American Journal of Case Reports最新文献

{"title":"Dual-Plate Fixation in Treatment of Clavicle Fractures in Dementia Patients: A Case Series.","authors":"Dae-Geun Kim, Eugene Jae Jin Park, Sung Choi","doi":"10.12659/AJCR.945489","DOIUrl":"10.12659/AJCR.945489","url":null,"abstract":"<p><p>BACKGROUND Clavicle fractures are a common injury, and the standard surgical treatment for displaced shaft fractures is plate fixation using a single superiorly-placed plate. However, the use of this technique in dementia patients poses challenges, including increased risk of postoperative complications such as fixation failure, mal-union, and non-union. CASE REPORT This is a case series of 2 patients who had clavicle shaft fracture with dementia. The first was a 90-year-old woman with right clavicle fracture and vascular dementia. She underwent superior locking compression plate fixation, but the plate was pulled out because of her uncooperativeness. Therefore, we performed dual-plate fixation. She did not immobilize her arm after the surgery, but the plate did not pull out and she was doing well without any problems in daily life. The second patient was a 78-year-old man with advanced dementia who had a displaced midshaft clavicle fracture after a fall. Due to his inability to cooperate and follow postoperative instructions, a decision was made to employ a dual plating technique with plates applied anteriorly and superiorly. At 6-month follow-up, he had satisfactory functional outcomes and radiographic evidence of fracture healing. CONCLUSIONS The use of dual-plate fixation in the treatment of clavicle fractures in dementia patients is a viable option that can lead to successful outcomes and no failure-related implants.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945489"},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606543","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":"Anterior Mitral Line Ablation-Induced Complete Heart Block: A Cautionary Case Study.","authors":"Gabriel Velez Oquendo, Nivedha Balaji, Joon Ahn","doi":"10.12659/AJCR.945818","DOIUrl":"10.12659/AJCR.945818","url":null,"abstract":"<p><p>BACKGROUND Atrial flutter is associated with significant morbidity and mortality. Standard treatment involves rate and rhythm control medications, with ablation procedures reserved for more persistent cases. While ablation is generally successful, it carries risks, such as complete heart block, as in this case. CASE REPORT A 73-year-old woman presented for ablation of recurrent atypical atrial flutter. Electro-anatomic mapping demonstrated counterclockwise mitral annular flutter. An anterior ablation line was initially created from the right superior pulmonary vein to the mitral valve annulus. As the line was extended to the anterior mitral valve annulus at the 9 o'clock position, complete heart block occurred, and ablation was immediately terminated. Complete recovery of atrioventricular (AV) conduction occurred within 1 min. The catheter tip was within 1.8 cm from the His bundle, as denoted by the yellow tag on the CARTO map. A second mitral line was created anteriorly at the 11 o'clock position on the mitral valve annulus and extended to the left atrial roof line, with the termination and creation of a bi-directional mitral isthmus block. She remained in sinus rhythm after ablation, with PR prolongation and no AV block. The following day, she developed severe bradycardia due to complete heart block, with a slow ventricular escape rhythm, requiring implantation of a permanent pacemaker. CONCLUSIONS This case underscores the importance of precise catheter positioning during anterior mitral line ablation to prevent complications, such as AV block. Anterior mitral line ablation should be performed in a more anterior location away from the septum to minimize the risk of AV block.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945818"},"PeriodicalIF":1.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591967","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":"Priapism Following Coronary Angiography: A Case Report and Clinical Insights for Diagnosis and Management.","authors":"Tuersunjiang Naman, Najina Wugeti, Juan Sun, Refukaiti Abuduhalike, Nida Aslam, Ailiman Mahemuti","doi":"10.12659/AJCR.943609","DOIUrl":"10.12659/AJCR.943609","url":null,"abstract":"<p><p>BACKGROUND Priapism is a persistent penile erection that lasts longer than 4 hours. The most common causes of priapism are ischemia and the effects of drugs, including PDE-5 inhibitors, such as sildenafil and anticoagulants. Here, we describe the presentation and management of a 50-year-old man with priapism following coronary artery angiography for the investigation of ischemic heart disease (IHD). CASE REPORT A 50-year-old man was admitted to the Department of Cardiovascular Disease with the chief concern of intermittent precordial pain and discomfort for 1 year. After performing regular medical tests in the hospital, we confirmed that there was a need to identify the cause of the chest pain. Thus, after obtaining informed consent, we performed coronary angiography and diagnosed the patient with coronary artery disease based on the results of coronary angiography. However, half an hour after coronary angiography, he developed priapism. By performing ultrasound of the penis, we found that there was a thrombus in the penile vein. By combining blood aspiration from the corpus cavernosum of the penis with injection of hydroxylamine into the corpus cavernosum, we achieved a good treatment effect. CONCLUSIONS Priapism is becoming more common in middle-aged men. It should be treated as a medical emergency according to current management guidelines, and the underlying cause should be identified to prevent recurrence.