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Sample records for bilateral uterine rupture

  1. Spontaneous uterine rupture

    African Journals Online (AJOL)

    ABSTRACT. Rupture of a gravid uterus is a surgical emergency. Predisposing factors include a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present the case of a spontaneous complete uterine rupture at a gestational age of 34 weeks in a 35 year old patient ...

  2. Uterine rupture at Lagos University Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Omololu Adegbola

    2017-01-01

    Full Text Available Background: Uterine rupture remains a major life-threatening obstetric disaster encountered in many developing countries and is associated with a high maternal and perinatal mortality and morbidity. Objectives: The objective of this study was to determine the incidence, associated risk factors, trend, clinical presentation, management as well as maternal and fetal outcome of uterine rupture at the Lagos University Teaching Hospital (LUTH, Lagos, Nigeria. Materials and Methods: This was a retrospective study of patients with uterine rupture at the LUTH, Idi-Araba, Lagos, Nigeria, from June 1, 2005 to May 31, 2013. The case records of patients in this period were retrieved from the medical health records department. The relevant data of sociodemographic characteristics, clinical presentation, management as well as maternal and perinatal outcome were collated using a structured questionnaire. Results: Of the 13,138 deliveries during the study period, there were eighty cases of uterine rupture giving a hospital incidence of 6.1/1000 deliveries. Patients with parities of 1 (28.36% and 2 (38.81% were identified to be at higher risk of uterine rupture. Previous caesarean section (46.28%, obstructed labor (26.87%, and injudicious use of oxytocin (16.42% were the common associated factors. Rupture along previous anterior scar was the most common site affected in 32.84%; repair with bilateral tubal ligation was the surgical procedure in most of the cases (47.76%. The case fatality rate for ruptured uterus was 11.94% for the mothers and the perinatal mortality rate of 791/1000 babies. Conclusion: Uterine rupture is a major cause of maternal and perinatal death in Lagos, Nigeria.

  3. Uterine rupture without previous caesarean delivery

    DEFF Research Database (Denmark)

    Thisted, Dorthe L. A.; H. Mortensen, Laust; Krebs, Lone

    2015-01-01

    OBJECTIVE: To determine incidence and patient characteristics of women with uterine rupture during singleton births at term without a previous caesarean delivery. STUDY DESIGN: Population based cohort study. Women with term singleton birth, no record of previous caesarean delivery and planned...... vaginal delivery (n=611,803) were identified in the Danish Medical Birth Registry (1997-2008). Medical records from women recorded with uterine rupture during labour were reviewed to ascertain events of complete uterine rupture. Relative Risk (RR) and adjusted Relative Risk Ratio (aRR) of complete uterine...... rupture with 95% confidence intervals (95% CI) were ascertained according to characteristics of the women and of the delivery. RESULTS: We identified 20 cases with complete uterine rupture. The incidence of complete uterine rupture among women without previous caesarean delivery was about 3...

  4. Simultaneous bilateral patellar tendon rupture ?

    OpenAIRE

    Moura, Diogo Lino; Marques, Jos? Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2016-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a s...

  5. Simultaneous bilateral patellar tendon rupture.

    Science.gov (United States)

    Moura, Diogo Lino; Marques, José Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2017-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  6. Simultaneous bilateral patellar tendon rupture

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    Diogo Lino Moura

    Full Text Available ABSTRACT Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  7. Uterine rupture at Lagos University Teaching Hospital

    OpenAIRE

    Omololu Adegbola; Adesumbo Kanyinsola Odeseye

    2017-01-01

    Background: Uterine rupture remains a major life-threatening obstetric disaster encountered in many developing countries and is associated with a high maternal and perinatal mortality and morbidity. Objectives: The objective of this study was to determine the incidence, associated risk factors, trend, clinical presentation, management as well as maternal and fetal outcome of uterine rupture at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Materials and Methods: This was a ret...

  8. [Uterine rupture in the third trimester after a hysteroscopic metroplasty].

    Science.gov (United States)

    Chokri, A; Chekib, M; Fethi, Z; Anis, F; Sadok, M

    2000-01-01

    Uterine rupture during a pregnancy may occur following hysteroscopic metropasty. We report the case of a patient with a history of hysteroscopic resection complicated by of uterine rupture during pregnancy.

  9. The significance of a uterine rupture in subsequent births.

    Science.gov (United States)

    Eshkoli, Tamar; Weintraub, Adi Yehuda; Baron, Joel; Sheiner, Eyal

    2015-10-01

    To determine whether women with a previous uterine rupture have a higher risk of adverse perinatal outcome in subsequent births. A retrospective study comparing all subsequent singleton cesarean deliveries (CD) of women with a previous uterine rupture, with CD of women with no such history, during the years 1988-2011 was conducted. Out of 34,601 singleton CD that occurred during the study period, 0.1 % (n = 46) were of women with a previous uterine rupture. Previous uterine rupture was significantly associated with preterm delivery (birth weight (<2500 g), cervical tears, and dehiscence of the uterine scar. Pregnancies following a previous uterine rupture were associated with lower Apgar scores at 5 min. However, the perinatal mortality rate did not differ between the two groups. A recurrent uterine rupture occurred in 15.2 % of patients with a previous uterine rupture. Previous uterine rupture is a risk factor for adverse maternal and perinatal outcome and specifically recurrent uterine rupture. Appropriate consultation regarding these risks is needed for patients with a previous uterine rupture.

  10. Uterine Rupture due to Traumatic Assisted Fundal Pressure

    Directory of Open Access Journals (Sweden)

    Shen-Chuan Wei

    2006-06-01

    Conclusion: Assisted fundal pressure during painful delivery can be traumatic and results in uterine rupture. In this article, we suggest that uterine rupture should be considered whenever a pregnant woman experiences a sudden onset of abdominal pain during the course of assisted uterine fundal pressure.

  11. Misdiagnosed uterine rupture of an advanced cornual pregnancy

    DEFF Research Database (Denmark)

    Sant, Christian Linus Hastrup; Andersen, Poul Erik

    2012-01-01

    Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination...

  12. Simultaneous bilateral patellar tendon rupture without

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    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  13. Bladder And Uterine Rupture At Vaginal Birth After Cesarean Section

    African Journals Online (AJOL)

    Rupture of the uterus is still a major obstetric problem in developing countries. The urinary bladder is often affected especially when a lower segment Caesarean scar ruptures. We present a case of bladder rupture associated with uterine rupture in a patient who was attempting vaginal delivery after two previous Caesarean ...

  14. Underreporting of complete uterine rupture and uterine dehiscence in women with previous cesarean section.

    Science.gov (United States)

    Fogelberg, Maria; Baranov, Anton; Herbst, Andreas; Vikhareva, Olga

    2017-09-01

    To determine the true incidence of complete uterine rupture and uterine dehiscence among women delivered by cesarean section after a previous cesarean section. Medical records of all women who delivered at University Hospital in Malmö, Sweden, during 2005-2009 (n = 21 420) were retrieved from the electronic patient record system (EPRS). After adjustment for inaccuracies, 716 women who had undergone repeat cesarean section were identified and their operation reports were reviewed. Descriptions of complete uterine rupture or uterine dehiscence in operation reports were compared with diagnoses registered in EPRS with International Classification of Diseases codes version 10 (ICD-10). Sensitivity and specificity of complete uterine rupture registration were calculated. There were 13 women with a registered diagnosis of uterine rupture. After reviewing medical records of women with repeat cesarean section, seven additional cases of complete uterine rupture, 33 cases of uterine dehiscence and 39 cases of extremely thin myometrium were identified. The incidence of complete uterine rupture and uterine dehiscence for women who delivered by repeat cesarean section was 2.8% and 10.1%, respectively. Diagnosis of complete uterine rupture was underreported in the EPRS by 35% and diagnosis of uterine dehiscence was missing in 100% of cases.

  15. Bilateral spontaneous rupture of 'hale' kidneys

    International Nuclear Information System (INIS)

    Naumov, N.; Zozikov, B.; Otzetov, A.; Kamenova, M.; Martinova, F.; Kalyonski, R.

    2002-01-01

    A rare case of spontaneous bilateral rupture of the kidneys, occurring consecutively over a one-year period in a young male patient with 'hale' kidneys until then, is described. The patient's past history and thorough examination performed do not justify to assign the case under the heading of some of the etiological factors as the underlying cause of spontaneous kidney rupture. The literature survey on spontaneous bilateral non-tumor ruptures of kidneys shows that over a 20-year period, only 3 cases of bilateral spontaneous ruptures have been reported. It is pointed out that panarteritis nodosa followed by hemorrhagic fever with renal syndrome is the commonest underlying cause of such ruptures. Clinically spontaneous ruptures become manifest with emergency condition presenting severe renal colic, impaired to serious general condition, often with acute abdomen and hemodynamic breakdown, and no past history evidence of renal disease or injury. In the initial phase diagnosing is not always easy; it is usually made on the ground of physical examination and the full range of imaging studies used in urological practice and during operative treatment. Emphasis is laid on the fact that the imaging methods are not invariably sufficient to identify the exact etiological factor giving rise to such a severe condition, but nevertheless these methods have an essential practical bearing on diagnosing a rupture. (authors)

  16. Posterior uterine rupture secondary to use of herbs leading to ...

    African Journals Online (AJOL)

    Uterine rupture is a potentially avoidable complication resulting in poor perinatal and maternal outcomes. This case had a number of unusual features including delivery of a healthy live baby; spontaneous posterior uterine rupture in a primigravida (and unscarred uterus); and delayed presentation with signs of peritonitis ...

  17. Spontaneous Uterine Rupture at Twenty Weeks of Pregnancy ...

    African Journals Online (AJOL)

    Uterine rupture is one of the most feared obstetric complications affecting the pregnant woman and fetus. It is an obstetric dilemma. Most of the cases have various risk factors and mainly occur during the third trimester. However, spontaneous uterine rupture during the first and second trimester are extremely rare.

  18. Misdiagnosed Uterine Rupture of an Advanced Cornual Pregnancy

    Directory of Open Access Journals (Sweden)

    Christian Linus Hastrup Sant

    2012-01-01

    Full Text Available Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability.

  19. Bilateral synchronous rupture of the quadriceps tendon.

    LENUS (Irish Health Repository)

    Ellanti, P

    2012-09-01

    Bilateral simultaneous rupture of the quadriceps tendon is a rare entity. They are often associated with degenerative changes of the tendons and predisposing conditions such as diabetes or excessive steroid use. They most commonly tend to occur in patients of 40 years of age or older.

  20. Delayed Uterine Rupture After Fetal Reduction in a Case of Cornual Heterotopic Pregnancy

    OpenAIRE

    Su, Mei-Tsz; Kuo, Pao-Lin; Hsu, Keng-Fu

    2005-01-01

    Objective: Assisted reproductive technology has contributed to the rising rate of multiple and ectopic pregnancies. We report a case of heterotopic cornual pregnancy with delayed uterine rupture despite successful fetal reduction. To our knowledge, this has not been previously reported. Case Report: A 32-year-old woman, gravida 2, para 0, had secondary infertility. She had undergone laparoscopic tuboplasty for bilateral tubal obstruction and laparoscopic bilateral salpingectomy for hydrosa...

  1. Risk factors and perinatal outcome of uterine rupture in a low-resource setting.

    Science.gov (United States)

    Igwegbe, Anthony Osita; Eleje, George Uchenna; Udegbunam, Onyebuchi Izuchukwu

    2013-11-01

    Uterine rupture has continued to be a catastrophic feature of obstetric practice especially in the low-resource settings. This study determined the incidence, predisposing factors, treatment options and feto-maternal outcome of ruptured uterus. A 10-year retrolective study of all cases of uterine ruptures that were managed in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria between 1st January, 2001 and 31st December, 2010 was undertaken. The proforma was initially used for data collection, which was transferred to a data sheet before entering them into the Epi-info software. Analysis was done using Epi info 2008 (version 3.5.1). Out of 5,585 deliveries over the study period, 47 had uterine rupture, giving an incidence of 0.84% or 1 in 119 deliveries. All the patients were multiparous and majority (63.8%) was unbooked. Traumatic (iatrogenic) rupture predominated (72.1%). Uterine repair with (55.8%) or without (34.9%) bilateral tubal ligation was the commonest surgery performed. Case fatality rate was 16.3%, while the perinatal mortality rate was 88.4%. Average duration of hospitalization following uterine rupture was 10.3 days. Uterine rupture constituted a major obstetric emergency in the study hospital and its environs. The incidence, maternal and perinatal mortalities were high. The traumatic/iatrogenic ruptures constituted the majority of cases, hence, majority of the cases are preventable. There is therefore a dire need for education of our women on health-related issues, utilization of available health facilities, adequate supervision of labour and provision of facilities for emergency obstetric care.

  2. Degenerated uterine leiomyomas mimicking malignant bilateral ovarian surface epithelial tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Yi Boem Ha; Lee, Hae Kyung; Lee, Min Hee; Choi, Seo Youn; Chung, Soo Ho [Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2017-07-15

    Uterine leiomyomas are the most common benign uterine neoplasms. Undegenerated uterine leiomyomas are easily recognizable by the typical imaging findings on radiologic studies. However, degenerated fibroids can have unusual and variable appearances. The atypical appearances due to degenerative changes may cause confusion in diagnosis of leiomyomas. In this article, we report a case of a patient with extensive cystic and myxoid degeneration of uterine leiomyoma, mimicking malignant bilateral ovarian surface epithelial tumors.

  3. Frequency, predisposing factors and fetomaternal outcome in uterine rupture

    International Nuclear Information System (INIS)

    Malik, H.S.

    2006-01-01

    To determine the frequency and to analyze the predisposing factors, maternal and fetal outcome of uterine rupture. All cases of ruptured uterus, who were either admitted with or who developed this complication in the hospital, were included in the study. Demographic data, details regarding the most probable predisposing factor, type of rupture, the management and maternal and fetal outcome were taken into consideration for analysis.During three years, total number of deliveries was 18668, and there were 103 cases of uterine rupture (0.55%).Out of these, only 13 (12.62%) patients were booked. Most of the patients presented between the ages of 26-30 years (42.71%). Majority of ruptures occurred in para 2-4 (44.66%). Fifty five cases (53.39%) had a previous caesarean section scar. In 68 (66.01%) cases, the tear was located in lower uterine segment. In 93 (90.29%) cases, anterior uterine wall was involved. Rupture was complete in 79 (76.69%)cases. Repair of uterus was done in 79 (76.69%) cases. Hysterectomy was performed in 24 (23.30%) cases. There were 8 (7.76% or 77.66/1000) maternal deaths and 85 (81.73% or 825 / 1000) perinatal deaths.This study confirms high frequency of such serious preventable obstetrical problem which can lead to high fetomaternal mortality. Rupture of caesarean section scar was the most common cause of uterine rupture found in this series. (author)

  4. Use of ICD-10 codes to monitor uterine rupture

    DEFF Research Database (Denmark)

    Thisted, Dorthe L A; Mortensen, Laust Hvas; Hvidman, Lone

    2014-01-01

    OBJECTIVES: Uterine rupture is a rare but severe complication in pregnancies after a previous cesarean section. In Denmark, the monitoring of uterine rupture is based on reporting of relevant diagnostic codes to the Danish Medical Birth Registry (MBR). The aim of our study was to examine the vali......OBJECTIVES: Uterine rupture is a rare but severe complication in pregnancies after a previous cesarean section. In Denmark, the monitoring of uterine rupture is based on reporting of relevant diagnostic codes to the Danish Medical Birth Registry (MBR). The aim of our study was to examine...... the validity of registration of uterine rupture in the MBR within the population of pregnant women with prior cesarean section by conducting a review of the medical records. STUDY DESIGN: We reviewed 1709 medical records within the population of singleton pregnant woman delivering at term between 1997 and 2007....... We retrieved the medical records of all women in the MBR with a code for uterine rupture during labor regardless of whether or not a prior cesarean section had been reported to the registry. In addition medical records of all women with a code for previous cesarean section and delivery of a child...

  5. Obstetric Uterine Rupture: A 20-Year Clinical Analysis

    Directory of Open Access Journals (Sweden)

    Yeou-Lih Wang

    2004-09-01

    Conclusion: Physicians should be alert to the possibility of uterine rupture at all stages of pregnancy. The ability to recognize the various signs of a possible rupture event, such as fetal distress, maternal pain, or hypotension, and then to address the situation immediately, is critical to a good outcome.

  6. Spontaneous Uterine Rupture during Pregnancy: Case Report and ...

    African Journals Online (AJOL)

    Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present the case of a spontaneous complete uterine rupture at a gestational age of 34 weeks in a 35 year old patient. The case was managed at the University Teaching Hospital of Yaounde (Cameroon). She had past history of ...

  7. Uterine ruptures: epidemiological aspects and prognosis at N ...

    African Journals Online (AJOL)

    RESULT: We recorded 54 uterine ruptures among 9384 deliveries giving a frequency of 0.57%. The average age was 26. 8 years with a range of 15 to 40 years. Thirty two of the 54 patients (57.4%) were multiparous (average parity was 3.8). Eighteen had a scarred uterus (p=0,014). Among the causes, foeto–pelvic ...

  8. An analysis of uterine rupture at the Nnamdi Azikiwe University ...

    African Journals Online (AJOL)

    2011-07-31

    Jul 31, 2011 ... Previous caesarean section with concurrent use of oxytocics was the commonest risk factor documented.The maternal and perinatal ... update training programmes for health care providers and appropriate legislation on maternal care will significantly reduce the incidence of uterine rupture and improve its ...

  9. Uterine rupture: UCH, Ibadan experience | Ogunnowo | West African ...

    African Journals Online (AJOL)

    85.7% of the patients were unbooked. Common modes of presentation were bleeding per vaginam and abdominal pain. Spontaneous cause of rupture predominates. The interval between diagnosis and surgery was greater than 7 hours in 75% of cases. Uterine repair with or without tubal ligation was commonly employed.

  10. An analysis of uterine rupture at the Nnamdi Azikiwe University ...

    African Journals Online (AJOL)

    Materials and Methods: This descriptive case series was conducted at the department of Obstetrics and Gynaecology, Nnamdi Azikiwe, University Teaching Hospital Nnewi from March 2004 to February 2009. Results: The incidence of uterine rupture was 6.2 per 1000 deliveries. The commonest age range of occurrence ...

  11. Uterine Rupture in a Primigravida with Mullerian Anomaly at 27 ...

    African Journals Online (AJOL)

    Uterine Rupture in a Primigravida with Mullerian Anomaly at 27 Weeks Gestation. K Kunuthia, A Kihara, RJ Kosgei, AN Bosire. Abstract. Mullerian anomalies are rare and are often associated with infertility, chronic pelvic pain and pregnancy wastage. This is a case report of a primigravida at 27 weeks gestation, who ...

  12. Factors contributing to uterine rupture in women having vaginal ...

    African Journals Online (AJOL)

    Conclusion: The study shows socio economic factors, dependency on family decisions and belief in supernatural powers as major reasons our women chose unorthodox delivery despite prior caesarean section and recommend ways of preventing it. Keywords: vaginal birth after caesarean section, uterine rupture. Tropical ...

  13. Bilateral spontaneous rupture of flexor digitorum profundus tendons.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Spontaneous tendon rupture is an unusual condition usually associated with underlying disease processes such as rheumatoid arthritis, chronic renal failure or bony abnormalities of the hand. We report a case of spontaneous, non-concurrent bilateral rupture of flexor profundus tendons in an otherwise healthy individual. Treatment was successful and consisted of a two-stage reconstruction of the ruptured tendon.

  14. Ultrasound Diagnosis of Bilateral Quadriceps Tendon Rupture After Statin Use

    Directory of Open Access Journals (Sweden)

    Nesselroade, Ryan D

    2010-09-01

    Full Text Available Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors.The diagnosis was confirmed using bedside ultrasound. [West J Emerg Med. 2010; 11(4:306-309.

  15. Bilateral ruptures of the distal biceps brachii tendon.

    Science.gov (United States)

    Schneider, Adam; Bennett, J Michael; O'Connor, Daniel P; Mehlhoff, Thomas; Bennett, James B

    2009-01-01

    The purpose of this study was to identify characteristics associated with bilateral ruptures of the distal biceps tendons. We present a retrospective case series of 25 patients who sustained non-simultaneous bilateral distal biceps brachii tendon ruptures that were repaired surgically, with follow-up available on 10 patients. The average age of the patients was 50 years (range 28-76). All patients were male. The mean time from the first tendon rupture to the contralateral tendon rupture was 2.7 years (range 0.5 - 6.3). Follow-up averaged 45 months (range 24-85). Patients with bilateral ruptures tended to be middle-aged men, who commonly participated in weight lifting, manual labor, or sports, and who had higher rates of nicotine (50%) and anabolic steroid use (20%) than the general population. After surgical repair of 9 of 10 patients, patients with bilateral distal biceps tendon ruptures had good to excellent outcomes. With the numbers available, outcomes were not statistically associated with manual labor, past medical history, prescription medications, prior tendon injury, body mass index, current activity in sports, use of nutritional supplements, or anabolic steroid use, although worker's compensation claims approached statistical significance (p = 0.059). Patients who sustained bilateral distal biceps tendon ruptures tended to be middle-aged men with higher rates of nicotine and anabolic steroid use than the general population.

  16. A Rare Case of Simultaneous Acute Bilateral Quadriceps Tendon Rupture and Unilateral Achilles Tendon Rupture

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    Wei Yee Leong

    2013-07-01

    Full Text Available Introduction: There have been multiple reported cases of bilateral quadriceps tendon ruptures (QTR in the literature. These injuries frequently associated with delayed diagnosis, which results in delayed surgical treatment. In very unusual cases, bilateral QTRs can be associated with other simultaneous tendon ruptures. Case Report: We present a rare case of bilateral QTR with a simultaneous Achilles Tendon Rupture involving a 31 years old Caucasian man who is a semi-professional body builder taking anabolic steroids. To date bilateral QTR with additional TA rupture has only been reported once in the literature and to our knowledge this is the first reported case of bilateral QTR and simultaneous TA rupture in a young, fit and healthy individual. Conclusion: The diagnosis of bilateral QTR alone can sometimes be challenging and the possibility of even further tendon injuries should be carefully assessed. A delay in diagnosis could result in delay in treatment and potentially worse outcome for the patient. Keywords: Quadriceps tendon rupture; Achilles tendon rupture; Bilateral.

  17. The Risk of Uterine Rupture in Labour Induction of Women With Previous Cesarean Delivery

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    Kurdoglu Zehra

    2016-01-01

    Full Text Available Objective: Due to the increased number of labour inductions in women with previous cesarean section, the risk of uterine rupture leading to maternal and fetal mortality is also increasing. In this manuscript, we aimed to review the risk of uterine rupture in labour induction of women with prior cesarean section. Materials and Methods: Data from 48 reports belonging to the years 1994 through 2015, obtained via a search on various internet sources by the words "labour induction", "previous cesarean", "uterine scar", "uterine rupture" were used to characterize the risk factors, methods and complications of labour induction in women with previous cesarean section. Results: The success of labour induction after a previous cesarean section is related to a history of prior vaginal delivery, the indication of prior cesarean delivery, age, body mass index and ethnicity. The risk of uterine rupture is lower with mechanical dilatators compared to prostaglandins when they are used for cervical ripening. Oxytocin is associated with an increased risk of uterine rupture in such women but induction and augmentation of labor is an option for all women undergoing a trial of labor after cesarean section. Although some guidelines discourage the use of prostaglandin E1, some others support the use of prostaglandin E1 or E2 for induction of labor in rare situations provided that the women be informed of the higher risk of uterine rupture. Conclusions: Previous uterine surgery is the most common underlying reason for an increased risk of uterine rupture in subsequent trial of labour. When indicated, before considering a labour induction in these patients, a risk assessment should be performed based on various parameters. For prediction of uterine rupture, lower uterine segment may be measured by ultrasonography. Individually selected methods for labour induction should be discussed with the patients since they are mostly associated with increased risk of uterine

  18. Long-term functional outcome of bilateral spontaneous and simultaneous Achilles tendon ruptures.

    LENUS (Irish Health Repository)

    Ellanti, Prasad

    2012-10-01

    Bilateral simultaneous ruptures are rare comprising less than 1% of all Achilles tendon ruptures. Risk factors for bilateral ruptures include chronic diseases and medications such as corticosteroids and fluoroquinolones. There is little in the literature on the long-term functional outcome of bilateral Achilles tendon ruptures. This article present a series of 3 cases of simultaneous and spontaneous bilateral Achilles tendon ruptures with a minimum of 5-year follow up suggesting a good functional outcome.

  19. National Rates of Uterine Rupture are not Associated with Rates of Previous Caesarean Delivery

    DEFF Research Database (Denmark)

    Colmorn, Lotte B.; Langhoff-Roos, Jens; Jakobsson, Maija

    2017-01-01

    BACKGROUND: Previous caesarean delivery and intended mode of delivery after caesarean are well-known individual risk factors for uterine rupture. We examined if different national rates of uterine rupture are associated with differences in national rates of previous caesarean delivery and intende...

  20. Spontaneous Fundal Uterine Rupture in a Pregnant Woman at 32 Weeks Gestation who had Two Previous Cesarean Sections

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    Metin Kaba

    2017-08-01

    Full Text Available Spontaneous uterine rupture during pregnancy can cause severe complications, even maternal and fetal demise. We report successful management of a spontaneous fundal uterine rupture in a 32 week pregnant who had undergone two previous cesarean sections due to preterm delivery. We explain causes of spontaneous uterine rupture and the management of this rare event in the presented case report.

  1. Bilateral Spontaneous rupture of the Patella Tendon without ...

    African Journals Online (AJOL)

    Bilateral spontaneous rupture of the patella tendon is an uncommon injury. However when found, it is usually associated with an underlying systemic disease or steroid use. We report an unusual case in a 50 year old male who was not on any medication prior to the incident and had no known systemic illness. The rarity of ...

  2. An analysis of uterine rupture at the Nnamdi Azikiwe University Teaching Hospital Nnewi, Southeast Nigeria.

    Science.gov (United States)

    Mbamara, S U; Obiechina, Nja; Eleje, G U

    2012-01-01

    Uterine rupture is a preventable condition which has persistently remained in our environment. The aim of this study therefore is to ascertain the incidence of uterine rupture, examine the predisposing factors and maternal and fetal outcome of patients managed of uterine rupture in a tertiary hospital. This descriptive case series was conducted at the department of Obstetrics and Gynaecology, Nnamdi Azikiwe, University Teaching Hospital Nnewi from March 2004 to February 2009. The incidence of uterine rupture was 6.2 per 1000 deliveries. The commonest age range of occurrence was 30-34 years. Uterine rupture occurred predominantly among women of low parity. Previous caesarean section with concurrent use of oxytocics was the commonest risk factor documented.The maternal and perinatal mortality ratio was 94 per 100,000 deliveries and 6 per 1000 births respectively. Surgery was the main stay of treatment and the commonest procedure carried out was uterine repair only. Rupture of the gravid uterus is still a significant cause of maternal mortality and morbidity in our environment. The causes are commonly preventable. The provision of maternal care by skilled personnel, proper antenatal care, update training programmes for health care providers and appropriate legislation on maternal care will significantly reduce the incidence of uterine rupture and improve its prognosis.

  3. Posterior Uterine Rupture Causing Fetal Expulsion into the Abdominal Cavity: A Rare Case of Neonatal Survival

    Directory of Open Access Journals (Sweden)

    K. Navaratnam

    2011-01-01

    Full Text Available Introduction. Uterine rupture is a potentially catastrophic complication of vaginal birth after caesarean section. We describe the sixth case of posterior uterine rupture, with intact lower segment scar, and the first neonatal survival after expulsion into the abdominal cavity with posterior rupture. Case Presentation. A multiparous woman underwent prostaglandin induction of labour for postmaturity, after one previous caesarean section. Emergency caesarean section for bradycardia revealed a complete posterior uterine rupture, with fetal and placental expulsion. Upon delivery, the baby required inflation breaths only. The patient required a subtotal hysterectomy but returned home on day 5 postnatally with her healthy baby. Discussion. Vaginal birth after caesarean section constitutes a trial of labour, and the obstetrician must be reactive to labour events. Posterior uterine rupture is extremely rare and may occur without conventional signs. Good maternal and fetal outcome is possible with a prompt, coordinated team response.

  4. Uterine rupture in a primigravida with a term pregnancy: Case report ...

    African Journals Online (AJOL)

    Uterine rupture in a primigravida with a term pregnancy: Case report and lessons to learn. ... South African Journal of Obstetrics and Gynaecology ... with term pregnancies is a rare occurrence, but is increasing in frequency in high-income countries as a result of a concomitant rise in rates of gynaecological uterine surgery.

  5. Simultaneous Uterine and Urinary Bladder Rupture in an Otherwise Successful Vaginal Birth After Cesarean Delivery

    Directory of Open Access Journals (Sweden)

    Szu-Ying Ho

    2010-12-01

    Full Text Available Uterine rupture is the primary concern when a patient chooses a trial of labor after a cesarean section. Bladder rupture accompanied by uterine rupture should be taken into consideration if gross hematuria occurs. We report the case of a patient with uterine rupture during a trial of labor after cesarean delivery. She had a normal course of labor and no classic signs of uterine rupture. However, gross hematuria was noted after repair of the episiotomy. The patient began to complain of progressive abdominal pain, gross hematuria and oliguria. Cystoscopy revealed a direct communication between the bladder and the uterus. When opening the bladder peritoneum, rupture sites over the anterior uterus and posterior wall of the bladder were noted. Following primary repair of both wounds, a Foley catheter was left in place for 12 days. The patient had achieved a full recovery by the 2-year follow-up examination. Bladder injury and uterine rupture can occur at any time during labor. Gross hematuria immediately after delivery is the most common presentation. Cystoscopy is a good tool to identify the severity of bladder injury.

  6. Spontaneous Rupture of Uterine Artery in a 14-Week Pregnant Woman

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    João Paulo Mancusi de Carvalho

    2016-01-01

    Full Text Available We report a case of uterine artery rupture in a woman at 14 weeks’ gestation who presented with abdominal pain, tachycardia, and hypotension and underwent a diagnostic laparoscopy. During this procedure, a spontaneous rupture of the left uterine artery was diagnosed and the surgery was converted into a laparotomy. The artery was bound to its origin and to its distal uterine portion. The patient exhibited excellent postoperative recovery and was discharged two days after the surgery. The pregnancy continued without other maternal or fetal complications, and the patient delivered a healthy newborn via cesarean section at 39 weeks of gestation.

  7. Sonographic Measurement of Lower Uterine Segment Thickness to Predict Uterine Rupture During a Trial of Labor in Women With Previous Cesarean Section: A Meta-analysis

    NARCIS (Netherlands)

    Kok, N.; Wiersma, I. C.; Opmeer, B. C.; de Graaf, I. M.; Mol, B. W.; Pajkrt, E.

    2014-01-01

    Along with the increasing rate of cesarean section (CS) births has been a concomitant decrease in the rate of vaginal birth after cesarean (VBAC), mostly due to concerns about uterine rupture during a trial of labor (TOL). The risk of uterine rupture in laboring women with a previous CS must be

  8. [Uterine rupture in a patient with bicornuate uterus at 12 weeks of amenorrhea: about a case].

    Science.gov (United States)

    Itchimouh, Sanaa; Khabtou, Karima; Mahdaoui, Sakher; Boufettal, Houssine; Samouh, Naima

    2016-01-01

    The incidence of uterine malformations affecting reproduction is difficult to assess. Their identification requires a specific assessment (hysterosalpingography, hysteroscopy, laparoscopy). Spontaneous fertility can be affected depending on the type of uterine abnormality. All these abnormalities can affect the evolution of pregnancy causing early and late miscarriage, ectopic pregnancy, threat of premature labour, premature labour, vascular pathologies during pregnancy and inadequate intra-uterine growth. Bicornuate uterus is the most common uterine malformation and represents about half of all uterine anomalies The occurrence of this type of pregnancy is associated with an increased risk of maternal mortality, but early diagnosis and proper monitoring can lead pregnancies to term on malformed uterus. Ultrasound screening should allow for a systematic identification of such cases in order to take the necessary preventive measures. We report a case of uterine rupture in a patient with unicervical bicornuate uterus at 12 weeks of amenorrhea.

  9. Delayed presentation of uterine rupture in a didelphys uterus misdiagnosed as appendicitis: a case report and review of the literature.

    Science.gov (United States)

    Shi, Linsen; Lin, Xiaoman; Sha, Suoyou; Yao, Libin; Zhu, Xiaocheng; Shao, Yong

    2017-11-01

    Uterine rupture during pregnancy caused by uterine dysplasia, such as the double uterus, is very rare and easily overlooked by the surgeon. A 25-year-old woman, at 17 weeks of gestation presented to our emergency center with acute right lower abdominal pain for more than 10 h. The initial diagnosis is acute appendicitis, but during the exploration, we found about 2500 mL of intraperitoneal hemorrhage, appendix was normal, pregnancy in one of the double uterine and ruptured at the right bottom. The pregnancy was removed and the uterine defect was repaired. Uterine rupture caused by double uterus is very rare and easily Ignored by the surgeon. The survival of patients suffered from uterine rupture depends on the time interval between rupture and intervention.

  10. US-color Doppler early diagnosis of uterine rupture with protrusion of umbilical cord.

    Science.gov (United States)

    Del Vecchio, Vittoria; Chincoli, Annarosa; Caradonna, Francesco; Vimercati, Antonella

    2016-01-01

    to analyze a case of uterine rupture in a pregnant woman that had a previous laparoscopic myomectomy. pregnant woman at 34 weeks gestation came to our emergency room for abdominal pain. She had undergone a previous laparoscopic multiple myomectomy. Patient was evaluated in our Department, that is a tertiary center, by a team of experienced ultrasonographers. at a first clinical examination, the findings were a deep abdominal pain, dysuria and a positive Giordano's sign on the right. 2D ultrasound showed an alive intrauterine foetus, normal anterior fundal placenta and mild reduction of amniotic fluid. It revealed also a maternal right pyelectasis. A further meticulous ultrasound evaluation plus color Doppler revealed on the left side of the uterus the presence of a small vascularised area with venous and arterial flow that seemed to be in continuity with umbilical cord and that had its ultrasound characteristics. Emergency laparotomy was performed and confirmed the hypothesis of uterine rupture. uterine rupture seems to occur more frequently as a consequence of a laparoscopic myomectomy and the classic signs and symptoms are fetal distress, loss of uterine contractility, abdominal pain, hemorrhage and shock, so the early US suspect of uterine rupture was extremely important in the decision to perform an emergency caesarean section. the correlation between clinical examination and ultrasound-Doppler findings has been essential to recognise an obstetrical emergency and to perform prompt surgery.

  11. Management of uterine rupture: a case report and review of the literature.

    Science.gov (United States)

    Egbe, Thomas Obinchemti; Halle-Ekane, Gregory Edie; Tchente, Charlotte Nguefack; Nyemb, Jacques Ernest; Belley-Priso, Eugene

    2016-11-21

    Maternal morbidity and mortality has been a major World Health Organization concern over the years, especially in sub-Saharan Africa. This paper reports uterine rupture with severe hypovolemic shock managed at the Douala General Hospital, Cameroon. Early clinical diagnosis is paramount to maternal survival. Mrs. MM aged 25 years, G3P2012, of the Bamileke tribe in Cameroon was admitted to our Department in hypovolemic shock BP = 70/40 mmHg, pulse 120 beats per minute, with altered consciousness (Glasgow Coma Scale = 13). She has a history of missed abortion at 19 weeks gestation and an attempt to evacuate the uterus with misoprostol that led to uterine rupture. She underwent a total abdominal hysterectomy and blood transfusion. Her post-operative stay in hospital was uneventful. Uterine rupture is a complication that can be eliminated under conditions of best obstetric practice. To attain this objective, use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. The survival of patients after uterine rupture depends on the time interval between rupture and intervention, and the availability of blood products for transfusion.

  12. Bilateral simultaneous quadriceps tendon rupture in a patient with secondary hyperparathyroidism: a case report

    International Nuclear Information System (INIS)

    Lee, Yeon Soo; Son, Sang Beom; Han, Chang Whan; Kang, Si Won

    2001-01-01

    Simultaneous bilateral rupture of the quadriceps tendon without a significant history of trauma may occur in association with chronic metabolic disorders such as chronic renal failure and secondary hyperparathyroidism, though has rarely been reported. We describe a case of spontaneous bilateral quadriceps tendon rupture in a 36-year-old female patient with secondary hyperparathyroidism

  13. Uterine rupture in a primigravida with a term pregnancy: Case report ...

    African Journals Online (AJOL)

    Uccella S, Cromi A, Bogani G, Zaffaroni E, Ghezzi F. Spontaneous prelabour uterine rupture in a primigravidae: A case report and review of the literature. Am J Obstet Gynecol 2011;205(5):e6-8. [http://dx.doi.org/10.1016/j.ajog.2011.08.013]. 3. Mizutamari E, Honda T, Ohba T, Katabuchi H. Case report: Spontaneous rupture ...

