Case Of Rupture Research Articles

Traumatischer zervikaler Bandscheibenvorfall nach Niedriggeschwindigkeitsunfall?

Abstract Background Generally, disc changes are of degenerative origin and develop over a longer time span. Accidental incidents with isolated traumatic disc ruptures are rare events; however, occupants involved in low velocity accidents often claim a causal relationship between disc changes and accidents. In forensic casework the adequacy of the biomechanical load to cause traumatic disc rupture has to be assessed. Objective Based on patient data we addressed the following issues: – Do traumatic cervical disc rupture occur in low velocity accidents? – Are there always accompanying injuries in neuroradiological imaging? – What are the main injury mechanisms? Methods In this study we analyzed cases of traumatic disc ruptures without other severe injuries in patients who underwent surgical treatment between 2010 and 2021. The purpose was to identify cases with traumatic disc ruptures following low velocity scenarios. The sample contained 16 cases with the main diagnosis of traumatic cervical disc rupture. Results Falls caused traumatic disc rupture in 14 of the cases, while traffic accidents caused disc injury in 2 cases only. Radiological signs of acute trauma as well as sensorimotor deficits or pain were present in every case. Of the patients six did not sustain accompanying fractures. In the majority of cases a hyperextension mechanism was assumed, even though an exact reconstruction of the load was not possible in every case. Conclusion This study renders traumatic genesis of a disc rupture highly unlikely in patients involved in low velocity scenarios. Medical imaging without accompanying injuries or signs of acute trauma, e.g., in terms of bleeding, bony or ligamentous lesions, supports a non-accidental cause of disc changes. Nevertheless, expert opinions require case by case evaluation taking account of patient-specific and case-specific conditions.

Splenic artery aneurysm rupture after using enoxaparin for COVID-19: is it a coincidence or complication?

Splenic artery aneurysm is a rare and usually asymptomatic disease that is more common among women. It is usually diagnosed as a result of rupture during pregnancy. It may result in mortality if patients with rupture are not diagnosed and treated early. Although the endovascular method is the first choice in treatment, the surgical procedure can also be applied in hemodynamically unstable patients. In this report, we present a case of splenic artery aneurysm rupture that occurred due to the use of enoxaparin in a patient diagnosed with COVID-19 and followed up at home.

Total hip arthroplasty monobloc stem neck rupture in patient with massive heterotopic ossifications: a case report and literature review.

Fractures of the femoral stem neck are a rare complication in hip prosthetic surgery, especially in non-modular components. The authors report a case associated with massive heterotopic ossifications, with the purpose to analyze risk factors and specific characteristics. A case of femoral monobloc stem neck rupture is described. A non-systematic literature review regarding risk factors for femoral stem neck fracture was conducted in the PubMed database. We report the case of a 61-year-old male who underwent surgery to remove calcifications four years after THA. Four months later the patient reported acute pain in the left hip, arising after a combined movement of external rotation and axial load while standing on the left foot, in the absence of any prodromic symptom. On radiographs, a displaced fracture of the neck of the hip prosthesis was revealed, together with massive heterotopic ossifications. After THA revision the patient's symptoms were resolved. Prosthetic femoral neck fractures are a rare complication. We suggest that this case represents a unique type of fatigue rupture, where neck length and the presence of massive heterotopic calcifications contributed to flexion forces, resulting in failure in the midpoint of the neck.

Clinical Application of Microscope-Assisted Minimally Invasive Anterior Lumbar Interbody Fusion

This study aims to investigate the technical aspects of microscope-assisted anterior decompression fusion and to introduce a spreader system suitable for minimally invasive anterior lumbar interbody fusion (Mini-ALIF). This article is a technical description of anterior lumbar spine surgery under a microscope. We retrospectively collected information on patients who underwent microscope-assisted Mini-ALIF surgery at our hospital between July 2020 and August 2022. A repeated-measures ANOVA was used to compare imaging indicators between periods. Forty-two patients were included in the study. The mean volume of intraoperative bleeding was 180 mL, and the mean operative time was 143 min. The mean follow-up time was 18 months. Apart from one case of peritoneal rupture, no other serious complications occurred. The postoperative foramen and disc height were both higher on average than before surgery. The spreader-assisted micro-Mini-ALIF is simple and easy to use. It can provide good intraoperative disc exposure, good discrimination of important structures, adequate spreading of the intervertebral space, and the restoration of the necessary intervertebral height, which is very helpful for less experienced surgeons.

