Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) Patients Treated with Laparoscopic Neovaginal with The Davydov Procedure with Epidural Anesthesia: A Case Report

Introduction. MRKH syndrome is characterized by incomplete or absent of vaginal and uterine agenesis. Currently there are no official guidelines on the management of MRKH syndrome. This case report is about the operative management in MRKH patients by neovaginal with laparoscopic Davydov procedure. Case presentation. A 26-year-old woman admitted that she had never had a period, the patient admitted that her breasts began to grow at the age of 13, and the patient was planning to get married, and refused to take further planning. The patient then came back to the RSMH urogynecology clinic after marriage, from the examination it was found that the pubic hole was ± 0.5 cm deep, speculum examination could not be done, the uterus could not be palpable from the rectal toucher. From the ultrasound examination, it was found that both ovaries were within normal limits and suspected uterine hypoplasia. Hormone tests were within normal limits, with the following values: LH 27.01 mIU / mL, FSH 57.08 mIU / mL, Estradiol 10 pg / mL, Prolactin 5.94 ng / mL. Patients with a history of atrial septal defect (ASD) and ventricular septal defect (VSD) Conclusion. Treatment of MRKH syndrome patients is usually complex and requires multidisciplinary counseling, therapy, and management, so it is hoped that it can help patients to make a functional vagina. Further research and collaboration from various multidisciplinary make pregnancy in patients with MRKH syndrome, not impossible, along with current technological and scientific developments, the selection of surrogate mothers, and uterine transplantation is an option.

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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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Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01441-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Zai-Qiang Zhang ◽

Jia-Wang Ding

Keyword(s):

Case Report ◽

Atrial Septal Defect ◽

Septal Defect ◽

Emergency Operation ◽

Atrial Wall ◽

Aortic Sinus ◽

Case Presentation ◽

Lethal Complications ◽

Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

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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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Acute Iodine Toxicity from a Suspected Oral Methamphetamine Ingestion

Clinical Medicine Insights Case Reports ◽

10.4137/ccrep.s20086 ◽

2014 ◽

Vol 7 ◽

pp. CCRep.S20086 ◽

Cited By ~ 3

Author(s):

Marilyn N. Bulloch

Keyword(s):

Case Report ◽

Gastrointestinal Symptoms ◽

Liver Function Tests ◽

Oral Ingestion ◽

Methamphetamine Abuse ◽

Normal Limits ◽

Naturally Occurring ◽

History Of ◽

Systemic Symptoms ◽

Iodine Toxicity

Background Iodine is a naturally occurring element commercially available alone or in a multitude of products. Iodine crystals and iodine tincture are used in the production of methamphetamine. Although rarely fatal, iodine toxicity from oral ingestion can produce distressing gastrointestinal symptoms and systemic symptoms, such as hypotension and tachycardia, from subsequent hypovolemia. Objective The objective of this case report is to describe a case of iodine toxicity from suspected oral methamphetamine ingestion. Case Report A male in his early 20′s presented with gastrointestinal symptoms, chills, fever, tachycardia, and tachypnea after orally ingesting a substance suspected to be methamphetamine. The patient had elevated levels of serum creatinine, liver function tests, and bands on arrival, which returned to within normal limits by day 4 of admission. Based on the patient's narrow anion gap, halogen levels were ordered on day 3 and indicated iodine toxicity. This is thought to be the first documented case of iodine toxicity secondary to suspected oral methamphetamine abuse. Conclusion Considering that the incidence of methamphetamine abuse is expected to continue to rise, clinicians should be aware of potential iodine toxicity in a patient with a history of methamphetamine abuse.

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A Case Report of Delirium Induced by Herbal Laxative Senna

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210636 ◽

2021 ◽

Vol 11 (6) ◽

pp. 231-233

Author(s):

Nimitha K J ◽

Porimita Chutia ◽

Pooja Misal

Keyword(s):

