Uterovaginal prolapse following suspected sexual abuse to a child: a case report

Abstract Background Uterovaginal prolapse occurs when damaged connective tissues allow the uterus to drop into the vagina. Rare in children, uterovaginal prolapse can occur as a result of violent sexual assault. This case is being reported because there has been no previous report of acquired pelvic organ prolapse following trauma suspected to be sexual abuse in a child in our setting. Case presentation Two-year-old female presented to our hospital with a 3-day history of abnormal protrusion from the vagina and a 2-day history of bleeding per vagina. Traumatic rupture of the hymen was observed. The urethra was not edematous or hyperemic. The reduction was done successfully under sedation and maintained using a crepe bandage. There was no recurrence after 3-month follow-up. Conclusions Uterovaginal prolapse presenting among children below 5 years is rare. If bleeding per vagina is reported in a child, the clinician should be aware of the possibility of uterovaginal prolapse.

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The spontaneous resolution of a vortex vein varix: case report

BMC Ophthalmology ◽

10.1186/s12886-021-01861-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara L Weidmayer ◽

Hakan Demirci

Keyword(s):

Case Report ◽

Natural History ◽

Extended Period ◽

Spontaneous Resolution ◽

Case Presentation ◽

Clinical Resolution ◽

History Of ◽

Vortex Vein ◽

Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

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Neglected Pessary in Patient with Pelvic Organ Prolapse: A Case Report

Journal of Family & Reproductive Health ◽

10.18502/jfrh.v13i3.2132 ◽

2019 ◽

Author(s):

Zinat Ghanbari ◽

Maryam Deldar-Pesikhani ◽

Tahereh Eftekhar ◽

Leila Pourali ◽

Atiyeh Vatanchi ◽

...

Keyword(s):

Case Report ◽

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Pelvic Organ ◽

Purulent Discharge ◽

Vaginal Mucosa ◽

Academic Hospital ◽

Vaginal Pessary ◽

First Choice

Objective: To report the neglected pessary in a patient with pelvic organ prolapse. Pelvic organ prolapse (POP) is one of the most important medical challenges in women especially elderly. One of the conservative treatments of symptomatic POP is pessary placement. Case report: A 84-year-old woman, para 10 was referred to female pelvic floor clinic of an academic hospital for vaginal bleeding and neglected vaginal pessary. Vaginal examination in the pelvic floor clinic revealed an entrapped ring pessary in severely atrophic vaginal mucosa with purulent discharge. Conclusion: Although pessary is the first choice and one of the best conservative treatment for pelvic organ prolapse, it shouldn’t be used for poor cooperative patient who cannot comply with regular follow-up visits which may cause harmful complications.

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Migration of Neglected Vaginal Pessaries: A Case Report

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2021.42 ◽

2020 ◽

Vol 9 (3) ◽

pp. 225-227

Author(s):

Hyun A Bae ◽

Jeong In Choi ◽

Soo-Ho Chung ◽

Jae Hong Sang

Keyword(s):

Case Report ◽

Pelvic Organ Prolapse ◽

Patient Education ◽

Pelvic Organ ◽

Estrogen Treatment ◽

Case Presentation ◽

Vaginal Orifice ◽

Vaginal Pessary ◽

Rectovaginal Fistulas ◽

And Migration

Introduction: Vaginal pessaries are commonly used to manage pelvic organ prolapse. Pessaries are usually tolerated although some severe complications can occur in cases of negligence, including vesicovaginal and rectovaginal fistulas. Case Presentation: This is a report of two cases of a neglected vaginal pessary and migration into the rectovaginal space to form a vaginal orifice. Based on examinations, no vaginal pessaries in both cases migrated into the rectum. These pessaries were removed by cutting and rotating movements. Finally, the two patients were discharged after surgery without any complications. Conclusions: Neglected pessaries can lead to serious complications. Thus, patient education, local estrogen treatment, and careful follow-ups are important to prevent such complications.

