scholarly journals A case report: spontaneous postpartum rupture of unscarred uterus

2018 ◽  
Vol 7 (8) ◽  
pp. 3420
Author(s):  
Swati Singh ◽  
Ravinder Ahlawat
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Emergency Laparotomy ◽  
Full Thickness ◽  
Uterine Incision ◽  
History Of ◽  
Rupture Of Uterus ◽  
Specific Symptoms

Rupture of uterus is characterized by a breach in the wall of the uterus involving its full thickness. An unscarred uterus rupture is uncommon. It has non-specific symptoms and presentation differs according to site and time of rupture. Authors report an unusual case of spontaneous rupture of unscarred uterus. A 32-year-old, pregnant woman, developed postpartum bleeding with no history of prior uterine incision. She was diagnosed as a case of rupture of uterus and emergency laparotomy was done. Early diagnosis and immediate surgical intervention may significantly improve the prognosis. Differential diagnosis of uterine rupture should always be kept in mind in all patients with or without risk factors.

scholarly journals Differential Diagnosis between the Varieties of Vasculitis Forms

2018 ◽  
Vol 6 (2) ◽  
pp. 1-8
Author(s):  
Joana Hankollari ◽  
Marsida Duli ◽  
Qamil Dika ◽  
Xhenila Duli ◽  
Indrit Bimi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Blood Vessel ◽  
Specific Form ◽  
The Body ◽  
Imaging Studies ◽  
Patient Assessment ◽  
Diagnostic Difficulties ◽  
History Of ◽  
Specific Symptoms

Vasculitis is an inflammation of the blood vessels. It can affect any blood vessel in the body by manifesting a variety of systemic, non-specific symptoms that make difficult the diagnosis of this pathology and especially its specific form. In front of any patient suspected of being affected by vasculitis, some questions are asked: Is the vasculitis or other pathology that camouflages, whether it is primary or secondary vasculitis, in which vessels this pathology extends, how can the diagnosis be confirmed and how can it be determined the type of vasculitis?The purpose of this study is to inform about the protocols to be followed to perform differential diagnosis of vasculitis types.This study is a review based on the research of world studies and literature regarding the recommendations for performing differential diagnosis among the variety of vasculitis forms.Primary patient assessment involves taking the history of the medications it uses, risk factors for infectious pathology, history of cardiac valve pathologies, and autoimmune pathologies. Then laboratory and imaging studies are carried out, aiming at setting the diagnosis, determining the affected organ and the degree of disease activity. And recently we refer to algorithms to make differential diagnosis between the varieties of vasculitis forms.Despite the diagnostic difficulties of vasculitis, the variety of its forms, the separation of responsibilities among many specialities, there are protocols that need to be followed rigorously to arrive at a safe diagnosis as well as auxiliary algorithms to distinguish the type of vasculitis.

scholarly journals Metastatic adrenal pheochromocytoma to the thoracic spine

2010 ◽  
Vol 9 (3) ◽  
pp. 343-346 ◽  
Author(s):  
Michael T. Scalfani ◽  
Paul M. Arnold ◽  
Karen K. Anderson
Keyword(s):  
Differential Diagnosis ◽  
Surgical Intervention ◽  
Hepatic Metastases ◽  
Posterior Fixation ◽  
Original Diagnosis ◽  
Average Survival ◽  
Progression Of Disease ◽  
Adrenal Pheochromocytoma ◽  
History Of ◽  
Work Up

To report on a case of pheochromocytoma metastases to the spine occurring more than 20 years after initial diagnosis. A 34-year-old female with a history of metastatic pheochromocytoma diagnosed at age 12 presented with weakness, heart palpitations, and circumferential back pain of five months duration. The patient had undergone multiple laparatomies for abdominal and hepatic metastases. Work-up revealed a destructive lesion at T9. After two weeks of preoperative phenoxybenzamine to control her hypertension, she underwent decompression, posterior fixation and fusion. Surgical intervention was followed by radiation therapy, zoledronic acid, and only one cycle of chemotherapy due to intolerance of side effects. The patient survived 25 years after original diagnosis, which far exceeds the average survival of less than 15 years. The patient died 26 months postoperatively due to progression of disease. Pheochromocytoma with spine metastases occurring more than 20 years after diagnosis is very uncommon, and should be considered in the differential diagnosis of a patient with a history of pheochromocytoma.

scholarly journals Subglottic acute lymphoblastic leukaemia

2018 ◽  
Vol 11 (1) ◽  
pp. e226364
Author(s):  
Shilpa Ojha ◽  
Julian Gaskin ◽  
Michael Saunders
Keyword(s):  
Differential Diagnosis ◽  
Paediatric Patient ◽  
Acute Lymphoblastic Leukaemia ◽  
Airway Obstruction ◽  
Lymphoblastic Leukaemia ◽  
Unusual Case ◽  
Acute Airway Obstruction ◽  
History Of ◽  
Low Threshold

