Annals of Medicine and Surgery最新文献

{"title":"Transcatheter vs. surgical aortic valve replacement in patients with aortic stenosis and chronic kidney disease: a comprehensive meta-analysis.","authors":"Maneeth Mylavarapu, Israel Garcia, Niharika Tanwar, Nidhi Laxminarayan Rao, Nithin Karnan, Samiksha Jain, Sri Lakshmi Sai Monica Chilla, Kaksha Parrikh, Lakshmi Sai Meghana Kodali, Madiha Kiyani","doi":"10.1097/MS9.0000000000003599","DOIUrl":"10.1097/MS9.0000000000003599","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic stenosis (AS) is treated with either transcatheter aortic valve replacement (TAVR) or Surgical aortic valve replacement (SAVR). However, limited data exist to study the postoperative clinical outcomes in patients with AS and chronic kidney disease (CKD). The objective of this study is to compare TAVR and SAVR postoperative clinical outcomes in patients with AS and CKD.</p><p><strong>Methods: </strong>According to PRISMA guidelines, a comprehensive search was conducted across various databases such as PubMed, EMBASE, Scopus, and Google Scholar. Original studies that compared the clinical outcomes between TAVR and SAVR in patients with underlying CKD were included in the study.</p><p><strong>Results: </strong>Twenty-three studies with 69 017 patients with chronic kidney disease who underwent TAVR or SAVR were included in this study. Patients who underwent TAVR had significantly lower odds of in-hospital mortality (OR 0.54; 0.32, 0.91; <i>P</i> = 0.02), acute kidney injury [AKI] (OR 0.41; 0.33, 0.51; <i>P</i> < 0.00001), AKI requiring dialysis (OR 0.66; 0.48, 0.91; <i>P</i> = 0.01), and postoperative complications (OR 0.34; 0.23, 0.50; p<0.0001). However, patients who underwent TAVR had significantly higher odds of permanent pacemaker implantation [PPI] (OR 2.69; 1.96, 3.69; <i>P</i> < 0.0001), major vascular complications (OR 2.56; 1.09, 5.99; <i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>In patients with AS and CKD, TAVR is associated with significantly lower in-hospital mortality, a reduced incidence of acute kidney injury, and fewer postoperative complications compared to SAVR. However, TAVR carries higher risks of pacemaker implantation and major vascular complications, highlighting the importance of individualized risk assessment and considering TAVR as a favorable alternative to SAVR in appropriately selected CKD patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5953-5962"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991357","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":"Age inconsistent brain atrophy following post cardiac arrest brain injury (PCABI): case report and review of literature.","authors":"Muhammad Hassa Raza, Muhammad Hamza Khan, Abdul Sattar Anjum, Sadia Anjum, Faria Saeed, Ajay Pandey","doi":"10.1097/MS9.0000000000003635","DOIUrl":"10.1097/MS9.0000000000003635","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Age-inconsistent brain atrophy refers to brain shrinkage that is not proportional to chronological age. This case report is first to report a young patient who developed age-inconsistent brain atrophy due to post cardiac arrest brain injury (PCABI). Due to limitations in the available data, we report our experience and novel magnetic resonance (MR) imaging changes in the brain over the course of 2 months.</p><p><strong>Case presentation: </strong>We report a case of a 28-year-old woman who developed sudden cardiac arrest during a routine cesarean section, with loss of consciousness for an unspecified period of time. She was resuscitated, intubated and later transferred to intensive care unit (ICU); where her Glasgow Coma Scale on arrival was 4/15. Detailed history, physical examination, and radiological investigations confirmed the diagnosis of PCABI. She was treated in ICU along with physiotherapy for speedy recovery.</p><p><strong>Clinical discussion: </strong>PCABI is the major cause of long-term disability and mortality following cardiac arrest. In this novel case report, we establish that it can lead to age-inconsistent brain atrophy.</p><p><strong>Conclusion: </strong>Serial MR imaging scans of the brain should be performed for suspected or confirmed PCABI to evaluate brain atrophy and other changes. This will not only aid in deciphering residual brain deficits but also help in guiding the correct management of the patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6158-6162"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991087","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":"Dual pathology, single solution: concurrent bile duct injury and hepatic artery pseudoaneurysm managed by interventional radiology after converted cholecystectomy.","authors":"Burhan Zafar, Tanveer Ul Haq, Mallick Muhammad Zohaib Uddin, Huzafa Ali, Aisha Tariq, Ayesha Nazeef, Junaid Iqbal, Jeevan Gyawali","doi":"10.1097/MS9.0000000000003634","DOIUrl":"10.1097/MS9.0000000000003634","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic cholecystectomy (LC) is the gold standard for gallbladder pathologies, but carries risks of bile duct injury (BDI) and vascular complications, such as hepatic artery pseudoaneurysm (HAP). While BDI occurs in 0.3-0.5% of cases, HAP is rare (0.8%), with concurrent injuries being exceptionally uncommon.