Journal of Medical Case Reports最新文献

{"title":"Rimegepant in airplane headache treatment: a case report.","authors":"Massimo Autunno, Marcella De Luca, Ludovica Ferraù, Carmelo Rodolico","doi":"10.1186/s13256-025-05304-0","DOIUrl":"10.1186/s13256-025-05304-0","url":null,"abstract":"<p><strong>Background: </strong>Airplane headache is a rare condition first identified in 2004 and subsequently included in the International Classification of Headache Disorders (Headache Classification Committee of the International Headache Society in Cephalalgia 33:629-808, 2013. https://doi.org/10.1177/0333102413485658 ). Airplane headache typically presents as intense, stabbing, unilateral pain in the frontal or orbital regions, with a severity of 8-10 on the numeric rating scale. Despite its relatively low prevalence and generally nondisabling nature, the intense pain associated with airplane headache often leads to significant anxiety and fear of flying, underscoring the need for effective treatment strategies. Currently, there are no established guidelines for the treatment of airplane headache. Various anecdotal treatments have been reported, including nasal decongestants, nonsteroidal antiinflammatory drugs, and triptans.</p><p><strong>Case presentation: </strong>We describe the case of a 28-years old Caucasian female patient with recurrent airplane headache successfully treated with rimegepant, a calcitonin gene-related peptide receptor antagonist, taken half an hour before plane departure. A 10-month follow-up confirmed the treatment efficacy.</p><p><strong>Conclusion: </strong>This novel use of rimegepant, typically employed in migraine management, demonstrates a promising therapeutic option for airplane headache.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"243"},"PeriodicalIF":0.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119842","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":"A response of rituximab plus lenalidomide therapy in patients with post-transplant lymphoproliferative disease and methotrexate-related lymphoproliferative disorder in the central nervous system: a case report.","authors":"Hanguo Guo, Hong Zhang, Wenyu Li","doi":"10.1186/s13256-025-05307-x","DOIUrl":"10.1186/s13256-025-05307-x","url":null,"abstract":"<p><strong>Background: </strong>Post-transplant lymphoproliferative disorder and methotrexate-related lymphoproliferative disorder are rare complications normally with unfavorable prognosis. Post-transplant lymphoproliferative disorder of the central nervous system is a rare disorder and predominantly presents as diffuse large B-cell lymphomas of non-germinal center cell origin. However, the treatment for these patients with this diagnosis has not reached a consensus. CASE 1 AND 2 PRESENTATIONS: In this case report, one patient with post-transplant lymphoproliferative disorder and another patient with methotrexate-related lymphoproliferative disorder were both diagnosed with Epstein-Barr virus-diffuse large B-cell lymphomas of primary central nervous system. The former case was a 37-year-old Han Chinese female diagnosed with post-transplant lymphoproliferative disorder of the central nervous system after a kidney transplant, and the latter case was a 61-year-old Han Chinese male diagnosed with methotrexate-related lymphoproliferative disorder after receiving methotrexate treatment for psoriasis. The initial treatment for both of them was rituximab plus lenalidomide followed by lenalidomide as maintenance for disease progression or intolerance. After the treatment, magnetic resonance imaging showed partial response or complete remission of their brain lesions. In addition, the renal function of the patient with post-transplant lymphoproliferative disorder of the central nervous system was normal, and psoriasis did not recur in the patient with methotrexate-related lymphoproliferative disorder during lenalidomide maintenance treatment.</p><p><strong>Conclusion: </strong>The treatment has proved to be a promising therapeutic method for post-transplant lymphoproliferative disorder of the central nervous system and methotrexate-related lymphoproliferative disorder, when the decreasing or withdrawal of immunosuppressive therapy could not achieve a satisfying outcome. Owing to the relatively small sample size, the effect of this treatment should be further investigated under a larger sample size.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"244"},"PeriodicalIF":0.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119708","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":"Osteomyelitis of the great trochanter after removal of a femoral nail: a case report.","authors":"A Cosentino, G Odorizzi, W Berger","doi":"10.1186/s13256-025-05291-2","DOIUrl":"10.1186/s13256-025-05291-2","url":null,"abstract":"<p><strong>Background: </strong>Osteomyelitis following orthopedic hardware removal is a rare but serious complication, particularly in pediatric patients. This case report describes a unique instance of osteomyelitis of the great trochanter following the removal of a femoral nail in a 14-year-old girl, highlighting diagnostic challenges and management strategies.