Case Reports in Women's Health最新文献

{"title":"Gracilis flap and partial colpocleisis of Kahr for pelvic organ prolapse after anterior exenteration: A case report","authors":"Greta Lisa Carlin ,&nbsp;Sören Lange ,&nbsp;Werner Haslik ,&nbsp;Harun Fajkovic ,&nbsp;Engelbert Hanzal","doi":"10.1016/j.crwh.2024.e00673","DOIUrl":"10.1016/j.crwh.2024.e00673","url":null,"abstract":"<div><div>Anterior exenteration is a radical surgical option for treating locally advanced pelvic malignancies when alternative treatments are deemed ineffective or inappropriate. Due to its nature as an ablative treatment, interference with supportive structures of the pelvic floor can result in pelvic organ prolapse.</div><div>A 70-year-old woman presented with prolapse after radical cystectomy and following two unsuccessful attempts at Le Fort colpocleisis, the second of which was further complicated by rupture of the vaginal cuff. After exploratory laparotomy to evaluate pelvic adhesions and potential tumor recurrence, the necrotic vaginal apex was excised via the vaginal route, and a musculus gracilis flap was created to cover the levator hiatus in a <em>Z</em>-shaped pattern. The introitus was then narrowed by partial colpocleisis of Kahr. The postoperative course was uneventful and high patient satisfaction and an adequate anatomic result were found at one-year follow-up.</div><div>There is a scarcity of literature regarding the optimal treatment for pelvic organ prolapse after anterior exenteration, and to our knowledge this is the first published report of the use of a gracilis flap combined with partial colpocleisis of Kahr with a satisfactory outcome in this complicated situation. This case underscores the importance of a multidisciplinary approach in managing prolapse after radical cystectomy, showcasing the successful integration of expertise across gynecology, urology, and reconstructive surgery.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00673"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884988","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":"Management of primary hepatic pregnancy: A case report","authors":"Yusuf Mohammed Yusuf ,&nbsp;Gulilat Tigiye Endeshaw ,&nbsp;Berhanu Mohammed Shifa ,&nbsp;Biniyam Afework Abate ,&nbsp;Ashenafi Aberra Buser ,&nbsp;Mohammednur Ali Mohammed ,&nbsp;Shimelis Ayalew Yimer ,&nbsp;Yabets Tesfaye Kebede ,&nbsp;Bekri Delil Mohammed","doi":"10.1016/j.crwh.2024.e00668","DOIUrl":"10.1016/j.crwh.2024.e00668","url":null,"abstract":"<div><div>Hepatic pregnancy, an exceedingly rare subtype of abdominal ectopic pregnancy, remains clinically challenging due to its infrequency, diverse presentations, and diagnostic difficulties. We report the clinical course, diagnostic journey and treatment of a woman with a primary hepatic pregnancy.</div><div>The patient presented with acute pain in the right hypochondrium and vomiting. Imaging revealed a peripheral hypodense gestational sac within the right hepatic lobe containing a fetus with heart pulsations, as well as peritoneal fluid and pelvic collection. Following administration of mifepristone, the patient underwent a laparotomy, and expelled a developed fetus. Hepatic resection utilizing the Pringle maneuver was performed, and methotrexate was administered postoperatively. The patient had a stable recovery and vital signs and was discharged two days after surgery.</div><div>This case highlights the diagnostic and management challenges of hepatic pregnancy, and emphasizes the need for heightened clinical suspicion and thorough evaluation. By sharing the experience, we aim to contribute insights to guide the diagnosis and management of similar cases.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00668"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743483","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":"Gynaecological Emergencies","authors":"Annabelle Huguenin","doi":"10.1016/j.crwh.2024.e00672","DOIUrl":"10.1016/j.crwh.2024.e00672","url":null,"abstract":"","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00672"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142740","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":"Laparoscopic surgery for left ovarian hemorrhage in a patient with an implantable left ventricular assist device on antithrombotic therapy and a history of right salpingo-oophorectomy open surgery for right ovarian bleeding: A case report","authors":"Yasuto Kinose,&nbsp;Aasa Shimizu,&nbsp;Mamoru Kakuda,&nbsp;Satoshi Nakagawa,&nbsp;Tsuyoshi Takiuchi,&nbsp;Tadashi Iwamiya,&nbsp;Michiko Kodama,&nbsp;Eiji Kobayashi,&nbsp;Yutaka Ueda,&nbsp;Kenjiro Sawada,&nbsp;Tadashi Kimura","doi":"10.1016/j.crwh.2024.e00669","DOIUrl":"10.1016/j.crwh.2024.e00669","url":null,"abstract":"<div><div>Ovarian hemorrhage during antithrombotic therapy is sometimes difficult to manage. A 38-year-old woman, diagnosed with Marfan syndrome and implanted with a left ventricular assist device (LVAD) and taking aspirin and warfarin potassium, had a history of right adnexal oophorectomy via open surgery for a right ovarian hemorrhage at the age of 35 years. Thereafer, she had been treated with dienogest to suppress ovulation as much as