BMJ Case Reports最新文献

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Third trimester diagnosis of body stalk anomaly in a dichorionic diamniotic twin pregnancy. 双绒毛膜双羊膜双胎妊娠体柄异常的晚期诊断。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-04 DOI: 10.1136/bcr-2025-264983
Sara Wetzler, Meralis Lantigua-Martinez, Sara G Brubaker, Judith Chervenak
{"title":"Third trimester diagnosis of body stalk anomaly in a dichorionic diamniotic twin pregnancy.","authors":"Sara Wetzler, Meralis Lantigua-Martinez, Sara G Brubaker, Judith Chervenak","doi":"10.1136/bcr-2025-264983","DOIUrl":"https://doi.org/10.1136/bcr-2025-264983","url":null,"abstract":"<p><p>This is a case report of a G1P0 woman in her early 30s with a dichorionic diamniotic twin gestation with limited prenatal care and a third trimester diagnosis of body stalk anomaly (BSA) in one of the twins. Initially diagnosed with an omphalocele, the patient established care in our centre at 31 weeks gestation, and numerous anomalies were noted on ultrasound. However, definitive characterisation was limited by the advanced gestational age and maternal body habitus. Fetal MRI clearly demonstrated anomalies consistent with BSA. A scheduled caesarean delivery was performed at 36 weeks in the setting of severe pre-eclampsia and fetal growth restriction of the unaffected twin. The affected twin was stillborn and post-mortem inspection confirmed the prenatal diagnosis of BSA with abdominal contents adherent to the placenta. This case highlights the role of fetal MRI in the late diagnosis of multiorgan anomalies, particularly when ultrasound imaging is limited.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233121","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
Management of aluminium phosphide poisoning. 磷化铝中毒的处理。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-04 DOI: 10.1136/bcr-2024-264419
Omar Azuara-Antonio, Habacúc Enríquez-Sandoval, Mario I Ortiz, Gamaliel Rivero-Veras
{"title":"Management of aluminium phosphide poisoning.","authors":"Omar Azuara-Antonio, Habacúc Enríquez-Sandoval, Mario I Ortiz, Gamaliel Rivero-Veras","doi":"10.1136/bcr-2024-264419","DOIUrl":"10.1136/bcr-2024-264419","url":null,"abstract":"<p><p>This manuscript presents a clinical case of a patient poisoned by aluminium phosphide in its hydrolysed form, phosphine gas, following a suicide attempt, and its therapeutic management in the emergency room. The cardiovascular, metabolic and gasometric changes described in the pathophysiology of this poisoning were documented. There is no specific antidote, and treatment involves careful supportive care and reduction of the bioavailability of the phosphine in the poisoned patient. In this case, the patient was treated with vegetable oil, mannitol, bicarbonate and activated charcoal during the first 24 hours of hospitalisation. The patient had an excellent evolution of symptoms and electrocardiographic and haemodynamic changes and was discharged from the hospital without any sequelae. The treatment used was based on the pathophysiology of phosphide poisoning, and it may be implemented according to the severity of the pathology and the resources of the medical unit.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233116","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
Spontaneous postpartum recovery of mild traumatic brain injury induced growth hormone deficiency. 轻度外伤性脑损伤所致生长激素缺乏症的产后自发恢复。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2024-264400
Jason B Tabor, Kirstie Lithgow, Gregory A Kline, Chantel T Debert
{"title":"Spontaneous postpartum recovery of mild traumatic brain injury induced growth hormone deficiency.","authors":"Jason B Tabor, Kirstie Lithgow, Gregory A Kline, Chantel T Debert","doi":"10.1136/bcr-2024-264400","DOIUrl":"https://doi.org/10.1136/bcr-2024-264400","url":null,"abstract":"<p><p>A woman in her late 20s developed persistent post-concussion symptoms (PPCS) following a mild traumatic brain injury (mTBI) sustained in a motor vehicle collision. Symptoms included daily headaches, cognitive and physical fatigue and vision disturbances, which persisted despite extensive rehabilitation and medical interventions by multiple specialists. At 20 months post-mTBI, an endocrinological assessment confirmed post-traumatic growth hormone deficiency (GHD) through provocative glucagon stimulation testing (GST) revealing a peak GH level of 1.2 µg/L, and recombinant human growth hormone (rhGH) therapy was initiated. The patient's fatigue and overall quality of life improved on treatment, but therapy was paused during pregnancy and breastfeeding. After giving birth, the patient requested a re-evaluation for GHD before resuming treatment. Remarkably, provocative testing revealed spontaneous recovery of the hypothalamic-pituitary-somatotropic axis with a peak GH level of 18.0 µg/L, and rhGH therapy was discontinued.</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":"144214898","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
Navigating foreign body ingestion in paediatric patients with a history of congenital abdominal wall defects. 有先天性腹壁缺陷史的儿科患者异物摄入的导航。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2025-264979