Acute lymphoblastic leukaemia (ALL) is one of the the most common malignancies of childhood and can occasionally present as acute airway obstruction. We present the unusual case of a 1-year-old boy who was referred to our Paediatric Otolaryngology (ENT) clinic with a recurrent history of croup. This is the first reported case of localised ALL presenting as a subglottic mass in a paediatric patient. It highlights the need to have a broader differential diagnosis in children presenting with ‘recurrent croup’ including extramedullary presentation of leukaemia and to have a low threshold for performing endoscopy in such cases.

scholarly journals Paediatric oropharyngeal tularaemia requiring surgical intervention

2019 ◽  
Vol 12 (9) ◽  
pp. e229754
Author(s):  
Amina Nemmour ◽  
Adzreil Bakri ◽  
Claude A Fischer ◽  
Yves Brand
Keyword(s):  
Surgical Intervention ◽  
Cervical Lymphadenopathy ◽  
Who Guidelines ◽  
Clinical Progression ◽  
Delay In Diagnosis ◽  
History Of ◽  
Deep Neck Abscess ◽  
Extended Course ◽  
Specific Symptoms

Tularaemia is a rare infectious disease endemic in most European countries caused by the bacterium Francisella tularensis. 1 Patients often show acute non-specific symptoms, which causes a delay in diagnosis and proper treatment, potentially resulting in significant morbidities such as deep neck abscess, meningitis, endocarditis and septic shock. The authors present a case of a 5-year old boy with a 4-day history of fever, sore throat and painful cervical lymphadenopathy, whose clinical progression worsened despite being treated with recommended antibiotics as per WHO guidelines once the diagnosis of Tularaemia was confirmed by serologic tests. He developed a parapharyngeal abscess and a persistent left necrotic cervical lymph node, which both were surgically drained and excised, respectively, and an extended course of antibiotic was given. Subsequently, the patient fully recovered from the illness and the follow-up was negative for relapse.

scholarly journals Unusual case of classic testicular seminoma in a 90-year-old patient: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Ahmad Al-Mousa ◽  
Mohammad Nour Shashaa ◽  
Mohamad Shadi Alkarrash ◽  
Mohamad Alkhamis ◽  
Lina Ghabreau ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Elderly Patients ◽  
Unusual Case ◽  
Medical Literature ◽  
Testicular Tumor ◽  
Testicular Seminoma ◽  
Case Presentation ◽  
History Of ◽  
Pure Seminoma

Abstract Background Seminoma is the most common subtype of testicular cancer and occurs most commonly in patients aged 30–49 years, but decreases to a very low level in men in their 60s or older. Case presentation A 90-year-old Syrian man with a 6-year history of an increase in size of his right scrotum, presented to the urological clinic and, on clinical examination, the findings suggested testicular tumor. After orchiectomy and histology results based on microscopic and immunohistochemical examinations, a pure seminoma was diagnosed, so we describe in this case report the second-oldest patient with classical seminoma in the medical literature. Conclusion This case report has been written to focus on the probability of any type of testicular tumor occurring at any age or decade; urologists should consider seminoma as a differential diagnosis with any testicular swelling even in elderly patients.

scholarly journals Profile of Ectopic Pregnancy at Kathmandu Model Hospital

2016 ◽  
Vol 10 (2) ◽  
pp. 10-13
Author(s):  
HK Pradhan ◽  
G Dangal ◽  
A Karki ◽  
R Shrestha ◽  
K Bhattachan
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Discharge Summary ◽  
Reproductive Age ◽  
Emergency Laparotomy ◽  
Average Hospital ◽  
Pain Abdomen ◽  
Number Of Patients ◽  
History Of ◽  
Age Range

Aims: The study was done to analyze the epidemiology, diagnosis and treatment aspect of patients with ectopic pregnancy at Kathmandu Model Hospital.Methods: This was a retrospective study of patients with ectopic pregnancy who received treatment at Kathmandu Model Hospital from January 2008 to September 2015. Data were analyzed from patient records and discharge summary. Delivery number was obtained from maternity record.Results: There were 61 cases of ectopic pregnancy with the hospital incidence of 1.46%. Highest number of patients 20 (32.79%) were in the age range of 28-32 years. Most of the patients were nullipara 22 (36.06%) or with parity two 20 (32.79%). Some risk factors were found in 29 (47.54%) cases. The commonest risk factor was pelvic inflammatory disease in 12 (19.67%). All presented with pain abdomen, 48 (78.68%) had per vaginal bleeding, 17 (27.87%) presented in shock. Cervival excitation was present in 38 (62.29%). Urine for pregnancy test was positive in all and 37 (60.66%) had ultrasonography. Ten (16.39%) patients underwent emergency laparoscopic surgery and 40 (65.57%) had emergency laparotomy. Salpingectomy was required in 53 (86.89%) cases. The average hospital stay was 5 days.Conclusions: The study showed that ectopic pregnancy could occur at any reproductive age without obvious risk factors. Although not all patients gave history of amenorrhoea, pain abdomen was present in all.

