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Vernix caseosa peritonitis presenting as a soft tissue mass. 皮脂性腹膜炎表现为软组织肿块。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2024-264641
Laura Wharton, Tessa Bonnett, Emma Ferriman, Madeleine Macdonald
{"title":"Vernix caseosa peritonitis presenting as a soft tissue mass.","authors":"Laura Wharton, Tessa Bonnett, Emma Ferriman, Madeleine Macdonald","doi":"10.1136/bcr-2024-264641","DOIUrl":"https://doi.org/10.1136/bcr-2024-264641","url":null,"abstract":"<p><p>Vernix caseosa peritonitis (VCP) is a rare condition characterised by non-necrotising granulomatous inflammation within the peritoneal cavity following childbirth. Its presentation is typically with acute abdominal pain and fever following caesarean section (CS), and management involves broad-spectrum antibiotics and surgical intervention. Conservative management is rare.We report two cases of VCP, which presented with abdominal masses 4 weeks following elective CS. CT scan demonstrated a soft tissue mass with diffuse peritoneal thickening, suspicious for an atypical infection or malignancy. Biopsy revealed non-necrotising granulomatous inflammation consistent with VCP. Both patients were managed conservatively and experienced a full recovery.In spite of increasing CS rates, VCP remains a rarely reported complication which may be underdiagnosed. It should be considered in patients presenting with abdominal pain beyond the usual timeframe for infection, with careful examination to detect any soft tissue masses. Conservative management, with biopsy for histological diagnosis, may be a safe option for systemically well women in whom urgent surgical intervention is not indicated.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Complex genitourinary anomaly presenting in adolescence: should antenatal kidney abnormalities prompt future screening for Mullerian abnormalities? 青春期出现的复杂泌尿生殖系统异常：产前肾脏异常是否应提示将来进行苗勒管异常筛查？
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2024-264645
Beth Thompson, Valentina Shaw
{"title":"Complex genitourinary anomaly presenting in adolescence: should antenatal kidney abnormalities prompt future screening for Mullerian abnormalities?","authors":"Beth Thompson, Valentina Shaw","doi":"10.1136/bcr-2024-264645","DOIUrl":"https://doi.org/10.1136/bcr-2024-264645","url":null,"abstract":"<p><p>Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) is a rare congenital syndrome encompassing both Mullerian and mesonephric duct abnormalities. An early adolescent female presented with acute onset lower abdominal pain and sepsis several days after menarche. The accurate diagnosis was only achieved after her second presentation, a diagnostic laparoscopy and both CT and MRI. Her antenatal history was significant for a multicystic dysplastic kidney. As 30% of renal anomalies are associated with a Mullerian anomaly, an opportunity exists antenatally to facilitate screening for this in females with a prenatal diagnosis of a renal abnormality, thereby possibly avoiding the complications of diagnostic delay.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diverting opinions: surgical debate around method of Meckel's resection. 转移观点：关于梅克尔切除方法的外科争论。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2025-265448
Katharine Ji, Melanie Crispin, Janindu Goonawardena, Raevin Ravindra
{"title":"Diverting opinions: surgical debate around method of Meckel's resection.","authors":"Katharine Ji, Melanie Crispin, Janindu Goonawardena, Raevin Ravindra","doi":"10.1136/bcr-2025-265448","DOIUrl":"https://doi.org/10.1136/bcr-2025-265448","url":null,"abstract":"<p><p>Meckel's diverticulum (MD) is the most common congenital anomaly of the GI tract and can present with obstruction, inflammation or haemorrhage, which requires surgical intervention. Primary malignancies of MD are rare with a reported incidence of 0.5%-3.2%. The standard treatment of symptomatic MDs is resection. However, there is no standard protocol regarding the type of resection. Similarly, for asymptomatic MDs, there is no standard management. We report our experience with a patient in her 60s who required emergent surgery for perforated MD where histology revealed a plexiform fibromyxoma at the junction of the ileum and MD. Current surgical resection techniques for MDs vary from linear or wedge diverticulectomy to segmental bowel resection. This case of an unexpected tumour supports segmental bowel resection in the treatment of MD and raises the question of whether incidental asymptomatic MDs should also be resected due to the risk of tumour or malignancy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
First experience in Spain of large ventral hernia treated with botulinum toxin combined with robot-assisted transversus abdominis release (R-TAR) using the Hugo RAS system. 在西班牙首次使用Hugo RAS系统联合机器人辅助腹侧释放（R-TAR）治疗肉毒杆菌毒素治疗大腹疝。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2024-264022
Riccardo Caruso, Yolanda Quijano, Camilla Farè, Valentina Ferri
