scholarly journals Uncontrollable uterine atony after replacement of uterine inversion managed by hysterectomy: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Daisuke Katsura ◽  
Suzuko Moritani ◽  
Shunichiro Tsuji ◽  
Kounosuke Suzuki ◽  
Kazutaka Yamada ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Surgical Intervention ◽  
Massive Hemorrhage ◽  
Japanese Woman ◽  
Uterine Atony ◽  
Artery Embolization ◽  
Case Presentation ◽  
Balloon Tamponade ◽  
Uterine Inversion ◽  
Old Japanese

Abstract Background Uterine inversion may cause massive hemorrhage, resulting in maternal deterioration and death. Replacement of the inverted uterus must be performed as soon as possible. As time passes, the inverted uterus becomes atonic and necrotic, and a surgical approach may be required. Case presentation A 27-year-old Japanese woman was admitted to our hospital 4 hours postpartum with increased hemorrhage after the replacement of an inverted uterus. Recurrent inversion was diagnosed, and though the atonic uterus was replaced again by the Johnson maneuver, hemorrhage persisted. Balloon tamponade was not successful in stopping the hemorrhage, and uterine artery embolization was performed. Bleeding resumed the next day on removal of the balloon, and hysterectomy was performed. Massive hemorrhage, coagulopathy, and uterine necrosis caused uterine atony, and the reperfused blood flow on replacement of the ischemic uterus increased hemorrhage. Conclusions Cases of uterine inversion with coagulopathy lasting for more than 4 hours may require a surgical intervention, and uterine replacement may have to be delayed until the maternal hemodynamic condition is stabilized. Uterine replacement under laparotomy may be also be considered due to the risk of increased hemorrhage.

scholarly journals Is uterine artery embolization in postpartum hemorrhage due to uterine atony a fertility-sparing intervention?

2022 ◽  
Vol 226 (1) ◽  
pp. S572-S573
Author(s):  
Rosine Ravaud ◽  
Michael Dassa ◽  
Jérome Soussan ◽  
Jean-Michel Bartoli ◽  
Aubert Agostini ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Uterine Atony ◽  
Artery Embolization ◽  
Fertility Sparing

scholarly journals Uterine rhabdomyosarcoma complicated by cerebral venous thrombosis and uterine inversion in a young woman: case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongfa Peng ◽  
Jingjing Jiang ◽  
Xianghua Huang
Keyword(s):  
Venous Thrombosis ◽  
Adolescent Girls ◽  
Cerebral Venous Thrombosis ◽  
Actinomycin D ◽  
Surgical Intervention ◽  
Abnormal Uterine Bleeding ◽  
Uterine Neoplasms ◽  
Case Presentation ◽  
Uterine Inversion ◽  
First Case

Abstract Background Uterine rhabdomyosarcoma is an extremely rare malignant tumor that usually affects young women and has a poor prognosis. Case presentation A 19-year-old nulliparous woman presented to the emergency department under sedation due to seizures. Imaging examination revealed cerebral venous thrombosis. During thrombolytic therapy, she developed vaginal bleeding followed by uterine inversion secondary to uterine rhabdomyosarcoma. The inverted uterus was mistaken for a cervical tumour and was removed vaginally. The patient’s disease progressed despite chemotherapy with vincristine, actinomycin D and cyclophosphamide and she died within 6 months. To our knowledge, this is the first case of uterine rhabdomyosarcoma complicated with cerebral venous thrombosis. Conclusions Malignancy is an important diagnostic in patients with cerebral venous thrombosis with no obvious cause. This case demonstrates the importance of considering uterine neoplasms in the differential diagnosis of adolescent girls with abnormal uterine bleeding. Further, careful anatomical evaluation of vaginal masses should be performed prior to surgical intervention.

scholarly journals A case of solitary plasmacytoma of bone showing co-expression of both immunoglobulin light chains

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ryota Matsuoka ◽  
Noriaki Sakamoto ◽  
Takayasu Kato ◽  
Shigeru Chiba ◽  
Masayuki Noguchi
Keyword(s):  
Plasma Cell ◽  
Japanese Woman ◽  
Solitary Plasmacytoma ◽  
Case Presentation ◽  
Plasma Cell Neoplasm ◽  
Plasma Cell Neoplasms ◽  
Old Japanese ◽  
Single Tumor Cell ◽  
Single Tumor

