Cases reported "Genital Diseases, Female"

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11/19. retroperitoneal fibrosis: a two decade experience and gynecologic manifestations.

    A 20-year experience with idiopathic retroperitoneal fibrosis (RPF) is presented (6 cases). Its gynecologic manifestations with the simulation of pelvic malignancy is discussed. Three of the patients presented with pelvic masses, one of these a para-vaginal mass. In one patient, RPF followed or was concurrent with invasive squamous cell carcinoma of the cervix, of which this is the first reported case. The subject of RPF is reviewed with the modes of management and evidence for an autoimmune etiology. thrombocytopenia, a previously unreported finding with RPF, was noted in three of the six patients. The reversal of the A/G ratio in these patients is discussed, correlating this finding with the progression of azotemia.
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ranking = 1
keywords = gynecologic
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12/19. Recurrent anaphylactic reaction to intraperitoneal dextran 75 used for prevention of postsurgical adhesions.

    The use of intraperitoneal dextran at the conclusion of a gynecologic surgical procedure to prevent postoperative adhesions has increased recently. Although anaphylactic reaction to dextran administered intravenously is well documented, the authors report such a reaction after intraperitoneal administration. The delayed appearance and the continuation of the undesirable reaction until the intraperitoneal reservoir of dextran was removed by means of a culdocentesis are noteworthy. physicians should be alerted to this potential complication.
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ranking = 0.2
keywords = gynecologic
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13/19. Post-transfusion purpura as a gynecologic complication.

    Post-transfusion purpura (PTP) is a recently separated category of thrombocytopenic purpura occurring mainly in women. It is an acute, severe thrombocytopenic state with clinical manifestations of hemorrhage that may be fatal. It usually occurs 5 to 8 days after transfusion, usually after administration of whole blood. The typical patient is a middle-aged, multiparous white woman who has received a transfusion and has undergone an operation, often a gynecologic procedure. diagnosis may be suspected by normal clotting studies, bone marrow biopsy showing increased megakaryocytes, and demonstration of a potent antibody reactive against platelets by clot-retraction inhibition, complement fixation, or 51Cr-release studies. The treatment of choice is exchange transfusion or plasmapheresis, unless these procedures are medically contraindicated. Because of the lack of reports in the gynecology literature on PTP, a case report and discussion are presented.
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ranking = 1
keywords = gynecologic
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14/19. Drug induced myopia associated with treatment for gynecological problems.

    We present three cases of women who developed acute transient myopia caused by drugs for gynecological problems. One patient was treated with disothiazide for premenstrual edema. The second had acute cystitis and was treated by sulphonamide and the third developed myopia coincident with metronidazole treatment for trichomonas vaginalis. We followed these patients by A scan ultrasonographic ocular measurements, documenting reduction of the anterior chamber depth combined with lens thickening. The ocular and myopic changes cleared up completely on discontinuation of the causative agent. The possible mechanism is thought to be an allergic reaction to the drug.
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ranking = 1
keywords = gynecologic
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15/19. Regression of hepatic tumors during transdermal estradiol replacement therapy.

    A 39 year-old patient with long-standing diagnosis of pelvic endometriosis had been treated for over twenty years with oral contraceptives (OCs). A year prior to admission to the gynecological ward, an ultrasonographic examination revealed three hepatic lesions, which were not reported in previous liver sonography. These lesions progressed during OC use, over the next six months. liver function tests were normal. liver scan, CT and ultrasound imaging techniques supported the diagnosis of solid hepatic tumors. These lesions developed concomitantly to long-term use of OCs, therefore discontinuation of therapy was mandatory. Six months later, the patient was hospitalized due to pelvic pain. She underwent total abdominal hysterectomy and left salpingo-oophorectomy (the right adnexa had been removed years before). Due to the patient's young age, hormone replacement therapy was indicated. The preferred preparation was transdermal estradiol due to the fact that systemic absorption has no hepatic first-pass effect and therefore exerts minimal influence on liver enzymes and functions. Serial ultrasonographic examinations, performed while under treatment with transdermal estradiol, showed complete regression of the hepatic lesions over a period of two years. Our report demonstrates regression of multifocal hepatic tumors despite transdermal estradiol replacement therapy.
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ranking = 0.2
keywords = gynecologic
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16/19. Selective vascular embolization in benign gynecologic conditions.

