Case Reports in Women's Health最新文献

{"title":"Low-dose naltrexone as a treatment for vulvodynia: A case series","authors":"Renee T. Sullender,&nbsp;R. Gina Silverstein,&nbsp;Diamond M. Goodwin ,&nbsp;Asha B. McClurg,&nbsp;Erin T. Carey","doi":"10.1016/j.crwh.2024.e00677","DOIUrl":"10.1016/j.crwh.2024.e00677","url":null,"abstract":"<div><div>Vulvodynia is a chronic vulvar pain condition that can be challenging to treat and often requires multi-modal interventions for symptom management. Low-dose naltrexone (LDN) is a reversible competitive antagonist at opioid receptors and may have utility in treating chronic pain conditions. In a specialty gynecology clinic at an academic medical center, patients with poorly controlled vulvodynia who had failed standard treatments were offered LDN as an adjunct pain treatment. This case series describes the experience of three patients with chronic vulvodynia who added LDN to their treatment regimen. All patients reported subjective improvement in their symptoms without side-effects. Additional research is needed on the efficacy of LDN for chronic pelvic pain conditions such as vulvodynia as well as the long-term safety profile of such use.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00677"},"PeriodicalIF":0.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969750","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":"Bilateral avascular necrosis leading to hip fracture in pregnancy: A case report","authors":"Marlon M. Mencia ,&nbsp;Pedro Pablo Hernandez Cruz ,&nbsp;Shanta Bidaisee ,&nbsp;Allan Beharry","doi":"10.1016/j.crwh.2024.e00675","DOIUrl":"10.1016/j.crwh.2024.e00675","url":null,"abstract":"<div><div>Avascular necrosis (AVN) of the hip, a rare cause of pelvic pain in the third trimester of pregnancy, often presents with nonspecific symptoms that resemble common musculoskeletal conditions. This ambiguity, coupled with concerns about the safety of magnetic resonance imaging (MRI) during pregnancy, can hinder timely diagnosis. We report a unique case of a 32-year-old primigravida diagnosed with a hip fracture and bilateral AVN of the femoral head in the immediate postpartum period, a complication seemingly not previously documented in pregnant patients. The initial management involved closed reduction and internal fixation using cannulated screws. However, progressive femoral head collapse necessitated revision to a total hip arthroplasty. This case underscores the importance of early diagnosis and recognition of AVN in pregnancy to prevent severe complications. It highlights the diagnostic challenges and emphasizes the need for heightened awareness and earlier imaging investigations in similar clinical scenarios.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00675"},"PeriodicalIF":0.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098482","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":"Prenatal diagnosis of clinodactyly and its association with genetic syndromes: A case report","authors":"Themistoklis Loukopoulos ,&nbsp;Athanasios Zikopoulos ,&nbsp;Nikolaos Vlassis ,&nbsp;Emmanouil Manolakos ,&nbsp;Sotirios Sotiriou ,&nbsp;Anastasia Vatopoulou ,&nbsp;Fani Gkrozou ,&nbsp;Anastasios Potiris ,&nbsp;Sofoklis Stavros ,&nbsp;Charikleia Skentou","doi":"10.1016/j.crwh.2024.e00674","DOIUrl":"10.1016/j.crwh.2024.e00674","url":null,"abstract":"<div><div>A curvature of a finger that bends inwards relative to the other fingers is a common observation during prenatal screening. When the angulation exceeds 10 degrees, it is known as “clinodactyly” and could suggest a variety of underlying issues. Even though it usually remains unnoticed during pregnancy, it may be a sign of serious fetal disease. We report the case of a fetus diagnosed with clinodactyly of the thumb accompanied by tachycardia, abnormal levels of maternal hormones in the first trimester and increased impedance to flow in the uterine arteries. Although non-invasive prenatal testing was normal, amniocentesis was carried out and two deviations at chromosome 20 were identified through molecular karyotyping. Our report aims to raise clinical suspicion regarding the potential association between genetic abnormalities and clinodactyly. A careful clinical and genetic consultation is required in order to achieve the most favorable outcome for both mother and child.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00674"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884989","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":"Dedifferentiated recurrent liposarcoma of the uterine corpus: A case report and literature review","authors":"Sana Mushtaq ,&nbsp;Muhammad Arslan Ul Hassan ,&nbsp;Yan Li ,&nbsp;Ikran Abdi ,&nbsp;Aqsa Ahmad ,&nbsp;HaiNing Li","doi":"10.1016/j.crwh.2024.e00670","DOIUrl":"10.1016/j.crwh.2024.e00670","url":null,"abstract":"<div><div>Liposarcoma of the uterine corpus represents an exceptionally rare tumor, with few cases documented in the literature, underscoring its unique histopathologic characteristics and management challenges. This case describes the clinical management of a 57-year-old patient with well-differentiated liposarcoma of the uterine corpus who presented with a three-month history of abdominal pain and distension. She underwent an abdominal hysterectomy followed by chemotherapy but experienced local recurrence in the mesentery and retroperitoneum after 21 months. Tumor resection was performed again, followed by chemotherapy, but the patient experienced a second recurrence 15 months later, involving the small intestine, vaginal stump, and ureter, with evidence of dedifferentiated liposarcoma. A third surgical resection was carried out without administering chemotherapy and the patient remained asymptomatic at follow-up appointments every 3 months for a year. This case highlights the importance of acknowledging the aggressive nature of recurrent liposarcoma, especially its transition into dedifferentiated liposarcoma, and the need for tailored management strategies.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00670"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743488","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":"Uterine rupture with induction using misoprostol for intrauterine foetal death in the second trimester: A case report","authors":"Akiko Yamamoto,&nbsp;Patrick Jn-Charles","doi":"10.1016/j.crwh.2024.e00671","DOIUrl":"10.1016/j.crwh.2024.e00671","url":null,"abstract":"<div><div>Uterine rupture is a well-known, life-threatening complication of misoprostol use; the incidence is remarkably low. Herein, we report what seems to be the first documented case of uterine rupture following induction of labour for intrauterine foetal death in the second trimester without a uterine scar. A 40-year-old woman with no history of caesarean section or uterine surgery presented with mild lower abdominal pain and mild genital bleeding. Transabdominal ultrasonography revealed intrauterine foetal death, at presumed gestational age of 20 weeks. Two hours after three doses of 400 μg 3-hourly of misoprostol, the patient complained of abdominal pain; however, the foetus was not expelled. Repeat sonography revealed the foetus in the abdominal cavity and fluid collection in the pelvis. Based on the probable diagnosis of uterine rupture, a laparotomy was performed. The intra-abdominal haemorrhage volume was approximately 250–300 ml. There was a linear rupture approximately 10 cm long on the posterior wall of the uterus, and as a consequence, a macerated and foetid foetus and part of the placenta were found in the abdominal cavity. A total hysterectomy was performed, and the patient was discharged three days after the intervention without any postoperative complications. In conclusion, while misoprostol is generally safe for second-trimester pregnancy termination, its use should be approached with caution and close monitoring in cases of uterine inflammation.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"44 ","pages":"Article e00671"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881379","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":"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}