</p><p><strong>Case presentation: </strong>A 14-year-old Mediterranean white girl presented with persistent pain and swelling at the site of a previously removed femoral nail, used to treat a prior femoral shaft fracture. Symptoms developed 2 weeks post-removal, accompanied by erythema and increased warmth over the great trochanter. Laboratory findings showed elevated inflammatory markers. Imaging studies, including magnetic resonance imaging, confirmed osteomyelitis of the great trochanter. The patient underwent surgical debridement, followed by targeted intravenous antibiotic therapy based on culture sensitivities. The patient responded well to surgical debridement and a 3-week course of intravenous antibiotics, with subsequent transition to oral antibiotics. Follow-up at 1 year showed resolution of symptoms, normalization of inflammatory markers, and no signs of infection recurrence on imaging. The patient was free of pain, demonstrated complete range of motion, and the wound showed no signs of infection, as confirmed by clinical examination and accompanying photographs.</p><p><strong>Conclusion: </strong>This case underscores the importance of prompt diagnosis and comprehensive management of osteomyelitis following hardware removal in pediatric patients. Early intervention with appropriate surgical and antibiotic treatment can lead to excellent outcomes in managing this rare complication.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"241"},"PeriodicalIF":0.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110972","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":"Bounce effect or local recurrence after low-dose-rate brachytherapy of the prostate? When prostate-specific membrane antigen positron emission tomography-computed tomography is false positive: a case report.","authors":"Tamas Rozsos, Daniel S Engeler, Hans-Peter Schmid, Christoph Schwab","doi":"10.1186/s13256-025-05268-1","DOIUrl":"10.1186/s13256-025-05268-1","url":null,"abstract":"<p><strong>Introduction: </strong>Low-dose-rate brachytherapy has been increasingly utilized as a minimally invasive treatment option in patients with low- and intermediate-risk prostate cancer. Following 1-2 years of treatment, a \"bounce phenomenon\" might occur in approximately 30% of patients undergoing low-dose-rate brachytherapy, characterized by a transient rise in prostate-specific antigen levels followed by a subsequent decrease. This phenomenon has been identified as a favorable prognostic factor. To date, only a few cases of a potential false-positive prostate-specific membrane antigen positron emission tomography-computed tomography related to the bounce phenomenon have been reported in literature. By presenting our clinical case, we aim to suggest refinements in the follow-up strategies and to assess the diagnostic value of prostate-specific membrane antigen positron emission tomography-computed tomography in managing cases with the bounce phenomenon.</p><p><strong>Case presentation: </strong>A 66-year-old Caucasian (western European) male patient achieved a prostate-specific antigen nadir of 1.37 µg/l at 9 months after undergoing brachytherapy. At 21 months post-procedure, his prostate-specific antigen rose to 4.16 µg/l-following a period of stable and low prostate-specific antigen levels-prompting his general practitioner to refer him for prostate-specific membrane antigen positron emission tomography-computed tomography (298 MBq F-18-PSMA). Imaging revealed a prostate-specific membrane antigen-avid lesion within the prostate, suggesting a local recurrence, resulting in the offer of salvage therapy for the patient. However, a routine prostate-specific antigen screening before initiating salvage radiotherapy revealed a decrease to 3.75 µg/l with an additional reduction to 2.68 µg/l at 2 months later. The pattern of transient prostate-specific antigen elevation strongly suggested a bounce phenomenon rather than a recurrence, allowing any unnecessary treatment to be avoided. To date, prostate-specific antigen levels have been decreasing to as low as 0.48 µg/l, showing a satisfactory progress.</p><p><strong>Conclusion: </strong>Our case illustrates a sporadically recognized false-positive prostate-specific membrane antigen positron emission tomography-computed tomography finding associated with a bounce phenomenon following low-dose-rate brachytherapy for prostate cancer. A single prostate-specific antigen test effectively ruled out the suspicion of local recurrence. While prostate-specific membrane antigen positron emission tomography-computed tomography is undoubtedly a valuable tool for detecting metastasis postoperatively, careful interpretation of local findings is essential owing to the potential for false positives. This consideration is vital when evaluating a patient with a rising prostate-specific antigen level after brachytherapy, to avoid premature initiation of salvage therapy.