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e943609"},"PeriodicalIF":1.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584013","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":"Takotsubo Syndrome-Induced Cardiogenic Shock in Lung Transplantation: Importance of Early Diagnosis and ECMO Implantation.","authors":"Céline Boudart, Omar Assam, Ioannis Veliziotis, Maarten Vander Kuylen, Laurent Perrin","doi":"10.12659/AJCR.944942","DOIUrl":"10.12659/AJCR.944942","url":null,"abstract":"<p><p>BACKGROUND Takotsubo syndrome, or stress-induced cardiomyopathy, is a rare but serious condition that mimics myocardial infarction and can cause temporary cardiac dysfunction in the absence of coronary artery disease. General anesthesia can make diagnosis more challenging. Although it has already been described in a context of solid organ transplantation, takotsubo syndrome remains under-reported in lung transplantation, necessitating awareness to avoid diagnostic and management delays. CASE REPORT We report a case of takotsubo syndrome in a 54-year-old woman undergoing pulmonary transplantation for end-stage chronic obstructive pulmonary disease. Preoperative evaluations showed no cardiac pathology. During surgery, she developed severe left ventricular failure with ST-segment elevations and diffuse hypokinesia, leading to cardiogenic shock and multiorgan dysfunction. Delayed diagnosis of takotsubo syndrome and late initiation of veno-arterial extracorporeal membrane oxygenation worsened her condition. Postoperatively, she developed lung abscesses, broncho-cutaneous fistula, and hemorrhagic shock, resulting in a prolonged intensive care unit stay. Two years after the transplant, left ventricular dysfunction was persistent, significantly affecting her quality of life. CONCLUSIONS This case report highlights the importance of awareness of takotsubo syndrome associated with lung transplantation, particularly in at-risk patients. Indeed, early diagnosis and management of this cardiomyopathy are crucial for improving outcomes. Multimodal monitoring, including transesophageal echocardiography and continuous ST-segment monitoring, is essential for timely diagnosis. Although rare, this complex clinical condition should be considered in lung transplant recipients with sudden heart failure to ensure prompt and effective treatment. Further research is needed to understand this stress cardiomyopathy in this specific setting and to develop effective management strategies.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944942"},"PeriodicalIF":1.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576962","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":"Surgical Management of Acute Forearm Compartment Syndrome Due to Suspected Edematous Cutaneous Loxoscelism.","authors":"Ángel Sánchez Tinajero, Iván Santana Salgado, Danna Patricia Ruiz Santillan, Alexis Genaro Ortiz Altamirano, Erika Sierra Rodriguez, David Alejandro Resendiz Zavala","doi":"10.12659/AJCR.945401","DOIUrl":"10.12659/AJCR.945401","url":null,"abstract":"<p><p>BACKGROUND Compartment syndrome of the forearm has been associated with a variety of etiologies, including fractures, snake bites, complications of certain infections, and, very rarely, spider bites. Loxoscelism is the venom-related clinical manifestation of the bite of spiders of the genus Loxosceles, also called brown or fiddler (violinist) spiders. It manifests locally/regionally with pain, erythema, and edema, with subsequent necrotic plaque formation at the site of the bite. This condition can threaten the function and integrity of the limbs and, in severe cases, can be life-threatening. The basis of treatment is surgical decompression of the affected compartments to restore limb perfusion and avoid irreversible sequelae. CASE REPORT A 62-year-old male patient, without comorbidities, had edematous cutaneous loxoscelism and secondary development of acute compartment syndrome of the right forearm. He promptly visited the Emergency Department and underwent surgical treatment, in addition to the application of pharmacological treatment, under a multidisciplinary team. The evolution was favorable. The biochemical levels of rhabdomyolysis decreased, the compartment syndrome resolved, the fasciotomies were closed, and the patient was discharged without further complications. CONCLUSIONS Although arachnid bites are relatively uncommon in urban hospitals, it is crucial that general, vascular, and plastic surgeons maintain a high index of clinical suspicion for acute compartment syndrome. It is important to make an accurate differential diagnosis, and equally important is the interdisciplinary approach to treating this condition, ensuring prompt medical treatment and, if necessary, early surgical intervention.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945401"},"PeriodicalIF":1.