failed pregnancy, implantation of a fertilized egg without development into an embryo, haemorrhage into the decidua, and adjacent tissue necrosis. Also known as: Blighted ovum or nonhydatidiform mole | anembryonic pregnancy | blighted ovum | blood mole | carneous mole Includes: Pathological ovum [GB06.1] Priapism Definition: A condition of the penis, caused by acute leukaemia, sickle cell anaemia, infection, a penile or central nervous system lesion, or the use of certain pharmacological agents. This condition is characterised by prolonged or persistent painful penile erection lasting over four hours without physical or psychological sexual arousal. Also known as: Priapism | mentulagra | pathologic erection | Painful erection | High-flow priapism Includes: Painful erection [6C71] Kleptomania Definition: Kleptomania is characterised by a recurrent failure to control strong impulses to steal objects in the absence of an apparent motive (e.g., objects are not acquired for personal use or monetary gain). There is an increasing sense of tension or affective arousal before instances of theft and a sense of pleasure, excitement, relief, or gratification during and immediately after the act of stealing. The behaviour is not better explained by intellectual impairment, another mental and behavioural dis Also known as: Kleptomania | pathological stealing Includes: pathological stealing Excludes: shoplifting as the reason for observation for suspected mental disorder, ruled out [6D10.Z] Personality disorder, severity unspecified Also known as: Personality disorder, severity unspecified | Personality disorder | Specific personality disorders | Enduring personality change after psychiatric illness (deprecated) | Anankastic personality disorder [2D40] Adenocarcinoma of unspecified site Definition: A common cancer characterised by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreting product (e.g., mucinous, serous). Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell carcinoma, hepatocellular carcinoma (hepatoma), colon adenocarcinoma, and prostate adenocarcinoma. Also known as: Adenocarcinoma of unspecified site | adenoacanthoma of unspecified site | adenocarcinoid of unspecified site | adenocarcinoid tumour of unspecified site | adenocarcinoma and carcinoid combined of unspecified site [2C0Y] Other specified malignant neoplasms of intestine Also known as: Other specified malignant neoplasms of intestine | Adenocarcinoma of intestine | adenocarcinoma of intestine NOS [2C25.0] Adenocarcinoma of bronchus or lung Definition: A carcinoma that arises from the lung and is characterised by the presence of malignant glandular epithelial cells. There is a male predilection with a male to female ratio of 2:1. Usually lung adenocarcinoma is asymptomatic and is identified through screening studies or as an incidental radiologic finding. If clinical symptoms are present they include shortness of breath, cough, hemoptysis, chest pain, and fever. Tobacco smoke is a known risk factor. Also known as: Adenocarcinoma of bronchus or lung | primary lung adenocarcinoma | lung adenocarcinoma | bronchiolar adenocarcinoma of unspecified site | Mucinous adenocarcinoma of lung [2C94.0] Adenocarcinoma of urinary bladder Definition: A rare adenocarcinoma arising from metaplastic bladder epithelium. It is frequently associated with long-standing local irritation. The majority of cases originate from the trigone and the posterior wall of the bladder. Also known as: Adenocarcinoma of urinary bladder | Adenocarcinoma of bladder [2B70.0Z] Adenocarcinoma of oesophagus, unspecified Also known as: Adenocarcinoma of oesophagus, unspecified | Adenocarcinoma of oesophagus | oesophageal adenocarcinoma === GRAPH WALKS === --- Walk 1 --- [5C64.5] Disorders of calcium metabolism Def: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important ... --RELATED_TO--> [?] Hypercalciuria --PARENT--> [?] Abnormal levels of serum electrolytes in the urine --- Walk 2 --- [5C64.5] Disorders of calcium metabolism Def: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important ... --RELATED_TO--> [?] Hypercalciuria --PARENT--> [?] Abnormal levels of serum electrolytes in the urine --- Walk 3 --- [JA04] Blighted ovum or nonhydatidiform mole Def: A condition caused by genetic abnormality, abnormal cell division, or poor quality ovum or sperm. This condition is characterised by a failed pregnancy, implantation of a fertilized egg without develo... --PARENT--> [?] Abortive outcome of pregnancy Def: A group of conditions characterised by pregnancy which does not result in live offspring. These conditions include e.g. abortion, ectopic pregnancy or molar pregnancy.... --EXCLUDES--> [?] Recurrent pregnancy loss --- Walk 4 --- [JA04] Blighted ovum or nonhydatidiform mole Def: A condition caused by genetic abnormality, abnormal cell division, or poor quality ovum or sperm. This condition is characterised by a failed pregnancy, implantation of a fertilized egg without develo... --PARENT--> [?] Abortive outcome of pregnancy Def: A group of conditions characterised by pregnancy which does not result in live offspring. These conditions include e.g. abortion, ectopic pregnancy or molar pregnancy.... --CHILD--> [JA02] Molar pregnancy Def: A condition caused by the over-production of cells arising into the placenta during pregnancy. This condition is characterised by a pregnancy with abnormal placental growth in which the chorionic vill... --- Walk 5 --- [GB06.1] Priapism Def: A condition of the penis, caused by acute leukaemia, sickle cell anaemia, infection, a penile or central nervous system lesion, or the use of certain pharmacological agents. This condition is characte... --PARENT--> [GB06] Certain specified disorders of penis --EXCLUDES--> [?] Redundant prepuce, phimosis or paraphimosis Def: Several conditions of the foreskin, caused by abnormalities in the prepuce. This condition is characterised by redundant or tight foreskin and lack of retractability of the foreskin or the inability o... --- Walk 6 --- [GB06.1] Priapism Def: A condition of the penis, caused by acute leukaemia, sickle cell anaemia, infection, a penile or central nervous system lesion, or the use of certain pharmacological agents. This condition is characte... --PARENT--> [GB06] Certain specified disorders of penis --CHILD--> [GB06.1] Priapism Def: A condition of the penis, caused by acute leukaemia, sickle cell anaemia, infection, a penile or central nervous system lesion, or the use of certain pharmacological agents. This condition is characte...
