Yi Yan

Objective To explore the suitability of conservative management for neonatal ovarian cysts in newborns. Methods A retrospective cohort study was conducted, involving infants diagnosed with neonatal abdominal/pelvic cysts at two separate medical institutions from January 2015 through July 2021. Data collection included clinical characteristics, imaging results, pathological findings, and postnatal outcomes. Statistical analyses were performed using the Student's t ‐test, Mann–Whitney U ‐test, and receiver operating characteristic (ROC) curve. Results In total, 34 cases of neonatal abdominal/pelvic cystic masses were detected, with mean birth weight of 3401 ± 515 g. Of these, 22 patients underwent postnatal cystectomy/oophorectomy. Pathological assessments revealed 16 uncomplicated cysts, 5 complex cysts, and 1 ovarian cyst with torsion complications. Notably, the cysts' dimensions at the time of surgical intervention had significantly decreased from the initial measurements ( p = 0.015). The ROC curve analysis presented an area under the curve of 0.642, indicating moderate accuracy in employing cyst size as a discriminative feature to differentiate complex from simple ovarian cysts. Additionally, a short‐term follow‐up of nonsurgical cases indicated a 100% resolution rate by 24 months of age ( n = 9). Conclusion Given their predominantly benign nature, the majority of neonatal ovarian cysts seem to be amenable to conservative management. This approach remains justified for larger cysts with minimal torsion risk, as well as considering the observed reduction in cyst size at birth, which further supports the case against surgical intervention.

Introduction: Acquired uterine arteriovenous malformation (uAVM) is a rare disease and could occur after dilation and curettage, cesarean section, or neoplastic processes. Patient concerns: A 29-year-old female presented with acute right lower abdominal pain and positive beta human chorionic gonadotropin (β-hCG). Diagnosis: A 6 cm ectopic right cornual pregnancy was found on ultrasound examination. Interventions: She underwent a laparoscopic resection of the cornual ectopic pregnancy. She returned with extensive vaginal bleeding 6-month post surgery, and eventually diagnosed with arteriovenous malformation at the previous surgical site by Color Dopplor endovaginal ultrasound. Percutaneous transcatheter uterine artery embolization (UAE) was attempted, however, vaginal bleeding continued. She was taken to the operation room for a hysteroscopic ablation of uAVM. Outcomes: Complete cessation of the bleeding was achieved without hysterectomy. Conclusion: We report an extremely unusual case of acquired uAVM after a wedge resection of cornual pregnancy. Ultrasound evaluation of patients with post-operative persistent bleeding should be considered for evaluation of a possible arteriovenous malformation.

Purpose. The goal of this study was to understand the impact of COVID-19 pandemic and associated lockdown measures on the volume, rate, and type of trauma presenting to the emergency department (ED) by using trauma-initiated CT studies to capture patient data. Materials and Methods. We performed a retrospective observational study comparing patients undergoing CT scans for trauma during the 1st and 2nd lockdown periods compared to corresponding prepandemic months. During two lockdown periods, public places such as restaurants, libraries, parks, and shops across the province were shut down. Government-led messaging advised that people should stay at home and practice social distancing. The rate of trauma-initiated CT scans and the proportion of different types of traumas were compared between time periods. Results. There was no significant difference in overall trauma-initiated CT scans between the prepandemic and pandemic levels. Motor vehicle collision (MVC) cases decreased from 18.2% to 15.6% during the first lockdown period ( p = 0.049) and also reduced from 29.1% to 25.2% during the second lockdown period ( p = 0.013). Trauma from falls increased from 19.1% to 27.5% ( p = 0.036) during the first lockdown, despite no significant change during the 2nd lockdown. Furthermore, the percentage of stab injuries increased from 25.0% to 38.9% while blunt trauma decreased from 68.5% to 54.3% during two lockdowns ( p = 0.015). Conclusion. The total number of trauma-initiated CT scans did not significantly decrease during the lockdown periods. Stabbings and falls increased during lockdown periods while MVCs and blunt trauma decreased.