1/14. Pelvic abscess in the second half of pregnancy after oocyte retrieval for in-vitro fertilization: case report.We describe a very late manifestation of pelvic abscesses after oocyte retrieval for in-vitro fertilization (IVF). In a twin pregnancy achieved after intracytoplasmic sperm injection, rupture of bilateral ovarian abscesses occurred at the end of the second trimester. An emergency laparotomy was necessary because of an acute abdomen. This complication led to severe maternal and neonatal morbidity, preterm birth and neonatal death. The rare occurrence of acute abdomen in pregnancy due to pelvic infection and the non-specific symptoms of a pelvic abscess after oocyte retrieval for IVF are discussed.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
2/14. Adnexal torsion presenting as an acute abdomen in a patient with bilateral cystic teratoma of the ovary.Benign cystic teratomas are the most common ovarian neoplasms in women. Teratomas are usually benign, unilateral, and most often found in young and premenopausal women. Most are 5 cm to 10 cm in diameter when diagnosed, and on sectioning, they usually contain thick sebaceous material, tangled hair, and various dermal structures. One of the major complications seen in cystic teratoma is torsion, a partial or complete twisting of the ovarian suspensary pedicle causing severe pain, nausea, and tissue necrosis. The patient described had bilateral cystic teratomas, one uncommonly large and torsed, causing an acute abdomen. Discussion includes the diagnosis, operative management, and postoperative findings.- - - - - - - - - - ranking = 2.5keywords = abdomen (Clic here for more details about this article) |
3/14. Actinomycotic tubo-ovarian abscess mimicking pelvic malignancy.A 39-year-old multipara was admitted to hospital with lower abdominal pain. She had used an intrauterine device (IUD) for 10 years. Three years ago, her tubes were ligated. Ultrasound examination revealed a 9.5 x 6 cm multiloculated cystic mass in the right part of her lower abdomen. CA-125 was also found to be increased. Since ovarian malignancy was suspected, laparotomy was performed. Pathologically, an actinomycotic tubo-ovarian abscess with sulfur granules was disclosed.- - - - - - - - - - ranking = 0.5keywords = abdomen (Clic here for more details about this article) |
4/14. Undescended ovary and unicornuate uterus: simplified diagnosis by the use of clomiphene citrate ovarian stimulation and magnetic resonance imaging (MRI).BACKGROUND: Although the association between unicornuate uterus and undescended ovaries is well established, little information is available on this entity, suggesting the possibility that many cases are not recognized at all. Consequently, important clinical information is missed in many patients worldwide. methods: During a period of 5 years, eight cases of unicornuate uterus were observed in our infertility clinic. The first three patients received magnetic resonance imaging (MRI) after mild clomiphene citrate (CC) stimulation due to a discrepancy between estradiol levels and follicular growth and because a suspected ectopic ovary could not be visualized on ultrasound. Based on this experience, five consecutive patients were offered MRI after CC stimulation as part of this study. RESULTS: In five out of eight patients with unicornuate uterus (62.5%) an undescended ovary could be visualized in the upper abdomen. Abdominal ultrasound revealed the ectopic ovary in only two cases. The use of CC stimulation undoubtedly facilitated the diagnosis of the undescended ovary on MRI. CONCLUSION: It is suggested that MRI after CC stimulation is an excellent non-invasive method to diagnose undescended ovaries in women with a unicornate uterus.- - - - - - - - - - ranking = 0.5keywords = abdomen (Clic here for more details about this article) |
5/14. Percutaneous catheter drainage of tubo-ovarian abscesses.We present the successful treatment of tubo-ovarian abscesses in three young patients by continuous percutaneous drainage, inserted under the guidance of real-time ultrasonography using only local anesthesia. Each patient had been diagnosed laparoscopically as suffering from acute pelvic inflammatory disease, but had formed abscesses despite extensive broad-spectrum antibiotic therapy. One case involved a complication of the ovum pick-up procedure; the woman had tubo-ovarian abscesses with infected hematomas. Because the abscesses were localized anteriorly in the lower abdomen and did not reach the pouch of Douglas, they could not be drained through a posterior colpotomy. Ultrasound guidance allowed us to drain all the areas of the multioculated abscesses. We suggest that percutaneous abscess drainage be the initial treatment of choice for tubo-ovarian abscesses before laparotomy is considered.- - - - - - - - - - ranking = 0.5keywords = abdomen (Clic here for more details about this article) |