Abstract Background Solitary plasmacytoma of bone (SPB) is a rare plasma cell neoplasm. It arises in bone as a single locus in the absence of any plasma cell myeloma lesions. Plasma cell neoplasms intrinsically express only one immunoglobulin light chain (IgL)—kappa or lambda—and using this fact, kappa/lambda deviation is the decisive factor for diagnosis. Co-expression of both IgLs in a single tumor cell is extremely rare. Case presentation We report a case of SPB that arose in the vertebra of a 52-year-old Japanese woman. Histologically, the resected mass showed diffuse plasma cell proliferation. Dual IgL expression was detected by flow cytometry, immunohistochemistry, and in situ hybridization (ISH) targeting IgL mRNA. Conclusion We have presented an extremely rare case of SPB showing dual expression of kappa and lambda IgLs. This unusual case of plasma cell neoplasia might represent a possible exceptional example of failure of “IgL isotypic exclusion.”

scholarly journals A case of Sphingomonas paucimobilis causing peritoneal dialysis-associated peritonitis and review of the literature

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chiharu Kinoshita ◽  
Koichi Matsuda ◽  
Yumiko Kawai ◽  
Takayuki Hagiwara ◽  
Akane Okada
Keyword(s):  
Peritoneal Dialysis ◽  
Japanese Woman ◽  
Catheter Removal ◽  
Sphingomonas Paucimobilis ◽  
Test Results ◽  
Review Of The Literature ◽  
Case Presentation ◽  
Old Japanese ◽  
Empirical Antibiotics ◽  
Number Of Cells

Abstract Background Peritoneal dialysis (PD)-associated peritonitis caused by Sphingomonas paucimobilis (S. paucimobilis) is very rare, and most of the characteristics of such cases are still unknown. Case presentation An 80-year-old Japanese woman on PD was diagnosed with PD-associated peritonitis and received ceftazidime and cefazolin. The number of cells in the peritoneal dialysate decreased quickly. However, because S. paucimobilis was detected, the antibiotic was changed to meropenem according to the susceptibility test results. She was treated with meropenem for two weeks and discharged. After 21 days, she was hospitalized for relapsing peritonitis. S. paucimobilis was detected again, and improvement after the administration of meropenem was poor, eventually resulting in catheter removal. Conclusions S. paucimobilis may be resistant to empirical antibiotics; furthermore, catheter removal may still be required, even with sensitive-antibiotic treatment.

Serum fibrinogen levels could be an index of successful use of balloon tamponade in postpartum hemorrhage

2018 ◽  
Vol 46 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Ayaka Nakashima ◽  
Kazuhide Ogita ◽  
Masaya Chita ◽  
Takeshi Yokoi
Keyword(s):  
Postpartum Hemorrhage ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Fibrinogen Level ◽  
Medical Center ◽  
Success Rates ◽  
Artery Embolization ◽  
Peripartum Hysterectomy ◽  
Factors Associated ◽  
Balloon Tamponade

AbstractObjective:The object of our study was to determine whether serum fibrinogen levels could be used to predict the success rates of balloon tamponade and decrease the use of invasive methods.Methods:This retrospective study, conducted at Rinku General Medical Center, was aimed to identify factors associated with high success rates in balloon tamponade. Forty-six patients with postpartum hemorrhage (PPH), non-responsive to uterotonics and treated with balloon tamponade between April 2008 and March 2015, were included.Results:Forty-six women were included, of which 34 underwent vaginal delivery and 12 underwent cesarean delivery. There were no complications from balloon tamponade and its success rate was 73.3%. Seven women required additional procedures: One used gauze packing, three used uterine artery embolization, and five underwent peripartum hysterectomy. The cut-off line of serum fibrinogen level was 172.5 mg/dL (P=0.002) with its 77.4% sensitivity and 66.7% specificity.Conclusion:We recommend measuring serum fibrinogen level for predicting whether the balloon tamponade can be used successfully or not.

Incidence and risk factors for surgical intervention after uterine artery embolization

2008 ◽  
Vol 199 (6) ◽  
pp. 671.e1-671.e6 ◽  
Author(s):  
Amy J. Park ◽  
Justin C. Bohrer ◽  
Linda D. Bradley ◽  
Gouri B. Diwadkar ◽  
Eunice Moon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Surgical Intervention ◽  
Artery Embolization
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