scholarly journals Pathological post-obstructive diuresis following obstructive uropathy due to constipation in the post-partum period: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamed Rishard ◽  
Thalagala Kossinnage Maheeka Kossinna ◽  
Mohamed Nazar Latiff ◽  
Susantha De Silva ◽  
Mohamed Hilmy Mohamed Asmath
Keyword(s):  
Post Partum ◽  
Rare Complication ◽  
Obstructive Uropathy ◽  
Multidisciplinary Care ◽  
Complete Recovery ◽  
Fecal Impaction ◽  
Fluid Replacement ◽  
Lifestyle Modifications ◽  
Severe Constipation ◽  
Extensive Evaluation

Abstract Background Constipation during pregnancy is not uncommon. Usually, this does not warrant extensive evaluation and settles with minor interventions or lifestyle modifications. Severe fecal impaction in chronically constipated patients can rarely lead to obstructive uropathy. Relief of obstruction can result in a diuretic phase which may be self-limiting or pathological. However, occurrence of pathological post-obstructive diuresis as a result of severe constipation is an extremely rare complication during pregnancy and puerperium which can even be fatal if not promptly diagnosed and adequately monitored and timely intervened. We describe the management of a pathological post-obstructive diuresis which occurred in the immediate postpartum period after treatment of severe constipation and obstructive uropathy. Case presentation A woman who had undergone an emergency caesarean section due to deep transverse arrest 1 week ago, presented with fecal impaction and anuria. On relief of urinary obstruction which had developed secondary to fecal impaction, she developed pathological post-obstructive diuresis. Careful and timely monitoring with exact fluid replacement, correction of electrolyte imbalances and multidisciplinary care ensured complete recovery of the patient. Conclusions Despite obstructive uropathy being uncommon in obstetric practice, clinicians need to have a high index of suspicion to monitor and promptly manage the potentially life-threatening condition of post-obstructive diuresis in pregnant and puerperal women undergoing urinary tract decompression. Due to unreliability of laboratory cutoff values in pregnancy and puerperium, a more vigilant and multidisciplinary approach with lower threshold for intervention is more prudent in the management of these patients.

scholarly journals Effective Management Of Patients With Amniotic Fluid Embolism In The Intensive Care Unit: Two Case Reports

10.3823/2527 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Leonidas Grigorakos ◽  
Nikolaos Markou ◽  
Daria Lazarescu ◽  
Katerina Tzortzopoulou ◽  
Magda Gkouni ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Case Reports ◽  
Post Partum ◽  
Rare Complication ◽  
Recovery Process ◽  
Complete Recovery ◽  
Positive Outcome ◽  
Amniotic Fluid Embolism ◽  
Short Period ◽  
Clonic Seizures

Amniotic Fluid Embolism (AFE) is a rare complication of the intra- and early post-partum period, which may also be encountered with cesarean delivery and during abortions. Its symptompatology includes respiratory distress with cyanosis, shock and possibly tonic-clonic seizures. Disseminated intravascular coagulation (DIC) frequently occurs and is usually fatal. The aim of this case report is to present the positive outcome and our gained experience from two cases suffering from AFE. Thus, we analyze the case of two patients, in the second trimester of pregnancy who presented symptoms of AFE. Our study reveals that in the case of patients with AFE, early diagnosis, prompt management and proper treatment increase survival rate and may ensure complete recovery in a relatively short period of time. However, DIC is a serious aggravating factor which makes the recovery process slower.  

scholarly journals De Quervain’s thyroiditis: current concepts and a report of four cases

2013 ◽  
pp. 49-54
Author(s):  
Roberto Boni ◽  
Pier G. Rabitti
Keyword(s):  
Post Partum ◽  
Rare Complication ◽  
Treatment Options ◽  
Current Treatment ◽  
Subacute Thyroiditis ◽  
Literature Discussion ◽  
Inflammatory Disorder ◽  
Upper Respiratory Tract ◽  
Systemic Symptoms ◽  
End Stage

