scholarly journals Pyomyoma as a Rare Source of Postpartum Sepsis

2015 ◽  
Vol 2015 ◽  
pp. 1-2 ◽  
Author(s):  
A. DeMaio ◽  
M. Doyle
Keyword(s):  
Abdominal Pain ◽  
Unusual Case ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Clinical Suspicion ◽  
Subsequent Infection ◽  
Severe Morbidity ◽  
History Of ◽  
High Index Of Suspicion ◽  
Obvious Source

Pyomyoma, also known as suppurative leiomyoma, is a rare clinical complication that occurs when a leiomyoma undergoes infarction and subsequent infection. A high index of suspicion is required to make the diagnosis and can be guided by a classic triad of symptoms that includes abdominal pain, sepsis without an obvious source, and a history of leiomyoma. In the vast majority of these cases, total abdominal hysterectomy is required to avoid severe morbidity and potential mortality. We present an unusual case of a postpartum pyomyoma that was successfully treated without the need for hysterectomy. With strong clinical suspicion, early diagnosis, and appropriate management, some affected patients may preserve fertility.

scholarly journals Metastatic Uterine Leiomyosarcoma in a Nullipara with Primary Infertility: A Case Report

2019 ◽  
Vol 4 (11) ◽  
Author(s):  
Okechukwu B. Anozie ◽  
Johnbosco I. Nwafor ◽  
Chidi U. Esike ◽  
Chukwuemeka I. Ukaegbe ◽  
Richard L. Ewah ◽  
...  
Keyword(s):  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Leiomyosarcoma ◽  
Presenting Symptoms ◽  
Primary Infertility ◽  
History Of ◽  
Uterine Cancers ◽  
Operative Findings ◽  
High Index Of Suspicion ◽  
Lost To Follow Up

Uterine leiomyosarcoma accounts for 1-2% of uterine cancers. It is an extremely aggressive malignancy associated with a poor prognosis. Women affected may vary in age, but are most common between 4th and 7th decades of life. Presenting symptoms mimic uterine leiomyoma. Preoperative diagnosis of uterine leiomyosarcoma is difficult and often made at time of surgical resection. We report a case of Mrs A.E, a 40 year old nullipara with history of primary infertility of 20 years duration, who presented with abdominal swelling of 3 years and vaginal bleeding of 7 weeks duration. Abdominopelvic ultra-sonography done at presentation was suggestive of leiomyoma. She was scheduled for myomectomy and subsequently had total abdominal hysterectomy and omentectomy following intra-operative findings of features suggestive of leiomyosarcoma with evidence of metastasis to omentum. These findings were confirmed on histology of the specimen. She received one cycle of combination chemotherapy but was lost to follow up. Uterine LMS is an aggressive tumour, therefore, a high index of suspicion is needed especially for huge uterine nodules and such patients must be closely monitored for adequate management.

scholarly journals Degenerated fibroid - a diagnostic challenge

2016 ◽  
Vol 6 (1) ◽  
pp. 292
Author(s):  
Sonal Bhuyar ◽  
Bhavana Sontakke ◽  
Pooja Mukund Rajbhara
Keyword(s):  
Ovarian Tumor ◽  
Unusual Case ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Large Mass ◽  
Abdominal Hysterectomy ◽  
Diagnostic Challenge ◽  
Malignant Ovarian Tumor ◽  
History Of ◽  
Leiomyoma Of The Uterus

Leiomyoma of the uterus is the most common type of tumor affecting the female pelvis and arises from uterine smooth muscle. The size of leiomyoma varies from microscopic to giant; giant myoma is exceedingly rare. We report an unusual case of a large, cystic, uterine leiomyoma mimicking a primary malignant ovarian tumor on sonography and CT. A 39 year old infertile nulliparous woman presented with a history of lump in abdomen since 2 years and 6 months of amenorrhea. Sonography and CT examination showed a large mass that filled the abdomen. A preoperative diagnosis of a primary malignant ovarian tumor was made. The patient underwent laparotomy with total abdominal hysterectomy preserving tubes and ovaries. The histology revealed a leiomyoma with extensive hyaline degeneration. The current established management of uterine fibroids may include expectant, surgical, or medical management or uterine artery embolization or a combination of these treatments. A surgical approach is preferred for management of giant leiomyomas. Leiomyomas should be considered in the differential diagnosis of a multilocular and predominantly cystic adnexal mass.

