SARS-CoV-2 can induce a hypercoagulable state, occasionally resulting in pulmonary venous thrombosis (PVT) due to inflammation and endothelial injury. Documented cases of PVT with active COVID-19 and post-COVID are rare. We report a 40-year-old postpartum female with unprovoked PVT following a recent nonhospitalized COVID-19 infection. She presented with cough, right pleuritic chest pain, and worsening dyspnea. Imaging confirmed right lower lobe PVT with ground glass infiltrates. Despite a negative hypercoagulable workup, the patient\'s postpartum and post-COVID status suggest an unprovoked PVT. Treated with a high-intensity heparin drip and transition to apixaban, she showed resolution of the thrombus. This case underscores the importance of considering COVID-19 as a potential risk factor for venous thromboembolism and highlights the need for vigilant monitoring in post-COVID-19 patients.

Hydatid disease, caused primarily by Echinococcus granulosus, is prevalent in regions where livestock farming is common. Although typically considered benign, ruptured hydatid cysts into the abdominal cavity present a rare but severe complication requiring urgent surgical intervention. We hydatid liver cyst, emphasizing the unprecedented nature of this occurrence, as it has never been reported in the literature before. The case underscores the role of computed tomography (CT) imaging in diagnosis and multidisciplinary management involving emergency physicians, radiologists, anesthetists, and surgeons. Key points highlighted include the rarity of postpartum hydatid cyst rupture, the diagnostic utility of CT scans, and the necessity of immediate surgical intervention. Surgical strategies include conservative techniques and intraoperative lavage with hypertonic saline solution to prevent recurrence. Postoperative albendazole therapy and regular follow-up aid in preventing recurrence and early detection of complications. This case underscores the importance of suspecting ruptured hydatid cysts in postpartum women with underlying hepatic hydatid cyst and features of peritonitis, necessitating prompt recognition and management of complications in hydatid disease.

UNASSIGNED: Recent changes to medical recommendations for exercise in pregnancy and postpartum have expanded to include recreational athletes. While women are transitioning into motherhood at the height of their athletic careers, there is limited guidance on musculoskeletal training from pregnancy through safe return to activity. The lack of education and support in this population may lead to increased prevalence of symptoms and delay of treatment, ultimately hindering athletic performance. The purpose of this case series is to assess pelvic floor symptoms through implementing a new pre- and postnatal exercise training paradigm in a group of women aiming to return to recreational athletics.
UNASSIGNED: Case series.
UNASSIGNED: Six recreationally athletic women between 25-35 years of age were referred to physical therapy during pregnancy to participate in this protocol. The women completed a standardized pregnancy and postpartum rehabilitation plan focused on core and pelvic floor control in addition to specific strength and mobility training.
UNASSIGNED: Pain, urinary dysfunction, and pelvic floor muscle strength were assessed at six weeks postpartum and at discharge. Meaningful improvement was noted in pain, urinary dysfunction, and muscle strength by the time of discharge.
UNASSIGNED: The decrease in symptoms and improvements in measures of musculoskeletal health suggests that a physical therapist guided rehabilitation protocol may be useful as part of the standard of care to reduce prevalence of pain and dysfunction, particularly in the recreational athlete population. Improving understanding of exercise training in this population may minimize musculoskeletal symptoms and encourage additional research to improve the standard of care for this group of patients.
UNASSIGNED: Level 4.

暂无摘要。

Background/Objectives: The infrequent occurrence of pyoderma gangrenosum (PG) during pregnancy and in postpartum, with its subsequent diagnostic intricacies, caused us to present the following case. Methods: This article describes a rare case of PG in postpartum in a patient without any prior pathology and a short review of the literature, aiming to identify similar rare instances. Results: We conducted a literature review to ascertain the prevalence of postpartum pyoderma gangrenosum, and we identified a total of 41 cases. Conclusions: Our article underlines again the importance of interdisciplinary collaboration for the prompt identification and commencement of necessary therapeutic interventions in postpartum women afflicted by pyoderma gangrenosum.

Primary psoas abscess is an uncommon yet critical factor contributing to postpartum sepsis. This report is of a case of postpartum primary psoas abscess in a 24-year-old Moroccan woman. After an uncomplicated vaginal delivery, a 24-year-old primiparous Moroccan woman presented to our hospital with a 3-week history of severe left-sided lower abdominal pain that radiated to the anterior aspect of the left thigh. She had been taking ciprofloxacin, metronidazole, and paracetamol for a week without any improvement. On examination, she was febrile and pale. The laboratory analysis revealed the presence of microcytic anemia, an elevated erythrocyte sedimentation rate, and an increased level of C-reactive protein. Computed tomography scans of the abdomen, and pelvis were conducted, revealing a substantial left psoas abscess. Under the guidance of computed tomography, anterior abdominal percutaneous drainage of the abscess was successfully performed. A pan-sensitive Streptococcus agalactiae strain was identified through culture of the specimen. The patient showed a favorable response to treatment with amoxicillin/clavulanate and gentamicin. This case illustrates that primary psoas abscess should be considered in cases of any postpartum infectious presentation.

