Pub Date : 2024-07-24DOI: 10.5348/100169z08km2024rv
Klara S Missling, Sarah Araji, Kimberly S Sullivan
Congenital urinary tract anomalies are one of the more common defects noted on prenatal ultrasound. There are a variety of anomalies that can occur with a broad spectrum of outcomes with different degrees of severity based on pathologic processes. Ultrasound is the imaging modality utilized to allow visualization of the urinary tract system to diagnose these anomalies. We provide a review of these classifications with imaging and diagnostic recommendations, as well as epidemiology and associated defects. The aim of this review is to bring a clinically relevant and succinct understanding of congenital urinary tract anomalies and considerations for their various pathologies
{"title":"Prenatal diagnosis, management, and outcomes of urinary tract anomalies","authors":"Klara S Missling, Sarah Araji, Kimberly S Sullivan","doi":"10.5348/100169z08km2024rv","DOIUrl":"https://doi.org/10.5348/100169z08km2024rv","url":null,"abstract":"\u0000 Congenital urinary tract anomalies are one of the more common defects noted on prenatal ultrasound. There are a variety of anomalies that can occur with a broad spectrum of outcomes with different degrees of severity based on pathologic processes. Ultrasound is the imaging modality utilized to allow visualization of the urinary tract system to diagnose these anomalies. We provide a review of these classifications with imaging and diagnostic recommendations, as well as epidemiology and associated defects. The aim of this review is to bring a clinically relevant and succinct understanding of congenital urinary tract anomalies and considerations for their various pathologies\u0000","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":"53 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141806884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-18DOI: 10.5348/100170z08kk2024cr
Katherine Koniares, P. Godiwala, Claudio Benadiva, A. DiLuigi
Introduction: The objective of this case report is to present the first known case of a primary omental ectopic pregnancy following frozen-thawed embryo transfer. Case Report: A 35-year-old G0 female with severe male factor infertility underwent a frozen-thawed single embryo transfer. Serial transvaginal ultrasounds and beta human chorionic gonadotropin levels led to the diagnosis of ectopic pregnancy. The patient did not respond to medical management with methotrexate. On laparoscopy, an ectopic pregnancy was diagnosed on the greater omentum. The pregnancy was resected with the LigaSure device. Pathology evaluation was consistent with an omental ectopic pregnancy. Conclusion: Although rare, omental ectopic pregnancy should remain in the differential in the setting of a pregnancy of unknown location.
{"title":"Primary omental ectopic pregnancy after frozen-thawed single embryo transfer: A case report and review of the literature","authors":"Katherine Koniares, P. Godiwala, Claudio Benadiva, A. DiLuigi","doi":"10.5348/100170z08kk2024cr","DOIUrl":"https://doi.org/10.5348/100170z08kk2024cr","url":null,"abstract":"\u0000 Introduction: The objective of this case report is to present the first known case of a primary omental ectopic pregnancy following frozen-thawed embryo transfer.\u0000\u0000 Case Report: A 35-year-old G0 female with severe male factor infertility underwent a frozen-thawed single embryo transfer. Serial transvaginal ultrasounds and beta human chorionic gonadotropin levels led to the diagnosis of ectopic pregnancy. The patient did not respond to medical management with methotrexate. On laparoscopy, an ectopic pregnancy was diagnosed on the greater omentum. The pregnancy was resected with the LigaSure device. Pathology evaluation was consistent with an omental ectopic pregnancy.\u0000\u0000 Conclusion: Although rare, omental ectopic pregnancy should remain in the differential in the setting of a pregnancy of unknown location.\u0000","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140685806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.5348/100165z08lg2023cr
Lamine Gueye, M. Thiam, O. Thiam, TL Bentefouet, O. Gassama, Pape Abdoulaye Ba, N. Dabo, ML Cissé
Introduction: Benign vulvar epithelial tumors developing from glandular structures are rare. Given the resemblance of vulvar fibroadenomas to those of mammary locations, some authors have put forward the hypothesis of development from accessory mammary glands. Case Report: We report a case of hyperalgesic giant vulvar fibroadenoma occurring in a 22-year-old female patient at 28 weeks, 3 days gestation. She was admitted for a painful mass on the right labia majora that had been present for two years, with a remarkable increase in volume during pregnancy. Faced with the acute vulvar pain and the discomfort caused by the mass, the decision to perform a vulvar lumpectomy was made and carried out semi-urgently, leading to the excision of a mass weighing 1103 grams. Microscopic examination revealed an adenofibroma. The patient gave birth vaginally at 38 weeks of gestation to a male baby weighing 3115 grams, 10 weeks after lumpectomy. Conclusion: Fibroadenoma is a benign tumor located in most cases in the breast, its location in the vulva is rare and can lead to a diagnostic delay. Surgical treatment by complete excision allows healing.