Cricotracheal separation: a review and a case with bilateral recovery of recurrent laryngeal nerve function

2006 ◽  
Vol 120 (6) ◽  
pp. 497-501 ◽  
Author(s):  
D J McCrystal ◽  
C Bond
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Unusual Case ◽  
Open Repair ◽  
Laryngeal Nerve ◽  
Clinical Suspicion ◽  
Nerve Function ◽  
Short Term ◽  
High Index Of Suspicion ◽  
Type Of Injury

Cricotracheal separation (CTS) is an uncommon injury, with a high index of suspicion required to establish the diagnosis. Computerized tomography (CT) plays a role in diagnosis but cannot necessarily be relied upon. Bilateral recurrent laryngeal nerve (RLN) palsies are usually associated with this type of injury. We recently treated a patient with CTS in whom one RLN was intact from the time of the injury and the other nerve recovered within three months. Computed tomography was inconclusive.Early open repair of the injury and frequent follow-up examinations led to successful decannulation after six weeks and excellent short-term voice and airway outcomes.A detailed discussion of this unusual case is followed by a review of the current literature on CTS, with particular emphasis on significant management dilemmas and controversies.Clinical suspicion remains more sensitive than investigations in diagnosing CTS. Permanent bilateral RLN palsies are not inevitable following these injuries.

Clear cell carcinoma of Mullerian origin in the urinary bladder: A rare entity

2021 ◽  
pp. 205141582098766
Author(s):  
Harshit Garg ◽  
Brusabhanu Nayak ◽  
Tripti Nakra ◽  
Prabhjot Singh ◽  
Seema Kaushal
Keyword(s):  
Urinary Bladder ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Rare Entity ◽  
Level Of Evidence ◽  
History Of ◽  
Carcinoma Of The Bladder

Mullerian neoplasms of the urinary system are rare but complex tumor-like lesions. The identification of the Mullerian neoplasm is crucial for patient management owing to its etiology, natural history, and prognosis. We present a case of a 42-year-old female with a history of three lower segment cesarean sections presenting with complaints of dysmenorrhea and suprapubic pain with no history of hematuria or any urinary symptoms. Magnetic resonance imaging revealed a 2 cm×2 cm exophytic lesion suspicious of being either a bladder lesion or an endometrial lesion infiltrating the urinary bladder. Cystoscopy and transurethral biopsy of this suspicious bladder tumor revealed a malignant tumor with papillary and tubulocystic architecture. Based on the overall histomorphological and immunohistochemical features, a diagnosis of clear cell carcinoma of Mullerian origin was made, and the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and partial cystectomy. The patient was kept on regular surveillance and showed no signs of recurrence at the one-year follow-up. Clear cell carcinoma of the bladder of Mullerian origin is a rare entity and is established on histopathology. Prompt diagnosis and a multidisciplinary approach are indispensable for management. Level of evidence: Level 4.

scholarly journals Unusual case of Giardia lamblia causing eosinophilic ascites along with Plesiomonasshigelloides gastroenteritis

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 321-323
Author(s):  
Ballal Mamatha ◽  
Shetty Vignesh ◽  
Agarwal Manali ◽  
Nayal Bhavna ◽  
Umakanth Shashikiran
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Giardia Lamblia ◽  
Complete Resolution ◽  
Unusual Case ◽  
Peripheral Eosinophilia ◽  
Short Trip ◽  
Eosinophilic Ascites ◽  
History Of

