Acute Abdomen in Pregnancy: Are Tocolytics and Early Surgical Intervention Justified?

Objective: Isolated tubal torsion in pregnancy is a rare condition we want to present this case. Case(s): In our study, we present a 23-year-old woman primigravida at 37 weeks of gestation with acute right lower abdominal pain. The clinical and Magnetic resonance imaging (MRI) findings led to diagnosis of acute appendicitis. Emergency exploratory laparotomy and cesarean section were performed. A twisted right Fallopian tube and Morgagni’s cyst was noted and right salpingectomy was performed. Conclusion: Although isolated tubal torsion during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity.

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Right ovarian torsion and oophorectomy in second trimester of pregnancy with subsequent live birth at term

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1239 ◽

2021 ◽

Vol 2 (4) ◽

Author(s):

Omotade A Ijarotimi ◽

◽

Olumide A Adeniyi Omitinde ◽

Stephen O Omitinde ◽

Akaninyene E Ubom ◽

...

Keyword(s):

Acute Abdomen ◽

Live Birth ◽

Surgical Intervention ◽

Delayed Diagnosis ◽

Exploratory Laparotomy ◽

First Trimester ◽

Ovarian Torsion ◽

Polycystic Ovaries ◽

Case Presentation ◽

In Pregnancy

Introduction: Ovarian torsion is a cause of acute abdomen in pregnancy with an incidence of less than 1% occurring most commonly in the first trimester. The symptoms are non-specific with a propensity for missed or delayed diagnosis which may worsen the morbidity associated with this condition. Management is mainly surgical and pregnancy outcome is usually satisfactory. Case presentation: We present the case of a 29-year-old G2 P0 +1 with background polycystic ovaries who complained of abdominal pains at an Estimated Gestational Age (EGA) of 21 weeks in pregnancy. Clinical suspicion was confirmed with a 2D abdominopelvic ultrasound and she subsequently had emergency exploratory laparotomy with right oophorectomy. Pregnancy progressed well and she had a live birth at term. Conclusion: Ovarian torsion is rare in pregnancy. Complications following prompt surgical intervention are however, few and pregnancy outcomes are usually favourable. Keywords: Ovarian cyst; torsion; acute abdomen; cyst accident; pregnancy.

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Early Surgical Intervention in Non-specific Pleural Empyema

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2007-1014081 ◽

1985 ◽

Vol 6 (01) ◽

pp. 41-43 ◽

Cited By ~ 5

Author(s):

P. Frimodt-Møller ◽

H. Vejlsted

Keyword(s):

Surgical Intervention ◽

Pleural Empyema ◽

Early Surgical Intervention

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Early surgical intervention for active thoracic spinal tuberculosis patients with paraparesis and paraplegia

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04078-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Weiwei Li ◽

Zheng Liu ◽

Xiao Xiao ◽

Zhenchao Xu ◽

Zhicheng Sun ◽

...

Keyword(s):

Blood Loss ◽

Surgical Intervention ◽

Spinal Tuberculosis ◽

Thoracic Spinal ◽

Cobb’S Angle ◽

Perioperative Complication ◽

The Mean ◽

Early Surgical Intervention ◽

Thoracic Spinal Tuberculosis

Abstract Background To explore the therapeutic effect of early surgical intervention for active thoracic spinal tuberculosis (TB) patients with paraparesis and paraplegia. Methods Data on 118 active thoracic spinal TB patients with paraparesis and paraplegia who had undergone surgery at an early stage (within three weeks of paraparesis and paraplegia) from January 2008 to December 2014 were retrospectively analyzed. The operation duration, blood loss, perioperative complication rate, VAS score, ASIA grade and NASCIS score of neurological status rating, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle, and duration of bone graft fusion were analyzed to evaluate the therapeutic effects of surgery. Results The mean operating time was 194.2 minutes, and the mean blood loss was 871.2 ml. The perioperative complication rate was 5.9 %. The mean preoperative VAS score was 5.3, which significantly decreased to 3.2 after the operation and continued decreasing to 1.1 at follow up (P<0.05). All cases achieved an increase of at least one ASIA grade after operation. The rate of full neurological recovery for paraplegia (ASIA grade A and B) was 18.0 % and was significantly lower than the rate (100 %) for paraparesis (ASIA grade C and D) (P<0.05). On the NASCIS scale, the difference in the neurological improvement rate between paraplegia (22.2 % ± 14.1 % in sensation and 52.2 % ± 25.8 % in movement) and paraparesis (26.7 % ± 7.5 % in sensation and 59.4 % ± 7.3 % in movement) was remarkable (P<0.05). Mean preoperative ESR and CRP were 73.1 mm /h and 82.4 mg/L, respectively, which showed a significant increase after operation (P>0.05), then gradually decreased to 11.5 ± 1.8 mm/h and 2.6 ± 0.82 mg/L, respectively, at final follow up (P<0.05). The mean preoperative kyphotic Cobb’s angle was 21.9º, which significantly decreased to 6.5º after operation (P<0.05) while kyphotic correction was not lost during follow up (P>0.05). The mean duration of bone graft fusion was 8.6 ± 1.3 months. Conclusions Early surgical intervention may be beneficial for active thoracic spinal TB patients with paraparesis and paraplegia, with surgical intervention being more beneficial for recovery from paraparesis than paraplegia.

