scholarly journals Medical Management of Pyometra in the Delayed Postoperative Period

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Natalie A. Vukmer ◽  
Heather Urrego ◽  
A. Mitch Dizon
Keyword(s):  
Abdominal Pain ◽  
Uterine Cavity ◽  
Rare Condition ◽  
Operative Management ◽  
Uterine Perforation ◽  
Normal Female ◽  
Diffuse Abdominal Pain ◽  
Life Threatening ◽  
Timely Fashion ◽  
Hospital Stays

Pyometra is a rare condition in which purulent material becomes entrapped within the uterine cavity. If unrecognized in a timely fashion, life-threatening complications can arise. The following is a case report of a 50-year-old female who presented to the emergency department with abdominal pain and heavy vaginal bleeding. She was diagnosed with a pyometra based on imaging and treated conservatively with antibiotics. The patient ultimately had an uncomplicated hysterectomy with resolution of normal female pelvic anatomy prior to surgery. Pyometra should be considered when women present with diffuse abdominal pain or peritonitis. As demonstrated in this report, early detection and conservative management may help prevent serious complications such as uterine perforation, lead to shorter hospital stays, and result in safer operative management.

scholarly journals Diffuse peritonitis caused by spontaneous perforation of pyometra: A case report and literature review

2021 ◽  
Author(s):  
Hao Xu ◽  
Yifan Zhuang ◽  
Caiming Wang ◽  
Yongjie Zhou ◽  
Haofei Chen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Abdominal Pain ◽  
Early Diagnosis ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Uterine Cavity ◽  
Uterine Perforation ◽  
Diffuse Peritonitis ◽  
Appropriate Treatment ◽  
The Right

Abstract BackgroundUterine perforation is commonly caused by iatrogenic injuries, tumours, and traumas. Uterine perforation resulting from infection is less common, and such perforation rarely causes abdominal empyema and diffuse peritonitis. Infectious complications such as shock and multiple organ dysfunction are extremely dangerous and even life threatening. Correct early diagnosis and appropriate treatment can reduce the mortality of pyometra.Case presentationA 62-year-old woman presented to our hospital with persistent abdominal pain for 5 hours. The patient had undergone hysteroscopy six months ago, and a cystic space-occupying lesion of the uterus was found one month ago. Perfect the various examinations, consider the patient as acute diffuse peritonitis Perforation of the digestive tract? Uterine cavity infection. In the emergency department, laparoscopic exploration was performed. During the operation, it was diagnosed as pyometra and perforation of the right uterine fundus. Then, combined with a gynecologist, a hysterectomy with double appendages was performed. The operation went smoothly. The patient had paralytic intestinal obstruction after the operation. After active symptomatic treatment The patient recovered well and was discharged. Postoperative pathology results were as follows: 1. Moderately differentiated squamous cell carcinoma of the cervix (non-keratinizing type); 2. Metastatic squamous cell carcinoma of the right ovary; 3. Perforation of the fundus of the uterus, pyometra, and extensive purulent inflammation of the muscle wall .ConclusionsUterine perforation is a rare cause of acute abdomen. Clinicians often don't know enough about this, and they are prone to misdiagnosis and missed diagnosis. For elderly women with abdominal pain and peritonitis, the possibility of empyema perforation should be considered during diagnosis and treatment, and the examination should be improved to avoid misdiagnosis, because correct early diagnosis and appropriate treatment can reduce the mortality of empyema.

scholarly journals Uterine Perforation & Abortion- A Case Report

KYAMC Journal ◽  
2017 ◽  
Vol 5 (1) ◽  
pp. 491-493
Author(s):  
Mst Atia Sultana ◽  
Rakib Uddin ◽  
Rubiyat Farzana Hussain ◽  
Masuma Khatun
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Vaginal Bleeding ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
Placental Tissue ◽  
Uterine Perforation ◽  
Gentle Traction ◽  
Cord Prolapse

Sreemoti Ratna Sarker 30 years old lady presented to us with the complaints of amenorrhea for 5 months, lower abdominal pain for 5 days, slight per vaginal bleeding for 2-3 days, a cord like structure is coming down p/v on the day of admission. On general examination she was stable and on p/v examination there was cord prolapse. A gentle traction was given and it was expelled out along with a small piece of placental tissue without any fetal parts and bleeding. Then she was advised for USG of abdomen. USG reported a fetus like structure in the abdominal cavity and the empty uterine cavity . She was managed surgically. Now she is doing well.KYAMC Journal Vol. 5, No.-1, Jul 2014, Page 491-493

scholarly journals Midgut Volvulus: A Rare but Fatal Cause of Abdominal Pain in Pregnancy—How Can We Diagnose and Prevent Mortality?

