Pub Date : 2025-06-01DOI: 10.1016/j.crwh.2025.e00718
Martina Beretta, Philippe Demoustier, Gabriel Charaf
Spontaneous hemoperitoneum in the postpartum period is rare and potentially fatal, especially following an uncomplicated vaginal delivery. We present the case of a 37-year-old woman who developed hypovolemic shock and acute abdominal pain four days postpartum. Imaging revealed massive intra-abdominal bleeding. Emergency laparotomy identified a spontaneous rupture of the left broad ligament with 3 l of hemoperitoneum. Surgical repair and resuscitation were successful. This case underlines the importance of considering internal bleeding in postpartum patients with abdominal symptoms, even in the absence of obstetric complications.
{"title":"Spontaneous broad ligament rupture following uncomplicated vaginal delivery: A case report","authors":"Martina Beretta, Philippe Demoustier, Gabriel Charaf","doi":"10.1016/j.crwh.2025.e00718","DOIUrl":"10.1016/j.crwh.2025.e00718","url":null,"abstract":"<div><div>Spontaneous hemoperitoneum in the postpartum period is rare and potentially fatal, especially following an uncomplicated vaginal delivery. We present the case of a 37-year-old woman who developed hypovolemic shock and acute abdominal pain four days postpartum. Imaging revealed massive intra-abdominal bleeding. Emergency laparotomy identified a spontaneous rupture of the left broad ligament with 3 l of hemoperitoneum. Surgical repair and resuscitation were successful. This case underlines the importance of considering internal bleeding in postpartum patients with abdominal symptoms, even in the absence of obstetric complications.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"46 ","pages":"Article e00718"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178760","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 : 2025-06-01DOI: 10.1016/j.crwh.2025.e00719
Masoud Edalati , Karam Khouri , Ahmed Lazim , Shuanzeng Wei , Anjali Seth , Daniela Proca
Cotyledonoid dissecting leiomyoma (CDL), also known as Sternberg tumor, is a rare uterine leiomyoma variant with distinct imaging, gross, and microscopic features that deviate from classic leiomyomas. Despite its benign nature, CDL frequently mimics malignancy on radiologic and clinical evaluations, posing a diagnostic challenge. Understanding its unique characteristics is crucial for correct diagnosis to prevent unnecessary aggressive treatment. This report concerns the case of a 52-year-old postmenopausal woman with abnormal bleeding and an enlarged uterus. Ultrasound revealed a 4.3 × 3.5 × 3.5 cm complex echogenic mass of undetermined etiology in the right adnexa. MRI demonstrated a heterogeneously enhancing, irregular mass between the right ovary and uterine fundus. Given her postmenopausal status, a total hysterectomy with bilateral salpingo-oophorectomy was performed. Gross examination revealed a red, spongy, nodular, and cystic tumor containing gelatinous material. The mass involved the right lateral uterine wall, extending toward the fundus and round ligament, but remained distinct from the ovary and fallopian tube. Microscopically, interlacing smooth muscle fascicles whorled around prominent thick-walled vessels, confirming the diagnosis of CDL—a rare, benign uterine leiomyoma with a unique gross and microscopic appearance. Recognizing CDL is critical for both clinicians and pathologists to avoid misdiagnosing it as malignancy. Increased awareness can prevent unnecessary radical treatment, ensuring appropriate patient management while avoiding potential overtreatment and associated complications.
