Giant Hemorrhagic Ovarian Cyst with Torsion-Rare Case Report
Durga K, MD, Yasodha A and S Yuvarajan
Article Type: Case Report | First Published: July 23, 2020
Giant ovarian tumours are rare nowadays due to early recognition of these tumours in clinical practice. Management of these tumours depends on age of the patient, size of the mass and its histopathology. We are reporting a rare case of torsion of hemorrhagic ovarian cyst presented to us with acute abdomen. 22-year-old, unmarried girl came to our outpatient department with complaints of lower abdominal pain for 3 days. Patient was apparently normal before 3 days after which she developed lower ab...
A Case of a 33-Week Pregnant Woman with COVID-19 and Term Birth
György Léhner, MD, Walter Krugluger, MD, Stephan W Aberle, MD, Lukas Weseslindtner, MD and Beda Hartmann, MD
Article Type: Case Report | First Published: July 17, 2020
In this case report, we present a pregnant woman diagnosed with COVID-19 at 33 weeks gestation and having a vaginal birth at term. The postpartum and neonatal courses were uncomplicated. Anti-SARS-CoV-2-IgG antibodies were detected in the neonate. A vaginal delivery in this case was safe with clinical diagnosis of COVID-19. To date, there are only limited data about the effect of novel coronavirus (SARS-CoV-2) infection on pregnancy, delivery and placental transfer of antibodies. According to re...
Conservative Management of Endometrial Carcinoma and Precursor Lesions Preceding IVF Treatment: A Case Series
Huda Afaneh, MD, Ahmed SZ Moustafa, MD, Stephanie Leiva, MD, Youssef Youssef, MD, Ahmed Abdullah, MD, John Hebert, III, MD, FACOG and Mostafa Abuzeid, MD, FACOG, FRCOG
Article Type: Case Series | First Published: July 11, 2020
Endometrial cancer (EC) is the most common gynecological malignancy in developed countries with a lifetime risk of 3% for women living in the United States. Women younger than 45 years of age represent 7% of endometrial cancer cases. Type 1 endometrioid adenocarcinoma is the most common type. Endometrial intraepithelial neoplasia (EIN) is a precursor lesion that carries a risk of concomitant invasive disease in up to 40% of patients. Risk factors for type 1 endometrial cancer and EIN include uno...
A Rare Case: Nodular Adenomyosis Can Deceive Cornual Ectopic Pregnancy
Elvin Piriyev, Walter Mellin and Thomas Romer
Article Type: Case Report | First Published: July 03, 2020
Adenomyosis refers to the occurrence of ectopic endometrial glands and the surrounding stroma within the myometrium. A distinction is made between diffuse and focal forms (rare nodular forms and an adenomyoma). Ectopic pregnancy (EUG) occurs in about 1.5 to 2.0% of pregnancies and can be a life-threatening event. 2% of all EUG are cornual/intramural ectopic pregnancy. We present the case of a 33-year-old women (GII/PI) who complained about vaginal bleeding in the 6th week of pregnancy. The next ...
A Rare Presentation of Herlyn Werner Wunderlich Disease in Young Female
Nicola Zampieri, MD, PhD
Article Type: Case Report | First Published: May 08, 2020
Herlyn-Werner-Wunderlich syndrome is a rare urogenital anomaly consisted of renal agenesia, uterovaginal duplication and ipsilateral blind hemivagina. Usually it presents some months after menarche with pelvic pain, acute abdomen, intermenstrual bleeding. A 13 year premenarchal female was transferred to our unit for acute abdomen and MR findings of left renal agenesis, blind hemivagina distended by ematic material, complete uterus duplication, dilated tuba and left ovarian mass with torsion. A d...