</p><p><strong>Case presentation: </strong>A 31-year-old male who developed BDI and HAP after LC was managed successfully through interventional radiology (IR). The patient was managed by LC, which was converted to an open cholecystectomy, and presented with complaints of fever, vomiting, and abdominal pain for 8 days. Angioembolization of the 4.5 mm HAP via a covered stent in the common hepatic artery and computed tomography-guided drainage of a large infected biloma were performed. Persistent bile leak required percutaneous transhepatic biliary drainage (PTBD). After the procedure, the patient's condition improved drastically, and the patient was discharged without complications.</p><p><strong>Discussion: </strong>IR plays a significant role in the identification and treatment of biliary lesions. IR's key part in dealing with dual complications and suggests a minimally invasive alternative to reoperation. Isolated BDI or HAP has been documented, but the co-occurrence of BDI or HAP is rare, and there is limited literature on IR-based management.</p><p><strong>Conclusion: </strong>The combined use of angioembolization and biliary drainage highlights a minimally invasive and effective approach to avoid the need for further surgical intervention. This case report provides valuable insight into the management of dual complications.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6153-6157"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991098","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":"Random forest classification of four unsaturated fatty acids for infection diagnosis and prognosis in female Chinese patients.","authors":"Shuhua Tong, ShiShi Wu, Jiaying Wu, Siyu Zhuo, Jin Ruyi, Qian Jingjing, Peng Zhou, Li Wang, Lufeng Hu, Xinjie Zhu","doi":"10.1097/MS9.0000000000003570","DOIUrl":"10.1097/MS9.0000000000003570","url":null,"abstract":"<p><strong>Objective: </strong>Unsaturated fatty acids (UFAs) are important in immune regulation and inflammation; however, their diagnostic and prognostic value in infected patients is unclear. This study evaluated UFAs in infected female patients versus healthy controls using random forest (RF) analysis.</p><p><strong>Methods: </strong>A total of 115 female subjects, consisting of healthy controls and infected patients, were recruited. Clinical indices and UFAs, arachidonic acid (AA), docosahexaenoic acid (DHA), linoleic acid, and alpha-linolenic acid (ALA), and complete blood cell (CBC) count data were analyzed. Correlation and regression analyses were conducted to assess the relationships between UFAs in healthy and infected states. Receiver operating characteristic (ROC) analysis and orthogonal partial least squares discriminant analysis (OPLS-DA) modeling were performed to evaluate the diagnostic value of UFAs. An RF model was developed to classify infected and healthy populations.</p><p><strong>Results: </strong>Significant differences were observed in CBC and UFA indices between healthy and infected female patients. The ROC analysis demonstrated that UFAs showed statistically significant differences, although these indices alone did not completely discriminate between infected and healthy individuals. However, the RF model, incorporating both UFAs and CBC data, achieved a clear separation between the infected and healthy groups, outperforming the OPLS-DA model. The ROC results for both UFAs and CBC datasets indicated predictive value for infection prognosis.</p><p><strong>Conclusion: </strong>The integration of UFAs and CBC data within an RF model provides enhanced diagnostic and prognostic accuracy compared to OPLS-DA. UFAs, particularly AA and ALA, possess substantial predictive value for infection prognosis.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"4841-4847"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815691","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":"Barriers to timely transitions to comfort care in cancer patients: a review.","authors":"Tenzin Tamdin, Sadikshya Bhandari, Samikshya Bhandari, Matthew Barbery, Ravi Bajwa","doi":"10.1097/MS9.0000000000003618","DOIUrl":"10.1097/MS9.0000000000003618","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;\"Comfort care\" is a holistic approach for patients with terminal conditions, such as cancer, who are not expected to recover. It focuses on managing pain, among other end-of-life symptoms, and providing support to both the patient and their family during the dying process, which can last unpredictably from hours to days. End-of-life care concepts are often shaped by personal judgment and culture and thus lack a single consensus. This can lead to ambiguity in the term \"comfort care\" itself as well as create confusion in medical communication and treatment, making the transition to comfort care more challenging. In this review, we strive to evaluate the barriers preventing the timely conversion of end-stage cancer patients to comfort care. We also discuss the possible measures to limit these sensitive barriers to avoid futility in treatment and to ensure an ambiguity-free transition to ensure the best possible outcome for the patient. In this paper, we aim to systematically identify and categorize the key barriers that delay comfort care transitions in terminal cancer patients and to propose actionable strategies grounded in current evidence to address these challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology: &lt;/strong&gt;We conducted a literature search using PubMed and MEDLINE, covering studies published between January 2020 and March 2025. Search terms included a combination of MeSH terms and keywords such as \"Palliative Care,\" \"Terminal Care,\" \"Hospice Care,\" \"Communication Barriers,\" \"Cultural Factors,\" \"Cancer,\" and \"Prognostic Uncertainty.