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"242"},"PeriodicalIF":0.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110967","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":"Small bowel obstruction from urachal cyst abscess: a diagnostic challenge easily confused with invasive urachal cancer-A case report.","authors":"Tung Minh Ly, Hau Minh Hong Bui, Phuoc Thanh Bui, Nguyen Ly","doi":"10.1186/s13256-025-05265-4","DOIUrl":"10.1186/s13256-025-05265-4","url":null,"abstract":"<p><strong>Overview: </strong>Urachal cysts, though rare, can become infected or undergo malignant transformation. A rare case of small bowel obstruction caused by an infected urachal cyst is presented, which can be misdiagnosed as invasive urachal cancer.</p><p><strong>Case presentation: </strong>A 31-year-old Vietnamese female presented with a 1-week history of abdominal pain and 3 days of obstipation, with no significant medical or surgical history. Her clinical examination indicated sepsis and small bowel obstruction. Imaging revealed a cystic urachal mass invading the abdominal wall and small intestine, causing obstruction. Emergency surgery confirmed bowel obstruction and perforation due to the mass. Postoperative histopathology revealed an abscessed urachal cyst with no malignancy.</p><p><strong>Conclusion: </strong>Complicated urachal cyst infections are challenging to diagnose and can be mistaken for malignancy. This is a rare cause of bowel obstruction in a patient without prior surgery or other preexisting conditions.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"240"},"PeriodicalIF":0.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110975","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":"Treatment for paraplegia due to severe kyphoscoliosis associated with neurofibromatosis type 1 via halo-pelvic traction: a case report.","authors":"Yuanxian Leng, Fuyi Yin, Yanling Yi, Deng Zhao, Yijian Liang","doi":"10.1186/s13256-025-05293-0","DOIUrl":"10.1186/s13256-025-05293-0","url":null,"abstract":"<p><strong>Background: </strong>A sharply angular thoracic deformity, commonly seen in dystrophic scoliosis associated with neurofibromatosis type 1, can compress the spinal cord and potentially cause neurological impairment. However, managing paraplegia due to severe kyphoscoliosis associated with neurofibromatosis type 1, coupled with low body mass index and extremely severe kyphoscoliosis, presents a significant challenge.</p><p><strong>Case presentation: </strong>A 13-year-old girl of Mongolian ethnicity with severe dystrophic kyphoscoliosis associated with neurofibromatosis type 1 presented with paraplegia and dyspnea. Preoperative radiograph imaging revealed the presence of a thoracic kyphosis and scoliosis, with a Cobb angle of 150° and 130°, respectively. A two-stage strategy was devised, comprising halo-pelvic traction and spinal fusion with pedicle screws. The neurological deficit showed gradual improvement and ultimately complete recovery during the distraction phase. The curve decreased to an acceptable level, and posterior pedicle screws were implanted and fused without osteotomy. Postoperatively, the hunchback was no longer visible. There were no complications associated with halo-pelvic traction. At the 3-year follow-up, the correction angle and trunk balance were well maintained.</p><p><strong>Conclusion: </strong>It is possible that neurological deficit resulting from severe scoliosis may be reversed following the correction of the spinal curvature. The application of halo-pelvic traction generates substantial corrective forces, facilitating the correction of severe spinal deformities in a gradual and secure manner. A two-stage treatment strategy for patients with severe kyphoscoliosis in neurofibromatosis type 1 may offer an alternative approach to correcting the severe curve while avoiding the potential complications associated with a rapid, one-stage correction.