Vaginal delivery after laparotomic myomectomy during pregnancy

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Anna Garofalo ◽  
Paolo Petruzzelli ◽  
Michela Chiadò Fiorio Tin ◽  
Silvia Parisi ◽  
Giulia Garofalo ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Vaginal Delivery ◽  
Best Practice ◽  
Adverse Pregnancy Outcome ◽  
Case Reports ◽  
Rare Condition ◽  
Case Presentation ◽  
Feasible Option ◽  
Adverse Pregnancy

Abstract Background Symptomatic myomas during pregnancy are a rare condition that could however turn into an emergency because of torsion, necrosis, growth and compression leading to acute abdomen, potentially threating for pregnancy. Surgeons are usually reluctant to perform myomectomy during pregnancy because of an increased uterine blood flow and volume can give rise to a potential risk for haemorrhagic complications, while uterine manipulation can determine adverse pregnancy outcome. However, in some rare cases surgery is compulsory. Case presentation Here, we described a case of a successful laparotomic myomectomy performed during pregnancy at 11 weeks of gestation when an acute abdomen occurred. Surgery was followed by regular obstetrics follow-up ended with a spontaneous vaginal delivery with no pregnancy complications. Conclusion Although few case reports are described in literature, other authors have performed a myomectomy during pregnancy, and fewer cases have had a subsequent vaginal delivery, so that nowadays there is no clinical evidence on which to base best practice. This case shows that vaginal delivery after a laparotomic myomectomy performed during pregnancy, in selected cases, can be considered as a feasible option.

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

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.

scholarly journals Fibromuscular dysplasia with recurrence after “long-term” following percutaneous transcatheter renal angioplasty: two case reports with a review of 26 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuntaro Oribe ◽  
Takafumi Toyohara ◽  
Eikan Mishima ◽  
Takehiro Suzuki ◽  
Koichi Kikuchi ◽  
...  
Keyword(s):  
Fibromuscular Dysplasia ◽  
Age Of Onset ◽  
Case Reports ◽  
Case Presentation ◽  
Renal Angioplasty ◽  
Long Term Follow Up ◽  
Percutaneous Transluminal Renal Angioplasty ◽  
The Difference

Abstract Background Fibromuscular dysplasia (FMD) often causes renal artery stenosis with renovascular hypertension. Recent clinical outcomes encourage percutaneous transluminal renal angioplasty (PTRA) to treat FMD; however, the necessary follow-up period remains unclear. Moreover, previous studies have not revealed the difference in the period until recurrence between two major types of FMD—multifocal and focal. Case presentation We describe two patients with multifocal FMD who developed hypertension during their teenage years and had recurrence of FMD > 10 years after PTRA. We further examined the types of FMD and age of onset in 26 patients who underwent PTRA. The period until recurrence of multifocal FMD was longer than that of focal FMD. Moreover, patients with early-onset multifocal FMD are likely to have a delayed recurrence after PTRA compared to other types. Conclusions Our report suggests that patients with multifocal FMD, especially those with onset at an early age, may need long-term follow-up for at least ≥ 10 years.

scholarly journals Composite phaeochromocytomas—a systematic review of published literature

2021 ◽  
Author(s):  
K. Dhanasekar ◽  
V. Visakan ◽  
F. Tahir ◽  
S. P. Balasubramanian
Keyword(s):  
Case Reports ◽  
Descriptive Analysis ◽  
Management Strategies ◽  
Gastrointestinal Symptoms ◽  
Rare Condition ◽  
Epidemiological Data ◽  
Human Case ◽  
Rare Tumour ◽  
Palpable Mass

Abstract Introduction Composite phaeochromocytoma is a tumour containing a separate tumour of neuronal origin in addition to a chromaffin cell tumour. This study reports on two cases from a single centre’s records and presents a systematic literature review of composite phaeochromocytomas. Methods In addition to describing 2 case reports, a systematic search of the Medline database from inception up to April 2020 was done for human case reports on composite phaeochromocytomas. Relevant titles and/or abstracts were screened, and full texts were reviewed to identify appropriate studies. Data was extracted and a descriptive analysis of presentation, clinical features, management strategies and outcomes was performed. The quality of included studies was assessed using a critical appraisal checklist. Results There were 62 studies included, with a total of 94 patients. Of 91 patients where data was available, the median (range) age of patients was 48 (4–86) years. Of 90 patients where information was provided, 57% were female. In at least 28% of patients, a genetic cause was identified. Common presenting features include abdominal pain, palpable mass, cardiovascular and gastrointestinal symptoms. The most common tumour component with phaeochromocytoma is ganglioneuroma; other components include ganglioneuroblastoma, neuroblastoma and malignant peripheral nerve sheath tumours. In patients with follow-up data (n=48), 85% of patients were alive and well at a median (range) follow-up time of 18 (0.5–168) months. Conclusion Composite phaeochromocytoma is a rare tumour, with a significant genetic predisposition. This review summarises available epidemiological data, which will be useful for clinicians managing this rare condition.

