International Medical Case Reports Journal最新文献

{"title":"Histopathologi⁠cally Confirmed Nasal Rhinosporidiosis in an Adolescent Male Presenting with Long-Standing Right-Si⁠ded Nasal Obstruction and Epistaxis: A Case Report.","authors":"Fahma Aden Mohamed, Abdishakur Mohamed Karim, Geoffrey Tabu","doi":"10.2147/IMCRJ.S629670","DOIUrl":"10.2147/IMCRJ.S629670","url":null,"abstract":"<p><strong>Introduction: </strong>Rhinosporidiosis is a chronic granulomatous mucosal infection caused by <i>Rhinosporidium seeberi</i>, most commonly affecting the nasal cavity and nasopharynx. It typically presents as a friable polypoidal lesion associated with nasal obstruction and recurrent epistaxis. Histopathological examination is essential for definitive diagnosis.</p><p><strong>Case presentation: </strong>A 17-year-old male presented with a five-year history of progressive right-sided nasal obstruction and recurrent epistaxis. The nasal mass gradually enlarged and eventually protruded through the right nostril. He reported repeated swimming and playing in a nearby pond before symptom onset. Baseline laboratory investigations showed a hemoglobin level of 13.9 g/dL, white blood cell count of 6.63 × 10⁹/L, and platelet count of 345 × 10⁹/L. Mean corpuscular volume was reduced at 76.2 fL. Computed tomography demonstrated a well-defined soft-tissue lesion occupying the right nasal cavity without obvious destructive bony erosion. The lesion was excised through a transnasal approach, followed by cauterization of its base. Histopathological examination demonstrated chronically inflamed subepithelial stroma containing numerous thick-walled sporangia filled with endospores, confirming nasal rhinosporidiosis. Sporangia were present at the resection margin, indicating incomplete histological clearance. Postoperatively, oral dapsone 100 mg once daily was commenced for a planned six-month course after confirmation of normal glucose-6-phosphate dehydrogenase status. At three-month follow-up, repeat computed tomography showed no radiological evidence of recurrence.</p><p><strong>Conclusion: </strong>Nasal rhinosporidiosis should be considered in patients with long-standing unilateral nasal obstruction, recurrent epistaxis, and pond-water exposure. Complete surgical excision with cauterization and continued postoperative surveillance are important, particularly when histological margins are involved.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"629670"},"PeriodicalIF":0.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008417","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":"Gestational Diabetic Ketoacidosis Complicated by a Probable Postpartum Functional Neurological Disorder Following Severe Preeclampsia and Intrauterine Fetal Demise: A Case Report.","authors":"Migisha Kazeneza Patrick, Célestin Kaputu-Kalala-Malu Snr, Antoine Osongo Onanga W, Baguma Mahemu Paulin, Koko Mihigo Francine Snr, Zanga Kitutu Jean, Baanitse Munihire Jeannot","doi":"10.2147/IMCRJ.S611001","DOIUrl":"10.2147/IMCRJ.S611001","url":null,"abstract":"<p><strong>Introduction: </strong>Gestational diabetic ketoacidosis (GDKA) is a rare but potentially fatal metabolic emergency associated with significant maternal morbidity and a high risk of fetal complications. Although its metabolic and obstetric complications are well described, functional neurological manifestations occurring during the postpartum period remain rarely reported.</p><p><strong>Case presentation: </strong>We report the case of a 28-year-old primigravida admitted at 34 weeks and 5 days of gestation for gestational diabetic ketoacidosis complicated by severe preeclampsia and intrauterine fetal demise. Management consisted of intensive care including intravenous fluid resuscitation, continuous insulin infusion, correction of electrolyte disturbances, administration of magnesium sulfate, and emergency cesarean delivery. Metabolic evolution was favorable. On postpartum day 4, the patient developed gait instability characterized by an unsteady gait without impaired consciousness or focal neurological deficits. Symptoms disappeared at rest and exhibited contextual variability. Neuropsychiatric and psychological assessments suggested a functional neurological disorder. Complete remission was observed by postpartum day 11.