  14. Combined uterine and urinary bladder rupture: an unusual complication of obstructed labor in a primigravida

    Directory of Open Access Journals (Sweden)

    Takai IU

    2016-07-01

    Full Text Available Idris Usman Takai,1 Abdulkadir Abubakar2 1Department of Obstetrics and Gynaecology, 2Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria Background: Combined uterine and urinary bladder rupture following prolonged obstructed labor is indeed a momentous uro-obstetric emergency. The urinary bladder involvement is distinctly rare in the absence of factors that predispose the bladder to be adherent to the lower uterine segment and is quite unusual in a primigravida. Objective: To report a rare case of uterine rupture involving urinary bladder secondary to a prolonged obstructed labor in a primigravida from a low resource setting. Case: A 17-year-old married unbooked primigravida who presented with a 3-day history of spontaneous onset of labor at term that was initially managed at home and later in a primary health care center where she had fundal pressure and oxytocin augmentation, respectively. The labor was complicated by combined uterine and urinary bladder rupture with sepsis. She was resuscitated and had exploratory laparotomy with uterine and urinary bladder repair. The postoperative period was uneventful and she was followed-up at the gynecology and family planning clinics. Conclusion: There is a need for community reawakening on the inherent risks of teenage pregnancy, bad obstetric practices, and unsupervised pregnancy, labor, and delivery, particularly in the rural settings as in the index patient. A high index of suspicion and prompt appropriate intervention will reduce the sequel of morbidity and occasional mortality from this predicament. Keywords: uterine rupture, bladder rupture, primigravida, labor

  15. [Simultaneous bilateral rupture in both cruciate knee ligaments (about a case)].

    Science.gov (United States)

    Yahyaoui, Mounir; Derfoufi, Abdelhafid; Abbassi, Najib; Daoudi, Abdelkarim; Agoumi, Omar; Yacoubi, Hicham; Najib, Abdeljaouad

    2017-01-01

    Bilateral cruciate ligament rupture is rare while simultaneous rupture in both anterior cruciate ligaments (ACL) is exceptional; that's why post-traumatic simultaneous bilateral cruciate ligament rupture has never been described in the literature making this case study based on patient's observation, follow-up and therapeutic discussion very interesting. The procedure was performed in two surgical steps spaced in time and results were very satisfactory for both us and patient.

  16. Uterine rupture: A seven year review at a tertiary care hospital in New Delhi, India

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    Maruti Sinha

    2016-01-01

    Full Text Available Objective: To identify the obstetric risk factors, incidence, and causes of uterine rupture, management modalities, and the associated maternal and perinatal morbidity and mortality in one of the largest tertiary level women care hospital in Delhi. Materials and Methods: A 7-year retrospective analysis of 47 cases of uterine rupture was done. The charts of these patients were analyzed and the data regarding demographic characteristics, clinical presentation, risk factors, management, operative findings, maternal and fetal outcomes, and postoperative complications was studied. Results: The incidence of rupture was one in 1,633 deliveries (0.061%. The vast majority of patients had prior low transverse cesarean section (84.8%. The clinical presentation of the patients with rupture of the unscarred uterus was more dramatic with extensive tears compared to rupture with scarred uterus. The estimated blood loss ranged from 1,200 to 1,500 cc. Hemoperitoneum was identified in 95.7% of the patient and 83% of the patient underwent repair of rent with or without simultaneous tubal ligation. Subtotal hysterectomy was performed in five cases. There were no maternal deaths in our series. However, there were 32 cases of intrauterine fetal demise and five cases of stillbirths. Conclusions: Uterine rupture is a major contributor to maternal morbidity and neonatal mortality. Four major easily identifiable risk factors including history of prior cesarean section, grand multiparity, obstructed labor, and fetal malpresentations constitute 90% of cases of uterine rupture. Identification of these high risk women, prompt diagnosis, immediate transfer, and optimal management needs to be overemphasized to avoid adverse fetomaternal complications.

  17. Audit of cases with uterine rupture: A process indicator of quality of ...

    African Journals Online (AJOL)

    Audit of uterine rupture (UR) used as a process indicator, can identify factors considered avoidable to improve future quality of obstetric care. Records of UR cases at a referral maternity in Luanda were studied retrospectively (n=43) and prospectively (n=67) including basic obstetric information, maternal and foetal outcome, ...

  18. Risk factors and perinatal outcome of uterine rupture in a low ...

    African Journals Online (AJOL)

    The proforma was initially used for data collection, which was transferred to a data sheet before entering them into the Epi-info software. Analysis was done using Epi info 2008 (version 3.5.1). Results: Out of 5,585 deliveries over the study period, 47 had uterine rupture, giving an incidence of 0.84% or 1 in 119 deliveries.

  19. Uterine rupture in a teaching hospital in Mbarara, western Uganda, unmatched case- control study

    NARCIS (Netherlands)

    Mukasa, P.K.; Kabakyenga, J.; Senkungu, J.K.; Ngonzi, J.; Kyalimpa, M.; van Roosmalen, J.

    2013-01-01

    Background: Uterine rupture is one of the most devastating complications of labour that exposes the mother and foetus to grave danger hence contributing to the high maternal and perinatal mortality and morbidity in Uganda. Every year, 6000 women die due to complications of pregnancy and childbirth,

  20. Uterine rupture after previous low segment transverse cesarean is rarely catastrophic.

    Science.gov (United States)

    Soltsman, Sofia; Perlitz, Yuri; Ben Ami, Moshe; Ben Shlomo, Izhar

    2018-03-01

    The cornerstone of concerns over trial of labor after cesarean (TOLAC) is the risk of uterine rupture. The purpose of this study was to document the rate of uterine rupture during TOLAC and to delineate its severity and consequences. We retrospectively collected the data on vaginal and cesarean deliveries after a previous cesarean section with specific emphasis on uterine rupture and dehiscence in our center from 2006 through 2013. 22,670 deliveries were registered, with 18.2% rate of cesarean section. 2890 women had a single cesarean scar; of them 1206 delivered vaginally and 194 were re-operated during unsuccessful TOLAC. Seven cases of uterine rupture and 16 cases of dehiscence were recorded. There were no maternal, intrapartum or neonatal deaths, and no cesarean hysterectomy. There was one re-laparotomy, one ICU admission, and one blood transfusion; one neonate was admitted to NICU. TOLAC was successful in 86.1% of cases. Cautious selection and close monitoring of candidates are the cornerstones of successful management of TOLAC. Readily available facilities for emergency cesarean delivery and concerted obstetrical team can save the mother and child from catastrophic complications.

  1. A case of recurrent spontaneous vesical rupture subsequent to irradiation for uterine cancer

    Energy Technology Data Exchange (ETDEWEB)

    Takemura, Hiroshi; Baba, Katsuyuki; Yajima, Michitaka; Yamakawa, Katsunori; Nishida, Shigehito; Iwamoto, Teruaki [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    2000-04-01

    The patient, a 68-year-old woman, had undergone radical hysterectomy and post-operative radiotherapy for uterine cancer in 1974. She was admitted to our hospital complaining of abdominal pain in February, 1996. Contrast-enhanced computed tomographic scan and cystography showed leakage of contrast medium around the bladder. We diagnosed her with spontaneous vesical rupture, and performed conservative therapy. Two months later, she was re-admitted with recurrent vesical rupture. We again performed conservative therapy. We consider that conservative therapy can be indicated for spontaneous vesical rupture with good general condition and no severe urinary tract infection. (author)

  2. Uterine rupture an obstetrics catastrophy; incidence, risk factors ...

    African Journals Online (AJOL)

    Context: Ruptured uterus is still an important obstetrics complication because it contributes significantly to both maternal and foetal morbidity and mortality in our setting. Therefore there is a need to further evaluate its causes and the outcome of its management. Objective: To determine the incidence, risk factors, ...

  3. Uterine rupture: a retrospective analysis of causes, complications ...

    African Journals Online (AJOL)

    We conducted a retrospective review of case notes (from 2003 to 2009) to determine the incidence, causes, complications and foetal/maternal outcome among women with a diagnosis of ... Out of 72,570 deliveries 163 cases of ruptured uterus were recorded in seven years, making an incidence of 2.25 per 1000 births.

  4. Severe Hemoperitoneum Following Rupture of Uterine Diverticulum due to Pregnancy: a Case Report

    Directory of Open Access Journals (Sweden)

    Yaghmaei Minoo

    2009-06-01

    Full Text Available Uterovaginal malformations, occur in 0.16% of women and contribute to the problems of infertility, recurrent pregnancy loss, dysmenorrhea, dyspareunia, amenorrhea and a poor outcome in pregnancy. True diverticulum is an exceedingly rare anomaly and is like a tubular formation connected to uterine cavity that ends in a cul-de sac and It is not classified as any of mullerian duct anomalies. In this article a case of uterine diverticulum rupture due to pregnancy in a 19 years old woman with nausea, vomiting and abdominal pain is reported. Although rare, in complicated pregnancy we should think to genital tract anomalies.

  5. Uterine Didelphys with Bilateral Cervical Agenesis in a 15-Year-Old Girl.

    Science.gov (United States)

    Arnold, Kate C; Thai, Theresa C; Craig, LaTasha B

    2018-02-01

    Isolated uterine didelphys requires no treatment in contrast to cervical agenesis, which requires a hysterectomy. Because of this, correct diagnosis of Müllerian anomalies is paramount for making recommendations for patient care. A 15-year-old girl presented to clinic with pelvic pain and primary amenorrhea. Uterine didelphys with bilateral cervical agenesis was diagnosed using imaging. Hysterectomy was recommended and diagnosis was confirmed at surgery and according to anatomic pathology. Our patient with uterine didelphys with bilateral cervical agenesis presented a diagnostic challenge, because, to our knowledge, it has never been reported before in the literature. Her pattern of anomalies had significant implications for future fertility. Radiology exam was vital to confirming this diagnosis in a young, virginal female patient. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  6. Delayed uterine rupture occurred 4 weeks after cesarean section following sexual intercourse: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Hsing-Fen Tsai

    2013-09-01

    Conclusion: The presented case demonstrated that delayed uterine rupture may occur even 4 weeks after delivery following intercourse, without any obvious abdominal pain or infection signs, which deserved the attention of obstetricians.

  7. A Rare Case of Second Trimester Uterine Rupture in Unscarred Uterus

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    Poonam Kashyap

    2017-11-01

    Full Text Available Second trimester uterine rupture is rare and presents with life threatening emergency. Few cases have been reported in literature. Most of the cases which have been reported are with the use of labor-induction agents in late termination of pregnancy. Others are involving any surgical procedures in placenta percreta or scarred uterus. The main contributory factors were scarred uterus and abnormal placentation. In this study, uterine rupture had occurred in unscarred uterus in non-laboring women in second trimester without any intervention which is very rare to found. The lack of index of high suspicion diverts attention to search for other non-gynecological causes. Our aim is to create awareness through this case study to avoid delay in diagnosis and timely management of such cases.

  8. Can Intrapartum Cardiotocography Predict Uterine Rupture among Women with Prior Caesarean Delivery?: A Population Based Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Malene M Andersen

    Full Text Available To compare cardiotocographic abnormalities recorded during labour in women with prior caesarean delivery (CD and complete uterine rupture with those recorded in controls with prior CD without uterine rupture.Women with complete uterine rupture during labour between 1997 and 2008 were identified in the Danish Medical Birth Registry (n = 181. Cases were validated by review of medical records and 53 cases with prior CD, trial of labour, available cardiotocogram (CTG and complete uterine rupture were included and compared with 43 controls with prior CD, trial of labour and available CTG. The CTG tracings were assessed by 19 independent experts divided into groups of three different experts for each tracing. The assessors were blinded to group, outcome and clinical data. They analyzed occurrence of defined abnormalities and classified the traces as normal, suspicious, pathological or pre-terminal according to international guidelines (FIGO.A pathological CTG during the first stage of labour was present in 77% of cases and in 53% of the controls (OR 2.58 [CI: 0.96-6.94] P = 0.066. Fetal tachycardia was more frequent in cases with uterine rupture (OR 2.50 [CI: 1.0-6.26] P = 0.053. Significantly more cases showed more than 10 severe variable decelerations compared with controls (OR 22 [CI: 1.54-314.2] P = 0.022. Uterine tachysystole was not correlated with the presence of uterine rupture.A pathological cardiotocogram should lead to particular attention on threatening uterine rupture but cannot be considered a strong predictor as it is common in all women with trial of labour after caesarean delivery.

  9. Value of intramuscular methotrexate and bilateral uterine artery embolization for treating cervical ectopic pregnancy

    International Nuclear Information System (INIS)

    Pan Feng; Xiong Bin

    2011-01-01

    Objective: To assess the clinical value of bilateral uterine artery chemotherapy embolization (UACE) for cervical ectopic pregnancy analyzed. Methods: Clinical records of 40 patients with cervical ectopic pregnancy treated using UACE were retrospectively analyzed. Results: 8 patients with severe active vaginal bleeding after curettage were treated urgently with UACE. The remaining 32 patients were treated with UACE combined with sequential ultrasound-guided curettage. Active vaginal bleeding was stopped after UACE. There was no recurrent hemorrhage with the sequential ultrasound-guided curettage procedure. The β-HCG levels of all patients were normalized after 1 month. Conclusion: Bilateral uterine artery chemotherapy embolization is valuable as emergency treatment for patients with severe vaginal bleeding from cervical ectopic pregnancy. UACE combined with sequential ultrasound-guided curettage may be more effective. (authors)

  10. Silent Uterine Rupture with the Use of Misoprostol for Second Trimester Termination of Pregnancy : A Case Report

    Directory of Open Access Journals (Sweden)

    Martin Cuellar Torriente

    2011-01-01

    Full Text Available Uterine rupture is an uncommon, but a life-threatening, complication following second trimester medical termination of pregnancy (TOP. The reported cases have been in both the scarred and unscarred uterus (Rajesh et al. 2002, Drey et al. 2006, and Dickinson. A 27-year-old with two previous deliveries, no previous caesarean section, no history of induced abortions, and no gynaecological operations. She presented with amenorrhoea, and according to her last normal menstruation, she was 10 weeks and 5 days. Ultrasound was done, and it reported 16 weeks and 5 days. She asked for TOP. According to the clinic's protocol, misoprostol 800 mcg (4 tabs were given to be used vaginally as a loading dose and another three to be taken orally after that. In the following day when she attended the clinic for follow up, a manual vacuum aspiration (MVA. A manual vacuum aspiration was indicated as an incomplete abortion. During the procedure, a uterine rupture was found in the uterine lower segment. A laparotomy was done and a lineal uterine rupture was found and sutured. The patient had a good postoperative recovery and was discharged from hospital after four days. The clinician dealing with second trimester terminations should be aware of the possibility of having a uterine rupture, especially in patients with a uterine scar in order to make an early diagnosis.

  11. Bilateral simultaneous spontaneous rupture of the quadriceps tendons

    African Journals Online (AJOL)

    simultaneous rupture of the quadriceps tendons. The injury occurs most often in elderly people and delay in the diagnosis is not uncommon. Early operative repair is recommended. By using a metal wire passing through a transverse hole in the superior pole of the patella and through the tendon proximal to the repair site, ...

  12. Bilateral simultaneous complete quadriceps rupture following chronic symptomatic tendinopathy: a case report

    Directory of Open Access Journals (Sweden)

    Arumilli Buchi

    2009-09-01

    Full Text Available Abstract Introduction Quadriceps rupture is a disabling injury mostly seen in men over 40 years of age. Bilateral quadriceps rupture is a rare injury that is often secondary to predisposing medical conditions. Ultrasound is a cheap and reliable tool for diagnosis but is operator dependent. Thus, magnetic resonance imaging is the preferred method of investigation despite its cost and availability. Prompt diagnosis and early surgical repair are needed for an optimal end result. Case presentation We report the case of a healthy 54-year-old Caucasian male farmer who presented with bilateral simultaneous complete quadriceps rupture, which was managed surgically and he was followed up for three years. He was previously under our care for enthesopathy of the quadriceps on both sides. We believe that chronic enthesopathy of the superior pole of patella made his quadriceps susceptible to complete rupture on eccentric loading. Conclusion Only a few cases of bilateral simultaneous complete quadriceps rupture in patients with symptomatic enthesopathy have been previously reported. We stress the importance of warning patients of the risk of developing complete tendon rupture when they present with an enthesopathy around the knee.

  13. Uterine rupture, obstetrical hemorrhage and maternal death. «The Rite» (2011

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    Oscar Rubén TREVIÑO MONTEMAYOR

    2016-10-01

    Full Text Available In the film The Rite, a seminarist is shown with doubts about his religious beliefs, therefore is sent with a mentor, the Father and exorcist Lucas who is performing an exorcism session to a young pregnant woman apparently affected by demonic possession. During the sessions the patient presents exacerbation of the signs and is hospitalized, acutely suffering from obstetric hemorrhage with loss of the product of pregnancy, culminating in maternal death. It is intended to present to uterine rupture as a diagnostic possibility, with discussion of this diagnostic entity, and then emphasize the usefulness of cinema in medical education in general medicine and specialty area.

  14. 4th Stage Transvaginal omental herniation during VBAC complicated by shoulder dystocia: a unique presentation of uterine rupture

    Science.gov (United States)

    2013-01-01

    Background Uterine rupture is a common complication in women attempting their first virginal birth after caesarean section (VBAC) but the risk diminishes with subsequent VBACs. It occurs in rates of 0.5-9% and is influenced by various factors. Case presentation A unique case of uterine rupture in a Kenyan woman of African descent during a repeat VBAC complicated by shoulder dystocia was discovered during the 4th stage of labour when omentum was noted protruding through the vagina. She had delivered 4 years earlier by caesarean section. Conclusion It is not common to experience uterine rupture among women attempting repeat VBAC. When it occurs, it may not always follow the known pattern intra-partum and is often associated with poor foetal outcome. PMID:23521920

  15. Uterine Didelphys with blind hemivagina, hematocolpos, ipsilateral renal agenesis (UD-BHRA) and bilateral ovarian tumors : a case report

    International Nuclear Information System (INIS)

    Lee, Young Rae; Choi, Byung Ik; Park, Hae Won; Kook, Shin Ho

    1998-01-01

    Uterine didelphys is a congenital malformation characterized by the presence of two separated hemiuteri and hemivaginas, due to lack of midfusion of the mullerian ducts. We report a case of UD-BHRA (uterine didelphys with blind hemivagina and ipsilateral renal agencies), a rare type of uterine dedelphys characterized by symptomatic unilateral hematocolpos due to blind hemivagina after menarche and ipsilateral renal agenesis. The MRI findings in 22-year-old woman with bilateral ovarian tumors demonstrated two separated uterine horns and cervical and vaginal canals, with left hematocolpos and left agenesis. (author). 7 refs., 1 fig

  16. Simultaneous bilateral distal biceps tendon ruptures repaired using an endobutton technique: a case report.

    Science.gov (United States)

    Dacambra, Mark P; Walker, Richard Ea; Hildebrand, Kevin A

    2013-08-23

    The simultaneous rupture of both distal biceps tendons is a rare clinical entity that is difficult to treat and can have poor outcomes. A variety of treatment and rehabilitation options exist and have been reported for single sided and staged bilateral repairs, but none have described an approach for acute bilateral ruptures. Repairing distal biceps tendon ruptures using a single anterior incision and a cortical suspensory button technique has become increasingly popular in recent years. We present a report of our surgical approach using an endobutton technique and rehabilitation algorithm for this unusual injury pattern. A 43-year-old Caucasian man presented with acute onset bilateral elbow pain while lifting a large sheet of drywall off the ground. He initially felt a 'pop' on the right and almost immediately felt another on the left after having to quickly shift the weight. He was unable to continue working and sought medical attention. His pain was predominantly in his bilateral antecubital fossae and he had significant swelling and ecchymoses. His clinical examination demonstrated no palpable tendon, a retracted biceps muscle belly, and clear supination weakness. Magnetic resonance imaging was performed and showed bilateral distal biceps tendon ruptures with retraction on both sides. After discussion with our patient, we decided that both sides would be repaired using a single anterior incision with endobutton fixation, first his right followed by his left six weeks later. Overall, our patient did very well and had returned to full manual work by our last follow-up at 30 months. Although he was never able to return to competitive recreational hockey and was left with mild lateral antebrachial cutaneous nerve dysesthesias on his right, he felt he was at 85% of his premorbid level of function. We describe what we believe to be, to the best of our knowledge, the first case of simultaneous bilateral distal biceps tendon ruptures successfully treated with a single

  17. Labor before a primary cesarean delivery: reduced risk of uterine rupture in a subsequent trial of labor for vaginal birth after cesarean.

    Science.gov (United States)

    Algert, Charles S; Morris, Jonathan M; Simpson, Judy M; Ford, Jane B; Roberts, Christine L

    2008-11-01

    To estimate the effect of the onset of labor before a primary cesarean delivery on the risk of uterine rupture if vaginal birth after cesarean (VBAC) is attempted in the next pregnancy. Longitudinally linked birth records were used to follow women from a primary cesarean delivery to a trial of labor at term for their next birth. The effects of characteristics of both the trial of labor and primary cesarean deliveries on the risk of uterine rupture were examined. Of 10,160 women who had a trial of labor, 39 (0.38%) had a uterine rupture. Women who were induced or augmented for their trial of labor had a greater relative risk (RR) of uterine rupture (crude RR 4.24, 95% confidence interval [CI] 2.23-8.07). Women whose primary cesarean delivery was planned or followed induction of labor also had an increased risk of uterine rupture (crude RR 2.61, 95% CI 1.24-5.49), and this risk remained after adjustment for other factors. Women with a history of either spontaneous labor or vaginal birth had one uterine rupture for every 460 deliveries; women without this history who required induction or augmentation to proceed with a VBAC attempt had one uterine rupture for every 95 deliveries. Labor before the primary cesarean delivery can decrease the risk of uterine rupture in a subsequent trial of labor. A history of primary cesarean delivery preceded by spontaneous labor is favorable for VBAC. II.

  18. Uterine rupture in twin pregnancy with normal fetus and complete hydatidiform mole.

    Science.gov (United States)

    Sánchez-Ferrer, María Luisa; Hernández-Martínez, Florentina; Machado-Linde, Francisco; Ferri, Belén; Carbonel, Pablo; Nieto-Diaz, Anibal

    2014-01-01

    We describe a rare case of complete hydatidiform mole with twin live fetus (CHMTF) confirmed by histopathology, flow cytometry and polymerase chain reaction techniques. No malformations were observed, fetal karyotype was normal and β-human chorionic gonadotropin levels were high (>100,000 IU/ml). The patient was informed of the risks and decided to continue with the pregnancy, but at week 15, she had to undergo hysterectomy due to uterine rupture. She subsequently developed persistent trophoblastic disease (PTD) with pulmonary metastases that required treatment with polychemotherapy. Patients with CHMTF should be informed of all known risks, including the considerable risk of PTD, which is similar to or, even higher than that associated with a singleton complete mole. The risk does not appear to be increased by continuing the pregnancy. Because so few series have been published, there is a lack of evidence-based clinical management guidelines. To our knowledge, this is the first report of uterine rupture in CHMTF. © 2013 S. Karger AG, Basel.

  19. Therapeutic analysis of bilateral uterine artery chemoembolization performed before uterine dilation and curettage for cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Zhou Kang; Li Xiaoguang; Jin Zhengyu; Zhang Xiaobo; Shi Haifeng; Sun Hao; Wang Zhiwei

    2012-01-01

    Objective: To evaluate the clinical outcomes of bilateral uterine artery chemoembolization (UACE) followed by uterine dilation and curettage in treating cesarean scar pregnancy. Methods: A total of 104 patients with cesarean scar pregnancy, admitted to hospital during the period from Jan. 2005 to Jan. 2009, were enrolled in the study. The patients were divided into group A (control group, n=49) and group B (study group, n=55). Patients in group A received uterine dilation and curettage only, and patients in group B received additional UACE, which was performed 24-72 hours before uterine dilation and curettage was carried out. The blood loss during the operation, the time for β-human chorionic gonadotrophin (β-hCG) level going down to normal, the success rate of operation, the hospitalization days, the occurrence of complications and the menstrual situation after operation were documented. The results were analyzed and compared between the two groups. Results: In group A, 4 patients had to receive hysterectomy due to massive hemorrhage or inadequate curettage. None of the patients in group B needed to have a hysterectomy. the technical success rates of curettage for group A and group B were 91.84% and 100%, respectively. The mean blood loss in group B was (54.36±38.09) ml, which was significantly lower than that of (54.36±38.09) ml in group A (P 0.05], while between those patients who had pregnancy time > 10 weeks, the blood loss in group B was much less than that of group A [(101.33±39.43) ml vs. (457.14±97.59) ml, P 0.05]. The difference in hospitalization days between the patients with pregnancy time ≤ 10 weeks in two groups [(11.21±3.24) days vs. (12.68±34.56) days] was not significant (P>0.05). But for patients with pregnancy time > 10 weeks, the hospitalization days of group B was significantly shorter than that of group A (13.46±4.87 days vs. 19.34±5.72 days, P<0.01), Except for 4 patients who had received hysterectomy, all patients regained

  20. Spontaneous rupture of bladder diverticulum after postoperative radiotherapy for carcinoma of the uterine cervix. A case report

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    Nishimura, Tetsuo; Suzuki, Kazunori; Iijima, Mitsuharu; Nozue, Masashi; Imai, Michiko; Suzuki, Sachiko; Sakahara, Harumi; Ohta, Nobutaka; Kasami, Masako [Hamamatsu Univ. School of Medicine, Shizuoka (Japan)

    2000-08-01

    We present a case of spontaneous rupture of bladder diverticulum three years after postoperative whole pelvic irradiation (50.4 Gy) for carcinoma of the uterine cervix. The patient had suffered from a neurogenic bladder after hysterectomy, but excretory urography revealed no abnormalities. Bladder diverticulum was found two years later. Spontaneous rupture of the urinary bladder is one of the late complications associated with radiotherapy, although it is very rare. Postoperative neurogenic bladder may also be associated with rupture. We should be aware of this rare complication in patients who receive pelvic irradiation. (author)

  1. An Unreported Uterine Rupture in an Unscarred Uterus After Induced Labor With 25 μg Misoprostol Vaginally

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    Eva Rydahl

    2014-01-01

    Full Text Available Uterine rupture without a former history of cesarean delivery or uterine scarring is an exceedingly rare complication in pregnancy and labor. Misoprostol is widely used to induce labor but there is a lack of knowledge about serious adverse effects. It is especially challenging to collect reports on side effects because misoprostol is not a registered drug. We report a case of a woman induced by one dose 25 μg misoprostol vaginally. Her pregnancy was uncomplicated and she had an unscarred uterus. Her labor progressed rapidly and she experienced hyperstimulation, meconium stained amniotic fluid, uterine rupture, and excessive blood loss of approximately 14 l. The child survived but is diagnosed with cerebral palsy. The case was never reported as an adverse event. This case questions the safety of misoprostol even in low dosage. It also underlines the need to report side effects to national reporting systems.

  2. Clinical application of bilateral uterine arterial chemoembolization in the treatment of massive hemorrhage due to cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Wan Jun; Gu Weijin; Wang Haiyun; Ye Lei; Wang Wei; Zhang Lei; Ji Lihua

    2009-01-01

    Objective: To investigate the clinical application of bilateral uterine arterial chemoembolization in treating massive hemorrhage due to uterine scar pregnancy after cesarean section. Methods: Sixteen patients with massive hemorrhage due to cesarean scar pregnancy were enrolled in the study, the mean blood loss was (2 200 ± 1 400) ml. With Seldinger technique, abdominal angiography by using a pig-tail catheter was carried out. When bilateral uterine arterial bleeding was confirmed, selective or super-selective catheterization was employed and bilateral uterine arterial chemoembolization with infusion of 5-Fu or methotrexate (MTX) together with gelatin sponge via the catheters was conducted. The clinical results were observed. Results: The technical success was achieved in all 16 patients. No recurrent bleeding occurred during a follow-up of 3-6 months. Conclusion: The emergency bilateral uterine arterial chemoembolization is a safe and effective treatment for massive hemorrhage due to cesarean scar pregnancy with no serious complications, therefore, this technique is worth being used in clinical practice. (authors)

  3. An Unreported Uterine Rupture in an Unscarred Uterus after Induction of Labour with 25 μg Misoprostol

    DEFF Research Database (Denmark)

    Rydahl, Eva; Clausen, Jette Aaroe

    2014-01-01

    Uterine rupture without a former history of cesarean delivery or uterine scarring is an exceedingly rare complication in pregnancy and labor. Misoprostol is widely used to induce labor but there is a lack of knowledge about serious adverse effects. It is especially challenging to collect reports...... on side effects because misoprostol is not a registered drug. We report a case of a woman induced by one dose 25 μg misoprostol vaginally. Her pregnancy was uncomplicated and she had an unscarred uterus. Her labor progressed rapidly and she experienced hyperstimulation, meconium stained amniotic fluid...

  4. Nationwide population-based cohort study of uterine rupture in Belgium: results from the Belgian Obstetric Surveillance System.

    Science.gov (United States)

    Vandenberghe, G; De Blaere, M; Van Leeuw, V; Roelens, K; Englert, Y; Hanssens, M; Verstraelen, H

    2016-05-17

    We aimed to assess the prevalence of uterine rupture in Belgium and to evaluate risk factors, management and outcomes for mother and child. Nationwide population-based prospective cohort study. Emergency obstetric care. Participation of 97% of maternity units covering 98.6% of the deliveries in Belgium. All women with uterine rupture in Belgium between January 2012 and December 2013. 8 women were excluded because data collection forms were not returned. Data on 90 cases of confirmed uterine rupture were obtained, of which 73 had a previous Caesarean section (CS), representing an estimated prevalence of 3.6 (95% CI 2.9 to 4.4) per 10 000 deliveries overall and of 27 (95% CI 21 to 33) and 0.7 (95% CI 0.4 to 1.2) per 10 000 deliveries in women with and without previous CS, respectively. Rupture occurred during trial of labour after caesarean section (TOLAC) in 57 women (81.4%, 95% CI 68% to 88%), with a high rate of augmented (38.5%) and induced (29.8%) labour. All patients who underwent induction of labour had an unfavourable cervix at start of induction (Bishop Score ≤7 in 100%). Other uterine surgery was reported in the history of 22 cases (24%, 95% CI 17% to 34%), including 1 case of myomectomy, 3 cases of salpingectomy and 2 cases of hysteroscopic resection of a uterine septum. 14 cases ruptured in the absence of labour (15.6%, 95% CI 9.5% to 24.7%). No mothers died; 8 required hysterectomy (8.9%, 95% CI 4.6% to 16.6%). There were 10 perinatal deaths (perinatal mortality rate 117/1000 births, 95% CI 60 to 203) and perinatal asphyxia was observed in 29 infants (34.5%, 95% CI 25.2% to 45.1%). The prevalence of uterine rupture in Belgium is similar to that in other Western countries. There is scope for improvement through the implementation of nationally adopted guidelines on TOLAC, to prevent use of unsafe procedures, and thereby reduce avoidable morbidity and mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  5. Bilateral simultaneous rupture of the quadriceps tendon in a patient with psoriasis: a case report and review of the literature

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    Radha Sarkell

    2011-07-01

    Full Text Available Abstract Introduction Bilateral quadriceps tendon rupture is not common in the absence of systemic disease. Patients with chronic systemic diseases such as uremia and systemic lupus erythematosus and patients who are being treated with systemic steroids or local steroid injections are more prone to tendon rupture. The tendon can rupture spontaneously or as a result of trauma. We report an unusual case of simultaneous bilateral traumatic quadriceps tendon rupture in a patient with psoriasis who was being treated with topical steroid preparations. Case presentation A 57-year-old Caucasian man with a known history of psoriasis, for which he was being treated with topical steroid preparations, presented to our hospital with clinical signs of bilateral quadriceps tendon rupture after he fell while walking down stairs. The diagnosis was confirmed by bilateral ultrasound scans of the thighs. The patient underwent surgery to repair both quadriceps tendons. Post-operatively, the patient was immobilized first in bilateral cylinder casts for six weeks, then in knee braces for the next four weeks. His knees were actively mobilized during physiotherapy. Conclusion Bilateral quadriceps tendon rupture is a rare occurrence in patients with psoriasis who are being treated with topical steroids.

  6. Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery.

    Science.gov (United States)

    Landon, Mark B; Spong, Catherine Y; Thom, Elizabeth; Hauth, John C; Bloom, Steven L; Varner, Michael W; Moawad, Atef H; Caritis, Steve N; Harper, Margaret; Wapner, Ronald J; Sorokin, Yoram; Miodovnik, Menachem; Carpenter, Marshall; Peaceman, Alan M; O'sullivan, Mary J; Sibai, Baha M; Langer, Oded; Thorp, John M; Ramin, Susan M; Mercer, Brian M; Gabbe, Steven G

    2006-07-01

    To determine whether the risk for uterine rupture is increased in women attempting vaginal birth after multiple cesarean deliveries. We conducted a prospective multicenter observational study of women with prior cesarean delivery undergoing trial of labor and elective repeat operation. Maternal and perinatal outcomes were compared among women attempting vaginal birth after multiple cesarean deliveries and those with a single prior cesarean delivery. We also compared outcomes for women with multiple prior cesarean deliveries undergoing trial of labor with those electing repeat cesarean delivery. Uterine rupture occurred in 9 of 975 (0.9%) women with multiple prior cesarean compared with 115 of 16,915 (0.7%) women with a single prior operation (P = .37). Multivariable analysis confirmed that multiple prior cesarean delivery was not associated with an increased risk for uterine rupture. The rates of hysterectomy (0.6% versus 0.2%, P = .023) and transfusion (3.2% versus 1.6%, P cesarean deliveries compared with women with a single prior cesarean delivery attempting trial of labor. Similarly, a composite of maternal morbidity was increased in women with multiple prior cesarean deliveries undergoing trial of labor compared with those having elective repeat cesarean delivery (odds ratio 1.41, 95% confidence interval 1.02-1.93). A history of multiple cesarean deliveries is not associated with an increased rate of uterine rupture in women attempting vaginal birth compared with those with a single prior operation. Maternal morbidity is increased with trial of labor after multiple cesarean deliveries, compared with elective repeat cesarean delivery, but the absolute risk for complications is small. Vaginal birth after multiple cesarean deliveries should remain an option for eligible women. II-2.

  7. Fluoroquinolone-induced bilateral rupture of the Achilles tendon: clinical and sonographic findings

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    P. Busilacchi

    2011-09-01

    Full Text Available The fluoroquinolones are antibiotics widely used in the clinical practice. The concomitant use of corticosteroids and fluoroquinolones in elderly patients is recognised as a risk factor for developing clinically relevant tendon lesions. Fluoroquinolone-induced tendinopathy is underreported in the literature. Clinical case. A 67-year-old man, came to our observation complaining of 5 days history of bilateral heel pain. The patient had a medical history of sarcoidosis and was treated with a daily dose of 5 mg of prednisone. He was initially given oral levofloxacin (500 mg/die for 10 days, because of an acute respiratory infection. Two days before the end of the antibiotic therapy, he developed bilateral heel pain. He denied any history of trauma. Physical examination revealed swelling and marked tenderness with mild palpation of the Achilles tendons at the calcaneal insertion. The ultrasound evaluation of the Achilles tendons revealed the following main abnormalities: diffuse thickening, loss of the “fibrillar” echotexture, blurred margins, and bilateral partial tendon tears. Discussion. Bilateral Achilles tendon pain and rupture has been described as a rare adverse effect of fluoroquinolone treatment. Most of the fluoroquinolone-induced tendinopathies of the Achilles tendon are due to ciprofloxacin. To the best of our knowledge, this is the first description of bilateral Achilles tendon rupture due to levofloxacin. The risk/benefit ratio of the fluoroquinolones should be carefully considered and these drugs should be prescribed cautiously in elderly patients treated with corticosteroids. This case can be regarded as a representative example of the potential clinical efficacy of sonography in daily rheumatological practise.

