JA Clinical Reports最新文献_第6页

Perioperative management of critical obstetric hemorrhage after cesarean delivery in a patient with hereditary hemorrhagic telangiectasia: a case report. 遗传性出血性毛细血管扩张患者剖宫产后危重产科出血的围手术期处理：1例报告。

IF 1

JA Clinical Reports Pub Date : 2025-10-21 DOI: 10.1186/s40981-025-00821-9

Saori Hayashi, Ryo Wakabayashi, Ken Kobayashi, Junko Tsukamoto, Kazuhito Mietani, Kanji Uchida

{"title":"Perioperative management of critical obstetric hemorrhage after cesarean delivery in a patient with hereditary hemorrhagic telangiectasia: a case report.","authors":"Saori Hayashi, Ryo Wakabayashi, Ken Kobayashi, Junko Tsukamoto, Kazuhito Mietani, Kanji Uchida","doi":"10.1186/s40981-025-00821-9","DOIUrl":"10.1186/s40981-025-00821-9","url":null,"abstract":"Background: Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant vascular disorder associated with hemorrhagic complications. In pregnant women with HHT, postpartum hemorrhage can be life-threatening and may necessitate hysterectomy.Case presentation: A 36-year-old primigravida woman with HHT underwent emergency cesarean delivery due to nonreassuring fetal status. Following delivery, she developed massive uterine bleeding. Despite intrauterine balloon tamponade, hemorrhage persisted. Under the direction of the attending anesthesiologist and obstetrician, maternal resuscitation was initiated. Contrast-enhanced computed tomography revealed active extravasation from the right uterine artery. During emergent interventional radiology, angiography identified contrast extravasation from a hypertrophied spiral artery at the peripheral end of the right uterine artery, and embolization achieved initial hemostasis. She subsequently received intensive care under the supervision of the critical care team and ultimately recovered without hysterectomy.Conclusions: Rapid multidisciplinary intervention for critical obstetric hemorrhage in a patient with HHT led to maternal survival and uterine preservation.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"56"},"PeriodicalIF":1.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337085","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}

引用次数: 0

Pain reduction through combined spinal cord stimulation and exercise therapy after spinal extradural arachnoid cystectomy: a case report. 脊髓硬膜外蛛网膜囊切除术后脊髓联合刺激和运动治疗减轻疼痛1例报告。

IF 1

JA Clinical Reports Pub Date : 2025-10-16 DOI: 10.1186/s40981-025-00811-x

Akari Ikemura, Daigo Shiroki, Satoshi Ohga, Takafumi Hattori, Yoko Sugiyama, Yuko Kito, Maki Mizogami, Takako Matsubara, Hiroki Iida

{"title":"Pain reduction through combined spinal cord stimulation and exercise therapy after spinal extradural arachnoid cystectomy: a case report.","authors":"Akari Ikemura, Daigo Shiroki, Satoshi Ohga, Takafumi Hattori, Yoko Sugiyama, Yuko Kito, Maki Mizogami, Takako Matsubara, Hiroki Iida","doi":"10.1186/s40981-025-00811-x","DOIUrl":"10.1186/s40981-025-00811-x","url":null,"abstract":"Background: Spinal extradural arachnoid cysts (SEACs) can cause persistent pain after surgery. Combining spinal cord stimulation (SCS) with structured exercise therapy may aid long-term pain modulation.Case presentation: A teenage female with over two years of severe rib pain and bilateral leg pain/numbness was diagnosed with SEACs and underwent resection. A trial of SCS alleviated leg symptoms; rib pain persisted. After SCS implantation, leg symptoms resolved, and a gradual exercise progressed from pain-free stretching to low-intensity lower-limb exercises. Over 12 months, rib pain decreased and skeletal muscle mass increased. Pressure pain threshold and conditioned pain modulation improved, suggesting reduced sensitization and enhanced descending inhibition.Conclusions: This case suggests that SCS may provide early pain relief, enabling initiation of structured exercise, associated with sustained pain reduction, improved pain modulation, and functional recovery. These observations suggest the SCS combined with exercise may be a useful option for selected patients with movement-limiting multifocal pain.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"55"},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300933","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}

引用次数: 0

Postoperative detection of pulmonary artery catheter entrapment during minimally invasive mitral valve repair: a case report. 微创二尖瓣修复术中肺动脉导管夹持1例。