</p><p><strong>Discussion: </strong>The combination of severe preeclampsia, intrauterine fetal demise, emergency cesarean section, and diabetic ketoacidosis constituted a major psychological stressor that may have contributed to the development of a functional neurological disorder. Although the clinical presentation was highly suggestive of this diagnosis, the absence of brain imaging represents an important limitation of this report.</p><p><strong>Conclusion: </strong>This case highlights the importance of prompt multidisciplinary management of gestational diabetic ketoacidosis and draws attention to the possibility of functional neurological disorder in patients developing neurological symptoms following severe obstetric complications.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"611001"},"PeriodicalIF":0.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989950","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":"Kikuchi-Fujimoto Disease Associated with Hashimoto's Thyroiditis: A Case Report.","authors":"Hala Alibrahim, Mohammad Yaman Haidar, Modar Doyya, Diana Yousef Saleem, Qutayba Abdullah, Zain Al Ibrahim","doi":"10.2147/IMCRJ.S640058","DOIUrl":"10.2147/IMCRJ.S640058","url":null,"abstract":"<p><strong>Background: </strong>Kikuchi-Fujimoto disease (KFD) is a rare, benign, and self-limiting disorder characterized primarily by cervical lymphadenopathy and fever. Although the disease has been reported worldwide, it is more frequently observed in young women of Asian descent. The etiology of this disease remains unclear. Kikuchi-Fujimoto disease has been reported in association with several autoimmune disorders. Its coexistence with Hashimoto's thyroiditis is rarely described in the literature.</p><p><strong>Objective: </strong>To present a case of KFD associated with Hashimoto's thyroiditis and highlight the importance of considering this diagnosis in patients with autoimmune disorders.</p><p><strong>Case presentation: </strong>A 37-year-old woman with a known history of Hashimoto's thyroiditis who presented with rapidly enlarging cervical lymphadenopathy. Laboratory investigations, Ultrasonography, and Excisional lymph node biopsy were performed.</p><p><strong>Results: </strong>Laboratory tests revealed mild anemia, elevated ESR, and positive anti-TPO antibodies. Ultrasound showed multiple hypoechoic cervical lymph nodes. Biopsy confirmed KFD with characteristic histopathological features. The patient improved spontaneously without specific treatment.</p><p><strong>Conclusions and significance: </strong>This case underscores the importance of including KFD in the differential diagnosis of cervical lymphadenopathy, particularly in young women with autoimmune diseases. Clinicians should be aware of this rare association to avoid misdiagnosis and unnecessary interventions.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"640058"},"PeriodicalIF":0.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989907","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":"Awake Fiberoptic Intubation for Segmental Mandibulectomy in a Patient with Follicular Ameloblastoma of the Anterior Mandible: A Case Report.","authors":"Noy Norman Kambuaya, Iwan Fuadi","doi":"10.2147/IMCRJ.S598769","DOIUrl":"10.2147/IMCRJ.S598769","url":null,"abstract":"<p><p>Awake tracheal intubation (ATI) is recommended for patients with predicted difficult airways. This approach preserves spontaneous ventilation until the airway is secured. In this case, a 52-year-old male (ASA II) with a large anterior mandibular tumor underwent segmental mandibulectomy. Awake fiberoptic intubation (AFOI) was performed nasally via a flexible bronchoscope in a semi-sitting, face-to-face position. Topical anesthesia was achieved by combining nebulized 2% lidocaine (4 mL, 80 mg) with the spray-as-you-go technique (2-4 mL of 2% lidocaine). The total dose used was approximately 120-160 mg, or 1.8-2.5 mg/kg for a 65-kg patient. Sedation was achieved with dexmedetomidine (loading dose 1 µg/kg over 10 minutes, then maintenance at 0.4 µg/kg/hour). As HFNO was unavailable due to limited equipment availability, oxygenation was maintained using a low-flow nasal cannula at 3 L/min. Tracheal tube placement was confirmed by direct visualization and capnography. No episodes of desaturation occurred. This report highlights the practical adaptability of the DAS sTOP framework for AFOI when HFNO availability is limited, demonstrating that low-flow nasal oxygen combined with dual-method topicalization and a single sedative agent may serve as a feasible alternative.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"598769"},"PeriodicalIF":0.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989929","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":"Antitachycardia Pacing for Fast Scar-Mediated Ventricular Tachycardia Across Non-Ischemic Cardiomyopathies: A Case Series.","authors":"Paschalis Karakasis, Georgios Stavropoulos, Georgios K Efthimiadis, Theodoros Karamitsos, Nikolaos Fragakis","doi":"10.2147/IMCRJ.S629503","DOIUrl":"10.2147/IMCRJ.S629503","url":null,"abstract":"<p><strong>Background: </strong>Fast monomorphic ventricular tachycardia (VT) in non-ischemic and inherited cardiomyopathies is frequently treated as an imminently shock-requiring rhythm. Yet ventricular rate is an imperfect surrogate for tachycardia mechanism. When VT remains regular, monomorphic, and sustained by an organized reentrant circuit with an accessible excitable gap, antitachycardia pacing (ATP) may terminate even very rapid episodes without high-energy shock delivery.</p><p><strong>Case series: </strong>We report five patients with distinct non-ischemic arrhythmogenic substrates in whom fast sustained monomorphic VT (≥188 beats/min; tachycardia cycle length ≤320 ms), including very fast/VF-zone events >250 beats/min, was successfully terminated by ATP. The phenotypes comprised LMNA cardiomyopathy with conduction disease and septal fibrosis; TTN truncating variant-associated dilated cardiomyopathy with VT at approximately 260 beats/min; δ-sarcoglycan-associated dilated cardiomyopathy with clustered VT/electrical storm; severe non-ischemic cardiomyopathy with left bundle branch block, CRT-D implantation, and circumferential ring-like fibrosis, followed by 27 early post-implant VT episodes all terminated by ATP; and hypertrophic cardiomyopathy with an apical left ventricular aneurysm and diffuse late gadolinium enhancement, complicated by shock-free electrical storm. Several episodes were asymptomatic or initially attributed to atrial arrhythmia, whereas device interrogation documented sustained VT requiring therapy.</p><p><strong>Discussion: </strong>Across these heterogeneous non-ischemic substrates, the unifying electrophysiological phenotype was fast, regular, monomorphic VT that remained susceptible to termination by ATP. The series illustrates how ATP response reflects the interaction among circuit organization, scar architecture, tachycardia cycle length, pacing-vector access, detection-zone design, and ATP programming. These observations complement randomized evidence supporting ATP for fast VT and contemporary shock-minimizing ICD programming, including PainFREE Rx II, PITAGORA ICD, MADIT-RIT, ADVANCE III, and APPRAISE ATP.</p><p><strong>Conclusion: </strong>Fast VT in non-ischemic cardiomyopathy should not be considered intrinsically shock-dependent. When the tachycardia is sustained, regular, monomorphic, and electrophysiologically organized, ATP may successfully terminate even very rapid episodes while preserving defibrillation as back-up therapy. The key clinical implication is that ventricular rate, although relevant to risk assessment and therapy, is an imperfect surrogate for ATP susceptibility and should not alone dictate device-programming strategy.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"629503"},"PeriodicalIF":0.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976879","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":"Advanced Uterine Prolapse in a Primiparous Postmenopausal Woman Successfully Treated with Total Vaginal Hysterectomy: A Case Report.","authors":"Frans Arvindo Irapanussa, Arif Satria Prabowo, Raden Kania Praharsini","doi":"10.2147/IMCRJ.S639791","DOIUrl":"10.2147/IMCRJ.S639791","url":null,"abstract":"<p><strong>Background: </strong>Pelvic organ prolapse (POP) results from weakness of pelvic floor support structures and may significantly impair quality of life. Multiparity and vaginal delivery are major risk factors for uterine prolapse. We report a rare case of stage IV uterine prolapse in a primiparous postmenopausal woman, highlighting the potential contribution of advanced age and postmenopausal status despite the absence of multiparity.