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Case Reports in Obstetrics and Gynecology

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https://www.readbyqxmd.com/read/28421152/spontaneous-adrenal-hemorrhage-in-pregnancy-a-case-series
#1
Ankita Gupta, Ruby Minhas, Hayley S Quant
Background. Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients. Cases. Patient 1 was a 35-year-old nullipara who presented at 36 weeks of gestation with left flank pain. Patient 2 was a 27-year-old multipara at 38 weeks who presented with left upper quadrant pain. Diagnosis of SAH was made by CT scan and both were managed with pain control, serial hemoglobin assessments, and abdominal exams resulting in uncomplicated vaginal deliveries...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28396810/management-of-liddle-syndrome-in-pregnancy-a-case-report-and-literature-review
#2
Michael Awadalla, Manasi Patwardhan, Adham Alsamsam, Nashat Imran
Liddle syndrome is an autosomal dominant genetic condition that causes hypertension and hypokalemia due to a gain-of-function mutation in the SCNN1B or SCNN1G genes which code for the epithelial sodium channel in the kidney. This leads to increased sodium and water reabsorption causing hypertension. We report a case of a 27-year-old pregnant woman who was admitted for hypertension and hypokalemia and later diagnosed and treated for Liddle syndrome using amiloride. Maintaining a high suspicion of Liddle syndrome in pregnancy is essential in such cases to be able to adequately and effectively treat the hypertension...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28386495/bilateral-sertoli-cell-tumors-in-a-patient-with-androgen-insensitivity-syndrome
#3
Roberta Fonseca de Souza, Janaina Pereira da Silva, Bruno Vieira Balla, Rodrigo Neves Ferreira, Antônio Chambô Filho
Androgen insensitivity syndrome is the most common cause of male pseudohermaphroditism and the third most common cause of primary amenorrhea. This genetic alteration is a consequence of inherited defects on the X chromosome causing total or partial damage to the intrauterine virilization process due to functional abnormalities in the androgen receptors. The present report describes a 22-year-old patient with a female phenotype and a 46, XY karyotype, presenting with bilateral inguinal tumors. The tumors were surgically removed at the Santa Casa de Misericórdia Hospital in Vitória, Espírito Santo, Brazil...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28357145/pneumoperitoneum-secondary-to-spontaneously-perforated-pyometra
#4
Benjamin A Raymond, Christopher Esper
Pyometra, by definition, is a collection of purulent fluid within the uterine cavity. Incidence has been estimated to range from 0.1% to 0.5%. Typically, this is linked to postmenopausal women; however, it has been linked to premenopausal women with concordant use of intrauterine devices. Based on our knowledge, there have been less than 50 recorded cases reported in the English literature regarding perforation of pyometra resulting in acute abdomen and fewer than 25 resulting in pneumoperitoneum. We report a patient who was evaluated for diffuse peritonitis caused by perforated pyometra who was successfully treated with surgical intervention...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28352483/ultrasound-echocardiography-mri-and-genetic-analysis-of-a-fetus-with-congenital-diaphragmatic-hernia-and-partial-11q-trisomy
#5
Yolanda Fernández-Perea, Lutgardo García-Díaz, Javier Sánchez, Guillermo Antiñolo, Salud Borrego
Congenital diaphragmatic hernia (CDH) is a serious birth defect with a significant mortality and morbidity. The current and constant progress in ultrasound techniques has led to the improvement of the prenatal diagnosis of this malformation. CDH is a developmental defect whose etiology is heterogeneous and takes place when the pleuroperitoneal folds and septum transversum fail to converge and fuse. Survival depends on the extent of pulmonary hypoplasia and the disease may be potentially worsened by the presence of added congenital defects...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28348906/rare-epithelioid-leiomyoma-of-the-vagina-exhibiting-a-pelvic-mass
#6
Yuji Tanaka, Mayuko Nagasaka, Mariko Takahashi, Masashi Kobayashi
Epithelioid leiomyoma of the vagina is extremely rare. Smooth muscle tumors of the vagina usually present with a submucosal growth pattern or a pedunculated growth pattern from the anterior vaginal wall into the vaginal cavity. Here we report a case of a 43-year-old woman with a solid epithelioid leiomyoma and a palpable mass in the pouch of Douglas. Transvaginal biopsy and angiography showed the epithelioid leiomyoma feeding from the vaginal artery behind the posterior vagina. An abdominal wide excision of the tumor with a partial vaginectomy was performed...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28348905/treatment-of-endometrial-cancer-in-association-with-pelvic-organ-prolapse
#7
Asama Vanichtantikul, Ekkasit Tharavichitkul, Imjai Chitapanarux, Orawee Chinthakanan