{"title":"A case report with pathological insights into cotyledonoid dissecting leiomyoma: Essential for differentiating this rare benign tumor from cancer","authors":"Masoud Edalati , Karam Khouri , Ahmed Lazim , Shuanzeng Wei , Anjali Seth , Daniela Proca","doi":"10.1016/j.crwh.2025.e00719","DOIUrl":"10.1016/j.crwh.2025.e00719","url":null,"abstract":"<div><div>Cotyledonoid dissecting leiomyoma (CDL), also known as Sternberg tumor, is a rare uterine leiomyoma variant with distinct imaging, gross, and microscopic features that deviate from classic leiomyomas. Despite its benign nature, CDL frequently mimics malignancy on radiologic and clinical evaluations, posing a diagnostic challenge. Understanding its unique characteristics is crucial for correct diagnosis to prevent unnecessary aggressive treatment. This report concerns the case of a 52-year-old postmenopausal woman with abnormal bleeding and an enlarged uterus. Ultrasound revealed a 4.3 × 3.5 × 3.5 cm complex echogenic mass of undetermined etiology in the right adnexa. MRI demonstrated a heterogeneously enhancing, irregular mass between the right ovary and uterine fundus. Given her postmenopausal status, a total hysterectomy with bilateral salpingo-oophorectomy was performed. Gross examination revealed a red, spongy, nodular, and cystic tumor containing gelatinous material. The mass involved the right lateral uterine wall, extending toward the fundus and round ligament, but remained distinct from the ovary and fallopian tube. Microscopically, interlacing smooth muscle fascicles whorled around prominent thick-walled vessels, confirming the diagnosis of CDL—a rare, benign uterine leiomyoma with a unique gross and microscopic appearance. Recognizing CDL is critical for both clinicians and pathologists to avoid misdiagnosing it as malignancy. Increased awareness can prevent unnecessary radical treatment, ensuring appropriate patient management while avoiding potential overtreatment and associated complications.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"46 ","pages":"Article e00719"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184997","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 : 2025-06-01DOI: 10.1016/j.crwh.2025.e00713
Jessica Benton, Honor Mijatovic, Belinda Lowe
Vault dehiscence is a rare but significant complication of hysterectomy that can result in bowel evisceration through the vagina. This condition occurs when there is separation of the surgically created vaginal cuff, which can lead to serious morbidity, including bowel evisceration, ischaemia, and peritonitis. Vault dehiscence usually occurs in the months following a hysterectomy, but there have been a few case reports of late vaginal vault dehiscence. This report explores the case of a 48-year-old multiparous menopausal woman who presented to the emergency department with unprovoked vaginal cuff dehiscence, on a background of open hysterectomy two years prior. The patient had undergone a laparoscopic hiatal hernia repair two weeks prior to her presentation at the emergency department with dehiscence, raising the question of whether that laparoscopic procedure was related to the presentation with vault dehiscence because it had resulted in weakness of the vaginal vault. She underwent emergency laparoscopic surgery to examine the eviscerated bowel and repair the vault defect. This case report outlines the risk factors for vault dehiscence and factors which may be associated with late and unusual presentations of vault dehiscence after hysterectomy.
{"title":"Vault dehiscence two years after total abdominal hysterectomy: A case report","authors":"Jessica Benton, Honor Mijatovic, Belinda Lowe","doi":"10.1016/j.crwh.2025.e00713","DOIUrl":"10.1016/j.crwh.2025.e00713","url":null,"abstract":"<div><div>Vault dehiscence is a rare but significant complication of hysterectomy that can result in bowel evisceration through the vagina. This condition occurs when there is separation of the surgically created vaginal cuff, which can lead to serious morbidity, including bowel evisceration, ischaemia, and peritonitis. Vault dehiscence usually occurs in the months following a hysterectomy, but there have been a few case reports of late vaginal vault dehiscence. This report explores the case of a 48-year-old multiparous menopausal woman who presented to the emergency department with unprovoked vaginal cuff dehiscence, on a background of open hysterectomy two years prior. The patient had undergone a laparoscopic hiatal hernia repair two weeks prior to her presentation at the emergency department with dehiscence, raising the question of whether that laparoscopic procedure was related to the presentation with vault dehiscence because it had resulted in weakness of the vaginal vault. She underwent emergency laparoscopic surgery to examine the eviscerated bowel and repair the vault defect. This case report outlines the risk factors for vault dehiscence and factors which may be associated with late and unusual presentations of vault dehiscence after hysterectomy.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"46 ","pages":"Article e00713"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178759","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 : 2025-06-01DOI: 10.1016/j.crwh.2025.e00704
Rie Okuya , Hiroshi Ishikawa , Nozomi Sakai , Eri Katayama , Kaori Kuroda , Kaori Koga