[ "[5C64.5] Disorders of calcium metabolism\n Def: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important ...\n --RELATED_TO--> [?] Hypercalciuria\n --PARENT--> [?] Abnormal levels of serum electrolytes in the urine", "[5C64.5] Disorders of calcium metabolism\n Def: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important ...\n --RELATED_TO--> [?] Hypercalciuria\n --PARENT--> [?] Abnormal levels of serum electrolytes in the urine", "[JA04] Blighted ovum or nonhydatidiform mole\n Def: A condition caused by genetic abnormality, abnormal cell division, or poor quality ovum or sperm. This condition is characterised by a failed pregnancy, implantation of a fertilized egg without develo...\n --PARENT--> [?] Abortive outcome of pregnancy\n Def: A group of conditions characterised by pregnancy which does not result in live offspring. These conditions include e.g. abortion, ectopic pregnancy or molar pregnancy....\n --EXCLUDES--> [?] Recurrent pregnancy loss", "[JA04] Blighted ovum or nonhydatidiform mole\n Def: A condition caused by genetic abnormality, abnormal cell division, or poor quality ovum or sperm. This condition is characterised by a failed pregnancy, implantation of a fertilized egg without develo...\n --PARENT--> [?] Abortive outcome of pregnancy\n Def: A group of conditions characterised by pregnancy which does not result in live offspring. These conditions include e.g. abortion, ectopic pregnancy or molar pregnancy....\n --CHILD--> [JA02] Molar pregnancy\n Def: A condition caused by the over-production of cells arising into the placenta during pregnancy. This condition is characterised by a pregnancy with abnormal placental growth in which the chorionic vill...", "[GB06.1] Priapism\n Def: A condition of the penis, caused by acute leukaemia, sickle cell anaemia, infection, a penile or central nervous system lesion, or the use of certain pharmacological agents. This condition is characte...\n --PARENT--> [GB06] Certain specified disorders of penis\n --EXCLUDES--> [?] Redundant prepuce, phimosis or paraphimosis\n Def: Several conditions of the foreskin, caused by abnormalities in the prepuce. This condition is characterised by redundant or tight foreskin and lack of retractability of the foreskin or the inability o...", "[GB06.1] Priapism\n Def: A condition of the penis, caused by acute leukaemia, sickle cell anaemia, infection, a penile or central nervous system lesion, or the use of certain pharmacological agents. This condition is characte...\n --PARENT--> [GB06] Certain specified disorders of penis\n --CHILD--> [GB06.1] Priapism\n Def: A condition of the penis, caused by acute leukaemia, sickle cell anaemia, infection, a penile or central nervous system lesion, or the use of certain pharmacological agents. This condition is characte..." ]
5C64.5
Disorders of calcium metabolism
[ { "from_icd11": "5C64.5", "icd10_code": "E8352", "icd10_title": "Hypercalcemia" }, { "from_icd11": "5C64.5", "icd10_code": "E8351", "icd10_title": "Hypocalcemia" }, { "from_icd11": "5C64.5", "icd10_code": "E8359", "icd10_title": "Other disorders of calcium metabolism" }, { "from_icd11": "5C64.5", "icd10_code": "E8350", "icd10_title": "Unspecified disorder of calcium metabolism" }, { "from_icd11": "5C64.5", "icd10_code": "E835", "icd10_title": "Disorders of calcium metabolism" }, { "from_icd11": "JA04", "icd10_code": "O020", "icd10_title": "Blighted ovum and nonhydatidiform mole" }, { "from_icd11": "JA04", "icd10_code": "O02", "icd10_title": "Other abnormal products of conception" }, { "from_icd11": "GB06.1", "icd10_code": "N4833", "icd10_title": "Priapism, drug-induced" }, { "from_icd11": "GB06.1", "icd10_code": "N4839", "icd10_title": "Other priapism" }, { "from_icd11": "GB06.1", "icd10_code": "N4830", "icd10_title": "Priapism, unspecified" }, { "from_icd11": "GB06.1", "icd10_code": "N4831", "icd10_title": "Priapism due to trauma" }, { "from_icd11": "GB06.1", "icd10_code": "N4832", "icd10_title": "Priapism due to disease classified elsewhere" }, { "from_icd11": "GB06.1", "icd10_code": "N483", "icd10_title": "Priapism" }, { "from_icd11": "6C71", "icd10_code": "F632", "icd10_title": "Kleptomania" }, { "from_icd11": "6D10.Z", "icd10_code": "F6089", "icd10_title": "Other specific personality disorders" } ]
E8352
Hypercalcemia
Scrub typhus, a mite-transmitted zoonosis caused by the intracellular Gram-negative bacteria, Orientia tsutsugamushi (previously known as Rickettsia tsutsugamushi ), is a disease distributed throughout the Asia Pacific rim and endemic in South Korea, China, Japan, Taiwan, Pakistan, India, Thailand, Malaysia and northern Australia. It is an acute febrile illness characterized by a typical necrotic primary lesion (eschar), generalized lymphadenopathy, maculopapular skin rash, and nonspecific symptoms and signs such as fever, chills, headache, alerted sensorium, seizure, sorethroat, otalgia, cough, dysponea, vomiting, abdominal pain, jaundice, diarrhea, hepatosplenomegaly, abnormal bleeding, arthralgia and myalgia. Unfortunately the typical eschar and skin rash are found on examination in 46%~92% of cases in Korea and less than 10% of cases in Thailand. Serious complications, including encephalitis, meningitis, pericarditis, myocarditis, cardiac arrhythmia, interstitial pneumonia, ARDS, acute renal failure, acute hepatic failure, acute hearing loss and septic shock, generally occur in the second week of the course and may be potentially fatal if there is a delay in diagnosis and treatment. Most cases of scrub typhus have a delayed (or no) diagnosis because the history of travel or exposure history is omitted and the pathognomonic eschar of scrub typhus is not found or not adequately searched for in patients with fever of unknown origin. The incidence of eschar, a slightly raised erythema surrounding a black necrotic center, over head, face and neck is 5%. In our present case, he was a solider and was on training in the jungle, so his ear was often close to the ground providing the mites with an opportunity to enter the ear canal and attach causing the resultant eschar. Although the eschar may be painless and otalgia is an unusual manifestation, there was an incidence of 19% in scrub typhus with otalgia and one case of acute sensorineural hearing loss has been reported. Initially, he was treated as otitis externa at a local clinic because of fever, otalgia, and an unusual and undetectable eschar in the external auditory canal, resulting in delayed diagnosis and treatment of scrub typhus complicated with ARDS and MOF with respiratory, renal, hepatic and hematologic involvement in our case. He was referred to our institution and scrub typhus was strongly suspected based on clinical exposure history, eschar in the external canal on physical examination and multiple organ involvement, so clinical therapeutic doxycycline was prescribed and the fever subsided dramatically. The pulmonary manifestations of scrub typhus include varying grades of bronchitis and interstitial pneumonitis progressing to ARDS. ARDS is a rarely reported but is a serious complication of scrub typhus with an incidence of 11.1%-15.2%. Only two short communication reports of scrub typhus complicated by ARDS have been published. Acute renal failure is due to acute tubular necrosis caused by direct invasion of Orientia tsutsugamushi . Abnormal laboratory evaluations include leukopenia (19%) or leukocytosis (6%-34%), thrombocytopenia (44%-100%), elevation of AST (81%-100%), ALT (75%-100%), ALP (84.2%-100%) and total bilirubin (38.5%-100%), hypoalbuminemia (83.3%), and increased creatinine (9%). Weil-Felix test has low sensitivity and specificity to the diagnosis of scrub typhus, but it can be a useful tool when used and interpreted in the correct clinical context. The criterion for a positive result is either one determination of a titer of 1:320 or greater or a four-fold rise in titer starting from 1:50. Weil-Felix test with Proteus OX-K titer of 1:1280 was obtained on day 11 after exposure in our case. While all current scrub typhus tests have limitations and the Weil-Felix and immunofluorescent antibody (IFA) tests have low sensitivity and specificity. Weil Felix was the only test available at our institution. Dyspnea, cough, white blood cell counts, hematocrit, platelet, total bilirubin, older age, chronic obstructive pulmonary disease, hypoalbuminemia, and prolonged prothrombin time, presence of early pneumonitis and delayed used of appropriate antibiotics have been reported as significant predictors of ARDS. The mortality rate was 6.1%-30% in previous literature and the major cause of mortality was delay in diagnosis and treatment. Scrub typhus was diagnosed based on the clinical picture and the rapid response to doxycycline in our case. In ICU, doxycycline for scrub typhus and ventilator support for ARDS were prescribed, so the clinical condition of this patient with multiorgan involvement, including respiratory, liver, renal and hematological involvement, improved gradually with a full course of doxycycline in this patient.
4.363281
0.754883
sec[2]/p[0]
en
0.999997
21450057
https://doi.org/10.1186/1471-2334-11-79
[ "scrub", "typhus", "eschar", "ards", "fever", "otalgia", "renal", "involvement", "doxycycline", "weil" ]
[ { "code": "NE61", "title": "Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified" }, { "code": "1C30.3", "title": "Typhus fever due to Orientia tsutsugamushi" }, { "code": "1C30.Z", "title": "Typhus fever, unspecified" }, { "code": "1C30.0", "title": "Epidemic louse-borne typhus fever due to Rickettsia prowazekii" }, { "code": "1C30.2", "title": "Typhus fever due to Rickettsia typhi" }, { "code": "1C30.1", "title": "Recrudescent typhus" }, { "code": "CB00", "title": "Acute respiratory distress syndrome" }, { "code": "MG26", "title": "Fever of other or unknown origin" }, { "code": "1D81.Z", "title": "Infectious mononucleosis, unspecified" }, { "code": "1B99", "title": "Pasteurellosis" } ]
=== ICD-11 CODES FOUND === [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified Also known as: Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, alcohols | alcohol poisoning | alcohol toxicity | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, Ethanol Excludes: corrosions | Bacterial foodborne intoxications [1C30.3] Typhus fever due to Orientia tsutsugamushi Also known as: Typhus fever due to Orientia tsutsugamushi | Tsutsugamushi fever | kedani fever | mite-borne typhus | mite-borne typhus due to rickettsia tsutsugamushi Includes: Tsutsugamushi fever [1C30.Z] Typhus fever, unspecified Also known as: Typhus fever, unspecified | Typhus fever | Typhus fever NOS | typhus NOS [1C30.0] Epidemic louse-borne typhus fever due to Rickettsia prowazekii Definition: This is a form of typhus so named because the disease often causes epidemics following wars and natural disasters. The causative organism is Rickettsia prowazekii, transmitted by the human body louse (Pediculus humanus corporis). This diagnosis is due to a species of gram-negative, obligate intracellular parasitic, aerobic bacteria (belonging to the class Alphaproteobacteria) that is the aetiologic agent of epidemic typhus, transmitted in the faeces of lice. Also known as: Epidemic louse-borne typhus fever due to Rickettsia prowazekii | classical typhus | epidemic typhus | epidemic typhus fever | louse-borne typhus [1C30.2] Typhus fever due to Rickettsia typhi Also known as: Typhus fever due to Rickettsia typhi | endemic murine typhus | endemic typhus | endemic typhus fever | flea-borne typhus [1C30.1] Recrudescent typhus Definition: This is a form of typhus so named because the disease often causes epidemics following wars and natural disasters. The causative organism is Rickettsia prowazekii, transmitted by the human body louse (Pediculus humanus corporis). Also known as: Recrudescent typhus | Brill disease | Brill-Zinsser disease | recrudescent typhus due to rickettsia prowazekii | recrudescent typhus fever Includes: Brill-Zinsser disease [CB00] Acute respiratory distress syndrome Definition: Acute respiratory distress syndrome ("ARDS") is a life-threatening inflammation with oedema in the lungs which leads to severe respiratory failure. ARDS is a clinical syndrome of lung injury with hypoxic respiratory failure caused by intense pulmonary inflammation that develops