{"title":"First experience in Spain of large ventral hernia treated with botulinum toxin combined with robot-assisted transversus abdominis release (R-TAR) using the Hugo RAS system.","authors":"Riccardo Caruso, Yolanda Quijano, Camilla Farè, Valentina Ferri","doi":"10.1136/bcr-2024-264022","DOIUrl":"https://doi.org/10.1136/bcr-2024-264022","url":null,"abstract":"<p><p>We present the first documented case in Spain of a large midline incisional hernia treated with botulinum toxin A (Botox A) in conjunction with robot-assisted transversus abdominis release utilising the Hugo robot-assisted surgery (RAS) by Medtronic (Minneapolis, MN, USA). The patient, a woman in her late 40s, was referred to our outpatient clinic due to two significant midline incisional hernias which were causing abdominal discomfort and constipation. Her medical history included a laparoscopic myomectomy that had been converted to open surgery, resulting in a sub-umbilical incision. This led to the development of a double-component midline incisional hernia: one at the umbilical level (site of laparoscopic access) and another located over the incision from the laparotomic conversion. Six weeks prior to surgery, we conducted preoperative ultrasound-guided electromyographic injections of Botulinum Toxin A into the lateral abdominal wall muscles. The surgical procedure lasted 450 min, during which there were no conversions or intraoperative complications. The robotic system was docked twice, once for each side, with a total docking time of thirty minutes. The patient's hospital stay extended to 4 days. In conclusion, our findings indicate that the combination of Botox A and robot-assisted transversus abdominis release utilising the Hugo RAS system is a safe and effective treatment option.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inferior hip dislocation following mudslide impact: a unique occupational injury. 泥石流冲击后髋关节下位脱位：一种独特的职业性损伤。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2025-265584
Rashid Anjum, Sabarathinam Ravi, Gagandeep Singh, Tarsem Motten, Dheeraj Vajpayee, Amit Thakur
{"title":"Inferior hip dislocation following mudslide impact: a unique occupational injury.","authors":"Rashid Anjum, Sabarathinam Ravi, Gagandeep Singh, Tarsem Motten, Dheeraj Vajpayee, Amit Thakur","doi":"10.1136/bcr-2025-265584","DOIUrl":"https://doi.org/10.1136/bcr-2025-265584","url":null,"abstract":"<p><p>Inferior hip dislocations are exceedingly rare in adults, with less than 20 cases documented in the literature in the 21st century. These injuries typically result from high-energy trauma and pose significant challenges in diagnosis and management. We present the case of a man in his 50s who sustained an inferior hip dislocation following a workplace mudslide impact. Diagnosis was confirmed through radiographic evaluation, and urgent closed reduction was performed under sedation. This report highlights the unique injury mechanism, a precise reduction technique, clinical and radiological features and the importance of early intervention in preventing complications such as avascular necrosis and post-traumatic instability.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adult patient with enteric intussusception in the emergency department. 急诊科的成年肠套叠患者。
IF 0.6
BMJ Case Reports Pub Date : 2025-05-30 DOI: 10.1136/bcr-2024-263679
Osama Abdelsamad, Helena Fitzpatrick, Barry Keane, Darragh Shields
{"title":"Adult patient with enteric intussusception in the emergency department.","authors":"Osama Abdelsamad, Helena Fitzpatrick, Barry Keane, Darragh Shields","doi":"10.1136/bcr-2024-263679","DOIUrl":"https://doi.org/10.1136/bcr-2024-263679","url":null,"abstract":"<p><p>Acute abdominal pain in adults is a quite common presentation to emergency departments (EDs) with a broad differential diagnosis. Intussusception in adults is rare, so a high index of suspicion is required to consider it as a differential diagnosis. The most common site of an adult's intussusception is the small bowel, most commonly due to a well-defined lesion resulting in a lead point. CT abdominal scan is the definitive investigation of choice, leading to prompt diagnosis and early definitive surgical treatment.We present a case of a woman in her 30s, with a previous laparoscopic partial gastrectomy, who presented to our ED with acute onset of abdominal pain associated with dry retching. Her abdominopelvic CT scan showed small bowel obstruction due to enteric intussusception. She underwent an urgent exploratory laparotomy with manual reduction of the intussusception with no adverse immediate postoperative outcomes due to early diagnosis and management.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 5","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abemaciclib-Induced Pseudo-AKI: an underrecognised finding. abemaciclib诱导的伪aki：一个未被充分认识的发现。
IF 0.6
BMJ Case Reports Pub Date : 2025-05-30 DOI: 10.1136/bcr-2024-261725
Payton Markley, Salam Kadhem, Joseph Moore