  8. Bilateral Renal Fornix Rupture Following Intraarterial Contrast Medium Application for Infrarenal Aortic Stent Placement

    International Nuclear Information System (INIS)

    Niggemann, Pascal; Brehmer, Bernhard; Schuermann, Karl

    2006-01-01

    A 74-year-old male claudicant who had a significant abdominal aortic stenosis was hydrated before aortic stent placement because of an elevated creatinine level. During the intervention the patient experienced acute abdominal pain with vomiting. No vascular cause was detected. Due to persistant pain, plain radiography and an abdominal CT scan were performed a few hours after the procedure. Images revealed a bilateral renal fornix rupture with a large retroperitoneal fluid collection. The patient was treated conservatively with ureteral double-J placement and percutaneous nephrostomy. The further course was uneventful and the patient was discharged 2 weeks later free of symptoms. Renal fornix rupture is a very rare complication after contrast medium application that can be treated without surgery

  9. Barriers to safe abortion access: uterine rupture as complication of unsafe abortion in a Ugandan girl.

    Science.gov (United States)

    Olson, Rose McKeon; Kamurari, Solomon

    2017-10-20

    A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. She developed profuse vaginal bleeding and haemorrhagic shock. She was found to have uterine rupture and emergent hysterectomy was performed. Young and poor women are at high risk of unplanned pregnancy and subsequent mortality during pregnancy and childbirth. Unsafe abortion is a leading and entirely preventable cause of maternal mortality worldwide. Multiple barriers restrict access to safe abortions including social and moral stigma, gender-based power imbalances, inadequate contraceptive use and sexual education, high cost and poor availability, and restrictive abortion laws. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Therapeutic effect of intra-arterial chemotherapy with DDP and 5-FU via bilateral uterine arteries for advanced uterine cervical cancer

    International Nuclear Information System (INIS)

    Zhou Kang; Li Xiaoguang; Jin Zhengyu; Yang Ning; Liu Wei; Pan Jie; Zhang Xiaobo; Shi Haifeng; Sun Hao; Wang Zhiwei

    2010-01-01

    Objective: To evaluate the therapeutic effect of intra-arterial chemotherapy with Ddp and 5-Fu via bilateral uterine arteries for advanced uterine cervical cancer. Methods: During the period of Jan. 2006-Jan. 2009, initial intra-arterial chemotherapy by using a combination of Ddp and 5-Fu via bilateral uterine arteries was performed in 72 patients (mean age 42.9 years) with advanced uterine cervical caner. Of 72 patients, stage I b2 cervical cancer was confirmed in 28, stage II a in 12 and stage II b in 32. Pathologically, cervical squamous cell carcinoma was seen in 56 and cervical adenocarcinoma in 16 patients. Ultrasonography and physical examination were conducted both before and after intra-arterial chemotherapy. The therapeutic results,complications,the surgical resection rate and the pathologic findings were observed and statistically analyzed. Results: Fifty-four patients received one treatment course and 18 patients received two treatment courses. The over all response rate was 77.8%. The response rates of patients with I b2, II a and II b cervical cancer were 92.9%, 83.3% and 62.5% respectively, the difference between three groups was statistically significant (P < 0.05). And the response rates of patients with squamous cell carcinoma and adenocarcinoma were 85.7% and 50.0% respectively, the difference between the two was statistically significant (P < 0.05). The most common side-effects included gastrointestinal symptoms and bone marrow suppression. Thirty-four patients received radical hysterectomy,among them, 22 (78.6%) had stage I b2, 8 (66.7%) had stage II a and 4 (12.5%) had stage II b cervical cancer (P < 0.05). Pathologic exam found no vaginal invasion and ovarian metastasis in all 34 patients. The occurrence of metastasis to lymph nodes and para uterine infiltration were 17.6% and 11.8% respectively. Conclusion: Intra-arterial chemotherapy with a combination of DDP and 5-Fu via bilateral uterine arteries can safely and effectively reduce the

  11. Associated Factors and Outcome of Uterine Rupture at Suhul General Hospital, Shire Town, North West Tigray, Ethiopia 2016: A Case-Control Study

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    Tefera Marie Bereka

    2017-01-01

    Full Text Available Background. Uterine rupture is tearing of the uterine wall during pregnancy or delivery. It may extend to partial or whole thickness of the uterine wall. It is usually a case where obstetric care is poor. In extensive damage, death of the baby and sometimes even maternal death are evident. Objective. This study assesses associated factors and outcome of uterine rupture at Suhul General Hospital, Tigray Region, Ethiopia, 2016. Methodology. A case-control study was conducted by review of data from September 2012 to August 2016. A total of 336 samples were studied after calculating by EPI-INFO using proportion of multiparity (53% and ratio of 1 : 2 for cases and controls, respectively. Analysis was done using SPSS version 20. Bivariate and multivariate logistic regression was applied with p<0.05. Result. ANC, grand multiparity, malpresentation, and obstructed labor had association, but previous cesarean delivery was not significant. Perinatal mortality was 105 (93% versus 13 (5.8% in cases and controls, respectively. Anemia was highest for both groups (53.7% versus 32.1%. Conclusion. Majority of uterine rupture is attributed to prolonged or obstructed labor. Cases of uterine rupture had prompt management preventing maternal mortality, but burden of perinatal death is still high.

  12. Quadriceps Tendon Rupture and Contralateral Patella Tendon Avulsion Post Primary Bilateral Total Knee Arthroplasty: A Case Report

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    Gaurav Sharma

    2016-07-01

    Full Text Available Background: Extensor mechanism failure secondary to knee replacement could be due to tibial tubercle avulsion, Patellar tendon rupture, patellar fracture or quadriceps tendon rupture. An incidence of Patella tendon rupture of 0.17% and Quadriceps tendon rupture of around 0.1% has been reported after Total knee arthroplasty. These are considered a devastating complication that substantially affects the clinical results and are challenging situations to treat with surgery being the mainstay of the treatment. Case Description: We report here an interesting case of a patellar tendon rupture of one knee and Quadriceps tendon rupture of the contralateral knee following simultaneous bilateral knee replacement in a case of inflammatory arthritis patient. End to end repair for Quadriceps tear and augmentation with Autologous Hamstring tendon graft was done for Patella tendon rupture. OUTCOME: Patient was followed up for a period of 1 year and there was no Extension lag with a flexion of 100 degrees in both the knees. DISCUSSION: The key learning points and important aspects of diagnosing these injuries early and the management techniques are described in this unique case of bilateral extensor mechanism disruption following knee replacements.

  13. Operative technique at caesarean delivery and risk of complete uterine rupture in a subsequent trial of labour at term. A registry case-control study.

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    Dorthe L A Thisted

    Full Text Available To estimate the relation of single-layer closure at previous caesarean delivery, and other pre-labour and intra-partum risk factors for complete uterine rupture in trial of vaginal birth after a caesarean (TOLAC at term.Population-based case-control study. We identified all women (n = 39 742 recorded in the Danish Medical Birth Registry (DMBR during a 12-year period (1997-2008 with a singleton pregnancy at term and TOLAC. Among these, all women with a complete uterine rupture were identified (cases. Information from the registry was validated against medical records. Controls were selected in the DMBR as the following two births with TOLAC at term and no uterine rupture. Detailed information from cases and controls was collected from manual review of medical records. Main outcome measure was complete uterine rupture during TOLAC at term.Upon validation, 175 cases and 272 controls met the above criteria. After adjustment for possible confounding factors there was no association between single layer closure and uterine rupture (aOR 1.38, CI: 0.88-2.17. Significant risk factors were: Induction with an unfavourable cervix (aOR 2.10 CI: 1.19-3.71, epidural (aOR 2.17 CI 1.31-3.57, augmentation by oxytocin for more than one hour (aOR 2.03 CI: 1.20-3.44, and birth weight ≥ 4000g (aOR 2.65 CI 1.05-6.64. Previous vaginal delivery (aOR 0.41 CI: 0.25-0.68 and inter-delivery interval of more than 24 months (aOR 0.38 CI: 0.18-0.78 reduced the risk of uterine rupture.Single-layer uterine closure did not remain significantly associated to uterine rupture during TOLAC at term after adjustment for confounding factors. Induction of labour with an unfavourable cervix, birth weight ≥ 4000g and indicators of prolonged labour were all major risk factors for uterine rupture.

  14. Operative technique at caesarean delivery and risk of complete uterine rupture in a subsequent trial of labour at term. A registry case-control study

    DEFF Research Database (Denmark)

    Thisted, Dorthe L. A.; Mortensen, Laust H.; Hvidman, Lone

    2017-01-01

    Objective: To estimate the relation of single-layer closure at previous caesarean delivery, and other pre-labour and intra-partum risk factors for complete uterine rupture in trial of vaginal birth after a caesarean (TOLAC) at term. Study design: Population-based case-control study. We identified...

  15. Risk of uterine rupture in women undergoing trial of labour with a history of both a caesarean section and a vaginal delivery.

    Science.gov (United States)

    de Lau, Hinke; Gremmels, Hendrik; Schuitemaker, Nico W; Kwee, Anneke

    2011-11-01

    To determine the risk of uterine rupture for women undergoing trial of labour (TOL) with both a prior caesarean section (CS) and a vaginal delivery. A systematic literature search was performed using keywords for CS and uterine rupture. The results were critically appraised and the data from relevant and valid articles were extracted. Odds ratios were calculated and a pooled estimate was determined using the Mantel-Haenszel method. Five studies were used for final analysis. Three studies showed a significant risk reduction for women with both a previous CS and a prior vaginal delivery (PVD) compared to women with a previous CS only, and two studies showed a trend towards risk reduction. The absolute risk of uterine rupture with a prior vaginal delivery varied from 0.17 to 0.46%. The overall odds ratio for PVD was 0.39 (95% CI 0.29-0.52, P history of both a CS and vaginal delivery are at decreased risk of uterine rupture when undergoing TOL compared with women who have only had a CS.

  16. Is uterine preservation combined with bilateral salpingo-oophorectomy to promote subsequent fertility safe in infiltrative mucinous ovarian cancer?

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    Sebastien Gouy

    2017-11-01

    Full Text Available According to the latest World Health Organization classification (2014, mucinous ovarian cancers should be classified histologically as being either expansile or infiltrative. Compared to other epithelial cancers, both of these mucinous patterns are diagnosed, in the main, at an early stage, although they can affect relatively young patients. The infiltrative subtype is characterized by a morphologically and clinically more aggressive disease versus the expansile form. Consequently, even in young patients who would prefer fertility sparing management, the removal of both ovaries (even for a unilateral tumor remains a common recommendation. However case reports describing the preservation of the uterus for a further potential pregnancy (following oocyte donation have now been described. In this series, we present six patients treated for stage I mucinous infiltrative cancer using bilateral salpingo-oophorectomy with uterine preservation. All but one patient underwent 1-step (n = 1 or 2-step (n = 4 surgery, including peritoneal and nodal (4 patients procedures. Disease stages were IA (n = 2, IC1 (n = 1, IC2 (n = 2, or IC3 (n = 1. While two patients subsequently became pregnant, two patients also suffered disease recurrence. For one patient, recurrence was at the pelvic peritoneum. For the second patient, an ultimately lethal disease recurrence involved the uterine serosa with nodal involvement. The results of this short series lead us to question the safety of this uterine-preserving strategy.

  17. Spontaneous uterine cornual rupture at 26 weeks' gestation in an interstitial heterotopic pregnancy following in vitro fertilization.

    Science.gov (United States)

    Paradise, Courtney; Carlan, S J; Holloman, Conisha

    2016-06-01

    Interstitial implantation in a heterotopic pregnancy is extremely rare, and despite currently available diagnostic modalities, early identification of an interstitial ectopic pregnancy remains difficult. This report describes a case of spontaneous cornual rupture at 26 weeks' gestation in a woman with diamniotic dichorionic twins that resulted in live births. The patient had previously undergone laparoscopic bilateral salpingectomy, and the pregnancy was conceived with in vitro fertilization. Interstitial implantation in a heterotopic pregnancy can go unrecognized, resulting in increased maternal and infant morbidity and mortality. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 44:322-325, 2016. © 2015 Wiley Periodicals, Inc.

  18. Diagnostic failure of ciprofloxacin-induced spontaneous bilateral Achilles tendon rupture: case-report and medical-legal considerations.

    Science.gov (United States)

    Pantalone, A; Abate, M; D'Ovidio, C; Carnevale, A; Salini, V

    2011-01-01

    Rare side-effects of fluoroquinolone therapy are tendinitis and tendon rupture. Many reports have demonstrated that the concomitant use of corticosteroids, in patients aged 60 years or older, increase the risk substantially. We present a case of spontaneous bilateral Achilles tendon rupture induced by ciprofloxacin and methylprednisolone. A 61-year-old woman was diagnosed with Bronchiolitis Obliterans with Organizing Pneumonia (BOOP) and was started on oral ciprofloxacin 500 mg twice daily for 3 weeks and on oral methylprednisolone 16 mg twice daily for 2 weeks. The diagnosis was made after doctors, rather than stop drug therapy and advise complete rest, had mistakenly prescribed for the woman to undergo physiotherapy and local NSAIDs, thus favoring the onset of tendon ruptures and resulting in surgical and legal implications. Inspired by this case, we also submit a brief review on professional liability in Orthopaedics.

  19. [Embolization of a ruptured pseudo-aneurysm of the uterine artery at 26weeks of gestation: Materno-fetal consequences; a case-report].

    Science.gov (United States)

    Maignien, C; Marcellin, L; Anselem, O; Silvera, S; Dousset, B; Grangé, G; Goffinet, F

    2015-09-01

    Rupture of a uterine artery pseudo-aneurysm during pregnancy is a rare condition with potential life-threatening complications, and management should take into account the fetal impact of the therapeutic choice. We report the case of a 2cm left uterine artery pseudo-aneurysm revealed by pelvic pain, in a 30-year-old pregnant woman at 26(+0)weeks of gestation (WG). Diagnosis was suspected at ultrasound scan, and confirmed with Magnetic Resonance angiography that showed signs of pre-rupture. An emergency selective embolization attempted in utero allowed the complete exclusion of the aneurysmal sac. The patient gave birth one month later to a girl at 31(+1)WG, initially managed by neonatologists, who is currently in good health. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. [Assessment, delivery and peripartum care in the case of a uterine rupture during labor of a woman with a previous C-section].

    Science.gov (United States)

    Parrilla-Fernández, Alberto; Manrique-Tejedor, Javier; Figuerol-Calderó, M Inmaculada; García-Romero, Verónica

    Uterine rupture is a rare but severe complication in obstetrics. A previous C-section is the most important risk factor. Its incidence during labor in women with a previous C-section is of approximately 0.3-0.47%, being potentially severe. We present the case of a pregnant women with a previous C-section who suffered uterine rupture during labor. The rapid assessment and action of the midwife and obstetric team was essential to obtain a successful obstetric outcome, avoiding maternal and fetal mortality; and nursing care given to the mother and the newborn after birth contributed to achieving a normal postpartum. It is necessary to have specific knowledge about this condition that, despite rare, can present insidiously with a potential risk for the mother and the fetus. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  1. Spontaneous Uterine Rupture at 15 Weeks' Gestation in a Patient with a History of Cesarean Delivery after Removal of Shirodkar Cerclage

    Directory of Open Access Journals (Sweden)

    Serika Kanao

    2014-05-01

    Full Text Available A pregnant woman presented with acute upper abdominal pain and nausea at 15 weeks' gestation. She had a history of cesarean delivery for abruption after the removal of a Shirodkar cerclage that was placed because of cervical shortening caused by conization. She became pregnant again 14 months later. Ultrasonography revealed no significant findings, and a single intrauterine pregnancy with positive fetal heart activity was confirmed. An intestinal obstruction was suspected because abdominal radiography showed multiple air–fluid levels in the colon. Over the 3 hours following admission, her symptoms gradually worsened, and plain abdominal computed tomography (CT showed a large hemorrhage in the abdominal cavity, but the uterine wall appeared intact at this time. Subsequently, dynamic CT revealed discontinuity of the uterine muscle layer. During laparotomy, uterine rupture with complete opening of the uterine wall at the site of the previous transverse scar was identified. A dead fetus was located within the amniotic sac in a blood-filled abdominal cavity. She received a total of 10 units of packed red blood cells and 6 units of fresh frozen plasma for the resuscitation. She was discharged on the eighth postoperative day without any complications.

  2. Rupture

    CERN Multimedia

    Association du personnel

    2006-01-01

    Our Director-General is indifferent to the tradition of concertation foreseen in our statutes and is "culturally" unable to associate the Staff Association with problem-solving in staff matters. He drags his heels as long as possible before entering into negotiations, presents "often misleading" solutions at the last minute which he only accepts to change once a power struggle has been established. Faced with this rupture and despite its commitment to concertation between gentlemen. The results of the poll in which the staff is invited to participate this week. We therefore need your support to state our claims to the Governing Bodies. The Staff Association proposes a new medium of communication and thus hopes to show that it is ready for future negotiations. The pages devoted to the Staff Association are presented in a more informative, reactive and factual manner and in line with the evolution of the social situation at CERN. We want to establish strong and continuous ties between the members of CERN and ou...

  3. The Nordic Obstetric Surveillance Study: a study of complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery.

    Science.gov (United States)

    Colmorn, Lotte B; Petersen, Kathrine B; Jakobsson, Maija; Lindqvist, Pelle G; Klungsoyr, Kari; Källen, Karin; Bjarnadottir, Ragnheidur I; Tapper, Anna-Maija; Børdahl, Per E; Gottvall, Karin; Thurn, Lars; Gissler, Mika; Krebs, Lone; Langhoff-Roos, Jens

    2015-07-01

    To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. Prospective, Nordic collaboration. The Nordic Obstetric Surveillance Study (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. Rates of the studied complications and possible risk factors among parturients in the Nordic countries. The studied complications were reported in 1019 instances among 605 362 deliveries during the study period. The reported rate of severe blood loss at delivery was 11.6/10 000 deliveries, complete uterine rupture was 5.6/10 000 deliveries, abnormally invasive placenta was 4.6/10 000 deliveries, and peripartum hysterectomy was 3.5/10 000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35 years old, overweight, with a higher parity, and a history of cesarean delivery compared with the total population. The studied obstetric complications are rare. Uniform definitions and valid reporting are essential for international comparisons. The main risk factors include previous cesarean section. The detailed information collected in the NOSS database provides a basis for epidemiologic studies, audits, and educational activities. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Therapeutic efficacy of uterine arterial embolization for intractable uterine hemorrhage

    International Nuclear Information System (INIS)

    Liu Lang; Lu Lianwei; Ke Mengjia; Zhao Ru'en; Zeng Shaolan

    2010-01-01

    Objective: To evaluate the therapeutic efficacy of uterine arterial embolization (UAE) for intractable uterine hemorrhage. Methods: 16 patients with intractable uterine hemorrhage underwent bilateral UAE after failed conventional conservative treatment. Results: Uterine hemorrhage ceased within 12 hours in 15 patients (93.8%) after bilateral super-selective UAE. Internal iliac artery embolization was performed on one patient (6.2%) and hysterectomy was eventually carried out because of recurrent hemorrhage. Conclusion: UAE is a rapid and effective treatment method obviating hysterectomy for intractable uterine hemorrhage. (authors)

  5. Case Report: Rupture of the Pregnant Uterus in an Unbooked ...

    African Journals Online (AJOL)

    Uterine rupture is a life threatening complication in pregnancy in developing countries. While multiparity is a commonly associated factor, primigravida are said to be immune to uterine rupture. We present a case of uterine rupture in an unbooked primigravida who had massive bolus doses of intravenous oxytocin in the ...

  6. Bilateral akillesseneruptur hos nyretransplanterede

    DEFF Research Database (Denmark)

    Skovgaard, D; Feldt-Rasmussen, B F; Nimb, L

    1996-01-01

    Increased incidence of tendinitis and tendon ruptures is reported in recipients of a kidney transplant. Two cases of bilateral achilles tendon rupture after minimal trauma are described. Tendon ruptures are more frequent in individuals with kidney disease in dialysis or after transplantation comp...

  7. Four cases of spontaneous rupture of the urinary bladder

    International Nuclear Information System (INIS)

    Amano, Toshiyasu; Miwa, Sotaro; Takashima, Hiroshi; Takemae, Katsuro

    2002-01-01

    Between November 1997 and March 2001, 4 female patients from 44 to 65 years of age with a spontaneous rupture of the urinary bladder were analyzed. They complained of abdominal pain and had undergone an intra-pelvic gynecological operation (3 for uterine cancer, 1 for an ovarian cyst) several years before. The three with uterine cancer had also received radiation therapy. For their present condition, spontaneous urinary bladder rupture, their treatment was indwelling a urethral catheter. Two of them have had no recurrence of urinary bladder rupture after one month since having the urethral catheter indwelt. One, however, had to have the catheter re-indwelt due to unsuccessful suturing of the urinary bladder wall. The fourth patient had bilateral nephrostomy tubes due to severe radiation cystitis. Thus, one can infer that intra-pelvic gynecological operations and radiation therapy are major factors causing spontaneous urinary bladder rupture. While indwelling a urethral catheter may be effective for some patients with a spontaneous rupture of the urinary bladder, it may be very difficult to treat more complicated cases. (author)

  8. Spontaneous rupture of the urinary bladder in a woman with radiation cystitis. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kurizaki, Yoshiki; Ishizuka, Osamu [Kofu Municipal Hospital, Yamanashi (Japan)

    1997-07-01

    A 79-year-old woman was admitted to our hospital with gross hematuria and abdominal pain. She had had a uterine cancer 11 years previously and received 56 Gy {sup 60}Co external irradiation combined with 129 Gy {sup 137}Cs internal irradiation. She had a sign of pan-peritonitis. An emergency operation revealed an intraperitoneal rupture of the dome of the urinary bladder 8 cm in length. Because a primary suturing of the bladder wall was unsuccessful, bilateral cutaneous ureterostomy was performed. Histologically, the ruptured bladder wall showed a mucosal erosion and fibrosis of the muscle layer. (author)

  9. Rupture of primigravid uterus and recurrent rupture

    Directory of Open Access Journals (Sweden)

    Nahreen Akhtar

    2016-08-01

    Full Text Available Uterine rupture is a deadly obstetrical emergency endangering the life of both mother and fetus. In Bangladesh, majority of deliveries arc attended by unskilled traditional birth attendant and maternal mortality is still quite high. It is rare Ln developed country but unfortunately it is common in a developing country like Bangladesh. We report a case history of a patient age 32yrs from Daudkandi, Comilla admitted with H/0 previous two rupture uterus and repair with no living issue. We did caesarean section at her 31+ weeks of pregnancy when she developed Jabour pain. A baby of 1.4 kg was delivered. During cesarean section, focal rupture was noted in previous scar of rupture. Unfortunately the baby expired in neonatal ICU after 36 hours.

  10. Postmenopausal spontaneous uterine perforation: Case report

    Science.gov (United States)

    İşlek Seçen, Elçin; Ağış, Hilal; Altunkaya, Canan; Avşar, Ayşe Filiz

    2015-01-01

    Spontaneous uterine rupture and generalized peritonitis caused by pyometra occurs rarely with high morbidity and mortality. A correct and definite diagnosis can be made with laparotomy or laparoscopy. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and gynecologic symptoms are less frequent, which makes preoperative diagnosis difficult. We report a case of a patient aged 82 years who underwent surgery for spontaneous uterine rupture and generalized peritonitis as a result of pyometra. PMID:28913055

  11. [Chronic renal failure secondary to uterine prolapse].

    Science.gov (United States)

    Peces, R; Canora, J; Venegas, J L

    2005-01-01

    Acute and chronic renal failure secondary to bilateral severe hydroureteronephrosis is a rare sequela of uterine prolapse. We report a case of neglected complete uterine prolapse in a 72-year-old patient resulting in bilateral hydroureter, hydronephrosis, and chronic renal failure. In an attempt to diminish the ureteral obstruction a vaginal pessary was used to reduce the uterine prolapse. Finally, surgical repair of prolapse by means of a vaginal hysterectomy was performed. In conclusion, all patients presenting with complete uterine prolapse should be screened to exclude urinary tract obstruction. If present, obstructive uropathy should be relieved by the reduction or repair of the prolapse before irreversible renal damage occurs.

  12. Uterine Cancer

    Science.gov (United States)

    ... is pregnant. There are different types of uterine cancer. The most common type starts in the endometrium, ... the uterus. This type is also called endometrial cancer. The symptoms of uterine cancer include Abnormal vaginal ...

  13. Traumatic Fundal Rupture of unscarred Uterus in a Primigravida ...

    African Journals Online (AJOL)

    Background: Uterine rupture is an infrequent but life threatening obstetric emergency. Rupture of previously scarred uterus is often encountered especially in multiparous women, but the traumatic rupture of an unscarred primigravid uterus as presented here is a relatively rare event. We report a case of rupture of an ...

  14. Uterine fibroids

    Science.gov (United States)

    ... Instructions Hysterectomy - abdominal - discharge Hysterectomy - laparoscopic - discharge Hysterectomy - vaginal - discharge Uterine artery embolization - discharge Images Pelvic laparoscopy Female ...

  15. Rupture of the uterus in Durban in in the new millenium: why is it still ...

    African Journals Online (AJOL)

    This was an audit of the number of cases of uterine rupture that occurred hospital, in a large metropolitan setting. The audit showed that uterine ruptures are more likely to occur in women with 1 previous caesarean section undergoing vaginal birth after caesarean section (VBAC) than in women with unscarred uterine.

  16. Analysis of ruptured uterus in Debre Markos Hospital, Ethiopia ...

    African Journals Online (AJOL)

    Objective: To determine the incidence of uterine rupture in a rural hospital and to examine its cause, type and outcome. Design: A prospective study. Setting: Debre Markos Hospital, Ethiopia. Subject. All patients who were admitted and operated on for uterine rupture in the above mentioned hospital over a period of two ...

  17. Delay in the diagnosis of rupture of the uterus due to epidural anesthesia in labor.

    Science.gov (United States)

    Abraham, R; Sadovsky, E

    1992-01-01

    A case report of uterine rupture in labor with epidural anesthesia is presented. The woman had good analgesia on the left side, but complained of severe labor pais on her right side. Uterine rupture occurred which was manifested by sudden vaginal bleeding, fainting, low blood pressure and fetal distress. She did not feel any pains typical of uterine rupture. Rupture of the left uterine wall, with a large hematoma in the left parametrium was seen at surgery. It seems the unilateral anesthesia of the left side concealed the early signs of rupture.

  18. Single versus double-layer uterine closure at cesarean: impact on lower uterine segment thickness at next pregnancy.

    Science.gov (United States)

    Vachon-Marceau, Chantale; Demers, Suzanne; Bujold, Emmanuel; Roberge, Stephanie; Gauthier, Robert J; Pasquier, Jean-Charles; Girard, Mario; Chaillet, Nils; Boulvain, Michel; Jastrow, Nicole

    2017-07-01

    Uterine rupture is a potential life-threatening complication during a trial of labor after cesarean delivery. Single-layer closure of the uterus at cesarean delivery has been associated with an increased risk of uterine rupture compared with double-layer closure. Lower uterine segment thickness measurement by ultrasound has been used to evaluate the quality of the uterine scar after cesarean delivery and is associated with the risk of uterine rupture. To estimate the impact of previous uterine closure on lower uterine segment thickness. Women with a previous single low-transverse cesarean delivery were recruited at 34-38 weeks' gestation. Transabdominal and transvaginal ultrasound evaluation of the lower uterine segment thickness was performed by a sonographer blinded to clinical data. Previous operative reports were reviewed to obtain the type of previous uterine closure. Third-trimester lower uterine segment thickness at the next pregnancy was compared according to the number of layers sutured and according to the type of thread for uterine closure, using weighted mean differences and multivariate logistic regression analyses. Of 1613 women recruited, with operative reports available, 495 (31%) had a single-layer and 1118 (69%) had a double-layer closure. The mean third-trimester lower uterine segment thickness was 3.3 ± 1.3 mm and the proportion with lower uterine segment thickness cesarean delivery is associated with a thicker third-trimester lower uterine segment and a reduced risk of lower uterine segment thickness <2.0 mm in the next pregnancy. The type of thread for uterine closure has no significant impact on lower uterine segment thickness. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. PREMATURE RUPTURE OF THE MEMBRANES*

    African Journals Online (AJOL)

    In patients presenting with premature rupture of the membranes there are two factors which influence the foetal morbidity and mortality. These factors are prema- turity and intra-uterine infection. The purpose of this analysis was to elucidate which factor carried the greater risk to the foetus. Recently there has been a spate of.

  20. Rupture of a primigravid uterus following a domestic accident | Oriji ...

    African Journals Online (AJOL)

    Background: Uterine rupture is an infrequent but life threatening obstetric emergency especially in a developing country such as Nigeria. Often encountered is the rupture of previously scarred uterus especially in multiparous women, but the traumatic rupture of an unscarred primigravid uterus as presented here is a ...

  1. Uterine Cancer

    Science.gov (United States)

    ... I find more information about uterine and other gynecologic cancers? Centers for Disease Control and Prevention: 800-CDC-INFO or www. cdc. gov/ cancer/ gynecologic National Cancer Institute: 800-4-CANCER or www. ...

  2. The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids.

    Science.gov (United States)

    Pron, Gaylene; Bennett, John; Common, Andrew; Wall, Jane; Asch, Murray; Sniderman, Kenneth

    2003-01-01

    To evaluate fibroid uterine volume reduction, symptom relief, and patient satisfaction with uterine artery embolization (UAE) for symptomatic fibroids. Multicenter, prospective, single-arm clinical treatment trial. Eight Ontario university and community hospitals. Five hundred thirty-eight patients undergoing bilateral UAE. Bilateral UAE performed with polyvinyl alcohol particles sized 355-500 microm. Three-month follow-up evaluations including fibroid uterine volume reductions, patient reported symptom improvement (7-point scale), symptom life-impact (10-point scale) reduction, and treatment satisfaction (6-point scale). Median uterine and dominant fibroid volume reductions were 35% and 42%, respectively. Significant improvements were reported for menorrhagia (83%), dysmenorrhea (77%), and urinary frequency/urgency (86%). Mean menstrual duration was significantly reduced after UAE (7.6 to 5.4 days). Improvements in menorrhagia were unrelated to pre-UAE uterine size or post-UAE uterine volume reduction. Amenorrhea occurring after the procedure was highly age dependent, ranging from 3% (1%-7%) in women under age 40 to 41% (26%-58%) in women age 50 or older. Median fibroid life-impact scores were significantly reduced after UAE (8.0 to 3.0). The majority (91%) expressed satisfaction with UAE treatment. UAE reduced fibroid uterine volume and provided significant relief of menorrhagia that was unrelated to initial fibroid uterine size or volume reduction. Patient satisfaction with short-term UAE treatment outcomes was high.

  3. Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Seon; Lee, Do Yon; Kim, Yong Tae; Park, Ki Hyun; Park, Yong Won; Cho, Jae Sung; Kim, Myung Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of); Won, Je Hwan [Ajou Univ. College of Medicine, Suwon (Korea, Republic of); Kang, Byung Chul [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired.

  4. Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

    International Nuclear Information System (INIS)

    Park, Jeong Seon; Lee, Do Yon; Kim, Yong Tae; Park, Ki Hyun; Park, Yong Won; Cho, Jae Sung; Kim, Myung Jun; Won, Je Hwan; Kang, Byung Chul

    1999-01-01

    To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired

  5. Mullerian dysgenesis with bilateral inguinal hernia

    Directory of Open Access Journals (Sweden)

    Rohan Khairatkar

    2015-01-01

    Full Text Available The 45-year-female patient came with complaints of bilateral groin pain since 1-year. Clinical examination revealed bilateral groin swelling with cough impulse. Ultrasonography (USG revealed Mullerian dysgenesis with two separate noncommunicating uterine tissues and two ovaries. USG showed bilateral inguinal hernia with herniation of right ovary in right inguinal canal and left fallopian tube in left inguinal canal. Exploration of both inguinal canal revealed underdeveloped uterus, fallopian tube and ovary. Patient underwent bilateral hernioplasty.

  6. Pregnancy after uterine arterial embolization

    Directory of Open Access Journals (Sweden)

    Cláudio E. Bonduki

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter. Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2, and 87.5% were successful live births (n = 14. The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54. One of the pregnancies resulted in twins. The newborn weights (n = 14 ranged from 2.260 to 3.605 kg (mean, 3.072 kg. One (7.1% was considered to have a low birth weight (2.260 kg. There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%], one case of premature rupture of the membranes (PRM (6.3%, and one case of preeclampsia (6.3%. All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  7. Ruptured Cesarean Scar Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Sujatha BS

    2017-07-01

    Full Text Available A pregnancy with implantation on the scar of a past cesarean section is uncommon. However such pregnancies are on the rise due to the increasing number of lower segment cesarean section. One of the complications of such a pregnancy is uterine rupture in early pregnancy which can be life threatening to the patient. The following is a report of a patient who presented at 10 weeks of gestational age with features of hypovolemic shock and lower position of the gestational sac in relation to the uterus with normal fetal heart rate. The diagnosis of ruptured cesarean scar pregnancy was made only after laparotomy.

  8. Abnormal Uterine Bleeding

    Science.gov (United States)

    ... uterine cancer isn’t the cause. Women after menopause Hormone replacement therapy is a common cause of uterine bleeding after menopause. Other causes include endometrial and uterine cancer. These ...

  9. Abnormal uterine bleeding

    Science.gov (United States)

    Anovulatory bleeding; Abnormal uterine bleeding - hormonal; Polymenorrhea - dysfunctional uterine bleeding ... ACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Reaffirmed 2015. ACOG. ...

  10. Uterine artery embolization with Pingyangmycin lipiodol emulsion for treatment of symptomatic uterine fibroids

    International Nuclear Information System (INIS)

    Li Yanhao; Liu Biao; Zeng Qingle; Jiang Zhongpu; Chen Yong; Huang Weilang; Shen Qi; Zhao Zhongqing

    2000-01-01

    Objective: To evaluate the effectiveness and side effects of uterine arterial embolization with Pingyangmycin(a homogenous bleomycin) lipiodol emulsion(PLE) for symptomatic uterine fibroids. Methods: Uterine arterial embolization with PLE was performed in 25 patients. The improvement of symptoms and uterine size changes were followed up in 3-18 months(mean 6 months) after the procedure. Results: All but 2 cases were successfully treated bilaterally. Super-selective angiography showed enlargement of uterine artery, accompanied by tortuous branches. The uterine size was increased. The uterus itself was significantly stained and emptied slowly. Coagulation necrosis was found in resected fibroids after embolization in 3 patients. One month after the procedure, a mean 40% reduction of uterine volume was obtained in 18 followed-up cases. The clinical symptoms were relieved significantly. The main side effects were hypogastric pain(13/25),which was intense in 6 cases. Conclusion: Uterine arterial embolization with PLE is a good non-surgical therapy in symptomatic uterine fibroids with mild side effects

  11. Intrapartum Rupture of the Uterus Diagnosed by Ultrasound ...

    African Journals Online (AJOL)

    Background: Spontaneous uterine rupture is a life threatening obstetrical emergency encountered infrequently in the emergency department. Its diagnosis is often missed or delayed, leading to maternal and fetal mortality. Method: We present a case of ruptured uterus diagnosed by ultrasound in a 33-year-old gravid female ...

  12. Rupture of uterus treated with suture.

    Science.gov (United States)

    Klungsøyr, P; Kiserud, T

    1990-01-01

    Between August 1983 and August 1985, 63 patients in labor with uterine rupture were treated at Sidamo Regional Hospital, Yirgaalem, South Ethiopia, mainly by suture of the uterus. None of those operated on died. We recommend suturing as the treatment of choice. Hysterectomy is rarely indicated.

  13. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...

  14. Rupture disc

    International Nuclear Information System (INIS)

    Newton, R.G.

    1977-01-01

    The intermediate heat transport system for a sodium-cooled fast breeder reactor includes a device for rapidly draining the sodium therefrom should a sodium-water reaction occur within the system. This device includes a rupturable member in a drain line in the system and means for cutting a large opening therein and for positively removing the sheared-out portion from the opening cut in the rupturable member. According to the preferred embodiment of the invention the rupturable member includes a solid head seated in the end of the drain line having a rim extending peripherally therearound, the rim being clamped against the end of the drain line by a clamp ring having an interior shearing edge, the bottom of the rupturable member being convex and extending into the drain line. Means are provided to draw the rupturable member away from the drain line against the shearing edge to clear the drain line for outflow of sodium therethrough

  15. Globe Rupture

    Directory of Open Access Journals (Sweden)

    Reid Honda

    2017-07-01

    Full Text Available History of present illness: A 46-year-old male presented to the emergency department (ED with severe left eye pain and decreased vision after tripping and striking the left side of his head on the corner of his wooden nightstand. The patient arrived as an inter-facility transfer for a suspected globe rupture with a protective eye covering in place; thus, further physical examination of the eye was not performed by the emergency physician in order to avoid further leakage of aqueous humor. Significant findings: The patient’s computed tomography (CT head demonstrated a deformed left globe, concerning for ruptured globe. The patient had hyperdense material in the posterior segment (see green arrow, consistent with vitreous hemorrhage. CT findings that are consistent with globe rupture may include a collapsed globe, intraocular air, or foreign bodies. Discussion: A globe rupture is a full-thickness defect in the cornea, sclera, or both.1 It is an ophthalmologic emergency. Globe ruptures are almost always secondary to direct perforation via a penetrating mechanism; however, it can occur due to blunt injury if the force generated creates sufficient intraocular pressure to tear the sclera.2 Globes most commonly rupture at the insertions of the intraocular muscles or at the limbus. They are associated with a high rate of concomitant orbital floor fractures.2,3 Possible physical examination findings include a shallow anterior chamber on slit-lamp exam, hyphema, and an irregular “teardrop” pupil. Additionally, a positive Seidel sign, which is performed by instilling fluorescein in the eye and then examining for a dark stream of aqueous humor, is indicative of a globe rupture.4 CT is often used to assess for globe rupture; finds of a foreign body, intraocular air, abnormal contour or volume of the globe, or disruption of the sclera suggest globe rupture.2 The sensitivity of CT scan for diagnosis of globe rupture is only 75%; thus, high clinical

  16. Carcinosarcoma arising from uterine adenomyosis: A case report.

    Science.gov (United States)

    Kiuchi, Kaori; Hasegawa, Kiyoshi; Kanamori, Anriko; Machida, Hiromi; Kojima, Masaru; Fukasawa, Ichio

    2016-03-01

    Carcinosarcoma arising from uterine adenomyosis is extremely rare. We encountered such a patient and herein provide a review of the literature. A 56-year-old woman was referred for a huge pelvic tumor, suspected to be an advanced uterine leiomyosarcoma. Intraoperative inspection revealed a mass, mainly located in the uterine myometrium, invading the uterine serosa. The tumor had previously spontaneously ruptured and disseminated to the pelvic cavity. Pathological and immunohistochemical examination revealed an infiltrative pattern of biphasic tumor cells composed of endometrioid adenocarcinoma and a nonepithelial component with rhabdomyosarcomatous differentiation. Benign endometrial glands with stromal cells were found adjacent to the area of the carcinosarcoma. The endometrium and both ovaries and fallopian tubes were microscopically free of tumor cells. The final diagnosis was heterologous type carcinosarcoma with rhabdomyosarcomatous differentiation, originating from uterine adenomyosis. © 2015 Japan Society of Obstetrics and Gynecology.