after a severe physiologic insult. Also known as: Acute respiratory distress syndrome | Adult acute respiratory distress syndrome | Adult hyaline membrane disease | acquired respiratory distress syndrome | congestive atelectasis [MG26] Fever of other or unknown origin Definition: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process. Also known as: Fever of other or unknown origin | febrile | febris | fever | feverish Excludes: fever of unknown origin in newborn | Malignant hyperthermia due to anaesthesia [1D81.Z] Infectious mononucleosis, unspecified Also known as: Infectious mononucleosis, unspecified | Infectious mononucleosis | Glandular fever | Gammaherpesviral mononucleosis | kissing disease [1B99] Pasteurellosis Definition: A disease caused by an infection with the gram-negative bacteria Pasteurella. This disease is characterised by local cellulitis and may lead to other clinical signs depending on the route of infection. Transmission is commonly by direct contact through the bite, scratch, or lick from an infected animal, inhalation of infected respiratory secretions, or ingestion of contaminated meat. Confirmation is by identification of Pasteurella from the affected individual. Also known as: Pasteurellosis | pasteurella infection | shipping fever | transport fever === GRAPH WALKS === --- Walk 1 --- [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified --EXCLUDES--> [?] Bacterial foodborne intoxications Def: Any condition caused by an intoxication due to a bacterial toxin. Intoxication is by ingestion of contaminated food.... --EXCLUDES--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Other noxious substances eaten as food --- Walk 2 --- [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified --EXCLUDES--> [?] Burns Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute... --CHILD--> [?] Burns of eye or internal organs Def: Injury confined to the tissues of the eye and internal organs caused by contact with, for example, heat, steam, chemicals, or electricity.... --- Walk 3 --- [1C30.3] Typhus fever due to Orientia tsutsugamushi --PARENT--> [1C30] Typhus fever Def: A disease caused by an infection with the gram-negative bacteria Rickettsia. This disease is characterised by fever, delirium, back pain, or arthralgia. Transmission is commonly through the bite of an... --EXCLUDES--> [?] Rickettsiosis due to Ehrlichia sennetsu --- Walk 4 --- [1C30.3] Typhus fever due to Orientia tsutsugamushi --PARENT--> [1C30] Typhus fever Def: A disease caused by an infection with the gram-negative bacteria Rickettsia. This disease is characterised by fever, delirium, back pain, or arthralgia. Transmission is commonly through the bite of an... --CHILD--> [1C30.2] Typhus fever due to Rickettsia typhi --- Walk 5 --- [1C30.Z] Typhus fever, unspecified --PARENT--> [1C30] Typhus fever Def: A disease caused by an infection with the gram-negative bacteria Rickettsia. This disease is characterised by fever, delirium, back pain, or arthralgia. Transmission is commonly through the bite of an... --EXCLUDES--> [?] Rickettsiosis due to Ehrlichia sennetsu --- Walk 6 --- [1C30.Z] Typhus fever, unspecified --PARENT--> [1C30] Typhus fever Def: A disease caused by an infection with the gram-negative bacteria Rickettsia. This disease is characterised by fever, delirium, back pain, or arthralgia. Transmission is commonly through the bite of an... --EXCLUDES--> [?] Rickettsiosis due to Ehrlichia sennetsu
[ "[NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified\n --EXCLUDES--> [?] Bacterial foodborne intoxications\n Def: Any condition caused by an intoxication due to a bacterial toxin. Intoxication is by ingestion of contaminated food....\n --EXCLUDES--> [?] Harmful effects of or exposure to noxious substances, Substances chiefly nonmedicinal as to source, Other noxious substances eaten as food", "[NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified\n --EXCLUDES--> [?] Burns\n Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...\n --CHILD--> [?] Burns of eye or internal organs\n Def: Injury confined to the tissues of the eye and internal organs caused by contact with, for example, heat, steam, chemicals, or electricity....", "[1C30.3] Typhus fever due to Orientia tsutsugamushi\n --PARENT--> [1C30] Typhus fever\n Def: A disease caused by an infection with the gram-negative bacteria Rickettsia. This disease is characterised by fever, delirium, back pain, or arthralgia. Transmission is commonly through the bite of an...\n --EXCLUDES--> [?] Rickettsiosis due to Ehrlichia sennetsu", "[1C30.3] Typhus fever due to Orientia tsutsugamushi\n --PARENT--> [1C30] Typhus fever\n Def: A disease caused by an infection with the gram-negative bacteria Rickettsia. This disease is characterised by fever, delirium, back pain, or arthralgia. Transmission is commonly through the bite of an...\n --CHILD--> [1C30.2] Typhus fever due to Rickettsia typhi", "[1C30.Z] Typhus fever, unspecified\n --PARENT--> [1C30] Typhus fever\n Def: A disease caused by an infection with the gram-negative bacteria Rickettsia. This disease is characterised by fever, delirium, back pain, or arthralgia. Transmission is commonly through the bite of an...\n --EXCLUDES--> [?] Rickettsiosis due to Ehrlichia sennetsu", "[1C30.Z] Typhus fever, unspecified\n --PARENT--> [1C30] Typhus fever\n Def: A disease caused by an infection with the gram-negative bacteria Rickettsia. This disease is characterised by fever, delirium, back pain, or arthralgia. Transmission is commonly through the bite of an...\n --EXCLUDES--> [?] Rickettsiosis due to Ehrlichia sennetsu" ]
NE61
Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified
[ { "from_icd11": "NE61", "icd10_code": "T5802XA", "icd10_title": "Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T550X2A", "icd10_title": "Toxic effect of soaps, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T61781A", "icd10_title": "Other shellfish poisoning, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T551X2A", "icd10_title": "Toxic effect of detergents, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T5891XA", "icd10_title": "Toxic effect of carbon monoxide from unspecified source, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63711A", "icd10_title": "Toxic effect of contact with venomous marine plant, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63712A", "icd10_title": "Toxic effect of contact with venomous marine plant, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63713A", "icd10_title": "Toxic effect of contact with venomous marine plant, assault, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63714A", "icd10_title": "Toxic effect of contact with venomous marine plant, undetermined, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63791A", "icd10_title": "Toxic effect of contact with other venomous plant, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63792A", "icd10_title": "Toxic effect of contact with other venomous plant, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63793A", "icd10_title": "Toxic effect of contact with other venomous plant, assault, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63794A", "icd10_title": "Toxic effect of contact with other venomous plant, undetermined, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T61771A", "icd10_title": "Other fish poisoning, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T61772A", "icd10_title": "Other fish poisoning, intentional self-harm, initial encounter" } ]
T5802XA
Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter
A 41-year-old male presented with complaints of pain and a foreign body (FB) that had entered his right eye. As stated, the patient had worked on hitting the fence with a hammer and was suddenly attacked by metallic stones from the flour fence below that entered his right eye. No history of unconsciousness occurred following the injury. He presented with no history of any other illness or injury previously. He had come to our hospital (Shenyang Fourth People's Hospital) about 3 h after the injury occurred since May 13, 2021. On examination, his best corrected visual acuity (BCVA) remained light perception, with a full-thickness cornea-scleral laceration wound without uveal tissue prolapse at 7 O'clock; the wound extended 2.5 mm backward from the limbus. Ophthalmic examination revealed some exudates in the anterior chamber within the affected eye. An obvious intraocular foreign body was shown by a B-ultrasound scan and was localized in the vitreous cavity without any damage to the retina and lens. The four stones had come into the vitreous cavity through the full-thickness cornea-scleral laceration wound and were located in the peripheral retina. Extraocular muscle movement was normal. Urgently, he received an IVI of 1 mg/0.1 ml vancomycin on the day after the ocular trauma. The left eye was within the normal limit. During preparation for further treatments, it was found that endophthalmitis occurred approximately 6 h after trauma. Anterior segment examination showed hyphema accounting for 1/4 of the height at the bottom of the shallow anterior chamber . Some ocular symptoms such as conjunctival congestion, corneal edema, and aqueous humor turbidity also existed. The pupil of the eye dilated in response to injury, and the light reflection disappeared. Posterior segments of the eye manifested as vitreous hemorrhage, and the fundus was unclear . It was expected from the B-ultrasound scan examination, which revealed a small amount of hemorrhage and no serious morphological damage surrounding the foreign bodies such as retinal detachment . Immediately, four small stones were extracted from the only corresponding pars plana incision using a magnet without pars plana vitrectomy. A 20 g intravitreal foreign body magnet (Synergetics Inc., USA) was introduced into the vitreous body, and foreign bodies were gently dislodged and extracted via the wound. There was no impact on the retina and uvea. The intraocular fluid was also obtained, and its biochemical testing results indicated that the pathogenic microorganism was Staphylococcus aureus . On the second day, endophthalmitis was still serious and a traumatic cataract occurred. Hereinafter, he received IVI of 1.25% PI followed by a complete pars plana vitrectomy combined with expanding gas tamponade combined with irrigation of 0.025% PI, which was combined with cataract surgery with intraocular lens implantation. About 0.1 ml of 5% PI, which is an undiluted solution of PI, was taken in a 1 ml syringe and then 0.3 ml of saline solution was added. Three incisions in the flat part of the ciliary body were made by a 25G puncture knife. During the operation, the doctor found a little white purulent cluster in the vitreous body and on the retinal surface. After clearing the purulent clusters and vitreous body, the optic disc of the right eye was clear and pale red, the retina was flat, and the dark area of the macula was visible. Postoperative administration included intravenous cefoperazone + sulbactam (Zhuhai Jiayi Biotechnology Co., Ltd.) 2 × 2 g treatment twice daily for 1 week and topical 0.5% levofloxacin and 1% prednisolone acetate eye drop four times daily for 2 weeks. The BCVA of the involved eye stabilized at light perception 3 days after the surgery. The anterior segment showed that the hyphema had disappeared. The cornea and aqueous humour were clearer than before surgery. The pupil was dilated, avoiding synechia . Furthermore, the B-ultrasound examination showed slight turbidity of the vitreous body and vitreous organization . Ten days after the surgery, posterior segment examinations revealed that the vitreous hemorrhage was partially absorbed, and the optic nerve head could be seen faintly . After 1 month, the BCVA increased to 0.7 (refer to decimal visual acuity of 1.0). Anterior segments of the eye condition recovered without conjunctival congestion. Moreover, the B-ultrasound examination revealed thickening of the ocular wall and formation of organizing strips connected with the retina. Six months later, the eye was quiet, and no obvious tears, holes, or detachment was seen in the retina. The patient’s vision remained 0.7 and was happy. The visual acuity was improved, maybe due to cornea edema, hyphema, and vitreous opacity being clear.