scholarly journals Vernix Caseosa Peritonitis after Vaginal Delivery

2013 ◽  
Vol 6 ◽  
pp. CCRep.S12771 ◽  
Author(s):  
Shameema A. Sadath ◽  
Fathiya I. Abo Diba ◽  
Surendra Nayak ◽  
Iman Al Shamali ◽  
Michael F. Diejomaoh
Keyword(s):  
Cesarean Section ◽  
Acute Abdomen ◽  
Vaginal Delivery ◽  
Vacuum Extraction ◽  
Unusual Complication ◽  
Case Presentation ◽  
Vernix Caseosa ◽  
First Case ◽  
Surgical Emergencies ◽  
Uterine Scar

Introduction Vernix caseosa peritonitis (VCP) is a very unusual complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Twenty-seven cases have been reported, and all occurred after cesarean section. Case presentation We present a case of VCP following vaginal delivery; this may be the first case reported after vaginal delivery. Mrs. A, 28 years old, gravida 3, para 2, with one previous cesarean section, was admitted at 41 weeks gestation in active labor. Vacuum extraction was performed to deliver a healthy male baby, 4.410 kg, Apgar scores 7, 8. She developed fever, acute abdominal pain, and distension about 3 hours after delivery. A diagnosis of acute abdomen was made. Laparotomy was performed and it revealed neither uterine scar rupture nor other surgical emergencies, but 500 mL of turbid fluid and some cheesy material on the serosal surface of all viscera. Biopsies were taken. She had a course of antibiotics and her recovery was complete. Histology of the peritoneal fluid and tissue biopsy resulted in a diagnosis of VCP. Conclusion Clinical diagnosis of peritonitis due to vernix caseosa should be considered in patients presenting postpartum with an acute abdomen after vaginal delivery.

scholarly journals Chilaiditi Syndrome: A Case Report Highlighting the Intermittent Nature of the Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Esha M. Kapania ◽  
Christina Link ◽  
Joshua M. Eberhardt
Keyword(s):  
Case Report ◽  
Complete Resolution ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Delayed Diagnosis ◽  
Spontaneous Resolution ◽  
Radiographic Evidence ◽  
Case Presentation ◽  
Chilaiditi Syndrome

Background. Chilaiditi syndrome is a phenomenon where there is an interposition of the colon between the liver and the abdominal wall leading to clinical symptoms. This is distinct from Chilaiditi sign for which there is radiographic evidence of the interposition, but is asymptomatic. Case Presentation. Here, we present the case of a patient who, despite having clinical symptoms for a decade, had a delayed diagnosis presumably due to the interposition being intermittent and episodic. Conclusions. This case highlights the fact that Chilaiditi syndrome may be intermittent and episodic in nature. This raises an interesting question of whether previous case reports, which describe complete resolution of the syndrome after nonsurgical intervention, are perhaps just capturing periods of resolution that may have occurred spontaneously. Because the syndrome may be intermittent with spontaneous resolution and then recurrence, patients should have episodic follow-up after nonsurgical intervention.

scholarly journals Follow-up and management of recurrent pregnancy losses due to massive perivillous fibrinoid deposition

2017 ◽  
Vol 11 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Mai He ◽  
Alison Migliori ◽  
Nisreen S Maari ◽  
Niharika D Mehta
Keyword(s):  
Adverse Pregnancy Outcome ◽  
Perinatal Outcomes ◽  
Retrospective Chart Review ◽  
Subsequent Pregnancy ◽  
Case Review ◽  
Placental Pathology ◽  
Recurrent Pregnancy Losses ◽  
Consecutive Pregnancy ◽  
Adverse Pregnancy

Massive perivillous fibrinoid deposition is a rare placental pathology associated with significant adverse pregnancy outcome and can recur. We provide a detailed case review of a woman through 10 of her pregnancies, including 8 consecutive pregnancy losses and 2 live births. We also conducted a retrospective chart review of all massive perivillous fibrinoid deposition placenta specimens at our institution over an eight-year period. A total of 42 cases of massive perivillous fibrinoid deposition were identified from 2007 to 2015, yielding an incidence of 0.16%. Recurrence was seen in subsequent pregnancy in eight out of nine (88.9%) cases with more than one specimen. The clinical characteristics, perinatal outcomes and α-feto protein level of the 42 cases are presented. Also, presented is a review of the literature discussing placental pathology, pathogenetic mechanisms and management of this condition.