possible. The patient was admitted to a local hospital with lower abdominal pain, and computed tomography showed a 10 cm left adnexal mass with suspected ovarian hemorrhage. Two days after the initiation of careful conservative treatment, with the cessation of antithrombotic therapy and monitoring of hemostasis, the patient was referred to a tertiary hospital. As the left ovarian hemorrhage continued 3 days after the transfer, emergency laparoscopic left salpingo-oophorectomy was performed due to the difficulty in conserving the left normal ovary. Although coagulopathy caused continuous oozing of blood from the pelvis after the removal of the left ovarian mass, hemostasis was successfully achieved laparoscopically. No postoperative bleeding was noted, and anticoagulant therapy was resumed on postoperative day 1 to prevent life-threatening thrombotic events associated with the LVAD. Postoperative pathological examination of the left ovary revealed an endometriotic cyst. To manage surgical menopause, complementary therapy using Japanese traditional herbal medicine was administered, as hormone replacement therapy was not recommended, to avoid the risk of fatal LVAD-associated thrombosis. Less invasive laparoscopic surgery for ovarian hemorrhage during anticoagulant therapy can be considered for reducing bleeding during and after surgery.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00669"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743487","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":"Successful management of intraoperative cesarean section bleeding due to cervical arteriovenous malformation: A case report","authors":"Vitcha Poonyakanok ,&nbsp;Kridtin Jarutatsanangkoon ,&nbsp;Pattarawalai Talungchit","doi":"10.1016/j.crwh.2024.e00667","DOIUrl":"10.1016/j.crwh.2024.e00667","url":null,"abstract":"<div><div>Cervical arteriovenous malformation is an exceedingly rare condition that can lead to antepartum hemorrhage, posing risks for both maternal and perinatal morbidity. We report the case of a 30-year-old primigravida, at a gestational age of 31⁺² weeks, who presented to hospital with antepartum hemorrhage. A speculum examination revealed a 500 mL blood clot. Despite a thorough examination, the cause of the antepartum hemorrhage remained elusive. An emergency cesarean section was done due to hypovolemic shock and a fetal NICHD category III assessment. Following the delivery of the fetus, a pulsatile tubular structure was identified at the endocervix and biopsied. Suture ligation followed by insertion of a Bakri balloon, effectively controlled the bleeding with blood loss of 1200 mL. Histopathology confirmed the diagnosis of arteriovenous malformation. This case underscores the importance of recognizing cervical arteriovenous malformation and demonstrates the effectiveness of suture ligation and balloon tamponade in managing associated hemorrhage, offering insights for similar cases.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00667"},"PeriodicalIF":0.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703059","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":"Postpartum multiple vertebral fractures in a patient with osteogenesis imperfecta type I: A case report and literature review","authors":"Yumiko Miyazaki,&nbsp;Mizuki Hosokawa,&nbsp;Sho Kudo,&nbsp;Toshimichi Onuma,&nbsp;Makoto Orisaka,&nbsp;Yoshio Yoshida","doi":"10.1016/j.crwh.2024.e00666","DOIUrl":"10.1016/j.crwh.2024.e00666","url":null,"abstract":"<div><div>A 39-year-old woman with type I osteogenesis imperfecta reported experiencing back pain at 35 weeks of gestation. Two days following an elective cesarean section, the patient developed a Th12 vertebral compression fracture; 3 weeks postoperatively, she sustained an L3 vertebral compression fracture. The patient displayed a lumbar spine <em>Z</em>-score of −1.7; she subsequently discontinued breastfeeding, and treatment with active vitamin D was initiated. Genetic testing confirmed a diagnosis of osteogenesis imperfecta.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00666"},"PeriodicalIF":0.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703060","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":"Caesarean scar pregnancy complicated by partial rupture in the second trimester: A case report","authors":"Prakriti Garkhail ,&nbsp;Astrid S.M. Vinkesteijn ,&nbsp;Sabina de Weerd","doi":"10.1016/j.crwh.2024.e00665","DOIUrl":"10.1016/j.crwh.2024.e00665","url":null,"abstract":"<div><div>This case report examines caesarean scar pregnancy, a rare but significant complication associated with increasing global caesarean rates. It explores diagnostic challenges, therapeutic interventions, and the importance of a multidisciplinary approach. This report details the case of a patient at 13 + 4 weeks of amenorrhea presenting with severe abdominal pain, diagnosed with caesarean scar pregnancy and scar dehiscence causing major haemorrhage. Emergency surgery and interventional radiology were employed for pregnancy evacuation and haemorrhage control. This report emphasizes niche pregnancy complexities and underscores the need for evidence-based practices to mitigate maternal morbidity and mortality. Additionally, it emphasizes the need for training in niche detection by transvaginal ultrasound for all clinicians encountering patients with early pregnancies.