scholarly journals A Case of Ruptured Rudimentary Horn of Uterus during Pregnancy

2020 ◽  
Vol 32 (2) ◽  
pp. 121-123
Author(s):  
Ruman U ◽  
Khanam K ◽  
Akhter S ◽  
Karim R
Keyword(s):  
Abdominal Pain ◽  
Gestational Age ◽  
Hypovolemic Shock ◽  
Emergency Laparotomy ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Severe Haemorrhage ◽  
Life Threatening ◽  
History Of ◽  
Threatening Situation

Pregnancy in a rudimentary horn of an unicornuate uterus is a rare and life threatening situation for mother and fetus. Usually pregnancy continues upto approximately 18-20 weeks of gestational age. Then it usually ruptures and severe haemorrhage ensues. Emergency laparotomy is the treatment of choice. Here we report a case of 36 years woman with secondary subfertility who has history of taking ovulation inducing drug. She presented with 20 weeks amenorrhoea with severe abdominal pain and hypovolemic shock. Urgent laparotomy was done and the diagnosis was confirmed. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 121-123

scholarly journals Pregnancy in Noncommunicating Rudimentary Horn of Unicornuate Uterus: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Melese Gezahegn Tesemma
Keyword(s):  
Ectopic Pregnancy ◽  
Hypovolemic Shock ◽  
Emergency Laparotomy ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Ultrasound Evaluation ◽  
Compatible Blood ◽  
High Index Of Suspicion ◽  
Time Of Presentation ◽  
Rule Out

Pregnancy implanted in the rudimentary horn of unicornuate uterus is very rare with an incidence of 1 in 75,000 to 1 in 150,000 pregnancies. Both prerupture and postrupture diagnosis of ectopic pregnancy in the rudimentary horn of a unicornuate uterus is difficult. Here is a case of a 21-year-old gravida 5 para 3 abortion 1 mother presented with abdominal pain of 2 days duration following a falling accident. The patient was severely anemic and was in hypovolemic shock at the time of presentation. She had diffused lower abdominal tenderness with hemoperitonium. After clinical and ultrasound evaluation, emergency laparotomy was decided for preop diagnosis of ruptured cornual ectopic pregnancy to rule out uterine rupture at gestational age of 16 weeks. Intraoperatively, ruptured ectopic pregnancy in noncommunicating rudimentary horn was diagnosed. Resection of rudimentary horn and ipsilateral salpingectomy was done. She was transfused with 5 units of compatible blood. It is better to increase awareness about pregnancy occurring in this rare uterine anomaly, so as to have a high index of suspicion as early detection before it gets ruptured is difficult.

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

scholarly journals Incarcerated Lumbar Hernia Complicated by Retroperitoneal Pseudoaneurysm 50 Years after Resection and Radiation Therapy of a Sarcoma

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Oluwatobi Onafowokan ◽  
Dabanjan Bandyopadhyay ◽  
Dale Johnson ◽  
Hugo J. R. Bonatti
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Ct Scan ◽  
Late Complication ◽  
Abdominal Hernia ◽  
Emergency Laparotomy ◽  
Incisional Hernias ◽  
History Of ◽  
The Right

Background. Lumbar hernias are rare abdominal hernias. Surgery is the only treatment option but remains challenging. Posterior incisional hernias are even rarer especially with incarceration of intra-abdominal contents.Case Presentation. A 68-year old female presented with a 3-day history of worsening acute abdominal pain and distension, with multiple episodes of emesis. A CT scan indicated a large incarcerated posterolateral abdominal hernia. The patient had a history of resection of a sarcoma on her back as a child and also received chemotherapy and radiation. During emergency laparoscopy, a hemorrhagic small bowel segment incarcerated in the hernia was reduced and resected, and the distended small bowel was decompressed. An elective hernia repair was scheduled. After temporary clinical improvement, the patient again developed abdominal pain, distention, and emesis. During emergency laparotomy, a large hematoma in the right flank was found and partially evacuated. The right colon was mobilized out of the hernia and the duodenum was kocherized. A20×20cm BIO-A mesh was placed on top of the Gerota fascia and cranially tucked under liver segment VI. Anteriorly, the mesh was fixated with absorbable tacks. The duodenum and colon were placed into the mesh pocket. A postoperative CT scan identified a 2 cm pseudoaneurysm of a side branch of a lumbar artery, and the bleeding source was embolized. The postoperative course was complicated byClostridium difficile-associated colitis, but ultimately, the patient recovered fully. At 6-month follow-up, there was no evidence for a recurrent hernia.Discussion. There is a paucity of literature concerning lumbar incisional hernias. Repair with bioabsorbable mesh seems feasible, but longer follow-up is necessary as the mesh was placed in an unusual fashion due to the retroperitoneal hematoma. The exact cause of the hemorrhage is unclear and may have been caused during the initial incarceration, during surgery, or may be a late complication of her previous radiation.

scholarly journals Amlodipine overdose with hypotension and noncardiogenic pulmonary edema

2016 ◽  
Vol 13 (1) ◽  
pp. 27-29 ◽  
Author(s):  
Anish Hirachan ◽  
Sushil Baral ◽  
Miqdaadh Shareef ◽  
Rishikesh Rijal ◽  
Laxman Tibrewala
Keyword(s):  
Hospital Stay ◽  
Pulmonary Edema ◽  
Calcium Gluconate ◽  
High Flow ◽  
Suicidal Intent ◽  
High Flow Oxygen ◽  
Refractory Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Threatening Situation

Amlodipine overdose can be a life threatening situation when it is manifested as noncardiogenic pulmonary edema. Treatment remains challenging when it is complicated with refractory hypotension and pulmonary edema. Here we describe a 23 year old female with history of ingestion of 45 tabs (5mg) of amlodipine as a suicidal intent and presented within 36 hours to the hospital. High flow oxygen, IV fluids, calcium gluconate infusion and antibiotics were used for the management. After 7 days of hospital stay, patient was discharged with full recovery.   Nepalese Heart Journal 2016; 13(1): 27-29

scholarly journals Non-occlusive mesenteric ischaemia associated with anorexia nervosa

2019 ◽  
Vol 12 (5) ◽  
pp. e229703
Author(s):  
Takashi Sakamoto ◽  
Alan Kawarai Lefor ◽  
Tadao Kubota
Keyword(s):  
Anorexia Nervosa ◽  
Distal Ileum ◽  
Interdisciplinary Management ◽  
Emergency Laparotomy ◽  
Diffuse Peritonitis ◽  
Chronic Haemodialysis ◽  
Mesenteric Ischaemia ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of

Non-occlusive mesenteric ischaemia (NOMI) is a life-threatening condition that requires emergent intervention and anorexia nervosa is a chronic eating disorder that requires careful medical and nutritional management. A 54-year-old woman with a history of anorexia nervosa and undergoing chronic haemodialysis developed abdominal pain and called an ambulance. On arrival, she was in shock and abdominal examination was consistent with diffuse peritonitis. Computed tomography scan suggested ischaemia from the distal ileum to the ascending colon. Emergency laparotomy revealed NOMI from the distal ileum to the transverse colon. The treatment strategy included staged operations and careful medical management to optimise nutritional support and electrolyte management with survival of the patient. NOMI and anorexia nervosa are both difficult to manage. Meticulous interdisciplinary management can result in a good outcome.

scholarly journals A rare cause of neutropenic enterocolitis: Propylthiouracil-induced agranulocytosis

2018 ◽  
Vol 25 (5) ◽  
pp. 286-289 ◽  
Author(s):  
Vermi Degerli ◽  
Fulya Yilmaz Duran ◽  
Mustafa Kucuk ◽  
Ibrahim Atasoy
Keyword(s):  
Abdominal Pain ◽  
Complete Blood Count ◽  
Multiple Organ ◽  
Antithyroid Drugs ◽  
Gastrointestinal Complication ◽  
Emergency Physicians ◽  
Neutropenic Enterocolitis ◽  
High Clinical Suspicion ◽  
Life Threatening ◽  
History Of

Introduction: Neutropenic enterocolitis is a life-threatening gastrointestinal complication of neutropenia that is rarely seen in adults. Neutropenic enterocolitis is more common in oncology patients, especially in those with leukemia. Antithyroid drugs are widely used to treat hyperthyroidism, but they can rarely cause agranulocytosis. Although the pathophysiology is not well understood, high clinical suspicion and immediate and appropriate treatment responses are essential to reduce the mortality rate of neutropenic enterocolitis. Case presentation: We present a case of a 57-year-old male patient who developed neutropenic enterocolitis as a result of agranulocytosis caused by the use of propylthiouracil. He had history of hyperthyroidism and was on propylthiouracil. He presented to the emergency department with abdominal pain but eventually died due to rapid deterioration of sepsis and multiple organ failure despite medical and surgical treatment. Discussion: Thioamides can cause agranulocytosis which can result in serious complication including neutropenic enterocolitis. Complete blood count must be monitored in patients receiving thioamides, and these patients should be educated on symptoms of agranulocytosis. Conclusion: Since patients with neutropenic enterocolitis are often evaluated first by emergency physicians, emergency physicians must be vigilant for neutropenic enterocolitis in patients with neutropenia and abdominal pain.

scholarly journals Haematometra in one half of the uterus or rudimentary horn?