3.935547
0.980957
sec[1]/p[0]
en
0.999999
PMC9896414
https://doi.org/10.3389/fsurg.2022.988776
[ "vitreous", "body", "that", "retina", "foreign", "occurred", "injury", "cornea", "wound", "without" ]
[ { "code": "9D20", "title": "Bullous aphakic keratopathy following cataract surgery" }, { "code": "9B8Y", "title": "Other specified disorders of the vitreous body" }, { "code": "9B82", "title": "Vitreous prolapse" }, { "code": "9B8Z", "title": "Disorders of the vitreous body, unspecified" }, { "code": "LA13.0", "title": "Congenital anomalies of the vitreous" }, { "code": "ND51.Y", "title": "Other specified injuries of spine or trunk, level unspecified" }, { "code": "MG20.Z", "title": "Cachexia, unspecified" }, { "code": "ND56.Z", "title": "Unspecified injury to unspecified part of trunk, limb or body region" }, { "code": "8A22", "title": "Lewy body disease" }, { "code": "ME86.Z", "title": "Problem of unspecified body part" } ]
=== ICD-11 CODES FOUND === [9D20] Bullous aphakic keratopathy following cataract surgery Also known as: Bullous aphakic keratopathy following cataract surgery | vitreous touch syndrome | vitreous syndrome | Vitreal corneal syndrome Includes: Vitreal corneal syndrome [9B8Y] Other specified disorders of the vitreous body Also known as: Other specified disorders of the vitreous body | Crystalline deposits in vitreous body | Asteroid hyalosis | asteroid hyalitis | Benson disease [9B82] Vitreous prolapse Also known as: Vitreous prolapse | vitreous prolapse, unspecified eye Excludes: vitreous syndrome following cataract surgery [9B8Z] Disorders of the vitreous body, unspecified Also known as: Disorders of the vitreous body, unspecified [LA13.0] Congenital anomalies of the vitreous Also known as: Congenital anomalies of the vitreous | Congenital vitreous cysts | Congenital malformation of vitreous humour, not otherwise specified | congenital malformation of vitreous humour | Congenital vitreous opacity [ND51.Y] Other specified injuries of spine or trunk, level unspecified Also known as: Other specified injuries of spine or trunk, level unspecified | Superficial injury of trunk, level unspecified | multiple superficial injuries of trunk | Abrasion of trunk, level unspecified | Contusion of trunk, level unspecified [MG20.Z] Cachexia, unspecified Also known as: Cachexia, unspecified | Cachexia | cachectic | general body deterioration | inanition [ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region Also known as: Unspecified injury to unspecified part of trunk, limb or body region | Injury of unspecified body region | injury NOS | trauma NOS | traumatic injury NOS [8A22] Lewy body disease Definition: Lewy body disease is a neurodegenerative disorder and the second most common form of dementia in the elderly after Alzheimer disease. Lewy bodies are histologically defined as intracytoplasmic eosinophilic neuronal inclusions in the cortex or brainstem. Also known as: Lewy body disease | Lewy body | DLBD - [diffuse Lewy body disease] | diffuse Lewy body disease | CLBD - [cortical Lewy body disease] [ME86.Z] Problem of unspecified body part Also known as: Problem of unspecified body part | Symptom or complaint of a body part === GRAPH WALKS === --- Walk 1 --- [9D20] Bullous aphakic keratopathy following cataract surgery --PARENT--> [?] Postprocedural disorders of eye or ocular adnexa --CHILD--> [9D20] Bullous aphakic keratopathy following cataract surgery --- Walk 2 --- [9D20] Bullous aphakic keratopathy following cataract surgery --PARENT--> [?] Postprocedural disorders of eye or ocular adnexa --RELATED_TO--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --- Walk 3 --- [9B8Y] Other specified disorders of the vitreous body --PARENT--> [?] Disorders of the vitreous body Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina.... --CHILD--> [9B81] Posterior vitreous detachment --- Walk 4 --- [9B8Y] Other specified disorders of the vitreous body --PARENT--> [?] Disorders of the vitreous body Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina.... --CHILD--> [9B81] Posterior vitreous detachment --- Walk 5 --- [9B82] Vitreous prolapse --EXCLUDES--> [?] Bullous aphakic keratopathy following cataract surgery --PARENT--> [?] Postprocedural disorders of eye or ocular adnexa --- Walk 6 --- [9B82] Vitreous prolapse --PARENT--> [?] Disorders of the vitreous body Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina.... --CHILD--> [9B81] Posterior vitreous detachment
[ "[9D20] Bullous aphakic keratopathy following cataract surgery\n --PARENT--> [?] Postprocedural disorders of eye or ocular adnexa\n --CHILD--> [9D20] Bullous aphakic keratopathy following cataract surgery", "[9D20] Bullous aphakic keratopathy following cataract surgery\n --PARENT--> [?] Postprocedural disorders of eye or ocular adnexa\n --RELATED_TO--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified", "[9B8Y] Other specified disorders of the vitreous body\n --PARENT--> [?] Disorders of the vitreous body\n Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina....\n --CHILD--> [9B81] Posterior vitreous detachment", "[9B8Y] Other specified disorders of the vitreous body\n --PARENT--> [?] Disorders of the vitreous body\n Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina....\n --CHILD--> [9B81] Posterior vitreous detachment", "[9B82] Vitreous prolapse\n --EXCLUDES--> [?] Bullous aphakic keratopathy following cataract surgery\n --PARENT--> [?] Postprocedural disorders of eye or ocular adnexa", "[9B82] Vitreous prolapse\n --PARENT--> [?] Disorders of the vitreous body\n Def: Any condition of the transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina....\n --CHILD--> [9B81] Posterior vitreous detachment" ]
9D20
Bullous aphakic keratopathy following cataract surgery