</p><p><strong>Case presentation: </strong>A 58-year-old primiparous (P1A0) postmenopausal woman presented with a two-year history of a vaginal bulge that had progressively worsened over the preceding two months and became irreducible. She reported incomplete bladder emptying, straining during micturition, weak urinary stream, and persistent vaginal discomfort after pessary insertion. Pelvic examination revealed stage III anterior vaginal wall prolapse, stage IV uterine prolapse, stage III posterior compartment prolapse, and cervical elongation. The patient underwent total vaginal hysterectomy (TVH) with anterior colporrhaphy. Her postoperative course was uneventful, with stable clinical condition, adequate pain control, no significant bleeding, and satisfactory recovery.</p><p><strong>Discussion: </strong>Surgical management was selected because of advanced prolapse, persistent symptoms, and unsuccessful conservative treatment with a pessary. In this postmenopausal patient, uterine preservation was not a priority. The transvaginal approach enabled direct management of the prolapsed uterus while simultaneously restoring apical and anterior compartment support.</p><p><strong>Conclusion: </strong>Total vaginal hysterectomy with anterior colporrhaphy can effectively treat advanced uterine prolapse involving multiple compartments in postmenopausal women with persistent symptoms following unsuccessful conservative treatment.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"639791"},"PeriodicalIF":0.7,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955991","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":"Lithopedion Following Presumed Primary Abdominal Pregnancy in a 42-Year-Old Woman from Somaliland: A Case Report and Literature Review.","authors":"Abdisamed Mohamoud H Ali, Ahmed Osman Mohamed, Khadar Jama Ibrahim","doi":"10.2147/IMCRJ.S634443","DOIUrl":"10.2147/IMCRJ.S634443","url":null,"abstract":"<p><strong>Background: </strong>Lithopedion is an exceptionally rare complication of abdominal pregnancy in which a deceased fetus becomes calcified following prolonged retention in the maternal abdomen. Because of its indolent course and nonspecific symptoms, it is frequently diagnosed late, particularly in resource-limited settings.</p><p><strong>Case presentation: </strong>We report a 42-year-old multiparous woman (gravida 4, para 3) who presented with a three-year history of chronic lower abdominal pain and progressive abdominal heaviness. She had a remote history suggestive of an untreated pregnancy that spontaneously ceased without medical evaluation. Clinical examination revealed a firm, irregular, non-mobile abdominopelvic mass extending to the umbilical level. Laboratory investigations revealed mild anemia (hemoglobin 9.0 g/dL), while serum β-hCG was <5 mIU/mL (negative). Ultrasonography demonstrated a calcified abdominopelvic mass with an empty uterine cavity. Contrast-enhanced computed tomography with three-dimensional reconstruction demonstrated a well-defined calcified extrauterine fetal skeleton consistent with lithopedion. Intraoperative findings met Studdiford's criteria; however, because these criteria were applied retrospectively several years after the index pregnancy, the underlying gestation is described as a presumed primary abdominal pregnancy.</p><p><strong>Management and outcome: </strong>The patient underwent exploratory laparotomy with complete surgical excision of the calcified fetus without intraoperative complications. Postoperative recovery was uneventful, and the patient demonstrated complete resolution of symptoms at follow-up.</p><p><strong>Conclusion: </strong>Lithopedion should be considered in women presenting with chronic abdominal or pelvic symptoms and a history suggestive of prior untreated pregnancy. In this patient, cross-sectional imaging, and particularly CT with three-dimensional reconstruction, was valuable for characterizing the lesion and planning surgery, although ultrasonography and magnetic resonance imaging may be sufficient in other circumstances. Surgical management in symptomatic cases can result in excellent outcomes even in resource-limited settings.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"634443"},"PeriodicalIF":0.