A case report of a healthy, immunocompetent male,an international traveller from Germany who had visited India for a short trip,presented at our OPD with a history of loose stools, fever and abdominal pain,for two months. After thorough investigations, he was diagnosed to have an infection withGiardia lambliaacute gastroenteritis (AGE) along witheosinophilic ascites with peripheral eosinophilia, withassociatedPlesiomonasshigelloidesdiarrhoea. He was then treated with metronidazole and cotrimoxazole, which resulted in complete resolution of the symptoms.

scholarly journals Uterus-sparing myomectomy for idiopathic uterine pyomyoma in a young woman: A case report

2020 ◽  
Vol 2 (2) ◽  
pp. 19-22
Author(s):  
Ugur Sen ◽  
Tuğba Karadeniz ◽  
Emrah Beyan
Keyword(s):  
Risk Factor ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Proper Treatment ◽  
Imaging Findings ◽  
Cervical Stenosis ◽  
Mortality And Morbidity ◽  
Risk Of Mortality ◽  
History Of

Pyomyoma, or suppurative leiomyoma, is a rare but serious complication of uterine fibroids. The mechanism of pyomyoma is an infection caused by microorganisms coming from ascending or hematogenously on the ground of necrosis following ischemia and infarction. It can be seen during the course of pregnancy or after abortion and birth. It can also develop after uterine instrumentation or due to cervical stenosis. Patients often present with pain and fever. It should be considered in cases had no other etiology of fever and had a history of uterine fibroids. Diagnosis and treatment are often delayed due to non-specific presentation and imaging findings. This delay increases the risk of mortality and morbidity such as fertility loss. In the vast majority of these cases, total abdominal hysterectomy is required. The case we presented is a premenopausal and sexually inactive woman without any history of pregnancy or uterine instrumentation or immunocompromised. This patient is the 5th case of pyomyoma without risk factor and the 3rd case that was successfully treated with myomectomy. Knowing the proper treatment of pyomyoma will be beneficial to prevent potential mortality and morbidity.

scholarly journals Vesico-Vaginal Fistula Repair Through Abdominal Approach

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 129-132
Author(s):  
Hafiz Al Asad ◽  
Asif Yazdani ◽  
Zulfia Zinat Chowdhury ◽  
Muhammad Faruk Hussain ◽  
AKM Shahadat Hossaion ◽  
...  
Keyword(s):  
Wound Infection ◽  
Operative Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Surgery ◽  
Vaginal Fistula ◽  
Abdominal Approach ◽  
History Of ◽  
Vesico Vaginal Fistula

Background: Vesico-Vaginal Fistula (VVF) is a major cause for concern in many developing countries with significant morbidity. Among the different techniques abdominal approach of VVF repair is important one. Objective: To find out the outcome of VVF repair by abdominal approach. Materials and Methods: It is a prospective study. Twenty-three patients with VVF were operated with abdominal approach from the period of January 2016 to January 2019. Age of patients, co-morbidities, cause, size and location of VVF were evaluated. Then abdominal approach of VVF repair was done. Operative time and need of blood transfusion were encountered. Post operative (POD) urine leakage, wound infection or other complications were enlisted. Patients were discharged with keeping urethral catheter for 14 days. Follow up was done after 1 and 3 month and in each follow up history and physical examination was done. All collected data were evaluated. Results: Mean age of the patient was 40 years. Among the 23 patients 12 (52%) patients had history of total abdominal hysterectomy, 9 had history of caesarian section and 2 cases had history of pelvic surgery. VVF repair was done at least 12 weeks after its occurrence. Operative time ranged from 90 minutes to 150 minutes. In the immediate POD no obvious complications were noted except one patient developed wound infection on 7th POD. Follow-up done as per schedule and no recurrence of VVF noted. Conclusion: VVF repair through abdominal approach is a feasible, safe and effective technique if performed meticulously. KYAMC Journal Vol. 11, No.-3, October 2020, Page 129-132