{"title":"Corrigendum to “Unexpected acute appendicitis found at laparoscopic surgery for a right ovarian teratoma: A case report” [Case Rep Womens Health. 2025 Jan 31:45:e00691]","authors":"Rie Okuya , Hiroshi Ishikawa , Nozomi Sakai , Eri Katayama , Kaori Kuroda , Kaori Koga","doi":"10.1016/j.crwh.2025.e00704","DOIUrl":"10.1016/j.crwh.2025.e00704","url":null,"abstract":"","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"46 ","pages":"Article e00704"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253871","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}
{"title":"Corrigendum to “A rare presentation of isolated right-sided pleural effusion in the context of ovarian hyperstimulation syndrome: A case report” [Case Reports in Women's Health 32 (2021) e00347]","authors":"Angela Vidal , Christiane Wachter , Alexandra Kohl Schwartz , Carolin Dhakal","doi":"10.1016/j.crwh.2025.e00703","DOIUrl":"10.1016/j.crwh.2025.e00703","url":null,"abstract":"","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"46 ","pages":"Article e00703"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253870","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 : 2025-06-01DOI: 10.1016/j.crwh.2025.e00721
Manuela Neri , Paolo Albino Ferrari , Elisabetta Sanna , Giovanni Caocci , Valerio Vallerino , Sonia Nemolato , Giorgia Locci , Clelia Madeddu , Matteo Runfola , Anna Maria Paoletti , Antonio Macciò
The management of Fournier's gangrene in pregnancy in a woman with chronic idiopathic neutropenia is described. A 36-year-old pregnant woman was admitted at 12 weeks of gestation with sepsis, high fever, severe anemia requiring transfusions, and a perianal necrotic area approximately 10 cm in diameter extending to the perineum, consistent with Fournier's gangrene. She required both surgery and medical therapy. Surgery included a laparoscopic defunctioning sigmoid loop colostomy and perineal debridement. The skin and mucous membranes of the perineum were cleansed daily using water irrigation, decontamination and disinfection, and the vagina and rectum were irrigated with antiseptic and antifungal solutions. The necrotic areas were removed. Granulocyte colony-stimulating factor and erythropoietin were administered to restore normal levels of white blood cells and hemoglobin. Vital parameters, hematological values, and clinical examination of the perineum showed progressive improvement during treatment, and complete restoration of the perineum was achieved. The patient successfully carried the pregnancy to term. In conclusion, key factors for success were treatment of the sepsis, loop colostomy, granulocyte growth factor therapy and cleansing of the anus and perineum.
{"title":"Fournier's gangrene in a woman with chronic neutropenia presenting at 12 weeks of pregnancy: a case report and literature review","authors":"Manuela Neri , Paolo Albino Ferrari , Elisabetta Sanna , Giovanni Caocci , Valerio Vallerino , Sonia Nemolato , Giorgia Locci , Clelia Madeddu , Matteo Runfola , Anna Maria Paoletti , Antonio Macciò","doi":"10.1016/j.crwh.2025.e00721","DOIUrl":"10.1016/j.crwh.2025.e00721","url":null,"abstract":"<div><div>The management of Fournier's gangrene in pregnancy in a woman with chronic idiopathic neutropenia is described. A 36-year-old pregnant woman was admitted at 12 weeks of gestation with sepsis, high fever, severe anemia requiring transfusions, and a perianal necrotic area approximately 10 cm in diameter extending to the perineum, consistent with Fournier's gangrene. She required both surgery and medical therapy. Surgery included a laparoscopic defunctioning sigmoid loop colostomy and perineal debridement. The skin and mucous membranes of the perineum were cleansed daily using water irrigation, decontamination and disinfection, and the vagina and rectum were irrigated with antiseptic and antifungal solutions. The necrotic areas were removed. Granulocyte colony-stimulating factor and erythropoietin were administered to restore normal levels of white blood cells and hemoglobin. Vital parameters, hematological values, and clinical examination of the perineum showed progressive improvement during treatment, and complete restoration of the perineum was achieved. The patient successfully carried the pregnancy to term. In conclusion, key factors for success were treatment of the sepsis, loop colostomy, granulocyte growth factor therapy and cleansing of the anus and perineum.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"46 ","pages":"Article e00721"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221684","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 : 2025-05-31DOI: 10.1016/j.crwh.2025.e00720
Siman Liu, Yujie Huang, Xiu Lin
Interstitial pregnancy is a rare form of ectopic pregnancy in which the gestational sac implants in a unique location within the uterus. Rupture of an interstitial pregnancy can lead to severe, potentially life-threatening uterine hemorrhage. Common treatment options include laparoscopic surgery to incise the myometrium and remove the embryo, laparoscopic wedge resection of the lesion, or medical therapy. However, these surgical interventions can compromise the integrity of the uterine muscle layer and may lead to fallopian tube obstruction.
This report concerns the case of a 29-year-old patient who underwent frozen-thawed blastocyst transfer and presented at 6 weeks of gestation. A 3D ultrasound suggested a possible interstitial tubal pregnancy. Hysteroscopy was performed, during which no gestational sac was identified within the uterine cavity. Under ultrasound guidance, microforceps were introduced via hysteroscopy into the interstitial portion of the right fallopian tube, and fresh chorionic villi were successfully retrieved. Follow-up 3D ultrasound showed no abnormalities.