IF 1

JA Clinical Reports Pub Date : 2025-10-16 DOI: 10.1186/s40981-025-00822-8

Ayaka Higashi, Sachiko Yamazaki, Atsushi Kainuma, Toshihito Mihara, Yuya Takahashi, Hiroki Matsuyama, Akiyuki Takahashi, Masahiro Sakaguchi

{"title":"Postoperative detection of pulmonary artery catheter entrapment during minimally invasive mitral valve repair: a case report.","authors":"Ayaka Higashi, Sachiko Yamazaki, Atsushi Kainuma, Toshihito Mihara, Yuya Takahashi, Hiroki Matsuyama, Akiyuki Takahashi, Masahiro Sakaguchi","doi":"10.1186/s40981-025-00822-8","DOIUrl":"10.1186/s40981-025-00822-8","url":null,"abstract":"Background: Pulmonary artery catheter (PAC) entrapment is a rare but serious complication caused by inadvertent suturing to cardiac or vascular structures.Case presentation: A 42-year-old man underwent minimally invasive mitral valve repair via right mini-thoracotomy. Thirty minutes after weaning from cardiopulmonary bypass (CPB), pulmonary artery pressure suddenly dropped, and the waveform became identical to that of central venous pressure. Two centimeters of PAC mobility, aspiration of blood from the balloon port, and blood accumulation in the monitor connector were noted. On postoperative day 1, resistance was encountered during catheter withdrawal at 7 cm, and chest radiography revealed abnormal catheter curvature. Reoperation under CPB confirmed PAC entrapment at the left atriotomy suture line, and the catheter was successfully removed.Conclusions: In minimally invasive mitral valve repair, a left atriotomy approach might be associated with a risk of PAC entrapment, and the option of not inserting a PAC should always be considered.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"54"},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300920","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}

引用次数: 0

Anesthesia management for laparoscopic surgery in the Trendelenburg position in a patient with Fontan physiology and severe hypoxemia: a case report. 伴有Fontan生理和严重低氧血症的患者在Trendelenburg位腹腔镜手术的麻醉管理：1例报告。

IF 1

JA Clinical Reports Pub Date : 2025-09-29 DOI: 10.1186/s40981-025-00820-w

Shunsuke Okano, Masahiro Kuroki, Shun Abe, Yu Matsuura, Ayuka Narisawa, Hiroaki Toyama

{"title":"Anesthesia management for laparoscopic surgery in the Trendelenburg position in a patient with Fontan physiology and severe hypoxemia: a case report.","authors":"Shunsuke Okano, Masahiro Kuroki, Shun Abe, Yu Matsuura, Ayuka Narisawa, Hiroaki Toyama","doi":"10.1186/s40981-025-00820-w","DOIUrl":"10.1186/s40981-025-00820-w","url":null,"abstract":"Background: Pneumoperitoneum and Trendelenburg positioning are thought to increase pulmonary vascular resistance (PVR). In Fontan circulation, increased PVR is directly related to decreased ventricular preload and can result in circulatory failure.Case presentation: A 23-year-old female patient with Fontan physiology was diagnosed with left paraovarian cyst torsion and underwent laparoscopic cystectomy. SpO2 was 70% in room air. General anesthesia was induced with remimazolam, fentanyl, and rocuronium and maintained with remimazolam and remifentanil combined with an abdominal wall block. The difference between SpO2 and central venous oxygen saturation (ScvO2) increased during the induction of anesthesia and further increased with the initiation of pneumoperitoneum and Trendelenburg positioning but recovered at the completion of the surgery.Conclusions: Patients with Fontan physiology and severe hypoxemia can tolerate short-term laparoscopic surgery in the Trendelenburg position under strict management. In these patients, monitoring ScvO2 provides important circulatory information regarding the effects of pneumoperitoneum and Trendelenburg positioning.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"53"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191688","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}

引用次数: 0

Early epidural analgesia for the preoperative management of suspected spontaneous pheochromocytoma rupture: a case report. 怀疑自发性嗜铬细胞瘤破裂的术前早期硬膜外镇痛1例。