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Histiocytoid Giant Cellulitis-Like Sweet Syndrome At The Site of Sternal Aspiration: A Case Report

10.21203/rs.3.rs-966833/v1 ◽

2021 ◽

Author(s):

Dewan Zhao ◽

Jing Ni ◽

Xiuli Sun

Keyword(s):

Case Report ◽

Cutaneous Lesion ◽

Blood Cultures ◽

Puncture Site ◽

Angioneurotic Edema ◽

Sweet Syndrome ◽

Case Presentation ◽

Floor Of The Mouth ◽

History Of

Abstract Background: Sweet syndrome with both histiocytoid pathology and giant cellulitis-like lesion feature is extremely rare and has only been reported once. Our case is different from the previous report because the cutaneous lesion was caused by local invasive irritation, which made it much more difficult to distinguish from cellulitis.Case presentation: A 52-year-old male was diagnosed with myelodysplastic syndrome with multilineage dysplasia (MDS-MLD) associated with myelofibrosis (MDS-F) as well as angioneurotic edema of the tongue and floor of the mouth. Seven days after sternal aspiration, a cellulitis-like lesion was formed at the puncture site. Since he had neutropenia, history of glucocorticoid use and didn't keep the site dry and clean after aspiration, cellulitis was diagnosed, followed by broad-spectrum antibiotics and debridement. However, the lesion continued to expand, associated with blisters formation, accompanied by chills and fever. Blood cultures and blister smears didn't detect any pathogens. Biopsy of the lesion was performed and histiocytoid Sweet syndrome was diagnosed. He received prednisone treatment, and the fever relieved within 24 hours and the cutaneous lesion resolved within one week. He has had no recurrence during two-month follow-up.Conclusions: This case can provide help for timely diagnosis and treatment and a reference for further summarizing the characteristics of this rare variant.

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Case report of Ureaplasma urealyticum meningitis in a patient with thymoma and hypogammaglobulinaemia

BMC Infectious Diseases ◽

10.1186/s12879-021-06831-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ting Zhang ◽

Haiyan Li ◽

Shuping Hou ◽

Huanxin Yu ◽

Wei Yue

Keyword(s):

Case Report ◽

Ureaplasma Urealyticum ◽

Previous History ◽

Cns Infection ◽

Considerable Proportion ◽

Case Presentation ◽

History Of ◽

Next Generation Sequencing Ngs ◽

Minocycline Therapy

Abstract Background Ureaplasma urealyticum (UU) is found among the normal vaginal flora in a considerable proportion of asymptomatic women; however, adult central nervous system (CNS) infection of UU is extremely rare. Good's syndrome (GS) is an adult-onset immunodeficiency characterized by thymoma, hypogammaglobulinaemia, low or absent B‑cells, and an inverted CD4+/CD8+ T‑cell ratio. Patients with GS usually have severe or recurrent infections. Case presentation We describe the case report of a 49-year-old woman who developed UU meningitis. Initial routine anti-viral and anti-bacterial therapy showed no improvement in the patient's condition. Next-generation sequencing (NGS) of cerebrospinal fluid (CSF) identified the UU DNA sequence. Accordingly, a diagnosis of UU meningitis was made, and minocycline therapy was initiated. The patient responded favourably, with no signs of disease at subsequent follow-up. According to the severity and rarity of the case, secondary immunodeficiency was suspected. Flow cytometry found hypogammaglobulinaemia. Combined with the previous history of thymoma, the patient was diagnosed with immune deficiency disease of GS. Conclusions This case may be the first adult case report in the literature describing UU meningitis in a patient with GS. The diagnosis of GS should be considered in patients presenting with unexplained antibody deficiency and thymoma.

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Vulvar Leiomyomatosis: A Diagnostic Challenge Case Report

Current Women s Health Reviews ◽

10.2174/1573404815666190128152642 ◽

2020 ◽

Vol 16 (1) ◽

pp. 81-83

Author(s):

Malihe Hasanzadeh ◽

Somayeh Moeindarbari ◽

Leila Mousavi Seresht ◽

Amir Hosein Jafarian ◽

Anahita Hamidi ◽

...

Keyword(s):

Case Report ◽

Virgin Female ◽

Surgical Excision ◽

Final Diagnosis ◽

Definite Diagnosis ◽

Diagnostic Challenge ◽

Case Presentation ◽

Smooth Muscle Tumors ◽

History Of

Introduction: Vulvar leiomyomas are rare and usually misdiagnosed as Bartholin’s cyst on initial presentation. Leiomyoma of vulva accounts for only 0.03% of all gynecological neoplasm. Definite diagnosis is based on surgical excision of the tumor. The aim of this report is to introduce a case of leiomyoma of the vulva which was initially misdiagnosed as Bartholin’s cyst. Case Presentation: We present a case of a 36-year old virgin female (BMI>30) who was referred to the clinic with a 5-year history of left labial mass which was initially diagnosed as Bartholin’s cyst. The mass was removed and the pathologist confirmed that the final diagnosis was vulvar leiomyoma. Conclusion: Vulvar leiomyoma is usually misdiagnosed with Bartholin cyst and distinguishing between benign and malignant forms is confusing, so it is a diagnostic challenge. Surgical excision is the treatment of choice in all smooth muscle tumors of the vulva. Continuing follow-up after treatment is highly recommended.

