MyMedR

Pre-natal diagnosis of intra-abdominal pregnancy is difficult. Ultrasound has been the frontline modality to date; however, it gives a diagnostic error of 50-90% and its use is disappointing. In recent years, MRI has emerged as an appealing imaging modality. With its good soft tissue contrast and non-ionizing property, it acts as a means of definitive non-invasive assessment before surgical intervention when ultrasound is inconclusive.

Matched MeSH terms: Rupture, Spontaneous/diagnosis

Rare postpartum ruptured degenerated fibroid: a case report

Tan YL, Naidu A

J Obstet Gynaecol Res, 2014 May;40(5):1423-5.

PMID: 24689652 DOI: 10.1111/jog.12334

Spontaneous rupture of uterine fibroid is rarely encountered. We present a case of a 31-year-old who presented with acute abdominal pain at 9 weeks postpartum. On examination, the abdomen had diffuse tenderness, with rebound tenderness in the suprapubic area and in both iliac fossae. On ultrasonography, a 12.7 × 8.6 × 8.9-cm sized hyperechoic mass was visible on the posterior wall of the uterus. A large amount of fluid was visible in the paracolic gutters and the Pouch of Douglas (POD). The patient underwent an exploratory laparotomy. A ruptured, cystic degenerated uterine fibroid with active bleeding was found, as well as approximately half a liter of free, bloodstained peritoneal fluid and pus. Myomectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, preoperative diagnosis of a perforated, uterine fibroid with spontaneous intra-abdominal hemorrhage is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.

Matched MeSH terms: Rupture, Spontaneous

Rupture of the lateral ventricle secondary to a fourth ventricle tumour resulting in an indirect nontraumatic cerebrospinal fluid fistula

Tan SP, Abdullah BJ, Waran V, Liew WF

Neuroradiology, 2003 Jan;45(1):53-5.

PMID: 12525956

We present a rare indirect nontraumatic cerebrospinal fluid (CSF) fistula secondary to a fourth ventricle ependymoma. The fistula resulted from rupture of the left temporal horn, distant from the tumour. The fistula was well demonstrated by MRI. High-resolution CT demonstrated a defect in the roof of the sphenoid sinus, but no leakage of CSF was seen on CT cisternography.

Matched MeSH terms: Rupture, Spontaneous

Intraperitoneal haemorrhage from a ruptured corpus luteum. A cause of "acute abdomen" in women

Sivanesaratnam V, Singh A, Rachagan SP, Raman S

Med J Aust, 1986 Apr 14;144(8):411, 413-4.

PMID: 3959969

During the 10-year period 1974-1983, 68 patients with intraperitoneal haemorrhage as a result of the rupture of a corpus luteum were managed at the University Hospital, Kuala Lumpur, Malaysia. Most of the patients were aged between 18 and 35 years. In 63% of the patients the rupture occurred between the 14th and the 35th day of the menstrual cycle, and 10 patients had intraperitoneal bleeding severe enough (450-1500 mL) to require blood transfusion. The condition is often confused with other surgical emergencies such as appendicitis and ectopic pregnancy. An increased awareness of the problem in women of reproductive age and the use of laparoscopy, when indicated, will allow a more conservative approach to be adopted for those patients with minimal bleeding. The performance of an appendicectomy in the presence of blood in the peritoneal cavity did not appear to increase morbidity in those patients with a preoperative diagnosis of "appendicitis".

Matched MeSH terms: Rupture, Spontaneous

Spontaneous extravasation of contrast medium associated with acute renal colic

Singh J, Young WB

Med J Malaysia, 1974 Jun;28(4):244-7.

PMID: 4279004

Matched MeSH terms: Rupture, Spontaneous/etiology

Fulltext Infected and ruptured retroperitoneal teratoma

Shahizon AM, Mohd Zaki F, Julian MR, Hanafiah M

BMJ Case Rep, 2014;2014.

PMID: 24493108 DOI: 10.1136/bcr-2013-200862

Matched MeSH terms: Rupture, Spontaneous/complications; Rupture, Spontaneous/surgery

Fulltext Morbidly adherent placenta at extreme prematurity: can major haemorrhage and hysterectomy be prevented?

Shafiee, M.N., Rahana, A.R., Lim, P.S., Nor Azlin, M.I., Wan Faraliza, Z.A., Isa, M.R., et al.

Journal of Surgical Academia, 2011;1(1):56-60.

MyJurnal

Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage.

Matched MeSH terms: Rupture, Spontaneous

Fatal spontaneous rupture of splenic artery aneurysm in third trimester pregnancy

Samberkar PN, Chow TK, Samberkar SP

Malays J Pathol, 2018 Dec;40(3):337-341.

