Acta Medica Lituanica最新文献

{"title":"IgG4-related Disease Manifesting as Autoimmune Pancreatitis, Sialadenitis, and Cholangitis: Case Report.","authors":"Augustina Tumelytė, Vytautas Rimkus, Paulina Tekoriutė, Limas Kupčinskas","doi":"10.15388/Amed.2025.32.2.11","DOIUrl":"10.15388/Amed.2025.32.2.11","url":null,"abstract":"<p><p>IgG4-related disease (IgG4-RD) is a rare autoimmune disease which can affect almost any organ. We present a case of IgG4-RD, which manifested as chronic autoimmune pancreatitis with pancreatic insufficiency, severe malnutrition, autoimmune sialadenitis, and cholangitis. After the administration of prednisolone and mycophenolate mofetil, the patient's condition improved significantly.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"398-403"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143812","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":"Heavy Chain Disease with Cystic Lung Disease Presenting as Recurrent Spontaneous Pneumothorax in a Young Adult.","authors":"Konstantinos Dodos, Tsampika Vasileia Kalamara, Vasiliki Epameinondas Georgakopoulou","doi":"10.15388/Amed.2025.32.2.15","DOIUrl":"10.15388/Amed.2025.32.2.15","url":null,"abstract":"<p><p>Heavy chain diseases (HCDs) are rare B-cell/plasma cell disorders characterized by secretion of truncated immunoglobulin heavy chains without light chains. Pulmonary involvement has been described but is typically limited to interstitial or infiltrative patterns; whereas, cystic lung disease is exceptionally rare. We report a 23-year-old previously healthy male who presented with recurrent spontaneous pneumothoraces over a two-year period. High-resolution computed tomography revealed numerous bilateral thin-walled cysts with upper-lobe predominance, with several of these abutting the pleural surface. Laboratory evaluation demonstrated a discrete monoclonal spike on serum protein electrophoresis, and immunofixation confirmed an isolated IgG heavy chain without light chains, consistent with γ-heavy chain disease (γ-HCD). Bone marrow biopsy showed a mild increase in plasma cells (5-10%) without overt malignancy, and alternative causes of cystic lung disease, including Birt-Hogg-Dubé syndrome, autoimmune disease, α1-antitrypsin deficiency, and HIV, were excluded. This case highlights γ-HCD as a rare cause of diffuse cystic lung disease with recurrent pneumothorax, expanding the pulmonary spectrum of heavy-chain dyscrasias. The radiographic overlap with light-chain deposition disease emphasizes the need to include monoclonal gammopathies in the differential diagnosis of unexplained cystic lung disease. Recognition of γ-HCD in this context is clinically important, as it may precede lymphoproliferative malignancy and mandates careful longitudinal surveillance.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"424-430"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143828","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":"Antidepressant Prescription to Children/Adolescents and Its Effects on the Cardiovascular System, Comprising the Actual Questions of Periodicity of the Checkups, Cooperation among Pediatricians, Family Doctors, Cardiologists and Children-Adolescent Psychiatrists.","authors":"Reda Montvilaitė","doi":"10.15388/Amed.2025.32.1.15","DOIUrl":"10.15388/Amed.2025.32.1.15","url":null,"abstract":"<p><strong>Background: </strong>Pharmacological treatment is one of the most effective ways to help psychiatric patients with depressive disorders. However, prescription of antidepressants to children and adolescents creates controversial thoughts due to possible negative effects on the cardiovascular system. Despite being beneficial in controlling serious illnesses, there is less research done on the side effects of antidepressants which would require periodical checkups and cooperation among medical specialists. This literature review was completed to evaluate effects of antidepressants on the cardiovascular system and the necessity of regular assessment while treating children and adolescents.</p><p><strong>Aim: </strong>To review the cardiovascular effects of antidepressants prescribed to children and adolescents; to discuss the need for regular patient checkups with a multidisciplinary team: pediatricians, family doctors, cardiologists and children-adolescent psychiatrists.</p><p><strong>Methodology: </strong>Literature sources were selected from the <i>Pubmed, Google Scholar, Clinical Key</i>, and <i>Research Gate</i> databases by following dates from 2013 to 2024 while using the following keywords and their combinations: antidepressant, cardiovascular, side effects, cardiovascular risk, children and adolescents, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), psychotropic medication, antidepressants in pediatrics, atypical antidepressants, benzodiazepines, lipid metabolism.