Cases reported "Uterine Diseases"

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11/18. CT of vesicocorporeal fistula with menouria: a complication of uterine biopsy.

    Vesicouterine fistulas are a rare complication of obstetrical-gynecological interventions and are the least common of the acquired urogenital fistulas. They are almost solely associated with cesarean section. A case is reported in which a patient with adenomyosis and pelvic adhesions presented with menouria (vesical menstruation) after uterine biopsy. A vesicocorporeal fistula was demonstrated by cystography and CT and confirmed by cystoscopy and hysteroscopy.
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ranking = 1
keywords = gynecologic
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12/18. magnetic resonance imaging of intrauterine synechiae.

    magnetic resonance imaging (MRI) is a sensitive method to diagnose a variety of gynecologic conditions. Uterine anatomy may be accurately imaged with MRI providing a noninvasive method to assess both myometrial and endometrial architecture. MRI was used in 2 patients with amenorrhea and intrauterine synechiae to determine the possible role of this technique in assessing the endometrial cavity. MRI signal features in both patients provided an assessment of the endometrium complementary to the anatomy demonstrated on hysterosalpingography and suggested markedly different etiologies for similar clinical presentations. MRI may have a role supplementary to conventional studies in the evaluation of intrauterine synechiae.
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ranking = 1
keywords = gynecologic
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13/18. Gas embolism complicating obstetric or gynecologic procedures. case reports and review of the literature.

    Gas embolism is a rare life-threatening complication of obstetric or gynecologic procedures, arising as a result of gas bubbles being introduced into the circulation via severed blood vessels. Extensive brain damage and acute cardiovascular collapse will lead to a fatal outcome. A favourable outcome depends on early diagnosis and prompt treatment. hyperbaric oxygenation, which reduces bubble size and increases the supply of oxygen to hypoxic tissues, is the definitive treatment for gas embolism. We report four cases of gas embolism complicating obstetric or gynecologic procedures which were treated at the israel Naval Medical Institute followed by an updated review of the literature.
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ranking = 6
keywords = gynecologic
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14/18. Benign gynecologic conditions associated with a CA-125 level > 1,000 U/mL. A case report.

    BACKGROUND: CA-125 was initially investigated as a marker of ovarian cancer. However, various studies have noted that it can be minimally elevated in benign conditions. CASE: A case of CA-125 > 1,000 U/mL was associated with benign gynecologic conditions. A 37-year-old woman with a history of endometriosis and premature ovarian failure underwent hormonal therapy for donor in vitro fertilization. After an unsuccessful cycle, severe dysmenorrhea developed. Investigation revealed a CA-125 level of 1,036 U/mL and a uterine mass. On exploratory laparotomy, cystic adenomyosis and uterine endometriosis was found. After excision of these areas, the CA-125 levels returned to normal. In this case, cystic adenomyosis and endometriosis of the uterine serosa were responsible for the elevated CA-125 level. CONCLUSION: Very high levels of CA-125 are not always associated with a malignant process.
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ranking = 5
keywords = gynecologic
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15/18. Vascular complications of laparoscopic surgery.

    Laparoscopic surgery as an alternative to traditional laparotomies has become an important modality in the management of gynecologic diseases; however, it is not without potential risks. case reports describe numerous complications, including ureteral injuries, persistent ectopic pregnancies, hospital readmissions, unintended laparotomies to manage bowel or urinary tract injury, and hemorrhage. We retrospectively analyzed 195 women who underwent laparoscopic procedures to determine the frequency and severity of operative complications. Several procedures were often involved, including ablations of endometriosis and endometriomata, salpingo-oophorectomies, tubo-ovarian adhesiolyses, salpingo-salpingostomies, laser uterosacral nerve ablations, and laparoscopically assisted vaginal hysterectomies. Four major vascular complications were identified (2%), as well as one uterine perforation (0.5%) and two cases of subcutaneous emphysema (1%). There were no deaths. Three (1.5%) patients had an intraoperative laceration of the epigastric vessels during trocar placement, and one (0.5%) had a hematoma of the left common iliac vein that was self-contained. Management options included immediate laparotomy versus close observation with or without delayed laparotomy.
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ranking = 1
keywords = gynecologic
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16/18. giant cell arteritis of the uterus: case report and review.