Background. Uterine malignancy coexistent with pelvic organ prolapse (POP) is uncommon and standardized treatment is not established. The objective of this case study was to highlight the management of endometrial cancer in association with pelvic organ prolapse. Case Report. An 87-year-old woman presented with POP Stage IV combined with endometrioid adenocarcinoma of the uterus: clinical Stage IV B. She had multiple medical conditions including stroke, deep vein thrombosis, and pulmonary embolism. She was treated with radiotherapy and pessary was placed...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28331644/term-abdominal-pregnancy-revealed-by-amnioperitoneum-in-rural-area
#8
Henri Donald Mutarambirwa, Bruno Kenfack, Jovanny Tsuala Fouogue
Abdominal pregnancy (AP) accounts for 1% of ectopic implantations. In sub-Saharan Africa, the high prevalence of sexually transmitted infections explains the increasing frequency of this pathology. In Cameroon it rose from 1/10000 deliveries (1995) to 3.3/10000 (2015). Authors herein report a case of a viable abdominal pregnancy discovered at term during emergency laparotomy for suspected uterine rupture. The 24-year-old G2P0 patient was HIV-positive, under antiretrovirals, though AP exceptionally occurs in HIV patients...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28326210/cesarean-scar-endometriosis-an-uncommon-surgical-complication-on-the-rise-case-report-and-literature-review
#9
Imane Khachani, Abdelhai Filali Adib, Rachid Bezad
Endometriosis is defined by the presence and growth of ectopic functional endometrial tissue outside the uterus. Scar endometriosis has been described following obstetrical and gynecological surgery. It is a rare condition, though probably on the rise, due to the considerable increase of cesarean sections performed worldwide. Its physiopathology is complex; its symptomatology is rich and diverse but thorough clinical examination along with ultrasound imaging and potentially pretherapeutic cytologic evaluation are usually efficient in diagnosing the condition...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28316851/pure-primary-ovarian-squamous-cell-carcinoma-perforating-the-rectum
#10
Kazuya Mimura, Aiko Okada, Naotsugu Haraguchi, Kenjiro Sawada, Takuji Tomimatsu, Tadashi Kimura
Rectal perforation is uncommon in ovarian cancer, even in advanced stages. Pure primary ovarian squamous cell carcinoma is a very rare subtype of ovarian cancer and has not been reported to cause rectal perforation. A 50-year-old woman presented with rectal bleeding. Rectosigmoidoscopy suggested perforation of a pelvic tumor into the rectum. Abdominopelvic magnetic resonance imaging revealed a 9 cm heterogeneous mass in the pouch of Douglas. We performed complete cytoreduction, including an en-bloc resection of the tumor and rectosigmoid colon...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28316850/a-report-of-two-cases-of-age-related-changes-in-cervical-morphology-in-postmenopausal-women-with-vaginal-adenosis
#11
Marguerite B Vigliani
This paper presents two cases of women who had extensive vaginal adenosis from prenatal DES exposure, extending almost halfway down the vaginal canal. Both women were followed for decades with annual exams and Pap smears until after menopause. Clinical examination in both cases initially showed an absent pars vaginalis of the cervix, vaginal adenosis, and shallowness of the fornices. Several decades of annual exams showed these stigmata of DES exposure gradually disappear as the upper vagina progressively contracted...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28316849/spontaneous-pneumomediastinum-in-labor
#12
Mohamed Adnane Berdai, Said Benlamkadem, Smael Labib, Mustapha Harandou
Spontaneous pneumomediastinum and subcutaneous emphysema also known as Hamman's syndrome is a very rare complication of labor that is often related to the valsalva maneuver during the labor. In most case, Hamman's syndrome is a self-limiting condition, rarely complicated unless there are underlying respiratory diseases. Chest X-ray can be a useful early diagnostic technique in severe clinical presentation. We report an uneventful pregnancy in a primigravid parturient, which was complicated in the late second stage of labor by the development of subcutaneous emphysema, pneumomediastinum, and mild pneumothorax...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28299220/spontaneous-regression-of-uterine-arteriovenous-malformations-with-conservative-management
#13
Keiko Mekaru, Sugiko Oishi, Kozue Akamine, Chiaki Heshiki, Yoichi Aoki
Uterine arteriovenous malformation (AVM) can cause massive hemorrhage and is often treated with uterine artery embolization (UAE), which may lead to ovarian insufficiency. Thus, avoiding UAE should be considered, particularly in women undergoing fertility treatments. We present three women diagnosed with postmiscarriage AVM on color Doppler by transvaginal ultrasound imaging. They had no genital bleeding and a small mass, measuring 16-22 mm. If estradiol was >300 pg/mL when AVM was diagnosed, then a gonadotropin-releasing hormone agonist was administered...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28299219/spontaneous-rupture-of-pyometra-in-a-nonpregnant-young-woman
#14
Parvin Mostafa-Gharabaghi, Shima Bordbar, Shabnam Vazifekhah, Mohammad Naghavi-Behzad
