scholarly journals Transvaginal uterine evisceration during labor in a Bengal queen

2019 ◽  
Vol 5 (2) ◽  
pp. 205511691987230
Author(s):  
Mila Freire ◽  
Mouhamadou Diaw

Case summary A 2.5-year-old Bengal queen was admitted with a 12-h history of a mass protruding from the vulva during labor. At that time, three healthy kittens had already been delivered. Physical examination identified the mass as a portion of the uterus that was eviscerated without eversion of the mucosa. Exploratory laparotomy revealed a vaginal vault rupture with a large portion of the uterus herniated through the tear and eviscerated through the vulva. Ovariohysterectomy was performed, and a dead fetus was removed with the uterus. Reconstruction of the vaginal rupture required careful dissection and urethral catheterization. The queen recovered without complications. Relevance and novel information Uterine evisceration through a vaginal tear is a very rare condition that sometimes is erroneously referred to as ‘prolapse’. Uterine prolapse and uterine evisceration may have similar presenting signs; however, proper identification and surgical correction is key when the uterus is eviscerated. This case highlights the importance of differentiating these two conditions and of rapid identification and surgical intervention for successful patient survival.

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
A. Sakharpe ◽  
Y. K. Lee ◽  
G. Park ◽  
V. Dy

Stercoral perforation of the colon is a rare but serious complication of chronic constipation. We present a case of stercoral perforation requiring subtotal colectomy in a 41-year-old female who had been on methadone maintenance for a history of long-term intravenous heroin use. Our case highlights the importance of prompt and thorough surgical intervention in the successful treatment of this rare condition.


2013 ◽  
Vol 04 (02) ◽  
pp. 213-215 ◽  
Author(s):  
Anurag Gupta ◽  
Suman S Karanth ◽  
A Raja

ABSTRACTInfratentorial subdural empyema is an extremely rare condition which unfortunately mimics pyogenic meningitis in 75% of cases. While an ill‑planned lumbar puncture in these cases may be fatal, an inadvertent delay in treatment may be detrimental to the outcome for the patient. We present a case of a young boy with long standing history of chronic suppurative otitis media (CSOM) presenting with an infratentorial empyema with features suggestive of pyogenic meningitis. We also review the available literature to further define the condition in terms of clinical features, treatment options, and outcome. A misdiagnosis of this condition with failure to institute appropriate surgical intervention and antibiotic therapy is potentially life threatening. We highlight this rare condition which requires a high degree of suspicion especially in the presence of associated risk factors.


Uterine prolapse is a rare condition in cats that can be managed by performing either an external hysterectomy or manual reduction followed by ovariohysterectomy. This article describes surgical management of bilateral uterine prolapse in a queen. A one year old female, pluriparous Siamese cat (Felis catus) with no past history of dystocia and weighing 2.8 kg was presented to Andys Veterinary hospital, Nairobi, Kenya with a protruding mass through the vulval. The queen had a history of recent queening and had delivered three kittens a week earlier. The owner noticed the protruding mass about 24 hours after the delivery of the last neonate. A few days later, the cat was not suckling the kittens well and was in appetent. As a sequel to this, two kittens died. After a week, the protruding mass had a pungent smell and the client presented the cat to the hospital. Complete bilateral uterine prolapse was diagnosed after a visual examination and palpation of the mass. The uterus was swollen, had necrotic areas and debris. Accordingly, a two staged ovariohysterectomy was opted for to manage the case. An internal ovariectomy was first done via a ventral midline celiotomy followed by an external hysterectomy. Post-operative management included pain medication and antibiotic therapy and the patient recovered well and was discharged after 2 days. The skin sutures were removed 10 days postoperatively. The cat recovered uneventfully with no further complications reported by the owner. In conclusion, this article shows that when the prolapsed uterus is swollen, damaged and necrotic, a two staged ovariohysterectomy should be the method of treatment and the outcome is good despite the duration of the condition.


Author(s):  
Sium AF ◽  
◽  
Tilahun A ◽  
Mersha A ◽  
Yihun S ◽  
...  

Background: Compound presentation occurs in approximately 1/700 deliveries. Being the rarest type, there is scarce literature about the recommended management for vertex-hand-feet variety of compound presentation. We report a similar type of compound presentation. Case Summary: A 25 years-old primigravida who claimed to be 9 months ammenorric presented with a history of pushing down pain of 12 hours duration with associated history of passage of liquor of 4 hours duration. Up on physical examination she was in active first of labor at cervical dilation of 5 centimeters and the presentation was compound- a vertex-hand-feet variety. Cesarean delivery was done after two hours of conservative management and the outcome was an alive 2300grams male neonates with no perinatal or maternal complication. Conclusion: In the rarest variety of compound presentation, which is a vertex, hand, and feet type, spontaneous correction is unusual if the fetus is alive and interference is usually necessary.


2020 ◽  
Vol 1 (2) ◽  
pp. 10-16
Author(s):  
MA Oyinlola ◽  
OA Omisakin

Intestinal obstruction refers to the impairment to the abnormal passage of intestinal contents which can be due to the mechanical obstruction or failure of normal intestinal motility in the absence of an obstructing lesion. Extra luminal, intrinsic, and intraluminal are three categories of small bowel obstruction. In this retrospective observational study, patients presenting to the A&E department of surgery unit who had similar condition were screened. The study is based on total of 60 patients out of which 22 patients managed conservatively whereas 38 patients were managed surgically. Common symptoms were abdominal pain and vomiting. 20 patients had previous abdominal surgery; 16 had exploratory laparotomy for abdominal trauma, perforation, gynae procedure, etc. 4 patients developed characteristic of obstruction following laproscopic. 14 patients undergone surgery while 6 patients were managed conservatively. Surgically managed duration was 2.8 days on average. Mean duration for conservatively managed patients was 2.9 days. Among the surgically managed patients, 11 had strictures, 14 had adhesion, 8 had obstructed hernia, 1 had intussusception, and 4 had abdominal TB. Based on the cause of the obstruction, surgical procedure was carried out. History of abdominal surgery was found to be more frequent in whom obstruction was relieved conservatively. The conclusion of the study is that adhesions based on previously conducted surgery are important causes of SBO. Two common method of managing the condition is conservative management and surgical management. The criteria for utilizing particular method is based on several patient related factors. Clinical decisions guide the management of SBO and timing of surgical intervention.


2020 ◽  
Vol 28 (3) ◽  
pp. 217-220
Author(s):  
Güneş Topçu ◽  
Yağmur Şimşek ◽  
Şenay Çetin ◽  
Murat Muhçu ◽  
Ayşegül Özel

Objective: Isolated tubal torsion in pregnancy is a rare condition we want to present this case. Case(s): In our study, we present a 23-year-old woman primigravida at 37 weeks of gestation with acute right lower abdominal pain. The clinical and Magnetic resonance imaging (MRI) findings led to diagnosis of acute appendicitis. Emergency exploratory laparotomy and cesarean section were performed. A twisted right Fallopian tube and Morgagni’s cyst was noted and right salpingectomy was performed. Conclusion: Although isolated tubal torsion during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity.


PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 790-797
Author(s):  
M. G. PETERMAN ◽  
J. L. GARVEY

THIS case is presented because the circumstances provided an unusual opportunity to review and study a rare condition. The child concerned had been diagnosed as having a case of hypothyroidism and epilepsy and the parents had been advised to place her in an institution. The child was referred to the authors in a further effort to obtain relief or advice. CASE HISTORY A 12 yr. old girl was examined because of "incessant talking in a silly, immature fashion; excessive greed for food and salt; lethargy, fatigue, over-affection and clumsiness, awkwardness, inability to skate or ride a bicycle." A year before admission she began to scream in her sleep once or twice every night. Six months later she began to scream during the day. The attacks of screaming occurred suddenly without warning. She abruptly stopped what she was doing, stared ahead and screamed in a loud, hoarse voice for several seconds. Immediately afterward, she was embarrassed and tried to withdraw from the scene. Treatment elsewhere with adequate doses of phenobarbital, tridione, benzedrine, thyroid and pituitary extract had been ineffective. Report of a previous examination at a university clinic was "moderately plump girl with a round face and lethargic appearance. There was narrowing of the right palpebral fissure and mild ataxia of the lower extremities. The physical examination was otherwise unimportant. The IQ was 80." Examination later at a hospital-clinic was reported as "revealing obesity and cretinism in spite of a basal metabolic rate of minus 6 and minus 7." Mother and father are intelligent and the 4 siblings are normal and well-adjusted. There is no history of convulsive disorders or mental disease.