Lorraine Belisse Bermudez Rivera, Samantha Kennedy, Teerin Meckmongkol
{"title":"Navigating foreign body ingestion in paediatric patients with a history of congenital abdominal wall defects.","authors":"Lorraine Belisse Bermudez Rivera, Samantha Kennedy, Teerin Meckmongkol","doi":"10.1136/bcr-2025-264979","DOIUrl":"10.1136/bcr-2025-264979","url":null,"abstract":"<p><p>Foreign object ingestion is a common medical problem in children and can cause serious complications in patients with a history of abdominal surgeries. This case describes a male toddler with a history of complex gastroschisis repair who presented with severe abdominal pain. Imaging revealed multiple foreign bodies in the abdomen, first seen on X-ray 9 months prior, along with signs of bowel inflammation. Due to the prolonged presence of foreign bodies and potential complications, the patient underwent exploratory laparotomy. Significant adhesions were found, particularly in the transverse colon, preventing foreign body passage. The patient required a right hemicolectomy to remove both the inflamed segment of the colon and the foreign objects en bloc. Parents should monitor young children closely for ingestion, as prompt medical attention is essential to avoid complications. Children with previous abdominal surgery represent a unique challenge as they may require surgery following foreign body ingestion.</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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214896","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}
引用次数: 0
Kidney autotransplantation for renovascular hypertension due to hilar renal artery aneurysm: India's first in a child. 肾门肾动脉瘤所致肾血管性高血压肾自体移植:印度首例儿童肾自体移植。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2025-265223
Aishvary Gupta, Manjunath Maruti Pol, Pradeep Ramakrishnan Reddy, Mohammed Fawaz
{"title":"Kidney autotransplantation for renovascular hypertension due to hilar renal artery aneurysm: India's first in a child.","authors":"Aishvary Gupta, Manjunath Maruti Pol, Pradeep Ramakrishnan Reddy, Mohammed Fawaz","doi":"10.1136/bcr-2025-265223","DOIUrl":"https://doi.org/10.1136/bcr-2025-265223","url":null,"abstract":"<p><p>A boy in middle childhood with recurrent haematuria and refractory hypertension for 3.5 years was referred to our hospital with CT findings of a large right renal artery aneurysm. Following an unsuccessful endovascular intervention, a multidisciplinary team approach was set up, as well as a plan for right nephrectomy, complete excision of the aneurysm, reconstruction of the cut end of the branches of the renal artery using internal iliac artery (IIA) 'Y' graft followed by autotransplantation. The IIA 'Y' graft was then anastomosed with the external iliac artery, and the renal vein was anastomosed with the external iliac vein. Blood loss was minimal. Postoperatively, the patient had an uneventful recovery and was discharged on postoperative day 7 with restored renal anatomy, preserved normal renal mass and eliminated risk of rupture and aneurysmal complications. A follow-up at the end of 6 months showed improved quality of life; the child has been attending school, playing and living with a low dose of one antihypertensive medication.</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":"144214895","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
Postoperative sensorineural hearing loss in a non-otological surgery secondary to a dural tear after spinal surgery. 脊柱术后硬脑膜撕裂继发于非耳科手术的术后感音神经性听力损失。
IF 0.6
BMJ Case Reports Pub Date : 2025-06-02 DOI: 10.1136/bcr-2024-264032
Vasiliki Kalogianni, Fotios Vlahos, Iosifina Giannakikou
{"title":"Postoperative sensorineural hearing loss in a non-otological surgery secondary to a dural tear after spinal surgery.","authors":"Vasiliki Kalogianni, Fotios Vlahos, Iosifina Giannakikou","doi":"10.1136/bcr-2024-264032","DOIUrl":"https://doi.org/10.1136/bcr-2024-264032","url":null,"abstract":"<p><p>This case involves a woman in her 70s with a complex history of spinal surgeries and pre-existing left-sided sensorineural hearing loss (SNLH), who underwent elective spondylodesis for failed back surgery syndrome. Postoperatively, the patient complained of sudden onset, profound and painless hearing loss. Otorhinolaryngology (ENT) review confirmed bilateral sensorineural hearing loss. A large dural tear causing cerebral spinal fluid (CSF) leak was diagnosed. The CSF leak failed to heal with conservative management and required subsequent surgical repair. The SNHL was attributed to the drop in CSF pressure causing a disruption of the endolymph/perilymph balance. The patient made a complete recovery after a short course of intravenous steroids. SNHL is a documented but rare adverse event in non-otological surgeries. This manuscript stresses the importance of anaesthesiologists being aware of such a complication in high-risk patients. It also highlights modifiable factors to prevent SNHL and discusses possible treatments.</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":"144214897","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
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
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