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Successful Treatment of Graves Disease in Pregnancy with Lugol's Iodine

Scottish Medical Journal ◽

10.1177/003693300004500107 ◽

2000 ◽

Vol 45 (1) ◽

pp. 20-21 ◽

Cited By ~ 1

Author(s):

A. Jamieson ◽

C.G. Semple

Keyword(s):

Drug Therapy ◽

Successful Treatment ◽

Surgical Intervention ◽

Antithyroid Drug ◽

Primary Treatment ◽

Graves Disease ◽

Lugol’S Iodine ◽

Organic Iodine ◽

Antithyroid Drug Therapy ◽

In Pregnancy

We report a case of Grave's disease in pregnancy complicated by intolerance of standard antithyroid drug therapy. We describe the success of prolonged use of organic iodine as a primary treatment prior to surgical intervention.

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Early Surgical Intervention for Infective Endocarditis

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230201000403 ◽

2002 ◽

Vol 10 (4) ◽

pp. 298-301 ◽

Cited By ~ 1

Author(s):

Hong Sheng Zhu ◽

Pei Yan Yao ◽

Jia Hao Zheng ◽

A Thomas Pezzella

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Heart Disease ◽

Infective Endocarditis ◽

Complex Disease ◽

Surgical Intervention ◽

Elective Surgery ◽

Postoperative Bleeding ◽

Arterial Embolization ◽

Early Surgical Intervention

Infective endocarditis remains a serious and complex disease with significant morbidity and mortality. Sixty cases of infective endocarditis were retrospectively reviewed, consisting of 41 males and 19 females aged 7 to 50 years (mean, 30 years). Congenital heart disease was diagnosed in 19 of the patients and rheumatic heart disease in 41. Congestive heart failure occurred in 36 and systemic embolism in 8 cases. Blood cultures were positive in only 21.7% of the cases, while vegetations were detected by 2-dimensional echocardiography in 70%. Elective surgery was performed in 57 patients and emergent operation for systemic arterial embolization and/or intractable congestive heart failure in 3 patients. Two patients required reoperation for postoperative bleeding. All but 2 patients had been followed up for 6 to 160 months with no evidence of reinfection. Three patients with mechanical valve implantation later died of intracranial bleeding due to over-anticoagulation. The remaining 55 resumed normal activity. The encouraging outcomes were the result of an aggressive diagnostic approach and early surgical intervention.

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Correction to: Early surgical intervention for structural infantile spasms in two patients under 6 months old: a case report

Acta Epileptologica ◽

10.1186/s42494-021-00050-4 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Haiyan Yang ◽

Zhiquan Yang ◽

Jing Peng ◽

Yehong Huang ◽

Zhuanyi Yang ◽

...

Keyword(s):

Case Report ◽

Surgical Intervention ◽

Infantile Spasms ◽

Early Surgical Intervention

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Mycobacterium mageritense infection following mastectomy and breast reconstruction requiring triple antibiotic therapy and surgical debridement

BMJ Case Reports ◽

10.1136/bcr-2020-237618 ◽

2021 ◽

Vol 14 (2) ◽

pp. e237618 ◽

Cited By ~ 1

Author(s):

Christie Alyce Joya ◽

Cara Deegan ◽

Todd D Gleeson

Keyword(s):

Antibiotic Therapy ◽

Surgical Intervention ◽

Treatment Guidelines ◽

Perforator Flap ◽

Published Data ◽

Gastrointestinal Distress ◽

Deep Inferior Epigastric Perforator ◽

Infectious Disease Specialists ◽

Systemic Symptoms ◽

Early Surgical Intervention

A 40-year-old woman was referred to infectious disease specialists for a Mycobacterium mageritense skin infection following mastectomy and bilateral reconstruction with deep inferior epigastric perforator flap. Her case demonstrates the difficulty in treating non-tuberculosis mycobacterial infections, especially the rarely seen species. She failed to respond to dual antibiotic therapy containing imipenem-cilastin despite reported sensitivity. Additionally, her course was complicated by intolerance to various regimens, including gastrointestinal distress, a drug rash with eosinophilia and systemic symptoms, and tendinopathy. With few published data, no treatment guidelines, and limited medications from which to choose for M. mageritense, her treatment posed a challenge. She ultimately required aggressive surgical intervention and a triple therapy antibiotic regimen. The duration of our patient’s treatment and the extent of her complications suggest a potential need for early surgical intervention in postsurgical wounds infected with M. mageritense that do not respond to conventional treatment.

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Intestinal Perforation during the Stabilization Period in a Preterm Infant with Congenital Diaphragmatic Hernia

European Journal of Pediatric Surgery Reports ◽

10.1055/s-0037-1606288 ◽

2017 ◽

Vol 05 (01) ◽

pp. e51-e54

Author(s):

Zbyněk Straňák ◽

Karel Pýcha ◽

Simona Feyereislova ◽

Jaroslav Feyereisl ◽

Michal Rygl

Keyword(s):

Birth Weight ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Intestinal Perforation ◽

Surgical Repair ◽

Very Low Birth Weight ◽

Surgical Intervention ◽

Multiple Organ ◽

Stabilization Period ◽

Early Surgical Intervention

Background Delayed surgery after stabilization of infants with congenital diaphragmatic hernia (CDH) is an accepted strategy. However, the evidence favoring delayed versus immediate surgical repair is limited. We present an extremely rare case of a very low-birth-weight infant with prenatally diagnosed left-sided CDH and unexpected transmural bowel perforations developing within the postnatal stabilization period. Case Report A neonate born at 31st week of gestation with a birth weight of 1,470 g with antenatally diagnosed left-sided CDH presented with bowel dilation leading to transmural bowel perforations on the 2nd day of life. Meconium pleuroperitonitis resulted in severe systemic inflammatory response syndrome, pulmonary hypertension, multiple organ failure, and death. Conclusion In neonates with CDH deteriorating under standard postnatal management, intestinal perforation, and early surgical intervention should be considered.

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