[ { "from_icd11": "9D20", "icd10_code": "H59011", "icd10_title": "Keratopathy (bullous aphakic) following cataract surgery, right eye" }, { "from_icd11": "9D20", "icd10_code": "H59091", "icd10_title": "Other disorders of the right eye following cataract surgery" }, { "from_icd11": "9D20", "icd10_code": "H59019", "icd10_title": "Keratopathy (bullous aphakic) following cataract surgery, unspecified eye" }, { "from_icd11": "9D20", "icd10_code": "H59099", "icd10_title": "Other disorders of unspecified eye following cataract surgery" }, { "from_icd11": "9D20", "icd10_code": "H590", "icd10_title": "Disorders of the eye following cataract surgery" }, { "from_icd11": "9B8Y", "icd10_code": "H43811", "icd10_title": "Vitreous degeneration, right eye" }, { "from_icd11": "9B8Y", "icd10_code": "H43813", "icd10_title": "Vitreous degeneration, bilateral" }, { "from_icd11": "9B82", "icd10_code": "H430", "icd10_title": "Vitreous prolapse" }, { "from_icd11": "9B8Z", "icd10_code": "H43819", "icd10_title": "Vitreous degeneration, unspecified eye" }, { "from_icd11": "9B8Z", "icd10_code": "H43812", "icd10_title": "Vitreous degeneration, left eye" }, { "from_icd11": "9B8Z", "icd10_code": "H4389", "icd10_title": "Other disorders of vitreous body" }, { "from_icd11": "9B8Z", "icd10_code": "H4320", "icd10_title": "Crystalline deposits in vitreous body, unspecified eye" }, { "from_icd11": "9B8Z", "icd10_code": "H43829", "icd10_title": "Vitreomacular adhesion, unspecified eye" }, { "from_icd11": "9B8Z", "icd10_code": "H4322", "icd10_title": "Crystalline deposits in vitreous body, left eye" }, { "from_icd11": "9B8Z", "icd10_code": "H43821", "icd10_title": "Vitreomacular adhesion, right eye" } ]
H59011
Keratopathy (bullous aphakic) following cataract surgery, right eye
A 71-year-old woman visited an otorhinolaryngologist with 5-year history of nasal congestion. She was diagnosed as having a nasal polyp. Since IP was found at biopsy, she was referred to our hospital in order to undergo surgery. In the nasal cavity, the tumor that was suspected to be IP was observed in the middle and inferior meatus . A CT scan of the paranasal sinus revealed a shadow that occupied the maxillary sinus and deviated to the ethmoidal sinus and a defect in the posterior wall and medial bone of the maxillary sinus . Preoperative squamous cell carcinoma (SCC) antigen level was high at 11.0 ng/mL. We suspected a cancerous change of IP or a complication of cancer and performed another biopsy, concluding that the condition was IP. The lesion was examined by CT and MRI to locate the origin of IP. The CT did not reveal localized thickening of the bone, and the MRI did not show secondary changes in the maxillary sinus or a distinctive mass of serpentine cerebriform filamentous structure . Findings revealed erosion or defects of the bone in the posterior and medial walls of the maxillary sinus, but the origin of IP could not be identified. It was believed that IP originated from a wide area. The patient refused to undergo lateral rhinotomy and was therefore informed that ESS and EMMM procedures would be used concomitantly and that a transantral approach (TA), Coldwell-Luc surgery, would be used if necessary. The patient gave her consent. The surgery was performed under general anesthesia. The uncinate process was removed and IP was found to be deviating into the nasal cavity and the normal mucosa in the anterior ethmoidal sinus. The frontal and maxillary sinuses were opened wide, while the posterior ethmoidal sinus was not opened. When observed at a 70-degree endoscope, the tumor in the maxillary sinus was seen to have adhered to the posterior, superior, and medial walls and the origin of IP was widely extensive, as anticipated preoperatively. The anterior and inferior lesions could not have been sufficiently resected if approached from the fontanelle of the maxillary sinus. Therefore, EMMM was selected . Slightly posterior to the pyriform aperture, the mucosa was incised from the superior portion of the inferior turbinate towards the nasal floor, and the nasal mucosa was elevated from the lateral wall of the nasal cavity. The mucosa on the lateral side of the inferior meatus was detached from the medial side of the maxillary sinus. The inferior turbinate bone was observed endoscopically and the conchal crest was cut with a chisel, allowing for the inferior portion of the nasolacrimal duct to be observed and for the inferior turbinate bone to be freely moved medially. As the nasolacrimal duct could be clearly observed by endoscope, the tumor deviating to the inferior meatus and the lateral mucosa and the bony wall of the inferior meatus could be sufficiently resected. The lacrimal process of the inferior turbinate, the frontal process of the maxilla, and the inferior portion of the lacrimal bone were ground with a 2.5-mm Curved Diamond DCR Bur (Medtronic), which made superior portion of lacrimal duct visible. Maxillary sinus was widely opened from the inferior meatus side so that endoscope could be inserted from inferior meatus towards maxillary sinus. The anterior, inferior, and medial walls of the maxillary sinus could be observed endoscopically. Inverted papilloma had adhered to the anterior, medial, and inferior walls; that is, it adhered to the entire circumference of the maxillary sinus. It was considered that there were all IP-involved mucosae without normal mucosa inside the maxillary sinus. The posterior portion could be observed with a 0-degree endoscope and the anterior portion could be observed by 70-degree endoscope. Inverted papilloma could be resected with highly curved forceps. The pyriform aperture and the mucosa of the inferior turbinate were sutured and the surgery was completed. Since part of the tumor had eroded the bone of the posterior wall, destroyed the inferior meatus, and deviated to the nasal cavity, a complication of cancer was suspected and an intraoperative consultation was performed. No malignant finding was obtained. In this case, there was no thickening of the bony wall of posterior wall of the maxillary sinus. We did remove the mucosa only without thinning of the bony wall of the maxillary sinus. The patient was free from recurrence 3 months after the surgery . The levels of SCC antigen had decreased to 2.9 ng/mL. Findings in the nasal cavity were similar to those after ESS , and the patient did not complain of either an empty nose or dryness in the nose. The patient had mild numbness around the lips, but no symptom in the eyes, such as lacrimation.
