{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T10:48:33Z","timestamp":1756464513246,"version":"3.40.4"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,11,21]]},"abstract":"<jats:p>Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35\u2009kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal\/epidural\u2009anaesthesia. Anticipated difficulty in securing a definitive airway was pivotal to choosing a regional anaesthetic technique. The operation was successful and the patient recovered well. This was a unique surgical and anaesthetic challenge due to abnormal facial, spinal and abdominal morphology compounded by the time-critical emergency nature of the case. Individually tailored perioperative management is frequently required for patients with rare syndromes.<\/jats:p>","DOI":"10.1136\/bcr-2017-221334","type":"journal-article","created":{"date-parts":[[2017,12,13]],"date-time":"2017-12-13T11:25:19Z","timestamp":1513164319000},"page":"bcr-2017-221334","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Emergency salpingectomy for ruptured ectopic pregnancy in patient with Melnick-Needles syndrome: a rare otopalatodigital syndrome"],"prefix":"10.1136","volume":"2017","author":[{"given":"Mark Zachary","family":"Johnson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cormac Francis","family":"Mullins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Declan","family":"Keane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid","family":"Browne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,12,13]]},"reference":[{"key":"2025042713144670000_2017.dec12_1.bcr-2017-221334.1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.2214\/ajr.97.1.39","article-title":"An undiagnosed bone dysplasia. A 2 family study of 4 generations and 3 generations","volume":"97","author":"Melnick","year":"1966","journal-title":"Am J Roentgenol Radium Ther Nucl Med"},{"key":"2025042713144670000_2017.dec12_1.bcr-2017-221334.2","first-page":"339","article-title":"Melnick-Needles syndrome (osteodysplasty). Clinical and radiological heterogeneity","volume":"41","author":"Dereymaeker","year":"1986","journal-title":"Helv Paediatr Acta"},{"key":"2025042713144670000_2017.dec12_1.bcr-2017-221334.3","unstructured":"Hennekam R . Gorlin\u2019s syndromes of the head and neck. 5th edn: Oxford University Press, 2010."},{"key":"2025042713144670000_2017.dec12_1.bcr-2017-221334.4","unstructured":"Robertson S . et al Otopalatodigital spectrum disorders. In: Bean LJH , Pagon RA , Adam MP , . eds. Gene Reviews. Seattle (WA): University of Washington, 1993."},{"key":"2025042713144670000_2017.dec12_1.bcr-2017-221334.5","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1002\/ajmg.a.33260","article-title":"Mutational analysis of two boys with the severe perinatally lethal Melnick-Needles syndrome","volume":"152A","author":"Santos","year":"2010","journal-title":"Am J Med Genet A"},{"key":"2025042713144670000_2017.dec12_1.bcr-2017-221334.6","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14189"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-221334","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T20:14:56Z","timestamp":1745784896000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-221334"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,13]]},"references-count":6,"alternative-id":["10.1136\/bcr-2017-221334"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-221334","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,12,13]]}}}