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"235"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101985","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":"Early intervention with transitional implants for congenitally missing lateral incisors in a pediatric patient: a case report.","authors":"Ishani Rahate, Punit Fulzele, Bhushan Mundada, Dhruvi Solanki, Nilima Thosar, Madhavi Selukar, Aakriti Chandra","doi":"10.1186/s13256-025-05283-2","DOIUrl":"10.1186/s13256-025-05283-2","url":null,"abstract":"<p><strong>Background: </strong>The anterior maxillary region can be affected by traumatic or congenital loss of a tooth so that a replacement is usually essential [1]. A new innovation is the dental implantation of teeth without requiring adjustments for growth in the jaws and teeth of young patients. It is uncommon to improve the bone area surrounding the dental implant in the presence of these changes. Dental implantology is among the most innovative and fastest-growing therapeutic modes in the field of clinical dentistry. These implants are usually narrow, ranging from 1.8 to 2.5 mm in diameter, making them suitable for placement in confined spaces without affecting adjacent structures. Their insertion involves a straightforward, minimally invasive surgical procedure, often eliminating the need for significant bone modification. Composed primarily of titanium or titanium alloys, they offer excellent biocompatibility and integrate well with bone while reducing the risk of adverse biological reactions [2]. These implants have experienced significant developments over the years, through which they became a major success in the treatment of missing teeth. In this way, dentistry has transformed the way professionals work on rediscovering function, beauty, and confidence for those patients who lost their teeth through decay or severe damage. Because of progress in implant materials, techniques, and technology, dental implants have become a staple of modern restorative medicine, offering reliable outcomes and enhanced quality of life to patients of all age groups.</p><p><strong>Case presentation: </strong>A 12-year-old Indian girl came with esthetic concerns and visited the pediatric dentistry department. Orthodontic therapy was performed for the correction of malocclusion, and the missing maxillary lateral incisors were restored with MS transitional implants. The transitional implant achieved outstanding esthetic results and ensured high patient compliance.</p><p><strong>Conclusion: </strong>Transitional implants in pediatric patients offer an effective solution for managing congenitally missing laterals and preserving esthetics and function. They provide an opportunity for bone and dental development while awaiting full growth, and long-term follow-up is essential to ensure successful outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"238"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101983","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":"A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case report.","authors":"Meghdad Ghasemi Gorji, Alireza Keshtkar, Ali Rafiei, Parsa Yazdanpanahi, Alireza Karimi","doi":"10.1186/s13256-025-05276-1","DOIUrl":"10.1186/s13256-025-05276-1","url":null,"abstract":"<p><strong>Background: </strong>The incidence of acute aortic dissections is 3-6 patients per 100,000 in a year, with a high mortality rate of 40% at the initial diagnosis and increasing to 90% in an hour. There are several known risk factors for acute aortic dissection; however, the most common risk factor is systemic hypertension. Different conditions have been reported to be associated with resistant hypertension, including hyperaldosteronism.</p><p><strong>Case presentation: </strong>A 57-year-old Persian man came to our clinic with occasional claudication after 30 m distance walking, left leg pain, and symptoms of chronic limb ischemia, including a cold left leg with a shiny appearance. He had a past medical history of recently diagnosed resistant hypertension and a past surgical history of a femoropopliteal bypass and a balloon angioplasty. His computed tomography angiography of the abdominopelvic cavity and lower limbs revealed a dissection of the infrarenal aorta at the bifurcation of common iliac arteries, occlusion of the left external iliac artery, and dissection of the left common iliac artery. In addition, a mass measuring 6 cm × 5 cm × 2 cm was identified in the patient's left adrenal gland. The ostium of the false lumen was in the distal part of dissection so we decided to use an antegrade approach to repair the dissection. He underwent simultaneous surgeries for aneurysmal repair and adrenalectomy.</p><p><strong>Conclusion: </strong>A vast systematic search of literature in Scopus, Web of Science, PubMed, and Google Scholar was carried out to identify cases of hyperaldosteronism relating to vascular dissection that were either treated with surgery or medication. Our results support the theory suggesting that hyperaldosteronism can be considered a risk factor for vascular dissection despite its effects on hypertension.