1970 ◽  
Vol 2 (1) ◽  
pp. 59-62
Author(s):  
Suniti Rawal ◽  
Josie Baral ◽  
Meeta Singh ◽  
Samira Khan ◽  
Beemba Shakya ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Key Words ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Post Operative Period ◽  
Endometriotic Cyst

A unicornuate uterus with functioning and non communicating rudimentary horn is a rare Mullerian abnormality, difficult to diagnose at times usually low in the list of differential diagnosis for pelvic pain and dysmenorrhea. A 22 years P1 presented with severe lower abdominal pain and dysmenorrhoea, following laparotomy that was done for endometriotic cyst of left ovary 7 months back. Radiographic studies revealed the haematometra in the rudimentary horn with normal uterus, right ovary and the tube. Laparotomy with drainage of haematometra and excision of septum along with the reconstruction of uterine cavity was performed thus anatomizing it with the cavity of the rudimentary horn. Both the intra and the post operative period were uneventful. She was discharged on OCP along with the advice to follow up regularly. She is asymptomatic till date. Key words: Endometriosis, haematometra, rudimentary horn doi:10.3126/njog.v2i1.1480 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 59 - 62 May -June 2007

scholarly journals PICA LEADING TO LITHOBEZOAR AND TRICHOBEZOAR IN ADULT MALE: A CASE REPORT

2020 ◽  
pp. 1-3
Author(s):  
Bhuvana Lakshmi Sundararajan ◽  
Siddartha Gowthaman ◽  
Arul Kumar ◽  
Ramanathan M
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Developmental Disabilities ◽  
Adult Male ◽  
Conservative Management ◽  
Foreign Bodies ◽  
Exploratory Laparotomy ◽  
Life Threatening ◽  
History Of

INTRODUCTION: Pica is common in patients with developmental disabilities and can be life-threatening. It is important to identify pica and manage it appropriately. CASE REPORT:A 19-year-old male presented with history of abdominal pain and vomiting for two days.On imaging he was found to have multiple foreign bodies within the small and large bowel.After trial of conservative management,he was taken up for exploratory laparotomy. He was found to have trichobezoar and lithobezoar obstructing the bowel at terminal ileum.Bezoars when removed via enterotomy. DISCUSSION: Bezoars are conglomerates of non-absorbable food or fibre formed in the alimentary tract.Trichobezoar forms following ingestion of hair and usually leads to gastric outlet obstruction.Lithobezoar refers to the accumulation of stones in the GIT. Reports of colonic lithobezoar are rare. Pica is the persistent ingestion of non-nutritive substances beyond a developmentally inappropriate age. Patients should be referred to a psychologist/behaviour analyst and caregivers should also be educated

scholarly journals The Challenge of the Non-Compliant Patient: A Case of Caesarean Section Scar Ectopic Pregnancy

2021 ◽  
pp. 1-3
Author(s):  
Jessica Audet ◽  
Brittany Noel Robles ◽  
Nicolle M Arroyo Lluberas ◽  
Jessica Audet ◽  
Daniel Faustin ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Emergency Laparotomy ◽  
Pharmacological Management ◽  
Compliant Patient ◽  
Life Saving ◽  
Close Observation ◽  
Life Threatening ◽  
History Of ◽  
Ruptured Uterus

Ectopic pregnancy is a quite common and life-threatening pregnancy. The most common site of ectopic implantation of a fertilized embryo is the fallopian tube. In extremely rare situations, the embryo can implant in other locations, which makes the diagnosis and management even more complex. Although close observation of a new pregnancy is key in the diagnosis and treatment of an ectopic pregnancy, there is still a major risk of life-threatening outcomes. This is a case report of a 31-year-old patient with a history of multiple pregnancies who presented to a community hospital in the spring of 2021 with an ectopic caesarean scar pregnancy. A diagnosis of ectopic pregnancy was on a timely basis, and surgical management was advised. Upon refusal of treatment and admission, pharmacological management was initiated, but patient compliance challenged the success of the therapy. Patient non-compliance to close follow-up resulted in a ruptured uterus. Emergency laparotomy with supracervical hysterectomy was performed as a life-saving procedure.

Spontaneous rupture of a splenic artery aneurysm during the third trimester of pregnancy

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Nuri Peker ◽  
Nazif Harun Vicdanlı ◽  
Ahmet Demir ◽  
Mehmet Buğra Bozan ◽  
Savaş Gündoğan
Keyword(s):  
Maternal Death ◽  
Spontaneous Rupture ◽  
Splenic Artery ◽  
Strong Association ◽  
Hypovolemic Shock ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Third Trimester ◽  
Life Threatening ◽  
Threatening Situation

Abstract Spontaneous rupture of a splenic artery aneurysm (SAA) during pregnancy is a rare but life-threatening situation typically presenting with sudden and unexpected fetal and maternal death. The etiology is unclear; however, there is a strong association between pregnancy and the rupture of a SAA. Maternal and fetal prognosis is poor and mortality rates remain at 70% and 90%, respectively. Here, we present a case report of the spontaneous rupture of a SAA at the 35th week of gestation, which presented as suddenly developed hypovolemic shock ending in fetal and maternal death.

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