SAGE open medical case reports
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SAGE Open Med Case Rep · Jan 2019
Case ReportsVirginity-sparing management of hematocolpos with imperforate hymen: case report and literature review.
Imperforate hymen results from failure of the endoderm of the urogenital sinus to completely canalize and has an incidence of 0.01% to 0.05%. This sometimes presents as a pelvic mass that compresses the bladder causing acute urinary retention. A 13-year-old girl was referred to our department with a history of primary amenorrhea, cyclic lower abdominal pain, abdominal-pelvic mass, constipation and acute urinary retention. ⋯ She underwent X-shaped hymenotomy with a favorable outcome. Diagnosis of imperforate hymen requires high suspicion index. Virginity-sparing surgery constitutes a good treatment option for cultural and religious reasons.
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SAGE Open Med Case Rep · Jan 2019
Case ReportsFournier's gangrene as an initial manifestation of acute promyelocytic leukemia: A case report and review of the literature.
Fournier's gangrene is classically associated with diabetes mellitus and alcohol use disorder. While it is associated with chemotherapy, there are few case reports of Fournier's gangrene as the initial presentation of acute myelogenous leukemia. A 38-year-old male presented with progressive scrotal swelling and hematochezia. ⋯ This is the fourth case of acute myelogenous leukemia presenting as Fournier's gangrene in the literature and the only case to have survived. This brings forth a possible diagnostic consideration in patients without obvious predisposing risk factors for Fournier's gangrene, particularly in those with pancytopenia. Coordination with surgical services as well as hematology/oncology specialists is imperative to survival of these dual diagnosis patients.
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SAGE Open Med Case Rep · Jan 2018
Case ReportsBlood patch for the treatment of post-dural puncture tinnitus.
Audiometric disturbances are recognised as potential complications after spinal or epidural anaesthesia; however, incidences of tinnitus occur less frequently. We report a case of a patient with severe bilateral tinnitus post-lumbar puncture who was treated with an epidural blood patch. A 40-year-old ASA I lady (a medically fit patient with no known medical problem) presented with ongoing bilateral severe tinnitus for 6 days after a lumbar puncture. ⋯ By her 1-month follow-up, her hearing loss was back to normal. In our experience, an epidural blood patch is an effective treatment for post-dural puncture tinnitus. Its effects are instantaneous and complete resolution is achieved by 24 h.
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SAGE Open Med Case Rep · Jan 2018
Case ReportsTraumatic hemothorax due to chance fracture requiring emergency surgical management: A report of two cases.
Traumatic hemothorax is usually caused by thoracic organ damage. Cases of atypical bleeding sources may be difficult to diagnose. Here we present two surgical cases of vertebral fracture that caused hemothorax. ⋯ Total cross-fracture of the vertebral body solely caused the hemothorax. If bleeding source is unclear in elderly patients, this etiology should be considered. We saved both patients by performing spinal fusion surgery at the appropriate time.
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SAGE Open Med Case Rep · Jan 2018
Case ReportsA delayed presentation of splenic laceration and hemoperitoneum following an elective colonoscopy: A rare complication with uncertain risk factors.
Splenic laceration is a rare yet often underreported complication of colonoscopy that is infrequently discussed with the patient during the consent process. Most cases present within 48 h after the inciting colonoscopy; a delayed presentation is rare. ⋯ Traditionally perceived risk factors such as intra-abdominal adhesions, splenomegaly, anticoagulation use, biopsy, polypectomy, a technically challenging procedure, and anesthesia assistance have not been clearly shown to increase the incidence of splenic injury following a colonoscopy. Since the risk factors of splenic injury remain unclear, the clinical presentation is nonspecific, and the consequences can be serious, the endoscopist should make an effort to inform the patient of this rare complication before the procedure.