PMID: 30580366

INTRODUCTION: Unforeseen emergency in late pregnancy can be catastrophic and cause unexpected maternal and foetal demise. Moreover, lack of awareness and failure of prompt treatment raise mortality rate. Such fatalities warrant a forensic autopsy as it may raise redundant medico-legal concerns.

CASE REPORT: We report a case that revealed significant intra-abdominal haemorrhage at autopsy. The source of haemorrhage was at the spleen hilum and histology established rupture of splenic artery aneurysm. There was no associated obstetric cause found.

CONCLUSION: Knowledge of spontaneous rupture of splenic artery aneurysm in late pregnancy is essential for monitoring maternal and foetal, morbidity and mortality. However, in the eventuality of death a comprehensive forensic autopsy is the only investigation to recognise such calamity and clear clinical confusion.

Matched MeSH terms: Rupture, Spontaneous/pathology

Fulltext The deceiving encounter of a spontaneously ruptured urinary bladder

Salleh H, Azli S, Khairul-Asri MG, Jagwani A

Ann R Coll Surg Engl, 2022 Mar;104(3):e67-e69.

PMID: 34812665 DOI: 10.1308/rcsann.2021.0129

Spontaneous urinary bladder rupture is a rare condition. Radiotherapy treatment for malignancy of a pelvic organ such as cervix or prostate is one cause of this condition. We report a case of a 71-year-old woman who presented with this illness 30 years after radiotherapy treatment.

Matched MeSH terms: Rupture, Spontaneous

Intrahepatic biloma: an unusual complication of cholangiocarcinoma treated endoscopically

Ranjeev P, Goh KL, Rosmawati M, Tan YM

Gastrointest Endosc, 1999 Nov;50(5):711-3.

PMID: 10536338

Matched MeSH terms: Rupture, Spontaneous

Ruptured ectopic pregnancy presenting as an irreducible inguinal hernia

Prasannan S, Jabar MF, Gul YA

Acta Chir. Belg., 2004 Oct;104(5):591-2.

PMID: 15571031

An inguinal hernia that suddenly becomes irreducible may be secondary to a variety of other underlying conditions which can occasionally mislead the attending surgeon. Benign, inflammatory or neoplastic processes, as well as surgical emergencies such as intraperitoneal or retroperitoneal haemorrhage, have all been previously reported to mimic an inguinal hernia that suddenly becomes irreducible with or without clinical features of strangulation. We add an additional interesting presentation to this list in the form of a ruptured ectopic pregnancy, which is the first such case reported in the literature. A swelling in the groin may be much more complicated than it seems on superficial consideration and good clinical acumen is constantly required in managing such cases if a satisfactory outcome without any morbidity is to be expected.

Matched MeSH terms: Rupture, Spontaneous

Fulltext Spontaneous biceps tendon rupture in a patient with mixed connective tissue disease

Ong SG

Malays Fam Physician, 2013;8(3):31-3.

PMID: 25893055 MyJurnal

Tendon rupture is a rare complication that occurs in patients receiving corticosteroid therapy. We report a case of a middle-aged man with mixed connective tissue disease who presented with spontaneous biceps tendon rupture 5 weeks after initiation of high-dose corticosteroid therapy. Musculoskeletal ultrasonography was performed at the clinic and helped to confirm the diagnosis. It is a new imaging modality that is increasingly used in rheumatology clinics in Malaysia as it serves as an extension to physical examination. Musculoskeletal ultrasonography is preferred by patients as it is noninvasive, does not involve ionising radiation, painless, relatively inexpensive and can be performed readily at the clinic.
KEYWORDS: corticosteroid; musculoskeletal ultrasonography; tendon rupture

Matched MeSH terms: Rupture, Spontaneous

Fulltext Spontaneous Rupture in a Non-Laboring Uterus at 20 Weeks: A Case Report

Omar NS, Mat Jin N, Mohd Zahid AZ, Abdullah B

Am J Case Rep, 2020 Aug 10;21:e924894.