{"title":"Vulvar adenofibroma and pregnancy: A case study, at the regional hospital of Thiès","authors":"Lamine Gueye, M. Thiam, O. Thiam, TL Bentefouet, O. Gassama, Pape Abdoulaye Ba, N. Dabo, ML Cissé","doi":"10.5348/100165z08lg2023cr","DOIUrl":"https://doi.org/10.5348/100165z08lg2023cr","url":null,"abstract":"\u0000 Introduction: Benign vulvar epithelial tumors developing from glandular structures are rare. Given the resemblance of vulvar fibroadenomas to those of mammary locations, some authors have put forward the hypothesis of development from accessory mammary glands.\u0000\u0000 Case Report: We report a case of hyperalgesic giant vulvar fibroadenoma occurring in a 22-year-old female patient at 28 weeks, 3 days gestation. She was admitted for a painful mass on the right labia majora that had been present for two years, with a remarkable increase in volume during pregnancy. Faced with the acute vulvar pain and the discomfort caused by the mass, the decision to perform a vulvar lumpectomy was made and carried out semi-urgently, leading to the excision of a mass weighing 1103 grams. Microscopic examination revealed an adenofibroma. The patient gave birth vaginally at 38 weeks of gestation to a male baby weighing 3115 grams, 10 weeks after lumpectomy.\u0000\u0000 Conclusion: Fibroadenoma is a benign tumor located in most cases in the breast, its location in the vulva is rare and can lead to a diagnostic delay. Surgical treatment by complete excision allows healing.\u0000","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":"45 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-12DOI: 10.5348/100164z08am2023cr
Andrea Salcedo, Alexandra Maidan
Introduction: The differential diagnoses for labial edema are diverse. Labial edema after a kidney transplantation requires a thorough understanding of the various common and uncommon causes. Comprehensive history taking, physical examination, and awareness of anatomical knowledge will lead to proper diagnosis and treatment. Case Report: We present the case of an 18-year-old female with a past medical history of end stage renal disease secondary to bilateral atrophic kidneys and grade 3 vesicoureteral reflux status post deceased donor kidney transplant. She presented to the emergency department on postoperative day 5 due to uncontrolled hypertension and significant left labia minora edema with extreme pain to palpation. Gynecology evaluation and consultation determined the lesion was not suspicious for infection, abscess, or hematoma, and supportive care and conservative measures were initiated. Computed tomography (CT) was performed to rule out other causes of the anasarca, and after conservative management and doses of furosemide on hospital days 3 and 4, the patient showed improvement of the labial edema and blood pressure. Conclusion: A comprehensive differential diagnoses with reliance on anatomy and potential anomalies will lead clinicians and surgeons to properly treat potential postoperative complications. In this case, a thorough understanding of Mullerian anatomy and hemodynamic balance with implementation of conservative measures postoperatively resulted in resolution of the patient’s symptoms.
{"title":"Left labial edema after kidney transplantation","authors":"Andrea Salcedo, Alexandra Maidan","doi":"10.5348/100164z08am2023cr","DOIUrl":"https://doi.org/10.5348/100164z08am2023cr","url":null,"abstract":"\u0000 Introduction: The differential diagnoses for labial edema are diverse. Labial edema after a kidney transplantation requires a thorough understanding of the various common and uncommon causes. Comprehensive history taking, physical examination, and awareness of anatomical knowledge will lead to proper diagnosis and treatment.\u0000\u0000 Case Report: We present the case of an 18-year-old female with a past medical history of end stage renal disease secondary to bilateral atrophic kidneys and grade 3 vesicoureteral reflux status post deceased donor kidney transplant. She presented to the emergency department on postoperative day 5 due to uncontrolled hypertension and significant left labia minora edema with extreme pain to palpation. Gynecology evaluation and consultation determined the lesion was not suspicious for infection, abscess, or hematoma, and supportive care and conservative measures were initiated. Computed tomography (CT) was performed to rule out other causes of the anasarca, and after conservative management and doses of furosemide on hospital days 3 and 4, the patient showed improvement of the labial edema and blood pressure.\u0000\u0000 Conclusion: A comprehensive differential diagnoses with reliance on anatomy and potential anomalies will lead clinicians and surgeons to properly treat potential postoperative complications. In this case, a thorough understanding of Mullerian anatomy and hemodynamic balance with implementation of conservative measures postoperatively resulted in resolution of the patient’s symptoms.\u0000","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":"45 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139008089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-10DOI: 10.5348/100163z08yd2023cr
Wynn Thi Da, Hannah Wright
Introduction: Bilateral tubal pregnancy (BTP) is the rarest form of ectopic pregnancy. The reported incidence of spontaneous BTP is 5 in 1 million deliveries. Case Report: A 34-year-old woman with a previous diagnosis of right tubal pregnancy who had undergone surgery three weeks before presented with persistent pregnancy symptoms and abdominal pain prompting further investigation. Subsequently, bilateral tubal pregnancy was diagnosed after she underwent a second surgery for another ectopic pregnancy on the left side of the tube. Notably, both ectopic pregnancies were confirmed by histological examination. Conclusion: This case highlights the importance of clinical awareness of the possibility of bilateral tubal pregnancy even after a patient has recently undergone surgery for an ectopic pregnancy.
