CME journal of clinical case reports最新文献

{"title":"Post-Caesarean and Post-Laparotomy Abdominal Wall Reconstruction (Tummy Tuck) For Aesthetic and Functional Restoration in A Low Resource Setting: A Case Report.","authors":"Chinedu Nnaemeka Ilokanuno, George Uchenna Eleje, Chimaobi Markson Isiguzo, Chichi Ukoha, Ekeuda Uchenna Nwankwo, Emmanuel Chukwubuikem Egwuatu, Kenechukwu Ezekwesili Obi, Chukwuemeka Chukwubuikem Okoro, Chukwudubem Chinagorom Onyejiaka, Chiemezie Mac Kingsley Agbanu, Michel Chiedu Egbuniwe, Adanna Vivian Egwim, Johnbosco Emmanuel Mamah, Obinna Kenneth Nnabuchi, Chigozie Geoffrey Okafor, Stanley Chigaemezu Egbogu, Onyecherelam Monday Ogelle, Emmanuel Onyebuchi Ugwu, Gerald Okanandu Udigwe, Blessing Ifunanya Enyi, Uchenna Clara Chijioke Ofoma, Chidinma Theresa Ezidiegwu, Ahizechukwu Chigoziem Eke","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Complex abdominal wall reconstruction following multiple surgical interventions remains challenging in resource-limited settings. We report the first successful case of combined post-caesarean and post-laparotomy total abdominal wall reconstruction with mesh reinforcement in a low-to-middle-income country setting.</p><p><strong>Case presentation: </strong>A 27-year-old multipara Nigerian woman presented with severe abdominal wall laxity and aesthetic deformity following caesarean delivery complicated by cryptogenic ascites requiring exploratory laparotomy. Clinical examination revealed extensive abdominal wall weakness with positive diastasis recti (Diver's test). She underwent comprehensive abdominal wall reconstruction, including total abdominoplasty with polypropylene mesh reinforcement. Intraoperative findings demonstrated diffuse muscle attenuation without discrete hernial defects. The procedure was completed without complications, with 0.8kg of excess tissue excised. The patient achieved complete wound healing by postoperative day 15 with excellent functional and aesthetic outcomes maintained at 15-month follow-up. No postoperative complications, mesh-related adverse events, or recurrence of abdominal wall laxity were observed.</p><p><strong>Conclusion: </strong>This case demonstrates the feasibility and safety of complex abdominal wall reconstruction in resource-constrained environments when appropriate patient selection, surgical technique, and perioperative management are employed. The successful outcome challenges conventional assumptions about the technical requirements for such procedures and supports the expansion of reconstructive surgical services in low-resource settings.</p>","PeriodicalId":521061,"journal":{"name":"CME journal of clinical case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133134","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":"Natural History of Preterm Pre-labour Rupture of Membranes in a Singleton Primipara in a Rural Low-Resource Setting in the Absence of Early Antibiotic Intervention: a Case Report.","authors":"George Uchenna Eleje, Emeka Philip Igbodike, William Amebeobari Mube, Agabus Iheanacho Nwachukwu, Stanley Chigaemezu Egbogu, Kesito Chikwendu Nwachukwu, Jessica Chinonso Onyeadurunu, Oluchukwu Praise Chukwudi, Esther Enekole Edoh, Augusta Amarachi Ibemere, Ihechinyerem Kelechi Osuagwu, Chinaza Michael Egbobe, Ekeuda Uchenna Nwankwo, Chigozie Geoffrey Okafor, Onyeka Chukwudalu Ekwebene, Kingsley Chidiebere Nwaogu, Emmanuel Chukwubuikem Egwuatu, Gerald Tochukwu Igwemadu, Isaiah Chukwuebuka Umeoranefo, Odigonma Zinobia Ikpeze, Michel Chiedu Egbuniwe, Eziamaka Pauline Ezenkwele, Nnanyelugo Chima Ezeora, Chekwube Martin Obianyo, Ngozichukwu Gertrude Uzoewulu, Samuel Owusu-Sekyere, Emeka Franklin Okechukwu, Johnbosco Emmanuel Mamah, Blessing Ifunanya Enyi, Uchenna Clara Chijioke Ofoma, Chidinma Theresa Ezidiegwu, Onyecherelam Monday Ogelle, Joseph Ifeanyichukwu Ikechebelu, Gerald Okanandu Udigwe, Ahizechukwu C Eke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case report presents the clinical course of a 33-year-old primiparous woman whom at 30 weeks of gestation experienced preterm pre-labour rupture of membranes (PPROM) in a low-resource setting. The patient, with a history of primary infertility, was managed conservatively without antibiotics for 28 days at a resource-limited health facility, where she was treated until clinical symptoms indicating chorioamnionitis appeared, leading to her referral. She underwent an emergency caesarean section at 34 weeks gestational age due to suspected chorioamnionitis resulting in the delivery of a healthy male infant. However, the baby developed neonatal jaundice which was successfully managed with phototherapy over five days. This case provides insight into the natural course of PPROM that lasted for 28 days, a condition that would have been ethically challenging to study in a research setting. It emphasizes the difficulties of managing PPROM in low-resource environments, especially when there is no immediate access to antibiotics and advanced neonatal care.</p>","PeriodicalId":521061,"journal":{"name":"CME journal of clinical case reports","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784384","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}