{"title":"Abemaciclib-Induced Pseudo-AKI: an underrecognised finding.","authors":"Payton Markley, Salam Kadhem, Joseph Moore","doi":"10.1136/bcr-2024-261725","DOIUrl":"https://doi.org/10.1136/bcr-2024-261725","url":null,"abstract":"<p><p>Targeted therapy-induced acute kidney injury (AKI) can complicate oncologic treatment. We present a case of creatinine elevation induced by abemaciclib, a cyclin-dependent kinases 4 and 6 inhibitor used in advanced breast cancer which can also cause nephrotoxicity. A female patient in her mid-sixties was referred to nephrology for elevated serum creatinine after starting abemaciclib. Diagnostic workup, including blood urea nitrogen (BUN), serum cystatin C, urine protein measurement, and serum electrolytes revealed no evidence of renal dysfunction. This case emphasises the importance of distinguishing creatinine elevation from true nephrotoxicity to avoid unnecessary treatment adjustments. Abemaciclib and other targeted therapies can induce creatinine elevation by inhibiting proximal tubule secretory transporters, rather than through direct nephrotoxicity. By incorporating additional assessments such as BUN, serum cystatin C, and additional biomarkers including urinary neutrophil gelatinase-associated lipocalin and kidney injury molecule 1, clinicians can distinguish creatinine elevation from AKI to guide appropriate management of oncologic diseases.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 5","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rare aggressive presentation of primary cutaneous diffuse large B-Cell lymphoma, leg type, in the upper arm with concurrent non-small cell lung cancer. 罕见侵袭性原发性皮肤弥漫性大b细胞淋巴瘤，腿部型，上臂并发非小细胞肺癌。
IF 0.6
BMJ Case Reports Pub Date : 2025-05-30 DOI: 10.1136/bcr-2024-264401
Zinab Alatawi, Lauren Passby, Ghazia Kaushal
{"title":"Rare aggressive presentation of primary cutaneous diffuse large B-Cell lymphoma, leg type, in the upper arm with concurrent non-small cell lung cancer.","authors":"Zinab Alatawi, Lauren Passby, Ghazia Kaushal","doi":"10.1136/bcr-2024-264401","DOIUrl":"https://doi.org/10.1136/bcr-2024-264401","url":null,"abstract":"<p><p>A female patient in her early 90s presented with a rapidly growing erythematous plaque on the right upper arm. Histopathological analysis revealed dense dermal lymphoid infiltrate with a non-germinal centre phenotype (CD20+, MUM1+, BCL2+, BCL6+, CD10-). Histology confirmed the diagnosis to be primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT). Elevated Ki-67 (90%) indicated aggressive disease. Subsequent Positron Emission Tomography (PET)-CT staging revealed right axillary lymphadenopathy and coincidentally diagnosed recurrent non-small cell lung cancer (NSCLC). The PCDLBCL-LT was treated with localised radiotherapy after the patient declined chemotherapy. This case report highlights an unusual presentation of PCDLBCL-LT on the upper limb. It further emphasises the challenges posed in diagnosing and treating solitary skin lesions among older patients with a prior oncological history while highlighting the importance of an individualised multidisciplinary approach for safe and efficacious treatment in the context of advanced age and multiple comorbidities.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 5","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-trauma lymphangiectasis of the lower limb mimicking haematoma. 创伤后下肢淋巴管扩张，类似血肿。
IF 0.6
BMJ Case Reports Pub Date : 2025-05-29 DOI: 10.1136/bcr-2024-264111
Zahran Al-Thuhli, Naima Al Balushi
{"title":"Post-trauma lymphangiectasis of the lower limb mimicking haematoma.","authors":"Zahran Al-Thuhli, Naima Al Balushi","doi":"10.1136/bcr-2024-264111","DOIUrl":"https://doi.org/10.1136/bcr-2024-264111","url":null,"abstract":"<p><p>Lymphangiectasia of the lower limbs is a rare condition characterised by the dilation of lymphatic vessels, often resulting from damage or obstruction to deeper lymphatic structures. This disruption leads to increased lymphatic pressure. While lymphangiectasia typically manifests in the viscera, its occurrence in the lower limbs is less common but still clinically relevant.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 5","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From cranes to crutches: the disabling potential of necrotising myopathy. 从起重机到拐杖：坏死性肌病的致残潜力。
IF 0.6
BMJ Case Reports Pub Date : 2025-05-28 DOI: 10.1136/bcr-2024-262878
Jessica Liang, Leslie Lin, Tanushri Bhushan, Mazhar Shapoo, Arabi Rasendrakumar
{"title":"From cranes to crutches: the disabling potential of necrotising myopathy.","authors":"Jessica Liang, Leslie Lin, Tanushri Bhushan, Mazhar Shapoo, Arabi Rasendrakumar","doi":"10.1136/bcr-2024-262878","DOIUrl":"https://doi.org/10.1136/bcr-2024-262878","url":null,"abstract":"<p><p>We present a case of a middle-aged man with progressive bilateral proximal muscle weakness. Laboratory studies showed a creatine kinase level of 22 000 units/L and hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibody IgG of 109 units. Muscle biopsy revealed necrotic fibres undergoing phagocytosis as well as mixed regenerated and atrophic muscle fibres. The diagnosis of HMGCR necrotising myopathy was confirmed, with marked clinical improvement following mycophenolate mofetil and intravenous immunoglobulin therapy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 5","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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