    We here report a rare case of giant cell arteritis (GCA) of the myometrium found incidentally in a 68-year-old Caucasian woman presenting with uterovaginal prolapse and a known past history of temporal arteritis/polymyalgia rheumatica. histology revealed a segmental arteritis of small, medium and some quite large myometrial arteries with extensive destruction of both internal and external elastic laminae. Multinucleate giant cells, lymphocytes and histiocytes were most prominent in the inflammatory infiltrate. The findings in this case are compared with previous reports. In a review of the literature it was found that almost one third of cases presented with generalised symptoms such as fever, anemia, fatigue and weight loss. The symptoms were not immediately recognised as temporal arteritis or polymyalgia rheumatica. On routine physical examination or radiological investigation, benign gynecological pathology such as a simple ovarian cyst or uterine leiomyoma were found. The subsequent unexpected discovery of GCA on histological examination was the critical event in alerting clinicians to the diagnosis of temporal arteritis/polymyalgia rheumatica. Without exception steroid therapy was successful in achieving relief of generalised symptoms.
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ranking = 1
keywords = gynecologic
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17/18. Rare case of the utero-vesical fistula caused by intrauterine contraceptive device.

    The vesico-uterine fistula is a very rare disease. There have only been 150-200 causes. We are reporting on a case in which the chronic fistula was caused by an IUD having been placed 4 years ago and it "wandered" through the bladder. A 30 year-old patient in 1992 and IUD was inserted. She had gynecological controls twice, in 1993 last time. She has problem of urination very often. A cyclical bladder bleeding drew the attention to the disease. In ambulanterely performed cystoscopy we found an IUD perforating towards the interior of bladder in the borderline of its bottom and back wall and was situated in the bladder with its 3/4. We have removed it with forceps. After six weeks of expectation and strict observation did we want to manage the fistula after having consolidated the symptoms of the inflamed surroundings. During the operation we have noticed a wallment size mass of scar between the uterus and the bladder expanding to the height of the orifice of the uterus. The scarily fixed bladder has been separated from the cervix and the scarry wall of the fistula has been cut out. We have brained the cervix towards the vagina and then we've sutured the cervix and the bladder with Dexon 'O' treat, as well. We have interposed a surgical net between the cervix and the bladder followed by blood-clotting and peritonisation. We should take the follows into consideration: careful separation, fine operative technique, and strong well absorbing thread as well as trying to keep the organ. In our opinion the bioplast--interpositum used on our case maker the efficiency of the operation higher.
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ranking = 1
keywords = gynecologic
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18/18. Transarterial embolization of the uterine arteries: patient reactions and effects on uterine vasculature.

    BACKGROUND: Therapeutic embolization of the uterine arteries has been successfully used to manage profuse gynecological hemorrhage. In the present study we aimed to investigate whether embolization of uterine arteries may serve as a safe and effective alternative treatment in cases of menorrhagia in fertile and perimenopausal women. As a first step, we have evaluated the methodology, patient reactions and effects on the uterine vasculature. methods: The distal part of the uterine artery was embolized with polyvinyl alcohol particles via catheterization of the right femoral artery. Total abdominal hysterectomy was performed the next day. RESULTS: Bilateral embolization in two patients resulted in considerable pain that required morphine analgesic medication and epidural analgesia. One patient was embolized unilaterally and experienced only slight discomfort with no need for analgesic medication at all, indicating that unilateral embolization is a well-tolerated method. After embolization, angiography showed stagnant flow in embolized vessels without contrast filling of distal branches. angiography of the specimen showed normal vascular architecture in non-treated vessels. In treated vessels the main arterial trunks were patent but all smaller branches were occluded. histology showed that most of the particles lodged in small arteries and that arterioles never showed injected material. CONCLUSION: The study indicates that the procedure involves an efficient occlusion of uterine vessels and that unilateral embolization of uterine arteries is well tolerated.
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ranking = 1
keywords = gynecologic
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