Case Report ◽

Serum Sodium ◽

Elderly Population ◽

Oral Intake ◽

Mental Illnesses ◽

Electrolyte Imbalance ◽

Normal Limits ◽

Icd 10 ◽

Current Scenario ◽

History Of

Constipation is one major complaint in elderly population. It may be due to physiological and anatomical reasons of aging, but it can be also due chronic medical and mental illnesses and due to use of multiple medications. Constipation itself is a precipitating factor for delirium. Drugs used for constipation can also be the culprit. A 64-year-old female who had a history of hypertension and chronic constipation presented with symptoms of confused and altered behavior, decreased oral intake, decreased sleep. On history taking it was known that she was using Herbal medication containing senna glycoside and other compounds since 8-9months. On examination she had signs of dehydration, disoriented and attention was impaired. On investigation her serum sodium was 122.6 mmol/ and other investigations were within normal limits. She was diagnosed as a case of Delirium according to ICD-10 criteria. Her dehydration was corrected by giving intravenous fluids and serum sodium level was corrected using salt capsules 2 tablets thrice daily. For disturbed sleep she was prescribed Tab Melatonin 10mg at bedtime and constipation was treated with per rectal enema and syrup lactulose 30ml at bedtime. Patient improved in 1 week time. Senna a herbal laxative used to treat constipation. It can alter intestinal electrolyte transportation and irritates intestinal mucosa. It is due to increased peristalsis and increased defecation and even diarrhea Prolonged use can cause dehydration, electrolyte imbalance and delirium. Senna, an over-the-counter laxative with FDA approval is a matter of concern in the current scenario. This case report warns into the judicious use of laxatives containing senna in elderly population. Key words: Delirium, Herbal Laxative, Senna, Constipation.

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Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

The Journal of Critical Care Medicine ◽

10.1515/jccm-2017-0013 ◽

2017 ◽

Vol 3 (2) ◽

pp. 84-88

Author(s):

Thomas-Michael Schneider ◽

Friederike Klenner ◽

Franz Brettner

Keyword(s):

Case Report ◽

Extracorporeal Membrane Oxygenation ◽

Therapeutic Option ◽

High Dose ◽

Great Success ◽

Case Presentation ◽

Computed Tomographic ◽

Rehabilitation Hospital ◽

Membrane Oxygenation ◽

History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

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An unusual cause of delayed hematoma after carotid endarterectomy: a case report

BMC Surgery ◽

10.1186/s12893-019-0601-x ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Yi Zhao ◽

Zhichao Lai ◽

Xiaojun Song ◽

Rong Zeng ◽

Changwei Liu ◽

...

Keyword(s):

Prostate Cancer ◽

Case Report ◽

Carotid Endarterectomy ◽

Early Stage ◽

Prostatic Hyperplasia ◽

Surgical Patients ◽

Blood Products ◽

Case Presentation ◽

Life Threatening ◽

History Of

Abstract Background Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively. Case presentation We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed. Conclusions This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

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Unicuspid aortic valve concomitant with aortic insufficiency presenting with infectious endocarditis: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-019-2239-9 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Naoko Yuzawa-Tsukada ◽

Toshikazu D. Tanaka ◽

Satoshi Morimoto ◽

Michihiro Yoshimura

Keyword(s):

Case Report ◽

Aortic Valve ◽

Aortic Insufficiency ◽

Infectious Endocarditis ◽

Cardiac Abnormality ◽

Case Presentation ◽

Old Japanese ◽

History Of ◽

Nonbacterial Thrombotic Endocarditis ◽

High Turbulence

Abstract Background A unicuspid aortic valve is a rare congenital cardiac abnormality. Despite its uncommon finding on an initial presentation, aortic insufficiency is accompanied with unicuspid aortic valve and this might reflect the natural history of progression in the morphology of unicuspid aortic valve. Case presentation We describe a 65-year-old Japanese man who was evaluated for endocarditis and found to have a unicuspid aortic valve concomitant with moderate aortic insufficiency, which was, owing to the lack of evidence of valve membrane destruction, independent of underlying infectious endocarditis. In addition, aortic insufficiency was progressed because of nonbacterial thrombotic endocarditis on the ventricular side, in areas of high turbulence around the heart valve. Conclusions Our case is unusual given the unicuspid aortic valve concomitant with aortic insufficiency, which was presumably independent of underlying infectious endocarditis because of the location of the vegetation and the lack of evidence of valve destruction. Therefore, attention should be paid to a variety of complications in the setting of unicuspid aortic valve.

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

Journal of Medical Case Reports ◽

10.1186/s13256-020-02517-3 ◽

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.

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Case Report: Migrainous Infarct without Aura

Case Reports in Neurology ◽

10.1159/000481281 ◽

2017 ◽

Vol 9 (3) ◽

pp. 241-251

Author(s):

Kamesh Gupta ◽

Anurag Rohatgi ◽

Shivani Handa

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Case Report ◽

Rare Case ◽

Case Presentation ◽

The Past ◽

Need To Evaluate ◽

History Of ◽

Complicated Migraine ◽

Full Investigation

Background: Stroke in a migraine with aura has been documented in several cases, even deserving the merit of a classification as complicated migraine. Herein, we present a rare case of migrainous infarct without aura. The diagnosis was challenging due to lack of risk factors. The patient was unique in not having any other comorbidities. Case Presentation: The case is of a 21-year-old female presenting with right-sided hemiplegia and facial drooping. She had had an index presentation of throbbing headaches for the past 2 years, typical of a migraine but not preceded by any aura symptoms. However, in the current episode, the pain became excessively severe and accompanied by right-sided hemiplegia and facial drooping. A full investigation workup using MRI revealed evidence of infarct in the left temporoparietal and basal ganglion region. Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.

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