Cangrelor in an Obstetric Patient Undergoing Cesarean Section on Dual Antiplatelet Therapy after Cerebral Stent Placement: A Case Report
Lauren Carlos, MD, Stephanie Paolini, MD, Christine Hawkes, MD, Janet FR Waters, MD, Ashutosh Jadhav, MD, PhD and Jonathan H Waters, MD
Article Type: Case Report | First Published: April 30, 2020
In this case, a 34-year-old woman G1P0 at 31 weeks gestation required intracranial stenting for an acute ischemic stroke. She was placed on aspirin and clopidogrel to prevent stent occlusion. The patient wished to undergo a cesarean delivery. Patients on dual antiplatelet therapy are at high risk of hemorrhage. Five days prior to the surgery, clopidogrel was replaced with cangrelor, a short-acting, reversible P2Y12 receptor inhibitor which was turned off at anesthesia induction. Surgery and the ...
Urinary Retention in The Case of a Retroverted Uterus in Pregnancy
Camille A Clare, MD, MPH
Article Type: Case Report | First Published: April 08, 2020
Acute urinary retention in patients with retroverted uteri is a rare, obstetrical emergency, and requires immediate intervention. If not treated, it may lead to serious maternal and/or fetal complications. This manuscript describes the case of a 35-year-old female who presents with lower abdominal pain and urinary hesitancy. Physical examination noted a palpable urinary bladder, which was also distended on pelvic ultrasound. Obstetrical ultrasound noted a viable intrauterine pregnancy. The patie...
Surgical Management of a Juvenile Cystic Adenomyoma: A Unique Presentation of Adenomyosis
Huda Afaneh, MD, Karen Moses, MD, Omari Young, MD and Mostafa Abuzeid, MD, FACOG, FRCOG
Article Type: Case Report | First Published: April 03, 2020
Endometriosis is characterized by the presence of endometrial glands and stroma in ectopic locations within the peritoneal cavity. More commonly, the lesions can be found on areas such as the cul-de-sac and other pelvic parietal surfaces. Endometrial glands and stroma infiltrating the myometrium characterizes Adenomyosis. Adenomyosis is usually characterized by diffuse foci of endometrial glands scattered throughout the myometrium. Meanwhile, a less common type of adenomyosis, in which the lesio...
Immature Fetiform Teratoma: An Unexpected Cause of Retroperitoneal Mass
Fernando Vazquez Rueda, Maria Rosa Ibarra Rodriguez, Francisco Javier Murcia Pascual, Sharmila Devi Ramnarine Sanchez, Sandra Rocio Wiesner Torres and Rosa Maria Paredes Esteban
Article Type: Case Report | First Published: February 06, 2020
A 5-month-old with normal prenatal checks, with a right permeable hydrocele antecedent, a non-painful and well-delimited mass, which occupied the entire right hemi abdomen, was incidentally detected. Ultrasound and abdominal CT show a retroperitoneal lesion that occupied the entire abdominal cavity, with the presence of fat bulbs and calcifications, which did not depend on any organic structure. Tumor markers were normal. Laparotomy was performed with complete exéresis of tumour. Histopathologi...
Uterine Rupture Following Misoprostol Induction of Labour at 36 Weeks Gestation in an Unscarred Uterus
Ansong G, Sebuabe SA and Afrani AK
Article Type: Case Report | First Published: January 30, 2020
Case report of a 33-year-old G5P3+1SA diagnosed with an intrauterine foetal death at 36 weeks gestation and induction of labour started with 400 ug of misoprostol vaginally, which was complicated by a uterine rupture with subsequent referral and management in our facility. Intra-operative findings during laparotomy revealed uterine rupture with a macerated still birth intra-abdominally and moderate hemoperitoneum. Uterine rupture in an unscarred uterus following unsuccessful induction is an adve...
A Rare Form of Dermoid Cyst: A Fetiform Teratoma
Erciyestepe SG, Turan H and Kahramanoglu I
Article Type: Case Report | First Published: January 24, 2020
Thirty three-years-old patient presented with abdominal distention and intermittent abdominal pain. She gave vaginal birth 2 times; last one three years ago. She didn’t have history of any abdominal operation, family history, or comorbidities. Her menstrual periods were regular. Review of the systems were unremarkable. In the pelvic examination, a 10 cm abdominal mass palpated which deviated to the left side. The pelvic mass had a soft consistency and free mobility. In the ultrasonography, 80*...
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...