Spontaneous rupture of an unscarred uterus during pregnancy: A rare but life-threatening emergency: Case series.

In most cases, uterine rupture occurs during the third trimester of pregnancy or during labor. Even fewer reports have been published about the occurrence of this condition without a gynecologic history of any surgical procedure. Due to their scarcity and variable clinical presentation, early diagnosis of uterine rupture may be difficult, and if the diagnosis is not timely, the condition may be life-threatening. Herein, 3 cases of uterine rupture from a single institution are described. Three patients are at different gestational weeks and all have no history of uterine surgery. They came to the hospital due to acute abdominal pain, which is characterized by severe and persistent pain in the abdomen, with no apparent vaginal bleeding. All 3 patients were diagnosed with uterine rupture during the operation. One patient underwent uterine repair surgery; while the other 2 underwent subtotal hysterectomy due to persistent bleeding and pathological examination after surgery confirmed placenta implantation. The patients recovered well after the operation, and no discomfort occurred in the follow-up. Acute abdominal pain during pregnancy can pose both diagnostic and therapeutic challenges. It is important to consider the possibility of uterine rupture, even in cases where there is no history of prior uterine surgery. The key to the treatment of uterine rupture is to shorten the diagnosis time as much as possible, this potential complication should be carefully monitored for and promptly addressed to ensure the best possible outcomes for both the mother and the developing fetus.

A Bilateral Quadricipital Tendon Rupture in a Patient with Chronic Renal Failure

Bilateral quadricipital tendon rupture is a rare lesion, especially in patients with different chronic diseases. We report the case of a bilateral rupture of the quadricipital tendon in a young patient followed for chronic renal failure on hemodialysis for 17 years. Surgical repair was successfully performed using bone sutures and reinforcement by metal framing. We present our results with a literature review.

Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant.

Background and Objectives: With the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), it has become necessary to identify the implant shell type patients have received. Therefore, an immediate, reliable method for identifying a breast implant shell type is essential. Evidence-based research and applying a real-world technique that identifies the surface topographic information of the inserted breast implants, without surgery, has become of paramount importance for breast implant physicians. Methods and Materials: A review of the medical records of 1901 patients who received 3802 breast implants and subsequently received an ultrasound-assisted examination was performed. All patients received not only a breast cancer examination but also a high-resolution ultrasonography (HRUS) assisted examination of the device at a single center between 31 August 2017 and 31 December 2022. Results: Most patients had breast implants within 10 years (77.7%) of the examination. Of the 3802 implants screened, 2034 (53.5%) were identified with macro-textured shell topography in ultrasonography. A macrotextured shell type implant was used in 53.5% of cases and a smooth type in 42.7% of cases. Seventy-three (1.9%) breast implant shell types could not be identified due to ruptures. However, 250 breast implant shell types could be identified despite rupture cases (6.5%). Conclusions: HRUS was found to be a useful and reliable image modality for identifying various surface shell types of breast implants. The shell type information would be helpful to patients who lack information about their breast implants and are concerned about BIA-ALCL.

Diagnosis and Management of Uterine Rupture in the Third Trimester of Pregnancy: A Case Series and Literature Review.

Uterine rupture is associated with clinically significant uterine bleeding, fetal distress, expulsion or protrusion of the fetus, placenta or both into the abdominal cavity requiring prompt cesarean delivery and uterine repair or hysterectomy. Previous cesarean section is the most common risk factor. The most consistent early indicator of it is the onset of prolonged and profound fetal bradycardia. In this study, we present six cases of uterine rupture highlighting risk factors, and challenges in diagnosis and management, along with a review of the literature. A retrospective case series identified eight cases during the five-year study period.All cases from January 1, 2018 to December 31, 2022 were reviewed.Cases with multiple previous cesarean sections were excluded. Six cases meeting the study criteria were included in our case series.Uterine rupture was a rare occurrence with a prevalence of nine in 31,315 births representing 0.03% of deliveries.No maternal mortality or need for hysterectomy occurred in our study.Fifty percent of uterine ruptures were associated with stillbirths. The most common risk factor was a previous cesarean section in 83.3%. The most common presenting sign was non-reassuring fetal status patterns in 66.6%.A single case hada silent rupture. Signs and symptoms of uterine rupture are nonspecific making diagnosis challenging. Delay in definitive management causes significant fetal morbidity and mortality. For best outcomes, vaginal birth after a previous cesarean section needs close monitoring in appropriately prepared units with the ability to perform immediate cesarean delivery and provide advanced neonatal support.

Spontaneous Rupture of the Extensor Pollicis Longus Tendon: A Systematic Review.

Extensor pollicis longus (EPL) rupture and tenosynovitis of the third dorsal compartment is often described in association with a history of rheumatoid arthritis or in the setting of a distal radius fracture. However, the literature suggests multiple other potential factors that may lead to a seemingly spontaneous rupture. We performed a systematic review following guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search consisted of headings and keywords related to tendon injuries, tendinopathy, hand surgery, tendon transfer, and injections, as published in reports and studies. Citations were screened by title and abstract against predetermined inclusion and exclusion criteria by 2 independent reviewers, with a third reviewer resolving discrepancies. To be eligible, articles had to meet the following inclusion criterion: describe cases of spontaneous EPL rupture or tenosynovitis of the third dorsal compartment. The exclusion criterion was any history of distal radius fracture or rheumatoid arthritis. We identified 29 articles that met the inclusion criterion. A myriad of prodromal events or predisposing factors ultimately led to EPL rupture or tenosynovitis of the third compartment. Methods of reconstruction described included primary repair, tendon grafting, and tendon transfer techniques; all with generally good outcomes. These results highlight the inherent fragility of this tendon and support the historical recommendation for early release of the EPL tendon in the setting of tenosynovitis of the third dorsal compartment.

Rotura espontánea de vena ilíaca: una causa infrecuente de abdomen agudo hemorrágico

Spontaneous rupture of the iliac vein is a rare cause of fatal retroperitoneal hemorrhage that is generally associated with trauma and iatrogenic injury during lower abdominal or pelvic surgery. It usually occurs in the left common and external iliac veins. We report a fatal case of spontaneous rupture of the left external iliac vein to emphasize the clinical and imaging characteristics of this rare condition. Treatment is based on open surgical repair or endovascular stenting in selected cases. High level of suspicion is essential for early diagnosis and treatment to improve the associated morbidity and mortality.

Spontaneous liver rupture after uncomplicated delivery: medical case report.

In this article, the authors describe a case of spontaneous liver rupture occurring on the sixth day of an uncomplicated pregnancy in postpartum. According to the literature, liver rupture in the obstetrical setting is mostly linked to pre-eclampsia and HELLP syndrome. A collaborative multidisciplinary approach is required to define adequate medical and surgical management when there is suspicion of liver rupture in pregnant women.

Traumatic rupture of anterolateral papillary muscle in a patient with congenital deficiency of left hemi-pericardium: case report

Abstract Congenital absence or deficiency of the pericardium or hemi-pericardium is uncommon. When it happens, the protection given to the heart is greatly reduced, and blunt or penetrating trauma to the chest is transmitted directly to the heart. Valvular injuries from these traumas are however rare with a case of tricuspid valve rupture reported. Traumatic papillary muscle rupture in all patients group is also rare. Co-existing rupture of papillary muscle in patients with congenital absence of the pericardium is extremely rare. We report the rare case of a patient with deficient left hemi-pericardium who had a traumatic rupture of the anterolateral papillary muscle from a road traffic accident.