{"title":"Bilateral tubal pregnancy: An unusual presentation of a rare case","authors":"Wynn Thi Da, Hannah Wright","doi":"10.5348/100163z08yd2023cr","DOIUrl":"https://doi.org/10.5348/100163z08yd2023cr","url":null,"abstract":"Introduction: Bilateral tubal pregnancy (BTP) is the rarest form of ectopic pregnancy. The reported incidence of spontaneous BTP is 5 in 1 million deliveries. Case Report: A 34-year-old woman with a previous diagnosis of right tubal pregnancy who had undergone surgery three weeks before presented with persistent pregnancy symptoms and abdominal pain prompting further investigation. Subsequently, bilateral tubal pregnancy was diagnosed after she underwent a second surgery for another ectopic pregnancy on the left side of the tube. Notably, both ectopic pregnancies were confirmed by histological examination. Conclusion: This case highlights the importance of clinical awareness of the possibility of bilateral tubal pregnancy even after a patient has recently undergone surgery for an ectopic pregnancy.","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":"115 14","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135138381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-06DOI: 10.5348/100161z08fz2023cr
Federica Zammit, Sarah Sultana Grixti, Charles Savona-Ventura
Introduction: This case highlights the long-term obstetric risks following salpingectomy. These include recurrent ipsilateral interstitial ectopic pregnancy and uterine rupture. Case Report: A 29-year-old lady presented with acute abdominal pain as well as signs and symptoms of hemorrhagic shock at 14 weeks of gestation. She was subsequently diagnosed with a ruptured right-sided interstitial ectopic pregnancy, which was managed surgically. The patient had a past history of open salpingo-oophorectomy for a complicated right-sided ectopic pregnancy involving the ovary at 12 weeks of gestation in her previous pregnancy. A subsequent pregnancy a year later was complicated by impending uterine rupture at 30 weeks of gestation. A healthy baby was delivered by Cesarean section. Conclusion: A meticulous surgical technique is of the essence when performing a salpingectomy for whatever pathology. The risk of a recurrent ipsilateral interstitial ectopic pregnancy must always be considered. Also, the risk of antenatal and intrapartum uterine rupture must be addressed in future pregnancies following interstitial pregnancies.