    Eight patients with benign obstetric and gynecologic conditions required embolization. There was a total of 11 embolizations, and embolizing agents were chosen depending on the abnormality requiring embolization. Gelfoam, Ivalon and alcohol were used to treat vascular malformations. Ovarian veins were embolized with coils. Postoperative bleeding was managed with Gelfoam, coils and/or Ivalon. Four patients had bleeding after hysterectomy or vaginal suspension. One patient had postdelivery bleeding. All the bleeding was controlled after embolization. A uterine arteriovenous malformation was managed with embolization, allowing the patient to carry her next pregnancy to term. The symptoms of a vulvar hemangioma and ovarian syndrome were controlled with vascular embolization. morbidity was minimal. Embolization is the primary treatment of choice in obstetric and gynecologic patients with postoperative bleeding or symptomatic vascular malformation.
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ranking = 1.2
keywords = gynecologic
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17/19. The role of magnetic resonance imaging in problematic gynecologic diagnoses.

    MRI is a modality that provides excellent anatomic detail, especially of soft tissue and bone. Comparison of T1-weighted and T2-weighted images offers significant diagnostic information of pelvic pathology. In five problematic gynecologic cases, magnetic resonance imaging (MRI) provided key information for optimal treatment planning or a definitive diagnosis for the gynecologist.
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ranking = 1
keywords = gynecologic
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18/19. Necrotizing surgical infection and necrotizing fasciitis in obstetric and gynecologic patients.

    Necrotizing fasciitis (NF) is a rapidly progressive disease characterized by extensive necrosis of the skin, fascia, and subcutaneous tissue, with sparing of the underlying muscle. diabetes mellitus, Bartholin's gland abscess, and recent surgical procedures (including episiotomy) are factors often found in obstetric and gynecologic patients. mortality in this group of patients is higher than in the general surgical population. death is usually due to overwhelming sepsis, renal and respiratory failure, and multiple organ failure. The infections are usually polymicrobial, with alpha-hemolytic streptococci, gram-negative coliforms, and anaerobic bacteria. Lower survival has been reported in large series when the groin is involved or when the general nutritional state is poor. From October 1988 to August 1990, we treated five patients with necrotizing fasciitis. Certain important characteristics of such patients have not been discussed in the obstetric and gynecologic literature. nutritional status, with special emphasis on total protein, albumin, and the effects of alcoholism, has a significant impact on mortality. nutritional support of these patients may improve survival. To limit the impact of secondary infections, surgical approaches should be modified by the anatomic location of the initial lesions. More frequent debriding in the operating room and early fecal diversion are recommended.
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ranking = 1.2
keywords = gynecologic
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19/19. Deep obstetrical and gynecological infections caused by non-typeable Haemophilus influenzae.

    Six patients with deep obstetrical and gynecological infections due to non-typeable haemophilus influenzae are presented. 3 patients had tubo-ovarian abscesses, 2 septic abortions and 1 postpartum sepsis. All our patients with tubo-ovarian abscesses had used intra-uterine contraceptive devices until admission and all had a protracted course of illness. Both patients with septic abortion had a severe course, one of them with disseminated intravascular coagulation demanding treatment in the intensive care unit. The patient with postpartum infection had a milder course. The possibility of infection with H. influenzae and the emergence of beta-lactamase producing strains warrant adequate culture procedures in women with obstetrical and gynecological infections in order to ensure proper treatment.
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ranking = 1.2
keywords = gynecologic
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