6/14. Surgical cytoreduction and hormone therapy of an advanced endometrial stromal sarcoma of the ovary.BACKGROUND: Primary endometrial stromal sarcomas of the ovary are rare gynecologic malignancies. We report a disseminated case of this tumor arising from ovarian endometriosis. CASE: A 45-year-old woman presented with an abdominal pelvic mass and an elevated CA 125. Exploration showed extensive tumor spread from the ovaries to the upper abdomen. Surgery included a total hysterectomy, bilateral salpingo-oophorectomy, splenectomy, partial gastrectomy, partial pancreatectomy, transverse colectomy, appendectomy, and omentectomy. Final pathology showed a low-grade endometrial stromal sarcoma of the ovary arising from foci of endometriosis. megestrol acetate was initiated, and she is currently without evidence of disease. CONCLUSION: This is an advanced case of a primary low-grade endometrial stromal sarcoma of the ovary arising from endometriosis managed by total resection and progestational therapy.- - - - - - - - - - ranking = 0.5keywords = abdomen (Clic here for more details about this article) |
7/14. diagnosis of adnexal torsion in the third trimester of pregnancy: a case report.The diagnosis of adnexal torsion is difficult to establish on the basis of symptoms, physical findings, or radiologic techniques. If possible, in pregnancy the diagnostic workup should avoid any risk of drug administration, and the indication for a surgical intervention needs to be severe. Between 10% and 20% of ovarian torsions are associated with pregnancy, but adnexal torsion in the third trimester is rare. We present the case of a 22-year-old female presenting with a sudden onset of severe right lower quadrant abdominal pain associated with nausea and vomiting. The presumptive diagnosis was appendicitis. Transvaginal sonography showed some free fluid in the pouch of Douglas, but could not define the accurate diagnosis. In transabdominal ultrasound, a predominantly hyperechogenic mass containing small cysts was found in the right lower abdomen. No blood flow within the mass was detected with color and power Doppler sonography. With ultrasound, the anatomic relation of the mass could not be precisely identified. magnetic resonance imaging clearly delineated the mass, which was due to enlargement of the right ovary, with predominately hyperintense signal containing small areas with hypointense lesions in T2-weighted images, a potential sign of hemorrhagic infarction. The mesovarium was hyperintense in T2-weighted images and also enlarged. The left ovary seemed to be normal. Due to the displacement of the ovaries in the second and third trimesters, the diagnostic workup is very largely restricted when using transvaginal ultrasound. Especially in pregnancy, it is mandatory to obtain a reliable diagnosis to reduce any risk to the fetus. Our case report indicates that the combination of magnetic resonance imaging and Doppler sonography fulfills these requirements and allows for accurate and fast diagnosis of adnexal torsion.- - - - - - - - - - ranking = 0.5keywords = abdomen (Clic here for more details about this article) |
8/14. A case of ovarian sarcoidosis mimicking malignancy.We present a case of systemic sarcoidosis with ovarian and peritoneal involvement. The atypical clinical presentation of the disease has lead to a problem of the differential diagnosis with ovarian cancer. A 72-year-old female was admitted because of low grade fever, fatigue and dilatation of the abdomen. Clinical and laboratory evaluation of the patient revealed moderate right pleural effusion, ascites, diffuse ovarian infiltration, presence of enlarged intraabdominal lymph nodes and a substantially high value of serum CA 125. Histological examination after laparotomy was indicative of ovarian sarcoidosis.- - - - - - - - - - ranking = 0.5keywords = abdomen (Clic here for more details about this article) |
9/14. Tubo-ovarian abscess caused by streptococcus pneumoniae.A 46-year-old black woman underwent exploratory surgery for evaluation of a tender mass in her abdomen. During the exploratory surgery bilateral tubo-ovarian abscesses ruptured. Specimens from both tubes and from the wall of the abscesses contained bacteria seen on the Brown-Hopps tissue gram stain. The bacteria were gram-positive, lancet-shaped diplococci characteristic of streptococcus pneumoniae. Immunoperoxidase stains confirmed the identification of the organism as S pneumoniae.- - - - - - - - - - ranking = 0.5keywords = abdomen (Clic here for more details about this article) |
10/14. Simultaneous occurrence of ovarian torsion and gangrenous strangulation through a congenital opening in the mesosalpinx.A case of simultaneous occurrence of ovarian torsion and gangrenous strangulation through a congenital opening in the mesosalpinx is presented. This case closely resembles that of intestinal strangulation through a mesosalpingeal defect, which is also very rare. 1) The condition was recognized at laparotomy performed for symptoms and signs of "an acute abdomen"; 2) the patient was a pregnant woman; 3) the final outcome was good after prompt surgical intervention.- - - - - - - - - - ranking = 0.5keywords = abdomen (Clic here for more details about this article) |
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