scholarly journals A Free Terminal Ileal Perforation From Active Crohn Disease in Pregnancy: A Diagnostic Challenge

2015 ◽  
Vol 100 (3) ◽  
pp. 450-454 ◽  
Author(s):  
Sunu Philip ◽  
Armin Kamyab ◽  
Paraskevi Orfanou
Keyword(s):  
Surgical Management ◽  
Crohn Disease ◽  
Surgical Intervention ◽  
Second Trimester ◽  
Diagnostic Challenge ◽  
Free Perforation ◽  
Ileal Perforation ◽  
Competing Interests ◽  
In Pregnancy ◽  
Uncommon Complication

The surgical management of the complications of Crohn disease is often challenging. These difficulties are compounded in pregnancy by competing interests of the mother and the baby. In this report, we describe the presentation and surgical management of a patient in her second trimester with active Crohn disease who required emergent surgical intervention. She had presented with the uncommon complication of a free perforation in the presence of active untreated disease.

Management of prolonged epistaxis in pregnancy: case report

2013 ◽  
Vol 127 (8) ◽  
pp. 811-813 ◽  
Author(s):  
K Cornthwaite ◽  
K Varadharajan ◽  
M Oyarzabal ◽  
H Watson
Keyword(s):  
Case Report ◽  
Multidisciplinary Approach ◽  
Surgical Intervention ◽  
Pregnant Patient ◽  
Evidence Based ◽  
Second Trimester ◽  
Severe Epistaxis ◽  
Life Threatening ◽  
Evidence Based Guidelines ◽  
In Pregnancy

AbstractObjectives:To report a case of life-threatening epistaxis in a pregnant patient, describe the links between pregnancy and epistaxis, and discuss the management of such cases. Life-threatening epistaxis in pregnancy is rare, and there are no specific evidence-based guidelines regarding the management of these patients.Case report:A 31-year-old primigravida presented with severe epistaxis in the second trimester of her pregnancy. Conservative measures failed, thereby necessitating surgical intervention.Conclusion:This case illustrates the importance of a multidisciplinary approach in the management of a pregnant patient presenting with severe epistaxis, and highlights the surgical challenges presented in such a situation.

Neurological manifestation in severe hypothyroidism in pregnancy

2020 ◽  
Vol 13 (12) ◽  
pp. e238069
Author(s):  
Aparna Sharma ◽  
Nilofar Noor ◽  
Vatsla Dadhwal
Keyword(s):  
Peripheral Neuropathy ◽  
Facial Palsy ◽  
Caesarean Delivery ◽  
Thyroid Stimulating Hormone ◽  
Neurological Manifestations ◽  
Second Trimester ◽  
Pituitary Hyperplasia ◽  
Very High ◽  
In Pregnancy

Neurological manifestations of hypothyroidism include peripheral neuropathy and pituitary hyperplasia. However, these associations are rarely encountered during pregnancy. We report a case of a known hypothyroid with very high thyroid stimulating hormone (TSH) values (512 μIU/mL) in the second trimester. At 24 weeks she developed facial palsy and pituitary hyperplasia which responded to a combination of steroids and thyroxine. She had caesarean delivery at 35 weeks and 3 days gestation in view of pre-eclampsia with severe features and was discharged on oral antihypertensives and thyroxine. On follow-up at 5 months, TSH normalised and pituitary hyperplasia showed a greater than 50% reduction in size. To our knowledge, this is the first reported case of facial palsy and pituitary hyperplasia associated with hypothyroidism during pregnancy.

scholarly journals IgG4-related intracranial disease

2018 ◽  
Vol 32 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Shahine Goulam-Houssein ◽  
Jeffrey L Grenville ◽  
Katerina Mastrocostas ◽  
David G Munoz ◽  
Amy Lin ◽  
...  
Keyword(s):  
Plasma Cells ◽  
Surgical Intervention ◽  
Case Series ◽  
Hypertrophic Pachymeningitis ◽  
Diagnostic Challenge ◽  
Perineural Spread ◽  
Related Disease ◽  
The Third ◽  
Igg4 Related Disease ◽  
Intracranial Involvement