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569786","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":"Finerenone as a Novel Treatment for Gitelman Syndrome: A Case Study of a 35-Year-Old Male with Adrenal Mass and Hypokalemia.","authors":"Rujie Jiang, Qiue Liu, Yanan Sun, Xiaoqing Dai, Feng Xu, Fang Wang","doi":"10.12659/AJCR.944492","DOIUrl":"10.12659/AJCR.944492","url":null,"abstract":"<p><p>BACKGROUND Gitelman syndrome (GS) is an autosomal recessive salt-losing tubulopathy characterized by renal potassium loss, hypokalemia, metabolic alkalosis, hypocalciuria, hypomagnesemia, and hyper-reninemic hyperaldosteronism. Finerenone is a non-steroidal mineralocorticoid receptor antagonist that inhibits receptor-mediated sodium reabsorption and decreases receptor overactivation. This report describes a 35-year-old man with hypokalemia, a mass in the right adrenal gland, and a diagnosis of Gitelman syndrome with a c.1456>A heterozygous variant of the SLC12A3 gene, treated with finerenone. CASE REPORT A 35-year-old man was admitted to the affiliated Hospital of Qingdao University because of a mass in the right adrenal gland. He was in generally good condition upon admission. He was a non-smoker and non-drinker. The examination at admission led to diagnosis of severe hypokalemia. Genetic tests showed that he carried a homozygous pathogenic variant c.1456>A in SLC12A3, which can confirm the diagnosis of Gitelman syndrome. Spironolactone was used to increase the blood potassium level, but after adverse effects were noted, finerenone was used, which greatly improved his blood potassium levels. CONCLUSIONS For patients with Gitelman syndrome who cannot tolerate adverse effects such as sex hormone-related adverse reactions from using non-selective mineralocorticoid receptor antagonists, especially male patients, finerenone may be considered as an adjunct therapy for potassium retention and magnesium supplementation. To the best of our knowledge, this is the first report in the world of using finerenone to treat Gitelman syndrome. This provides more options for treatment of patients in the future.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944492"},"PeriodicalIF":1.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565150","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":"Adult Intestinal Malrotation with Atypical Presentation: A Case Report and Diagnostic Challenge.","authors":"Thamer Alghamdi, Abdullah Mushra Alghamdi, Fatemah Hussain Agafli, Ahmed Mahmoud","doi":"10.12659/AJCR.945197","DOIUrl":"10.12659/AJCR.945197","url":null,"abstract":"<p><p>BACKGROUND A congenital defect known as intestinal malrotation, which has only rarely been described in adults, is most frequently identified in children. For life-threatening consequences, such as intestinal ischemia and death, to be avoided, prompt detection is essential. We report a rare case of adult intestinal malrotation to emphasize the difficulty in diagnosis and surgical treatment. CASE REPORT An 18-year-old Saudi woman presented with generalized, gradually intermittent abdominal pain accompanied by nausea, and non-bilious vomiting. An abdominal computed tomography (CT) scan showed that the small-bowel loops were identified at the right side of the abdomen with the duodenojejunal junction at the right side or just right paramedian level as well, the superior mesenteric artery and vein had an inverted relationship, and the cecum was observed in the left lumber region. She was treated by open exploratory laparotomy adhesiolysis, the cecum was mobilized, the small-bowel adhesion under the liver was released, and an appendectomy was carried out. Postoperatively, she was managed with a double antibiotic regimen of ceftriaxone and metronidazole for 7 days. CONCLUSIONS Although intestinal malrotation is uncommon in adults and very difficult to identify, it is frequently encountered in young populations. Adults with long history of vague or unexplained abdominal pain should undergo radiological studies to assess findings of intestinal malrotation. In our case, the result of a CT scan helped to make the diagnosis preoperatively.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945197"},"PeriodicalIF":1.0,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565147","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":"Focal and Segmental Glomerulosclerosis in a Multiple Myeloma Patient After Belantamab Mafodotin Therapy and Severe COVID-19 Infection: A Case Report.","authors":"Mohamed Sabbah, Stephanie Nguyen, Maya Ouzegdouh, Sylvain Choquet, David Buob, Jean Jacques Boffa, Alexandre Cez, Laurent Garderet","doi":"10.12659/AJCR.944681","DOIUrl":"10.12659/AJCR.944681","url":null,"abstract":"<p><p>BACKGROUND Focal segmental glomerulosclerosis (FSGS) very rarely occurs in patients with multiple myeloma. Much more common are renal impairments secondary to monoclonal light-chain tubulopathy, AL amyloidosis, light-chain deposition disease, and the so-called monoclonal gammopathy of renal significance. CASE REPORT We report the case of a 79-year-old myeloma patient without noticeable medical problems but with a long history of myeloma treatment beginning 13 years ago. In the ninth line of therapy, he was successfully treated with belamaf mafodotin, an anti-BCMA monoclonal antibody coupled to monomethyl auristatin F. After 1.5 years of treatment, without any eye toxicity, and while he was in complete hematologic remission, he experienced a very severe COVID-19 infection followed 1 month later by a nephrotic syndrome. The renal biopsy revealed a FSGS not otherwise specified. He was successfully treated symptomatically. One and a half years later, and without treatment for 1 year, he is still in hematologic remission, with a remaining renal insufficiency. CONCLUSIONS Our patient had a particularly long response to belamaf mafodotin of more than 2.5 years, which is still ongoing. This is particularly remarkable because the very unusual acute renal impairment was not myeloma related. This is a very rare case of FSGS in a myeloma patient, potentially linked to a COVID-19 infection considering the chronology of the events and the immunosuppressive status secondary to the malignancy and its treatment.