\" Eligible studies were peer-reviewed, published in English, and focused on adult cancer patients receiving palliative or end-of-life care, with a clear emphasis on barriers to timely transitions to comfort care. Studies unrelated to cancer, lacking a focus on barriers, or published in non-English languages were excluded. A total of 156 articles were identified; titles and abstracts were screened for relevance, followed by full-text review based on inclusion criteria. Data from the selected studies were analyzed using a thematic synthesis approach, in which two authors independently categorized findings under three main themes: prognostic uncertainty, communication challenges, and cultural factors. Discrepancies were resolved through discussion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Based on our extensive search, we classified the barriers for transition to comfort care into three main headings: Prognostic uncertainty, Challenges to Communication, and cultural factors. High levels of distress were observed in both patients and healthcare providers due to prognostic uncertainty, which complicates the prediction of illness trajectories, negatively affecting quality of life and delaying the transition to comfort care. Communication challenges, such as short consultations, language barriers, and difficult conversations about care goals, were also prevalent. The COVID-19 pandemic exacerbated these is","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5770-5774"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991270","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":"Exploring the history of an unsung hero in pioneering biomedical research: Dr Yellapragada Subbarow.","authors":"L V Simhachalam Kutikuppala, Sushil Sharma, C Madhavrao, Gaurav Rangari, Arup Kumar Misra, Srinivasa Rao Katiboina, Pavani Saggurthi, Golla Varshitha","doi":"10.1097/MS9.0000000000003621","DOIUrl":"10.1097/MS9.0000000000003621","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6242-6244"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991351","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":"Diagnostic approach to glomerular diseases: integrating clinical, laboratory, and histopathological assessments.","authors":"Chukwuka Elendu, Chiemezie E Ejiogu, Elijah O A Adetunji, Linda S Mensah, Treasure A Chinuokwu, Tochukwu W Okahia, Abolore Aminat Ajakaye, Boluwatife D Oshin, Varun Tyagi, Lordsfavour I Anukam, Chiamaka O Oguoma, Aminu A Dogondaji, Chukwuemeka C Njoku","doi":"10.1097/MS9.0000000000003637","DOIUrl":"10.1097/MS9.0000000000003637","url":null,"abstract":"<p><strong>Background: </strong>Glomerular diseases are a significant contributor to chronic kidney disease globally, accounting for up to 30% of end-stage kidney disease cases. Diagnostic accuracy is crucial for appropriate management but remains challenging, especially in low-resource settings.</p><p><strong>Objective: </strong>Our paper addresses the diagnostic approach to glomerular diseases by integrating clinical evaluation, laboratory findings, imaging techniques, and histopathological assessments. It also highlights regional disparities and systemic barriers affecting diagnostic capacity.</p><p><strong>Methods: </strong>We conducted a narrative review of published literature, synthesizing data from peer-reviewed articles, international registries, and survey reports to explore current diagnostic approaches to glomerular diseases. We searched databases, including PubMed, Scopus, and Google Scholar, for relevant studies published between January 2020 and December 2024.</p><p><strong>Results: </strong>Biopsy access was markedly limited in Africa, with only 49.7% of respondents able to perform biopsies in more than 10% of indicated cases, compared to 95.7% in Asia. Immunofluorescence and electron microscopy were unavailable or underutilized in many centers, especially in Africa. Serological testing for autoimmune glomerulopathies and the availability of key immunosuppressive therapies were also significantly constrained. These limitations frequently led to empiric treatment without a definitive diagnosis, raising concerns about mismanagement and healthcare inequities.</p><p><strong>Conclusion: </strong>A multidisciplinary diagnostic approach remains essential for managing glomerular diseases. However, significant disparities in access to biopsy, nephropathology, and serological testing hamper optimal care in many regions. Investment in diagnostic infrastructure, clinician training, and health policy reforms are critical for improving global kidney health outcomes.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5814-5821"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991118","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":"Spontaneous retrograde migration of a ureteric calculus: a rare phenomenon.","authors":"Tayyaba Kauser, Zain Ul Abdin, Wishah Urwatil Wusqa, Munna William, Momena Rashid, Rejina Chhetri","doi":"10.1097/MS9.0000000000003606","DOIUrl":"10.1097/MS9.0000000000003606","url":null,"abstract":"<p><strong>Introduction: </strong>While spontaneous anterograde passage of ureteric stones is well documented, retrograde migration-movement of the stone back towards the kidney is exceedingly rare. The mechanisms underlying this unusual migration pattern remain poorly understood, with only a few cases reported in the literature.