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00665"},"PeriodicalIF":0.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661847","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":"Posterior uterine wall rupture in an unscarred uterus in a term pregnancy; a case report","authors":"Mesfin Ayalew Tsegaye ,&nbsp;Alemayehu Nigusssie Adugna ,&nbsp;Rebecca Haile Tesfay ,&nbsp;Elias Gashaw Endegnanew ,&nbsp;Kidist Nega Aragaw","doi":"10.1016/j.crwh.2024.e00664","DOIUrl":"10.1016/j.crwh.2024.e00664","url":null,"abstract":"<div><div>Uterine rupture is a catastrophic separation of the uterine walls due to several risk factors. It is a common complication of scarred uterus during labor and delivery. Early detection is associated with better maternal and fetal outcomes. Due to nonspecific presentation, a high level of suspicion especially on pregnancies with risk factors could help pick uterine rupture early. This report presents a gravida 11 para 10 mother who presented with vaginal bleeding and severe abdominal pain after laboring for 24 h at home. Intra-op findings were approximately 1000 ml of hemoperitoneum with the fetus and the placenta floating on the peritoneal cavity and a 13 cm posterior uterine rupture with vaginal extension. A subtotal hysterectomy and left salpingo-oophorectomy were done She was discharged well after several blood transfusions. The objective is to present a rare case of posterior wall uterine rupture and to emphasize the importance of early detection of posterior wall uterine ruptures.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00664"},"PeriodicalIF":0.7,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661845","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":"Septic shock after a saline infusion hysterosalpingosonogram in a woman with stage IV endometriosis and infertility: A case report","authors":"Mariah Colussi ,&nbsp;Geneviève Horwood ,&nbsp;Jenn McCall ,&nbsp;Jenna Gale ,&nbsp;Sukhbir Singh","doi":"10.1016/j.crwh.2024.e00663","DOIUrl":"10.1016/j.crwh.2024.e00663","url":null,"abstract":"<div><div>Saline infusion sonohysterography/hysterosalpingo-contrast sonography is commonly used in the work-up of infertility. Overall, pelvic infection following these investigations is rare, but risk may be increased in patients with deep infiltrating endometriosis. Antibiotic prophylaxis is not professionally recommended in patients with advanced endometriosis, a point that requires reconsideration. A 29-year-old woman with stage IV endometriosis presented with pelvic inflammatory disease and sepsis following a saline hysterosalpingo-contrast sonogram for investigation of infertility. Her infection was resistant to antibiotic treatment and she required extensive surgical intervention for source control, which impacted her fertility. The immunodeficient pelvic microenvironment in patients with endometriosis and endometrioma can increase the risk and severity of pelvic infection. Antibiotic prophylaxis should always be utilized in those with stage IV endometriosis who are due to undergo saline infusion sonohysterography or hysterosalpingo-sonography.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00663"},"PeriodicalIF":0.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661844","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":"Recurrent adnexal torsion in a teenager with hypermobile Ehlers-Danlos syndrome: A case report","authors":"Michail Panagiotopoulos,&nbsp;Maria Tsiriva,&nbsp;Lito Vogiatzi-Vokotopoulou,&nbsp;Konstantinos Koukoumpanis,&nbsp;Nikolaos Kathopoulis,&nbsp;Athanasios Douligeris,&nbsp;Athanasios Protopapas,&nbsp;Lina Michala","doi":"10.1016/j.crwh.2024.e00661","DOIUrl":"10.1016/j.crwh.2024.e00661","url":null,"abstract":"<div><div>Hypermobile Ehlers-Danlos syndrome (hEDS) is the most common type of EDS, characterized by joint hypermobility, frequent dislocations, and chronic pain. Genetic markers are not typically used in diagnosis.</div><div>A 17-year-old clinically diagnosed with hEDS presented with recurrent lower abdominal pain, later attributed to intermittent partial adnexal torsion. Whole-genome sequencing revealed a missense mutation c.1691G &gt; A (p.Arg564His) in the COL1A1 gene. She had undergone two exploratory laparotomies at ages 8 and 10 due to acute pain, resulting in a left adnexectomy and right detorsion with hydrosalpinx drainage. It was suspected that the recurrent adnexal torsion was linked to hEDS-related tissue elasticity, and so a laparoscopic right oophoropexy by shortening the utero-ovarian ligament was performed. At one-year follow-up, she was asymptomatic.</div><div>This case highlights the potential connection between hEDS and adnexal torsion, which may contribute to chronic abdominal pain, often misattributed to other conditions, such as irritable bowel syndrome.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00661"},"PeriodicalIF":0.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661843","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}