Trial of labor versus elective cesarean delivery for patients with two prior cesarean-sections: A retrospective propensity score analysis

IntroductionDespite awareness of obstetricians to the constant increase in the number of cesarean sections in recent years, the fear of a uterine scar rupture is still present and influences the choice of the mode of delivery in patients with two previous cesarean sections. However, several clinical studies have suggested that, under certain conditions, vaginal birth after two cesarean sections is usually successful and safe. ObjectiveThe objective of this study was to compare maternal and neonatal issues according to the planned mode of delivery in patients with two previous cesarean sections. MethodsIt was a retrospective observational comparative study at Rennes University Hospital between January 1, 2013, and December 31, 2020. We performed a propensity score for the comparison of neonatal outcomes: cord pH, cord lactates, Apgar scores, transfer to neonatal unit and deaths, according to the planned delivery mode. Secondary outcomes were maternal issues: uterine rupture, post-partum hemorrhage, deaths. ResultsA total of 410 patients with two previous cesarean section were eligible for our study. Prophylactic cesarean was performed in 358 cases (87.3%). Trial of labor was attempted in the 52 remaining patients (12.7%), 67.3 % of whom were successful. Neonatal weight, APGAR score at 1–5–10 min, and pH on cord blood were comparable in both groups. One case of uterine rupture occurred in the trial of labor group. ConclusionTrial of labor seems to be a reasonable option for women with two previous cesarean sections in a selected population.

Comparison of Misoprostol and Evening Primrose Oil on Cervical Preparation Before Gynecological Surgery.

This study aimed to evaluate the efficacy and safety of evening primrose oil (EPO) for cervical ripening before gynecologic procedures and compare it to misoprostol. In this study, 40 hysteroscopy and dilation and curettage candidates were enrolled. Patients were randomly assigned to receive either 2000mg of vaginal EPO (n=20) or 200μg of vaginal misoprostol (n=20) 2hours before the expected procedure. The measured outcomes were the size of the Hegar dilator that passed through the cervix effortlessly, uterine cervicovaginal complications, and drug-related side effects. The two groups were not significantly different in age, number of gravity, parity, type of delivery, and menopausal status (P>.05). The mean±SD size of the first dilator was 5.25±1.55 in the misoprostol group and 7.30±1.08 in the EPO group (P<.001). The pain complaint in the EPO group was significantly lower (P=.027), but the two groups were not significantly different in terms of other complications. No cases of uterine or cervical rupture were seen in either group. The present study showed that 2000mg of vaginal EPO was significantly more effective for cervical ripening than 200μg of vaginal misoprostol before gynecological surgery. Therefore, it is recommended to use EPO as an alternative to misoprostol.

Quantifying the probability and uncertainty of multiple-structure rupture for Taiwan

This study identifies structure pairs with the potential for simultaneous rupture in a coseismic period and quantifies their rupture recurrence intervals. To assess the potential for a multiple-structure rupture, we calculated the probability of Coulomb stress triggering between seismogenic structures in Taiwan. We assumed that a multiple-structure rupture would occur if two structures could trigger each other by enhancing the plane with thresholds of a Coulomb stress increase and the distance between the structures and identified various sets of seismogenic structure pairs accordingly. We discussed the uncertainty of multiple-structure pair identification from various thresholds of stress change and structure distances, effective friction coefficient, and rotation of rake angles. To estimate the recurrence intervals for multiple-structure ruptures, we implemented a scaling law and the Gutenberg-Richter law in which the slip rate could be partitioned based on the magnitudes of the individual structure and multiple-structure ruptures. Considering that one structure may be involved in multiple cases of multiple-structure ruptures, we developed new formulas for slip partitioning in a complex fault system. By implementing the range of rupture area and slip rate of each structure, the magnitudes and recurrence intervals of multiple-structure ruptures could be estimated. We discussed the epistemic uncertainties of recurrence interval from deviations of slip rate and rupture area, various empirical formula of rupture parameters. The multiple-structure rupture with a larger characteristic magnitude would be crucial for the safety evaluation of infrastructures.

Cesarean scar niche, fertility and uterine rupture during labor – A retrospective study

ObjectivesTo determine how does a uterine niche diagnosed prior to conception, affects future fertility and obstetrical outcomes, in a group of patients with secondary infertility undergoing fertility treatments. Study designA retrospective case-control study was performed, recruiting patients after cesarean delivery, before fertility treatment. Using stored ultrasound photos and video loops, we determined niche's sonographic parameters during the preconception period and retrieved the fertility and obstetrical outcomes thereafter. Results104 patients met the inclusion criteria, and 86 were available for analysis. 56 (65%) had uterine niches larger than 2 mm in depth, and 30 (34%) had a uterine scar of 2 mm or less. Demographic characteristics were not different between groups. No statistically significant differences were observed regarding rates of implantation and clinical pregnancy between the groups. There were four cases of cesarean scar rupture during failed trial of labor (TOLAC), all of which were in the group with larger than 2 mm niche (33% of all TOLAC cases in the respected group). ConclusionsWhile it appears that pre-conception presence of uterine niches larger than 2 mm in depth does not adversely affect future fertility, these niches might serve as a risk factor for future uterine rupture during TOLAC.