In this case, the interstitial tubal pregnancy was removed via hysteroscopy using non-electrosurgical instrumentation, effectively preserving the integrity of the myometrium and avoiding thermal damage to the endometrium. This approach enabled rapid recovery and reduced the risk of uterine rupture in future pregnancies.
{"title":"Hysteroscopic treatment for interstitial pregnancy: A case report","authors":"Siman Liu, Yujie Huang, Xiu Lin","doi":"10.1016/j.crwh.2025.e00720","DOIUrl":"10.1016/j.crwh.2025.e00720","url":null,"abstract":"<div><div>Interstitial pregnancy is a rare form of ectopic pregnancy in which the gestational sac implants in a unique location within the uterus. Rupture of an interstitial pregnancy can lead to severe, potentially life-threatening uterine hemorrhage. Common treatment options include laparoscopic surgery to incise the myometrium and remove the embryo, laparoscopic wedge resection of the lesion, or medical therapy. However, these surgical interventions can compromise the integrity of the uterine muscle layer and may lead to fallopian tube obstruction.</div><div>This report concerns the case of a 29-year-old patient who underwent frozen-thawed blastocyst transfer and presented at 6 weeks of gestation. A 3D ultrasound suggested a possible interstitial tubal pregnancy. Hysteroscopy was performed, during which no gestational sac was identified within the uterine cavity. Under ultrasound guidance, microforceps were introduced via hysteroscopy into the interstitial portion of the right fallopian tube, and fresh chorionic villi were successfully retrieved. Follow-up 3D ultrasound showed no abnormalities.</div><div>In this case, the interstitial tubal pregnancy was removed via hysteroscopy using non-electrosurgical instrumentation, effectively preserving the integrity of the myometrium and avoiding thermal damage to the endometrium. This approach enabled rapid recovery and reduced the risk of uterine rupture in future pregnancies.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00720"},"PeriodicalIF":0.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241216","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 : 2025-05-27DOI: 10.1016/j.crwh.2025.e00717
Carla Ettore , Elisa Pappalardo , Ferdinando Antonio Gulino , Giosuè Giordano Incognito , Sebastiano Bianca , Giuseppe Ettore
Sirenomelia is a rare congenital malformation characterized by the fusion of the lower limbs and is generally associated with severe multisystem anomalies. Advances in prenatal imaging have significantly improved the ability to diagnose this condition early in pregnancy, allowing for timely counseling and management. We report the case of a 37-year-old woman who was referred at 13 weeks of gestation for first-trimester combined screening. Ultrasound revealed a single viable fetus with hallmark features of sirenomelia. The diagnosis was confirmed on postmortem after termination of pregnancy at 16 weeks of gestation. Postmortem radiographic imaging and genetic analysis ruled out chromosomal abnormalities, supporting a sporadic etiology. This case highlights the value of antenatal ultrasonography, which has high sensitivity for the diagnosis of sirenomelia, a rare condition with a poor prognosis. Earlier diagnosis allows for proactive, patient-centred counseling and management.
{"title":"First-trimester ultrasound diagnosis of sirenomelia: A case report","authors":"Carla Ettore , Elisa Pappalardo , Ferdinando Antonio Gulino , Giosuè Giordano Incognito , Sebastiano Bianca , Giuseppe Ettore","doi":"10.1016/j.crwh.2025.e00717","DOIUrl":"10.1016/j.crwh.2025.e00717","url":null,"abstract":"<div><div>Sirenomelia is a rare congenital malformation characterized by the fusion of the lower limbs and is generally associated with severe multisystem anomalies. Advances in prenatal imaging have significantly improved the ability to diagnose this condition early in pregnancy, allowing for timely counseling and management. We report the case of a 37-year-old woman who was referred at 13 weeks of gestation for first-trimester combined screening. Ultrasound revealed a single viable fetus with hallmark features of sirenomelia. The diagnosis was confirmed on postmortem after termination of pregnancy at 16 weeks of gestation. Postmortem radiographic imaging and genetic analysis ruled out chromosomal abnormalities, supporting a sporadic etiology. This case highlights the value of antenatal ultrasonography, which has high sensitivity for the diagnosis of sirenomelia, a rare condition with a poor prognosis. Earlier diagnosis allows for proactive, patient-centred counseling and management.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"46 ","pages":"Article e00717"},"PeriodicalIF":0.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169792","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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