</p><p><strong>Results: </strong>Antidepressants, including SSRIs, SNRIs, TCAs, atypical antidepressants and benzodiazepines, are associated with significant cardiovascular risks in children and adolescents. SSRIs, like citalopram and escitalopram, can disturb the heart rhythm by prolonging the QT interval, or increasing the risk of serious arrhythmias. SNRIs have been linked to an elevated blood pressure and heart rate. TCAs are known for their proarrhythmic effects, particularly in overdose situations, posing a high risk of sudden cardiac events. Atypical antidepressants like bupropion can cause cardiovascular disturbances, especially when overdosed. Additionally, less commonly prescribed benzodiazepines contribute to cardiovascular risks when combined with SSRIs during pregnancy, due to increasing the likelihood of congenital heart defects. These risks underscore the importance of careful monitoring, dosage management and thorough cardiovascular assessment when prescribing these medications to children, adolescents, and pregnant women. A team consisting of professional specialists - children-adolescent psychiatrists, cardiologists, pediatricians and family doctors - should detect long-term effects of pharmacotherapy by checking up the young patients regularly.</p><p><strong>Conclusions: </strong>The use of antidepressants in children and adolescents, though crucial for managing se","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"52-63"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609804","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":"Mechanical Mitral Valve Prosthesis Thrombosis: A Case Report.","authors":"Viktorija Pareikaitė, Silvija Makrickaitė, Giedrė Bakšytė","doi":"10.15388/Amed.2025.32.1.13","DOIUrl":"10.15388/Amed.2025.32.1.13","url":null,"abstract":"<p><strong>Background: </strong>A rare but serious complication of heart valve replacement, prosthetic valve thrombosis carries significant risks of morbidity and mortality. Effective management depends on prompt diagnosis and the appropriate treatment, often involving fibrinolytic agents. Protocols using slower infusion rates and lower doses of these agents have led to improved therapy outcomes.</p><p><strong>Clinical case: </strong>We report a case of a 56-year-old man admitted to the Lithuanian University of Health Sciences Kaunas Clinics due to mechanical mitral valve prosthesis thrombosis complicated by a respiratory failure and atrial fibrillation. The patient was treated with ultraslow thrombolysis with alteplase. The function of the mechanical valve prosthesis became normal, and the patient was discharged from the hospital.</p><p><strong>Discussion and conclusions: </strong>Managing prosthetic valve thrombosis is challenging due to overlapping clinical features with other diagnoses and the lack of consensus on the treatment methods. Slow-infusion, low-dose thrombolytic therapy with alteplase can be a life-saving intervention with a high success rate.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"132-137"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609829","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":"Role of Proton Beam Therapy in Hepatic Oligometastasis: Review of Evidence.","authors":"Satyajeet Rath","doi":"10.15388/Amed.2025.32.1.25","DOIUrl":"10.15388/Amed.2025.32.1.25","url":null,"abstract":"<p><p>Hepatic oligometastasis (hOMC) incidence varies from 10-40% in the literature. While the old standard for local treatment was surgical resection, options like TACE, TARE, SBRT with photons and off late protons have come to the fore. The proton beam therapy (PBT) use has gradually started to get adopted in all regions worldwide with increasingly better availability and ever-reducing costs. The role of PBT in hOMC has been studied in many retrospective cohort studies. Although there is a plethora of evidence on photon-SBRT, there are very few analyses on the role of PBT in hOMC. The author intends to analyse the efficacy in terms of the local control (LC) and the overall survival (OS) for PBT and its toxicity profile in this systematic review. LC remains persistently high (76-89% at 1-2 years) across breast, colo-rectum, stomach, and esophagus. Sites like colo-rectum and breast show relatively better survival outcomes, with progression free survival (35-52% at 1-2 years) and OS (33-78% at 1-2 years) than other sites, likely due to disease biology. Breast primary derived hOMCs had the best 3-year OS of 67.6%. Toxicities remain remarkably low with grade 3 plus toxicities ranging from 0-3%, which reflects the ability of proton therapy to deliver beams with precision.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"36-51"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609835","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":"An Anomalous Right Coronary Artery Originating from the Left Anterior Descending Artery, a Case Report of Successful Percutaneous Coronary Intervention.","authors":"Ebrahim Nematipour, Arash Shekari, Shapour Shirani, Seyyed Mojtaba Ghorashi","doi":"10.15388/Amed.2025.32.2.7","DOIUrl":"10.15388/Amed.2025.32.2.7","url":null,"abstract":"<p><strong>Background: </strong>An anomalous right coronary artery (RCA) originating from the left anterior descending artery (LAD) is a rare subtype of single coronary artery ostium. Revascularization in such cases is challenging due to the large feeding territory or the potential for compression by an adjacent vessel.</p><p><strong>Case description: </strong>We report the case of a 57-year-old woman who presented to our hospital with exertional chest pain and dyspnea. An anomalous RCA was identified, originating from the mid-portion of the LAD. Coronary angiography and coronary multi-detector computed tomography revealed a significant stenosis at the LAD just proximal to the RCA bifurcation. A successful percutaneous coronary intervention was performed to revascularize the LAD stenosis. The patient was discharged in good general condition two days later.