A 40-year-old woman presented with severe vaginal bleeding. Initial workup with an abdominal sonography revealed endometrium for about 3 mm and free fluid in the abdomen. Hemodynamic instability with abdominal pain and free fluid in the abdomen prompted blood transfusion and laparotomy. There were about 1000 cc blood and clots in the abdomen at laparotomy. There was a longitudinal rupture from fundus up to cervix at the left side of the uterus. Tearing was in full thickness from serosa to endometrium. Scar of previous cesarean was transvers and not associated with this tearing...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28299218/can-surgery-be-avoided-exclusive-antibiotic-treatment-for-pelvic-actinomycosis
#15
M P Ruiz, E M Williams, C M Markey, A M Johnson, P B Morales-Ramirez
Pelvic actinomycosis is an uncommon, slowly progressing granulomatous infection that has been associated with the presence of intrauterine devices. Due to its unspecific clinical and radiologic findings, it can mimic pelvic or intra-abdominal malignancy leading to mutilating surgery of high morbidity. Rarely, diagnosis is made preoperatively and in most cases surgical intervention is necessary. The patient in our case is a 42-year-old female with an IUD for 15 years diagnosed with pelvic actinomycosis. Patient was uniquely diagnosed preoperatively through paracentesis and treated conservatively with prolonged antibiotic therapy and without any type of surgical intervention...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28299217/management-of-retained-genital-piercings-a-case-report-and-review
#16
Laura J Moulton, Amelia M Jernigan
The prevalence of genital piercing among women is increasing. As the popularity increases, the number of complications from infection, injury, and retained jewelry is likely to rise. Techniques to remove embedded jewelry are not well described in the literature. The purpose of this report was to describe a case of a patient with a retained clitoral glans piercing, discuss a simple technique for outpatient removal, and review current evidence regarding associated risks of clitoral piercings. A 24-year-old female presented to the emergency department with an embedded clitoral glans piercing...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28293443/ovarian-mature-and-immature-teratomas-in-monozygotic-twins-a-case-report-of-simultaneous-presentation
#17
Daisuke Shigemi, Naoki Kawai, Toshiyuki Takeshita
Mature cystic teratoma is one of the most common kinds of ovarian tumor, and immature teratoma is a rare tumor, representing less than 1% of all ovarian teratomas. Although there are some reports about familial occurrences of ovarian tumors, literature concerning the clinical cases of monozygotic twins is rare. We report the 5-year clinical courses of a 12-year-old Japanese girl with a recurrent bilateral ovarian mature teratoma and her monozygotic twin with a unilateral ovarian mature teratoma and contralateral ovarian immature teratoma...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28286684/prenatal-and-peripartum-management-of-patients-with-hypofibrinogenemia-resulted-in-two-successful-deliveries
#18
Yuko Teraoka, Hiroshi Miyoshi, Kumi Oshima, Satoshi Urabe, Norifumi Tanaka, Yoshiki Kudo
Fibrinogen is an essential agent involved in maintaining pregnancy and coagulation. Since inherited fibrinogen disorders introduce greater risks for conditions such as placental abruption and postpartum hemorrhage, careful prenatal and perinatal management is essential for this patient population. We report two cases of successful deliveries in patients with hypofibrinogenemia. Case 1 is of a 26-year-old (gravida 1, para 1) woman. The patient's fibrinogen level increased spontaneously to higher than 300 mg/dL during pregnancy, without treatment...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28286683/low-grade-appendiceal-mucinous-neoplasm-presenting-as-an-adnexal-mass
#19
P Panagopoulos, T Tsokaki, E Misiakos, V Domi, C Christodoulaki, D Sioutis, N Papantoniou
Appendiceal tumors are rare, late diagnosed neoplasms that may not be differentiated from adnexal masses even by advanced imaging methods and other diagnostic procedures. They may be asymptomatic and remain undiagnosed until surgery. We report a case of an 80-year-old postmenopausal woman presenting with a pelvic mass and a history of weight loss. The patient underwent laparotomy which revealed an appendiceal mucocele, for which she received a full oncological procedure. The histology report showed a low-grade appendiceal mucinous neoplasm, and the patient underwent six cycles of chemotherapy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28280642/severe-preeclampsia-in-the-setting-of-myasthenia-gravis
#20
Adam J Lake, Antoun Al Khabbaz, Renée Keeney
Myasthenia gravis (MG) is a rare autoimmune disease that leads to progressive muscle weakness and is common during female reproductive years. The myasthenic mother and her newborn must be observed carefully, as complications during all stages of pregnancy and the puerperium may arise suddenly. Preeclampsia is a common obstetrical condition for which magnesium sulfate is used for seizure prophylaxis. However, magnesium sulfate is strongly contraindicated in MG as it impairs already slowed nerve-muscle connections...
2017: Case Reports in Obstetrics and Gynecology
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