Two cases of spontaneous rupture of the uterine artery in the perinatal period: A case report.

Uterine artery spontaneous rupture is a rare but potentially life-threatening complication during pregnancy and puerperium. The lack of typical symptoms makes it difficult to diagnose, which can result in serious consequences for both the mother and fetus. Case 1 presented with fainting and lower abdominal discomfort, while Case 2 developed hypotension after delivery and remained in poor condition even after rehydration. Both cases were diagnosed with uterine artery spontaneous rupture, with intraoperative findings revealing ruptures in different branches of the uterine artery. Both cases underwent surgical interventions, with laparoscopic surgery performed in Case 1 and repair of the ruptured artery in Case 2. Both cases had successful outcomes, with the ruptured arteries repaired and the patients discharged from the hospital within a week after surgery. Uterine artery spontaneous rupture is a rare but potentially life-threatening complication that may present with atypical symptoms. Early diagnosis and prompt surgical intervention are crucial in preventing serious complications for both the mother and fetus. Clinicians should maintain a high level of suspicion for this condition when evaluating patients presenting with unexplained symptoms or signs of peritoneal irritation during pregnancy and puerperium.

Posterior capsule dynamics during femtosecond laser lens fragmentation

PurposeThe dynamics of the posterior capsule during femtosecond laser lens fragmentation has received little attention in the literature. We analysed the movements of the posterior capsule to identify the rupture risk factors, if any, and to suggest possible modification of the laser spot energy pattern during fragmentation.Materials and methodsPosterior capsule ruptures during fragmentation were identified over a 10-year period of femtosecond laser use. In addition, the dynamics of the posterior capsule were identified through the real-time swept-source OCT lateral view available during the surgeries.ResultsOut of the 1465 laser cataract procedures performed, we recorded 1 case of posterior capsule rupture during lens fragmentation, which was caused by eye movement that was detected but ignored by the surgeon. Three types of posterior capsule dynamics were identified, all related to a gas bubble formation during the first part of the lens fragmentation. In eyes with a hard nucleus, the concussion of the posterior capsule was evident, however, with no capsule rupture.DiscussionMaintaining good docking throughout the whole procedure seems important in avoiding a posterior capsule cut by the femtosecond laser. In addition, a Gaussian pattern of spot energy is suggested when fragmenting hard cataracts.

A Rare Case of Post-Traumatic Partial Rupture of the Quadriceps Tendon

Traumatic ruptures of the quadriceps tendon are rare and usually occur after the age of 40, as a result of indirect trauma in athletes (contrary flexion of the knee) or minor trauma in sedentary individuals. Pre-existing tendinopathy is common. The rupture is most often complete and occurs at the body of the tendon in 60% of cases, or quadricipital avulsion at the upper edge of the patella (40% of cases). The diagnosis is primarily clinical, with complementary examinations (ultrasound and magnetic resonance imaging) playing a key role. Surgical treatment, combined with functional rehabilitation, produces better outcomes. The timing of intervention is a very important prognostic factor. We report a case of post-traumatic rupture of the quadriceps tendon in a 47-year-old patient.

Rupture of the Pectoralis Major: A Case Report

The rupture of the pectoralis major muscle is a rare entity. It occurs in young, healthy athletes during violent, eccentric contraction of the muscle with the arm held in an abducted and extended position, particularly in weightlifting. Diagnosis of pectoralis major tendon rupture can be made based on clinical examination but imaging plays a crucial role into confirming the diagnosis. Magnetic resonance imaging (MRI) is the most sensitive imaging modality for diagnosing, grading, evaluation and surgical planning of pectoralis major rupture. Early surgical treatment is associated with better outcome. We report a case of rupture of the pectoralis major in a 32-year-old man who presented a rupture of the pectoralis major after weight lifting.