BACKGROUND Traumatic cloacal deformities are a result of major obstetric injury and usually happens after a fourth-degree perineal laceration.This is characterized by complete disruption of the perineal body,anterior ...BACKGROUND Traumatic cloacal deformities are a result of major obstetric injury and usually happens after a fourth-degree perineal laceration.This is characterized by complete disruption of the perineal body,anterior defect of the internal and external anal sphincter,and loss of the distal rectovaginal and/or anovaginal septum.The common chamber incorporating vagina and recto anal outlet ensues as cloaca.CASE SUMMARY We present a case of unmarried 15-year female,who developed hematometra and was diagnosed as cervical ostia obstruction at the age of 12 year.She underwent drainage of hematometra,and later some abdominal and perineal procedures elsewhere and subsequently developed fecal discharge from the vagina.Examination revealed absence of posterior wall of vagina and anterior wall of anorectum.In addition,the anterior half of the anal sphincter was also absent.She underwent vaginoplasty,anorectoplasty,sphincteroplasty with levatorplasty with creation of rectovaginal septum.CONCLUSION This case report highlights expert management of a case of mismanaged benign gynaecological condition in a young female that resulted in lifelong impairment of the patient's quality of life following hysterectomy and salpingo-oophorectomy,leading to the development of a common cloaca.展开更多
BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases.AIM To review the cases of medi...BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases.AIM To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic accident.METHODS A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were investigated.RESULTS A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, respectively.Likewise, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff verdict.CONCLUSION Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.展开更多
The authors regret that misuse of images occurred in when typeset-ting a large number of images due to unclear file management and similar image naming,as well as a misunderstanding of the transverse and longitudinal ...The authors regret that misuse of images occurred in when typeset-ting a large number of images due to unclear file management and similar image naming,as well as a misunderstanding of the transverse and longitudinal sections of the skin.The authors have thoroughly checked the original data and confirm that this error does not affect the overall experimental conclusions of the study.Images had been cor-rected in the updated Fig.7b.展开更多
文摘BACKGROUND Traumatic cloacal deformities are a result of major obstetric injury and usually happens after a fourth-degree perineal laceration.This is characterized by complete disruption of the perineal body,anterior defect of the internal and external anal sphincter,and loss of the distal rectovaginal and/or anovaginal septum.The common chamber incorporating vagina and recto anal outlet ensues as cloaca.CASE SUMMARY We present a case of unmarried 15-year female,who developed hematometra and was diagnosed as cervical ostia obstruction at the age of 12 year.She underwent drainage of hematometra,and later some abdominal and perineal procedures elsewhere and subsequently developed fecal discharge from the vagina.Examination revealed absence of posterior wall of vagina and anterior wall of anorectum.In addition,the anterior half of the anal sphincter was also absent.She underwent vaginoplasty,anorectoplasty,sphincteroplasty with levatorplasty with creation of rectovaginal septum.CONCLUSION This case report highlights expert management of a case of mismanaged benign gynaecological condition in a young female that resulted in lifelong impairment of the patient's quality of life following hysterectomy and salpingo-oophorectomy,leading to the development of a common cloaca.
基金the Clinical Research Development Center of Taleghani and Imam Ali Hospital, University of Medical Sciences, Kermanshah, IranShohada Tajrish Clinical Research Development Center at Shahid Beheshti University of Medical Sciences in Tehran, Iran, for their support。
文摘BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases.AIM To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic accident.METHODS A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were investigated.RESULTS A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, respectively.Likewise, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff verdict.CONCLUSION Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.
基金supported by the National Natural Science Foundation of China(32171369 and 82102113)2023 cross-research project on basal research fund in Central Universities(21623410)+1 种基金the Jinan University-Honest Medical Joint Innovation Center(HX20220013)the Pre-study on transdermal technology and product development(ZX20220244).
文摘The authors regret that misuse of images occurred in when typeset-ting a large number of images due to unclear file management and similar image naming,as well as a misunderstanding of the transverse and longitudinal sections of the skin.The authors have thoroughly checked the original data and confirm that this error does not affect the overall experimental conclusions of the study.Images had been cor-rected in the updated Fig.7b.