IF 1

JA Clinical Reports Pub Date : 2025-09-26 DOI: 10.1186/s40981-025-00813-9

Yukina Oshiba, Sho C Shibata, Taehun Lee, Junichi Inoue, Takashi Kita

{"title":"Early epidural analgesia for the preoperative management of suspected spontaneous pheochromocytoma rupture: a case report.","authors":"Yukina Oshiba, Sho C Shibata, Taehun Lee, Junichi Inoue, Takashi Kita","doi":"10.1186/s40981-025-00813-9","DOIUrl":"10.1186/s40981-025-00813-9","url":null,"abstract":"Background: Acute abdominal pain is an uncommon manifestation of pheochromocytoma. Poor pain management may delay preoperative optimization of hemodynamics and intravascular blood volume. We report a case in which early epidural analgesia facilitated preoperative preparation for a laparoscopic adrenalectomy.Case presentation: A female patient diagnosed with pheochromocytoma developed the sudden onset of severe left lower abdominal pain, hypertension, nausea, and vomiting. Pain treatment with acetaminophen and loxoprofen was insufficient, and opioids were avoided due to persistent nausea and constipation. Initiation of continuous thoracic epidural analgesia with 0.25% levobupivacaine resulted in rapid pain relief and improved gastrointestinal symptoms. Over a 9-day period, blood pressure and intravascular blood volume were optimized while epidural analgesia was continued. She underwent a successful adrenalectomy and was discharged without complications.Conclusions: This case illustrates the potential utility of early epidural analgesia in the preoperative management of pheochromocytoma, particularly in patients with refractory abdominal pain and limited opioid tolerance.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"49"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148679","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}

引用次数: 0

Perioperative airway strategy for a singer using a supraglottic airway device and bronchial blocker to prevent hoarseness following robotic lobectomy. 一位歌手使用声门上气道装置和支气管阻滞剂预防机器人肺叶切除术后声音嘶哑的围手术期气道策略。

IF 1

JA Clinical Reports Pub Date : 2025-09-26 DOI: 10.1186/s40981-025-00817-5

Keisuke Yoshida, Kazuho Saito, Yuzo Iseki, Yoshie Noji, Satoki Inoue

引用次数: 0

Learning from the aircraft cockpit: optimizing anesthesia workspace layout within the primary field of view. 向飞机驾驶舱学习：在主视场内优化麻醉工作空间布局。

IF 1

JA Clinical Reports Pub Date : 2025-09-26 DOI: 10.1186/s40981-025-00814-8

Keisuke Yoshida, Yui Akama, Satoki Inoue

引用次数: 0

Perioperative anaphylaxis attributed to acetaminophen following intravenous acetaminophen administration: a case report. 静脉给药对乙酰氨基酚后引起的围手术期过敏反应：1例报告。

IF 1

JA Clinical Reports Pub Date : 2025-09-26 DOI: 10.1186/s40981-025-00816-6

Yasuhiro Amano, Yosuke Taki, Yuko Konishi, Tasuku Fujii, Takahiro Tamura

{"title":"Perioperative anaphylaxis attributed to acetaminophen following intravenous acetaminophen administration: a case report.","authors":"Yasuhiro Amano, Yosuke Taki, Yuko Konishi, Tasuku Fujii, Takahiro Tamura","doi":"10.1186/s40981-025-00816-6","DOIUrl":"10.1186/s40981-025-00816-6","url":null,"abstract":"Background: Anaphylaxis caused by intravenous acetaminophen is extremely rare, but a few case reports have identified mannitol, an excipient, as the causative component. Since mannitol is widely present in medications and foods, distinguishing the true antigen is essential to prevent recurrence.Case presentation: A 67-year-old woman developed anaphylaxis with pulseless electrical activity during ophthalmic surgery after intravenous administration of acetaminophen (Acelio®). Allergy testing revealed positive reactions to both Acelio® and acetaminophen in skin tests and the basophil activation test, while reactions with mannitol were negative. Acetaminophen was confirmed as the causative agent. Hence, the patient was instructed to avoid only acetaminophen.Conclusions: Accurate identification of the causative component in intravenous acetaminophen formulations is critical. Clarifying whether the reaction is due to the active ingredient or an excipient such as mannitol helps prevent unnecessary drug restrictions and expands future treatment options.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"52"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148774","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}

引用次数: 0

Low-dose epidural morphine for postpartum pain relief: a randomized, single-blind study. 低剂量硬膜外吗啡用于产后疼痛缓解：一项随机、单盲研究。