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944681"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559081","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":"Trastuzumab-Induced Early Corneal Melt in HER2-Positive Breast Cancer: A Case Report and Review.","authors":"Daniel Barmas-Alamdari, Hasnain Chaudhary, Elmira Baghdasaryan, Prachi Dua, Isha Cheela","doi":"10.12659/AJCR.945488","DOIUrl":"10.12659/AJCR.945488","url":null,"abstract":"<p><p>BACKGROUND Trastuzumab (Herceptin) is a recombinant DNA-derived humanized monoclonal antibody that the US Food and Drug Administration (FDA) approved in 1998 for metastatic human epidermal growth factor receptor 2 (HER2)-positive breast cancer therapy. It selectively binds to the extracellular domain of HER2 and mediates an antibody-dependent cellular toxicity in various tissues. Trastuzumab use alone does not typically cause aggressive ocular complications. However, herein is a case report of a patient presenting with corneal ulceration in both eyes and perforation in the left eye after 2 months of trastuzumab therapy. CASE REPORT A 59-year-old woman with a history of metastatic breast cancer receiving chemotherapy was consulted for ophthalmic evaluation. She denied any history of ocular conditions and complained of eyelid crusting and sandy sensation in both eyes for 2 weeks. She had been using antibiotic eyedrops for presumed eye infection before her vision deteriorated 3-4 days prior to presentation. A thorough workup for autoimmune and infectious diseases was unyielding. Ophthalmologic examination revealed multiple epithelial defects with ulceration in the right eye and a corneal ulcer with perforation in the left eye. Corneal cultures were negative. Orbital imaging revealed metastases with optic nerve compression. In conjunction with the oncology team, further trastuzumab treatment was deferred. Therapeutic keratoplasty along with ocular surface therapy eventually stabilized both eyes. CONCLUSIONS Ocular adverse effects such as corneal epithelial changes and melts have been reported with trastuzumab. We recommend ophthalmology consultation for any ocular symptoms in patients on trastuzumab treatment.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945488"},"PeriodicalIF":1.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548146","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":"Ruptured Appendiceal Diverticulum Leading to Tubo-Ovarian Abscess in a Non-Sexually Active Woman: A Case Study.","authors":"Hiba Alenazi","doi":"10.12659/AJCR.945366","DOIUrl":"10.12659/AJCR.945366","url":null,"abstract":"<p><p>BACKGROUND Pelvic inflammatory diseases and tubo-ovarian abscesses (TOAs) are rarely seen in non-sexually active (NSA) women. While the pathogenesis of TOA remains unclear, its risk factors include ascending infection of the genital tract, gastrointestinal tract translocation, congenital genitourinary anomalies, as well as virulence of the causative agents, with preceding bacteremia and septicemia. CASE REPORT Herein, we present the case of a 25-year-old female patient who was initially diagnosed with ovarian torsion and underwent diagnostic laparoscopy. Her intraoperative findings included bilateral TOAs and adhesions. Owing to this uncommon presentation, further investigation was conducted, including postoperative computed tomography. The results showed a likelihood of a perforated appendix, with a repeat laparoscopy confirming this diagnosis. Appendectomy and drainage were done. The microbial culture from the ovarian abscess revealed Streptococcus constellatus, a commensal organism found in the oral, gastrointestinal, and urogenital flora. This microorganism is rarely isolated as a pathogenic organism in immune-competent populations. Furthermore, the histopathology report of the appendix showed a rare occurrence of chronic active diverticulitis, with perforation and peri-appendicitis. CONCLUSIONS TOA in NSA women should be considered when evaluating differential diagnoses, with the possibility of infection with an atypical organism. Broad-spectrum antibiotics or multidrug therapy should be administered. When suspicion is raised, an imaging study with a broader view to detect the pathology of other organ systems is recommended. Lower abdominal pain in young female patients still poses a diagnostic dilemma and should be investigated; however, when the clinical presentation suggests a gynecological emergency, the time frame can pose challenges.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945366"},"PeriodicalIF":1.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548145","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}