</p><p><strong>Case presentation: </strong>A 23-year-old female presented with acute left flank pain, imaging for which revealed a calculus in the left proximal ureter. A repeat imaging after a few weeks of medical management revealed a calculus of the same dimension at the lower pole calyx of the left kidney, with no calculus present at the initial site, indicating retrograde migration of the calculus. The patient subsequently underwent extracorporeal shockwave lithotripsy with complete stone clearance.</p><p><strong>Discussion: </strong>Retrograde migration of ureteric calculi is a rare phenomenon. Proposed mechanisms include reverse ureteral peristalsis, proximal ureteral dilation, antiperistaltic waves due to irritant stimuli, and the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on ureteric peristalsis. Awareness of this occurrence is important for appropriate diagnosis and management, as retrograde migration can affect treatment planning and outcomes.</p><p><strong>Conclusions: </strong>The case highlights an unusual presentation of urolithiasis that radiologists and urologists should be aware of as this can have significant implications for clinical management.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"5330-5332"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815720","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":"Efficacy and safety of chemoradiotherapy versus chemotherapy for resectable gastric cancer: a systematic review and meta-analysis.","authors":"Allahdad Khan, Shree Rath, Meenab Fatima, Muhammad Nouman Javed, Haji Abdul Rehman Akhter, Faisal Naseer, Muhammad Saeed, Shariq Ahmad Wani, Shamikha Cheema, Linta Malik, Hameer Ali, Raza Aslam, Mohamed Antar, Bireera Muzaffar","doi":"10.1097/MS9.0000000000003608","DOIUrl":"10.1097/MS9.0000000000003608","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is a leading cause of cancer-related deaths. Surgery combined with adjuvant treatments improves survival. This meta-analysis compares the efficacy of chemoradiotherapy (CRT) vs. chemoimmunotherapy (CT) in resectable gastric cancer.</p><p><strong>Methods: </strong>A comprehensive search across five databases from inception to December 2024 identified studies on efficacy of CRT vs CT in adult patients with resectable gastric cancer. Data were pooled as odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CI). Analysis used Review Manager 5.4 with a random-effects model.</p><p><strong>Results: </strong>A total of 29 studies with 20 794 patients were included for further quantitative and qualitative analysis. CRT was associated with significantly higher recurrence-free survival (HR: 0.79; 95%CI: 0.69, 0.91; <i>P</i> = 0.004) and slightly improved overall survival (HR: 0.85; 95%CI: 0.73, 1; <i>P</i> = 0.05). The odds of locoregional metastases (OR: 0.60; 95%CI: 0.43, 0.82; <i>P</i> = 0.001) were significantly reduced following CRT. Adverse events between both treatments were comparable, although the risk of neutropenia (OR: 1.54; 95%CI: 1.29, 1.84; <i>P</i><0.0001) and gastrointestinal side effects (OR: 1.30; 95%CI: 1.01, 1.69; <i>P</i> = 0.04) was significantly higher in the CRT arm.</p><p><strong>Conclusion: </strong>This meta-analysis concludes a higher efficacy of CRT over CT in improving survival and preventing recurrence, while limiting regional metastasis. Further studies are needed to assess modulation of radiotherapy dosage to reduce the adverse event while maintaining its efficacy.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5973-5989"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991148","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":"Pelvic splenosis implanted in Douglas pouch mimics pseudo-endometriosis symptoms: a case report study.","authors":"Azamosadat Mousavi, Farzaneh Golfam, Aghdas Ebadi Jamkhane, Soheila Sarmadi","doi":"10.1097/MS9.0000000000003486","DOIUrl":"10.1097/MS9.0000000000003486","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Pelvic splenosis is characterized by the autotransplantation of spleen fragments following tissue rupture. Since the fragments are mostly implanted into the Douglas pouch, endometriosis-like symptoms are developed, clinically. Thus, this case report demonstrated a successful surgical procedure for pelvic splenosis management.</p><p><strong>Clinical presentation: </strong>A 43-year-old woman with chronic pelvic pain was admitted to hospital. Medical history showed a car accident (at the age of 5 years) and severe spleen trauma followed by splenectomy. Patient assessment and sonography procedure revealed the presence of retrouterine mass with primary endometriosis diagnosis. Exploratory laparotomy was applied and total hysterectomy and bilateral salpingo-oophorectomy were conducted. The mass was excised and histopathologic assessment revealed the splenosis with pseudo-endometriosis symptoms.</p><p><strong>Clinical discussion: </strong>Severe spleen trauma followed by rupture can potentially lead to displaced splenic fragments. Since these tissue segments implant in Douglas pouch, anatomical relations can lead to chronic pelvic symptoms misdiagnosed with endometriosis.</p><p><strong>Conclusion: </strong>Thus, to prevent misdiagnosis and ineffective interventions, it is recommended for clinicians to consider the presence of pelvic splenosis in women with a history of acute splenic trauma and subsequent splenectomy.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"5234-5237"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815681","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}