International Medical Case Reports Journal最新文献

{"title":"Apparent Mineralocorticoid Excess Syndrome: Case Report.","authors":"Saad Aqeel Alsaadoun, Ameinah Thamer Alrasheedi, Seham Hossny Gazar, Ghadah Abdulrahman Alsallum","doi":"10.2147/IMCRJ.S520238","DOIUrl":"10.2147/IMCRJ.S520238","url":null,"abstract":"<p><p>Apparent Mineralocorticoid Excess (AME) syndrome is a rare form of high-blood pressure syndrome caused by genetic mutations in the 11b-hydroxysteroid dehydrogenase type 2 (HSD11B2) gene, inherited in an autosomal recessive manner. The condition can be either congenital or acquired. This report presents two cases of AME in children from consanguineous families identified through clinical assessment and whole-exome sequencing (WES). Symptoms included high blood pressure, hypokalemia, and metabolic alkalosis. AME syndrome was confirmed by WES, which revealed a homozygous missense pathogenic mutation c.622C>T p.(Arg208Cys) in exon 3 of the HSD11B2 gene. Treatment with spironolactone, and potassium chloride alone was not effective, so low-dose dexamethasone was added. Post-treatment, both patients showed significant improvement in their blood pressure and electrolyte levels. Diagnosis of AME syndrome can is often challenging because it is an extremely rare autosomal recessive disorder. Only five cases have been reported in Saudi Arabia, and only four case studies discussed treatment plans. This case report provides additional data to support the current literature and treatment protocols.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"671-676"},"PeriodicalIF":0.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy-Associated Oral Lesions in a Geriatric Patient with Nasal Squamous Cell Carcinoma: A Case Report.","authors":"Ulfa Fetriani, Wahyu Hidayat","doi":"10.2147/IMCRJ.S516633","DOIUrl":"10.2147/IMCRJ.S516633","url":null,"abstract":"<p><strong>Background: </strong>Patients who receive chemotherapy or radiotherapy may experience oral complications such as oral mucositis, xerostomia, dental caries, periodontal disease, tissue fibrosis, opportunistic infections of the mucous membranes, neurosensory disorders, loss of taste, osteoradionecrosis, and trismus. This complication often causes high morbidity, oral frailty, and decreased quality of life. Oral mucositis is a common side effect of radiotherapy and often causes nutritional disorders and interruption in treatment.</p><p><strong>Purpose: </strong>This case report shows topical management in radiotherapy-treated geriatric patients with multiple oral lesions. It also shows the effectiveness of topical therapy for oral lesions in this case.</p><p><strong>Case presentation: </strong>A 76-year-old male patient underwent radiotherapy for stage 4 nasal squamous cell carcinoma. After 22 radiotherapy sessions, the patient developed oral mucositis Grade 3 based on WHO criteria, characterized by painful ulcers, trismus, and dysphagia.</p><p><strong>Case management: </strong>The patient was given topical drug therapy with a combination of 0.9% NaCl compress, 0.025% hyaluronic acid mouthwash, and petroleum jelly. Significant improvement was observed within five days, and resolution of oral mucositis occurred at the third visit.</p><p><strong>Conclusion: </strong>Management of oral lesions in geriatric patients receiving radiotherapy or chemotherapy is useful to prevent disruption of treatment and reduce the risk of oral frailty.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"663-669"},"PeriodicalIF":0.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Overlay Associated with Self-Medication of Sulfadoxine-Pyrimethamine Overdose in a Patient with HIV/AIDS Infection: A Case Report.","authors":"Abdulai Jalloh, Onome T Abiri, Ishmael I T Jalloh, Fawzi Thomas, Thomas Ansumus Conteh Jnr, Martha Y E Forde, Mohamed Sesay, James P Komeh","doi":"10.2147/IMCRJ.S506969","DOIUrl":"10.2147/IMCRJ.S506969","url":null,"abstract":"<p><p>Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) overlap is a severe delayed-type hypersensitivity reaction causing widespread blistering and necrosis of skin and mucosa. Sulfadoxine-pyrimethamine (SP) and HIV/AIDS infection are associated with hypersensitivity reactions, including SJS and TEN. A 20-year-old female with HIV/AIDS presented with fever, body pain, and skin blisters on her face, neck, trunk, and perineum. She was non-compliant with antiretroviral therapy. The lesions developed three days after self-administering SP for malaria, taken as two tablets every 12 hours for three days. The skin involvement was 23% of total body surface area (TBSA). The Naranjo Adverse Drug Reaction Scale Score of four suggested a possible association between SP and SJS/TEN overlap, considering HIV/AIDS can precipitate this reaction. The severity-of-illness score of toxic epidermal necrolysis (SCORTEN) score was one, with predicted mortality of 3.2%. The patient received conservative treatment including fluids, antimicrobials, nutrition, and wound care, leading to complete recovery. It is imperative that the medicine regulatory authority and healthcare professionals educate HIV patients to avoid self-medication with antibiotics such as SP due to the increased risk of serious adverse drug reactions, including SJS/TEN.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"657-661"},"PeriodicalIF":0.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodegeneration, Intracranial Calcifications, Microcephaly and Drug-Resistant Epilepsy Caused by a Novel Homozygous Missense Variant in the <i>NRROS</i> Gene: A Case Report.","authors":"Mohammed A Al-Omari","doi":"10.2147/IMCRJ.S516299","DOIUrl":"10.2147/IMCRJ.S516299","url":null,"abstract":"<p><p>Negative regulator of reactive oxygen species (<i>NRROS</i>)-related microgliopathy (MIM# 618875) is a rare autosomal recessive neurodegenerative disorder. This case report describes a Saudi Arabian child with a novel homozygous <i>NRROS</i> variant, NM_198565.2: c.257T>C (p.Leu86Pro) presenting with drug-resistant epilepsy, rapid developmental regression, microcephaly, dystonia, and intracranial calcifications. Neuroimaging revealed bilateral intracranial calcifications, generalized brain volume loss, and connatal cysts; EEG showed a slow, suppressed background with multifocal epileptiform discharges. The variant is predicted to be deleterious by multiple in silico tools, suggesting a pathogenic effect on microglial function. This case underscores the importance of considering <i>NRROS</i>-related microgliopathy in children with early-onset neurodegeneration, drug-resistant epilepsy, and intracranial calcifications, enabling targeted genetic testing, diagnosis, and counseling.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"651-655"},"PeriodicalIF":0.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertriglyceridemia-Induced Acute Pancreatitis with Lipemic Samples in a Type 2 Diabetic Patient: A Case Report in a Resource-Limited Setting.","authors":"Hussein Mahdi Ahmed, Mohamed Hassan Osman, Shafie Abdulkadir Hassan, Hassan Mohamud Dirie, Mowlid Abdikarin Mohamed","doi":"10.2147/IMCRJ.S516349","DOIUrl":"10.2147/IMCRJ.S516349","url":null,"abstract":"<p><strong>Background: </strong>Hypertriglyceridemia (HTG) is a known but relatively uncommon cause of acute pancreatitis (AP), accounting for approximately 1-7% of cases. Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) can lead to significant morbidity if not promptly identified and managed. This case report describes a patient with poorly controlled type 2 diabetes mellitus (T2DM) who presented with HTG-AP, characterized by a lipemic blood sample, in a resource-limited setting.</p><p><strong>Case presentation: </strong>A 45-year-old male with a history of poorly controlled T2DM and hyperlipidemia presented with a 24-hour history of severe epigastric abdominal pain, fatigue, and vomiting. Clinical examination revealed diffuse abdominal tenderness, tachypnea, tachycardia, and a habitus consistent with central obesity. His BMI was 33.2 kg/m². Initial laboratory findings included seriously elevated triglycerides (1509 mg/dL), lipase (83 U/L), and amylase (161 U/L), along with hyperglycemia (465mg/dL). Abdominal computed tomography (CT) scan showed peripancreatic fatty stranding, consistent with early acute pancreatitis, as well as a fatty liver and a focal hypodense lesion in the right lobe. Treatment included intravenous insulin, dextrose, and potassium infusions to reduce triglyceride levels, analgesics, intravenous fluids for electrolyte imbalances, and thromboprophylaxis with enoxaparin.</p><p><strong>Conclusion: </strong>This case highlights the importance of early recognition of HTG-AP in patients with poorly controlled diabetes and hyperlipidemia. Prompt triglyceride-lowering therapy, primarily with insulin in resource-limited settings, is crucial for improving patient outcomes and preventing complications.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"645-649"},"PeriodicalIF":0.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Upadacitinib in Prurigo Nodularis: A Case Report and Review of the Literature.","authors":"Bohui Li, Wo Yao, Ran Diao, Boyun Yang, Yongfang Wang, Ting Li, Liuya Ge, Huiying Wang","doi":"10.2147/IMCRJ.S514339","DOIUrl":"10.2147/IMCRJ.S514339","url":null,"abstract":"<p><strong>Background: </strong>Prurigo nodularis (PN), while rare, presents significant clinical challenges due to its diverse pathogenesis and presentation. Effective therapy recommendations for PN remain limited. Upadacitinib, an oral highly selective type 1 Janus-associated kinase (JAK, Intracellular tyrosine kinases that phosphorylate cytokine receptors). Inhibitor plays an excellent role in alleviating itching in atopic dermatitis (AD). This is a report on the treatment of PN with upadacitinib, which offers a new option for refractory PN.