</p><p><strong>Conclusions: </strong>Despite the rarity of coronary anomalies, future studies could be undertaken to assess the potential benefits of screening, particularly in specific populations such as professional athletes.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"377-383"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143716","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 Fifth Metatarsal Fracture or a Rare Anatomical Variant?: A Report of Two Cases of Symptomatic Os Vesalianum Pedis and a Review of the Literature.","authors":"Kristina Petrova, Svetlomir Rangelov, Lyubomir Gaydarski, Boycho Landzhov, Georgi P Georgiev","doi":"10.15388/Amed.2025.32.2.17","DOIUrl":"10.15388/Amed.2025.32.2.17","url":null,"abstract":"<p><strong>Background: </strong>Accessory bones of the foot are common anatomical variants, with <i>Os Vesalianum Pedis</i> (OVP) representing a rare example located near the base of the fifth metatarsal within the peroneus brevis tendon. Although typically asymptomatic, OVP can become painful following trauma and may be misdiagnosed as a fracture, leading to inappropriate management.</p><p><strong>Case presentation: </strong>We present two cases of symptomatic OVP in patients who reported lateral foot pain after acute ankle inversion injuries. Following radiological evaluation at a regional polyclinic, both patients were initially diagnosed with fractures of the fifth metatarsal base and referred to a traumatologist. However, further physical examination and detailed review of previous radiographs, revealing well-corticated, smoothly contoured ossicles, led to the correct diagnosis of OVP. Both patients were treated conservatively with rest, ice, elevation, physiotherapy, and NSAIDs, achieving complete functional recovery within three weeks.</p><p><strong>Conclusions: </strong>These cases highlight the importance of recognizing OVP as a potential cause of lateral foot pain after trauma. Accurate diagnosis based on imaging characteristics can prevent mismanagement. Conservative treatment remains highly effective, and awareness of OVP is essential for appropriate clinical decision-making.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"438-445"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143742","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":"Rare Run-Over Clinical Case. Evisceration of the Intestines through the Wrist.","authors":"Jekaterina Strelčenko, Diana Vasiljevaitė, Sigitas Chmieliauskas, Sigitas Laima, Jurgita Stasiūnienė, Paulius Petreikis","doi":"10.15388/Amed.2025.32.2.9","DOIUrl":"10.15388/Amed.2025.32.2.9","url":null,"abstract":"<p><strong>Background: </strong>Deaths resulting from car-pedestrian collisions are frequently encountered in forensic practice. Such accidents often cause extensive, multi-system injuries, many of which are concealed beneath minimally damaged soft tissues and may not be immediately visible externally. Common external injuries include extensive skin abrasions, subcutaneous hematomas, and lacerations. Internally, these incidents typically result in multiple bone fractures and severe organ ruptures. A less frequent but noteworthy injury is the evisceration of abdominal organs through ruptures in the diaphragm, rectum, or abdominal wall. This report presents a unique case of small intestine evisceration through damaged skin on the wrist.</p><p><strong>Materials and methods: </strong>The literature search was conducted in the <i>PubMed</i> and <i>Google Scholar</i> databases using keywords. The analysis focused on scientific literature that was published in last 10 years but also referred to older scientific papers with strong arguments. To the best of our knowledge, there are no reported cases of evisceration of abdominal contents through the damaged skin of the lower arm (wrist). A clinical case examination from the Lithuanian State Forensic Medicine Service data was performed.</p><p><strong>Case presentation: </strong>A 70-year-old woman was injured in the run-over accident by a truck. The victim died at the scene. External examination revealed multiple injuries, including significant soft tissue deformities in the left arm. During the internal examination of the corpse, multiple fractures with ruptures of internal organs were found. Only isolated fragments of intestinal loops were present in the abdominal cavity. Evisceration of the small intestines through the left upper arm and forearm was found.</p><p><strong>Conclusions: </strong>Run-over accidents involving heavy vehicles are a common cause of fatal injuries. These incidents often result in extensive lacerations, multiple comminated fractures, and severe damage to internal organs. In rare cases, evisceration of internal organs can occur through various anatomical sites. This case demonstrates that evisceration can occur not only through common locations such as the diaphragm, abdominal wall, rectum, or vagina but also through atypical sites, such as the skin of the wrist. In such cases, it is particularly important for a forensic pathologist to assess the damage of clothing and to evaluate the macromorphological appearance of the injuries to determine the mechanism of injury.