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Vesicouterine Fistula – a Rare Delayed Complication of Cesarean Section S Akter Et Al Complications, Likeanaemia

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Vesicouterine Fistula – a Rare Delayed Complication of Cesarean Section S Akter Et Al Complications, Likeanaemia On the basis of history, clinical examinations and it was soon found that labile factor and factor V were laboratory investigations- a diagnosis of Parahaemophilia one and same factor.1,3 was made. Patient was treated with FFP and The coagulation factors that function as enzymatically haematinics. Two weeks later, follow up physical active serine protease activators, factor VIII and examination and investigations showed disappearance factor V, are cofactors in the coagulation cascade. of ecchymosis, stoppage of per rectal bleeding and epistaxis with factor v level increasing up to 20% of Activated factor V is a cofactor in the conversion of normal range. She completely recovered after 04 prothrombin to thrombin by factor Xa in an action weeks having factor V level 30% and has been that are phospholipid and calcium dependent. The followed up at the out patient department. Family activator complex formed by factor Xa, activated screening of other family membersrevealed no factor V, phospholipid and calcium was called the coagulation abnormality. Due to non-availability, prothrombinase complex. Activation of factor V by mutation study was not performed. thrombin is achieved through a series of proteolytic cleavages. Activated factor V was inactivated by Discussion: activated protein C in a surface dependent reaction In 1943, Owren described a female patient who had a that requires calcium ion and protein S.9 bleeding diathesis attributable to the lack of single blood clotting factor, namely factor V or labile factor. Our patient presented with history and features which Owren designated the disease “parahemophilia,” to overlapped with the features of Haemophilia B and emphasize the clinical similarity to hemophilia. At Von Willebrand Disease. These overlapping features that time, only four coagulation factors were posed a diagnostic dilemma. Parahaemophilia is a considered: fibrinogen, calcium, prothrombin, milder disorder than other congenital haemorrhagic thrombokinase. After owren reported parahemophilia, disorder. Even though patient may develop Journal of Bangladesh College of Physicians and Surgeons Vol. 38, No. 4, October 2020 complications, likeanaemia. If not timely diagnosed; 2. Charles WB: Parahaemophilia (Congenital Factor V did not complain of dysuria or lower abdominal pain. bladder either during uterotomy or uterine closure. b) In our case the supratrigonal vesicouterine fistula was 10. jόzwik M jόzwik M. clinical classification of 20. Moon SG , kim SH, Lee HJ, Moon MH, Myung JS. difficulty communicating with her classmates. Failed Written consent was taken from patient’s guardian to Deficiency). Can Med Assoc J. 1965; 92:979-981. it would have been fatal. She also did not give any history of urinary Inadequate downward mobilization of bladder or repaired through intraperitonial approach. In bladder, vesicouterine fistula. Int j gynecol Obst. 2000;70:353-7. Pelvic fistulas complicating pelvic surgery or diseases: eruption of her permanent teeth was the reason that publish her disease features and photographs. https://doi.org/10.1016/S0020-7292(00)00247-2 Factor V is labile coagulation factor which appears to 3. Gilbert C, White II. Coagulation factors V and VIII incontinence. Then she was given progesterone to direct injury to that portion of the bladder which spectrum of imaging findings. Korean J radiol the patient sought treatment. Her parents reported an Normal function and clinical disorder. In: Robert IH, fistula opening was closed in two layers after be necessary both for the production of fully potent Vesicouterine fistula – a rare delayed complication of stop menstruation for 2 months. At that time there sometimes adherent to the anterior vaginal wall or 11. Porcaro AB, Zicari M, Zecchini Antniolli S, Pianon R, (2001)2:97-104. https://doi.org/10.3348/kjr.2001.2.2.97, unremarkable medical history. She was in good Samuel EL, Thomas PS, eds. Blood, Principles & mobilization of uterine wall from bladder by intrinsic thromboplastin and for the rapid conversion lower segment wall5 , c) aberrant sutures placed so Monaco C, Migliorini F, et al. Vesicouterine fistulas PMid:11752977 PMCid:PMC2718108 health with no medications and no known allergies. practice of Hematology. 1995;1151-1179. cesarean section was no per vaginal bleeding or passage of bloody dissection and uterine opening was repaired in single following cesarean section: report on a case, review and of prothrombin to thrombin in the presence of tissue that a knuckle of bladder is caught in the sutures5. 