Introduction: De Quervain’s subacute thyroiditis is a self-limiting granulomatous inflammatory disorder, which is thought to be virally induced in genetically predisposed individuals. It is characterized by thyroid pain and thyrotoxicosis, as well as by systemic symptoms like fever, hepatic cytolysis, and an elevated erythrocyte sedimentation rate. It is often mistaken for an upper respiratory tract infection. Materials and methods: The authors review recent advances in the understanding of the pathogenesis and pathophysiology of De Quervain’s subacute thyroiditis; risk factors for complications, with emphasis on relapses and end-stage hypothyroidism; differential diagnosis and the exclusion of other subtypes of thyroiditis; and current treatment options. Four cases of De Quervain’s thyroiditis are then analyzed and compared with cases in the literature. Discussion: In three of the patients, onset occurred in June and was probably related to a small, seasonal epidemic cluster. These cases were quite different from the fourth one, which occurred in October, suggesting that two distinct viruses might be involved. One of the patients presented a very rare complication, vocal-cord paralysis, which responded well to glucocorticoid therapy. Another presented with an even rarer post-partum form of painful thyroiditis.

scholarly journals A Rare Case of Urinary Tract Fungal Ball Leading to Fungemia and Bilateral Chorioretinitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Christopher Ferari ◽  
Chad Crigger ◽  
Chad Morley ◽  
David Duchene
Keyword(s):  
Urinary Tract ◽  
Type Ii Diabetes ◽  
Rare Complication ◽  
Obstructive Uropathy ◽  
Treatment Options ◽  
Type Ii ◽  
Invasive Treatment ◽  
Case Presentation ◽  
Fungal Ball

Background. Fungemia due to obstructive urinary tract fungal ball is exceedingly rare. These patients often have multiple predisposing conditions, including diabetes or antimicrobial exposure. While candiduria can be relatively common in this population, urinary tract fungal balls are a rare entity. Hospitalists should be aware of this rare complication in patients presenting with funguria. Case Presentation. We present a case of a 44-year-old male with type II diabetes, chronic hepatitis C secondary to injection drug use, and chronic kidney disease who developed a urinary tract fungal ball leading to fungemia and subsequent bilateral chorioretinitis, additionally complicated by emphysematous cystitis and pyelonephritis. Additional invasive treatment options beyond typical antifungals are often required in the case of urinary tract fungal ball, and in this case, bilateral nephrostomy tubes and micafungin were employed. Hospital course was complicated by C. tropicalis fungemia with subsequent bilateral fungal chorioretinitis on dilated fundus exam. This was effectively treated with cyclogyl and prednisolone drops along with bilateral voriconazole injections. Follow-up imaging and cultures showed resolution of fungemia, urinary tract masses, and chorioretinal infiltrates; however, recurrent polymicrobial UTIs continue to be an issue for this patient. Conclusions. Special multidisciplinary management is required in the treatment of urinary tract fungal balls with subsequent fungemia, including nephrostomy tubes, antifungal irrigation, ureterorenoscopy, and more powerful antifungals such as amphotericin B and 5-flucytosine. This management draws from a myriad of specialties, including urology, infectious disease, and interventional radiology. Additionally, the literature has demonstrated that only approximately half of patients with fungemia receive an ophthalmologic evaluation. Ophthalmologic and urologic cooperation is essential in the case of obstructive uropathy leading to fungemia as the obstructive uropathy must be relieved and these patients should receive a dilated fundus exam.

scholarly journals Post-operative compressive pneumocephalus: A rare complication of lumbar spinal drainage

2020 ◽  
Vol 10 (4) ◽  
pp. 127-128
Author(s):  
F Lakhdar ◽  
M Benzagmout ◽  
K Chakour ◽  
ME Chaoui
Keyword(s):  
Oxygen Therapy ◽  
Rare Complication ◽  
Rare Condition ◽  
Bed Rest ◽  
Fluid Replacement ◽  
Primary Surgery ◽  
Csf Leakage ◽  
Lumbar Spinal ◽  
Possible Cause ◽  
Inspired Oxygen

Compressive pneumocephalus is a rare condition, most often secondary to head trauma or surgery. We report post-operativecompressive pneumocephalus in a patient who underwent primary surgery for anterior clinoidmeningioma complicated by CSF leakage treated by lumbar spinal drainage. CT scanclearly demonstrates a compressive pneumocephaluswith the sign of the Mount Fuji. The patient was treated with definite bed rest and plenty of fluid replacement with good outcome. Compressive pneumocephalus is a serious, infrequent complication anda possible cause of postoperative worsening.Medical treatment combining highly inspired oxygen therapy and rehydration are sufficient to correct the condition.

scholarly journals SUCCESSFUL TREATMENT OF TRAUMATIC ORBITAL APEX SYNDROME WITH LOW DOSE STEROIDS - A CASE REPORT

2020 ◽  
pp. 214-215
Author(s):  
Tharini Senthamizh ◽  
Subashini Kaliaperumal
Keyword(s):  
Visual Loss ◽  
Low Dose ◽  
Rare Complication ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Dramatic Improvement ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Surgical Evacuation ◽  
Displaced Fracture

Traumatic Orbital Apex Syndrome is a rare complication of trauma presenting with visual loss, ophthalmoplegia, and anesthesia of cornea, forehead and maxillary regions. It requires immediate action as it poses great threat to permanent visual loss. The incidence of Traumatic orbital apex syndrome is very less compared to Superior Orbital fissure syndrome and traumatic optic neuropathy alone and only few cases have been reported till now. Management depends on the cause, those with displaced fracture fragments are treated by surgical decompression whereas those with edema or hematoma causing compression can be treated with steroids or surgical evacuation of hematoma. Previous reports have proved the usefulness of mega dose steroids in such cases. We report a case of Traumatic Orbital Apex Syndrome who presented with painful proptosis, visual loss, ophthalmoplegia and loss of sensation in periorbital region. Imaging confirmed hematoma causing compression of neurovascular structures and hence a trial of low dose corticosteroids was started. Our patient showed dramatic improvement in signs and symptoms with complete recovery in three weeks. Low dose steroids can be considered as an alternative to mega dose steroids to treat patients with indirect traumatic Orbital Apex Syndrome, thereby reducing the necessity of surgical evacuation in such cases.

Cervicothoracic epidural hematoma after chiropractic spinal manipulation therapy

2007 ◽  
Vol 7 (5) ◽  
pp. 571-574 ◽  
Author(s):  
Maurizio Domenicucci ◽  
Alessandro Ramieri ◽  
Maurizio Salvati ◽  
Christian Brogna ◽  
Antonino Raco
Keyword(s):  
Epidural Hematoma ◽  
Unique Feature ◽  
Rare Complication ◽  
Complete Recovery ◽  
Good Health ◽  
Spinal Epidural Hematoma ◽  
Manipulation Therapy ◽  
Cervical Spine Manipulation ◽  
Spinal Epidural ◽  
Brown Sequard Syndrome

✓A spinal epidural hematoma is an extremely rare complication of cervical spine manipulation therapy (CSMT). The authors present the case of an adult woman, otherwise in good health, who developed Brown–Séquard syndrome after CSMT. Decompressive surgery performed within 8 hours after the onset of symptoms allowed for complete recovery of the patient's preoperative neurological deficit. The unique feature of this case was the magnetic resonance image showing increased signal intensity in the paraspinal musculature consistent with a contusion, which probably formed after SMT. The pertinent literature is also reviewed.

scholarly journals Early outcome of acute peripartum cardiomyopathy in eastern part of Nepal

2017 ◽  
Vol 14 (1) ◽  
pp. 13-15
Author(s):  
Rajesh Nepal ◽  
Madhav Bista ◽  
Sita Ghimire
Keyword(s):  
Post Partum ◽  
Complete Recovery ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Inclusion Criteria ◽  
Predictors Of Outcome ◽  
Medical College ◽  
Term Delivery ◽  
Study Population

Background and Aims: Peripartum cardiomyopathy (PPCM) is an uncommon complication of pregnancy with variable outcome. There is paucity of data related to its outcomes in Nepal. We studied the clinical and echocardiographic outcome of PPCM patients in eastern part of Nepal.Methods: In this prospectively designed study all patients admitted with the diagnosis of acute severe PPCM at Nobel Medical College, Biratnagar, meeting the inclusion criteria over a period of 14 month, were enrolled and followed up for 3 months post partum.The LVEF and Left ventricular end diastolic dimension (LVEDD) was assessed by echocardiography at baseline and 3 months postpartum. Mortality and survival with normal or depressed ejection fraction were determined. Predictors of outcome were evaluated. Statistical analysis were done using SPSS version 17.Results: Mean age of the study population was 27.6}5.6 years. Ninety five percent of patient had term delivery. Sixty four percent were primigravida. Eighty four percent had the symptoms onset in post partum period. Pulmonary edema was present in 64% during first hospital admission. Mortality was 9% during 3-month follow up period. Thirty six percent had complete recovery of LVEF at 3 months. Fifty five percent survived with depressed LVEF. Age, LVEF less than 30% and LVEDD more than 60 mm at study entry did not correlate significantly with poor clinical recovery at 3 months.Conclusion: This study demonstrates that survival outcome is better even in the patients with severe acute PPCM with early diagnosis and proper management of heart failure.  

