scholarly journals Extraordinary Bulging Mass in the Foetus - A Case Report of Bladder Exstrophy

2018 ◽  
Vol 8 (1) ◽  
pp. 48-52
Author(s):  
Joanna Łosińska ◽  
Maria Respondek-Liberska
Keyword(s):  
Case Report ◽  
Good Condition ◽  
Bladder Exstrophy ◽  
External Genitalia ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Abnormal Development ◽  
Normal Limits ◽  
Incomplete Closure ◽  
Tract Infections

Abstract INTRODUCTION: Prenatal diagnosis of bladder exstrophy is extremley rare and difficult. BACKGROUND: Due to abnormal development of the cloacal membrane there is an incomplete closure of the lower abdominal wall, absence of the anterior wall of the bladder and external exposition of the posterior wall. The pubic bones are usually separated, the umbilical cord low inserted and there is abnormal external genitalia development. CASE REPORT: At 21st week of gestation of 39-year-old multigravida multipara referred by a primary care obstetrician to high-specialised centre for a detailed ultrasound examination with a suspicion of bladder absence and inferior umbilical localisation. At 29 weeks of gestation presence of bulging mass of 2 cm, between the umbilical outlet and labia was detected. At 31 weeks of gestation previously detected structure among thighs had 3 cm diameter with lateral umbilical outlet. Major labia were prominent and minor labia were within normal limits. Between two umbilical arteries with an appropriate intraabdominal course there were no transsonic area corresponding to the urinary bladder. The newborn baby was born at term in a good condition, but with an exposed bladder of 4 cm in diameter. The urethral outlet was not visualised and the female genitals were abnormal. After a month the girl underwent primary bladder exstrophy closure. Although she suffers from recurring urinary tract infections, she is in a good general condition. CONCLUSIONS: Due to prenatal diagnostics it was possible to detect and make an initial diagnosis of severe malformation. Early diagnosis allowed to prepare parents for a newborn with a defect and teach them how to take care of the baby.

Neo-esophago-sternocutaneous fistula after coloesophagoplasty: A case report

2019 ◽  
Vol 27 (8) ◽  
pp. 695-697
Author(s):  
Georgi Yankov ◽  
Yordanka Yamakova ◽  
Borislav Vladimirov ◽  
Viktoria Ilieva ◽  
Svilen Alexov ◽  
...  
Keyword(s):  
Case Report ◽  
Revision Surgery ◽  
Distal Part ◽  
Late Complication ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Challenging Problem ◽  
Benign Stricture ◽  
Large Defect ◽  
Track Formation

Revision surgery following colon interposition is a challenging problem. We describe a case of successful surgery for neo-esophago-sternocutaneous fistula as a late complication following coloesophagoplasty for intractable benign stricture. The cutaneous part of the fistula was excised and the distal part of the sternum was resected. On the anterior wall of the colon graft, there was a large defect that communicated with the posterior wall of the osteomyelitis-transformed sternum with sinus track formation. After excising the edges of the neoesophagus defect, Roux-en-Y neo-esophagojejunostomy and gastrostomy were carried out.

scholarly journals Long Term Follow Up of Complete Bladder Exstrophy Repair. A Case Report

Folia Medica ◽  
2014 ◽  
Vol 56 (1) ◽  
pp. 60-63
Author(s):  
Stella Mouskou ◽  
Theodoros T. Dionysis ◽  
Theodoros Aivazoglou ◽  
George P. Kapouleas
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Normal Renal Function ◽  
Bladder Exstrophy ◽  
Complete Repair ◽  
Tract Infections

ABSTRACT OBJECTIVE: Bladder exstrophy is a congenital anomaly which is not always successfully managed by surgery. Major goals of surgical intervention in such cases are preservation of normal renal function, development of adequate bladder function and urinary continence and avoidance of future urinary tract infections. We present 5-year data on a patient who underwent complete repair of the bladder exstrophy. CASE REPORT: We describe a full term female infant who presented at birth with complete bladder exstrophy. Complete repair of the condition was performed 3 days after birth (Ransley technique). During hospitalization the patient had a positive urinary culture with Candida lusitaniae, enterococcus and septicemia with Klebsiella pneumoniae ESBL. The patient had no complications until the age of 20 months when she developed an episode of pyelonephritis and five further episodes of cystitis with E. coli. Radiographic testing showed small bladder capacity (23 ml at the age of 3 years), bilateral vesicoureteral reflux, a long stenotic urethra and no loss of renal function. Because of the recurrent urinary tract infections, dilatations of the stenotic urethra (Scheldinger technique) were successfully performed at the age of 3. Twenty-two months later the child had negative urinary cultures, a normal renal function and had also gained partial control of the bladder sphincters. CONCLUSIONS: Surgical repair of bladder exstrophy remains a challenging surgery for the pediatric urologist. Following surgical correction both early and long-term post-operative complications may be present. Longitudinal follow up is required by an experienced team of health care professionals

scholarly journals Vanishing Non-immune Hydrops in Giant Chorioangioma of Placenta

2021 ◽  
Author(s):  
Sunita Dubey ◽  
Aayushi Kaushal ◽  
HN Pavithra
Keyword(s):  
Peak Systolic Velocity ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Normal Female ◽  
Normal Limits ◽  
Biophysical Profile ◽  
Antenatal Sonography ◽  
Female Baby ◽  
Foetal Lung ◽  
Preterm Rupture Of Membranes