21. Ali-El-Dein, El- Tabey N, El- Hefnawy A, Osman Y, She had no history of trauma to the mouth, teeth, or 4. Ruth AS: Parahemophilia. Medical Clinics of North urine. USG showed normal uterine and ovarian layer suture. There was no menouria after repair and update of the literature. Int urol Nephrol (2002) thromboplastin. Thus, the patients with Factor V S AKTERa, K BEGUMb, J SAHAc Repeated Cesarean sections may result in progressive Soliman S, Shaaban AA, Diagnosis , treatment and need jaws. America 1972;56:119-125. https://doi.org/10.1016/ S0025- structure, no stone in urinary bladder. Urine routine menses was commenced normally. 34:335-44. https://doi.org/10.1023/A:1024443822378, deficiency manifest impaired thromboplastin PMid:12899224 for hysterectomy in management of post cesarean section 7125(16)32427-0 microscopic examination revealed normal. devitalization and scarring of the uterus and bladder A general physical examination revealed a short- generation and prolongation of prothrombin time.10 base by damaging their vascular network, thus After correction of VUF, successful pregnancy vesico uterine fistula. Scand J Urol (2014) 48:460-5., 5. Miletich JP, Majerus DW, Majerus PW. Patients with Abstract: section. Diagnosis was confirmed by cystoscopy and 12. B.K. Park, S. H. Kim, J.Y. Cho, J.S.Sim and C.K. Seong, statured, well-oriented young girl with narrow, AFB was not found in endometrial tissue. Then predisposing to delayed fistula formation11. But to "Vesicouterine fistula after cesarean section: https://doi.org/10.3109/21681805.2014.903511, Diagnosis is based on prolonged prothrombin (PT) congenital factor V deficiency have decreased factor Xa A vesicouterine fistula is an abnormal pathway outcome was also reported. drooped shoulders (Figure-1). Further examination fistula was repaired through trans abdominal ultrasonographic findings in two cases," Journal of PMid:24694181 and activated partial thromboplastin times (APTT) binding sites on their platelets. J Clinic invest cystoscopic evaluation was done . Trigone was develop vesicouterine fistula after 8 years of LUCS showed an abnormal facility in opposing her 1978;62:824-831. https://doi.org/10.1172/JCI109194, between the urinary bladder and the uterus. It is a surgery. She regained normal vaginal menses 4 Conclusion: Ultrasound in Medicine, vol.18, no. 6, pp. 441443,1999. normal . There was a small opening about 1 mm in is most unlikely and rare. Her endometrial tissue and 22. Tancer ML. Observation on prevention and management shoulders (Figure 2) due to malformed or absent and on low plasma Factor V levels.Bleeding time PMid:701480; PMCid:PMC371834 rare urogynaecological fistula. In vesicouterine months after surgery. Vesicouterine fistula is a rare variety of genitourinary https://doi.org/10.7863/jum.1999.18.6.441, 11 fistula margin was send for histopathology but no of vesicovaginal fistula after total hysterectomy. Surg (BT) can be prolonged in severe cases. fistula, clinical presentations are cyclic haematuria supratrigone region of bladder. No feature of PMid:10361852 clavicles, which was later confirmed with a small 6. Moret A: Next generation sequencing in bleeding Keywords: vesicouterine fistula, delayed complication, granulomatous lesion was found. AFB stain was also fistula. Previously it was occurred after complicated Gynecol Obstet (1992) 175:501-6. Figure 3: X-ray Chest P/A view shows malformed Differential diagnoses include vWD, Haemophilia disorders: two novel variants in the F5 gene (Valencia-1 (menouria), amenorrhoea, urinary continence which granuloma was found. 13. Hadzi- Djokic JB, Pejcic TP, Colovic VC. Vesico-uterine malformed clavicle in chest radiograph (Figure 3). Youssef’s syndrome, cystoscopy. negative. vaginal delivery. Due to increasing trend of lower small clavicle. (homozygous type), inhibitors to coagulation factor, and Valencia-2) associated with mild factor V deficiency. mimics Youssef’s syndrome. This case presents, a fistula: Report of 14 cases. BJU int 2007;100:1361-3. 23. P. Narayanan, M. Nobbenhuis, K. M. Reynolds, A. Facial examination showed a brachycephalic head Methylene blue dye was pushed through cervix and it segment cesarean section, incidence of VUF also Sahdeb, R. H. Reznek, and A.G. Rockall, " fistulous in and very rarely combined deficiency of factor V and J Thromb Thrombolysis 2019 Nov;48(4). https://doi.org/ 37 year old multiparous woman with vesicouterine (J Bangladesh Coll Phys Surg 2020; 38: 209-212) If the diagnosis of VUF is early and the fistula https://doi.org/10.1111/j.1464-410X.2007.07067.x, with frontal and parietal bossing, hypoplasticzygomatic Figure 5: CBCT frontal view shows multiple 10.1007/s11239-019-01911-z, PMid:31267299 passed through the bladder opening. Then decision of rise. So surgeons should be more careful during PMid:17590179 malignant gynecologic disease; etiology, imaging and factor VIII. fistula which she developed 8 years after cesarean DOI: https://doi.org/10.3329/jbcps.v38i4.48984 presumed to be
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