</p><p><strong>Case presentation: </strong>We share our successful treatment experience of upadacitinib on a 43-year-old female patient with refractory PN failing to conventional therapies. She showed significant improvement at the follow-up visits and no obvious adverse effects happened. We also reviewed published case reports of PN patients and PN-related review researches and made a comprehensive discussion of the potential mechanism of JAK1 inhibitors in treating PN.</p><p><strong>Conclusion: </strong>Upadacitinib may be a safe and potent alternative for patients with refractory PN.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"637-644"},"PeriodicalIF":0.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Trans-Epithelial PRK and PTK for Treatment of Corneal Opacity Following Acanthamoeba Keratitis: A Case Report.","authors":"Rosa Buonamassa, Giuseppe Addabbo, Francesco Pignatelli, Alfredo Niro, Fedele Passidomo","doi":"10.2147/IMCRJ.S495729","DOIUrl":"10.2147/IMCRJ.S495729","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of Corneal Opacity following Acanthamoeba Keratitis (AK) treated successfully with transepithelial customized Photorefractive Keratectomy (PRK) combined with Photorefractive Keratectomy (PRK).</p><p><strong>Methods: </strong>One case report.</p><p><strong>Results: </strong>A 27-year-old woman was referred to our clinic for Acanthamoeba keratitis in her left eye. After 1 year from the infection, the patient returned to our attention for developing a central corneal scar and decreased corrected distance visual acuity (CDVA) in the left eye. The slit-lamp examination showed a central corneal opacity involving anterior stroma. A single-step topography-guided trans-epithelial PRK combined with PTK (CIPTA^®2 software, iVis Technologies) was performed in the left eye. After surface ablation using PRK, PTK was performed using masking agents (1% hydroxymethylcellulose) to smooth the ablated surface. Subsequently, 0.02% Mitomycin C was applied over the ablated surface. At the 1-month follow-up, a resolution of the corneal opacities was observed, with a visual improvement to 20/20, which was maintained at the 3-, 6-, and 12-months follow-up. Furthermore, there was an improvement in spherical equivalent and corneal morphological irregularity index.</p><p><strong>Conclusion: </strong>Corneal opacity following AK may be successfully treated using a combined topography-guided trans-epithelial PRK and PTK in selected patients.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"629-635"},"PeriodicalIF":0.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Risk Factors for Blood Culture-Positive Klebsiella pneumoniae Liver Abscess: A Retrospective Study.","authors":"Hui-Fang Zhang, Jia-Wen Chen, Shan-Shan Li, Shi-Wen Wu, Shu Li, Chen-Yi Liu, Chao Cai, Ming-Qin Lu","doi":"10.2147/IMCRJ.S516742","DOIUrl":"10.2147/IMCRJ.S516742","url":null,"abstract":"<p><strong>Background: </strong>Positive blood cultures for Klebsiella pneumoniae liver abscess (KPLA) are associated with an increased risk of extrahepatic organ infections and severe complications such as septicemia and septic shock, leading to higher mortality rates. This study aimed to investigate the clinical characteristics of patients with blood culture-positive KPLA and identify potential predictive indicators.</p><p><strong>Methods: </strong>We performed a retrospective analysis of clinical data from 263 KPLA patients diagnosed at our hospital between January 2019 and December 2023. The objective was to compare clinical characteristics between patients with positive and negative blood cultures and explore factors influencing blood culture positivity. Patients were divided into a blood culture-positive group (study group) and a blood culture-negative group (control group). We compared baseline characteristics, laboratory parameters, ultrasound findings, and complications. Logistic regression identified risk factors, and receiver operating characteristic (ROC) curves assessed the predictive value of inflammatory markers.</p><p><strong>Results: </strong>The study group exhibited higher ICU admission rates, longer hospital stays, and elevated qSOFA scores (≥2, 15.1 vs 2.6, P=0.003) along with a greater prevalence of diabetes and biliary diseases. Key laboratory values, including glucose, creatinine, procalcitonin (PCT), and C-reactive protein (CRP), were significantly higher, while albumin and platelet levels were lower (P < 0.05). Complications such as pleural effusion (35.1 vs 12.8, P<0.001), ascites (15.1 vs 2.6, P=0.003), pulmonary infections (27.6 vs 7.7, P<0.001), and extrahepatic abscesses (15.7 vs 5.1, P=0.018) were notably more common. Diabetes was identified as an independent risk factor for blood culture-positive KPLA. Among inflammatory markers, PCT showed the highest predictive value for blood culture positivity (AUC=0.683; cutoff=4.97 ng/mL; sensitivity=70.3%; specificity=62.8%).</p><p><strong>Conclusion: </strong>Patients with underlying diabetes mellitus are more prone to developing blood culture-positive KPLA. PCT demonstrates better predictive performance for blood culture-positive KPLA, and patients with PCT levels ≥4.97 ng/mL have a higher likelihood of positive blood culture results.