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"384-392"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143939","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":"Giant Descending Thoracic Aortic Aneurysm: A Case Report.","authors":"Rassul Zhumagaliyev, Yerlan Orazymbetov, Serik Aitaliyev, Sidar Arslan, Tadas Lenkutis, Adakrius Siudikas, Rimantas Benetis","doi":"10.15388/Amed.2025.32.2.14","DOIUrl":"10.15388/Amed.2025.32.2.14","url":null,"abstract":"<p><strong>Background: </strong>Giant descending thoracic aortic aneurysm (GDTAA) is a rare vascular disease characterized by an aortic diameter exceeding 10 cm. GDTAA carries a significant risk of rupture and mortality and requires timely diagnosis and intervention. Despite the clinical severity of the disease, the literature on GDTAA remains sparse, particularly in cases with extreme aneurysmal dilatation.</p><p><strong>Case presentation: </strong>We present the case of a 68-year-old man with a GDTAA of 14.08 × 10.04 cm, one of the largest ever reported. The patient initially presented with recurrent syncope, chronic cough and fatigue. Imaging studies, including <i>Computed Tomography</i> (CT) angiography, revealed a massive aneurysmal dilatation in the distal post-arch segment of the descending aorta with compression of the trachea and bronchi. The patient underwent a successful open surgical repair with a Dacron graft and simultaneous <i>Coronary Artery Bypass Grafting</i> (CABG). Postoperative complications included respiratory acidosis, emphysema and transient haemodynamic instability, which were effectively treated. The patient was discharged in a stable condition on the tenth postoperative day.</p><p><strong>Conclusion: </strong>This case highlights the importance of early recognition and surgical intervention in GDTAA in order to prevent catastrophic consequences. Comprehensive preoperative evaluation, careful surgical planning and attentive postoperative care are essential for optimal recovery. Our results emphasise the importance of modern imaging techniques for accurate anatomical assessment and risk stratification in patients with extreme aneurysm growth. Further research is needed to establish standardised protocols for the treatment of GDTAA.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"413-423"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143811","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":"Pathomorphological Patterns of Placental Dysfunction in Late Manifestation of Fetal Growth Restriction.","authors":"Oksana Zhurakivska, Yuliia Yarotska, Dmytro Govsieiev, Oksana Ostrovska, Mariana Rymarchuk","doi":"10.15388/Amed.2025.32.2.21","DOIUrl":"10.15388/Amed.2025.32.2.21","url":null,"abstract":"<p><p>Fetal growth restriction is one of the main factors contributing to neonatal mortality, stillbirth, and cardiovascular dysfunction in a fetus and newborn, where one of the common causes is placental dysfunction; it can occur as a result of placental vascular anomalies, which requires clarification and systematization of existing scientific provisions based on the assessment of morphological patterns of fetoplacental circulatory disorders. The aim of the study was to investigate and evaluate morphological markers of fetoplacental blood flow disorders in late manifestation of fetal growth restriction by pathohistological examination of placental tissue.</p><p><strong>Materials and methods: </strong>Clinical and anamnestic features were assessed in 80 pregnant women with late manifestation of fetal growth restriction (the main group of research) and in 40 patients with a timely labour and birth of fetuses with normal fetometry parameters for the gestational age. 32 and 10 placental tissue samples were selected in the main group and in the comparison group, respectively, for pathohistological examination, and a postnatal macro-histomorphological assessment of the placenta was performed.</p><p><strong>Results: </strong>Postnatal macromorphometric characteristics of placental tissue reflect pathological features of its formation, dominated by an abnormal shape (46-57.5%), eccentric umbilical cord insertion (43-53.8%) with main and intermediate types of vascular branching (37-46.2%), and a statistically lower placental weight and diameter. A combination of maternal and fetal vascular malperfusion was noted, with the following most significant markers: infarctions (13-40.6%), distal villous hypoplasia (24-75.0%), increased syncytial nodules as a manifestation of delayed villous maturation as a manifestation of premature maturation (24-75.0%), decidual arteriopathy (13-40.6%). Analysis of histopathological data indicates malperfusion of the fetal vessels, with the proportion of villitis and markers of intrauterine infection verified in one third of the samples (13-40.6%).</p><p><strong>Conclusions: </strong>In cases of late-onset fetal growth restriction, placental lesions occur with the development of maternal and fetal vascular malperfusion. Pathomorphological criteria of maternal vascular malperfusion are statistically significant in the main group: infarctions, distal villous hypoplasia, decidual arteriopathy, and chorionic villous dysmaturation. Fetal vascular malperfusion is characterized by obliteration and thrombosis of the stem vessels of the anchoring and intermediate villi, avascularization, hyalinosis of the villi, and, less frequently, delayed maturation with the development of stromal-vascular karyorexis. In our study, both Type 1 and Type 2 fetal vascular malperfusion in different placentas with fetal growth restriction were found, but the segmental type was still the most common.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"301-312"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143902","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}