{"title":"Recurrent ipsilateral interstitial ectopic pregnancy after salpingectomy","authors":"Federica Zammit, Sarah Sultana Grixti, Charles Savona-Ventura","doi":"10.5348/100161z08fz2023cr","DOIUrl":"https://doi.org/10.5348/100161z08fz2023cr","url":null,"abstract":"Introduction: This case highlights the long-term obstetric risks following salpingectomy. These include recurrent ipsilateral interstitial ectopic pregnancy and uterine rupture. Case Report: A 29-year-old lady presented with acute abdominal pain as well as signs and symptoms of hemorrhagic shock at 14 weeks of gestation. She was subsequently diagnosed with a ruptured right-sided interstitial ectopic pregnancy, which was managed surgically. The patient had a past history of open salpingo-oophorectomy for a complicated right-sided ectopic pregnancy involving the ovary at 12 weeks of gestation in her previous pregnancy. A subsequent pregnancy a year later was complicated by impending uterine rupture at 30 weeks of gestation. A healthy baby was delivered by Cesarean section. Conclusion: A meticulous surgical technique is of the essence when performing a salpingectomy for whatever pathology. The risk of a recurrent ipsilateral interstitial ectopic pregnancy must always be considered. Also, the risk of antenatal and intrapartum uterine rupture must be addressed in future pregnancies following interstitial pregnancies.","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":"5 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135635157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.5348/100159z08ef2023cr
Emily Fronk, Annalyn Welp, Megan Dibbern, Anne Mills, Leigh Cantrell
Introduction: Metastasis of pancreatic adenocarcinoma to the ovaries is uncommon and can clinically present similarly to primary ovarian disease, presenting challenges for diagnosis. Immunohistochemical staining is typically useful in distinguishing ovarian primaries from ovarian metastasis. A newer and rarer variant of pancreatic adenocarcinoma, that with intestinal-type differentiation, has not previously been reported as metastasizing to the ovary. Its diagnosis is particularly difficult due to the overlap in staining patterns with primary ovarian neoplasms. Case Report: This case report presents the case of a 60-year-old female who presented with non-specific abdominal symptoms and was found to have a large adnexal mass. Imaging showed additional lesions in the peritoneum, pancreas, and liver. She underwent biopsy with morphology and immunohistochemical staining consistent with pancreatic ductal adenocarcinoma with intestinal-type differentiation. She was started on FOLFIRINOX therapy but ultimately opted to pursue comfort care due to disease progression. Conclusion: Although rare, with this being the first report of this disease course to our knowledge, clinicians should be aware of this possibility, as it impacts choice of treatment.
{"title":"Pancreatic ductal adenocarcinoma (intestinal-type differentiation) presenting as ovarian metastases: A case report","authors":"Emily Fronk, Annalyn Welp, Megan Dibbern, Anne Mills, Leigh Cantrell","doi":"10.5348/100159z08ef2023cr","DOIUrl":"https://doi.org/10.5348/100159z08ef2023cr","url":null,"abstract":"Introduction: Metastasis of pancreatic adenocarcinoma to the ovaries is uncommon and can clinically present similarly to primary ovarian disease, presenting challenges for diagnosis. Immunohistochemical staining is typically useful in distinguishing ovarian primaries from ovarian metastasis. A newer and rarer variant of pancreatic adenocarcinoma, that with intestinal-type differentiation, has not previously been reported as metastasizing to the ovary. Its diagnosis is particularly difficult due to the overlap in staining patterns with primary ovarian neoplasms. Case Report: This case report presents the case of a 60-year-old female who presented with non-specific abdominal symptoms and was found to have a large adnexal mass. Imaging showed additional lesions in the peritoneum, pancreas, and liver. She underwent biopsy with morphology and immunohistochemical staining consistent with pancreatic ductal adenocarcinoma with intestinal-type differentiation. She was started on FOLFIRINOX therapy but ultimately opted to pursue comfort care due to disease progression. Conclusion: Although rare, with this being the first report of this disease course to our knowledge, clinicians should be aware of this possibility, as it impacts choice of treatment.","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":"5 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135863287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-28DOI: 10.5348/100158z08km2023cr
Keturah Murray, Damian Best
Unilateral tubal ectopic pregnancies (UTEP) are commonly encountered by physicians. Bilateral tubal ectopic pregnancies (BTEPs), however, are rare and due to the identical clinical presentations of BTEP and UTEP, there is a significant degree of diagnostic difficulty for the former, requiring a high index of suspicion. It should be considered a possibility in any newly pregnant woman of child-bearing age. The purpose of this article is to provide the reader with an example of a clinical presentation of BTEP, and a discourse on management of these patients. We present a case of a 27-year-old patient, who was seen at the emergency department of the Queen Elizabeth Hospital, Barbados, with signs and symptoms of a ruptured ectopic pregnancy. Intraoperative findings included a ruptured left ectopic pregnancy and an intact right fallopian tubal ectopic pregnancy. Left salpingectomy and right salpingostomy were performed, conserving the intact tube; her recovery was solely complicated by a superficial surgical site infection.