IF 1

JA Clinical Reports Pub Date : 2025-09-26 DOI: 10.1186/s40981-025-00818-4

Hiroaki Kondo, Shunsuke Hyuga, Yoshinori Tomoda, Tomoe Fujita, Mariko Adachi, Toshiyuki Okutomi

{"title":"Low-dose epidural morphine for postpartum pain relief: a randomized, single-blind study.","authors":"Hiroaki Kondo, Shunsuke Hyuga, Yoshinori Tomoda, Tomoe Fujita, Mariko Adachi, Toshiyuki Okutomi","doi":"10.1186/s40981-025-00818-4","DOIUrl":"10.1186/s40981-025-00818-4","url":null,"abstract":"Introduction: Epidural morphine administration following vaginal delivery reduces postpartum pain; however, side effects may occur. We investigated whether a lower dose could achieve pain relief without increasing the incidence and severity of side effects.Methods: Eighty women treated with combined spinal-epidural analgesia received 0.75 mg epidural morphine (morphine group) or normal saline (normal saline group) after delivery. The primary outcome was the area under the curve (AUC) of the visual analog scale score assessing perineal and contraction pain for 24 h following delivery. Secondary outcomes were time until initial request for additional analgesics, number of analgesic medications, and side effects incidence and severity.Results: The morphine group did not show lower mean AUCs for postpartum perineal (290, interquartile range [IQR]: 90-580 vs 450, IQR: 265.6-760; P = 0.07) or contraction pain (18.8, IQR: 0-105 vs 156.3, IQR: 11.5-300; P = 0.004). The time until the initial request for additional analgesics was longer in the morphine group (530 min, 95% confidence interval [CI]: 365 to 915 min vs 268 min, 95% CI: 230 to 385 min; P = 0.001). The median (IQR) number of analgesic medications within 24 h were 2 (0.5-3) and 2.5 (2-3) in the morphine and saline groups, respectively (P = 0.007). There were no differences in the incidence of side effects between the groups.Conclusions: Epidural morphine following vaginal delivery reduces contraction pain but not perineal pain and prolongs the time until initial request for additional analgesia without increasing side effects.Clinical trials registration number: The University Hospital Medical Information Network Clinical Trials Registry (registration number: UMIN000039351).","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"51"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148833","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}

引用次数: 0

Anesthetic management of occult traumatic pneumothorax with one-lung ventilation avoiding prophylactic chest tube: a case report. 隐蔽性外伤性气胸单肺通气避免预防性胸管麻醉处理1例。

IF 1

JA Clinical Reports Pub Date : 2025-08-29 DOI: 10.1186/s40981-025-00812-w

Kazuyasu Aoki, Taku Mayahara, Tomohiro Katayama, Yuya Hirai, Masao Uchihashi, Ryosuke Fukuoka

{"title":"Anesthetic management of occult traumatic pneumothorax with one-lung ventilation avoiding prophylactic chest tube: a case report.","authors":"Kazuyasu Aoki, Taku Mayahara, Tomohiro Katayama, Yuya Hirai, Masao Uchihashi, Ryosuke Fukuoka","doi":"10.1186/s40981-025-00812-w","DOIUrl":"10.1186/s40981-025-00812-w","url":null,"abstract":"Background: Guidelines recommend prophylactic chest tube placement in patients with traumatic pneumothorax who require positive pressure ventilation to prevent tension pneumothorax. However, chest tube insertion is not without complications, and avoiding it when safely possible is desirable.Case presentation: A man in his 50 s with a left clavicle fracture and mild left-sided occult pneumothorax on computed tomography was scheduled for surgery under general anesthesia. Conservative management was chosen given the absence of respiratory symptoms and stable imaging. To minimize the risk of pneumothorax progression during positive pressure ventilation, one-lung ventilation was employed to avoid ventilating the affected lung. Surgery proceeded uneventfully, with transient hypoxemia that was managed by increasing FiO2 to 100%. Postoperative imaging confirmed re-expansion of the left lung and no pneumothorax progression. The patient was discharged in good condition.Conclusions: General anesthesia was safely managed without prophylactic chest tube placement by employing one-lung ventilation in a patient with occult traumatic pneumothorax.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"47"},"PeriodicalIF":1.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954626","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}

引用次数: 0