scholarly journals Management outcomes of ectopic pregnancy depending on different treatment modalities: a cohort study

2021 ◽  
Vol 10 (3) ◽  
pp. 842
Author(s):  
Shawqi H. Alawdi ◽  
Mayada Roumieh ◽  
Marwan Alhalabi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Single Dose ◽  
Ectopic Pregnancy ◽  
Surgical Intervention ◽  
Expectant Management ◽  
Pelvic Surgery ◽  
Dose Methotrexate ◽  
Significant Difference ◽  
History Of

Background: Ectopic pregnancy is the most common cause of maternal morbidity and mortality during the first trimester of pregnancy. The present study aimed to review and evaluate the management outcomes of ectopic pregnancy in Damascus University Maternity Hospital, Syria.Methods: A retrospective cohort study was performed on women referring to Damascus University Hospital of Obstetrics and Gynecology (OBGYN) for ectopic pregnancy. Patients were assigned into groups by method of treatment: expectant management (Group 1), single-dose methotrexate regimen (Group 2), two-dose methotrexate regimen (Group 3), and surgical intervention (Group 4). Parameters assessed were risk factors for ectopic pregnancies, transvaginal ultrasonography findings, serum human chorionic gonadotropin (hCG) levels on Days 0, 4, 7, and types of surgical intervention in women that underwent any surgical intervention. A treatment modality was considered successful when hCG levels declined to less than 5 mIU/L without further administration of methotrexate dose or need for surgery.Results: Seventy-seven women with ectopic pregnancy were admitted to the hospital during the study period. Groups 1, 2, 3, and 4 constituted 20.8%, 13.0%, 6.5% and 59.7% of the patients respectively. The most common encountered risk factors for ectopic pregnancy in the patients were history of previous intra-abdominal or pelvic surgery (57.1%) and history of miscarriage (41.6%). A statistically significant difference in the serum hCG concentrations measured on day 0, day 4, and day 7 were observed between the groups.Conclusions: The success rate in ectopic pregnancy treatment was 56.25% for the expectant management, 70% for the single-dose methotrexate regimen, and 40% for two-dose methotrexate regimen.

scholarly journals Placenta Percreta: An Unusual Etiology for Spontaneous Rupture of Uterus Near Term

2014 ◽  
Vol 6 (3) ◽  
pp. 180-182
Author(s):  
Anupam Varshney ◽  
Neerja LNU ◽  
Manju Varma ◽  
RK Thakral
Keyword(s):  
Pregnant Women ◽  
Uterine Rupture ◽  
Spontaneous Rupture ◽  
Placenta Percreta ◽  
Emergency Laparotomy ◽  
Lower Segment Cesarean Section ◽  
Spontaneous Uterine Rupture ◽  
History Of ◽  
Rupture Of Uterus ◽  
Near Term

ABSTRACT Uterine rupture is a life-threatening complication in pregnancy with an incidence of 0.07%, out of which 80% are spontaneous rupture. Placenta percreta is the rarest form of placental implantation abnormalities, with an incidence 1 in 2500 pregnant women.1,2 Spontaneous uterine rupture due to placenta percreta is very rare, with an incidence of 1 in 4,366 pregnant women.3 It often occurs in patients with a history of scar in the uterus.4 Placenta percreta-induced spontaneous uterine rupture at term with previous lower segment cesarean section (LSCS) is difficult to diagnose. A 25-year-old pregnant woman, with history of one incomplete abortion treated by dilatation and curettage followed by a vaginal delivery with stillbirth and one LSCS again with stillbirth at term, was admitted in the emergency ward with history of approx 9 months amenorrhea, breathlessness, pain in abdomen (unable to lie down or even sit), vomiting and loss of fetal movements for last 24 hours. O/E: GC fair, afebrile, Pallor +++, pedal edema +, pulse 100/minutes regular, resp. rate; 40/minutes, thoracic, BP 110/70 mm Hg, lung fields clear with no abnormality detected in heart. On P/A: skin was stretched and a Pfannensteil scar healed by primary intention was present Abdomen tense, tender therefore fundal height could not be assessed. Fetal parts were not palpable and lie/presentation could not be made out. FHS were absent. On P/V; os closed with uneffaced cervix, presenting part could not be made out and was high. No bleeding or leaking per-vaginum was present. Hb 6.7 gm%, TLC 15600, DLC P90, L8, E2, M0. Ultrasound done on 27.5.12 (one month back) outside revealed 32.3 weeks gestation with normal scar thickness, placenta located in upper segment, grade I. No comment was made on the interface between placenta and myometrium in ultrasound report. Patient was subjected to emergency laparotomy, massive hemoperitoneum was found. Examination of uterus revealed an intact previous scar. A full term male stillborn baby was delivered by uterine scar (LSCS) on 21.6.2012, at 10.30 pm The placenta could not be delivered as there was no plain of cleavage between placenta and myometrium. Uterus was exteriorized and to surprise there was a rent of about 3 × 2 cm at left cornua, placental tissue peeping out on removing the clots. Subtotal hysterectomy was performed. Three units blood were transfused. Postoperative period was uneventful and the patient was discharged in satisfactory condition on 9th day. Histopathological examination of the uterine specimen revealed placenta percreta. To conclude uterine rupture should be considered in the differential diagnosis in pregnant women who present with acute abdomen with or without shock. How to cite this article Neerja, Varma M, Thakral RK, Varshney A. Placenta Percreta: An Unusual Etiology for Spontaneous Rupture of Uterus Near Term. J South Asian Feder Obst Gynae 2014;6(3):180-182.