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Eelyn Chong ◽  
David S Liu ◽  
Neil Strugnell ◽  
Vishnupriya Rajagopal ◽  
Krinal K Mori
Keyword(s):  
Abdominal Pain ◽  
Rare Condition ◽  
Definitive Treatment ◽  
Fetal Mortality ◽  
Midgut Volvulus ◽  
Loss Of Life ◽  
Delay In Diagnosis ◽  
Life Threatening ◽  
Low Incidence ◽  
In Pregnancy

Midgut volvulus in pregnancy is rare but life-threatening, resulting in high maternal and fetal mortality. This surgical emergency commonly masquerades as symptoms of pregnancy, which together with its low incidence often leads to delay in diagnosis and definitive treatment. Here, we review the last three decades of the literature, discuss the challenges in managing this rare condition, and raise awareness among clinicians to minimise loss of life.

scholarly journals Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Toshihiro Kitai ◽  
Kentaro Okuno ◽  
Hiromi Ugaki ◽  
Yoshiko Komoto ◽  
Satoshi Fujimi ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Uterine Cavity ◽  
Severe Infection ◽  
Wound Dehiscence ◽  
Multiple Organ ◽  
Uterine Perforation ◽  
Diffuse Peritonitis ◽  
Spontaneous Perforation ◽  
Diffuse Abdominal Pain ◽  
Generalized Peritonitis

Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized peritonitis secondary to perforation of the gastrointestinal tract or uterus, supravaginal hysterectomy and bilateral salpingo-oophorectomy were performed. Unfortunately, wound dehiscence and infection occurred during the postoperative course, which were exacerbated by her immunocompromised state. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on the 36th postoperative day. Although correct diagnosis, early intervention, and proper treatment can reduce morbidity and mortality of spontaneous perforation of pyometra, if severe infection occurs, this disease can be life threatening for immunocompromised hosts.

scholarly journals Two Dabigatran Fast Reversals in a 4-month Period – a Case Report

2019 ◽  
Author(s):  
Vítor Fagundes ◽  
Mari Mesquita
Keyword(s):  
Atrial Fibrillation ◽  
Abdominal Pain ◽  
Case Report ◽  
Subdural Haematoma ◽  
Cerebral Haemorrhage ◽  
Case Description ◽  
Diffuse Abdominal Pain ◽  
Urgent Surgery ◽  
Feasible Option ◽  
Life Threatening

Introduction: Idarucizumab is available for immediate reversal of dabigatran-induced anticoagulation in life-threatening bleeding or urgent surgery in patients with non-valvular atrial fibrillation (nvAF). Case description: We report a case of an 85-year-old female treated with dabigatran for nvAF, submitted to two fast reversal procedures with idarucizumab in a 4-month period. In the first emergency episode, the patient was admitted due to a fall-related cerebral haemorrhage and subdural haematoma. There was a fast reversal of the effects of dabigatran after idarucizumab administration, which allowed stoppage of the bleeding and a decrease in intracranial pressure, with full patient recovery. Four months later, the patient revisited the hospital complaining of diffuse abdominal pain while on the same antithrombotic therapy. Physical examination showed signs of peritoneal irritation and the use of idarucizumab to reverse the effects of dabigatran was decided upon to secure normal bleeding conditions before surgery. Discussion: Idarucizumab is an efficient, safe and feasible option for dabigatran-treated nvAF patients, when urgent anticoagulant effect reversal is needed.

scholarly journals Hemoperitoneum Secondary to Spontaneous Rupture of a Retroperitoneal Varix

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Derrick D. Eichele
Keyword(s):  
Abdominal Pain ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Acute Abdominal Pain ◽  
Early Recognition ◽  
Relevant Literature ◽  
Hypovolemic Shock ◽  
Rare Condition ◽  
Unique Case ◽  
Life Threatening

Hemoperitoneum due to a ruptured retroperitoneal varix is an exceedingly rare condition and a poor prognostic sign with catastrophic and life-threatening complication of portal hypertension. We present a unique case of a 56-year-old female with cirrhosis secondary to primary sclerosing cholangitis who presented with acute abdominal pain and hypovolemic shock prior to a cardiac arrest following a ruptured retroperitoneal varix without prior esophageal varices and a newly identified intrahepatic cholangiocarcinoma. The clinical presentation with abdominal pain and hemorrhagic shock is consistently reported in the relevant literature. Early recognition affords appropriate management and urgent surgical intervention leading to survival.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

scholarly journals The Global Registry for Hereditary Angioedema due to C1-Inhibitor Deficiency

2021 ◽  
Author(s):  
Andrea Zanichelli ◽  
Henriette Farkas ◽  
Laurance Bouillet ◽  
Noemi Bara ◽  
Anastasios E. Germenis ◽  
...  
Keyword(s):  
Hereditary Angioedema ◽  
Rare Condition ◽  
C1 Inhibitor ◽  
C1 Inhibitor Deficiency ◽  
Therapeutic Decisions ◽  
Life Threatening ◽  
Enhance Patient Care ◽  
Electronic Support ◽  
The Impact ◽  
Global Registry

AbstractHereditary angioedema (HAE) is a rare condition, mostly due to genetic deficiency of complement C1 inhibitor (C1-INH). The rarity of HAE impedes extensive data collection and assessment of the impact of certain factors known to affect the course of this disabling and life-threatening disease. Establishing a global registry could assist to overcome such issues and provides valuable patient data from different countries. The HAE Global Registry is a disease-specific registry, with web-based electronic support, where data are provided by physicians and patients through a dedicated application. We collected data between January 1, 2018, and August 31, 2020. Data on 1297 patients from 29 centers in 5 European countries were collected. At least one attack was recorded for 497 patients during the study period. Overall, 1182 patients were diagnosed with HAE type 1 and 115 with type 2. At the time of database lock, 389 patients were taking long-term prophylactic medication, 217 of which were on danazol. Most recorded attacks affected the abdomen, were generally moderate in severity, and occurred in patients who were not on prophylactic treatment (70.6%, 6244/8848). The median duration of attacks was 780 min (IQR 290–1740) in patients on prophylactic medication and 780 min (IQR 300–1920) in patients not on continuous prophylactic medication. In conclusion, the establishment of a registry for C1-INH-HAE allowed collection of a large amount of data that may help to better understand the clinical characteristics of this disease. This information may enhance patient care and guide future therapeutic decisions.

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals Successful Management of Acquired Hemophilia A Associated with Bullous Pemphigoid: A Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Quentin Binet ◽  
Catherine Lambert ◽  
Laurine Sacré ◽  
Stéphane Eeckhoudt ◽  
Cedric Hermans
Keyword(s):  
Bullous Pemphigoid ◽  
Neutralizing Antibodies ◽  
Hemophilia A ◽  
Rare Condition ◽  
Term Treatment ◽  
Acquired Hemophilia A ◽  
Acquired Hemophilia ◽  
Short Term Treatment ◽  
Life Threatening ◽  
Dose Levels

Background. Acquired hemophilia A (AHA) is a rare condition, due to the spontaneous formation of neutralizing antibodies against endogenous factor VIII. About half the cases are associated with pregnancy, postpartum, autoimmune diseases, malignancies, or adverse drug reactions. Symptoms include severe and unexpected bleeding that may prove life-threatening.Case Study. We report a case of AHA associated with bullous pemphigoid (BP), a chronic, autoimmune, subepidermal, blistering skin disease. To our knowledge, this is the 25th documented case of such an association. Following treatment for less than 3 months consisting of methylprednisolone at decreasing dose levels along with four courses of rituximab (monoclonal antibody directed against the CD20 protein), AHA was completely cured and BP well-controlled.Conclusions. This report illustrates a rare association of AHA and BP, supporting the possibility of eradicating the inhibitor with a well-conducted short-term treatment.

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