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944618","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":"When Immune System and Herpes Virus Infection Collide: A Case of Severe Stromal Herpetic Keratitis in a Patient with Rheumatoid Arthritis Under Methotrexate.","authors":"Claudia Corda, Filippo Lixi, Antonio Budroni, Mara-Ioana Tomi, Alina-Gabriela Gheorghe, Giuseppe Giannaccare","doi":"10.2147/IMCRJ.S632102","DOIUrl":"10.2147/IMCRJ.S632102","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of refractory herpes simplex virus keratitis (HSVK) complicated by keratolysis and severe stromal thinning in a patient with rheumatoid arthritis (RA) under treatment with methotrexate (MTX).</p><p><strong>Observations: </strong>A 79‑year‑old patient with a history of HSVK and RA, treated with weekly MTX, presented with pain and photophobia in the right eye. Best‑corrected visual acuity (BCVA) was limited to counting fingers. Slit‑lamp examination revealed a supero-nasal corneal ulcer (area of 2.98 mm²) with deep stromal involvement and keratolysis. A recurrent episode of HSVK was diagnosed, and treatment with 3 times daily oral acyclovir, 4 times daily 0.15% ganciclovir ophthalmic gel, and 3 times daily 0.15% topical dexamethasone was started. After one week, the picture worsened with corneal thinning (corneal thinnest point [CTP] 82 µm) and anterior chamber fibrin. Cycloplegic therapy 3 times daily was added. Considering the refractory course, the history of recurrent HSVK, and the concomitant systemic immunomodulation, the MTX injection scheduled for the subsequent weeks was interrupted. After 2 weeks, conjunctival hyperemia improved (Efron grade II) and a progressive increase of corneal thickness (CTP 199 µm) was documented. Two months later, complete healing was achieved with no signs of active inflammation or recurrence; BCVA improved to 0.4 LogMAR, with mild residual stromal thinning and opacity (CTP 231 µm).</p><p><strong>Conclusion and importance: </strong>This case underscores how systemic immunomodulatory treatment may play a clinically relevant role in patients with recurrent HSVK. In selected cases, a conservative, surgery‑sparing approach through the optimization of systemic therapy can help promoting viral load control and corneal healing.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"632102"},"PeriodicalIF":0.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919692","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":"In Countries Where Dog Bites are Endemic, Health Authorities Must Provide Appropriate Diagnostic Tools for Rabies [Letter].","authors":"Josef Finsterer","doi":"10.2147/IMCRJ.S652127","DOIUrl":"10.2147/IMCRJ.S652127","url":null,"abstract":"","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"652127"},"PeriodicalIF":0.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911986","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":"Spontaneous Mid-Gestational Uterine Rupture in a Non-Scarred Uterus.","authors":"Philémon Mumbere Matumo, Blaise-Pascal Furaha Nzanzu, Dieumerci Wasingya Kaseso, Eric Kambale Kavunga, Patient Malekani Kitumaini, Anasthasie Kahindo Katsongeri, Rock Kasereka Masuka, Patrick Kahindo Muyayalo, Jean-Jeannot Juakali Sihalikyolo","doi":"10.2147/IMCRJ.S628171","DOIUrl":"10.2147/IMCRJ.S628171","url":null,"abstract":"<p><p>A rare case of a late-diagnosed life-threatening second-trimester uterine rupture in a 26-year-old nulliparous woman (G2P0) with a non-scarred uterus at 20+4 weeks of gestation. Her history was significant for a spontaneous abortion, 17 months prior, managed by instrumental curettage. Initially managed as threatened miscarriage over 10 days, the patient was transferred in Stage IV hypovolemic shock. Ultrasound and diagnostic abdominal paracentesis revealed a massive hemoperitoneum and a non-viable fetus in the peritoneal cavity. An emergency laparotomy identified an anterofundal arcuate rupture on a suspected fundal placenta percreta spectrum. We performed a subtotal hemostatic hysterectomy. Five episodes of cardiac arrest complicated the procedure. Following intensive resuscitation and transfusions, the patient stabilized and was later discharged in good condition. Prior curettage was the plausible cause of focal decidual defects, facilitating deep trophoblastic invasion with a placenta percreta spectrum. High index of suspicion for an eventual mid-gestation spontaneous uterine rupture must be considered in patients with prior instrumentation history.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"628171"},"PeriodicalIF":0.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905619","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}