Herlyn-Werner-Wunderlich Syndrome: A Rare Cause of Acute Abdomen in Adolescent Girls
Maher AlZaiem, MD, CU, ABPS, Abdulnaser Ali Alatili, MD, Ahmed Alawi, SBPS and Fadi Zaiem, MBBS
Article Type: Case Report | First Published: December 30, 2019
Herlyn-Werner-Wunderlich syndrome (HWHS) is a rare developmental anomaly of Mullerian ducts, characterized by the presence of a uterus didelphys with longitudinal vaginal septum obstructing the hemivagina and the presence of ipsilateral renal agenesis. It is a very rare syndrome with only a few cases that have been reported. We describe, In this report, the clinical presentation and the successful surgical management of an 11-year-old girl who presented with acute lower abdominal pain and palpab...
Erector Spinae Plane Block for Peripartum Analgesia in a Patient with Tarlov Cysts
LT Scott B Hughey, MD/MBA, MC(FS), USN, LT Jacob H Cole, MD, MC, USN, LCDR Thomas F Olson, MD, MC(FMF), USN and LCDR Victor A Rivera, MD, MC(FS), USN
Article Type: Case Report | First Published: December 21, 2019
Tarlov cysts are sacral perineural cysts which occur in up to 4.6% of the population. Neuraxial anesthesia is relatively contraindicated in these patients. Similarly, many of these patients have chronic pain from the cysts, often requiring chronic opioid use. Pain during labor may be difficult to control in these patients due to concerns regarding neuraxial analgesia and submaximal benefit from systemic remifentanil infusions. The Erector Spinae Plane (ESP) Block has recently been described as a...
Endovascular Management of Refractory Puerperal Hematomas: A Case Report and Review of the Literature
Simon Bradette, MD, FRCPC, Melissa Marien, MD, PGY-3, Melanie Rousseau, MD, FRCPC, Mathieu Beland, MD, FRCPC and Catherine Lalonde, MD, FRCPC
Article Type: Case Report | First Published: November 06, 2019
Pelvic hematomas can be a serious complication of vaginal delivery. They can be associated with significant morbidity related to blood loss, infection, surgery and blood product transfusion. Reported incidence varies from 1/300 to 1/1500. Operative vaginal delivery and episiotomy are among the most common risk factors associated with puerperal hematomas, but they may also occur in the absence of laceration of the surrounding tissue. They are classified as vulvar, vaginal, vulvovaginal or retrope...