{"title":"Spontaneous bilateral tubal ectopic pregnancy: A case report","authors":"Keturah Murray, Damian Best","doi":"10.5348/100158z08km2023cr","DOIUrl":"https://doi.org/10.5348/100158z08km2023cr","url":null,"abstract":"Unilateral tubal ectopic pregnancies (UTEP) are commonly encountered by physicians. Bilateral tubal ectopic pregnancies (BTEPs), however, are rare and due to the identical clinical presentations of BTEP and UTEP, there is a significant degree of diagnostic difficulty for the former, requiring a high index of suspicion. It should be considered a possibility in any newly pregnant woman of child-bearing age. The purpose of this article is to provide the reader with an example of a clinical presentation of BTEP, and a discourse on management of these patients. We present a case of a 27-year-old patient, who was seen at the emergency department of the Queen Elizabeth Hospital, Barbados, with signs and symptoms of a ruptured ectopic pregnancy. Intraoperative findings included a ruptured left ectopic pregnancy and an intact right fallopian tubal ectopic pregnancy. Left salpingectomy and right salpingostomy were performed, conserving the intact tube; her recovery was solely complicated by a superficial surgical site infection.","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135386500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5348/100160z08nt2023cr
Nga Tran, James Liu, Paige Harrison, Jefferson Jones II
Introduction: Pseudotumor cerebri (PTC), idiopathic intracranial hypertension, is a serious condition that is most associated with pregnancy. It is believed that symptoms are due to increased stroke volume and fluid retention ultimately increasing intracranial pressure. This increased pressure can lead to cerebral edema and dysfunction of the optic nerve fibers. The initial workup for PTC is conducting a computed tomography (CT) or magnetic resonance imaging (MRI) brain scan to rule out structural abnormalities that may induce a headache. A lumbar puncture can be performed to acutely relieve the symptoms and definitively diagnose PTC; however, the definitive treatment is acetazolamide through the inhibition of carbonic anhydrase alleviating intracranial pressure. Case Report: This case report discusses how a pseudotumor cerebri affected the pregnancy of a 29-year-old female who presented with headache, blurry vision with eye pain, and abdominal pain. Her pregnancy was complicated by several comorbidities. Ultrasound showed a viable intrauterine pregnancy, while an MRI without contrast of the head revealed bilateral papilledema. She was treated with acetazolamide and underwent a primary low transverse cesarean section due to fetal malpresentation and pseudotumor cerebri diagnosis. Conclusion: It is imperative that symptoms of PTC are recognized as a larger diagnosis and that imaging confirms the increased intracranial pressure. The initial workup for PTC is conducting a CT or MRI brain scan to rule out structural abnormalities that may induce a headache. A lumbar puncture can relieve the symptoms and definitively diagnose PTC. The definitive treatment is acetazolamide through the inhibition of carbonic anhydrase alleviating intracranial pressure.
{"title":"Pseudotumor cerebri in pregnant obese patient: A case report","authors":"Nga Tran, James Liu, Paige Harrison, Jefferson Jones II","doi":"10.5348/100160z08nt2023cr","DOIUrl":"https://doi.org/10.5348/100160z08nt2023cr","url":null,"abstract":"Introduction: Pseudotumor cerebri (PTC), idiopathic intracranial hypertension, is a serious condition that is most associated with pregnancy. It is believed that symptoms are due to increased stroke volume and fluid retention ultimately increasing intracranial pressure. This increased pressure can lead to cerebral edema and dysfunction of the optic nerve fibers. The initial workup for PTC is conducting a computed tomography (CT) or magnetic resonance imaging (MRI) brain scan to rule out structural abnormalities that may induce a headache. A lumbar puncture can be performed to acutely relieve the symptoms and definitively diagnose PTC; however, the definitive treatment is acetazolamide through the inhibition of carbonic anhydrase alleviating intracranial pressure. Case Report: This case report discusses how a pseudotumor cerebri affected the pregnancy of a 29-year-old female who presented with headache, blurry vision with eye pain, and abdominal pain. Her pregnancy was complicated by several comorbidities. Ultrasound showed a viable intrauterine pregnancy, while an MRI without contrast of the head revealed bilateral papilledema. She was treated with acetazolamide and underwent a primary low transverse cesarean section due to fetal malpresentation and pseudotumor cerebri diagnosis. Conclusion: It is imperative that symptoms of PTC are recognized as a larger diagnosis and that imaging confirms the increased intracranial pressure. The initial workup for PTC is conducting a CT or MRI brain scan to rule out structural abnormalities that may induce a headache. A lumbar puncture can relieve the symptoms and definitively diagnose PTC. The definitive treatment is acetazolamide through the inhibition of carbonic anhydrase alleviating intracranial pressure.","PeriodicalId":479864,"journal":{"name":"Journal of Case Reports and Images in Obstetrics and Gynecology","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135316720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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