1/6. Postpartum angiographic embolization for vulvovaginal hematoma. A report of two cases.BACKGROUND: Puerperal hematomas can become a life-threatening obstetric emergency. Their incidence is 1 or 2/1,000 deliveries. When mainstay methods of suture and packing fail, arterial embolization becomes an excellent alternative to definitive treatment, laparotomy. CASES: A 32-year-old woman, para 2-0-2-2, developed extreme rectal and vulvar pain one hour postpartum. A 12 x 10-cm vulvovaginal hematoma was identified, drained, sutured and packed. Bleeding continued, blood products were administered, and selective angiographic embolization of the pudendal and inferior gluteal arteries was successfully performed. A 31-year-old woman, para 1-0-1-1, developed a left vaginal hematoma immediately postpartum. She failed vaginal packing and underwent angiographic arterial embolization successfully. The patient was discharged on the fourth postpartum day. At six weeks postpartum, neither patient had evidence of hematoma formation. CONCLUSION: In the setting of a puerperal hematoma refractory to conventional first-line therapy, arterial embolization provides a rational, effective alternative for achieving hemostasis with minimal morbidity.- - - - - - - - - - ranking = 1keywords = vulvovaginal (Clic here for more details about this article) |
2/6. Ischemic fasciitis: an unusual vulvovaginal spindle cell lesion.Ischemic fasciitis is a benign reactive lesion that most commonly occurs in elderly, immobile patients in weight-bearing areas that are subject to intermittent ischemia with subsequent tissue breakdown and regenerative changes. The lesion can be clinically and pathologically mistaken for malignancy. Here we describe the first reported case of ischemic fasciitis of the vulvovaginal region in a 20-year-old paraplegic woman who presented with a clinically suspicious vulvar swelling. Histologic examination showed surface ulceration and underlying fibrinoid necrosis with surrounding reactive atypical fibroblast-like cells and small blood vessels, the characteristic histologic features of ischemic fasciitis.- - - - - - - - - - ranking = 1keywords = vulvovaginal (Clic here for more details about this article) |
3/6. Puerperal vulvovaginal hematoma: sonographic findings with MRI correlation.Puerperal hematomas are a major complication of delivery. Little information about the role of sonography in the management of puerperal hematomas is available in the English literature. We report a case of a vulvovaginal hematoma that developed subsequent to vaginal delivery and that was managed conservatively using sonography. Our report includes the sonographic follow-up of the lesion with MRI correlation. The present case report suggests that sonography has a role in the detection and follow-up of the condition, with MRI providing a more detailed mapping of the lesion and excluding any retroperitoneal involvement.- - - - - - - - - - ranking = 1keywords = vulvovaginal (Clic here for more details about this article) |
4/6. Severe vulvar scarring in patients with erosive lichen planus: a report of 4 cases.BACKGROUND: Oral lichen planus (LP) is thought to affect 1% of the population. It is an autoimmune inflammatory disease process with varied clinical manifestations. Glabrous skin scarring is rare, but that of mucosal membranes may be more common than recognized. It has been estimated that 25% of patients with oral lesions also harbor genital lesions. CASE: We report 4 cases of LP with genital involvement treated at various stages of development. Severe mucosal scarring occurred, and vulvovaginal scarring commonly resulted in significant dyspareunia. CONCLUSION: Early and aggressive diagnosis and therapy may abrogate the scarring potential of this debilitating disease process.- - - - - - - - - - ranking = 0.2keywords = vulvovaginal (Clic here for more details about this article) |
5/6. Primary management of postpartum vulvovaginal hematomas by angiographic embolization.Three cases of large postpartum vulvovaginal hematomas are reported. After conservative measures including incision and drainage, ligation of bleeding sites, vaginal packing and replacement of volume and coagulation factors failed to control the bleeding in each, pelvic angiography was performed. Brisk arterial bleeding demonstrated on arteriography was controlled by Gelfoam embolization in all three cases. Intra- or postpartum hematologic evaluation revealed a previously undiagnosed coagulation disorder in each patient. The authors suggest that angiography be considered before hypogastric artery ligation whenever possible in patients with large postpartum hematomas and that all such patients be evaluated for coagulopathy.- - - - - - - - - - ranking = 1keywords = vulvovaginal (Clic here for more details about this article) |
6/6. Combined allergy to human seminal plasma and latex: case report and review of the literature.The case is reported of a young atopic woman with combined Type I and possible Type IV allergy to human seminal plasma, as well as Type-I allergy to latex. Clinical symptoms were swelling and a burning sensation on the vulva and in the vulvovaginal area during or after coitus, followed by vesiculation, lichenification and the development of generalized eczema. diagnosis was confirmed by investigation (RAST, prick testing, histology). literature on the subject is reviewed.- - - - - - - - - - ranking = 0.2keywords = vulvovaginal (Clic here for more details about this article) |