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Renal failure caused by severe pelvic organ prolapse

BMJ Case Reports ◽

10.1136/bcr-2019-229318 ◽

2019 ◽

Vol 12 (7) ◽

pp. e229318

Author(s):

Eliane A Lucassen ◽

Claire F la Chapelle ◽

Esmee Krouwel ◽

Marc Groeneveld

Keyword(s):

Renal Failure ◽

Pelvic Organ Prolapse ◽

Kidney Function ◽

Ureteral Obstruction ◽

Kidney Injury ◽

Pelvic Organ ◽

Uterovaginal Prolapse ◽

Pelvic Organs ◽

Causative Factors

Pelvic organ prolapse (POP), the transvaginal descent of pelvic organs, can cause mild hydronephrosis but rarely leads to a deterioration in kidney function. We present a case of severe uterovaginal prolapse that caused bilateral ureteral obstruction and led to renal failure and urinary tract infection. During outpatient follow-up, kidney function had already been deteriorating, but POP was not recognised as a causal factor. A longer duration of ureteral obstruction can lead to irreversible kidney damage, and therefore, timely recognition and intervention is of essence. Even in complex cases with various causative factors for kidney injury, the presence of severe POP and kidney injury should prompt the clinician to exclude this cause.

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Management of pelvic organ prolapse of ruptured and extruded bladder from a rare complication of vaginal hysterectomy: a case presentation

BMC Surgery ◽

10.1186/s12893-021-01047-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Piao-Piao Ye ◽

Xiao-Jian Yan ◽

Yasmeen Bano ◽

Hong-Qin Zhao ◽

Feng-Feng Xie ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Vaginal Hysterectomy ◽

Rare Complication ◽

Emergency Operation ◽

Pelvic Organ ◽

Abdominal Pressure ◽

Case Presentation ◽

Urinary Drainage ◽

Significant Mass

Abstract Background The prolapse of a ruptured and extruded bladder after vaginal hysterectomy is rare in clinical practice. We report the case of a significant mass that prolapsed from the vagina after a vaginal hysterectomy in a multiparous postmenopausal woman. Case presentation A 67-year old multiparous postmenopausal Chinese woman was found to have a significant mass extruding from the vagina after a vaginal hysterectomy. The mass was a ruptured and everted bladder, and the diagnosis was confirmed after physical and imaging examinations and urethral catheterization. The patient underwent an emergency operation for mass reduction, bladder repair, and partial colpocleisis under general anesthesia. She recovered without prolapse or urinary drainage complications after 35 months of follow-up. Conclusions The present case serves as a guide for the management of patients with pelvic organ prolapse. The condition of patients should be carefully evaluated before surgery, and individualized operation should be performed. Careful postoperative follow-up is crucial for the timely exclusion of complications, especially in elderly patients with persistently increased abdominal pressure.

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An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

10.31487/j.gscr.2020.01.03 ◽

2020 ◽

pp. 1-5

Author(s):

Anton Stift ◽

Kerstin Wimmer ◽

Felix Harpain ◽

Katharina Wöran ◽

Thomas Mang ◽

...

Keyword(s):

Case Report ◽

Sigmoid Colon ◽

Immunohistochemical Staining ◽

Late Onset ◽

Hirschsprung Disease ◽

Endoscopic Examination ◽

Case Presentation ◽

Idiopathic Megacolon ◽

History Of ◽

Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

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Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

African Journal of Urology ◽

10.1186/s12301-019-0006-1 ◽

2019 ◽

Vol 25 (1) ◽

Author(s):

Danielle Whiting ◽

Ian Rudd ◽

Amit Goel ◽

Seshadri Sriprasad ◽

Sanjeev Madaan

Keyword(s):

Case Reports ◽

Case Presentation ◽

Open Adrenalectomy ◽

Large Size ◽

History Of ◽

Loin Pain ◽

Benign Tumours ◽

Spontaneous Haemorrhage ◽

Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

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