Pregnancy-associated gastric cancer is extremely rare. In many cases, the cancer is already advanced at the time of diagnosis, and the prognosis is often poor. A 39-year-old primigravida, with dichorionic diamniotic twins, was admitted to our hospital for threatened preterm labor at 31 weeks of gestation. At 32 weeks of gestation, she developed a fever and tested positive for influenza A. She recovered from influenza A on the following day but had an emergency cesarean section for premature rupture of the membranes at 32 weeks of gestation. She was discharged on postpartum day six. Thereafter, she was again infected with influenza A. On day 18, she underwent an abdominal ultrasound revealing multiple mass lesions in the liver, because she had an uncomfortable upper gastric with persistent fever. She was referred to the internal medicine team, who made a diagnosis of stage IV gastric cancer. Importantly, non-specific symptoms and physical signs that are not explicable by the normal course of pregnancy may be recognized through conscientious history-taking and physical observations. If gastrointestinal symptoms are prolonged, or if symptoms such as severe weight loss, melena, a tender abdominal mass, or persistent and unexplained fever develop, an endoscopic assessment should be conducted to suspect other diseases. In addition, proactive ultrasound scanning, including the upper abdomen, may detect pregnancy-associated gastric cancer and lead to further in-depth investigations.

Hypophysitis is a rare pituitary gland disease primarily seen in females of reproductive age. Patients can present with various non-specific symptoms, which makes diagnosis challenging. Appropriate endocrine workup supplemented with magnetic resonance imaging (MRI) helps establish a diagnosis. We present a case of a 22-year-old postpartum female who came with nausea, vomiting, and abdominal pain. Global endocrine insufficiency was seen in the laboratory workup, and an MRI confirmed the diagnosis of hypophysitis. She was treated with steroid and thyroid hormone supplementation.

Septic pelvic thrombophlebitis (SPT) is a rare condition that forms thrombosis in the pelvic veins, typically the ovarian veins, with subsequent infection and inflammation. We present a case of right ovarian vein thrombosis (ROVT), methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and delayed onset of SPT symptoms, requiring tissue-plasminogen activator. A 40-year-old woman, G3P2, at 38 weeks\' gestation, was admitted with a fever of 39°C. She had cervical insufficiency and had been often on bed rest. Blood culture revealed MRSA and computed tomography revealed a large ROVT. She received vancomycin and direct oral anticoagulant, and her fever resolved by day 3. On day 16, fever recurred with severe pain over the ROVT. Second computed tomography showed thickening of venous wall with enhancement around ROVT, consistent with SPT. Since pain and fever gradually exacerbated despite treatment with DOAC and antimicrobials, she was started on heparin and tissue plasminogen activator on days 23 and 25, respectively. Along with recanalization on the thrombosis by day 29, fever and abdominal pain resolved. We experienced a case of delayed onset SPT associated with MRSA bacteremia and a large ROVT. MRSA bacteremia might cause the originally existing ROVT to become an infection source, resulting in SPT with recurrent symptoms and long-term treatment. Early and strict anticoagulation is crucial in cases with a large thrombosis and bacteremia, due to the high risk of progression to SPT. This case highlights the importance of recanalization for the treatment of SPT and usefulness of administration of tissue-plasminogen activator for the massive thrombosis.

Rectus sheath hematoma is a well-recognized, uncommon clinical entity and may not be the initial consideration when evaluating a postpartum patient with abdominal pain or mass. Here, we report three cases of postpartum rectus sheath hematomas (RSH) managed during the last three years. The mean age of the patient was 28 (25-30) years. All patients had a history of cesarean section and presented with pain and distension in the abdomen. The cesarean was performed eight days, one day, and three days in cases 1, 2, and 3, respectively, before presentation to the hospital. Two (Cases 1 and 3) of the three patients received conservative care and were discharged in stable condition. One patient (Case 2) who was operated on for RSH and hemoperitoneum expired due to multiorgan dysfunction syndrome (MODS). Our case series suggests that, depending on the severity of the hematoma and the hemodynamic condition of the patient, RSHs may require medical intervention ranging from conservative management to surgical treatment. Early diagnosis and intervention help prevent hazardous complications and prevent maternal morbidity and mortality.