Giant Chorioangioma of placenta is a rare nontrophoblastic tumour of placenta. It may lead to various maternal and foetal complications like massive antepartum haemorrhage, sudden intrauterine foetal demise and non-immune hydrops, although in few cases mother and the foetus remain unaffected. This report is of a 35-year-old G3P1L1A1, presented to hospital at 32 weeks gestation with pain abdomen followed by watery discharge from vagina. Ultrasonography at 30 weeks revealed a huge mass on anterior wall with placenta on posterior wall of uterus although her previous antenatal sonography did not reveal any abnormality either in the foetus or in placenta. Diagnosis of preterm rupture of membranes was confirmed. Hence, she was kept on conservative management; received antibiotics and steroids for foetal lung maturity. Subsequently, the foetus developed mild, steady non-immune hydrops probably due to high output cardiac failure as Values of Middle Cerebral Artery’s Peak Systolic Velocity (MCA-PSV) were within normal limits. Biophysical profile and nonstress test were normal. Guarded foetal prognosis was given due to non-immune hydrops but she delivered a normal female baby with good Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score with huge chorioangioma of placenta. Although rare, chorioangiomas of placenta should be kept in differential diagnosis of non-immune hydrops that needs regular foetal surveillance and timely intervention in affected foetuses to increase survival after birth.

RESEARCH EPIDURAL ANALGESIA TO PAIN RELIEF ON LABOR PROGRESS

2012 ◽  
pp. 31-41
Author(s):  
Quang Thuy Phung ◽  
Ngoc Thanh Cao ◽  
Quang Vinh Truong
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Pain Relief ◽  
Epidural Anesthesia ◽  
Good Condition ◽  
Cervical Dilation ◽  
Normal Birth ◽  
Normal Limits ◽  
Constant Pain ◽  
Background Pain

Background: Pain during labor as pain in the fracture is not treated, chronic pain, so pain is very essential issues to be studied. Epidural anesthesia (NMC) has many advantages over spinal anesthesia in constant pain. Study objectives: 1. Assessing the effects analgesia by epidural anesthesia during labor. 2. Assessing progress and final results of labor for pregnant women and fetuses. Materials and Methods: The study described 37 pregnant from 38 to less than 42 weeks had a positive phase of labor to pain relief by continuous epidural anesthesia method, with cervical dilation between 3 cm and 4 cm. Results: Women feel very satisfied (67.5%) on methods of natural pain relief during labor. Most women deliver normally (73%). Evolution of the cervix takes place smoothly. Duration of labor within the normal birth. Breast sucking good condition accounted for 86.5% rate, the reflecting normal 94.6%. Conclusions: This is the effective method of pain relief during labor birth. Duration of labor in normal limits. Side effects occur less and can be well controlled. Keywords: epidural anesthesia; relief pain on labor.

Posterior wall myocardial infarction: A case report

2017 ◽  
Vol 70 (1-2) ◽  
pp. 44-47
Author(s):  
Milenko Cankovic ◽  
Snezana Bjelic ◽  
Vladimir Ivanovic ◽  
Anastazija Stojsic-Milosavljevic ◽  
Dalibor Somer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Chest Pain ◽  
Myocardial Revascularization ◽  
Posterior Wall ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Therapeutic Benefits ◽  
St Segment ◽  
Therapeutic Algorithms

Introduction. Acute myocardial infarction is a clinical manifestation of coronary disease which occurs when a blood vessel is narrowed or occluded in such a way that it leads to irreversible myocardial ischemia. ST segment depression in leads V1?V3 on the electrocardiogram points to the anterior wall ischemia, although it is actually ST elevation with posterior wall myocardial infarction. In the absence of clear ST segment elevation, it may be overlooked, leading to different therapeutic algorithms which could significantly affect the outcome. Case report. A 77 year-old female patient was admitted to the Coronary Care Unit due to prolonged chest pain followed by nausea and horizontal ST segment depression on the electrocardiogram in V1?V3 up to 3 mm. ST segment elevation myocardial infarction of the posterior wall was diagnosed, associated with the development of initial cardiogenic shock and ischemic mitral regurgitation. An emergency coronarography was performed as well as primary percutaneous coronary intervention with stent placement in the circumflex artery, the infarct-related artery. Due to a multi-vessel disease, surgical myocardial revascularization was indicated. Conclusion. Posterior wall transmural myocardial infarction is the most common misdiagnosis in the 12 lead electrocardiogram reading. Routine use of additional posterior (lateral) leads in all patients with chest pain has no diagnostic or therapeutic benefits, but it is indicated when posterior or lateral wall infarction is suspected. The use of posterior leads increases the number of diagnosed ST segment elevation myocardial infarctions contributing to better risk assessment, prognosis and survival due to reperfusion therapy.

scholarly journals Ovarian Torsion in a 5-Year Old: A Case Report and Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Tract ◽  
Clinical Suspicion ◽  
Ovarian Torsion ◽  
Surgical Emergencies ◽  
High Clinical Suspicion ◽  
Tract Infections ◽  
Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

Duplicated Renal Collecting System With Ectopic Ureter in Female Bladder Exstrophy: A Case Report

Urology ◽  
2016 ◽  
Vol 89 ◽  
pp. 129-131 ◽  
Author(s):  
Pokket Sirisreetreerux ◽  
Kathy M. Lue ◽  
Jason E. Michaud ◽  
Heather N. Di Carlo ◽  
John P. Gearhart
Keyword(s):  
Case Report ◽  
Bladder Exstrophy ◽  
Ectopic Ureter ◽  
Female Bladder ◽  
Collecting System
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