2021 ◽  
Author(s):  
Leila Pourali ◽  
Hamidreza Ghorbani ◽  
Atiyeh Vatanchi ◽  
Sedigheh Ayati ◽  
Ghazal Ghasemi ◽  
...  

Uterine prolapse and bladder exstrophy (BE) during pregnancy is a rare condition. The aim of this study was to present a rare case of pregnancy complicated by both bladder exstrophy and uterine prolapse. A 39-year-old pregnant woman (gravida 2, para 1) presented to the maternity department at 39 weeks of gestation with labor pain. Physical examination showed regular uterine contractions; the cervix was completely out of the vaginal opening with dilatation of 3 cm and effacement of 30%. She had a history of multiple surgeries for correction of bladder exstrophy and also suffered from uterine prolapse. In active labor, abnormal fetal heart rate tracing happened, so an emergent cesarean section was planned, and a healthy neonate with the normal Apgar score was born. At regular follow-up until four months after delivery, there was no sign or symptom of uterine proplase. Multidisciplinary management of patients with BE and uterine prolapse may result in optimal perinatal outcomes. Uterine prolapse may disappear after delivery, even in the complicated case of bladder exstrophy.


2013 ◽  
Vol 49 (3) ◽  
pp. 169-174 ◽  
Author(s):  
Dominique Gagnon ◽  
Brigitte Brisson

The purposes of this retrospective study were to review cases of colonic torsion/volvulus between July 1992 and August 2010 and to determine if any predisposing factors exist for the development of this condition. Six dogs were diagnosed with colonic torsion/volvulus during the study period. Four dogs had a history of previous gastric dilation-volvulus (GDV) with prophylactic gastropexy. Three of six dogs diagnosed with colonic torsion/volvulus had large intestinal entrapment and strangulation around the gastropexy site at the time of surgery. The history, clinical signs, physical examination, and radiologic findings were not specific for colonic torsion/volvulus in any dog. Early exploratory laparotomy was indicated to confirm the diagnosis and perform surgical correction of the affected bowel segments. Three of five dogs that underwent surgery had a left abdominal wall colopexy performed. All five dogs that underwent surgery in this study survived postoperatively. One patient was euthanized without surgical intervention. Results suggest that colonic torsion/volvulus should be considered in any large-breed dog with nonspecific gastrointestinal clinical signs and a history of previous gastropexy. Early recognition and prompt treatment of this condition may result in a good outcome.


2020 ◽  
Vol 4 (5) ◽  
pp. 1-4
Author(s):  
Kevin Leow ◽  
Courtney Isreb ◽  
Martin Brown

Abstract Background The incidence of infective endocarditis (IE) following a MitraClip is rare with 17 reported cases in the literature. The reported mortality rate is high, at 41%, despite both medical and surgical therapies. To date, this is the first documented case of IE following a MitraClip procedure in Australia. Case summary An 88-year-old male presented with a 1-week history of confusion and dyspnoea. Clinical examination was significant for a temperature of 37.7°C, a pansystolic murmur and bilateral pitting oedema to mid-shin, but no peripheral stigmata of IE. His history included a MitraClip procedure 11 weeks prior for severe mitral regurgitation. Initial blood cultures grew enterococcus faecalis. A transthoracic echocardiogram did not identify vegetations on the MitraClip. Subsequent transoesophageal echocardiogram (TOE) identified a 4 mm × 2 mm echodensity on the posterior mitral valve leaflet suggestive of IE. He was deemed not suitable for surgical intervention due to poor cognitive reserve and his medical comorbidities, so he commenced intravenous (IV) Ampicillin and Ceftriaxone which was later changed to Benzylpenicillin. Repeat TOE 2 weeks later showed the vegetation to have increased to ∼1 cm in length, so his treatment was reverted to Ampicillin. A further TOE 4 weeks later showed reduction in size to 5 mm × 2 mm. After 6 weeks of IV antibiotics, the patient was discharged on lifelong oral antibiotics. Discussion Infective endocarditis following MitraClip procedure is rare. This disease has a high mortality rate despite optimal medical and surgical therapy. Increased awareness amongst clinicians is important given an increasing volume of MitraClip procedures.


Sign in / Sign up

Export Citation Format

Share Document