PMID: 32776917 DOI: 10.12659/AJCR.924894

BACKGROUND Uterine rupture is uncommon but when it happens, it can cause significant morbidity and mortality to both mother and fetus. Incidence reportedly is higher in scarred than in unscarred uteri. Most cases occur in laboring women in their third trimester with a previous history of uterine surgery, such as caesarean delivery or myomectomy. We present a case of spontaneous uterine rupture in a non-laboring uterus in the mid-trimester of pregnancy. CASE REPORT The patient presented with threatened miscarriage at 17 weeks' gestation and ultrasound findings were that raised suspicion of a morbidly adherent placenta. Her history was significant for two previous cesarean deliveries more than 5 years ago followed by two spontaneous complete miscarriages in the first trimester. The patient was managed conservatively until 20 weeks' gestation, when she presented with acute abdomen with hypotensive shock. Her hemoglobin dropped to a level such that she required blood transfusion. An emergency exploratory laparotomy was performed, which revealed a 5-cm rupture in the lower part of the anterior wall of the uterus, out of which there was extrusion of part of the placenta. Given the patient's massive bleeding, the decision was made to proceed with subtotal hysterectomy. Histopathology of the specimen confirmed the diagnosis of placenta percreta. CONCLUSIONS Identification of uterine scarring with morbidly adherent placenta is crucial because even in early pregnancy, it can lead to uterine rupture. Furthermore, failure to recognize and promptly manage uterine rupture may prove fatal.

Matched MeSH terms: Rupture, Spontaneous/etiology*; Rupture, Spontaneous/surgery

Fulltext Tarsal tunnel syndrome caused by ganglion

Ng WM, Chan KY

Med J Malaysia, 2004 Dec;59 Suppl F:69-71.

PMID: 15941169

We report a case of delayed diagnosis of tarsal tunnel syndrome caused by a ganglion arising from the talo-calcaneal joint. Unusually the symptoms were mainly due to the lateral planter nerve compression with a positive Tinel's sign. A surgical decompression was successful in relieving the dysaesthesia in spite of a 7 years history.

Matched MeSH terms: Rupture, Spontaneous

Giant cell myocarditis with cardiac tamponade: a rare combination

Murty OP

Am J Forensic Med Pathol, 2008 Sep;29(3):245-8.

PMID: 18725781 DOI: 10.1097/PAF.0b013e318183d55f

Giant cell myocarditis (GCM) is a rare but fatal disease of idiopathic origin. It results in focal necrosis of myocardium. This is a case report of middle aged Malaysian Indian female who died due to cardiac tamponade due to rupture myocardium and tear in the root of aorta. On naked eye examination, it simply resembled as recent as well as old fibrotic areas of myocardial infarction. She was clinically diagnosed as a case of obstructive cardiomyopathy with atrioventricular block, and was on pace maker. There was subendocardial fibrosis and left ventricular transmural infarction in the left ventricle. On histopathology, this was diagnosed as GCM, there were widespread areas of inflammatory cellular infiltration within the myocardium with multinucleated giant cells and granulomas interspersed with lymphocytes. Microscopic field showed up to 10 multinucleated giant cells. In this case, there were focal areas at multiple locations and caused uneven thickness in the left ventricle wall. Idiopathic GCM is very rare and causation of hemopericardium is the unique feature of this case. In this case the direct link of GCM with aortitis and rupture of left ventricle wall resulting in hemopericardium is shown. This case is documented through macroscopic as well as microscopic photographs in H&E, Ziel-Nelson, and GMS staining.

Matched MeSH terms: Rupture, Spontaneous

Percutaneous, non-operative radio frequency ablation for haemostasis of ruptured hepatocellular carcinoma

Manikam J, Mahadeva S, Goh KL, Abdullah BJ

Hepatogastroenterology, 2009 Jan-Feb;56(89):227-30.

PMID: 19453063

Spontaneous rupture and hemorrhage is a devastating complication of hepatocellular carcinoma (HCC). Results from current therapeutic modalities remain varied. Recent development of percutaneous radiofrequency ablation (RFA) in the management of this condition has shown promise. We describe 2 cases of ruptured HCC in which nonoperative, percutaneous radio frequency ablation (RFA) was successful in achieving hemostasis. The advantageous of RFA over other interventional techniques in the management of ruptured HCC are discussed.

Matched MeSH terms: Rupture, Spontaneous

Fulltext The bacteriology of perforated appendix

Lim VKE, Hussin Z, Abdul Wahab Y

Med J Malaysia, 1983 Dec;38(4):275-8.

PMID: 6599982

Perforated appendix is a serious surgical condition that carries a high morbidity. Antibiotic treatment is often started before the availability of bacteriological reports. The choice of antibiotics would depend on the bacteriology associated with perforated appendix. In a retrospective survey of the bacteriology of peritoneal pus obtained from cases of perforated appendix at the General Hospital, Kuala Lumpur, E. coli was found to be the most commonly encountered organism. This was followed in order of decreasing frequency by streptococci, Bacteroides species, Klebsiella-Enterobacter group and Pseudomonas aeruginosa. From the results of the antibiotic sensitivities an antibiotic regimen comprising of a combination of gentamicin, metronidazole and penicillin is recommended as appropriate chemotherapy in perforated appendix.

Matched MeSH terms: Rupture, Spontaneous

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