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"609-619"},"PeriodicalIF":0.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Influenza Patients Who Received Ventilator Management During the 2024 to 2025 Major Influenza-Endemic Season in a Tertiary Hospital in Japan.","authors":"Masafumi Seki, Daishi Shimada","doi":"10.2147/IMCRJ.S519471","DOIUrl":"10.2147/IMCRJ.S519471","url":null,"abstract":"<p><p>Three cases of severe influenza that required ventilator management in the 2024-2025 season, which was a major influenza season in Japan, are presented. Case 1: A 54-year-old man with obesity developed lobar pneumonia as a result of severe community-acquired pneumonia (CAP) secondary to methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA), as confirmed on sputum culture. The nasal swab was positive for influenza A antigen. Intravenous peramivir and piperacillin/tazobactam were administered for 2 days followed by lascufloxacin and linezolid for 2 weeks. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) was also performed. Case 2: A 63-year-old man with multiple myeloma and chronic kidney disease developed severe pneumonia as a result of CAP. Although influenza A antigen was detected, no bacteria were isolated from his specimens. He showed severe hypoxia and massive ground-glass opacities (GGOs) in both lung fields, but he recovered after administration of peramivir and levofloxacin with prednisolone for 2 days and 2 weeks, respectively, with non-invasive positive pressure support. Case 3: A 43-year-old man without any related medical history developed severe heart failure with mild bronchopneumonia and was admitted to our hospital. Acute heart failure caused by myocarditis and CAP due to influenza A were suspected and treated effectively with peramivir and a percutaneous ventricular assist device (IMPELLA), which involved an auxiliary circulating pump with veno-arterial ECMO (VA-ECMO) for 1 day and 2 weeks, respectively. In three middle-aged patients, influenza virus may have accelerated pneumonia/heart failure. All three patients had not received influenza vaccines and were not elderly. Although the emphasis on most vaccines has decreased after the COVID-19 pandemic appears to have subsided, we should stress the importance of influenza vaccines and improvement of critical care protocols, because severe influenza can be a concern for young and middle-aged adults during the influenza season after the post COVID-19 pandemic period.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"621-627"},"PeriodicalIF":0.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Sonographic and Biochemical Profiles of Patients with a Mainz II Pouch Urine Diversion in Rural Uganda. A Case Series.","authors":"Fred Kirya, David Aderu, Joseph Epodoi, Denise Apolot, Ritah Kiconco, Richard Mpango, Jacob Eperu, Ronald Opito","doi":"10.2147/IMCRJ.S515145","DOIUrl":"10.2147/IMCRJ.S515145","url":null,"abstract":"<p><strong>Background: </strong>Mainz II pouch urinary diversion is an alternative surgery for patients with an incurable vesicovaginal fistula (VVF). We report six (6) cases of patients who had incurable VVF and were offered Mainz II pouch surgery at Soroti Regional Referral Hospital, between 2009 and 2018 and followed up in 2023.</p><p><strong>Methods: </strong>A retrospective review of charts of 6 patients who were offered Mainz II pouch procedure and a cross-sectional assessment of their biochemical, sonographic and clinical profiles five (5) or more years after the procedure at Soroti Regional Referral Hospital were done. All case notes of patients who underwent the Mainz II procedure between 2009 and 2018 were retrieved from the registry and each patient profiled using a standard data abstraction tool.</p><p><strong>Results: </strong>The ages of the six participants ranged between 16 and 65 years at the time of the procedure. Four of the 6 participants had lived with the fistula for less than 10 years. Four participants had only one delivery and the other 2 had five and six deliveries. All the participants had lived with the Mainz II pouch urine diversion for at least five years (5-14 years). One participant (1/6) had hypertension (BP=161/101). Most participants reported nocturnal incontinence. Sonographic findings revealed one-sided mild vesicoureteral reflux with loss of corticomedullary differentiation in two participants (2/6). One of six (1/6) patients had severe vesicoureteral reflux grade 4. The commonest metabolic disorders were compensated metabolic acidosis (4/6).</p><p><strong>Conclusion: </strong>The Mainz II pouch procedure remains a viable option for managing incurable obstetric fistulas. However, the prevalence of metabolic complications, including acidosis and renal impairment, underscores the need for routine biochemical and sonographic monitoring to ensure optimal long-term patient outcomes.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"601-607"},"PeriodicalIF":0.7,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}