Uterine rupture of a patient with rudimentary horn pregnancy at 26th gestational weeks.

INTRODUCTION AND IMPORTANCE: Pregnancy of Rudimentary Horn is a type of ectopic pregnancy, that is recognized almost always during surgical treatment of a rupture of the rudimentary horn. This is an obstetric case diagnosed preoperatively by magnetic resonance imaging (MRI). CASE PRESENTATION: We report the case of a 19-years-old primigravida patient with rupture of rudimentary horn in 26th gestational week. The patient presented with sudden onset severe abdominal pain in the emergency room. Intraabdominal free fluid is detected. To evaluate the etiology of free fluid and location of the gestational sac, an abdominal magnetic resonance imaging (MRI) scan was planned. The decision of emergent laparotomy is made because of sonographic detection of abdominal excessive -concentrated- free fluid, abdominal tenderness, and 2 points decrease of hemoglobin value in the control hemogram. A rudimentary horn pregnancy and fundal rupture of the rudimentary part of the uterus are diagnosed during the surgical procedure. A baby -live- weighing 450 g was delivered. The ruptured rudimentary horn and same-sided tuba uterina were surgically removed. CLINICAL DISCUSSION: Rudimentary horn pregnancy is a rare ectopic pregnancy. Diagnosis is difficult clinically, even with diagnostic imaging modalities. Identifying both cornuas systematically in all patients increases the detection rate. The absence of continuity between the gestational sac's lumen and the cervical canal on imaging is an important finding. CONCLUSION: Due to the serious maternal and fetal complications, its detection at an early week may be life-saving.

Ordinal Scoring of Coronary Artery Calcification by Computed Tomography Pulmonary Angiography in Acute Pulmonary Embolism.

OBJECTIVE: To assess coronary artery calcification (CAC) in patients with acute pulmonary embolism and determine whether this correlates with right ventricular dilation (RVD) and mortality. METHODS: Computed tomography pulmonary angiography scans of 330 patients were used to perform retrospective assessment of the pulmonary artery computed tomography obstruction index (PACTOI), the right/left ventricle diameter ratio, the diameter of the pulmonary trunk, and the ordinal CAC score. RESULTS: Age (P < 0.001), urea level (P < 0.001), D-dimer level (P = 0.006), diameter of the pulmonary trunk (P < 0.001), and PACTOI (P < 0.001) were significantly higher in the RVD-positive patient group. We found a significant relation between increased CAC score and increased mortality (P = 0.038). Left-sided CAC was detected much more often in RVD-positive patients (P = 0.008). CONCLUSIONS: Coronary artery calcification is common in patients with acute pulmonary embolism, especially when those patients are also RVD-positive. A significant relation was found between RVD and left-sided CAC.

A very rare case: Hydatid cyst surrounding uterus and magnetic resonance imaging findings in the pregnant patient.

Hydatid cyst disease is very rare in pregnancy having an incidence of 1 in 20,000 pregnancies and there is no recommended standard treatment. Both surgical and medical modalities have been tried. Modalities that do not use ionizing radiation such as ultrasound and magnetic resonance imaging should be preferred for diagnosis and evaluating acute conditions in a pregnant patient. In this article, a rare pelvic cyst hydatid case surrounding the uterus and MRI findings in a young pregnant patient who was coincidentally determined is represented.

Longest surviving case of unoperated Stanford type A aortic dissection.

Stanford type A aortic dissection requires urgent intervention and immediate surgical approach in the emergency department. Survival rate is low, even in patients who undergo immediate surgery. Presently described is a case of unoperated Stanford type A aortic dissection that has been in follow-up under beta-blocker treatment for 7 years. To the best of our knowledge, our case is the longest surviving patient with unoperated type A aortic dissection reported in the literature.

Hydatid Cyst of the Posterior Cervical Region.

Hydatid cyst is an endemically seen parasitic disease and caused by the larval form of Echinococcus parasites. The disease is mostly seen in liver and lung, and the other involvement is rarely seen. Head and neck involvement is extremely rarely seen and its frequency in the literature is reported as less than 1%. It is usually asymptomatic and the symptoms are related to the compression to the adjacent structures. In this paper, the authors report a patient of hydatid cyst localized in the posterior cervical region.

Appendix Invagination Mimicking Ileocecal Intussusception in a Pediatric Patient: A Case Report.

BACKGROUND: Appendix invagination is a rare cause of right lower quadrant abdominal pain. Clinical findings are not specific and can mimic a wide range of diseases. CASE REPORT: An 8-year-old girl was admitted with abdominal pain lasting for 2 weeks. Clinical and radiologic findings suggested ileocecal intussusception initially. A failed hydrostatic reduction attempt and subsequent abdominal ultrasound and computed tomography studies showed that the underlying pathology was invagination of the vermiform appendix. The patient was managed conservatively and spontaneous reduction was observed during follow-up. She underwent appendectomy 9 months later due to chronic appendicitis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Appendix invagination should be kept in mind while evaluating patients with suspected ileocecal intussusception. In distinguishing between these two conditions, a blind-ending invaginating segment is an important clue in favor of appendix intussusception.