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Abstract Hematospermia is a distressing disorder in sexually active men resulting in great concern to the patient. We report an unusual case of hematospermia with an atypical presentation, involving a 54-year-old man presented with acute urinary retention after sexual intercourse. Although the causes are widely known, arteriovenous malformation as the cause of this disorder has not much been reported in the literature. Transcatheter embolization of internal pudendal artery is a promising option for hematospermia caused by arterial fistula or bleeding.
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HematospermiaRESUMEN
Renal angiomyolipoma is a rare disease seen during pregnancy. Rupture of renal angiomyolipoma could be catastrophic and might result in maternal and even perinatal mortality. Management includes conservative vs surgical approach. A 29-year-old woman Para 2 with history of bleeding renal angiomyolipoma in her first pregnancy at 11 weeks treated with selective arterial embolisation. The pregnancy was terminated. Even though having small residual tumour, her subsequent pregnancy progressed well with conservative management. Intervention is advisable in the presence of large or symptomatic renal angiomyolipoma prior to pregnancy in order to minimise potential lifethreatening haemorrhage during pregnancy. For those with small tumour of less than 4cm, perhaps conservative approaches i.e. frequent follow-up and close monitoring would assist in early identification of any rupture or bleeding.
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NefrectomíaRESUMEN
Venous thromboembolism has a strong association with pelvic malignancy, whereby a failure in recognizing this event will lead to mortality. The best intervention depends on the individual basis with the availability of supporting service. We illustrate a case of gynaecological malignancy with concurrent deep vein thrombosis undergoing staging laparotomy and debulking surgery. Inferior vena cava filter was inserted after initial thrombolytic therapy and subsequently a long term treatment. Death from massive pulmonary embolism and major bleeding was prevented and synchronous primary ovarian and endometrial cancer prognosis was reassured in this case
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Vulvo-vaginal haematomas are not an uncommon obstetric complication. Despite advances in obstetric care, practice and technique, vulvo-vaginal haematomas do occur especially in complicated vaginal deliveries. Various management options are available for vulvo-vaginal haematomas. We describe three cases of vulvo-vaginal haematomas with different severity and presentations which were managed in different manners i.e. local haemostasis control, laparotomy with hysterectomy, and transarterial embolisation. The choice of treatment options would mainly depend on the clinical presentations, availability of expertise as well as facilities. Early identification is crucial.
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Patients with end-stage renal disease typically require catheter hemodialysis during the time required for fistula or graft maturation or after other methods of hemodialysis are exhausted. When patients requiring indwelling catheters develop central venous occlusions, unconventional routes to the central veins are used. Translumbar catheterization of inferior vena cava is considered as one of the options for central venous access. We highlight a case of Translumbar central venous tunelled catheterization performed under Computed Tomography (CT) guidance combined with fluroscopy in a 40-year-old lady with end-stage renal failure.
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Dermoid cyst in a kidney is rarely seen. We report a case of intrarenal dermoid cyst which mimics malignant renal tumour and discuss the dilemma in managing this disease.
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Parapharyngeal abscess is a serious medical condition that may lead to life-threatening complications. Its incidence has dramatically decreased since the advent of antibiotics. We report two cases of parapharyngeal abscesses in immunocompromised patients. We believe that early diagnosis, broad-spectrum antibiotics, surgery and pus drainage can prevent serious complications.