4.054688
0.968262
sec[1]/p[0]
en
0.999998
26146581
https://doi.org/10.1155/2015/952923
[ "sinus", "maxillary", "nasal", "that", "mucosa", "meatus", "wall", "bone", "portion", "cavity" ]
[ { "code": "CA0A.Z", "title": "Chronic rhinosinusitis, unspecified" }, { "code": "CA0Y&XA3523", "title": "Nasal sinus obstruction" }, { "code": "CA0J.Y", "title": "Other specified nasal polyp" }, { "code": "LB03.Y", "title": "Other specified structural developmental anomalies of umbilical cord" }, { "code": "DA09.61", "title": "Periapical abscess with sinus" }, { "code": "DA06.Z", "title": "Diseases of jaws, unspecified" }, { "code": "CA0A.Y&XA1R64", "title": "Maxillary fistula" }, { "code": "DA0E.0Y&XA7VK5", "title": "Maxillary hypoplasia" }, { "code": "CA0J.Y&XA1R64", "title": "Maxillary sinus polyp" }, { "code": "NA0Z&XA7VK5", "title": "Injury of maxilla" } ]
=== ICD-11 CODES FOUND === [CA0A.Z] Chronic rhinosinusitis, unspecified Also known as: Chronic rhinosinusitis, unspecified | Chronic rhinosinusitis | Chronic sinusitis | chronic sinusitis NOS | unspecified sinusitis [CA0J.Y] Other specified nasal polyp Also known as: Other specified nasal polyp | Polyp of nasal cavity | Polyp of the nasopharynx | nasopharyngeal polyp | Polyp of adenoid tissue [LB03.Y] Other specified structural developmental anomalies of umbilical cord Also known as: Other specified structural developmental anomalies of umbilical cord | Umbilical cord calcifications | Omphalomesenteric duct remnants or cysts | Vitelline duct remnants and cysts | Persistent omphalomesenteric duct [DA09.61] Periapical abscess with sinus Also known as: Periapical abscess with sinus | Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus | periapical abscess fistula Includes: Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus [DA06.Z] Diseases of jaws, unspecified Also known as: Diseases of jaws, unspecified | Diseases of jaws | disease of jaw | diseases of the jaws | disorder of jaw === GRAPH WALKS === --- Walk 1 --- [CA0A.Z] Chronic rhinosinusitis, unspecified --PARENT--> [CA0A] Chronic rhinosinusitis Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d... --CHILD--> [CA0A.Z] Chronic rhinosinusitis, unspecified --- Walk 2 --- [CA0A.Z] Chronic rhinosinusitis, unspecified --PARENT--> [CA0A] Chronic rhinosinusitis Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d... --CHILD--> [CA0A.Y] Other specified chronic rhinosinusitis --- Walk 3 --- [CA0J.Y] Other specified nasal polyp --PARENT--> [CA0J] Nasal polyp Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,... --CHILD--> [CA0J.Y] Other specified nasal polyp --- Walk 4 --- [CA0J.Y] Other specified nasal polyp --PARENT--> [CA0J] Nasal polyp Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,... --CHILD--> [CA0J.Y] Other specified nasal polyp --- Walk 5 --- [LB03.Y] Other specified structural developmental anomalies of umbilical cord --PARENT--> [LB03] Structural developmental anomalies of umbilical cord Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period.... --CHILD--> [LB03.0] Allantoic duct remnants or cysts Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period. These conditions are characterised by cysts or remnants of allantoic tissue within the umbilical... --- Walk 6 --- [LB03.Y] Other specified structural developmental anomalies of umbilical cord --PARENT--> [LB03] Structural developmental anomalies of umbilical cord Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period.... --RELATED_TO--> [?] Umbilical cord haemangioma Def: Tumour composed of thin walled blood vessels lined by endothelium present within the cord....
[ "[CA0A.Z] Chronic rhinosinusitis, unspecified\n --PARENT--> [CA0A] Chronic rhinosinusitis\n Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...\n --CHILD--> [CA0A.Z] Chronic rhinosinusitis, unspecified", "[CA0A.Z] Chronic rhinosinusitis, unspecified\n --PARENT--> [CA0A] Chronic rhinosinusitis\n Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...\n --CHILD--> [CA0A.Y] Other specified chronic rhinosinusitis", "[CA0J.Y] Other specified nasal polyp\n --PARENT--> [CA0J] Nasal polyp\n Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...\n --CHILD--> [CA0J.Y] Other specified nasal polyp", "[CA0J.Y] Other specified nasal polyp\n --PARENT--> [CA0J] Nasal polyp\n Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...\n --CHILD--> [CA0J.Y] Other specified nasal polyp", "[LB03.Y] Other specified structural developmental anomalies of umbilical cord\n --PARENT--> [LB03] Structural developmental anomalies of umbilical cord\n Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period....\n --CHILD--> [LB03.0] Allantoic duct remnants or cysts\n Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period. These conditions are characterised by cysts or remnants of allantoic tissue within the umbilical...", "[LB03.Y] Other specified structural developmental anomalies of umbilical cord\n --PARENT--> [LB03] Structural developmental anomalies of umbilical cord\n Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period....\n --RELATED_TO--> [?] Umbilical cord haemangioma\n Def: Tumour composed of thin walled blood vessels lined by endothelium present within the cord...." ]
CA0A.Z
Chronic rhinosinusitis, unspecified
[ { "from_icd11": "CA0A.Z", "icd10_code": "J329", "icd10_title": "Chronic sinusitis, unspecified" }, { "from_icd11": "CA0A.Z", "icd10_code": "J324", "icd10_title": "Chronic pansinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J320", "icd10_title": "Chronic maxillary sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J322", "icd10_title": "Chronic ethmoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J323", "icd10_title": "Chronic sphenoidal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J328", "icd10_title": "Other chronic sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J321", "icd10_title": "Chronic frontal sinusitis" }, { "from_icd11": "CA0A.Z", "icd10_code": "J30-J39", "icd10_title": "" }, { "from_icd11": "CA0A.Z", "icd10_code": "J32", "icd10_title": "Chronic sinusitis" }, { "from_icd11": "DA09.61", "icd10_code": "K046", "icd10_title": "Periapical abscess with sinus" } ]
J329
Chronic sinusitis, unspecified