Refractory Hyperemesis Gravidarum in a Patient with Type 1 Diabetes Treated with Laparoscopically Assisted Feeding Jejunostomy Tube Placement
Melissa Chu Lam, MD, Briana Baxter, MD, Farrah Naz Hussain, MD, Kristina Martimucci Feldman, MD and Barak Rosenn, MD
Article Type: Case Report | First Published: November 04, 2019
Severe Hyperemesis gravidarum (HG) is a debilitating condition that affects less than 1% of pregnant women. Management of HG is further complicated in women with type 1 diabetes due to oscillations between hypo and hyperglycemia, often exacerbated by the presence of gastroparesis. We report a 25-year-old G1P0 with longstanding uncontrolled type 1 diabetes mellitus (HbA1C 10.5%), who presented to our service multiple times with hyperemesis and ketosis. On each of these admissions, she was diagnos...
Uterine Leiomyoma with Lung Metastases Stump Tumour
Martin N, Escobar A, Varela A, Guillem E and Cortes-Funes H
Article Type: Case Report | First Published: April 24, 2019
We present one clinical case of a 41-year-old, female Russian origin patient, with lung nodules suggestive of metastases, with no primary tumor found, referred for study and treatment in our Oncology Department. After a deep analysis of the case, reviewed the literature and result of the pathology of biopsy from lung lesions, the final diagnosis reached was: Benign muscle tumors of Gynecological origin, with the capacity for produce distant metastasis compatible with STUMP Tumor (Metastatic leio...
A Large Uterine Leiomyoma with Hypertrophied Omental Vessels: A Case Report
Ayse Nur Aksoy, Ebru Bulut Erdem, Gülsah Tanas Sarıkas and Elçin Telli
Article Type: Case Report | First Published: March 29, 2019
Uterine leiomyomas are the most common solid benign uterine neoplasms that arise from the overgrowth of smooth muscle and connective tissue in the uterus. It is estimated that 20-40% of women of reproductive age have uterine leiomyoma; the prevalence increases during the reproductive age and decreases after menopause. Uterine leiomyomas have been classified according to their location: Submucosal, intramural, subserosal. While subserosal uterine leiomyomas are usually asymptomatic; intramural an...
Incarcerated Retroverted Uterus Manually Replaced in 24 Week Pregnancy
Lucy May, Susan Rutter, E H Whitby and Adam Temple
Article Type: Case Report | First Published: February 28, 2019
An incarcerated uterus is a rare obstetric complication, with a reported incidence of 1 in 3000 pregnancies. It occurs when a retroverted uterus does not resolve beyond mid-gestation and the uterine corpus becomes confined in the hollow of the sacrum. This causes the cervix to become displaced above or against the pubic symphysis. Retroversion of the uterus occurs in 15% of pregnancies and is considered a normal anatomical variation and usually resolves to an anteverted position by 14-16 weeks g...
The Clinical Differences on 2:4 Finger Ratios of the Hirsute Women
Raziye Desdicioglu, Fatma Betul Erdemli, Selma Calıskan, Kadir Desdicioglu and Ayse Filiz Yavuz
Article Type: ORIGINAL ARTICLE | First Published: February 27, 2019
We aimed to research whether there was a difference in terms of the 2:4 finger ratio between women with hirsutism and healthy women without hirsutism and the correlation between degree of hirsutism and 2:4 finger ratios and clinically evaluated our results. Our study included 144 voluntary women (control group: 51, study group: 93) with ages from 18 to 38 years. The hirsutism level of patients was assessed using the Ferriman-Gallway scale with points given from 0 to 4 in 9 body regions. All pati...
Hyperextension of the Fetal Neck
CR Elizalde, P Dieste, J Fernandez, V Fernadnez and C Zulueta-Santos
Article Type: CASE REPORT | First Published: February 22, 2019
The purpose of this study was to review the current challenges that the diagnosis and clinical management of hyperextension of the fetal neck represent and to describe the clinical significance and differential diagnosis of this entity, detected by ultrasound prior to the onset of labour. A case of hyperextension the fetal neck is presented. The key points in the diagnosis and management of fetuses with these sonographic finding are reviewed. Hyperextension of the fetal neck is a sonographic fin...