1/5. uterine perforation resulting in bowel infarction: sharp traumatic bowel and mesenteric injury at the time of pregnancy termination.BACKGROUND: By law, elective terminations of pregnancy are not performed in U.S. military institutions. However, in the civilian sector, more than a million abortions are performed each year, some of which are on military beneficiaries. Although complications are relatively rare, patients not uncommonly present for follow-up care to their military installation. We report the case of a patient who presented after a second-trimester elective abortion and was found to have suffered uterine perforation with mesenteric and bowel injury that required bowel resection. CASE: An 18-year-old gravida 1 para 0 female presented from an outlying facility 1 week after elective termination at 18 weeks of gestation with complaints of severe abdominal pain, nausea, and vomiting. Exploratory laparotomy for presumed bowel obstruction revealed uterine perforation and bowel devitalization and necrosis, which required small bowel resection. Fetal bones were discovered within the surgical specimen. CONCLUSION: Morbid, even potentially fatal, complications can occur as a result of pregnancy termination. With second-trimester procedures, perforation can result in injury to abdominal viscera from the perforating instruments or even from sharp fetal bony structures. Military gynecologic surgeons, who are not in abortion practice, must nevertheless be cognizant of the potential for perforation leading to serious visceral injury.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
2/5. central nervous system involvement from malignant mixed Mullerian tumor (MMMT) of the uterus.The central nervous system is traditionally considered as an uncommon site for metastatic disease from the female genital tract, and cerebral metastasis as the primary manifestation of an occult gynecological malignancy is even more rare. Here, we report the case of a 61-year-old female who presented with neurological symptoms of confusion, headache, cerebellar ataxia and right-sided weakness. magnetic resonance imaging of the brain revealed two solid lesions in the frontal lobe and the left cerebellar hemisphere. Endometrial biopsy of a uterine mass detected during search for the primary lesion showed malignant mixed Mullerian tumor (MMMT). The patient refused surgery. Cranial radiotherapy for progressive cerebral disease led to resolution of her neurological symptoms. Two months after the diagnosis of MMMT the patient died from local complications of advanced pelvic disease. At autopsy, only the epithelial component of the tumor had metastasized to the brain. attention should be paid to possibility of unusual distant metastases associated to MMMT in order to avoid delay in diagnosis and treatment of these patients.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
3/5. Computed tomography features of spontaneously perforated pyometra: a case report.Spontaneous perforation of pyometra is an extremely rare emergent gynecologic disease. We report a 73-year-old woman with a spontaneously perforated pyometra presenting with acute abdomen in the emergency department. A dedicated computed tomography examination of the abdominal and pelvic regions revealed the diagnosis. The patient recovered well after surgical intervention and antibiotic treatment.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
4/5. pneumoperitoneum and an acute abdominal condition caused by spontaneous perforation of a pyometra in an elderly woman: a case report.pyometra, a collection of purulent material in the uterus, is an uncommon gynecologic entity. Spontaneous perforation of the uterus is an infrequent complication of pyometra, most often the result of malignant conditions in the uterus. We report the case of an elderly woman who had an acute abdominal condition and pneumoperitoneum due to a ruptured pyometra resulting from a degenerative and infected leiomyoma. Although uterine disease is a rare cause of an acute abdominal condition and pneumoperitoneum in the elderly, a perforated pyometra must be considered in the differential diagnosis.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
5/5. Pulmonary interstitial edema after probable carbon dioxide embolism during laparoscopy.carbon dioxide embolism is a well-known complication of laparoscopy that can be lethal. We describe a patient who showed signs of pulmonary interstitial edema revealing a probable gas embolism. This event occurred during a gynecologic laparoscopy performed for uterine perforation after a curettage.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |