1/9. broad ligament twin pregnancy following in-vitro fertilization.We report the first case of an ectopic twin pregnancy in the broad ligament following in-vitro fertilization and embryo transfer in a patient with a previous ipsilateral (left) salpingo-oophorectomy. The previous surgery was for endometriosis. We discuss the possible contribution of the embryo transfer technique, limitations of preventive measures and importance of transvaginal ultrasound in establishing the diagnosis.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/9. endometriosis arising during estrogen and testosterone treatment 17 years after abdominal hysterectomy: a case report.OBJECTIVE: To report the possible association between the use of oestrogen replacement therapy and endometriosis in a postmenopausal woman. methods: We present a case of a postmenopausal, previously hysterectomised, woman who received hormonal replacement therapy and developed a large broad ligament cyst. Two years prior to her presentation she had been complaining of pelvic pain and deep dyspareunia. RESULTS: Pelvic ultrasound showed an adnexal cyst that was increasing in size. CA-125 was normal. laparoscopy revealed multiple endometriotic deposits and a broad ligament cyst. cystectomy and oophorectomy were done. histology confirmed a diagnosis of endometriosis including the broad ligament cyst. CONCLUSIONS: Hormonal replacement therapy can be associated with de novo endometriosis including at sites, which are unusual.- - - - - - - - - - ranking = 0.6keywords = ligament (Clic here for more details about this article) |
3/9. Two dermoid cysts developing in an accessory ovary and an eutopic ovary.Accessory ovary is a rare gynecologic condition, and tumors arising in accessory ovaries are extremely rare. Accessory ovary may result from separation of migrating ovaries during embryogenesis and injuries such as inflammation and operation on normal ovary. Congenital malformations, most frequently malformations of the genitourinary organ, are seen in connection with the accessory ovary. We experienced the first case of two dermoid cysts developing in an accessory ovary located in the left infundibulopelvic ligament and another in the eutopic ovary at the same side concurrently. Here, we present this extremely rare case with a review of the literature.- - - - - - - - - - ranking = 0.2keywords = ligament (Clic here for more details about this article) |
4/9. Tuboovarian abscess mimicking intraligamentar uterine myoma and a intrauterine device: a case report.A case study is presented of tubo-ovarian abscess (pathohystological-verified actinomycosis) in a 41-year-old woman with an intrauterine device (IUD), which on US was found to be imposed upon an intraligamentary degenerated myoma (pyomyoma). The patient was afebrile, with normal vital functions (diuresis, blood pressure and pulse). Exposure of the abdominal cavity by lower transverse laparotomy performed under general endotracheal anaesthesia revealed slight uterus enlargement with normal left adnexa, whereas right adnexa were not exposed due to the soft tumour in the region of the right ligamentum latum, which displaced the urinary bladder and uterus leftward. The peritoneum fold was incised and deprepared, revealing a tumorous formation imposed onto the myoma or onto the 'cold' tubo-ovarian abscess. Total hysterectomy was then performed. Left adnexa showed a normal finding. Hemalaun-eosin staining of the preparation of the tumour capsule and tumour content showed colonies of threads extending radially to the surrounding tissues (drusen), surrounded by pus corpuscles, polymorphonuclears and macrophages containing lipids (sulfur granules). The patient was free from disease relapse at 2 years after the procedure. Thus, total abdominal hysterectomy and salpingoophorectomy, along with antibiotic therapy, were the definite mode of treatment for pelvic actinomycosis.- - - - - - - - - - ranking = 1.2keywords = ligament (Clic here for more details about this article) |
5/9. Subsequent asynchronous torsion of normal adnexa in children.Children who have suffered from ovarian torsion may be at increased risk for a repetitive event. Torsion in a normal adnexa may be due to excessive mobility resulting from congenitally long supportive ligaments. Oophoropexy or shortening of the ligamentous support of the remaining functional ovary after torsion is recommended in attempt to prevent a subsequent torsion. The evaluation of young females with abdominal pain should always include the consideration of ovarian torsion. Preoperative ultrasonography is not invasive and could lead to earlier operative intervention resulting in salvage of ovarian tissue. observation in these same children may allow a torsed edematous ovary to convert to a nonviable necrotic tissue necessitating oophorectomy. laparoscopy is useful in cases in which the diagnosis is unclear.- - - - - - - - - - ranking = 0.4keywords = ligament (Clic here for more details about this article) |