Mullerian Adenosarcoma of the Endometrium in a 19-Year-Old Girl: Case Report and a Literature Review

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Miyoshi A ◽  
◽  
Ueda Y ◽  
Sato K ◽  
Kimura T ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Transvaginal Ultrasound ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Tumor Biopsy ◽  
Surgical Specimen ◽  
Ultrasound Sonography ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Gross Examination

Mullerian adenosarcoma of the endometrium in adolescent girls is extremely rare, with only fifteen cases under 20 years old having been reported to date. We describe here a new case of adolescent Mullerian adenosarcoma and provide an updated review of the previous literature on such rare tumors. Our 19-year-old case presented with a six-month history of prolonged menstruation. She had not yet had any sexual relationship. On gross examination, a fragile mass was seen in her vagina that bled easily. A 4.0×2.0 cm mass was visualized with Magnetic Resonance Imaging (MRI). The tumor seemed to slightly invade the myometrium of the uterine corpus. Transvaginal ultrasound sonography confirmed the presence of a 4.0 cm mass located in the cervix and vagina. The tumor biopsy was diagnosed as a Mullerian adenosarcoma of the endometrium. We performed a Total Abdominal Hysterectomy (TAH) and Bilateral Salpingectomy (BS). The post-surgical specimen was diagnosed as a pT1aNXM0 Mullerian adenosarcoma of the endometrium. The patient did not require adjuvant chemotherapy. She has been monitored every 3 months and has been without recurrence now for 28 months.

scholarly journals Disseminated Histoplasmosis in an Elderly Man Presented with Fever, Weight loss, Abdominal Pain and Haemoptysis - A Case Report with Literature Review

2011 ◽  
Vol 12 (1) ◽  
pp. 81-85
Author(s):  
Mohammad Robed Amin ◽  
Farzana Shumi ◽  
Hasibuddin Khan ◽  
Syed Ahmed Abdullah ◽  
Shafiul Alam ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Case Report ◽  
Literature Review ◽  
Disseminated Histoplasmosis ◽  
History Of ◽  
Background History ◽  
Recurrent Haemoptysis ◽  
High Index Of Suspicion

An elderly patient presented with prolonged fever, gross weight loss, recurrent haemoptysis and abdominal pain. He had a background history of adrenal tuberculosis with completion of treatment without any obvious improvement. Clinically he was diagnosed as a case of adrenocotical insufficiency. Evaluation including histopathology revealed the diagnosis as disseminated histoplasmosis involving adrenal gland and lungs. The disease is a rarity without any underneath immunosuppression and hence high index of suspicion with appropriate steps for investigation is the key to achieve a diagnosis of disseminated histoplasmosis in Bangladesh. Keyword: . DOI: 10.3329/jom.v12i1.6936J Medicine 2011; 12 : 81-85

Delayed presentation of a congenital duodenal web managed successfully with incision of web

2020 ◽  
Vol 13 (12) ◽  
pp. e237307
Author(s):  
Mahendra Kumar Jangid ◽  
Reyaz Ahmad ◽  
Sujeet Pandre
Keyword(s):  
Abdominal Pain ◽  
Duodenal Obstruction ◽  
Accurate Diagnosis ◽  
Unusual Presentation ◽  
Contrast Study ◽  
Delayed Presentation ◽  
History Of ◽  
Duodenal Web ◽  
High Index Of Suspicion ◽  
The Web

One of the causes of congenital incomplete duodenal obstruction is the presence of congenital duodenal web with fenestration. This condition requires a high index of suspicion for an early and accurate diagnosis. We present an unusual presentation of duodenal web in a 6-year-old girl who presented with a 3-year history of cyclical and seasonal vomiting and abdominal pain. The diagnosis of congenital duodenal web with fenestration was made on contrast study and endoscopy and was treated surgically by incision of the web.

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