CASE REPORT: ODONTOGENIC CUTANEOUS FISTULA IN THE SUBMANDIBULAR CERVICAL SKIN IN TWO DOGS

2019 ◽  
Vol 45 (04) ◽  
pp. 135-140
Author(s):  
Shu-Fang Yang ◽  
Chung-Chao Chen ◽  
Pi-Chen Chang ◽  
Jian-Xi Yu ◽  
Wen-Wen Liang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Tooth Extraction ◽  
Surgical Intervention ◽  
Dental Radiography ◽  
Oral Antibiotics ◽  
Intact Male ◽  
Cutaneous Fistula ◽  
History Of ◽  
Cutaneous Nodule

Odontogenic cutaneous fistula is commonly misdiagnosed by practitioners, leading to incorrect and unnecessary treatment. Here, we present two cases. Case 1 involved an eight-year-old intact male Maltese with a submandibular cutaneous abscess following 2 weeks of antibiotic treatment who was later diagnosed, using dental radiography, with odontogenic cutaneous fistula. Case 2 involved an eight-year-old neutered female Maltese with a submandibular cutaneous nodule and general skin problems following 6 months of oral antibiotics and a history of surgical intervention who was finally diagnosed, using dental radiography and computed tomography, with an odontogenic cutaneous fistula that resolved completely following tooth extraction. These two cases highlight the importance of odontogenic infection in the differential diagnosis of typical lesions in the head and neck.

scholarly journals Chronic lymphocytic leukemia in a farmer and vegetable seller: Associated with exposure of multiple work-related hazards?

2021 ◽  
Vol 1 (2) ◽  
pp. 46-52
Author(s):  
Dewi S. Soemarko ◽  
Firly Ratsmita
Keyword(s):  
Risk Factors ◽  
Genetic Factors ◽  
Lymphocytic Leukaemia ◽  
Control Mechanism ◽  
The Body ◽  
Lymphocytic Leukemia ◽  
Work Related ◽  
Chronic Effects ◽  
History Of ◽  
Specific Symptoms

There are several risk factors associated with the incidence of chronic lymphocytic leukaemia (CLL), namely genetic factors, smoking, and occupational exposure to chemicals. We highlight a possible association of a CLL case and the occupational. We reported a case of CLL patient, a 69-year-old man, who had been working as a vegetable seller and a chili farmer since 15 and 4 years ago, respectively. The patient was diagnosed with CLL three months prior to admission and had a history of three times blood transfusions. The patient only complained of paleness and weakness without any specific symptoms. No swelling of the lymph nodes, hepatomegaly, or splenomegaly was found. As a vegetable seller and chili farmer, the patient was exposed to five hazards, physical, chemical, biological, ergonomic to psychosocial. Therefore, it is necessary to analyse whether there was an association between the patient's work and the current CLL. To diagnose occupational diseases, several steps are needed. In this patient, one of the risk factors that could lead to CLL was exposure to chemicals such as pesticides. However, information regarding the content of pesticides used was unclear and there were no results obtained from pesticides biomarker examination that might cause the disease, making it difficult to establish a definitive diagnosis of work-related cause. The patient could be advised to have biomarkers of pesticide substances checked, which requires control of farmers and vegetable sellers who might have been exposed to pesticides. The control mechanism might be started from elimination, substitution, engineering, administration, and use of personal protective equipment. A control mechanism is necessary to prevent the entry of contaminants into the body, especially through inhalation, oral, and dermal pathways. It is recommended to examine for biomarkers of pesticides containing organophosphates, organochlorines, or carbamates to determine the chronic effects on the accumulation of these chemicals that might cause CLL.

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