Optic neuritis and paranasal sinus diseases

Open Medicine ◽  
2011 ◽  
Vol 6 (1) ◽  
pp. 117-119 ◽  
Author(s):  
P. Čelakovský ◽  
J. Vokurka ◽  
L. Školoudík ◽  
J. Růžička
Keyword(s):  
Optic Nerve ◽  
Optic Neuritis ◽  
Paranasal Sinus ◽  
Imaging Techniques ◽  
Rare Complication ◽  
Complete Recovery ◽  
Paranasal Sinus Diseases ◽  
Immediate Surgery ◽  
Relationship Of ◽  
The Relationship

AbstractThe relationship of sinusitis and paranasal sinus mucoceles to optic neuritis (ON) remains a challenge for both the otolaryngologist and the ophthalmologist. Currently, ON is assumed to be a rare complication of paranasal sinus diseases. Three new cases of ON associated with paranasal sinus diseases are described. We postulate different pathophysiologic mechanisms of ON in our three patients: compression of optic nerve due to sphenoid mucocele in the first patient; extension of bacterial infection to the optic nerve in the second patient; and invasion of aspergillosis to the orbital apex in the third patient. We assume that the complete recovery of the patient’s vision in the second case resulted from surgery, which had been performed immediately. A timely operation could possibly have prevented permanent blindness in cases 1 and 3 as well. Optic neuritis can occasionally be a complication of bacterial and mycotic sinusitis or paranasal sinus mucoceles, especially if located in the sphenoid sinus and posterior ethmoids. The evaluation of paranasal sinuses using imaging techniques is necessary to diagnose the problem, and immediate surgery can prevent permanent sequelae in indicated cases.

Bilateral Serous Retinal Detachment in Preeclampsia: Case Report

2017 ◽  
Vol 71 (2) ◽  
pp. 143-145
Author(s):  
Ivo Kjaev ◽  
Jana Kjaeva Nivicka ◽  
Sasha Kjaeva ◽  
Dafina Karadjova ◽  
Irena Aleksioska ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Retinal Detachment ◽  
Medical Condition ◽  
Post Partum ◽  
Rare Complication ◽  
Serous Retinal Detachment ◽  
Initial Assessment ◽  
Ocular Involvement ◽  
Ocular Ultrasound

Abstract Introduction. Preeclampsia presents a medical condition in pregnancy that is manifested with increased blood pressure and protein urine. Ocular involvement is rare. Retinal detachment in preeclampsia is a rare complication; it only occurs in 1-2% of severe preeclampsia but in 10% of those with eclamptic seizures. Case report. A pregnant patient G1P0 visited the outpatient clinic of the University Clinic for Ophthalmology complaining on visual disturbances. The chief complaint was blurred vision and headaches. She was in 31 week of gestation and complained that she had increased blood pressure over the last month. After initial assessment she was suspected of central serous retinal ablation (CSCR). Ocular ultrasound and posterior segment OCT (optical coherence tomography) confirmed the diagnosis. Treatment and outcome. Obstetric examination confirmed high blood (TA180/130) pressure with dipstick urine showing(+++). Unfortunately, the ultrasound showed an eutrophic pregnancy in 31 g.w. with fetus mortus inutero. The patient was administered to the intensive care unit. She had an ophthalmologic check-upat 2 weeks and one month post-partum that showed regression and visual acuity was getting better. The final check-up after 6 months revealed that retina was in place with no subretinal substantial fluid and no macular edema. Conclusion. Serous retinal detachment is a rare complication of preeclampsia. In most case it resolves spontaneously few weeks post delivery.

scholarly journals Obstructive Uropathy Secondary to Missed Acute Appendicitis

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Mahir Gachabayov
Keyword(s):  
Acute Appendicitis ◽  
Rare Complication ◽  
Obstructive Uropathy ◽  
Open Appendectomy ◽  
Emergency Physicians

Hydronephrosis is a rare complication of acute appendicitis. We present a case of missed appendicitis in a 52-year-old female which presented as a right-sided hydronephrosis. 2 days after admission to the Department of Urology CT revealed acute appendicitis for what open appendectomy was performed. Acute appendicitis can lead to obstructive uropathy by periappendiceal inflammation due to adjacency. Urologists, surgeons, and emergency physicians should be aware of this rare complication of atypical acute appendicitis.

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