IgG4-related disease (IgG4-RD) is a multi-organ chronic inflammatory process caused by infiltration of IgG4-positive plasma cells in one or more organs. Intracranial involvement has only recently become better recognized. Our case series adds to the growing literature on the varying presentations of intracranial IgG4 by describing the clinical and imaging findings of three patients who presented to our institution with intracranial involvement. Our first patient presented with a mass-forming IgG4 pachymeningitis mimicking a sphenoid wing meningioma, which is to our knowledge the largest mass-forming pachymeningitis published in the literature. Our second case depicts another presentation of extensive IgG4 pachymeningitis involving both cavernous sinuses and surrounding Meckel’s caves. The third case describes a patient with presumed lymphocytic hypophysitis, which was later determined to be IgG4-related hypophysitis with concomitant pachymeningitis and perineural spread along the optic nerves. The delayed diagnoses in our cases illustrates the diagnostic challenge that clinicians face in differentiating intracranial IgG4-RD from other infiltrative diseases such as sarcoidosis, granulomatous disease, tuberculosis and lymphoma. Earlier consideration of IgG4-related hypophysitis and hypertrophic pachymeningitis in the differential diagnosis can prevent significant morbidity including unnecessary surgical intervention and organ failure secondary to extensive fibrosis.

Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanapak Wisetmongkolchai ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Loss Rate ◽  
Fetal Loss ◽  
Adverse Pregnancy Outcomes ◽  
Expert Group ◽  
Second Trimester ◽  
Single Institution ◽  
Adverse Pregnancy ◽  
In Pregnancy ◽  
Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

scholarly journals Ovarian Dysgerminoma in Pregnant Women with Viable Fetus: A Rare Case Report

2021 ◽  
pp. 141-146
Author(s):  
Reda Youssef ◽  
Gamal Sayed Ahmed ◽  
Samir Alhyassat ◽  
Sanaa Badr ◽  
Ahmed Sabry ◽  
...  
Keyword(s):  
Gestational Age ◽  
Ovarian Neoplasms ◽  
Imaging Modality ◽  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Short Period ◽  
Ovarian Dysgerminoma ◽  
The Impact ◽  
In Pregnancy

Dysgerminoma is an uncommon malignant tumor arising from the germ cells of the ovary. Its association with pregnancy is extremely rare, with a reported incidence of about 0.2–1 per 100,000 pregnancies. Women in the reproductive age group are more commonly affected. It can be extremely rare to conceive naturally, without assisted reproductive interventions, in cases with ovarian dysgerminoma. If a pregnancy does occur with a concurrent dysgerminoma, it is even more unusual to carry the pregnancy to viability or childbirth without fetal or maternal compromise. We report a case of right ovarian dysgerminoma in a young female with a viable intrauterine pregnancy at 10 weeks, which is rarely diagnosed and managed at this gestational age. Numerous factors played a role in her favorable outcome, including early suspicion by ultrasound and presenting history, surgery, histopathological assessment, imaging, and involvement of the multidisciplinary oncology team. Ovarian neoplasms may rapidly increase in size within a short period with little or no symptoms. This poses a diagnostic challenge for obstetricians and oncologists. Hence, we aimed to evaluate the role of imaging in pregnancy using ultrasound as an imaging modality for both early detection of ovarian neoplasms and for follow-up. In conclusion, patients with ovarian dysgerminoma in pregnancy can have favorable outcomes. Treatment should be individualized on a case-to-case basis, depending on many factors; cancer stage, previous reproductive history, the impact of imaging in staging or follow-up of tumor on the fetus, fetal gestational age, and whether termination of the pregnancy can improve survival or morbidity for the mother.

Tracheoinnominate fistula: surgical management of an iatrogenic disaster

2006 ◽  
Vol 120 (8) ◽  
pp. 676-680 ◽  
Author(s):  
R W Ridley ◽  
J B Zwischenberger
Keyword(s):  
Operating Room ◽  
Surgical Management ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Pectoralis Major Muscle ◽  
Muscle Flap ◽  
Rare Condition ◽  
Innominate Artery ◽  
Significant Potential ◽  
High Index Of Suspicion

Tracheoinnominate fistula (TIF) is a rare condition with significant potential for mortality if surgical intervention is not immediate. We present two cases of successfully managed TIF. Both cases involve ligation and resection of the innominate artery at the TIF followed by a pectoralis major muscle flap. In both cases, success was largely due to a high index of suspicion and immediate control of the bleeding with transport to the operating room for surgical repair. The history, aetiology, and pathogenesis of TIF are reviewed, yielding an algorithm for recommended management of TIF.

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

2000 ◽  
Vol 45 (1) ◽  
pp. 20-21 ◽  
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.

Sign in / Sign up

Export Citation Format

Share Document