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"237"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101979","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":"Abdominal wall endometriosis in a cesarean scar: a case report.","authors":"Marwa Aljbawi, Lana Redan, Ahmad Al-Bitar, Ebtihal Saghier","doi":"10.1186/s13256-025-05301-3","DOIUrl":"10.1186/s13256-025-05301-3","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis affects 6-15% of reproductive-aged women, with abdominal wall endometriosis occurring in 1-12% of extrapelvic cases. Cesarean scar endometriosis, the most common abdominal wall endometriosis subtype, arises in 0.03-3.5% of post-cesarean patients, often presenting as cyclical pain or a palpable mass near surgical scars. Diagnostic challenges stem from nonspecific symptoms and imaging overlap with granulomas, hernias, or tumors.</p><p><strong>Case presentation: </strong>A 25-year-old female Arab patient presented with a 1.6 cm tender subcutaneous nodule adjacent to her Pfannenstiel scar, worsening during menses. Ultrasound revealed a hypoechoic nodule, while magnetic resonance imaging showed a 15 × 12 mm subcutaneous lesion with low T1 and intermediate T2 signals. Despite imaging favoring granuloma, clinical suspicion for cesarean scar endometriosis prompted wide surgical excision. Histopathology confirmed endometrial glands, stroma, and hemosiderin-laden macrophages, confirming abdominal wall endometriosis. Postoperatively, cyclical pain resolved, with no recurrence at the 2-month follow-up.</p><p><strong>Conclusion: </strong>Cesarean scar endometriosis, though rare, requires high clinical suspicion in patients with prior cesarean sections and cyclical symptoms. Multimodal imaging aids differentiation, but histopathology remains definitive. Surgical excision with clear margins is curative, preventing complications such as malignant transformation. This case highlights the interplay of surgical history, hormonal factors, and anatomical predisposition in cesarean scar endometriosis pathogenesis. Clinicians must prioritize early recognition and intervention to optimize outcomes in this underdiagnosed condition.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"239"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101981","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":"Ureterovaginal fistula after hysterectomy with double-J stent misplacement into the inferior vena cava: a case report.","authors":"Nasibeh Hasani, Amir Afyouni, Ahmadreza Haddadi","doi":"10.1186/s13256-025-05277-0","DOIUrl":"10.1186/s13256-025-05277-0","url":null,"abstract":"<p><strong>Background: </strong>Double-J stent placement is a common and generally safe procedure in urology. However, rare complications such as stent misplacement into vascular structures can occur, posing significant risks. The case presented herein highlights an exceedingly rare complication of stent misplacement into the inferior vena cava during the management of a vesicovaginal fistula, emphasizing the importance of prompt recognition and multidisciplinary intervention.</p><p><strong>Case presentation: </strong>In February 2023, a 48-year-old Iranian woman with history of total abdominal hysterectomy presented with complaints of watery vaginal discharge 1 month postoperatively. She was diagnosed with a vesicovaginal fistula and underwent cystoscopy, ureteroscopy, and attempted placement of a double-J stent. Intraoperatively, the stent was found to be misplaced in the suprarenal segment of the inferior vena cava, near the right atrium, as confirmed by postoperative imaging. The patient subsequently underwent laparotomy for stent removal and ureteral reimplantation. A multidisciplinary surgical team, including vascular surgeons, participated in the procedure to mitigate potential complications. The stent was successfully removed via ureteroscopy without complications, and the ureter was reconnected to the bladder. The patient was followed up for 3 months after stent removal. She remained asymptomatic, with no recurrence of urinary leakage, ureteral obstruction, or thrombotic complications. Follow-up imaging confirmed proper ureteral healing and the absence of any further stent migration. At the final follow-up, the patient reported full recovery with no discomfort or residual symptoms. Written informed consent for publication of this case and accompanying images was obtained from both the patient and the hospital's ethics committee.</p><p><strong>Conclusion: </strong>This case demonstrates the need for vigilance during stent placement, particularly in patients with altered anatomy. It also underscores the value of timely imaging to identify complications and the importance of a multidisciplinary surgical approach in ensuring successful outcomes. The report contributes to the literature on managing rare urological complications and highlights the role of advanced endoscopic and surgical techniques.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"236"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101955","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}