6/9. Computed tomography of tuboovarian abscesses.The CT findings of tuboovarian abscesses are described in three consecutive patients who had both CT and surgery. Computed tomography showed fluid-density adnexal masses having visible walls, septations, and indistinct borders, with anterior displacement of the mesosalpinx, hydroureter, and increased density of the fat and ligaments anterior to the sacrum. These findings are not specific but suggest the diagnosis of tuboovarian abscesses in an appropriate clinical context.- - - - - - - - - - ranking = 0.2keywords = ligament (Clic here for more details about this article) |
7/9. Management of intermittent ovarian torsion by laparoscopic oophoropexy.BACKGROUND: Ovarian torsion is a serious gynecologic condition that often results in adnexal removal. If recurrent, this can result in castration of young patients. Torsion in the pediatric population is rare, but it presents more management challenges for gynecologists. There are few reports of prophylactic oophoropexy in patients with intermittent torsion. CASE: A patient with a history of left adnexal torsion was treated with salpingo-oophorectomy at age 10. She subsequently presented at age 12 with right lower quadrant pain, and was found to have a 7 x 6 cm right adnexal mass on ultrasound examination. She was diagnosed with ovarian edema secondary to intermittent torsion. At laparoscopy, she was found to have a 3-cm utero-ovarian ligament. She was treated with laparoscopic shortening of the utero-ovarian ligament, and has remained symptom-free for 1 year. CONCLUSION: We believe that this is the first reported case of laparoscopic triplication of the utero-ovarian ligament to prevent recurrent torsion. In young patients, this treatment may be a reasonable alternative to oophoropexy as prophylaxis for ovarian torsion.- - - - - - - - - - ranking = 0.6keywords = ligament (Clic here for more details about this article) |
8/9. intestinal obstruction and bilateral ureteral injuries after laparoscopic oophorectomy in a patient with severe endometriosis.The overall frequency of ureteral injury during laparoscopic adnexectomy for endometriosis is unknown, and intestinal obstruction after laparoscopy is rare. Our patient had two postoperative complications: small bowel obstruction and bilateral ureteral injuries discovered 2 and 39 days, respectively, after outpatient laparoscopic adhesiolysis and bilateral salpingo-oophorectomy for severe endometriosis. Pelvic examination and vaginal sonography revealed a large unilocular cystic mass. laparoscopy showed a fixed large endometrioma firmly attached to pelvic peritoneum and intestines in the pelvic cavity, and significant adhesions in the upper part of a midline incision from prior abdominal hysterectomy. These midabdominal adhesions were not released. The patient underwent laparoscopic bilateral adnexectomy as an outpatient. Two days later she was admitted with small bowel obstruction. Thirty-nine days later, diagnostic evaluation revealed urinary ascites with right ureteral stricture at the uterine artery level, and complete ligation and resection of the left ureter at the pelvic brim near the infundibulopelvic ligament stump. She underwent left ureteral implantation with psoas hitch and right ureterolysis. Follow-up cystogram and intravenous pyelography at 6 and 20 weeks revealed complete recovery. In cases of severe endometriosis with significant ureteral and intestinal involvement, laparotomy may have to be considered.- - - - - - - - - - ranking = 0.2keywords = ligament (Clic here for more details about this article) |
9/9. Oophoropexy to prevent sequential or recurrent torsion.Laparoscopic oophoropexy may prevent recurrent (repeat torsion of the same ovary) or sequential (subsequent torsion of the contralateral ovary) ovarian torsion. Two adolescent girls with sequential ovarian torsion underwent laparoscopic plication of utero-ovarian ligaments. Neither patient has had recurrence in the 6. 5 and 2 years, respectively, since surgery. Sequential ovarian torsion has been described,1-8 and in almost every instance the authors raised the question of whether or not oophoropexy should have been done at the time of the initial episode of torsion. In virtually every instance the second ovary was removed and the patient rendered menopausal. In two patients with sequential ovarian torsion the ovary was saved and oophoropexy performed laparoscopically in an effort to prevent recurrence.- - - - - - - - - - ranking = 0.2keywords = ligament (Clic here for more details about this article) |