scholarly journals Juvenile Xanthogranuloma Presenting as Bilateral Non-Infiltrative Extraconal Superior Orbital Tumour in a 27 Year Old Nigerian Woman: Features, Management and Outcome

2012 ◽  
Vol 5 ◽  
pp. CCRep.S10138 ◽  
Author(s):  
Okosa Michael Chuka ◽  
Anyiam Daniel Chukwuemeka Darlinton
Keyword(s):  
Systemic Disease ◽  
Rare Condition ◽  
Surgical Excision ◽  
Juvenile Xanthogranuloma ◽  
Case Presentation ◽  
Nigerian Woman ◽  
Upper Lid ◽  
Systemic Manifestations ◽  
Systemic Symptoms

Introduction Orbital masses in adults are often caused by systemic diseases or are associated with systemic manifestations. Juvenile xanthogranuloma as a cause is rare and unreported in Africa. We present clinical features, management, and outcomes of bilateral orbital adult onset juvenile xanthogranuloma. Case Presentation A 27 year old Nigerian woman presented with bilateral upper-lid lumps having lasted 5 months. These increased in size for about 1 month and stopped. Lid swelling was preceded by itchy eyes, redness of conjunctiva, and occasional mild pain. There were no visual or systemic symptoms. The lumps were firm, slightly mobile, not tender, and not attached to skin but rather to deeper structures. There was restriction on up-gaze but no proptosis or diplopia. Hematological, biochemical, and X-ray investigations were normal. Prednisolone tablets 10 mg daily for two weeks were not useful. Tissue biopsy was invaluable in diagnosis of this rare condition and disclosed juvenile xanthogranuloma. Partial surgical excision was done under lidocaine infiltration. No recurrence has occurred in 40 months of follow-up. No systemic disease has manifested. Conclusion Juvenile xanthogranuloma can present as bilateral superior orbital tumor in adults; functional and cosmetic aims were achieved by sub-total excision.

scholarly journals Persistent genital arousal disorder: always look beyond the surface - a case report

2021 ◽  
Vol 10 (4) ◽  
pp. 1691
Author(s):  
Rita Sarabando ◽  
Natacha Sousa ◽  
Ana C. Borges ◽  
Cristina Nogueira-Silva
Keyword(s):  
Endometrial Cancer ◽  
Rare Case ◽  
Case Reports ◽  
Rare Condition ◽  
Specific Context ◽  
Comprehensive Review ◽  
Genital Arousal ◽  
Arousal Disorder ◽  
Multiple Diagnosis

Persistent genital arousal disorder is a rare condition characterized by unwanted intrusive symptoms of sexual arousal without specific context. Their possible aetiologies and treatments are multiple and mostly based on case reports. We aim to do a comprehensive review of persistent genital arousal disorder and describe a case of a postmenopausal woman who developed this disease and, during the follow-up, was diagnosed with advanced endometrial cancer, reminding physicians to keep in mind the possibility of multiple diagnosis in the same patient, including malignancy. Although there is no description of this association in the literature, the possible aetiologies of persistent genital arousal disorder are diverse, and we sought this rare case should be disclosed.

scholarly journals Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism

Diabetes Care ◽  
2019 ◽  
Vol 42 (3) ◽  
pp. 381-392 ◽  
Author(s):  
Denise M. Scholtens ◽  
Alan Kuang ◽  
Lynn P. Lowe ◽  
Jill Hamilton ◽  
Jean M. Lawrence ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
Follow Up Study ◽  
Adverse Pregnancy

scholarly journals Pregnancy and Vaginal Delivery after Sacrohysteropexy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Deniz Balsak ◽  
Ahmet Eser ◽  
Onur Erol ◽  
Derya Deniz Altıntaş ◽  
Şerif Aksin
Keyword(s):  
Pelvic Organ Prolapse ◽  
Vaginal Delivery ◽  
Rare Condition ◽  
Pelvic Organ ◽  
Vaginal Birth ◽  
Pop Surgery ◽  
Long Term Follow Up ◽  
Pregnancy And Birth

Pregnancy and birth after a Pelvic Organ Prolapse (POP) surgery is a rare condition and less is known about the method for delivery. A 31-year-old women with gravida 3 para 3 underwent abdominal sacrohysteropexy and transobturatuar tape (TOT) procedures for stage III prolapse who delivered via vaginal birth and showed no relapse. Sacrohysteropexy is a good option for women with POP who desire fertility with a long term follow-up period.

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