RESUMO
BACKGROUND: McKusick Kaufman Syndrome (MKS), a rare genetic condition, presents in the neonatal period with a classic triad of postaxial polydactyly, congenital heart disease, and hydrometrocolpos. The diagnosis is typically clinical, based on the presence of polydactyly and hydrometrocolpos. CASE: We report the case of a 13-year-old female, who was diagnosed with MKS in infancy and underwent vaginal reconstructive surgery for a urogenital sinus. She was lost to follow-up thereafter. She presented to our institution at age 13 with pyometra, pyosalpinx, and tubo-ovarian abscess due to a stenotic cervix obstructing menstrual outflow. SUMMARY AND CONCLUSION: Gynecologic follow-up is imperative in patients with history of vaginal reconstruction to monitor for hematometra from outflow obstruction to prevent life threatening secondary bacterial infections.
Assuntos
Colo do Útero/patologia , Cardiopatias Congênitas/complicações , Hidrocolpos/complicações , Polidactilia/complicações , Puberdade , Doenças Uterinas/complicações , Anormalidades Múltiplas/cirurgia , Adolescente , Colo do Útero/cirurgia , Feminino , Cardiopatias Congênitas/cirurgia , Hematometra/etiologia , Hematometra/cirurgia , Humanos , Hidrocolpos/cirurgia , Polidactilia/cirurgia , Complicações Pós-Operatórias , Piometra/etiologia , Piometra/cirurgia , Tomografia Computadorizada por Raios X , Doenças Uterinas/cirurgiaRESUMO
OBJECTIVE: To describe bath salts and synthetic tetrahydrocannabinol (THC) exposures in the US from 2009 to 2012, hypothesizing a yearly increase. STUDY DESIGN: All exposures reported to American Association of Poison Control Centers between January 1, 2009, and April 30, 2012, were extracted from the National Poison Data System using generic and product codes. RESULTS: Bath salts and synthetic THC exposures totaled 7467 and 11,561, respectively. Bath salts exposures were 0 in 2009, 298 in 2010, and 6062 in 2011. Synthetic THC exposures were 14 in 2009, 2821 in 2010, and 6255 in 2011. First-tertile bath salts exposures were lower in 2012 (n = 1007) than in 2011 (n = 2027), and synthetic THC exposures were higher in 2012 (n = 2389) than in 2011 (n = 1888). Most exposures occurred in the midwest and southeast regions (64.8% of bath salts and 58% of synthetic THC exposures). Male subjects comprised 69% (n = 5153) of bath salts users and 74% (n = 8505) of synthetic THC users. Exposure to bath salts were highest in subjects 20-29 years of age (n = 2943), and exposure to synthetic THC was highest for subjects 13-19 years of age (n = 5349). Intentional abuse and inhalation were most common reason for and mode of exposure, respectively. CONCLUSIONS: Bath salts and synthetic THC abuse increased from 2009 to 2011. Synthetic THC emerged first and has more reported exposures than bath salts. In 2012, bath salts abuse declined and synthetic marijuana abuse increased. Young men intentionally abusing the drug via inhalation make up the majority of users.