  17. [Myomectomy and uterine desarterialization as conservative treatment for uterine fibroids: Review of clinic case].

    Science.gov (United States)

    Garcia-de la Torre, J I; Aguirre-Ramos, M A; Ramos-Alvarado, A M; Villa-Ponce, D; González-Cantú, G

    2016-02-01

    Uterine fibroids are the most common gynecological tumors; the prevalence increases with age. They can cause symptoms (20-50%). Myomectomy is an alternative for women who wish to preserve their fertility, increased risk of blood loss and longer operative time. Since 2000, a significant number of surgeons have performed occlusion of uterine arteries prior to myomectomy successfully. We report the case of a 24-year-old patient, with a history of premature birth; and starts her condition after obstetric event with abnormal uterine bleeding and postcoital bleeding, accompanied by intense, oppressive and stabbing abdominal pain and increased ab-dominal volume. At physical examination an enlarged abdominal wall by a tumor involving, abdominal pain on palpation, at the gynecological examination: frankly enlarged uterus, about 25 x 20 cm, painful and tenderness. Prior to myomectomy, uterine externalization takes place and proceeds to dearterialization of uterine arteries under the García-González technique, removing the tumor without complications, with an estimated 100 cc bleeding. The bilateral uterine artery ligation, is one of the methods used to re-duce intraoperative blood loss. It is a quick, simple technique, whose theoretical basis is that 90% of the irrigation of the uterus comes from the uterine arteries.

  18. Bilateral hydronephrosis

    Science.gov (United States)

    ... is most often from a common singular obstruction Neurogenic bladder - poorly functional bladder Posterior urethral valves - flaps on ... Vesicoureteric reflux - backup of the urine from the bladder up to the kidney Uterine prolapse ... a pregnancy ultrasound. A urinary tract infection in a newborn baby can signal a blockage ...

  19. Efeito do sulfato de magnésio sobre o índice de pulsatilidade das artérias uterinas, umbilical e cerebral média fetal de acordo com a persistência da incisura protodiastólica da artéria uterina na pré-eclâmpsia grave Effect of magnesium sulfate on pulsatility index of uterine, umbilical and fetal middle cerebral arteries according to the persistence of bilateral diastolic notch of uterine arteries in patients with severe preeclampsia

    Directory of Open Access Journals (Sweden)

    Alex Sandro Rolland Souza

    2009-02-01

    ção intravenosa de 6 g do sulfato de magnésio nas pacientes com pré-eclâmpsia grave, ocorre uma diminuição da pressão arterial e do IP das artérias uterinas, umbilicais e cerebral média fetal, além de aumento da frequência cardíaca materna, não influenciada pela presença de incisura protodiastólica bilateral nas artérias uterinas.PURPOSE: to evaluate the effect of magnesium sulphate on the pulsatility index (PI of the uterine, umbilical and fetal middle cerebral arteries, according to the persistency or not of the bilateral protodiastolic notch of the uterine arteries in severe pre-eclampsia. METHODS: a cohort study including 40 pregnant women with severe pre-eclampsia, 23 of them presenting bilateral protodiastolic notch, and 17, unilateral/absent notch. The patients were submitted to Doppler velocimetry before and 20 minutes after the intravenous administration of 6 g of magnesium sulphate. The examination was carried out with the patient in semi-Fowler position, the sonograms being obtained during fetal inactivity, in apnea and absent uterine contraction periods. All the exams were performed by two researchers, the average being considered as the final result. Wilcoxon's test was used to compare the PI, before and after magnesium sulphate in both groups. The difference between the two measurements (before and after magnesium sulphate was compared between the groups (bilateral incision and unilateral/absent incision using the Mann-Whitney test. RESULTS: there was a significant increase in the maternal heart rate (MHR and decrease in the maternal blood pressure, and in the PI medians of the two uterine arteries and in the fetal middle cerebral artery, after magnesium sulphate in both groups. There was a significant decrease in the PI of the left uterine artery and in the umbilical artery, only in the protodiastolic unilateral/absent notch group. Nevertheless, it was not found any significant difference regarding the PI of the right uterine artery, or the cerebral

  20. Transcatheter uterine arterial embolization for treatment of symptomatic uterine fibroids: preliminary experience

    International Nuclear Information System (INIS)

    Wang Zhongpu; Wang Maoqiang; Wu Chaoyang

    2000-01-01

    Objective: To evaluate the effectiveness of uterine arterial embolization (UAE) in the management of symptomatic uterine fibroids (UF). Methods: Ten patients with refractory vaginal bleeding, pelvic pain; and/or pelvic compression related to UF underwent UAE. The UF was diagnosed by radiological imaging and gynecological examination. 11 times of UAE were done in the ten patients, including bilateral uterine arterial embolization in 9 patients and un-bilateral embolization in 1 patient. The embolic materials used in this study was polyvinyl alcohol (PVA) particles. Results: All 10 patients underwent technically successful embolization. No serious complications related to the procedure have occurred. Follow-up data was available in 9 patients. Eight of the patients were experienced symptomatic relief after the treatment. One woman (the only patient undergoing un-bilateral UAE) exhibited no clinical response. The volume of dominant UF showed a mean 42% reduction 2 months after the treatment. Conclusions: Transcatheter uterine arterial embolization is a safe and effective method for the management of symptomatic UF. Longer follow-up is needed to evaluate the long term effects

  1. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with cipr......We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...... with ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

  2. Ruptured Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Valentina Park

    2016-09-01

    Full Text Available History of present illness: A 21-year-old female presented with sudden onset suprapubic abdominal pain associated with dysuria. The patient also experienced near syncope during bowel movements three times three days ago without falling or losing consciousness. She denied fever, nausea, and vomiting. She stated that she was five weeks pregnant by last menstrual period. She had an ultrasound a few weeks before that showed no intrauterine pregnancy, but she had not followed up for additional testing. Significant findings: The patient’s serum beta-hCG was 5,637 mIU/mL. The transvaginal ultrasound showed an empty uterus with free fluid posteriorly in the pelvis and Pouch of Douglas (00:00. A 4.5 cm heterogeneous mass was visible in the left adnexa concerning for an ectopic pregnancy (00:10. Discussion: Ectopic pregnancies are a leading cause of maternal morbidity and mortality, as well as decreased fertility.1,2 Differentiating between an ectopic pregnancy and a normal early pregnancy may be difficult, since ultrasound and quantitative beta-hCG may show inconclusive results.3,4 Patients who have used fertility treatment may further complicate the picture because they are at risk for heterotypic pregnancies.5 Ectopic pregnancies most commonly implant in the fallopian tube, but may alternatively implant in the ovary, cervix, abdomen, or uterine cornua.4 Ultrasonography may show an empty uterus, adnexal mass, pelvic free fluid, or an extra-uterine gestational sac, yolk sac, and/or embryo.6 Treatment options for ectopic pregnancy include surgery or methotrexate.2,4 Some patients may be candidates for close outpatient surveillance if the diagnosis is unclear or in very limited cases for early, non-ruptured ectopic pregnancies.2,4

  3. Uterine artery embolization to treat uterine fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Machan, L.; Martin, M. [Univ. of British Columbia Hospital, Dept. of Radiology, Vancouver, BC (Canada)

    2001-06-01

    The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

  4. Uterine artery embolization to treat uterine fibroids

    International Nuclear Information System (INIS)

    Machan, L.; Martin, M.

    2001-01-01

    The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

  5. Blunt traumatic diaphragmatic rupture

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Nogueira

    2011-09-01

    Full Text Available Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5%among patients who were victims of blunt trauma and underwent laparotomy.Clinical suspicion associated with radiological assessment contributes to earlydiagnosis. Isolated diaphragmatic injury has a good prognosis. Generallyworse outcomes are associated with other trauma injuries. Bilateral andright diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT scan of the chest and abdomen provides better diagnosticaccuracy using the possibility of image multiplanar reconstruction. Surgicalrepair via laparotomy and/ or thoracotomy in the acute phase of the injury hasa better outcome and avoids chronic complications of diaphragmatic hernia.The authors present the case of a young male patient, victim of blunt abdominaltrauma due to motor vehicle accident with rupture of the diaphragm, spleenand kidney injuries. The diagnosis was made by computed tomography of thethorax and abdomen and was confirmed during laparotomy.

  6. Bilateral Tubal Pregnancy without Known Risk Factor

    Directory of Open Access Journals (Sweden)

    Hyacinthe Zamané

    2017-01-01

    Full Text Available Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected. A laparotomy in emergency confirmed the diagnosis of bilateral ectopic gestation with a right ampullary unruptured pregnancy and a left isthmic ruptured gestation. A bilateral salpingectomy was performed and counseling was made for the use of medical help of procreation in case of future need of pregnancy.

  7. New techniques using transcervical uterine cannulation for the diagnosis of uterine disorders in bitches.

    Science.gov (United States)

    Watts, J R; Wright, P J; Lee, C S; Whithear, K G

    1997-01-01

    A technique for collecting uterine samples from bitches without the need for surgery was developed. This technique involved visualizing the cervix with a rigid endoscope and passing a catheter through the cervix into the uterus. Samples for microbiology and cytology were obtained by the infusion and aspiration of sterile normal saline. This technique allowed uterine microbiology and cytology of the normal bitch throughout the reproductive cycle. Microorganisms were frequently recovered from the uterus during pro-oestrus and oestrus, but rarely at other stages of the reproductive cycle. The uterine microflora often reflected the vaginal microflora during pro-oestrus and oestrus. The cells found in uterine cytology samples from normal bitches included endometrial epithelial cells, leukocytes, erythrocytes, cervical cells, spermatozoa and bacteria. The types, proportions, morphology and numbers of cells varied throughout the reproductive cycle. The endoscope could be passed into the uterus and the endometrium examined from parturition until day 23 post partum. These procedures and contrast hysterography were used to investigate the reproductive tract of bitches. The above techniques have facilitated the diagnosis of postpartum metritis (n = 3), pyometra (n = 2), endometritis (n = 1), abortion (n = 1), retained placenta (n = 1), postpartum uterine rupture (n = 1), endometrial subinvolution (n = 1) and misalliance (n = 1) in 21 bitches investigated.

  8. Saved from a fatal flight: A ruptured splenic artery aneurysm in a pregnant woman

    Directory of Open Access Journals (Sweden)

    Anke C. Heitkamp

    2015-01-01

    Conclusion: In case of pregnant women with acute abdomen and hypovolemia, emergency physicians, surgeons, anesthesiologists, and gynecologists should be aware of the possibility of a ruptured SAA, apart from more common causes like placental abruption, placenta percreta, or uterine rupture. Early recognition and prompt multidisciplinary treatment might save the life of mother and child.

  9. Bilateral dacryoadenitis

    Directory of Open Access Journals (Sweden)

    Charlotte Derr

    2012-01-01

    Full Text Available Acute dacryoadenitis is an uncommon condition that involves inflammation of the lacrimal gland. In rare instances, dacryoadenitis may be bilateral. A delay in proper treatment of an otherwise simple case of dacryoadenitis may lead to significant soft tissue morbidity such as cellulitis, lacrimal gland abscess, or orbital abscess. We report the case of a 24-year-old male who presented to the emergency department with acute bilateral dacryoadenitis. The patient′s symptoms did not respond to oral antibiotics and he subsequently required admission for intravenous antibiotics. During his hospitalization the patient had diagnostic testing to try to determine the etiology for his symptoms. The unique aspects of managing a case of bilateral dacryoadenitis as well as treatment recommendations are discussed in this case report.

  10. Rupture of a previously scarred uterus during second trimester ...

    African Journals Online (AJOL)

    Misoprostol is useful in ripening the cervix prior to mid-trimester termination of pregnancy. It is particularly indicated in cases of missed abortions whether the uterus is scarred or not. The procedure is safe in the majority of cases. We present a case of uterine rupture during induction of labour with vaginal misoprostol for a ...

  11. A Rare Case of Peritonitis Following Spontaneous Rupture of ...

    African Journals Online (AJOL)

    Pyometra is the accumulation of pus in the uterine cavity. The reported incidence varies from 0.5% in ... The cause of pyometra is the occlusion of cervical canal by benign or malignant growth, stenosis following age‑related atrophy, radiation treatment, or surgery on the cervix. A spontaneous rupture of pyometra causing ...

  12. Uterine artery embolisation in the management of recurrent vaginal ...

    African Journals Online (AJOL)

    However, owing to extensive collateral circulation in the pelvis, the success rate of bilateral hypogastric artery ligation ranges from. 40% to 100%[5] and uterine artery ligation has been shown to have a success rate of 92%.[6] Both these techniques aim to leave the uterus intact and preserve fertility. In 1979, transcatheter ...

  13. Postpartum Uterine Artery Embolization in a Patient with Uncontrolled Hemorrhage

    Directory of Open Access Journals (Sweden)

    Mehmet Osmanağaoğlu

    2011-04-01

    from the cervical os was continued. After consultation with an interventional radiologist, bilaterally uterine artery embolization was performed. Angiographic embolisation should be considered as the treatment of choice for intractable primary postpartum haemorrhage in appropriate selected cases.

  14. Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy

    DEFF Research Database (Denmark)

    Schlütter, Jacob Mørup; Johansen, Gry; Helmig, Rikke Bek

    2016-01-01

    case labor was induced at 37 + 4 weeks of gestation. However, due to sudden fetal distress and maternal abdominal pain, an emergency Caesarean section was performed during labor, and 3 liters of intra-peritoneal blood were encountered upon laparotomy, secondary to a ruptured uterine artery aneurysm....... In the second case, an elective Caesarean section was scheduled at 38 + 3 weeks of gestation, and the delivery and postpartum period were uncomplicated. Albeit a rare condition, a uterine artery aneurysm should be among the differential diagnosis considered in pregnant women who present with pelvic and vaginal...

  15. Spontaneous rupture of the pregnant uterus following salpingectomy: a literature review.

    Science.gov (United States)

    Stanirowski, Paweł Jan; Trojanowski, Seweryn; Słomka, Anna; Cendrowski, Krzysztof; Sawicki, Włodzimierz

    2015-01-01

    Spontaneous rupture of the uterus is a life-threatening obstetric complication in rare cases associated with previously performed salpingectomy. This paper presents an analysis of uterine rupture cases during pregnancy in patients after surgical removal of the fallopian tubes. The English and Polish language literature was reviewed for studies published between January 1, 1980 and September 30, 2014 to identify articles that described rupture of the uterus in women with a previous history of salpingectomy. Thirteen case reports and case series studies in 18 women were identified. 33% of cases of uterine rupture following salpingectomy occurred during intrauterine pregnancy, whereas the rest was associated with interstitial ectopic pregnancy. Laparoscopic salpingectomy more often resulted in rupture of the uterus during non-ectopic pregnancy as compared to laparotomy (4 vs. 2 cases, respectively). When interstitial pregnancies were excluded, uterine rupture was a cause of fetal death in 67% of reported gestations. There were no cases of maternal mortality. Conservative treatment was the preferred management option, and total hysterectomy was performed in only 2 patients. Particular attention should be paid to patients with a previous history of salpingectomy due to the risk of uterine rupture throughout the entire pregnancy. © 2015 S. Karger AG, Basel.

  16. Bilateral agreements

    International Nuclear Information System (INIS)

    Anon.

    2004-01-01

    The bilateral agreements concern Brazil with United States relative to the co operation in nuclear energy, Germany with Russian Federation relative to the elimination and disposal of nuclear weapons; The multilateral agreements concerns the signature of the Protocols to amend the Paris and Brussels Conventions, the multilateral nuclear environmental programme in the Russian Federation, the status of Conventions in the field of nuclear energy. (N.C.)

  17. Uterine artery embolisation for uterine leiomyomas

    African Journals Online (AJOL)

    in the public health sector in the Western Cape. Inclusion criteria were women with symptomatic uterine fibroids who declined surgery, had risk factors for surgery such as obesity or medical co-morbidities, or objected to blood products. Patients were treated by a multidisciplinary team comprising infertility specialists, general.

  18. Estimating rupture distances without a rupture

    Science.gov (United States)

    Thompson, Eric M.; Worden, Charles

    2017-01-01

    Most ground motion prediction equations (GMPEs) require distances that are defined relative to a rupture model, such as the distance to the surface projection of the rupture (RJB) or the closest distance to the rupture plane (RRUP). There are a number of situations in which GMPEs are used where it is either necessary or advantageous to derive rupture distances from point-source distance metrics, such as hypocentral (RHYP) or epicentral (REPI) distance. For ShakeMap, it is necessary to provide an estimate of the shaking levels for events without rupture models, and before rupture models are available for events that eventually do have rupture models. In probabilistic seismic hazard analysis, it is often convenient to use point-source distances for gridded seismicity sources, particularly if a preferred orientation is unknown. This avoids the computationally cumbersome task of computing rupture-based distances for virtual rupture planes across all strikes and dips for each source. We derive average rupture distances conditioned on REPI, magnitude, and (optionally) back azimuth, for a variety of assumed seismological constraints. Additionally, we derive adjustment factors for GMPE standard deviations that reflect the added uncertainty in the ground motion estimation when point-source distances are used to estimate rupture distances.

  19. Uterine Leiomyoma: Hysterosalpingographic Appearances

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2008-01-01

    Full Text Available Uterine leiomyoma is the most common benign tumor of genital tract. The etiology of myomasis unknown. Leiomyoma shows a broad spectrum of radiographic appearances depending on thenumber, size, and location of the tumor. The diagnostic method for uterine leiomyomas is basedprimarily on the clinical situation. Despite of the varied diagnostic options such as; transvaginalsonography, sonohysterography, hysteroscopy, laparoscopy and MRI; hysterosalpingography isstill one of the valuable imaging methods for identification of uterine leiomyoma.The various features of the proved leiomyoma are illustrated in this pictorial review. The incidence,risk factors and clinical features will also be discussed briefly.

  20. Evaluation of Mayer-Rokitansky-Kuester-Hauser syndrome with magnetic resonance imaging: Three patterns of uterine remnants and related anatomical features and clinical settings

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yue; Lu, Jingjing; Jiang, Bo; Feng, Feng; Jin, Zhengyu [Peking Union Medical College, Chinese Academy of Medical Sciences, Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Zhu, Lan; Sun, Zhijing [Chinese Academy of Medical Sciences, Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Bejing (China)

    2017-12-15

    To characterize the anatomical features and clinical settings of Mayer-Rokitansky-Kuester-Hauser (MRKH) syndrome and correlate them with patterns of uterine involvement. Pelvic magnetic resonance images and medical records of 92 MRKH patients were retrospectively reviewed. Patients were subgrouped by uterine morphology: uterine agenesis, unilateral rudimentary uterus and bilateral rudimentary uteri. Uterine volume, presence of endometrium, location of ovary, endometriosis and pelvic pain were compared among groups. The mean uterine volume was 33.5 ml (17.5-90.0 ml) for unilateral uterine remnants, and 16.1 ml (3.5-21.5 ml) for bilateral uterine rudiments (p<0.01). The incidence of presence of endometrium (100% vs. 22%, p<0.001), haematometra (56% vs. 3%, p<0.001) and ovarian endometriosis (22% vs. 3%, p<0.01) was significantly increased in the group of unilateral rudimentary uteri as compared with the group of bilateral uterine remnants. Thirty-one patients (38%) showed ectopic ovaries. Pelvic pain was more common in individuals with unilateral rudimentary uterus than those who had no (56% vs. 5%, p<0.01) or bilateral uterine remnants (56% vs. 14%, p<0.05). MRKH patients with different patterns of uterine involvement may have differentiated anatomical features and clinical settings. (orig.)

  1. Uterine fibroids: current perspectives

    Directory of Open Access Journals (Sweden)

    Khan AT

    2014-01-01

    Full Text Available Aamir T Khan,1 Manjeet Shehmar,1 Janesh K Gupta21Birmingham Women's Hospital, Edgbaston, Birmingham, UK; 2Academic Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham, UKAbstract: Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause. There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman's menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy. The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE has now been well-recognized as a uterine-sparing (fertility-preserving method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS or radiofrequency (VizAblate™ and Acessa™ for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge.Keywords: leiomyoma, menorrhagia, ultrasonography, selective progesterone receptor modulators, uterine artery embolization, myomectomy

  2. Concomitant Vesicouterine Rupture with Avulsion of Ureter: A Rare Complication of Vaginal Birth after Cesarean Section.

    Science.gov (United States)

    Sharma, Nalini; Thiek, J Lalnunnem; Sialo, Stephen; Ahanthem, Santa Singh

    2016-03-01

    Uterine rupture is the most serious and life threatening complication and occurs in 0.7-0.9% of vaginal birth after lower segment caesarean section. Cases of bladder rupture along with uterine rupture have been rarely reported and avulsion of ureter, required ureteric implantation is even rarer. This case report describe a very rare case of vesicouterine rupture with avulsion of ureter following vacuum assisted delivery in a grandmulti with previous lower segment cesarean section (LSCS). Haematuria is the most common presentation of bladder rupture. Antenatal counseling regarding this entity is recommended if woman opted for vaginal birth after cesarean section. Intrapartum and postpartum high index of suspicion are important in clinching the diagnosis.

  3. Successful Delivery of Twin Pregnancy in Class U3b/C2/V1 Uterus by Bilateral Caesarean Section after Spontaneous Conception

    Directory of Open Access Journals (Sweden)

    Yasmine El-Masry

    2015-01-01

    Full Text Available A case of a 19-year-old female with class U3b/C2/V1 uterus conceived a twin pregnancy with a fetus in each horn after spontaneous conception. She referred to our department with presentation of premature rupture of membranes, with a history of cesarean delivery of a single full term living fetus a year and a half before this delivery. Examination revealed two completely separate uterine horns with a fetus in each horn, two distinct externally rounded cervices, and a single vagina with a short nonobstructing vaginal septum in the upper part of the vagina. And as the appropriate mode of delivery is still unclear, each case should be managed as the condition requires, and in our case urgent bilateral caesarean sections were performed.

  4. Selective Uterine Artery Embolization for Management of Interstitial Ectopic Pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Boo; Lee, Sang Jin; Joe, Hwan Sung; Goo, Dong Erk; Chang, Yun Woo [Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Kim, Dong Hun [Chosun University Hospital, Gwangju (Korea, Republic of)

    2007-04-15

    Interstitial pregnancy is defined as any gestation that develops in the uterine portion of the fallopian tubes lateral to the round ligament. Interstitial pregnancies account for 2-4% of all ectopic pregnancies and have been reported to have an associated 2% to 2.5% maternal mortality rate. The traditional treatment for interstitial pregnancy using surgical cornual resection may cause infertility or uterine rupture in subsequent pregnancies. Recently, the early identification of intact interstitial pregnancy has been made possible in many cases with high resolution transvaginal ultrasound as well as more sensitive assays for betahuman chorionic gonadotropin ({beta}-hCG). The treatment includes: hysteroscopic transcervical currettage, local and systemic methotrexate (MTX) therapy and prostaglandin or potassium chloride injection of the ectopic mass under sonographic guidance. We describe a case of successful treatment of interstitial pregnancy using uterine artery embolization, after failure of methotrexate treatment.

  5. Selective Uterine Artery Embolization for Management of Interstitial Ectopic Pregnancy

    International Nuclear Information System (INIS)

    Yang, Seung Boo; Lee, Sang Jin; Joe, Hwan Sung; Goo, Dong Erk; Chang, Yun Woo; Kim, Dong Hun

    2007-01-01

    Interstitial pregnancy is defined as any gestation that develops in the uterine portion of the fallopian tubes lateral to the round ligament. Interstitial pregnancies account for 2-4% of all ectopic pregnancies and have been reported to have an associated 2% to 2.5% maternal mortality rate. The traditional treatment for interstitial pregnancy using surgical cornual resection may cause infertility or uterine rupture in subsequent pregnancies. Recently, the early identification of intact interstitial pregnancy has been made possible in many cases with high resolution transvaginal ultrasound as well as more sensitive assays for betahuman chorionic gonadotropin (β-hCG). The treatment includes: hysteroscopic transcervical currettage, local and systemic methotrexate (MTX) therapy and prostaglandin or potassium chloride injection of the ectopic mass under sonographic guidance. We describe a case of successful treatment of interstitial pregnancy using uterine artery embolization, after failure of methotrexate treatment

  6. Hysteroscopic view of uterine cavity after normal and PPROM pregnancies

    Directory of Open Access Journals (Sweden)

    Roshan Nikbakht

    2015-01-01

    Full Text Available Background: Preterm premature rupture of membranes (PPROM occurs in 17% of pregnancies, which leads to 20% of perinatal death. According to previous studies uterine anomalies are one of the risk factors for preterm birth, PPROM and pregnancies complications. The aim of this study was to evaluate the relationship between PPROM and rupture of membrane (ROM with uterine cavity anomalies based on hysteroscopic findings. Methods: This cross-sectional study was conducted in Imam Khomeini Hospital, Ahvaz, Iran, from May 2011 to May 2012. After conducting a pilot study, 66 nulliparous pregnant women at 14-37 weeks of pregnancy with PPROM and ROM were selected randomly. Then the women were evaluated by hysteroscopy at least six weeks after delivery or miscarriage. The control group includes 66 women with at least one normal pregnancy (without history of PPROM, secondary infertility or recurrent abortion, who underwent diagnostic or therapeutic hysteroscopy for other reasons than PPROM. The hysteroscope instrument specifications were KARL STORZ model (KARL STORZ GmbH & Co. KG, Tuttlingen, Germany, inner sheet 26153 BI, outer sheet 26153 BO, and BA lens with 30 degree. Normal saline solution (Sodium Chloride 0.9% also was applied as distention medium. The study was approved by Ethic Committee of Ahvaz Jundihspur University of Medical Sciences. Informed consent was obtained for all participants. Results: Overall, the frequency of uterine anomalies in case and control groups was 12.12% and 3%, respectively (P<0.05 based on Chi-square test. Possibility of uterine cavity anomalies in the women with preterm premature rupture of membranes (PPROM was significantly higher than the women with normal pregnancy (OR=4.41, CI 95%: 0.9-21/63. About 3% of patients in the case group had undefined uterine anomalies. This anomaly was not in mentioned uterine anomalies classification of American fertility association. We did not observe such anomaly in control group

  7. Repair of distal biceps brachii tendon ruptures.

    Science.gov (United States)

    Bell, R H; Wiley, W B; Noble, J S; Kuczynski, D J

    2000-01-01

    This study consisted of 26 male patients with distal biceps tendon ruptures, 2 of whom had bilateral injuries, making the total number of ruptures 28. The average age at injury was 45 years. The treatment groups were the following: 3 were treated without surgery, 4 were repaired with brachialis tenodesis, and 21 were reattached to the radial tuberosity by the 2-incision Boyd-Anderson approach. Patients underwent follow-up a minimum of 14 months after surgery, with the average being 43 months. Outcome was evaluated based on the physical examination, isokinetic testing of strength and endurance of flexion and supination, and radiographic analysis.

  8. Uterine restoration after repeated sloughing of fibroids or vaginal expulsion following uterine artery embolization

    International Nuclear Information System (INIS)

    Park, Hye Ri; Kim, Nack Keun; Lee, Mee Hwa; Kim, Man Deuk; Kim, Hee Jin; Yoon, Sang-Wook; Park, Won Kyu

    2005-01-01

    The aim of our study is to present our experience with uterine restoration after repeated sloughing of uterine fibroids or transvaginal expulsion following uterine artery embolization (UAE) and to determine its safety and outcome. One hundred and twenty-four women (mean age, 40.3 years; age range, 29-52 years) with symptomatic uterine fibroids were included in this retrospective study. We performed arterial embolization with poly(vinyl alcohol) particles (250-710 μm). Clinical symptoms and follow-up information for each patient were obtained through medical records. At an average of 3.5 months (range, 1-8 months) after embolization, magnetic resonance imaging examinations with T1- and T2-weighted and gadolinium-enhanced T1-weighted images were obtained for all patients. The mean follow-up duration was 120 days (90-240 days). Eight (6.5%) patients experienced uterine restoration after repeated sloughing of uterine fibroids or spontaneous transvaginal expulsion. The locations of the leiomyomas were submucosal (n=5), intramural (n=2) and transmural (n=1). The maximum diameter of the fibroids ranged from 3.5 to 18.0 cm, with a mean of 8.4 cm. The time interval from embolization to the uterine restoration was 7-150 days (mean 70.5 days). The clinical symptoms before and during vaginal sloughing or expulsion were lower abdominal pain (n=4), vaginal discharges (n=3), infection of necrotic myomas (n=2) and cramping abdominal pain (n=1). Gentle abdominal compression (n=1) and hysteroscopic assistance (n=1) were required to remove the whole fibroid. No other clinical sequelae, either early or delayed, were documented. Magnetic resonance images revealed the disappearance of leiomyomas, intracavitary rupture resulting in transformation of intramural or transmural myomas into submucosal myomas and localized uterine wall defects. Although the small size of this study precludes a strict conclusion, there appear to be few serious complications directly related to vaginal

  9. Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report

    Directory of Open Access Journals (Sweden)

    Perquin Denise

    2010-01-01

    Full Text Available Abstract Introduction Inversion of the uterus is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. A submucous myoma is mostly the cause of the non-puerperal inversion but diagnosis can be difficult. In young women, non-puerperal uterine inversion is likely associated with a malignancy. Case presentation A 19-year-old nulliparous woman presented with abnormal vaginal bleeding, dysmenorrhoea, and a large mass protruding from her cervix. The mass was interpreted as a prolapsed pedunculated submucosal myoma. After extirpation of the mass by clamping and twisting its pedicle, a laparotomy was required under suspicion of a uterine rupture. The diagnosis was confirmed and the patient's uterus could be preserved. Pathological examination revealed a submucous myoma. The uterine inversion happened when the uterus retracted to expel the submucous myoma with fundal attachment. By extirpating the stalk the fundus was also resected, causing a uterine rupture. Conclusion We report a case of non-puerperal uterine inversion associated with a benign submucous myoma. Non-puerperal uterine inversion is very uncommon in women of reproductive age and is usually caused by a malignant tumour. However, uterine-sparing surgery should be attempted in young women until the final pathology is known.

  10. Analysis of amenorrhea after transcatheter uterine artery embolization for uterine fibroids

    International Nuclear Information System (INIS)

    Chen Xiaoming; Li Yong; Lu Ligong; Hu Baoshan; Luo Pengfei; Du Juan; Zuo Yuewei; Hu Xiaoping; Hong Danhua

    2005-01-01

    Objective: To investigate the causes of amenorrhea after transcatheter uterine artery embolization (TUAE) for uterine fibroids. Methods: Two hundreds thirty-one cases of uterine fibroids with the range of age from 29 to 51 years (mean, 39.5 years) underwent TUAE between April 1999 and May 2004. TUAE was performed by injecting lipiodol-pingyangmycine emulsion (LPE) into bilateral uterine arteries, followed by administration of gelatin sponge particles in 186 of 231 patients. LPE was prepared with pingyangmycine 8-16 mg and ultra fluid lipiodol 6-20 ml. Results: Amenorrhea occurred in 2 of 231 (0.87%) patients respectively at 3 and 4 months after TUAE. Premature ovarian failure was proved to be etiology of amenorrhea in one patient because her serum estradiol (E 2 ) became decreased and serum follicle-stimulating hormone (FSH) level increased. This woman had normal amenorrhea later after receiving estrogen-progestogen sepuential therapy for 12 months. Another patient's amenorrhea was proved to be associated with endometrial atrophy after TUAE by hysteroscope. Conclusion: Amenorrhea caused by premature ovarian failure and endometrial atrophy may occur in a tiny minority of women undergoing TUAE. (authors)

  11. Puerperal uterine inversion managed by the uterine balloon ...

    African Journals Online (AJOL)

    The uterine inversion is a rare and severe puerperal complication. Uncontrolled cord traction and uterine expression are the common causes described.We report a case of uterine inversion stage III caused by poor management of the third stage of labor. It was about a 20 years old primigravida referred in our unit for ...

  12. Does coupling of uterine contractions reflect uterine dysfunction ...

    African Journals Online (AJOL)

    Patients who developed coupled contractions had a longer duration of labour, a higher uterine activity integral and an increased incidence of caesarean section for failure to progress. Because coupling of uterine contractions may be indicative of dysfunctional uterine activity, and hence a prolonged first stage of labour, ...

  13. Submucous Myoma Induces Uterine Inversion

    Directory of Open Access Journals (Sweden)

    Yu-Li Chen

    2006-06-01

    Conclusion: Nonpuerperal inversion of the uterus is rarely encountered by gynecologists. Diagnosis of uterine inversion is often not easy and imaging studies might be helpful. Surgical treatment is the method of choice in nonpuerperal uterine inversion.

  14. A pregnant woman with spontaneous rupture of the uterine artery

    DEFF Research Database (Denmark)

    Jònsdòttir, Fjòla; Pinborg, Anja; Wilken-Jensen, Charlotte

    2014-01-01

    Pregnant women with acute abdominal pain are a clinical challenge. We present a rare but potential life-threatening condition of a pregnant woman with acute abdominal pain. The woman was in gestational week 37 with severe abdominal pain and was admitted to the labour ward. She became haemo...

  15. Ventral hernia with uterine rupture after vaginal delivery

    Directory of Open Access Journals (Sweden)

    Jung Mi Byun

    2014-09-01

    Conclusion: If a patient has hernia-related symptoms or complications, the diagnosis and management of the hernia should be performed as soon as possible, regardless of the onset, to decrease maternal and fetal mortality.

  16. ACL Rupture in Collegiate Wrestler

    Directory of Open Access Journals (Sweden)

    Lindsay A. Palmer

    2016-05-01

    ACL and hamstring. After completing five months of physical therapy, the patient joined a college wrestling team in August 2013. The athletic training staff at the university started him on a quadriceps and hamstring strengthening rehabilitation program for about one month. The staff also worked on continuous flexion and extension of the knee to where the patient could feel comfortable with doing activities with his knee. The patient continues to participate in daily stretching and strengthening protocols for his quadriceps and hamstring bilaterally. Deviation from the Expected/Uniqueness: The patient still participated on a fully ruptured ACL for seven months with just complaining of minimal pain and discomfort. The athlete chose to complete two seasons of activities instead of receiving surgery immediately. The ratio of people who rupture their ACL is about 5 in every 100,000 people. It is interesting that the high school clinician could not diagnose the injury until the patient received an MRI two months post-injury. The patient was also told by doctors that he only uses about 50% of his ACL on a daily basis compared to anyone else who uses their ACL about 95%. The patient felt comfortable with the ACL ruptured and changed any discomfort by just wearing a brace. Conclusions: Not many people can play on a ruptured ACL for seven months before receiving any surgical repairs. We need to keep this in mind as Athletic Trainers so we are not sending our athletes back on the field and possibly causing them more damage. The athlete continues stretching protocols daily.

  17. Uterine sarcoma - current perspectives.

    Science.gov (United States)

    Benson, Charlotte; Miah, Aisha B

    2017-01-01

    Uterine sarcomas comprise a group of rare tumors with differing tumor biology, natural history and response to treatment. Diagnosis is often made following surgery for presumed benign disease. Currently, preoperative imaging does not reliably distinguish between benign leiomyomas and other malignant pathology. Uterine leiomyosarcoma is the most common sarcoma, but other subtypes include endometrial stromal sarcoma (low grade and high grade), undifferentiated uterine sarcoma and adenosarcoma. Clinical trials have shown no definite survival benefit of adjuvant radiotherapy or chemotherapy and have been hampered by the rarity and heterogeneity of these disease types. There is a role of adjuvant treatment in carefully selected cases following multidisciplinary discussion at sarcoma reference centers. In patients with metastatic disease, systemic chemotherapy can then be considered. There is activity of a number of agents, including doxorubicin, trabectedin, gemcitabine-based chemotherapy, eribulin and pazopanib. Patients should be considered for clinical trial entry where possible. Close international collaboration is important to allow progress in this group of diseases.

  18. Endovascular uterine artery interventions

    Directory of Open Access Journals (Sweden)

    Chandan J Das

    2017-01-01

    Full Text Available Percutaneous vascular embolization plays an important role in the management of various gynecologic and obstetric abnormalities. Transcatheter embolization is a minimally invasive alternative procedure to surgery with reduced morbidity and mortality, and preserves the patient's future fertility potential. The clinical indications for transcatheter embolization are much broader and include many benign gynecologic conditions, such as fibroid, adenomyosis, and arteriovenous malformations (AVMs, as well as intractable bleeding due to inoperable advanced-stage malignancies. The most well-known and well-studied indication is uterine fibroid embolization. Uterine artery embolization (UAE may be performed to prevent or treat bleeding associated with various obstetric conditions, including postpartum hemorrhage (PPH, placental implantation abnormality, and ectopic pregnancy. Embolization of the uterine artery or the internal iliac artery also may be performed to control pelvic bleeding due to coagulopathy or iatrogenic injury. This article discusses these gynecologic and obstetric indications for transcatheter embolization and reviews procedural techniques and outcomes.

  19. Uterine Vascular Lesions

    Science.gov (United States)

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

  20. The MRI diagnosis of extra-uterine pregnancy

    International Nuclear Information System (INIS)

    Huang Yong; Li Jianping

    2002-01-01

    Objective: It's an investigation of the finding and diagnostic value of MRI in extrauterine pregnancy. Methods: A retrospective analysis of the MR images and clinical data was made in 4 cases with extra-uterine pregnancy. All cases were confirmed by surgery and pathology. Results: All lesions were found in oviducts. Un-ruptured oviductal pregnancy represented a round hypo-intense area with a lower signaled center on T1WI, and a hyper-intense area on T2WI, while higher signal of the embryo sac wall was revealed on T2WI. In the rest 2 cases, ruptured ectopic pregnancy presented with a complicated intense mass on T1WI, where hyper-intense patches were scattered within lesion. On T2WI, the ruptured oviductal pregnancy was a mixture of iso-intense or hyper-intense components. On T2WI/IR fat suppressing sequence the hyper-intense area remained high signal intensity. A ruptured oviductal pregnancy resulted in a larger mass with hemorrhage found in pelvic cavity. Conclusion: Extra-uterine pregnancy has characteristic MRI manifestations, by which an accurate diagnosis is established with clinical data

  1. Sonographic evaluation of surgical repair of uterine cesarean scar defects.

    Science.gov (United States)

    Pomorski, Michal; Fuchs, Tomasz; Rosner-Tenerowicz, Anna; Zimmer, Mariusz

    2017-10-01

    The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured. The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation. A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post-repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:455-460, 2017. © 2017 Wiley Periodicals, Inc.

  2. Bilateral agreements

    International Nuclear Information System (INIS)

    1998-01-01

    Ten bilateral agreements are presented. These are: 1) Co-operation agreement relating to the peaceful uses of nuclear energy between Argentina and EURATOM (1996); 2) Agreement on co-operation in the peaceful uses of nuclear energy between Argentina and Greece (1997); 3) Implementing arrangement for technical exchange and co-operation in the area of peaceful uses of nuclear energy between Argentina and the United States (1997); 4) Agreement concerning co-operation in nuclear science and technology between Australia and Indonesia (1997); 5) Implementation of the 1985 Agreement for co-operation concerning the peaceful uses of nuclear energy between the People's Republic of China and the United States (1998); 6) Protocol of co-operation between France and Lithuania (1997); 7) Agreement on co-operation in energy research, science and technology, and development between Germany and the United States (1998); 8) Agreement on early notification of a nuclear accident and exchange of information on nuclear facilities between Greece and Romania (1997); 9) Agreement on early notification of nuclear accidents and co-operation in the field of nuclear safety between Hungary and the Ukraine (1997); 10) Agreement in the field of radioactive waste management between Switzerland and the United States (1997). (K.A.)

  3. Uterine mesenchymal tumors

    Directory of Open Access Journals (Sweden)

    Nikhil A Sangle

    2011-01-01

    Full Text Available Uterine mesenchymal tumors are a heterogeneous group of neoplasms that can frequently be diagnostically challenging. Differentiation between the benign and malignant counterparts of mesenchymal tumors is significant due to differences in clinical outcome, and the role of the surgical pathologist in making this distinction (especially in the difficult cases cannot be underestimated. Although immunohistochemical stains are supportive toward establishing a final diagnosis, the morphologic features trump all the other ancillary techniques for this group of neoplasms. This review therefore emphasizes the key morphologic features required to diagnose and distinguish uterine mesenchymal tumors from their mimics, with a brief description of the relevant immunohistochemical features.

  4. Regional lymphadonectomy in uterine cervix carcinoma patients after radiotherapy

    International Nuclear Information System (INIS)

    Bokhman, Ya.V.; Kuznetsov, V.V.

    1981-01-01

    A group of patients with uterine cervix carcinoma with metastatic indices in regional lymphatic vessels detected on lymphograms is studied. It is established that after radiation treatment the relative resistance of lymphogenic metastases to the ionizing radiation is found in 14.9% patients. Extraperitoneal removal of regional lymphatic collectors after a complete course of combined radiation therapy in patients with uterine cervix carcinoma with histologically proved metastases improves 3-year results of survival up to 40%. In the case of multiple and bilateral metastatic injury of regional lymph nodes the therapeutic value of extraperitoneal lymphadenectomy reduces sharply. The diagnostic value of X-ray contrast lymphography not only for defining regional metastases, but for planning and carrying out the treatment of patients with uterine cervix carcinoma is pointed out [ru

  5. Uterine artery pulsatility index in hypertensive pregnancies: When does the index normalize in the puerperium?

    OpenAIRE

    Lee, Seung Mi; Jun, Jong Kwan; Sung, Su Jin; Choo, Sung Il; Cho, Jeong Yeon; Yang, Hye Jin; Park, Chan-Wook; Park, Joong Shin; Syn, Hee Chul

    2016-01-01

    Objective To investigate whether the uterine artery pulsatility index (UtA PI) of hypertensive pregnancies is higher than that of normal pregnancies in the puerperium, as well as in the antepartum period. Methods The UtA PI was measured in hypertensive (group 1) and normal pregnancies (group 2) during antepartum, immediate postpartum or late postpartum periods. Using the transvaginal approach, the bilateral uterine artery indices were measured. Results One hundred twenty-two women were enroll...

  6. Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: A systematic review

    NARCIS (Netherlands)

    van de Laar, Rafli; van der Ham, David P.; Oei, S. Guid; Willekes, Christine; Weiner, Carl P.; Mol, Ben W. J.

    2009-01-01

    Preterm premature rupture of the fetal membranes (PPROM) is associated with intra-uterine infection. Early detection of intra-uterine infection may help prevent neonatal sepsis. C-reactive protein (CRP) is an acute phase protein often elevated when inflammation is present. The aim of this review was

  7. Superselective uterine artery embolization for the control and prevention of obstetric hemorrhage

    International Nuclear Information System (INIS)

    Song Li; Tong Xiaoqiang; Wang Jian; Yang Min; Lv Yongxing; Zou Yinghua

    2008-01-01

    Objectives: To evaluate the efficacy of superselective uterine artery embolization for treatment and prevention of obstetric hemorrhage. Methods: Between April 2004 and December 2007, 47 consecutive patients underwent uterine artery embolization to control or prevent hemorrhage, including 20 patients for preventing hemorrhage before abortion and 27 for controlling obstetric hemorrhage. Results: Bilateral uterine artery embolization was performed in all cases except one for abnormal vascular anatomy receiving unilateral approach. Within 10 days after embolization, curettage abortion or uterine-incision delivery was done without hysterectomy, and hemorrhage during abortion was less with average of 54 ml. Conclusions: The high success rate, effectiveness and possibility of preserving reproductive function have made uterine artery embolization the technique of choice to control obstetric hemorrhage, and prophylactic embolization, can prevent hemorrhage before abortion. (authors)

  8. The application of uterine artery chemoembolization in treating cesarean section scar pregnancy

    International Nuclear Information System (INIS)

    Zhang Guofu; Wang Tianping; Gu Shouxin; Han Zhigang; Zhang Di; Tian Xiaomei; Wang Xuezhen; Yu Fei; Huang Zirong

    2010-01-01

    Objective: To discuss the feasibility and safety of uterine artery chemoembolization in treating cesarean section scar pregnancy. Methods: During the period of Jun. 2005-Jun. 2010, uterine artery chemoembolization was performed in 130 patients with cesarean section scar pregnancy in authors' hospital. Via bilateral uterine arteries 100-150 mg MTX and 80 000 u Gentamycin were infused separately, which was followed by the embolization of bilateral uterine arteries with Gelfoam. Of the total 130 patients,coexisted leiomyoma was found in 23 and embolization therapy with PVA microspheres was employed. Curettage of uterus was carried out within 24-72 hours after the procedure. Results: The success rate of bilateral uterine artery chemoembolization was 100%. The blood loss during curettage procedure was 12-110 ml (mean 28.5 ml). No serious complications occurred. Conclusion: The uterine artery chemoembolization is an effective and safe treatment for cesarean section scar pregnancy. This technique can greatly avoid unnecessary uterectomy and, thus, preserve the fertility of the female patients. (authors)

  9. [Secondary peritonitis due to rupture of pyometra in cervical cancer].

    Science.gov (United States)

    Zeferino Toquero, Moisé; Bañuelos Flores, Joel

    2005-11-01

    Only 8 cases of spontaneous uterine rupture in untreated cervical cancer have been reported in the literature. We present the case of a 52-year-old female, who was admitted to the emergency room due to hypovolemic shock and signs of peritonitis. A 6x4x4 cm cervical tumor was detected at physical exam. At laparotomy 2000 mL of purulent material were found and a 1-cm perforation in the posterior portion of the uterine segment was identified. A subtotal hysterectomy was performed. The patient received antibiotic and support at Intensive Care Unit. Finally, the patient presented ascendant flaccid paralysis and died due to bronchoaspiration. Spontaneous pyometra rupture in untreated cervical cancer is a rare condition and must be considered in postmenopausal women with cervical tumors and peritonitis signs.

  10. Pregnancy in a non-communicating rudimentary uterine horn in an obese woman

    DEFF Research Database (Denmark)

    Munck, Dorete Frydshou; Markauskas, Algirdas; Lamont, Ronald Francis

    2013-01-01

    We would like to report the rare occurrence of a pregnancy in a non-communicating rudimentary uterine horn in an obese woman which evaded diagnosis, ruptured, and resulted in major intra-abdominal hemorrhage. A nulliparous woman, with a BMI of 36, presented at 21-weeks gestation with a history...

  11. Uterine Fibroid Embolization Can Still Be Improved: Observations on Post-Procedure Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Dorenberg, E.J.; Novakovic, Z.; Smith, H.J.; Hafsahl, G.; Jakobsen, J.Aa.

    2005-01-01

    PURPOSE: To evaluate the efficacy and completeness of uterine fibroid embolization (UFE) measured by changes in volume and signal intensity at magnetic resonance imaging (MRI), and to compare with clinical outcome. MATERIAL AND METHODS: 40 women with symptomatic uterine fibroids underwent bilateral uterine artery embolization. At MRI studies, including post-contrast sequences before and repeatedly after treatment, the uterus and dominant fibroids were evaluated for volume, location, and contrast enhancement. Prior to treatment, all myomas showed significant contrast enhancement. The mean uterine volume was 929 ml. Clinical examinations with emphasis on menorrhagia, pelvic pain, and urinary dysfunction were performed before and 6 and 12 months after treatment. RESULTS: UFE was bilaterally successful in 38 patients. After UFE, MRI showed no enhancement of myomas in 30 patients. In 8 patients, post-procedural MRI revealed partially remaining vascularization of fibroids despite angiographically complete embolization of the uterine arteries. On average, uterine volume decreased by 46.2% at 12 months. There was significant improvement of symptoms in the majority of patients, but slightly less improvement in patients with partially remaining vascularization of myomas. CONCLUSION: UFE causes significant volume reduction of myomas and clinical improvement. MRI can reveal remaining vascularization in myomas despite angiographically complete embolization of uterine arteries

  12. Uterine artery embolization for uterine fibroids: mid-long term follow up

    International Nuclear Information System (INIS)

    Guo Wenbo; Yang Jianyong; Chen Wei; Zhuang Wenquan; Li Lijuan; Zhu Yunxiao

    2006-01-01

    Objective: To evaluate the mid-long term effects of uterine fibroids embolization. Methods: Uterine artery embolization (UAE) was performed in 110 patients with uterine fibroids with follow up of 48-72 months. All the patients were examined with transvaginal color ultrasound. 51 cases were embolized with mixed liquor of lipiodol and pingyangmycin and another 59 cases with polyvinyl alcohol particles (350-700 μm, in diameter). The mid-long term clinical effects, complications, change of serum sexual hormone, pregnancy and delivery after UAE were observed. Results; Bilateral uterine artery embolization was performed in 110 cases with following outcomes in improvements of menorrhagia in 93/94 (98.9%) and the bulked-related symptoms in 26/26 (100%), decrease of the volumes of uterus 51.5% ± 3.1% (t value 2.861, P<0.01) and fibroids 64.2% ± 6.6% (t value 2.664, P<0.01). No statistical differences in serum levels of luteinizing, follicle stimulating hormone and estradiol before and after the uterine artery embolization were found. All events included abdominal pain in 6/110 (5.5%), fever in 90/110 (81.8%), colporrhagia in 95/110 (86.4%), haematuria in 11/110 (10.0%), non-targeted embolization of bladder in 1/110 (0.9%), transient amenorrhea in 3/110 (2.7%), permanent amenorrhea due to ovarian failure in 3/110 (2.7%), failure of embolization in 1/110 (0.9%) and recurrence after uterine fibroids embolization in 4/110 (3.6%). There were 7 times of pregnancies in 5 patients, including 4 times of deliveries in 4 patients, and one patient accepted artificial abortion 3 times, but with no fibroids recurrences or enlargement under ultrasound follow up. Conclusion: The mid-long term effects of uterine fibroids embolization are positive, stable and safe, but with a low recurrence rate slight ovarian functional change and still safe for pregnancy and delivery. (authors)

  13. Extramedullary Hematopoiesis in Uterine Leiomyoma Associated with Numerous Intravascular Thrombi

    Directory of Open Access Journals (Sweden)

    Xiaoyan Cui

    2014-01-01

    Full Text Available We report a case of extramedullary hematopoiesis (EMH in uterine leiomyoma and associated numerous intravascular thrombi. A 29-year-old nulliparous female presented with heavy vaginal bleeding and a hematocrit of 22%. No bone marrow biopsy has been performed. She had a history of uterine leiomyomata and menorrhagia for a year. A transvaginal ultrasound confirmed the presence of a uterine leiomyoma. The patient was treated conservatively with oral contraceptive pills due to desire for fertility. However, she continued to have heavy vaginal bleeding and developed bilateral upper extremity deep vein thrombosis and multiple superficial vein thromboses after two months. An exploratory laparotomy with uterine myomectomy was performed. Gross examination of the specimen revealed a single nodular mass measuring 10.0×9.5×7.5 cm with a white-tan swirling cut surface. Microscopic examination revealed benign smooth muscle consistent with leiomyoma and numerous intravascular thrombi both with areas of EMH. Immunohistochemical stains confirmed the presence of all three benign lineages of hematopoietic cells. Occurrence of EMH in uterine leiomyoma and intravascular thrombi is very rare. It may be related to systemic hematopoietic stimulation due to severe chronic anemia and local presence of hematopoietic growth factors and/or cytokines.

  14. Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy.

    Science.gov (United States)

    Schlütter, Jacob Mørup; Johansen, Gry; Helmig, Rikke Bek; Petersen, Olav Bjørn

    2017-01-01

    We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first case labor was induced at 37 + 4 weeks of gestation. However, due to sudden fetal distress and maternal abdominal pain, an emergency Caesarean section was performed during labor, and 3 liters of intra-peritoneal blood were encountered upon laparotomy, secondary to a ruptured uterine artery aneurysm. In the second case, an elective Caesarean section was scheduled at 38 + 3 weeks of gestation, and the delivery and postpartum period were uncomplicated. Albeit a rare condition, a uterine artery aneurysm should be among the differential diagnosis considered in pregnant women who present with pelvic and vaginal masses, vague bladder symptoms or radiating pelvic pain. The diagnosis is readily made by color Doppler imaging. Elective Caesarean section should be the preferred mode of delivery to avoid rupture of the aneurysm during labor. © 2016 S. Karger AG, Basel.

  15. ENDOVASCULAR HEMOSTASIS IN UTERINE BLEEDING IN PATIENTS WITH UTERINE LEIOMYOMA

    Directory of Open Access Journals (Sweden)

    M. M. Damirov

    2017-01-01

    Full Text Available We report results of treatment for 72 patients with uterine leiomyoma (LM of various sizes and location, who had arrived with excessive uterine bleeding. All patients underwent urgent or urgently-delayed endovascular hemostasis by performing uterine arteries embolization (UAE. We analyzed clinical features of the disease after UAE in various sizes of tumors and studied immediate and long-term results of UAE in patients with LM.

  16. Aortic plaque rupture in the setting of acute lower limb ischemia.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2012-02-01

    Acute aortic plaque rupture is an uncommon cause of acute lower limb ischemia. The authors report sequence computed tomographic imaging of a distal aortic plaque rupture in a young man with bilateral lower limb complications. Clinical awareness, prompt recognition and imaging, and appropriate treatment of this uncommon condition are necessary to improve patient outcomes.

  17. Analysis of adverse reactions and complications of transcatheter uterine artery embolization (TUAE) for uterine fibroids

    International Nuclear Information System (INIS)

    Chen Xiaoming; Luo Pengfei; Du Juan; Zuo Yuewei; Hu Xiaoping; Hong Danhua; Lin Huahuan; Li Gaowen; Liu Suyun

    2002-01-01

    Objective: To investigate the adverse reactions and complications as well as their preventive and therapeutic measures of TUAE for uterine fibroids. Methods: One hundred and eighty-two patients with uterine fibroids were treated by TUAE. Bilateral uterine arteries were embolized using lipiodol-pingyangmycin emulsion (LPE), together with Gelfoam particles. All patients were hospitalized for 3 to 10 days after TUAE and were followed up for 1 to 24 months to observe the adverse reactions and complications. Results: Adverse reactions of TUAE included postembolization syndrome ( n 182); urinary irritation ( n = 24), and hyporrhea of vagina ( n = 25 ) . Complications of TUAE included expelling of necrotic fibroids per vagina ( n = 5 ); urinary retention ( n = 10); urinary tract infection ( n = 1 ); ulcer of labia minora ( n = 1 ); ecchymosis and ulceration on buttock ( n = 1), and secondary infection of chocolate cyst of ovary. ( n = 1 ). All the above-mentioned side effects of TUAE recovered to normal after expectant or especial treatment without any sequels left. Conclusion: The adverse reactions of TUAE are reversible and the complications of TUAE are preventable and curable

  18. Efficacy of Combined Laparoscopic and Hysteroscopic Repair of Post-Cesarean Section Uterine Diverticulum: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Cuilan Li

    2016-01-01

    Full Text Available Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum. Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS, and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery. Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p<0.05, respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40. Three patients (3/40 = 7.5% developed partial improvement, and 1/40 (2.5% was lost to follow-up. Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum.

  19. Uterine Cancer: Cancer of the Uterus

    Science.gov (United States)

    ... receive Publications email updates Enter email Submit Uterine cancer Cancer of the uterus (uterine cancer) is cancer ... Institute . Expand all | Collapse all What is uterine cancer? Cancer is a disease in which certain body ...

  20. Uterine Diverticulum With Fetal Leg Entrapment: A Case Report.

    Science.gov (United States)

    Chandrasekaran, Nirmala; Yudin, Mark H; Berger, Howard

    2017-10-01

    Uterine anomalies causing fetal complications are very rarely encountered in obstetric practice and thus pose a diagnostic dilemma. A multigravid patient attended the clinic for an ultrasound examination in the third trimester following a recent hospital admission for abdominal pain. Ultrasound imaging revealed a large uterine diverticulum in the right cornu of the uterus with evidence of fetal leg entrapment. Because of concerns of increased soft tissue edema in the entrapped leg, the patient was delivered at 35 weeks' gestation by elective CS. The CS was complicated by uterine rupture at the diverticular portion. The neonatal course was complicated by compartment syndrome of the leg, and the infant underwent surgery on post-delivery day one with good outcome. Uterine diverticula are rare anomalies, and once they are diagnosed, the possibility of entrapment of fetal parts or placenta in pregnancy should be considered. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  1. Generalized peritonitis caused by spontaneous intraperitoneal rupture of the urinary bladder.

    Science.gov (United States)

    Tabaru, A; Endou, M; Miura, Y; Otsuki, M

    1996-11-01

    We report a case of generalized peritonitis caused by spontaneous intraperitoneal rupture of the urinary bladder. A 74-year-old female was admitted with abdominal pain and biochemical findings of acute renal failure (ARF). She had recently complained of macrohematuria. She had a past history of radiotherapy for uterine cervical cancer and Parkinson's disease treated with levodopa and amantadine. We diagnosed this case as intraperitoneal rupture of the bladder by cystogram. Biochemical findings of ARF might have resulted from urine reabsorption. Intraperitoneal rupture of the bladder should be considered in all cases of peritonitis, especially in patients with urological symptoms and features of ARF.

  2. Radiologic diagnosis and treatment of iatrogenic acquired uterine arteriovenous malformation

    International Nuclear Information System (INIS)

    Kwon, Jung Hyeok

    2002-01-01

    To analyze gray-scale US, color and duplex Doppler US, and angiographic findings in patients with acquired uterine arteriovenous malformations (AVMs), and to evaluate the usefulness of these modalities in the diagnosis of this disease and the effect of transcatheter arterial embolization in its treatment. During a recent seven-year period, we diagnosed 21 cases of acquired uterine AVM. Nineteen of these patients had a history of causative D and C (between one and seven D and C procedures per patient), one had a history of causative cesarean section, and one had cervical conization. All patients underwent transabdominal and endovaginal gray-scale, color Doppler, and duplex Doppler US and angiography, with therapeutic embolization of bilateral uterine arteries. The majority underwent follow-up Doppler US after embolization. The gray-scale US morphology of uterine AVMs included subtle myometrial inhomogeneity and multiple distinct, small anechoic spaces in the thickened myometrium or endometrium. Color Doppler US showed a tangle of tortuous vessels with multidirectional, high-velocity arterial flow, which was focally or asymmetrically distributed. Duplex Doppler US depicted a waveform of fast arterial flow with low resistance, while angiography demonstrated a complex tangle of vessels supplied by enlarged uterine arteries, in association with early venous drainage during the arterial phase, and staiss of contrast medium within abnormal vasculature. Where AVMs were combined with a pseudoaneurysm, this finding was observed. Transcatheter arterial embolization provided a complete cure, without recurrence. Color and duplex Doppler US in an appropriate modality for the detection and diagnosis of uterine AVMs and for follow-up after embolization. Transcatheter arterial embolization is a safe and effective method of treating this disease

  3. Radiologic diagnosis and treatment of iatrogenic acquired uterine arteriovenous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jung Hyeok [College of Medicine, Keimyung Univ., Taegu (Korea, Republic of)

    2002-05-01

    To analyze gray-scale US, color and duplex Doppler US, and angiographic findings in patients with acquired uterine arteriovenous malformations (AVMs), and to evaluate the usefulness of these modalities in the diagnosis of this disease and the effect of transcatheter arterial embolization in its treatment. During a recent seven-year period, we diagnosed 21 cases of acquired uterine AVM. Nineteen of these patients had a history of causative D and C (between one and seven D and C procedures per patient), one had a history of causative cesarean section, and one had cervical conization. All patients underwent transabdominal and endovaginal gray-scale, color Doppler, and duplex Doppler US and angiography, with therapeutic embolization of bilateral uterine arteries. The majority underwent follow-up Doppler US after embolization. The gray-scale US morphology of uterine AVMs included subtle myometrial inhomogeneity and multiple distinct, small anechoic spaces in the thickened myometrium or endometrium. Color Doppler US showed a tangle of tortuous vessels with multidirectional, high-velocity arterial flow, which was focally or asymmetrically distributed. Duplex Doppler US depicted a waveform of fast arterial flow with low resistance, while angiography demonstrated a complex tangle of vessels supplied by enlarged uterine arteries, in association with early venous drainage during the arterial phase, and staiss of contrast medium within abnormal vasculature. Where AVMs were combined with a pseudoaneurysm, this finding was observed. Transcatheter arterial embolization provided a complete cure, without recurrence. Color and duplex Doppler US in an appropriate modality for the detection and diagnosis of uterine AVMs and for follow-up after embolization. Transcatheter arterial embolization is a safe and effective method of treating this disease.

  4. Splenic rupture masquerading ruptured ectopic pregnancy | Kigbu ...

    African Journals Online (AJOL)

    The classical triad of presentation of delayed menses, irregular vaginal bleeding and abdominal pain may not be encountered at all! Overwhelming features of abdominal pain, amenorrhea, pallor, abdominal tenderness, shifting dullness with positive pregnancy test gave a clinical diagnosis of ruptured ectopic pregnancy.

  5. Comprehensive Staging of Uterine Carcinosarcoma Using a Multiquadrant Robotic Platform.

    Science.gov (United States)

    Dellinger, Thanh H; Wakabayashi, Mark T; Han, Ernest S

    To demonstrate the feasibility of multiquadrant staging of a uterine carcinosarcoma using the latest-generation robotic platform. Step-by-step explanation of the technique using videos and pictures (educative video). Although laparoscopic and robotic-assisted laparoscopic staging of high-risk uterine cancer is well incorporated into many gynecologic oncology practices, extensive para-aortic lymphadenectomies above the inferior mesenteric artery are less commonly performed. Additionally, infracolic omentectomies are frequently performed in lieu of infragastric omentectomies. A 67-year-old woman with a newly diagnosed uterine carcinosarcoma. Multiquadrant comprehensive staging of uterine carcinosarcoma using the latest-generation robotic platform. We demonstrate in this video a facile approach for robotic surgeons to perform an extensive para-aortic lymphadenectomy up to the renal vessels, as well an infragastric omentectomy, using the latest-generation multiquadrant robotic platform. This platform allows for facile rotation from an upper abdominal view to perform the para-aortic lymphadenectomy and omentectomy, to a pelvic view to complete the pelvic lymphadenectomies, hysterectomy and bilateral salpingo-oophorectomy. We demonstrate this technique in a 67-year-old woman with a newly diagnosed uterine carcinosarcoma who underwent a robotic-assisted laparoscopic total hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic and para-aortic lymphadenectomy, and infragastric omentectomy via the Xi Da Vinci Robot (Intuitive Surgical, Sunnyvale, CA). Total operative time was 280 minutes (50 minutes for the omentectomy, 86 minutes for the para-aortic lymphadenectomy). Estimated blood loss was 50 mL. Final pathology revealed a stage IA uterine carcinosarcoma; a total of 27 para-aortic lymph nodes and 20 pelvic lymph nodes were removed, and the size of the excised omentum was 68 × 10 × 1.2 cm. The technique of using alternating dual perspectives (upper

  6. Uterine fibroid: a review.

    Science.gov (United States)

    Akinyemi, B O; Adewoye, B R; Fakoya, T A

    2004-01-01

    Uterine fibroid is a benign tumour of uterine smooth muscle. The purpose of this review is to bring to light the current spectra of presentation and management status of this benign and very important cause of menstrual and fertility disturbance in African women and the Black race in general. This is especially so with the trivialization of its aetological factors and treatment by claims from alternative medical practitioners. This review, therefore sought to document what is currently known about the condition and what could possibly be done to achieve better results in its management. Literature on the subject above was reviewed using manual library search, electronic books such as CD-ROMS and journals articles published by various local and international authors on the subject; it also included internet search on relevant aspects of the topic. Fibroid is the commonest benign tumour of the female genital tract, it contributes about 70 to 80% of new growths in the female genital tracts, it is a cause of significant morbidity in women of reproductive age group and when complicated could be a significant cause of mortality. Spectrum of presentation mainly involves disturbance of menstruation, reduction in fertility, pressure and obstructive symptoms and rarely malignant presentations. When recognized early effective conservative and definitive therapies are available to offer relief for women and to make their menstrual and reproductive life more meaningful. From the literature reviewed, it was obvious that the subject of uterine fibroid is still not fully exhausted and there were a lot of research questions waiting to be answered on the aetiopathogenesis of the disease. There is also the need to fashion out better treatment alternatives that will reduce morbidity in the process of managing the patient as well as those that will further enhance reproductive potentials after treatment.

  7. Simultaneous bilateral distal biceps tendon repair: case report

    Directory of Open Access Journals (Sweden)

    Thiago Medeiros Storti

    Full Text Available ABSTRACT Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

  8. Lajjalu treatment of uterine prolapse

    Directory of Open Access Journals (Sweden)

    T M Shivanandaiah

    2010-01-01

    Full Text Available Mimosa pudica was found useful in cases of uterine prolapse with bleeding, consistent with my experience of working with the condition for more than 45 years, and treating hundreds of such cases of uterine prolapse. Hysterectomy has been avoided up to this date, and is not now expected to be recommended.

  9. Synchronous uterine adenocarcinoma and leiomyosarcoma – a case study

    Directory of Open Access Journals (Sweden)

    Kamila Dudzik

    2017-04-01

    Full Text Available Synchronous gynecological cancers are rarely described. Those cases account for approximately up to 6% of female genital tract malignancies. The presence of synchronous endometrial adenocarcinoma and gynecological tract neoplasia is rare – the most commonly described is synchronous adenocarcinoma and endometrial ovarian cancer (accounting for 15-20% of ovarian neoplasia and 5% of endometrial cancers. Concomitant uterine carcinosarcoma and ovarian cancer, or endometrial adenocarcinoma are extremely rare. Up till now, only 3 cases of synchronous adenocarcinoma and leiomyosarcoma were described. In the present study a case of 60-year-old woman diagnosed with synchronous endometrial adenocarcinoma and leiomyosarcoma uteri is described. As the preoperative evaluation revealed endometrial adenocarcinoma G2 with intermediate-risk of lymph node metastasis and synchronous leiomyosarcoma G3, total hysterectomy with bilateral salpingo-oophorectomy and systemic lymphadenectomy was performed showing no lymphatic involvement. In the postoperative evaluation the patient was qualified to adenocarcinoma low recurrence-risk group (adenocarcinoma G1 with no LVSI, FIGO IA – no further radiotherapy was required. However, as synchronous leiomyosarcoma G3 was diagnosed, we decided to refer the patient for adjuvant chemotherapy. Contemporary recommendation on the diagnosis and treatment of uterine carcinomas, especially uterine leiomyosarcomas, is also described in this paper. The presented case showed that diagnosis and treatment of women with uterine tumors should be individualized as in the same case an extremely rare cancer type can be present which, consequently, changes the treatment regimen and prognosis.

  10. Spontaneous Unruptured Bilateral Tubal Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Nayereh Ghomian

    2015-11-01

    Full Text Available Bilateral spontaneous tubal ectopic pregnancy is the rarest form of extra uterine pregnancy. The diagnosis is usually made intraoperatively and levels of serum BHCG and ultrasound has not been useful in the diagnosis of bilateral tubal ectopic pregnancy. A 33-year-old woman with 8 weeks amenorrhea and sever lower abdominal pain was admitted. A transvaginal pelvic ultrasound revealed left adnexal mass and massive fluid collection in the pelvis and abdomen. The serum BHCG was 5,700 mIU/ml and in laparotomy bilateral unruptured tubal pregnancy was noted. Left salpingectomy and right salpingostomy were performed. The diagnosis of bilateral spontaneous tubal ectopic pregnancy is usually made intraoperatively. Both tubes at the time of surgery should be closely examined in order to prevent maternal morbidity and mortality.

  11. Uterine culture in mares.

    Science.gov (United States)

    Brook, D

    1984-05-01

    A guarded, sterile swab is used to obtain samples for uterine culture. With the mare in stocks, the tail bandage and the perineum washed, the culture rod is introduced into the vagina with a gloved hand. After the rod is guided through the cervix, the guard cap is dislodged and the swab is rubbed along the endometrium, after which the rod is extracted. Samples for uterine culture should only be obtained during full estrus. Swabs should be directly plated onto agar within 2 hours of collection. Blood agar is appropriate for initial screening, but use of specialized types of agar expedites identification of microbes. Plates are incubated at 37 C and inspected for growth every 12 hours. The type and number of bacterial colonies should be coupled with the history and clinical signs in deciding on the necessity and type of treatment. Pure, heavy bacterial growth is usually accompanied by clinical signs of infection. Interpretation of the significance of moderate bacterial growth may be aided by cytologic examination of endometrial smears, made by rolling the swab onto a glass slide and staining with Diff - Quik . Large numbers of neutrophils indicate the need for antibiotic therapy. Mixed bacterial growth and variable numbers of neutrophils usually indicate faulty sampling technic. Microaerophilic or anaerobic cultures may aid diagnosis in cases of equivocal aerobic culture results.

  12. Post-Operative hemorrhage after myomectomy: Safety and efficacy of transcatheter uterine artery embolization

    International Nuclear Information System (INIS)

    Wan, Alvin Yu Hon; Shin, Ji Hoon; Yoon, Hyun Ki; Ko, Gi Young; Park, Sang Gik; Seong, Nak Jong; Yoon, Chang Jin

    2014-01-01

    To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage. We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted. The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients. Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.

  13. Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

    Directory of Open Access Journals (Sweden)

    K. H. Odubamowo

    2014-01-01

    Full Text Available Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide. Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation.

  14. Radiation Therapy, Paclitaxel, and Carboplatin in Treating Patients With Uterine Cancer

    Science.gov (United States)

    2015-01-16

    Stage IA Uterine Sarcoma; Stage IB Uterine Sarcoma; Stage IC Uterine Sarcoma; Stage IIA Uterine Sarcoma; Stage IIB Uterine Sarcoma; Stage IIIA Uterine Sarcoma; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Carcinosarcoma

  15. Ruptured Eardrum (Perforated Eardrum)

    Science.gov (United States)

    ... with air travel. Other events that can cause sudden changes in pressure — and possibly a ruptured eardrum — ... if it fails to heal. Possible complications include: Hearing loss. Usually, hearing loss is temporary, lasting only until ...

  16. Rupture traumatique du diaphragme

    OpenAIRE

    Nordback, P.L.G.

    2006-01-01

    Résumé Rupture traumatique du diaphragme La rupture traumatique du diaphragme a été décrite la première fois par Sennertus en 1541. Ambroise Paré, en 1579, décrivit le premier cas de rupture traumatique du diaphragme diagnostiqué à l'autopsie. Une rupture traumatique du diaphragme existe chez 3 à 5% des patients polytraumatisés. En général la réparation chirurgicale est simple. La mortalité globale atteint 20 à 25%, elle est en général liée aux lésions associées, à la sévérité de la ...

  17. Premature rupture of membranes

    Science.gov (United States)

    ... gov/ency/patientinstructions/000512.htm Premature rupture of membranes To use the sharing features on this page, ... water that surrounds your baby in the womb. Membranes or layers of tissue hold in this fluid. ...

  18. Acquire uterine vascular malformation: Clinical outcome of transarterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Chae Hoon [Dept. of Radiology, Gangneung Asan Hospital, Gangneung (Korea, Republic of); Yang, Seung Boo; Goo, Dong Erk; Kim, Yong Jae; Lee, Jae Myung; Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of)

    2017-02-15

    To evaluate clinical outcomes of transarterial embolization of bilateral uterine arteries (UAE) in patients with acquired uterine vascular malformation (UVM). This retrospective study was performed on the medical records of all 19 patients who underwent transarterial embolization of bilateral UAE for the treatment of symptomatic UVMs from January 2003 to June 2011. Embolization was performed via the unilateral femoral artery approach with a catheter and angiographic techniques. Clinical success was defined as definitive resolution of abnormal vaginal bleeding. Post-procedural complications included all adverse events related to the embolization procedure. A total of 20 procedures were performed in 19 patients. One patient required repeat embolization because of incomplete embolization related to prominent high flow malformation. Clinically, in all patients, bleeding was controlled immediately after embolization. No complications occurred in all patients during the follow up period. In all patients who underwent successful UAE, menstrual cycles were normally restored within 1-2 months. Normal pregnancy with term delivery was observed in two of the 19 cases. Transarterial bilateral UAE is a safe and effective treatment in patients with vaginal bleeding caused by acquired UVM, and it allows the possibility of future pregnancy.

  19. Uterine Artery Anatomy Relevant to Uterine Leiomyomata Embolization

    International Nuclear Information System (INIS)

    Gomez-Jorge, Jackeline; Keyoung, Andrew; Levy, Elliot B.; Spies, James B.

    2003-01-01

    To categorize the anatomic variants of uterine arteries, and determine the incidence of menopausal symptoms where the tubo-ovarian branches were seen prior to embolization. Between July 1997 and June 2000, 257 (n = 257) uterine fibroid embolizations were performed at our institution. Arteriograms were retrospectively evaluated. Uterine arteries were classified into groups: type I (the uterine artery as first branch of the inferior gluteal artery), type II (the uterine artery as second or third branch of the inferior gluteal artery), type III (the uterine artery, the inferior gluteal and the superior gluteal arteries arising as a trifurcation), type IV (the uterine artery as first branch of the hypogastric artery), inconclusive, or not studied. Tubo-ovarian branches were recorded if visualized prior to and/or after embolization. Menopausal symptoms were recorded (n = 175 at 3 months, n = 139 at 6 months, n = 98 at 1 year, n = 22 at 2 years) using written questionnaires. Five hundred and fourteen uterine arteries (n = 514) were evaluated. There were 38% classifiable types, 23% inconclusive, and 39% not studied. Classification was as follows: type I, 45%; type II, 6%; type III, 43%; type IV, 6%. Among 256 patients, tubo-ovarian arteries were seen in 36 prior to embolization, but not afterwards. In this group, 25 patients reported transient menopausal symptoms (hot flashes, amenorrhea). Five patients did not report any menopausal symptoms. Six patients did not answer the questionnaires. Type I is the most common type of anatomy, followed by type III. The tubo-ovarian arteries may be visualized prior to and/or after embolization. The embolization was monitored to avoid embolization of the tubo-ovarian branches. Menopausal symptoms were transient all patients when the tubo-ovarian branches were seen prior to embolization

  20. Uterine artery blood flow in patients with copper intrauterine device-induced abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Usama M. Fouda

    2010-07-01

    Conclusion: The results of our study confirm the hypothesis that there is an increase in the uterine blood flow (as indicated by decreased PI and RI in uterine artery in women with CIUD-induced abnormal uterine bleeding.

  1. Vaginal or uterine bleeding - overview

    Science.gov (United States)

    ... Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleeding ... of regular ovulation (anovulation). Doctors call the problem abnormal uterine bleeding (AUB) . AUB is more common in teenagers and ...

  2. Bilateral ekstrauterin graviditet

    DEFF Research Database (Denmark)

    Kirkegaard, Ida; Kruse, Christina

    2009-01-01

    Bilateral tubal pregnancies are extremely rare and they are usually found after assisted reproductive techniques have been applied. A rare case of bilateral tubal pregnancy after natural conception, occurring in a woman without any predisposing factors for ectopic pregnancy, is presented....... The condition was diagnosed during laparoscopic surgery, and she was optimally treated with conservative tubal surgery. A short review of the literature is provided and discussed along with the clinical features, diagnostic difficulties and treatment options of bilateral tubal pregnancy. Udgivelsesdato: 2009...

  3. Successful laparoscopic repair of uterine and rectal prolapse in an infant

    Directory of Open Access Journals (Sweden)

    Mariko Yoshida

    2017-12-01

    Full Text Available Neonatal or infantile uterine prolapse is a quite rare condition and is usually managed with conservative treatment. There is no standard surgical treatment for infantile uterine prolapse, and to the best of our knowledge, only 2 out of 30 patients suffering from it have been reported to undergo surgical repair in English literature since 1961. We here report the first successful case of laparoscopic repair for uterine prolapse in an infant. The patient was a 2-month old girl who had sacral myelomeningocele and Chiari type 2 malformation. She had undergone closure of myelomeningocele and ventriculoperitoneal shunting within 6 weeks after birth. At 7 weeks of age, the rectum and the uterus prolapsed, and the prolapse gradually deteriorated. Conservative treatments including repeated digital reduction, use of ointment and glycerin enema, and placement of a Foley catheter into the vagina were not effective. At the age of 100 days, she underwent laparoscopic hysteropexy and rectopexy. Three ports were placed on the umbilicus and the bilateral abdomen, and the bilateral mesovaria were sutured to the anterior abdominal wall to improve the visualization of the pelvis. The rectum and the uterine body were directly sutured to the sacral promontory with 2 non-absorbable braided sutures each, not using mesh prosthesis. The postoperative course was uneventful and neither uterine nor rectal prolapse has recurred for 2.5 years. We plan to follow up the patient for a long period since the long-term prognosis is not known.

  4. Sterility of the uterine cavity

    DEFF Research Database (Denmark)

    Møller, Birger R.; Kristiansen, Frank V.; Thorsen, Poul

    1995-01-01

    In a prospective open study the sterility of the uterine cavity was evaluated in 99 women admitted for hysterectomy. The indications for hysterectomy were in most cases persistent irregular vaginal bleeding and fibromyomas of the uterus. Samples for both aerobic and anaerobic bacteria, Chlamydia ...... which may play a causative role in endometritis. The results indicate that inflammation of the uterine cavity should be evaluated by hysteroscopic examination before hysterectomy is undertaken in patients with persistent irregular vaginal bleeding. Udgivelsesdato: 1995-Mar...

  5. Imaging of uterine cervix carcinoma

    International Nuclear Information System (INIS)

    Viala, J.

    2000-01-01

    Imaging of uterine cervix carcinoma has evolved during the last decade. Recent developments in magnetic resonance imaging have expanded the role of MRI in evaluating the pathology of uterine cervix carcinoma. MRI is now the modality of choice for tumor staging, evaluating tumor response to treatment, diagnosing recurrences and for evaluating pregnant patients. MRI images will soon be used to calculate dosimetry for brachytherapy with matching and fusion software. (author)

  6. Vaginal rupture and evisceration in a dog.

    Science.gov (United States)

    Prassinos, Nikitas N; Adamama-Moraitou, Katerina K; Ververidis, Haralabos N; Anagnostou, Tilemachos L; Kladakis, Stefanos E

    2010-09-01

    A 1.5-year-old German Shepherd mixed breed dog was admitted with mild haemorrhage from the vulva and a perineal mass of 24-hour duration, which had been first observed immediately after parturition. Parturition had occurred at low ambient temperature, and only one puppy survived out of the seven oversized fetuses. The dog was in poor body condition, dehydrated, hypothermic, depressed, non-ambulatory and in a state of shock. Intestinal loops, the urinary bladder and the uterine horns and body were protruding from the vulva. A true vaginal prolapse was also observed. The abdominal viscera were flushed with warm sterile saline solution, protected and maintained wet. The laboratory findings included moderate anaemia, leukocytosis, hypoalbuminaemia, azotaemia and elevated liver enzyme activities. Stabilisation of the dog's general condition was attempted before surgery. Antimicrobial and analgesic drugs were also administered. After exploratory laparotomy the protruding organs, which were in good condition, were reduced. A recent rupture in the vaginal wall, approximately 6 cm long, was observed. Ovariohysterectomy and partial vaginectomy were performed. The preoperative course of therapy was continued, but the bitch died 12 hours later. The probable cause of vaginal rupture and evisceration in this bitch was tenesmus and/or trauma due to the oversized fetuses.

  7. Localized leiomyosarcoma of the uterine cervix with rapid lung metastases

    Directory of Open Access Journals (Sweden)

    Joao Casanova

    2015-08-01

    Full Text Available Cervical sarcomas are extremely rare tumors associated with a poor prognosis. We report the case of a 63-year-old woman who was admitted to our institution due to abnormal vaginal bleeding and abdominal pain. Physical examination revealed a large cervical mass that was biopsied. Pathological features were compatible with a leiomyosarcoma of the uterine cervix. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. All histological and Immunohistochemical findings confirmed the diagnosis of leiomyosarcoma of the cervix. Adjuvant chemotherapy was started but unfortunately the disease progressed and 1 year after completion of the chemotherapy the patient developed lung metastases and eventually died.

  8. Uterine dysfunction in biglycan and decorin deficient mice leads to dystocia during parturition.

    Directory of Open Access Journals (Sweden)

    Zhiping Wu

    Full Text Available Cesarean birth rates are rising. Uterine dysfunction, the exact mechanism of which is unknown, is a common indication for Cesarean delivery. Biglycan and decorin are two small leucine-rich proteoglycans expressed in the extracellular matrix of reproductive tissues and muscle. Mice deficient in biglycan display a mild muscular dystrophy, and, along with mice deficient in decorin, are models of Ehlers-Danlos Syndrome, a connective tissue anomaly associated with uterine rupture. As a variant of Ehlers-Danlos Syndrome is caused by a genetic mutation resulting in abnormal biglycan and decorin secretion, we hypothesized that biglycan and decorin play a role in uterine function. Thus, we assessed wild-type, biglycan, decorin and double knockout pregnancies for timing of birth and uterine function. Uteri were harvested at embryonic days 12, 15 and 18. Nonpregnant uterine samples of the same genotypes were assessed for tissue failure rate and spontaneous and oxytocin-induced contractility. We discovered that biglycan/decorin mixed double-knockout dams displayed dystocia, were at increased risk of delayed labor onset, and showed increased tissue failure in a predominantly decorin-dependent manner. In vitro spontaneous uterine contractile amplitude and oxytocin-induced contractile force were decreased in all biglycan and decorin knockout genotypes compared to wild-type. Notably, we found no significant compensation between biglycan and decorin using quantitative real time PCR or immunohistochemistry. We conclude that the biglycan/decorin mixed double knockout mouse is a model of dystocia and delayed labor onset. Moreover, decorin is necessary for uterine function in a dose-dependent manner, while biglycan exhibits partial compensatory mechanisms in vivo. Thus, this model is poised for use as a model for testing novel targets for preventive or therapeutic manipulation of uterine dysfunction.

  9. Quadratus lumborum block in management of severe pain after uterine artery embolization.

    Science.gov (United States)

    Ben-David, B; Kaligozhin, Z; Viderman, D

    2018-01-16

    The quadratus lumborum (QL) block has been widely used for acute postoperative pain management after numerous surgical procedures including urological, abdominal, gynaecological and orthopaedic surgical procedures. The local anaesthetic spread in this area can provide unilateral sensory block in T6-L2 dermatomes. We performed bilateral quadratus lumborum block for the management of acute pain after the uterine artery embolization (UAE). A 43-year-old woman was admitted to the gynaecology department of Mother and Child Hospital, University Medical Center, for uterine artery embolization. Shortly, after successful completion of the UAE procedure, the patient began to complain of severe pain in the lower abdomen rated as a 9 on a verbal analogue scale (VAS) of 0-10. Intravenous tramadol 100 mg was infused over 30 min with minimal reduction in pain. Trimeperidine 20 mg was then infused over 30 min. Pain scores, however, remained 7-8/10 on the VAS. It was therefore decided to place a bilateral single-shot ultrasound-guided quadratus lumborum block. The procedure was well tolerated and brought notable pain relief. VAS declined from 8/10 to 5/10 after 30 min and to 3/10 at 60 min. Over the ensuing 24 h, VAS pain intensity remained 2-3/10. No further analgesics were necessary. A randomized control clinical trial is warranted to assess the efficacy of QL blockade and to compare it with other analgesic options in uterine artery embolization. Bilateral quadratus lumborum blockade may be an excellent pain control option after uterine artery embolization. Uterine artery embolization is associated with significant postprocedural pain which can prove difficult to manage with opioids. Bilateral quadratus lumborum block may be an excellent pain control option - one that might significantly reduce not only pain, but also the need for opioids and perhaps even the need for hospitalization. © 2018 European Pain Federation - EFIC®.

  10. Pregnancy following bilateral salpingectomy

    DEFF Research Database (Denmark)

    Oturai, Annette Bang

    2008-01-01

    This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy...

  11. Solitary uterine metastasis of invasive lobular carcinoma after adjuvant endocrine therapy: a case report.

    Science.gov (United States)

    Toyoshima, Masafumi; Iwahashi, Hideki; Shima, Takashi; Hayasaka, Atsushi; Kudo, Takako; Makino, Hiromitsu; Igeta, Saori; Matsuura, Rui; Ishigaki, Nobuko; Akagi, Kozo; Sakurada, Junko; Suzuki, Hiroyoshi; Yoshinaga, Kosuke

    2015-02-14

    Solitary uterine metastases from extragenital cancers are very rare. Breast cancer is the most frequent primary site of metastasis to the uterine corpus, with invasive lobular carcinoma more likely to spread to gynecologic organs than invasive ductal carcinoma. A 62-year-old postmenopausal Japanese woman was diagnosed with uterine leiomyomata more than 20 years ago and had been managed conservatively until menopause. Seven years prior to her presentation, she was diagnosed with breast cancer and underwent a partial resection of her right breast for stage IIA invasive lobular carcinoma. She underwent adjuvant chemotherapy, radiotherapy, and five years of anastrozole hormonal therapy. She presented with a growing uterine mass. Her tumor marker levels were markedly increased over the course of her follow-up, but a systemic examination revealed only a solitary uterine tumor. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A histopathological examination, including detailed immunohistochemistry, confirmed metastatic invasive lobular carcinoma, infiltrating both her uterine myometrium and fibroid tissue. We report a very rare metastatic pattern of invasive lobular carcinoma and demonstrate that gross cystic disease fluid protein-15 and mammaglobin are useful in the diagnosis of metastatic breast cancer.

  12. Uterine myomas in pregnancy, childbirth and puerperium

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2014-01-01

    Full Text Available Fibroids are the most common benign tumors of the genital organs of women in reproductive age. Achieving reproductive function later in life, with more frequent use of assisted reproductive technologies, leads to an increased number of pregnancies complicated with fibroids. Their size may change during pregnancy, but the changes are mostly individual. Most fibroids stop growing or decline during the puerperium. The effect of fibroids on pregnancy depends on their number, size and location. The mechanisms bringing about perinatal complications are not fully understood. Fibroids during pregnancy can cause many perinatal complications, such as bleeding in pregnancy, miscarriage, pain due to red degeneration, malpresentation, preterm labor, premature rupture of membranes, placental abruption and obstruction of delivery and are associated with higher incidence of cesarean section, operative vaginal delivery, uterine atony and postpartum hemorrhage. Postpartum hysterectomy in these women is also more likely than in general population. Postpartum infections are more common in patients with fibroids, and myomas may also cause retained placenta. The most common cause of neonatal morbidity is prematurity, due to pregnancy ending in an earlier gestational age. Monitoring of pregnancies complicated with fibroids is essentially indistinguishable from monitoring normal pregnancies. Therapy includes only bed rest and observation, symptomatic therapy in case of pain and intensive fetal surveillance, and surgery in the acute situations.

  13. Rupture, waves and earthquakes.

    Science.gov (United States)

    Uenishi, Koji

    2017-01-01

    Normally, an earthquake is considered as a phenomenon of wave energy radiation by rupture (fracture) of solid Earth. However, the physics of dynamic process around seismic sources, which may play a crucial role in the occurrence of earthquakes and generation of strong waves, has not been fully understood yet. Instead, much of former investigation in seismology evaluated earthquake characteristics in terms of kinematics that does not directly treat such dynamic aspects and usually excludes the influence of high-frequency wave components over 1 Hz. There are countless valuable research outcomes obtained through this kinematics-based approach, but "extraordinary" phenomena that are difficult to be explained by this conventional description have been found, for instance, on the occasion of the 1995 Hyogo-ken Nanbu, Japan, earthquake, and more detailed study on rupture and wave dynamics, namely, possible mechanical characteristics of (1) rupture development around seismic sources, (2) earthquake-induced structural failures and (3) wave interaction that connects rupture (1) and failures (2), would be indispensable.

  14. Rupture with Concurrent Splenic

    African Journals Online (AJOL)

    (Pavel et al., 2008). Infrequently, persistent or mild trauma can cause severe perirenal haematoma resulting in abdominal pain, hematuria and shock. In humans, kidney injury is common with falls and automobile accidents; however there is dearth of information of the causes ofkidney rupture in dogs. In veterinary patient ...

  15. Ruptured Eardrum (Perforated Eardrum)

    Science.gov (United States)

    ... your eardrum when the air pressure in your middle ear and the air pressure in the environment are out of balance. If the pressure is ... ruptured, the skin debris can pass into your middle ear and form a cyst. A ... a friendly environment for bacteria and contains proteins that can damage ...

  16. Rule and rupture

    DEFF Research Database (Denmark)

    Lund, Christian; Eilenberg, Michael

    This policy brief contributes to a novel understanding of public authority and state formation. It draws on a recent publication, Rule and Rupture, edited by Christian Lund and Michael Eilenberg (2016), and argues that public authority is not simply given but constituted through social contracts...

  17. Medical Treatment of Uterine Leiomyoma

    Science.gov (United States)

    Sabry, Mohamed; Al-Hendy, Ayman

    2012-01-01

    Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to be the most common indication for hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine myomas cause several reproductive problems such as heavy or abnormal uterine bleeding, pelvic pressure, infertility, and several obstetrical complications including miscarriage and preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine leiomyomas and has typically consisted of either hysterectomy or myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail. PMID:22378865

  18. Ruptured Abdominal Aortic Aneurysm

    Directory of Open Access Journals (Sweden)

    Jessica Andrusaitis

    2017-07-01

    Full Text Available History of present illness: A 69-year-old male with poorly controlled hypertension presented with 1 hour of severe low back pain that radiated to his abdomen. The patient was tachycardic and had an initial blood pressure of 70/40. He had a rigid and severely tender abdomen. The patient’s history of hypertension, abnormal vital signs, severity and location of his pain were suspicious for a ruptured abdominal aortic aneurysm (AAA. Therefore, a computed tomography angiogram (CTA was ordered. Significant findings: CTA demonstrated a ruptured 7.4 cm infrarenal abdominal aortic aneurysm with a large left retroperitoneal hematoma. Discussion: True abdominal aortic aneurysm is defined as at least a 3cm dilatation of all three layers of the arterial wall of the abdominal aorta.1 An estimated 15,000 people die per year in the US of this condition.2 Risk factors for AAA include males older than 65, tobacco use, and hypertension.1,3,4 There are also congenital, mechanical, traumatic, inflammatory, and infectious causes of AAA.3 Rupture is often the first manifestation of the disease. The classic triad of abdominal pain, pulsatile mass, and hypotension is seen in only 50% of ruptured AAAs.5 Pain (abdominal, groin, or back is the most common symptom. The most common misdiagnoses of ruptured AAAs are renal colic, diverticulitis, and gastrointestinal hemorrhage.6 Bedside ultrasonography is the fastest way to detect this condition and is nearly 100% sensitive.1 One study showed that bedside ultrasounds performed by emergency physicians had a sensitivity of .94 [95% CI = .86-1.0] and specificity of 1 [95% CI = .98-1.0] for detecting AAAs.7 CTA has excellent sensitivity (approximately 100% and yields the added benefit of facilitating surgical planning and management.1 Without surgical treatment, a ruptured AAA is almost uniformly fatal, and 50% of those who undergo surgery do not survive.1 Early resuscitation and coordination with vascular surgery should be

  19. Uterine artery embolization: an effective treatment for intractable obstetric haemorrhage

    International Nuclear Information System (INIS)

    Hong, T.-M.; Tseng, H.-S.; Lee, R.-C.; Wang, J.-H.; Chang, C.-Y.

    2004-01-01

    AIM: To present the findings of uterine artery embolization (UAE) in the management of obstetric haemorrhage. MATERIALS AND METHODS: From October 1999 to February 2003, 10 women with postpartum haemorrhage (n=7) and post-abortion haemorrhage with placenta accreta (n=3), were referred to our department for pelvic angiography and possible arterial embolization. RESULTS: Angiography revealed engorged and tortuous uterine arteries in all patients; and contrast medium extravasation in three patients. Eight patients (three with and five without detectable active bleeding) then underwent bilateral UAE. Medium-sized (250-355 μm) polyvinyl alcohol particles were injected via a coaxial catheter into the uterine arteries, followed by gelatin sponge pieces via a 4 F Cobra catheter. Microcoil devascularization was also performed in the two patients with visible, active bleeding. The vaginal bleeding resolved in all patients, without any ischaemic complications. At follow-up, all patients who underwent UAE had normal menstruation; three of them subsequently gave birth to full-term healthy babies. CONCLUSION: Selective UAE by the coaxial method is safe and effective to control obstetric haemorrhage, with the potential to preserve fertility

  20. Uterine Carcinosarcoma in a Patient with Didelphys Uterus

    Directory of Open Access Journals (Sweden)

    C. Iavazzo

    2013-01-01

    Full Text Available Background. Didelphys uterus is a noncommon finding in women. Till now, few cases with benign mesenchymal tumors in patients with didelphys uterus are described. We present a case of a patient with carcinosarcoma arising in a didelphys uterus. Case. A 73-year-old patient presented with profuse watery postmenopausal bleeding. On examination under anesthesia, left and right cervixes were identified. Tumor extended from the left cervix into the lower third of the vagina and was adherent to the right vaginal sidewall. There was no evidence of parametrial extension. Tissue was sent for biopsy which revealed high-grade uterine carcinosarcoma. Two uterine fundi and two vaginas in keeping with uterine didelphys were identified on imaging. The patient underwent vaginal excision of the protruding tumor measuring  cm with harmonic scalpel followed by total abdominal hysterectomy and bilateral salpingooophorectomy. Although a number of pelvic and paraaortic lymph nodes were also identified on imaging, she was not planned for lymphadenectomy after MDT (multidisciplinary team discussion because of her comorbidities. The final histology confirmed the diagnosis. Conclusion. According to our knowledge, this is the second case of carcinosarcoma arising in didelphys uterus in the world literature.

  1. Uterine artery embolization: an effective treatment for intractable obstetric haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Hong, T.-M.; Tseng, H.-S. E-mail: hstseng@vghtpe.gov.tw; Lee, R.-C.; Wang, J.-H.; Chang, C.-Y

    2004-01-01

    AIM: To present the findings of uterine artery embolization (UAE) in the management of obstetric haemorrhage. MATERIALS AND METHODS: From October 1999 to February 2003, 10 women with postpartum haemorrhage (n=7) and post-abortion haemorrhage with placenta accreta (n=3), were referred to our department for pelvic angiography and possible arterial embolization. RESULTS: Angiography revealed engorged and tortuous uterine arteries in all patients; and contrast medium extravasation in three patients. Eight patients (three with and five without detectable active bleeding) then underwent bilateral UAE. Medium-sized (250-355 {mu}m) polyvinyl alcohol particles were injected via a coaxial catheter into the uterine arteries, followed by gelatin sponge pieces via a 4 F Cobra catheter. Microcoil devascularization was also performed in the two patients with visible, active bleeding. The vaginal bleeding resolved in all patients, without any ischaemic complications. At follow-up, all patients who underwent UAE had normal menstruation; three of them subsequently gave birth to full-term healthy babies. CONCLUSION: Selective UAE by the coaxial method is safe and effective to control obstetric haemorrhage, with the potential to preserve fertility.

  2. Uterine artery embolisation for symptomatic adenomyosis-Mid-term results

    International Nuclear Information System (INIS)

    Bratby, M.J.; Walker, W.J.

    2009-01-01

    Purpose: To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis. Materials and methods: 27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome. Results: The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years. Conclusion: UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.

  3. Uterine artery embolisation for symptomatic adenomyosis-Mid-term results

    Energy Technology Data Exchange (ETDEWEB)

    Bratby, M.J. [Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX (United Kingdom); Walker, W.J. [Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX (United Kingdom)], E-mail: wjwalker@doctors.org.uk

    2009-04-15

    Purpose: To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis. Materials and methods: 27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome. Results: The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years. Conclusion: UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.

  4. Enhanced myometrial autophagy in postpartum uterine involution

    Directory of Open Access Journals (Sweden)

    Keng-Fu Hsu

    2014-09-01

    Conclusion: Autophagy of myocytes may play an important role in uterine involution. These results have implications for our understanding of myometrial functional adaptations during pregnancy and the physiological role of autophagy in the uterine remodeling events in the postpartum period.

  5. Bilateral giant femoropopliteal artery aneurysms: a case report

    Directory of Open Access Journals (Sweden)

    Perdikides Theodossios P

    2008-04-01

    Full Text Available Abstract Introduction Popliteal artery aneurysms are the most common peripheral arterial aneurysms, and are frequently bilateral. Acute limb ischemia, rupture and compression phenomena can complicate these aneurysms when the diameter exceeds 2 cm. Case Presentation We report an 82-year-old male patient with two giant femoropopliteal aneurysms, 10.5 and 8.5 cm diameters, managed in our institution. Both aneurysms were resected and a polytetrafluoroethylene (PTFE femoropopliteal interposition graft was placed successfully. Management and literature review are discussed. Conclusion We believe this is the first report in the medical literature of bilateral giant femoropopliteal aneurysms.

  6. Pregnancy following bilateral salpingectomy

    DEFF Research Database (Denmark)

    Oturai, Annette Bang

    2008-01-01

    This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy...... was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

  7. Ruptured rudimentary horn pregnancy with a history of an uneventful vaginal delivery.

    Science.gov (United States)

    Mishra, Nitin; Yadav, Nitin; Koshiya, Darshan; Jhanwar, Vikas

    2015-01-01

    Pregnancy in a rudimentary uterine horn is a rare event with an estimated incidence of 1 in 76,000 to 1 in 1,40,000 pregnancies. Unicornuate uterus with a rudimentary horn has a high incidence of obstetric and gynecological complications. Ruptured ectopic pregnancy in the rudimentary horn is one of the most dreaded complications, which can have grave consequences for both mother and fetus. In the majority of the cases, it is detected after rupture of the horn, usually during the first or second trimester of pregnancy. An ultrasonographic diagnosis made prior to rupture of the rudimentary horn may prevent this catastrophic outcome. We report a case of a G2 P1 L1 with a ruptured left rudimentary horn pregnancy at 16 weeks of gestation that was misdiagnosed as a pregnancy in the left uterine horn of a bicornuate uterus on prior prenatal ultrasound. The patient presented to our hospital with abdominal pain and vaginal bleeding. A diagnosis of ruptured left rudimentary horn pregnancy was made on the basis of emergency ultrasound and was later confirmed on laparotomy. The left rudimentary horn along with the ipsilateral fallopian tube was excised.

  8. Fertility-sparing uterine lesion resection for young women with gestational trophoblastic neoplasias: single institution experience.

    Science.gov (United States)

    Wang, Xiaoyu; Yang, Junjun; Li, Jie; Zhao, Jun; Ren, Tong; Feng, Fengzhi; Wan, Xirun; Xiang, Yang

    2017-06-27

    To evaluate the oncological safety and pregnant outcomes of fertility-sparing uterine lesion resection in treating gestational trophoblastic neoplasias. After the treatment of surgery and chemotherapy, all the patients achieved complete remission. With a median follow-up time of 44 months (range, 6-188), 3 patients (3.85%) relapsed within 3-26 months. Multivariate analysis showed that tumor size was the independent risk factor of recurrence and the cutoff value was 4.2cm. Among 37 patients who attempted to conceive, 31 achieved clinical pregnancy. The rate of pregnancy and live birth were 83.8% and 77.4%. Uterine rupture did not occurred no matter in cesarean section or vaginal delivery. No congenital abnormalities were reported among the live births. From January 1995 to December 2014, 78 patients with gestational trophoblastic neoplasias who underwent fertility-sparing uterine lesion resection at Peking Union Medical College Hospital were reviewed. The complete remission rate, fertility rate, pregnant outcomes and risk factors of recurrence were analyzed. Fertility-sparing uterine lesion resection might be considered as a safe and reasonable alternative for high-selected young women to remove uterine lesion in the treatment of gestational trophoblastic neoplasias.

  9. Secondary postpartum haemorrhage with uterine artery ...

    African Journals Online (AJOL)

    a left uterine artery PA, which measured 4 cm in diameter, with extravasation of contrast into a pocket that connected to the uterine cavity. After obtaining the patient's consent, selective left uterine artery embolisation was performed with a mixture of Gelfoam and contrast media, followed by one stainless steel coil insertion.

  10. Minimally invasive treatments of uterine fibroids

    NARCIS (Netherlands)

    Voogt, M.J.

    2012-01-01

    This thesis assesses clinical results and technical developments of two minimally invasive treatments for symptomatic uterine fibroids: uterine artery embolization (UAE) and magnetic resonance-guided high intensity focused ultrasound (MR-HIFU). Part I: Uterine artery embolization The results of a

  11. Pregnancy Following Uterine Artery Embolization with Polyvinyl Alcohol Particles for Patients with Uterine Fibroid or Adenomyosis

    International Nuclear Information System (INIS)

    Kim, Man Deuk; Kim, Nahk Keun; Kim, Hee Jin; Lee, Mee Hwa

    2005-01-01

    Purpose:To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy.Methods:Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were enrolled in this study. The age range of participants was 20-40 years. The data were collected through review of medical records and telephone interviews. Mean duration of follow-up duration was 35 months (range 22-60 months). Patients using contraception and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size of PVA particles used was 255-700 μm.Results:Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%) and 69.3% (range 36.3% to 93.3%), respectively.Conclusion:Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure

  12. Herbal preparations for uterine fibroids

    Science.gov (United States)

    Liu, Jian Ping; Yang, Hong; Xia, Yun; Cardini, Francesco

    2011-01-01

    Background Uterine fibroids are the most common non-malignant growths in women of childbearing age. They are associated with heavy menstrual bleeding and subfertility. Herbal preparations are commonly used as alternatives to surgical procedures. Objectives To assess the benefits and risks of herbal preparations for uterine fibroids. Search strategy Authors searched following electronic databases: the Trials Registers of the Cochrane Menstrual Disorders and Subfertility Group and the Cochrane Complementary Medicine Field, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 3), MEDLINE, EMBASE, the Chinese Biomedical Database, the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), AMED, and LILACS. The searches ended on 31st December 2008. Selection criteria Randomised controlled trials comparing herbal preparations with no intervention, placebo, medical treatment or surgical procedures in women with uterine fibroids. We also included trials of herbal preparations with or without conventional therapy. Data collection and analysis Two review authors collected data independently. We assessed trial risk of bias according to our methodological criteria. We presented dichotomous data as risk ratios (RR) and continuous outcomes as mean difference (MD), both with 95% confidence intervals (CI). Main results We included two randomised trials (involved 150 women) with clear description of randomisation methods. The methodological risk of bias of the trials varied. There were variations in the tested herbal preparations, and the treatment duration was six months. The outcomes available were not the primary outcomes selected for this review, such as symptom relief or the need for surgical treatment; trials mainly reported outcomes in terms of shrinkage of the fibroids. Compared with mifepristone, Huoxue Sanjie decoction showed no significant difference in the disappearance of uterine fibroids, number of

  13. Two uncommon cases of uterine leiomyosarcomas displaying heterologous osteosarcomatous de-differentiation

    Directory of Open Access Journals (Sweden)

    Pinki Parikh

    2015-01-01

    Full Text Available Uterine leiomyosarcomas uncommonly arise on a background of leiomyomas. Still rare is osteosarcomatous dedifferentiation in such tumors. A 60-year-old female presented with abdominal pain and underwent radiological imaging that disclosed a large, well-defined, heterogeneously enhancing uterine tumor. She underwent total abdominal hysterectomy with bilateral salpingectomy. Another, 38-year-old female with the complaints of infertility underwent myomectomy for multiple fibroids. Multiple tumor sections from both the cases showed leiomyomas along with leiomyosarcomas and osteosarcomatous dedifferentiation. Immunohistochemically, both the tumors displayed diffuse expression of smooth muscle markers in areas of leiomyomas, reduced expression of the same in areas of leiomyosarcoma and absent expression in areas of osteosarcomatous dedifferentiation. Unfortunately, both the cases were lost to follow-up. Present cases constitute as rare documentations of uterine leiomyosarcomas, arising on a background of leiomyomas and exhibiting osteosarcomatous dedifferentiation. The value of identifying these tumor components, with extensive tumor sampling relates to their relatively aggressive clinical course.

  14. Humoral hypercalcemia caused by uterine corpus carcinosarcoma consisting of squamous cell carcinoma in its epithelial component.

    Science.gov (United States)

    Takamatsu, Shiro; Matsumura, Noriomi; Baba, Tsukasa; Mandai, Masaki; Mikami, Yoshiki; Konishi, Ikuo

    2014-01-01

    Humoral hypercalcemia of malignancy (HHM) is a paraneoplastic syndrome primarily caused by a tumor-producing parathyroid hormone-related protein (PTH-rP). We describe the first reported case of a uterine carcinosarcoma causing HHM. A 70-year-old patient was transferred to our hospital for a uterine tumor accompanied by impaired consciousness. The laboratory tests indicated anemia, malnutrition, elevated serum calcium and elevated PTH-rP. Emergency surgery, including abdominal hysterectomy and bilateral salpingo-oophorectomy, was performed due to uncontrollable uterine bleeding. The pathological diagnosis was carcinosarcoma consisting of pure squamous cell carcinoma in its epithelial component. Postoperatively, chemotherapy with paclitaxel and carboplatin was performed. The patient had recurrent tumors at the para-aortic lymph nodes 11 months after the initial surgery and underwent a pelvic and para-aortic lymphadenectomy, which removed all of the recurrent tumors. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  15. Canine Uterine Leiomyoma with Epithelial Tissue Foci, Adenomyosis, and Cystic Endometrial Hyperplasia

    Directory of Open Access Journals (Sweden)

    George S. Karagiannis

    2011-01-01

    Full Text Available An 11-year-old Labrador Retriever bitch with a history of intermittent, sanguineous vaginal discharge of a six-month duration was presented. During exploratory laparotomy, two well-delineated, intramural masses were identified bilaterally in the uterine horns. Histopathologic examination of the mass on the left horn showed that it was a typical leiomyoma. However, the second mass appeared with an unusual coexistence of histological lesions, involving epithelial tissue foci, mild focal adenomyosis, and cystic endometrial hyperplasia. Interestingly, such combination was never encountered before in dogs. Although uterine leiomyoma is quite usual in the reproductive system of female dogs, this case resembled relevant cases of human uterine adenomyomas in morphology, and thus it was offered a similar tentative diagnosis.

  16. Coexisting Malignant Melanoma and Blue Nevus of the Uterine Cervix: An Unusual Combination

    Directory of Open Access Journals (Sweden)

    David Parada

    2012-01-01

    Full Text Available Malignant melanoma (MM and blue nevi of the uterine cervix are an extremely rare neoplasm, probably derived from embryologic migration of melanocytes from the neural crest. MM displays aggressive behavior with a poor prognosis. We report the case of a 76-year-old postmenopausal woman abnormal vaginal bleeding. She underwent a hysterectomy and bilateral salpingo-oophorectomy with paraaortic-iliac lymphadenectomy. Histopathological and immunohistochemical studies were consistent with the diagnosis of MM and blue nevi in the uterine cervix. Although it is extremely rare, this case suggests that MM of the uterine cervix should be considered in the differential diagnosis of undifferentiated neoplasm. Early diagnosis is essential in order to warrant a better prognosis, although there are no cases of cure described.

  17. Uterine arterial chemoembolization combined with curettage for the treatment of cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Ai Zhigang; Gao Shufeng; Zhang Xuehui

    2010-01-01

    Objective: To evaluate uterine arterial chemoembolization combined with curettage in treating cesarean scar pregnancy. Methods: Super-selective bilateral uterine arterial catheterization and angiography was performed in 64 patients with cesarean scar pregnancy (duration of amenorrhea 43-84 days), which was followed by arterial infusion of MTX and embolization with Gelfoam particles. Then curettage was carried out. The technical success rate and the therapeutic results were observed and analyzed. Results: Technical success in catheterization and in performing chemoembolization was achieved in all 64 patients. The pregnant tissues were successfully cleared away in 62 patients. The average blood loss during curettage procedure was 21.4 ml. For the remaining two patients lesion resection together with repair of lower segment was employed. No severe complications occurred after the treatment. Conclusion: Uterine arterial chemoembolization combined with curettage is a safe,minimally-invasive and effective treatment for cesarean scar pregnancy. It is worth popularizing this technique in clinical practice. (authors)

  18. Clinical outcomes of uterine carcinosarcoma: results of 94 patients.

    Science.gov (United States)

    Gokce, Zeynep Kestel; Turan, Taner; Karalok, Alper; Tasci, Tolga; Ureyen, Isin; Ozkaya, Enis; Kose, Mehmet Faruk; Tulunay, Gokhan

    2015-02-01

    We aimed to determine the clinicopathologic features and identify prognostic factors of patients with uterine carcinosarcoma. A total of 94 patients with uterine carcinosarcoma who were diagnosed between January 1993 and October 2013 were included. Staging surgery consisted of total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, peritoneal cytology, and omentectomy. Staging is undertaken according to the 2009 International Federation of Gynecology and Obstetrics staging system. Kaplan-Meier survival analysis was used to determine the effects of variables on disease-free survival (DFS) and overall survival (OS). Seventy-nine patients underwent staging surgery and none of them had residual tumor after surgery. Three-year DFS and 3-year OS were 42.7% and 59.2%, respectively. In the univariate analysis, stage, presence of para-aortic metastatic lymph nodes, uterine serosal spread, positive peritoneal cytology, and extrapelvic metastases were associated with 3-year DFS and stage, presence of para-aortic metastatic lymph nodes, uterine serosal spread, positive peritoneal cytology, adnexal involvement, and extrapelvic metastases were associated with 3-year OS. Seventy-four patients received adjuvant therapy. Adjuvant therapy did not reduce recurrence or improve survival. Any of the chemotherapy regimens was not superior to the others. In the multivariate analysis, only age was an independent prognostic factor for 3-year DFS and no parameter was statistically significant for 3-year OS. Age was an independent prognostic factor for 3-year DFS. Older age was associated with poor survival. Extrauterine spread was associated with survival. The aims of surgery should be both staging and providing tumoral debulking. Prospective randomized trials are needed to better define the necessity and modality of the administered adjuvant therapy.

  19. Treatment of early glassy cell carcinoma of uterine cervix

    International Nuclear Information System (INIS)

    Kim, Ok Bae; Kim, Jin Hee; Choi, Tae Jin

    2006-01-01

    The purpose of this study was to investigate the clinical findings, treatment, and outcome of patients with glassy cell carcinoma of cervix. We reviewed all cases of glassy cell carcinoma of the uterine cervix confirmed and treated at the Dongsan Medical Center, Keimyung University, between January 1993 and December 2005. There were 7 cases with histopathologically confirmed gassy cell carcinoma. A tumor was diagnosed as glassy cell carcinoma if over 50% of the tumor cell type displayed glassy cell features. Six patients with stage IB had radical hysterectomy and bilateral pelvic node dissection, and 2 of them received adjuvant external pelvic irradiation with concurrent chemotherapy. Remaining one patient with stage IIA had curative concurrent chemoradiotherapy with external pelvic irradiation and brachytherapy. There were 7 patients diagnosed as glassy cell carcinoma among the 3,745 (0.2%) patients of carcinoma of uterine cervix. The mean age of 7 patients was 44 years with range of 35 to 53 years of age. The most frequent symptom was vaginal bleeding (86%). By the punch biopsy undertaken before treatment of 7 cases, 2 only cases could diagnose as glassy cell carcinoma of uterine cervix, but remaining of them confirmed by surgical pathological examination. The mean follow up duration was 73 months with range of 13 to 150 months. All 7 patients were alive without disease after treatment. Glassy cell carcinoma of the uterine cervix is a distinct clinicopathologic entity that demonstrates an aggressive biologic behavior. However for early-stage disease, we may have more favorable clinical outcome with radical surgery followed by chemoradiotherapy

  20. Spontaneous Bilateral Tubal Gestation: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Marwah Sheeba

    2016-01-01

    Full Text Available Here a case is presented where the woman after a positive pregnancy test underwent medical abortion for unwanted pregnancy without ultrasound confirmation of intrauterine pregnancy. On persistence of symptoms, a second opinion was procured, when examination and a transvaginal ultrasound scan revealed ruptured unilateral tubal ectopic pregnancy. However upon subsequent laparotomy (considering deteriorating hemodynamic status of the patient, intraoperatively it turned out to be a bilateral tubal ectopic gestation.

  1. Distal biceps tendon rupture.

    Science.gov (United States)

    Savvidou, Olga D; Papagelopoulos, Panayiotis J; Mavrogenis, Andreas F; Partsinevelos, Antonios A; Karadimas, Evangelos J; Korres, Demetrios S

    2004-09-01

    The authors report a rupture of the distal tendon of biceps brachii in a 42-year-old athlete. Magnetic resonance imaging confirmed the injury. Early surgical repair was performed by reinsertion of the tendon on the radial tuberosity according to modified Boyd-Anderson technique. Indomethacin was administered prophylactically. No complications were noted. At the latest follow-up, the patient had full elbow range of motion and participated successfully in athletic activities and job.

  2. Uterine sarcoma – current perspectives

    Directory of Open Access Journals (Sweden)

    Benson C

    2017-08-01

    Full Text Available Charlotte Benson,1 Aisha B Miah1,2 1Sarcoma Unit, Royal Marsden Hospital, 2Department of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK Abstract: Uterine sarcomas comprise a group of rare tumors with differing tumor biology, natural history and response to treatment. Diagnosis is often made following surgery for presumed benign disease. Currently, preoperative imaging does not reliably distinguish between benign leiomyomas and other malignant pathology. Uterine leiomyosarcoma is the most common sarcoma, but other subtypes include endometrial stromal sarcoma (low grade and high grade, undifferentiated uterine sarcoma and adenosarcoma. Clinical trials have shown no definite survival benefit of adjuvant radiotherapy or chemotherapy and have been hampered by the rarity and heterogeneity of these disease types. There is a role of adjuvant treatment in carefully selected cases following multidisciplinary discussion at sarcoma reference centers. In patients with metastatic disease, systemic chemotherapy can then be considered. There is activity of a number of agents, including doxorubicin, trabectedin, gemcitabine-based chemotherapy, eribulin and pazopanib. Patients should be considered for clinical trial entry where possible. Close international collaboration is important to allow progress in this group of diseases. Keywords: sarcoma, leiomyosarcoma, endometrial stromal sarcoma, undifferentiated uterine sarcoma, leiomyoma

  3. Gemcitabine Hydrochloride, Docetaxel, and Radiation Therapy in Treating Patients With Uterine Sarcoma That Has Been Removed By Surgery

    Science.gov (United States)

    2015-01-16

    Stage IA Uterine Sarcoma; Stage IB Uterine Sarcoma; Stage IC Uterine Sarcoma; Stage IIA Uterine Sarcoma; Stage IIB Uterine Sarcoma; Stage IIIA Uterine Sarcoma; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Corpus Leiomyosarcoma

  4. Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Abdominal Imaging, Paris cedex 10 (France); Morel, Olivier [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Obstetrics, Paris cedex 10 (France)

    2008-06-15

    The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. (orig.)

  5. Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland; Morel, Olivier

    2008-01-01

    The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. (orig.)

  6. Canine Uterine Leiomyoma with Epithelial Tissue Foci, Adenomyosis, and Cystic Endometrial Hyperplasia

    OpenAIRE

    Karagiannis, George S.; Pelekanis, Mihalis; Loukopoulos, Panayiotis; Ververidis, Haris N.; Kaldrymidou, Eleni

    2011-01-01

    An 11-year-old Labrador Retriever bitch with a history of intermittent, sanguineous vaginal discharge of a six-month duration was presented. During exploratory laparotomy, two well-delineated, intramural masses were identified bilaterally in the uterine horns. Histopathologic examination of the mass on the left horn showed that it was a typical leiomyoma. However, the second mass appeared with an unusual coexistence of histological lesions, involving epithelial tissue foci, mild focal adenomy...

  7. Bilateral simultaneous infective keratitis.

    Science.gov (United States)

    On Annie, Lai Hiu; Ray, Manotosh

    2017-08-01

    To analyze the demographics, risk factors, clinical and microbiological characteristics of cases of bilateral simultaneous infective keratitis. In this retrospective case series, patients with clinical evidence of bilateral simultaneous infective keratitis were identified from January 1, 2011 to August 31, 2016. Demographics, risk factors, clinical and microbiological characteristics, and treatment outcomes were analyzed. Five patients (ten eyes) with bilateral simultaneous infective keratitis were identified. The mean age was 32.8 years (SD,±8.8; range, 24-44). All the patients were disposable soft contact lens wearers before presentation. The average size of the infiltrate was 4.76mm 2 (SD±9.0; range, 0.2-31.34). A total of 4 types of bacteria were isolated, with Pseudomonas aeruginosa being the most frequently isolated bacteria involving 5 eyes of four patients. Infection resolved with medical treatment in 9 eyes, 1 patient required therapeutic corneal transplantation for impending corneal perforation. The average time taken for infection to resolve was 6.7days (SD±4.5; range, 2-16). In this case series, the most common risk factor of bilateral simultaneous microbial keratitis was use of soft disposable contact lens and the most commonly isolated bacteria was Pseudomonas aeruginosa. Bilateral simultaneous infective keratitis is uncommon and is a serious complication of contact lens use in immunocompetent adult patients. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  8. The management of uterine leiomyomas.

    Science.gov (United States)

    Vilos, George A; Allaire, Catherine; Laberge, Philippe-Yves; Leyland, Nicholas

    2015-02-01

    The aim of this guideline is to provide clinicians with an understanding of the pathophysiology, prevalence, and clinical significance of myomata and the best evidence available on treatment modalities. The areas of clinical practice considered in formulating this guideline were assessment, medical treatments, conservative treatments of myolysis, selective uterine artery occlusion, and surgical alternatives including myomectomy and hysterectomy. The risk-to-benefit ratio must be examined individually by the woman and her health care provider. Implementation of this guideline should optimize the decision-making process of women and their health care providers in proceeding with further investigation or therapy for uterine leiomyomas, having considered the disease process and available treatment options, and reviewed the risks and anticipated benefits. Published literature was retrieved through searches of PubMed, CINAHL, and Cochrane Systematic Reviews in February 2013, using appropriate controlled vocabulary (uterine fibroids, myoma, leiomyoma, myomectomy, myolysis, heavy menstrual bleeding, and menorrhagia) and key words (myoma, leiomyoma, fibroid, myomectomy, uterine artery embolization, hysterectomy, heavy menstrual bleeding, menorrhagia). The reference lists of articles identified were also searched for other relevant publications. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date limits but results were limited to English or French language materials. Searches were updated on a regular basis and incorporated in the guideline to January 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, and national and international medical specialty societies. The majority of fibroids are asymptomatic and require no intervention or further

  9. Ruptured thymoma managed via thoracotomy.

    Science.gov (United States)

    Iyer, Anand; Malik, Paras; Krishnan, Ramya; Kugathasan, Gana; Ayobami, Opeyemi; Edwards, Mark

    2013-12-01

    Thymomas rarely present with chest pain due to hemorrhage. This could cause shortness of breath if it ruptures into the pleural space, and is best managed surgically. We describe the case of an 83-year-old woman who presented with such symptoms. Computed tomography showed a ruptured mediastinal mass with pleural effusion. She was managed successfully by thoracotomy with excision of the mass and drainage of the effusion. Histopathology revealed a ruptured thymoma with infarction and necrosis.

  10. Treatment of Ruptured Vertebral Artery Dissecting Aneurysms

    Science.gov (United States)

    Hamasaki, Osamu; Ikawa, Fusao; Hidaka, Toshikazu; Kurokawa, Yasuharu; Yonezawa, Ushio

    2014-01-01

    Summary We evaluated the outcomes of endovascular or surgical treatment of ruptured vertebral artery dissecting aneurysms (VADAs), and investigated the relations between treatment complications and the development and location of the posterior inferior cerebellar artery (PICA). We treated 14 patients (12 men, two women; mean age, 56.2 years) with ruptured VADAs between March 1999 and June 2012 at our hospital. Six and eight patients had Hunt and Hess grades 1-3 and 4-5, respectively. Twelve patients underwent internal endovascular trapping, one underwent proximal endovascular occlusion alone, and one underwent proximal endovascular occlusion in the acute stage and occipital artery (OA)-PICA anastomosis and surgical trapping in the chronic stage. The types of VADA based on their location relative to the ipsilateral PICA were distal, PICA-involved, and non-PICA in nine, two, and three patients, respectively. The types of PICA based on their development and location were bilateral anterior inferior cerebellar artery (AICA)-PICA, ipsilateral AICA-PICA, extradural, and intradural type in one, two, two, and nine patients, respectively. Two patients with high anatomical risk developed medullary infarction, but their midterm outcomes were better than in previous reports. The modified Rankin scale indicated grades 0-2, 3-5, and 6 in eight, three, and three patients, respectively. A good outcome is often obtained in the treatment of ruptured VADA using internal endovascular trapping, except in the PICA-involved type, even with high-grade subarachnoid hemorrhage. Treatment of the PICA-involved type is controversial. The anatomical location and development of PICA may be predicted by complications with postoperative medullary infarction. PMID:24976093

  11. [Achilles tendon rupture].

    Science.gov (United States)

    Thermann, H; Hüfner, T; Tscherne, H

    2000-03-01

    The treatment of acute of Achilles tendon rupture experienced a dynamic development in the last ten years. Decisive for this development was the application of MRI and above all the ultrasonography in the diagnostics of the pathological changes and injuries of tendons. The question of rupture morphology as well as different courses of healing could be now evaluated objectively. These advances led consequently to new modalities in treatment concepts and rehabilitation protocols. The decisive input for improvements of the outcome results and particularly the shortening of the rehabilitation period came with introduction of the early functional treatment in contrast to immobilizing plaster treatment. In a prospective randomized study (1987-1989) at the Trauma Dept. of the Hannover Medical School could show no statistical differences comparing functional non-operative with functional operative therapy with a special therapy boot (Variostabil/Adidas). The crucial criteria for therapy selection results from the sonographically measured position of the tendon stumps in plantar flexion (20 degrees). With complete adaptation of the tendons' ends surgical treatment does not achieve better results than non-operative functional treatment in term of tendon healing and functional outcome. Regarding the current therapeutic standards each method has is advantages and disadvantages. Both, the operative and non-operative functional treatment enable a stable tendon healing with a low risk of re-rupture (1-2%). Meanwhile there is consensus for early functional after-treatment of the operated Achilles' tendons. There seems to be a trend towards non-operative functional treatment in cases of adequate sonographical findings, or to minimal invasive surgical techniques.

  12. Staged bilateral carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Engell, Hans Christian

    1986-01-01

    In a series of 56 staged bilateral carotid endarterectomies, new neurologic symptoms developed in 5% and 20% following the first and second procedure, respectively. All complications were transient or minor. The incidence of postendarterectomy hypertension was significantly higher following...... the second procedure, when operations were staged less than 3 weeks apart. A correlation between these hypertensive episodes and the occurrence of new neurologic symptoms could not be shown. However, as this correlation has been proved in several other reports, bilateral carotid endarterectomy is advised...... to be staged at least 3 weeks apart. In addition, a conservative attitude towards contralateral asymptomatic lesions is proposed....

  13. Slow rupture of frictional interfaces

    Science.gov (United States)

    Bar Sinai, Yohai; Brener, Efim A.; Bouchbinder, Eran

    2012-02-01

    The failure of frictional interfaces and the spatiotemporal structures that accompany it are central to a wide range of geophysical, physical and engineering systems. Recent geophysical and laboratory observations indicated that interfacial failure can be mediated by slow slip rupture phenomena which are distinct from ordinary, earthquake-like, fast rupture. These discoveries have influenced the way we think about frictional motion, yet the nature and properties of slow rupture are not completely understood. We show that slow rupture is an intrinsic and robust property of simple non-monotonic rate-and-state friction laws. It is associated with a new velocity scale cmin, determined by the friction law, below which steady state rupture cannot propagate. We further show that rupture can occur in a continuum of states, spanning a wide range of velocities from cmin to elastic wave-speeds, and predict different properties for slow rupture and ordinary fast rupture. Our results are qualitatively consistent with recent high-resolution laboratory experiments and may provide a theoretical framework for understanding slow rupture phenomena along frictional interfaces.

  14. An Unexpected Near Term Pregnancy in a Rudimentary Uterine Horn

    Directory of Open Access Journals (Sweden)

    Elisabete Gonçalves

    2013-01-01

    Full Text Available Unicornuate uterus occurs due to a complete or partial nondevelopment of one Mullerian duct; sometimes it is associated with a rudimentary horn, which can communicate or not with uterine cavity or contain functional endometrium. Pregnancy in a rudimentary horn is rare and the outcome almost always unfavorable, usually ending in rupture during the first or second trimester with significant morbidity and mortality. Despite the availability and advances on imagiologic procedures, recognition of this ectopic pregnancy is frequently made at laparotomy after abdominal pain and collapse. The authors describe a case of a primigravida with 34 weeks of gestation admitted with a preeclampsia with severity criteria. A cesarean for fetal malpresentation was done and, unexpectedly, a rudimentary horn pregnancy was found with a live newborn. In the literature, few reports of a horn pregnancy reaching the viability with a live newborn are described, enhancing the clinical importance of this case. A review of literature concerning the epidemics, clinical presentation, and appropriate management of uterine horn pregnancies is made.

  15. A case of generalized peritonitis due to a rupture of the bladder caused by radiation cystitis

    International Nuclear Information System (INIS)

    Fujitake, Shin-ichi; Nozaki, Hideki; Shimizu, Minoru; Maeda, Yoshiyuki; Kataoka, Susumu

    1999-01-01

    An 83-year-old woman was admitted to the department of gastroenterology in our hospital with a diagnosis of adhesive ileus following operation for a uterine cancer on July 22, 1997. Conservative therapy was started, but three days later, peritoneal signs appeared and white blood cell count and CRP level increased. An emergency operation was performed. Upon laparotomy, there were a large volume of ascites and a rupture of the bladder of which wall had become fragile. It was thought that the cause of rupture might result from radiation cystitis because she received irradiation after operation for the uterine cancer. Ruptured site of the bladder was sutured. Possible causes of the ileus were thought to be intestinal paralysis due to generalized peritonitis and a narrowing of the ileum where inflammatory change was remarkable. For this, an excision of the ileum with ileostomy was performed. Thereafter a closure of the ileostomy and ileocolostomy were carried out. The patient had difficulty in management of evacuation for a while, but she was discharged on March 2, 1998. Spontaneous rupture of the bladder is rare. This paper presents such a rare case caused by radiation cystitis, together with 14 cases reported in Japan. It is thought that surgeons who manage acute abdomen may encounter the disease. (author)

  16. A case of generalized peritonitis due to a rupture of the bladder caused by radiation cystitis

    Energy Technology Data Exchange (ETDEWEB)

    Fujitake, Shin-ichi; Nozaki, Hideki; Shimizu, Minoru; Maeda, Yoshiyuki; Kataoka, Susumu [Meitetsu Hospital, Nagoya (Japan)

    1999-03-01

    An 83-year-old woman was admitted to the department of gastroenterology in our hospital with a diagnosis of adhesive ileus following operation for a uterine cancer on July 22, 1997. Conservative therapy was started, but three days later, peritoneal signs appeared and white blood cell count and CRP level increased. An emergency operation was performed. Upon laparotomy, there were a large volume of ascites and a rupture of the bladder of which wall had become fragile. It was thought that the cause of rupture might result from radiation cystitis because she received irradiation after operation for the uterine cancer. Ruptured site of the bladder was sutured. Possible causes of the ileus were thought to be intestinal paralysis due to generalized peritonitis and a narrowing of the ileum where inflammatory change was remarkable. For this, an excision of the ileum with ileostomy was performed. Thereafter a closure of the ileostomy and ileocolostomy were carried out. The patient had difficulty in management of evacuation for a while, but she was discharged on March 2, 1998. Spontaneous rupture of the bladder is rare. This paper presents such a rare case caused by radiation cystitis, together with 14 cases reported in Japan. It is thought that surgeons who manage acute abdomen may encounter the disease. (author)

  17. Bilateral lunate intraosseous ganglia

    International Nuclear Information System (INIS)

    Pablos, J.M.; Valdes, J.C.; Gavilan, F.

    1998-01-01

    An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that occurs in young and middle-aged adults. Most commonly seen adjacent to the hip, ankle, knee, or wrist, they are histologically identical to their soft tissue counterparts. A review of the literature revealed only two previously reported examples of bilateral symmetrical ganglia of the lunate bones. (orig.)

  18. Homogeneous bilateral block shifts

    Indian Academy of Sciences (India)

    Homogeneous bilateral block shifts. ADAM KORÁNYI. Department of Mathematics, The Graduate Center, City University of New York,. New York, NY 10016, USA. E-mail: Adam.Koranyi@lehman.cuny.edu. MS received 18 January 2013. Abstract. A new 3-parameter family of homogeneous 2-by-2 block shifts is described.

  19. Homogeneous bilateral block shifts

    Indian Academy of Sciences (India)

    A new 3-parameter family of homogeneous 2-by-2 block shifts is described. These are the first examples of irreducible homogeneous bilateral block shifts of block size larger than 1. Author Affiliations. Adam Korányi1. Department of Mathematics, The Graduate Center, City University of New York, New York, NY 10016, USA ...

  20. Bilateral breast carcinoma

    International Nuclear Information System (INIS)

    Kim, Eung Jo; Oh, Ki Keun

    1990-01-01

    We evaluate 311 breast cancer patients admitted to Yong Dong Severance Hospital Between October 1st 1985 and July 31th 1989, and were able to obtain the following conclusions. 1) There were 14(4.5%) bilateral breast cancers among the 311 confirmed breast cancers. 2) Among the bilateral breast cancers, 5(31%) were synchronous and 9(69%) metachronous. 3) Average interval between the first and the second breast cancer in metachronous cancers was 3.8 year(1-15 years). 4) Bilateral breast cancer was most prevalent in the fifth decade (6/14) with the mean age of 47 years. 5) Film mammogram and sonomammogram showed findings of typical breast malignancies. There was no additional specific findings for each cancer in bilateral breast cancers which was different from unilateral cancers. Therefor, in the patients with unilateral breast cancer, possibility of the second lesion in the contralateral side must be considered and a close follow up observation should be done for at least 3 years

  1. Homogeneous bilateral block shifts

    Indian Academy of Sciences (India)

    Douglas class were classified in [3]; they are unilateral block shifts of arbitrary block size (i.e. dim H(n) can be anything). However, no examples of irreducible homogeneous bilateral block shifts of block size larger than 1 were known until now.

  2. Bilateral meandering pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

    2015-06-15

    Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

  3. Innovative Oral Treatments of Uterine Leiomyoma

    Directory of Open Access Journals (Sweden)

    Mohamed Sabry

    2012-01-01

    Full Text Available Uterine fibroids (leiomyoma, the benign tumors of the uterine wall, are very common cause of morbidity in reproductive age women usually in the form of excessive vaginal bleeding, chronic pelvic pain, miscarriage and infertility. These tumors are the leading indication for hysterectomy in the United States. Uterine fibroids are about 4 times higher in blacks compared to whites and constitute a major health disparity challenge. The estimated cost of uterine fibroids is up to $34.4 billion annually. Additionally, women who suffer from this disease and desire to maintain their future fertility have very limited treatment choices. Currently, there is no effective long-term medicinal treatment for uterine fibroids. While surgery has traditionally been the gold standard for the treatment of uterine fibroids, there is growing interest towards orally administered medications for the management of leiomyoma-related symptoms. In this paper, we will discuss these promising innovative oral medical treatments in detail.

  4. Review literature on uterine carcinosarcoma

    Directory of Open Access Journals (Sweden)

    Rajendra Singh

    2014-01-01

    Full Text Available Carcinosarcoma of the uterus is a rare gynaecological neoplasm, which is also known as malignant mixed mesodermal tumor. Traditionally this tumour has been regarded as a subtype of uterine sarcoma, and its origin remains controversial. The exact nature and prognosis was not clear in the past. It is believed that uterine carcinosarcoma have a Mullerian duct origin and have a capacity to differentiate into various mesenchymal and epithelial components. Regarding the histogensis, various theories have been given; of which ′conversion theory′ was broadly accepted. Carcinosarcoma are mostly of monoclonal origin with the carcinomatous component being the driving force. This type of tumor is broadly divided into two groups, homologous and heterologous, depending on the characteristics of the stroma or mesenchymal components of endometrial tissue. It is more frequent in black women and postmenopausal women. Radiation is a possible etiological factor but the exact etiology is not known yet. However, tamoxifen may induce carcinogenesis in some patients. Its clinical feature is very similar to endometrial carcinoma i.e. postmenopausal vaginal bleeding, have a very aggressive behavior and a poor prognosis. This pelvic malignancy is treated by multimodality therapy including surgery, chemotherapy and radiotherapy. Here we are reviewing old concepts about the disease and modern understandings of the origin, classification, pathogenesis and recent advances in the treatment of the uterine carcinosarcoma.

  5. Review literature on uterine carcinosarcoma.

    Science.gov (United States)

    Singh, Rajendra

    2014-01-01

    Carcinosarcoma of the uterus is a rare gynaecological neoplasm, which is also known as malignant mixed mesodermal tumor. Traditionally this tumour has been regarded as a subtype of uterine sarcoma, and its origin remains controversial. The exact nature and prognosis was not clear in the past. It is believed that uterine carcinosarcoma have a Mullerian duct origin and have a capacity to differentiate into various mesenchymal and epithelial components. Regarding the histogensis, various theories have been given; of which 'conversion theory' was broadly accepted. Carcinosarcoma are mostly of monoclonal origin with the carcinomatous component being the driving force. This type of tumor is broadly divided into two groups, homologous and heterologous, depending on the characteristics of the stroma or mesenchymal components of endometrial tissue. It is more frequent in black women and postmenopausal women. Radiation is a possible etiological factor but the exact etiology is not known yet. However, tamoxifen may induce carcinogenesis in some patients. Its clinical feature is very similar to endometrial carcinoma i.e. postmenopausal vaginal bleeding, have a very aggressive behavior and a poor prognosis. This pelvic malignancy is treated by multimodality therapy including surgery, chemotherapy and radiotherapy. Here we are reviewing old concepts about the disease and modern understandings of the origin, classification, pathogenesis and recent advances in the treatment of the uterine carcinosarcoma.

  6. Uterine sarcoma – current perspectives

    Science.gov (United States)

    Benson, Charlotte; Miah, Aisha B

    2017-01-01

    Uterine sarcomas comprise a group of rare tumors with differing tumor biology, natural history and response to treatment. Diagnosis is often made following surgery for presumed benign disease. Currently, preoperative imaging does not reliably distinguish between benign leiomyomas and other malignant pathology. Uterine leiomyosarcoma is the most common sarcoma, but other subtypes include endometrial stromal sarcoma (low grade and high grade), undifferentiated uterine sarcoma and adenosarcoma. Clinical trials have shown no definite survival benefit of adjuvant radiotherapy or chemotherapy and have been hampered by the rarity and heterogeneity of these disease types. There is a role of adjuvant treatment in carefully selected cases following multidisciplinary discussion at sarcoma reference centers. In patients with metastatic disease, systemic chemotherapy can then be considered. There is activity of a number of agents, including doxorubicin, trabectedin, gemcitabine-based chemotherapy, eribulin and pazopanib. Patients should be considered for clinical trial entry where possible. Close international collaboration is important to allow progress in this group of diseases. PMID:28919822

  7. Abnormal uterine bleeding in perimenopause.

    Science.gov (United States)

    Goldstein, S R; Lumsden, M A

    2017-10-01

    Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office or primary-care setting. The wider availability of diagnostic tools has allowed prompt diagnosis and treatment of an increasing number of menstrual disorders in an office setting. This White Paper reviews the advantages and disadvantages of transvaginal ultrasound, blind endometrial sampling and diagnostic hysteroscopy. Once a proper diagnosis has been established, appropriate therapy may be embarked upon. Fortunately, only a minority of such patients will have premalignant or malignant disease. When bleeding is sufficient to cause severe anemia or even hypovolemia, prompt intervention is called for. In most of the cases, however, the abnormal uterine bleeding will be disquieting to the patient and significantly affect her 'quality of life'. Sometimes, reassurance and expectant management will be sufficient in such patients. Overall, however, in cases of benign disease, some intervention will be required. The use of oral contraceptive pills especially those with a short hormone-free interval, the insertion of the levonorgestrel intrauterine system, the incorporation of newer medical therapies including antifibrinolytic drugs and selective progesterone receptor modulators and minimally invasive treatments have made outpatient therapy increasingly effective. For others, operative hysteroscopy and endometrial ablation are proven therapeutic tools to provide both long- and short-term relief of abnormal uterine bleeding, thus avoiding, or deferring, hysterectomy.

  8. Biceps Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Daniel M Polvino

    2018-01-01

    Full Text Available History of present illness: A 55-year-old male presented to the emergency department with a chief complaint of right arm pain. Five days prior to arrival, he attempted to lift himself up on his van and experienced what he described as a “rubber band snapping” in his right arm. He reported severe pain at the time that persisted but lessened in severity. Additionally, he reported increasing bruising over the proximal right arm. He had no history of prior right arm or shoulder injury. Significant findings: Physical exam was significant for ecchymosis and mild swelling of the right bicep. When the right arm was flexed at the elbow, a prominent mass was visible and palpable over the right bicep. Right upper extremity strength was 4/5 with flexion at the elbow. Discussion: The biceps brachii muscle is comprised of a long and short head, which share a common attachment at the bicipital tuberosity on the radius. The short head originates from the coracoid process of the scapula and the long head originates from the supraglenoid tubercle.1 Biceps tendon rupture has been found to occur at a rate of 0.53/100,000 over five years, and is three times more likely to occur in men than women.2 Risk factors for biceps tendon rupture include male sex, old age, increased body mass index, smoking, and pre-existing shoulder pathology.3,4 Diagnosis of biceps tendon rupture is typically a clinical diagnosis utilizing inspection and palpation as well as special testing such as the Speed’s and/or Yergason’s tests. Ultrasound may be used to aid in diagnosis; in full-thickness tears, ultrasound was found to have a sensitivity of 88% and a specificity of 98%. However, in partial thickness tears ultrasound has a sensitivity of 27% and a specificity of 100%.5 Often considered the gold standard in diagnosis, MRI has been found to have a sensitivity of only 67% and specificity of 98% in detecting complete tears6. Treatment initially consists of rest, ice, compression

  9. Ovarian Artery Embolization in Patients With Collateral Supply to Symptomatic Uterine Leiomyomata

    International Nuclear Information System (INIS)

    Scheurig-Muenkler, C.; Poellinger, A.; Wagner, M.; Hamm, B.; Kroencke, T. J.

    2011-01-01

    Purpose: To evaluate the safety and outcome of ovarian artery embolization (OAE) in patients with collateral supply to symptomatic uterine leiomyomata. Materials and Methods: Thirteen patients with relevant leiomyoma perfusion by way of enlarged ovarian arteries underwent additional OAE during the same (N = 10) or a second procedure (N = 3). Uterine artery embolization (UAE) was performed bilaterally in 10 and unilaterally in 2 patients with a single artery. One patient had no typical uterine arteries but bilaterally enlarged ovarian arteries, prompting bilateral OAE. OAE was accomplished with coil embolization in one and particle embolization in 12 patients. Symptoms before therapy and clinical outcome were assessed using a standardized questionnaire. Contrast-enhanced magnetic resonance (MR) imaging after embolization was available in 11 of 13 patients and was used to determine the percentage of fibroid infarction. Results: UAE and OAE were technically successful in all patients. One patient experienced prolonged irritation at the puncture site. Median clinical follow-up time was 16 months (range 4–37). Ten of 13 patients showed improvement or complete resolution of clinical symptoms. One patient reported only slight improvement of her symptoms. These women presented with regular menses. Two patients (15%), 47 and 48 years, both with unilateral OAE, reported permanent amenorrhea directly after embolization. Their symptoms completely resolved. Seven patients showed complete and 4 showed >90% fibroid infarction after embolization therapy. Conclusions: OAE is technically safe and effective in patients with ovarian artery collateral supply to symptomatic uterine leiomyomata. The risk of permanent amenorrhea observed in this study is similar to the reported incidence after UAE.

  10. Medroxyprogesterone in Treating Patients With Endometrioid Adenocarcinoma of the Uterine Corpus

    Science.gov (United States)

    2016-03-17

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Recurrent Uterine Corpus Carcinoma; Stage I Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage III Uterine Corpus Cancer; Stage IV Uterine Corpus Cancer

  11. Uterine Artery Embolization for Ureteric Obstruction Secondary to Fibroids

    International Nuclear Information System (INIS)

    Mirsadraee, Saeed; Tuite, David; Nicholson, Anthony

    2008-01-01

    This case series examines the safety and efficacy of uterine artery embolization (UAE) in the treatment of obstructive nephropathy caused by large fibroids. Between 2004 and 2007, 10 patients referred with symptomatic uterine fibroids that were found to be causing either unilateral (7 patients) or bilateral (3 patients) hydronephrosis were treated by UAE. Presenting complaints included menorrhagia, dysmenorrhea, bulk symptoms, loin pain, postobstructive atrophy, and mild renal impairment. All had posterior intramural dominant fibroids >11 cm in maximum sagittal diameter and uterine volumes between 3776 and 15,625 ml. Outcome measures at between 12 and 36 months included procedural success, repeat intervention, relief of symptoms, resolution of hydronephrosis, stable renal function and size, and avoidance of hysterectomy. In all cases the cause of renal obstruction was confirmed to be a giant fibroid compressing the ureter at the pelvic brim. In all cases UAE was technically successful, though two patients required a repeat procedure. In eight patients hydronephrosis resolved and the obstruction was relieved, though two still had some bulk symptoms not requiring further treatment. Renal function improved or was stable in all cases. Renal size was stable in all cases. Where menorrhagia was part of the symptom complex it was relieved in all cases. Two patients diagnosed as having postobstructive atrophy of one kidney underwent retrograde ureteric stenting on the nonatrophied side prior to UAE. This was unsuccessful in one of the cases due to the distortion caused by the fibroid. Despite improvement in hydronephrosis this patient underwent hysterectomy at 7 months after a renogram demonstrated persistent obstruction at the pelvic brim. In the second patient a double pigtail stent was inserted with difficulty and eventually removed at 8 months. This patient has had stable renal function and size for 3 years post-UAE. We conclude that UAE is safe and effective in

  12. Bilateral matrix-exponential distributions

    DEFF Research Database (Denmark)

    Bladt, Mogens; Esparza, Luz Judith R; Nielsen, Bo Friis

    2012-01-01

    In this article we define the classes of bilateral and multivariate bilateral matrix-exponential distributions. These distributions have support on the entire real space and have rational moment-generating functions. These distributions extend the class of bilateral phasetype distributions of [1]....... As an application we demonstrate that certain multivariate disions, which are governed by the underlying Markov jump process generating a phasetype distribution, have a bilateral matrix-exponential distribution at the time of absorption, see also [4]....

  13. Perivascular epithelioid cell tumors of the uterine cervix.

    Science.gov (United States)

    Kudela, E; Biringer, K; Kasajova, P; Nachajova, M; Adamkov, M

    2016-08-01

    The World Health Organization (WHO) defines PEComas as mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular cells. Uterus is the most common site of a subgroup of PEComas not otherwise specified(NOS). PEComas of the uterine cervix are extremely rare, and only thirteen cases have been described in the English literature to date. In this review, we summarize the available data concerning diagnostics, immunohistochemical analysis, genetics and treatment of cervical PEComas. Radical hysterectomy with bilateral salpingooophorectomy is the best surgical approach available. Adjuvant therapy in its present form is not efficient. Therefore, further studies are needed to evaluate the newest treatment strategies. Copyright © 2016 Elsevier GmbH. All rights reserved.

  14. Bilateral renal calculi

    Science.gov (United States)

    Sreenevasan, G

    1974-01-01

    Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968—May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V—Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed. ImagesFig. 1Fig. 4Fig. 6Fig. 7 PMID:4845653

  15. Bilateral tuberculate supernumerary teeth.

    Science.gov (United States)

    Eigbobo, Joycelyn Odegua; Osagbemiro, Babatope Bamidele

    2011-05-16

    Supernumerary teeth are teeth in excess of the normal series occurring in any region of the dental arch. They are located mostly in the anterior maxillary region and are classified according to their location and morphology. The tuberculate type of supernumerary tooth possesses more than one cusp or tubercle (barrel shaped). It is rare to find bilateral tuberculate supernumerary teeth in the premaxillary region and when found they rarely erupt. This report describes a 13-year-old boy with erupted palatally placed bilateral tuberculate supernumerary teeth. The presence of these supernumerary teeth led to the labial displacement and rotations of the anterior maxillary teeth. The treatment involved extraction of the supernumerary teeth and a referral for orthodontic management of the crowding, displacement and rotations. The occurrence of erupted palatally placed tuberculate anterior teeth in this case is a rare experience. However, the associated orthodontic problems are within familiar spectrum.

  16. Bilateral Wilms' tumor

    International Nuclear Information System (INIS)

    Malcolm, A.W.; Jaffe, N.; Folkman, M.J.; Cassady, J.R.

    1980-01-01

    Twenty children with bilateral Wilms' tumor were presented to the Children's Hospital Medical Center and Children's Cancer Research Foundation, Sidney Farber Cancer Institute, and Joint Center for Radiation Therapy (CHMC-CCRF, SFCI, JCRT) from January 1, 1956 to December 31, 1976. Of these 20, 16 had simultaneous and 4 had metachronous disease on presentation. All patients were treated with surgery, radiation and chemotherapy. Of the 16 patients with simultaneous disease, 10 (63%) are alive and free of disease 12+ to 175+ months post diagnosis and treatment, with median follow-up of 121 months. There were no long-term survivors in the metachronous group; all were dead of disease within 21 months from initial presentation of original tumor. With these data we relate prognosis to extent of disease and discuss a general approach to the management of bilateral Wilms' tumor

  17. Bilateral Mandibular Paramolars

    Science.gov (United States)

    Dhull, Rachita Singh; Panda, Swagatika; Acharya, Sonu; Yadav, Shweta; Mohanty, Gatha

    2014-01-01

    ABSTRACT Supernumerary tooth is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. They can cause a variety of complications in the develo­ping dentition. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. Here is the presentation of a case of unusual location of supernumerary teeth located in between mandibular first and second molar region bilaterally. How to cite this article: Dhull KS, Dhull RS, Panda S, Acharya S, Yadav S, Mohanty G. Bilateral Mandibular Paramolars. Int J Clin Pediatr Dent 2014;7(1):40-42. PMID:25206236

  18. Bilateral chronic subdural hematoma

    DEFF Research Database (Denmark)

    Andersen-Ranberg, Nina Christine; Rom Poulsen, Frantz; Bergholt, Bo

    2017-01-01

    OBJECTIVE Bilateral chronic subdural hematoma (bCSDH) is a common neurosurgical condition frequently associated with the need for retreatment. The reason for the high rate of retreatment has not been thoroughly investigated. Thus, the authors focused on determining which independent predictors...... are associated with the retreatment of bCSDH with a focus on surgical laterality. METHODS In a national database of CSDHs (Danish Chronic Subdural Hematoma Study) the authors retrospectively identified all bCSDHs treated in the 4 Danish neurosurgical departments over the 3-year period from 2010 to 2012...... that a separated hematoma density and the absence of postoperative drainage were independent predictors of retreatment. CONCLUSIONS In bCSDHs bilateral surgical intervention significantly lowers the risk of retreatment compared with unilateral intervention and should be considered when choosing a surgical...

  19. Synchronous, bilateral tonsillar carcinomas

    DEFF Research Database (Denmark)

    Saber, Camelia Nami; Grønhøj, Christian; Jensen, David Hebbelstrup

    2017-01-01

    -based, consecutive cohort of OPSCCs. METHODS: We identified all patients diagnosed with tonsillar squamous cell carcinoma (TSCC) in eastern Denmark during a 15-year period to detect the incidence of synchronous BiTSCCs. The tumours were assessed for p16Ink4a expression, the presence of HPV DNA and HPV genotypes....... Furthermore, we systematically reviewed the literature examining BiTSCCs. RESULTS: Of the total of 1119 TSCCs diagnosed in eastern Denmark from 2000 to 2014, we identified 12 BiTSCCs, nine of which initially presented as a cancer of unknown primary (CUP) in the neck. Nine cases were bilaterally HPV16 positive...... (HPV16+), while two cases were HPV16+ in one tonsil and respectively, HPV33 and HPV35 positive in the contralateral tonsil. One case was bilaterally HPV-negative. We also identified an increase in the incidence of BiTSCCs after 2012 when histological examination of the entire tonsil tissue became...

  20. Preterm Delivery in the Setting of Left Calyceal Rupture

    Directory of Open Access Journals (Sweden)

    Brent Hanson

    2015-01-01

    Full Text Available Spontaneous rupture of the renal collecting system is a rare but serious complication of pregnancy. We report a case of nontraumatic left renal calyceal rupture in a pregnancy which ultimately progressed to preterm delivery. A 29-year-old primigravida with a remote history of urolithiasis presented with left flank pain, suprapubic pain, and signs of preterm labor at 33 weeks of gestation. The patient was believed to have urolithiasis, although initial renal ultrasound failed to demonstrate definitive calculi. After a temporary improvement in flank pain with medication, the patient experienced acute worsening of her left flank pain. Urology was consulted and further imaging was obtained. Magnetic resonance imaging (MRI was consistent with bilateral hydronephrosis and rupture of the left renal calyx. Given the patient’s worsening pain in the setting of left calyceal rupture, the urology team planned for placement of a left ureteral stent. However, before the patient could receive her stent, she progressed to active labor and delivered a viable female infant vaginally. Following delivery, the patient’s flank pain resolved rapidly and spontaneously, so no surgical intervention was performed. A summary of the literature and the details of this specific clinical situation are provided.

  1. Port-Site Metastasis of Uterine Carcinosarcoma after Laparoscopy.

    Science.gov (United States)

    Tan, Zhen; Li, Ang; Chen, Long; Xu, XiaoWen; Fu, ChuanGang

    2017-11-01

    We report a case of port-site metastasis after laparoscopic surgery for early stage uterine carcinosarcoma (UCS) and review the related literature. A 53-year-old woman with suspected uterine malignance underwent a total laparoscopic hysterectomy with bilateral salpingo-oophorectomy, infra-colic omentectomy, and pelvic lymphadenectomy resulting pathologically in a stage IA UCS. Twelve months later she developed a palpable abdominal-wall mass at the trocar site without other synchronous metastases. A mass resection was performed and it was pathologically diagnosed with port-site metastasis of UCS. When performing surgery for UCS, specimens should be carefully removed in case small pieces of the occult disseminated metastatic tissues are trapped between the outer surface of the trocar sleeve and the abdominal wall incisional canal. Despite the low incidence, a laparotomy might be considered rather than laparoscopy to prevent port-site metastasis and more gynecological oncology clinical practices might be relevant to the management of port-site metastasis. © 2017 The Korean Academy of Medical Sciences.

  2. Unexpected traumatic rupture of left atrium mimicking aortic rupture

    Directory of Open Access Journals (Sweden)

    Abdallah K Alameddine

    2014-01-01

    Full Text Available Left atrial (LA rupture is rare following blunt chest injury. We describe a case of blunt LA rupture that was treated surgically. This report is intended to alert practitioners for a need of a close multiple disciplinary collaborations among them for optimal management of patients with this type of trauma; because other non-cardiac injuries involving the head, abdomen, or extremities are considered covariates for in-hospital mortality. As in the present case, the patient eventually died from associated extrathoracic injuries. The diagnosis of LA rupture is by exclusion. However, the initial radiological reading may be misinterpreted, because this injury can easily be mistaking for an aortic rupture. The final reappraisal of the chest imaging studies should be interpreted by a skilled radiologist to avoid misdiagnosis. Subtle radiological features can help distinguish aortic thoracic injury as illustrated in this patient. These factors may be useful to the practicing surgeon in deciding surgical approach.

  3. Does coupling ofuterine contractions reflect uterine dysfunction?

    African Journals Online (AJOL)

    Abstract In a cohort analytical study 47 primigravidas in spontaneous nonnal labour at tenn were divided into two groups depending on the presence or absence of coupled uterine contractions during active labour. During Inonitoring with a pressure- tip intra-uterine catheter, 24 patients developed coupled contractions and ...

  4. Dysfunctional Uterine Bleeding (DUB) (For Teens)

    Science.gov (United States)

    ... Feelings Expert Answers Q&A Movies & More for Teens Teens site Sitio para adolescentes Body Mind Sexual Health ... English Español Abnormal Uterine Bleeding (AUB) KidsHealth / For Teens / Abnormal Uterine Bleeding (AUB) What's in this article? ...

  5. Hysterosalpingography in itrogenic uterine fistula | Nwankwo | West ...

    African Journals Online (AJOL)

    Fistulae were found in the fornices of the patients and these were the openings through which the contrast refluxed into the vagina preventing demonstration of the uterine cavity and fallopian tubes. These fistulae were cannulated after using the volselum forceps to clip the anterior and posterior lips of the cervix. The uterine ...

  6. Adverse obstetric outcomes in pregnant women with uterine fibroids in China: A multicenter survey involving 112,403 deliveries.

    Science.gov (United States)

    Zhao, Rong; Wang, Xin; Zou, Liying; Li, Guanghui; Chen, Yi; Li, Changdong; Zhang, Weiyuan

    2017-01-01

    To estimate the association between uterine fibroids and adverse obstetric outcomes. This was a retrospective cross-sectional study of 112,403 deliveries from 14 provinces and 39 different hospitals in 2011 in mainland China. We compared pregnancy outcomes in women with and without uterine fibroids who underwent detailed second trimester obstetric ultrasonography during 18 to 22 weeks. Obstetric outcomes include cesarean delivery, breech presentation, preterm delivery, placenta previa, placental abruption, premature rupture of membranes and neonatal birthweight. Univariate analyses and multivariate logistic regression analyses were performed. Of 112,403 women who underwent routine obstetric survey, 3,012 (2.68%) women were identified with at least 1 fibroid. By univariate and multivariate analyses, the presence of uterine fibroids was significantly associated with cesarean delivery (Adjusted odds radio [AOR] 1.8, 95% confidence interval [CI] 1.7-2.0), breech presentation (AOR 1.3, 95% CI 1.2-1.5) and postpartum hemorrhage (AOR 1.2, 95% CI 1.1-1.4). The size of uterine fibroids and location in uterus had important effect on the mode of delivery. The rates of PPH were significantly higher with increasing size of the uterine fibroid (Pobstetric outcomes through different ways. Such detailed information may be useful in risk-stratifying pregnant women with fibroids.

  7. Retrospective analysis of 29 cases with uterine sarcoma: A single center experience

    Directory of Open Access Journals (Sweden)

    Evrim Bostancı

    2015-06-01

    Full Text Available Objective: To determine the recurrence and survival rates of uterine sarcomas according to stages, treatment methods, histological type. Methods: In this study 29 patients were included who were diagnosed with uterine sarcoma at Zeynep Kamil Women and Children Diseases Hospital between 2001 and 2011. Demographic data of patients, treatment and diagnosis process were investigated retrospectively by accessing the file of patients. Disease progression, survival time, recurrence status was learned by calling. Results were analyzed statistically. Results: Average age of patients were 51, 2 (± 13SD. Most of the patients were in postmenopausal (n=20, 68.9%. The most frequently (72.3% complain was vaginal bleeding. 51.7% of patients were stage I and 34.4% of patients were stage 3 according to staging FIGO 2009. Twenty-two of the patients were treated with total abdominal hysterectomy (TAH+ bilateral salpingo-oophorectomy (BSO+bilateral pelvic and paraaortic lymphadenectomy (BPPLND and omentectomy. Mean tumor size were 10, 2(±8.5 cm. 34,4% of patients (n = 10 patients had lymph node involvement. Respectively, after the operation, the average life expectancy of 3.2 years. Twelve patients (41.37% died until data collected up to December 2013. Conclusion: Uterine sarcomas have poor prognosis even at early stages. Each histological type must be evaluated separately. The role of adjuvant therapy is controversial.

  8. Adverse obstetric outcomes in pregnant women with uterine fibroids in China: A multicenter survey involving 112,403 deliveries.

    Directory of Open Access Journals (Sweden)

    Rong Zhao

    Full Text Available To estimate the association between uterine fibroids and adverse obstetric outcomes.This was a retrospective cross-sectional study of 112,403 deliveries from 14 provinces and 39 different hospitals in 2011 in mainland China. We compared pregnancy outcomes in women with and without uterine fibroids who underwent detailed second trimester obstetric ultrasonography during 18 to 22 weeks. Obstetric outcomes include cesarean delivery, breech presentation, preterm delivery, placenta previa, placental abruption, premature rupture of membranes and neonatal birthweight. Univariate analyses and multivariate logistic regression analyses were performed.Of 112,403 women who underwent routine obstetric survey, 3,012 (2.68% women were identified with at least 1 fibroid. By univariate and multivariate analyses, the presence of uterine fibroids was significantly associated with cesarean delivery (Adjusted odds radio [AOR] 1.8, 95% confidence interval [CI] 1.7-2.0, breech presentation (AOR 1.3, 95% CI 1.2-1.5 and postpartum hemorrhage (AOR 1.2, 95% CI 1.1-1.4. The size of uterine fibroids and location in uterus had important effect on the mode of delivery. The rates of PPH were significantly higher with increasing size of the uterine fibroid (P<0.001. And the location of fibroid (intramural, submucosal or subserosal also have a statistically significant impact on the risk of PPH (5.6% [subserosal] vs 4.7% [submucosal] vs 8.6% [intramural].Pregnant women with uterine fibroids are at increased risk for cesarean delivery, breech presentation and postpartum hemorrhage. And different characteristics of uterine fibroids affect obstetric outcomes through different ways. Such detailed information may be useful in risk-stratifying pregnant women with fibroids.

  9. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten

    2004-01-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether...... breast implants for a median period of 12 years (range, 3 to 25 years). A follow-up magnetic resonance imaging examination was carried out in 2001, excluding women who underwent explantation in the period between the two magnetic resonance imaging examinations (n = 44). On the basis of these examinations......, the authors identified 64 women who had at least one ruptured implant at the first magnetic resonance imaging examination and, for comparison, all women who had intact implants at both examinations (n = 98). Magnetic resonance images from the two examinations were compared and changes in rupture configuration...

  10. Efficacy and safety of embolization in iatrogenic traumatic uterine vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Z.; Chen, J.; Shi, H.; Zhou, K.; Sun, H. [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Li, X., E-mail: pumch005@sina.com [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Pan, J.; Zhang, X.; Liu, W.; Yang, N.; Jin, Z. [Department of Radiology, Peking Union Medical College Hospital, Beijing (China)

    2012-06-15

    Aim: To retrospectively evaluate the efficacy of embolotherapy in patients with iatrogenic traumatic uterine arteriovenous malformations (AVMs). Materials and methods: A retrospective review of all patients who underwent uterine arterial embolization in Peking Union Medical College Hospital between January 2000 and December 2010 was performed. Forty-two patients were diagnosed with a uterine vascular malformation. All patients had obstetric manipulations before. Serial beta-human chorionic gonadotropin ({beta}-HCG) levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of bilateral uterine arteries. The complications, control of haemorrhage, and outcome of subsequent pregnancies were assessed. Results: A total of 49 embolization procedures were performed in 42 patients. Seven patients required repeated embolizations for recurrence of bleeding. The technical success rate of embolization was 100%. Bleeding was controlled in 35 of 42 patients (83%) after the first embolization procedures, and bleeding was controlled in another two patients who underwent repeat embolization at a median follow-up of 29 months (range 3 months to 5 years). The overall clinical success rate was 88% (37/42). Thirteen patients subsequently became pregnant and eight of 13 patients had uneventful intrauterine pregnancies carried to term. Seven patients had post-embolization syndrome and no other complication occurred. Conclusion: Percutaneous embolotherapy is a safe and effective treatment for traumatic AVMs. Future pregnancy is still possible after embolization.

  11. Pathological Findings in a Case of Failed Uterine Artery Embolization for Placenta Previa

    Directory of Open Access Journals (Sweden)

    Natsuko Wada

    2013-01-01

    Full Text Available The reported success rate of uterine artery embolization (UAE for obstetrical hemorrhage is more than 90%. We experienced a case of failed UAE for postpartum hemorrhage, although an embolic particle was found pathologically in the uterine vessels without coagulation. A 42-year-old woman (gravida 7, para 2 with placenta previa had genital bleeding at 35 weeks of gestation, and cesarean section was performed. We immediately added UAE aiming to reduce massive bleeding after the cesarean section, successful embolization of the bilateral uterine arteries and internal iliac arteries were confirmed by angiography regardless the vital sign was recovered with an appropriate amount of transfusion; the massive bleeding recurred after 1 hour of UAE. Hysterectomy was performed and pathological findings of the uterus showed that there was no coagulation in the vessels, which was supposed to be observed by the effect of gelatin sponge. In addition, despite the fact that no coagulation was found, only one gelatin sponge was found in 16 slices of the uterine wall specimens. We speculate that thrombotic materials were caught in vasoconstricted vessels triggered by hypovolemic shock due to acute blood loss, and then the gelatin sponge could be washed out after recovering to normalized circulation status leading to recurrent massive hemorrhage.

  12. Metastatic Small Cell Carcinoma of the Breast from Cancer of the Uterine Cervix: A Case Report

    Directory of Open Access Journals (Sweden)

    Beom Seok Kwak

    2018-01-01

    Full Text Available We report here on a case of 51-year-old woman with metastatic small cell carcinoma of the breast that came from her cancer of the uterine cervix. She underwent radical hysterectomy with bilateral salpingo-oophorectomy due to small cell carcinoma of the uterine cervix, and adjuvant radiotherapy was administered to the pelvis. Breast metastasis with a palpable mass then occurred 3 months after the primary surgery. Simple mastectomy and adjuvant chemotherapy were performed. She initially showed a good response to the therapy, yet she ultimately died of multiple metastases with a fulminating disease course. This is an extremely rare case, and only 1 similar case has been reported earlier, so we report on this case along with a review of the relevant literature.

  13. Diffuse uterine leiomyomatosis in a child

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Deepa; Coletti, Monette C.; Ladino-Torres, Maria; Caoili, Elaine [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Elkins, Matthew [University of Michigan Health System, Department of Pathology, Ann Arbor, MI (United States)

    2012-01-15

    Leiomyomas are the most common benign uterine tumor; however, this entity is relatively uncommon in the pediatric population. Although leiomyomas most commonly present as solitary uterine masses, unusual patterns of growth have been described including diffuse leiomyomatosis. In this condition, the myometrium of the uterus is symmetrically expanded by innumerable confluent leiomyomas; this pattern of growth is quite uncommon and has never been reported in a pediatric patient. This case report illustrates the imaging appearance of diffuse uterine leiomyomatosis in an otherwise healthy 16-year-old girl. (orig.)

  14. Rare Presentation of Chorioadenoma Destruens as Acute Haemoperitoneum Mimicking Ruptured Ectopic Pregnancy.

    Science.gov (United States)

    Sinha, M; Kaur, R; Gupta, R; Rani, R; Aggarwal, A

    2014-01-01

    Gestational trophoblastic neoplasms (GTN) are proliferative degenerative disorders of placental elements and include complete or partial mole (90%), invasivemole (5-8%), choriocarcinoma (1-2%) and placental site tumor (1-2%). Chorioadenoma destruens is a trophoblastic tumor, characterized by myometrial invasion through direct extension or via venous channels. We present a case of invasive mole eroding uterus and uterine vasculature, causing sudden rupture of uterus with massive haemoperitoneum mimicking ectopic pregnancy. A 20 year old G1P0 at 6 weeks gestation presented in Casualty of Kasturba Hospital complaining of severe acute onset lower abdominal pain for one hour. Clinical examination revealed shock. Sonography suggested ectopic pregnancy and immediate exploratory laparotomy was decided. On laparotomy, 2000cc of haemoperitoneum was noted. Grape like vesicles protruding through fundal perforation with profuse active bleeding was seen. Bleeding persisted despite evacuation. Step wise uterine devascularisation failed to achieve haemostasis. Total abdominal hysterectomy was performed as a life saving measure.

  15. Bilateral spontaneous carotid artery dissection.

    Science.gov (United States)

    Townend, Bradley Scott; Traves, Laura; Crimmins, Denis

    2005-06-01

    Bilateral internal carotid artery dissections have been reported, but spontaneous bilateral dissections are rare. Internal carotid artery dissection can present with a spectrum of symptoms ranging from headache to completed stroke. Two cases of spontaneous bilateral carotid artery dissection are presented, one with headache and minimal symptoms and the other with a stroke syndrome. No cause could be found in either case, making the dissections completely spontaneous. Bilateral internal carotid artery dissection (ICAD) should be considered in young patients with unexplained head and neck pain with or without focal neurological symptoms and signs. The increasing availability of imaging would sustain the higher index of suspicion.

  16. Embolization of iatrogenic uterine pseudoaneurysm

    Directory of Open Access Journals (Sweden)

    Luca Boi

    2017-05-01

    Full Text Available Uterine artery pseudoaneurysms (UAPs are rare vascular lesions that may be life threatening if not diagnosed and properly treated. The clinical presentation of UAPs includes a spectrum of symptoms that are often associated with other and more frequent gynecologic/obstetric pathologies, both with and without vaginal bleeding, and may span from postpartum hemorrhage to the absence of symptoms. We report cases of two patients with UAP, both of whom were diagnosed with ultrasonography and contrast-enhanced computed tomography and successfully treated with transcatheter embolization. The first patient presented delayed hypovolemic shock following surgery for endometriosis, whereas the second patient suffered from postpartum hemorrhage after cesarean section. Diagnosis of UAPs relies on noninvasive imaging; transcatheter arterial embolization is an effective treatment to control bleeding in both hemodynamically stable and unstable patients.

  17. Prolactin receptors in uterine leiomyomas

    International Nuclear Information System (INIS)

    Baban, Rayah S.; Farid, Yahya Y.; Al-Zuheiri, Shatha T.

    2008-01-01

    Objective was to identify the location of prolactin receptors in patientswith uterine leiomyomas and their host myometrium as well as normalmyometrium. A case control study was conducted at the College of MedicineAl-Nahrain University, Baghdad, Iraq during the period from 2004-2006. Thesamples were collected at Obstetrics and Gynecological Departments of 4hospitals in Baghdad City (Al-Khadimiya Teaching Hospital, Al-Noor,Al-Kharch, and Al-Sadoon Hospital). Sections from large and small tumors(n=53) with their host myometriums and from normal myometriums (n=40) werestained immunohistochemically for prolactin receptors. Prolactin receptorswere positively seen in all cases examined including patient and comparisontissues, in the form of dark brown staining. Staining was heterogeneous andvaried in intensity from one case to another and sometimes from one are toanother in the same section. The increase in prolactin receptors in leiomyomais expected given that the underlying host myometrium abnormal. (author)

  18. Bilateral Antepartum Mastitis

    Directory of Open Access Journals (Sweden)

    Peyman Alibeigi

    2010-12-01

    Full Text Available Antepartum mastitis is a rare condition, whereas postpartum orlactation mastitis is a common problem. This report introducesa case of complicated bilateral antepartum mastitis, which wastreated successfully by drain insertion and antibiotic therapy.The patient was a 23-year-old woman in the 23rd week of herfirst pregnancy. Her chief complaint was progressive swelling,redness and radicular pain in both breasts, which had beenstarted gradually from the 18th week of pregnancy. The patientwas admitted to hospital, and received oral and intravenous antibioticsempirically, which was not effective. The patient wastreated by drainage and oral antibiotic therapy. Based on theapproaches employed and the outcomes achieved it is suggestedthat early surgical insertion in the presence of fluid collection inantepartum mastitis will shorten hospitalization and course ofintravenous antibiotic therapy.Iran J Med Sci 2010; 35(4: 327-330.

  19. Idiopathic Bilateral Bloody Tearing

    Directory of Open Access Journals (Sweden)

    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  20. A Case Report of Ruptured Spontaneous Heterotopic Pregnancy

    Directory of Open Access Journals (Sweden)

    F Seidoshohadaei

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Heterotopic pregnancy refers to the simultaneous occurrence of pregnancy intrauterine and outside of uterine corpus. It is most often manifested in women who have undergone artificial reproductive technology (ART but rarely occurs spontaneously. Heterotopic pregnancy still remains as a diagnostic and therapeutic challenge to practitioners. In this situation physicians should have high suspicion for diagnosis and intrauterine pregnancy protection. This study reported a case of ruptured spontaneous heterotopic pregnancy. Case: A 32 year-old woman with abdominal pain, nausea, vomiting and hypovolumic shock in 1386 referred to emergency department in Sanandaj hospital. She reported one previous cesarean section. On examination, the patient's abdomen was distended. She had generalized tenderness and rebound tenderness in abdomen. The ultrasonographic examination revealed large amount of fluid in pelvic and abdominal cavity with a large hematoma in right adnex but there was intrauterine pregnancy at 7 weeks with normal fetal heart activity. She underwent laparotomy for heterotopic pregnancy and ruptured tube with tubal pregnancy removed. Intrauterine pregnancy continued without problem and led to birth of a healthy female neonate. Conclusion: Physicians should be quite cautious of heterotopic pregnancy in woman at reproductive age. Any abnormality on physical examination or ultrasonography of a patient with intrauterine pregnancy and abdominal pain should heighten the clinician's suspicion for heterotopic pregnancy

  1. Causes of renal forniceal rupture.

    Science.gov (United States)

    Gershman, Boris; Kulkarni, Naveen; Sahani, Dushyant V; Eisner, Brian H

    2011-12-01

    What's known on the subject? and What does the study add? Renal forniceal rupture is a common finding in patients with ureteral obstruction. It is thought to be due to increased renal pelvis pressure from backup of urine, causing one or more renal fornices to leak urine. This phenomenon has not been systematically studied. Herein we retrospectively review the causes and associated clinical findings in over 100 cases of renal forniceal rupture. • To perform a retrospective review aiming to identify causes of renal forniceal rupture. • A retrospective review was performed of the longitudinal medical record and CT records for patients identified as having renal 'forniceal rupture' or 'calyceal rupture' using a radiological database. • In total, 108 patients were identified with the CT diagnosis of renal 'forniceal' or 'calyceal' rupture. • Forniceal rupture was caused by ureteric stones in 80 cases (74.1%), malignant extrinsic ureteric compression in nine cases (8.3%), benign extrinsic ureteric compression in two cases (1.9%), pelvic-ureteric junction obstruction in two cases (1.9%), vesico-ureteric junction (VUJ) obstruction in one case (0.9%), bladder outlet obstruction in one case (0.9%) and iatrogenic causes in four cases (3.7%). • No definitive cause was found in nine cases (8.3%). For patients in whom a ureteric stone was the cause of forniceal rupture, the level of obstruction was proximal ureter in 24.3% of cases, distal ureter in 17.6% of cases and VUJ in 58.1% of cases. • Mean (sd) stone size was 4.09 (2.0) mm. Mean (sd) stone size was 5.34 (1.87) mm for proximal stones, 4.08 (1.69) mm for distal stones and 3.53 (1.96) mm for VUJ stones (P= 0.005). • Urinary tract infection was present in five out of 97 patients (5.2%) in whom data were available for analysis. • The most common aetiology of renal forniceal rupture is obstruction caused by distal ureteric stones followed by malignant extrinsic ureteric compression. © 2011 THE

  2. Uterine prolapse prevention in Eastern Nepal

    DEFF Research Database (Denmark)

    Radl, Christina Mathilde; Rajwar, Ranjita; Aro, Arja R.

    2012-01-01

    Abstract: Uterine prolapse is a major reproductive health issue in Nepal. There is a wide range of literature available on the causes and risk factors of uterine prolapse and on the ways to prevent and treat it. There is still a lack of published evidence on what prevention and treatment services......: It was found that patriarchy, gender discrimination, and cultural traditions such as early marriage and pregnancy make it difficult for people to discontinue uterine prolapse risk behaviors. Women are aware of risk factors, prevention, and treatment, but are powerless to change their situations. Health......, should be conducted. Furthermore, the involvement of other target groups (husbands, adolescents, and mothers-in-law) needs to be increased in order to make it easier for women to adapt low-risk behaviors. Finally, uterine prolapse prevention should be better integrated in national reproductive health...

  3. [Lower Uterine Segment Trial: A pragmatic open multicenter randomized trial].

    Science.gov (United States)

    Rozenberg, P; Deruelle, P; Sénat, M-V; Desbrière, R; Winer, N; Simon, E; Ville, Y; Kayem, G; Boutron, I

    2018-04-01

    performed by expert sonographers after certification by the main investigator. Women aged 18 years or older are eligible for this trial if they have a singleton pregnancy in cephalic presentation at a gestational age from 36 to 38 weeks, a previous low transverse cesarean delivery and sign the informed consent sheet. Women will be asked to participate in this study when they reach a term of 36 to 38 weeks of gestation. After agreement, women will be randomized into two groups: in the study group, they will have the LUS measured by ultrasound and the patient will be informed that, based on a threshold value of 3.5mm for the ultrasound measurement of the LUS thickness, the patient with a higher measurement will be considered at low risk and will be encouraged to choose a trial of labor whereas the patient with a measurement is equal to or less than this threshold will be considered at risk and encouraged to choose an elective repeat cesarean; in the control group, ultrasound LUS measurement will not be performed. The mode of delivery will be decided according to standard practice at the center. The primary composite outcome will include: uterine rupture, uterine dehiscence, hysterectomy, thromboembolic complications, transfusion, endometritis, maternal mortality, fetal prenatal and intrapartum mortality, hypoxic-ischemic encephalopathy and neonatal mortality. This trial assesses the efficacy of ultrasound measurement of the lower uterine segment in women with a prior cesarean delivery in reducing fetal and maternal morbidity and mortality and it will provide evidence in order to establish clinical recommendations. ClinicalTrials.gov identifier: NCT01916044 (date of registration: 5 August 2013). Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  4. Morphological, histological and molecular investigations on canine uterine tissue after ovariectomy.

    Science.gov (United States)

    Schäfer-Somi, S; Deichsel, K; Beceriklisoy, H; Korkmaz, D; Walter, I; Aslan, S

    2017-10-15

    In the present study, we investigated the course of atrophy in canine uterine tissue and the expression of estrogen receptors (ER) and progesterone receptors (PR) within 6 months after ovariectomy (OE). In nine primipar bitches of different breeds, bilateral OE and removal of one horn was performed. Six months after surgery, the remaining uterine tissue was removed. The tissue was examined for signs of inflammation and proliferation, and for expression of ER, PR and Ki67 by means of immunohistochemistry (IHC); furthermore transcription of vascular endothelial growth factor (VEGF), transforming growth factor-ß (TGF-ß), epithelial growth factor (EGF), platelet activating factor (PAF), tumor necrosis factor α (TNFα), and their specific receptors was determined by means of RT-qPCR. Serum concentrations of estrogen and progesterone were measured immediately before the first and second operation. Six month after OE, no inflammation was seen in any uterine tissue, the thickness of the stump was decreased in most bitches. Protein expression of Ki67 revealed high individual differences after the second operation. Concentration of both hormones was not significantly changed, the estrogen concentration always revealed high individual differences. The expression of ER was significantly decreased in stromal and smooth muscle cells of the uterine tissue (p < 0.01), and the expression of PR in stromal cells only (p < 0.05). The gene expression of growth factors did not change significantly between first and second operation. We conclude that complete atrophy did not occur within 6 months after OE, instead, a high percentage of uterine cells still expressed ER and PR, rendering the stump susceptible to hormone treatments. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. [Traumatic rupture of the diaphragm].

    Science.gov (United States)

    Mazuch, J; Kuník, Z; Herczegh, S; Pelc, J; Machan, L; Chamko, M

    1990-07-01

    Traumatic ruptures of the diaphragm occur most frequently at blunt injuries of the abdomen or thorax as a component of polytraumatism. At the acute stage they present a serious diagnostic problem since signs of polytrauma are predominant. The authors report 3 cases of traumatic rupture of the diaphragm with thoracotomy as the therapeutic approach. The first patient presented with severe polytraumatism and shock, rupture of the diaphragm, pericardium and lungs, along with serial fracture of the left ribs. The second patient was not in shock, he had suffered serial fracture of the left ribs and fracture of the pelvis. In both these cases of blunt injury to the thorax, careful examination of the patients resulted in early diagnosis and surgery. The third patient presented with open injury of the right side of the thorax, injured diaphragm and liver, serial fracture of the ribs, fractured sternum, and was in a state of deep shock. There was no mortality, all three patients recovered.

  6. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten

    2004-01-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether...... untreated ruptures are associated with changes over time in magnetic resonance imaging findings, serologic markers, or self-reported breast symptoms. A baseline magnetic resonance imaging examination was performed in 1999 on 271 women who were randomly chosen from a larger cohort of women having cosmetic...... breast implants for a median period of 12 years (range, 3 to 25 years). A follow-up magnetic resonance imaging examination was carried out in 2001, excluding women who underwent explantation in the period between the two magnetic resonance imaging examinations (n = 44). On the basis of these examinations...

  7. Isokinetic profile of subjects with the ruptured anterior cruciated ligament.

    Science.gov (United States)

    2016-07-01

    All changes in the knee that appear after anterior cruciate ligament (ACL) lesion lead to difficulties in walking, running, jumping especially during sudden changes of the line of movement. This significantly impairs quality of life of these subjects and leads to decrease in physical activity. Knee injuries make 5% of all most severe acute sport injuries. The aim of the study was to determine strength of the thigh muscles in persons with unilateral rupture of the ACL and to evaluate potential bilateral differences between healthy and injured leg. This study involved 114 male athletes of different sport specialities with the clinical diagnosis of ACL rupture. Each subject had unilateral ACL rupture and the other leg was actually the control for this research. An isokinetic device was used to evaluate the muscle strength of thigh muscles. Testing was performed for two testing speeds, 60º/s and 180º/s. Data analysis showed a statistically significant difference (p hamstrings to quadriceps (H/Q) ratio we found the unilateral disbalance of thigh muscle strength in ACL leg. A high level of validity makes isokinetic dynamometry the method for evaluation of thigh muscles strength and leaves this field of research open for new studies in order to improve both diagnostic and rehabilitation of patients with the insufficient ACL.

  8. Prostaglandins versus oxytocin for prelabour rupture of membranes at term.

    Science.gov (United States)

    Tan, B P; Hannah, M E

    2000-01-01

    The conventional method of induction of labour is with intravenous oxytocin. More recently, induction with prostaglandins, followed by an infusion of oxytocin if necessary, has been used. The objective of this review was to assess the effects of induction of labour with prostaglandins versus oxytocin for prelabour rupture of membranes at term. We searched the Cochrane Pregnancy and Childbirth Group trials register. Randomised and quasi-randomised trials of early stimulation of uterine contractions with prostaglandins (with or without oxytocin) versus with oxytocin alone (not combined with prostaglandins) in women with spontaneous rupture of membranes at term (37 weeks or more gestation). Two reviewers assessed trial quality and extracted data. Eight trials were included. Based on three trials, prostaglandins compared to oxytocin were associated with increased chorioamnionitis (odds ratio of 1.51, 95% confidence interval 1.07 to 2.12) and neonatal infections (odds ratio 1.63, 95% confidence interval 1.00 to 2.66). Based on four trials, prostaglandins were associated with a decrease in epidural analgesia (odds ratio of 0.86, 95% confidence interval 0.73 to 1.00) and internal fetal heart rate monitoring (based on one trial). Caesarean section, endometritis and perinatal mortality were not significantly different between the groups. Women with prelabour rupture of membranes at term having their labour induced with prostaglandins appear to have a lower risk of epidural analgesia and fetal heart rate monitoring. However there appears to be an increased risk of chorioamnionitis and neonatal infections after prostaglandin induction compared to oxytocin.

  9. FOETOMATERNAL AND NEONATAL OUTCOME OF PRETERM PREMATURE RUPTURE OF MEMBRANES

    Directory of Open Access Journals (Sweden)

    Kusumam Vilangot Nhalil

    2017-10-01

    Full Text Available BACKGROUND Preterm premature rupture of membrane is defined as rupture of foetal membrane before onset of labour at less than 37 completed weeks of gestation. Incidence of PPROM is around 3-10% of all deliveries. Primary complication for mother is infection and for foetus and neonate is prematurity, foetal distress, cord compression, deformation, pulmonary hypoplasia, necrotising enterocolitis and neurologic disorders. Most likely outcome is preterm delivery within 1 week. The aim of the study is to study the foetomaternal and neonatal outcome in PPROM patients and the common prevalent organism in PPROM. MATERIALS AND METHODS This is a cohort study of pregnant women from 24-37 weeks with PPROM admitted to IMCH for a period of 1 year, January 2016 to December 2016. 100 patients with PPROM were taken up for the study. The data was collected using the following inclusion and exclusion criteria. Inclusion criteria are gestational age 24-37 weeks confirmed by dates, clinical examination and ultrasound with lack of uterine contractions for at least 1 hour from PPROM; single live pregnancy in vertex presentation; PPROM confirmed by direct visualisation, neonates admitted in NICU soon after delivery. RESULTS 49% of patients with preterm premature rupture of membranes were from 18-24 years.68% of patients had a latency period of 3 weeks.15% of patients had maternal tachycardia, 4% had tenderness of uterus and 4% had leucocytosis and 14% had an elevated CRP. Thus, clinical chorioamnionitis was seen in 14% of patients, 38% of babies born had prematurity and 2% had sepsis and 19% had respiratory distress syndrome and hyperbilirubinaemia, 2% had perinatal asphyxia, 2% had anomalies, 1% had necrotising enterocolitis and 5% were NND. Common organisms were normal flora, E. coli, Streptococci and Enterococci. CONCLUSION PPROM increases the incidence of maternal morbidity with longer hospital stay due to chorioamnionitis. Neonatal morbidity is increased due to

  10. Predictors for prolonged interval from premature rupture of membranes to spontaneous onset of labor at term.

    Science.gov (United States)

    Hiersch, Liran; Krispin, Eyal; Aviram, Amir; Mor-Shacham, Moran; Gabbay-Benziv, Rinat; Yogev, Yariv; Ashwal, Eran

    2017-06-01

    To identify predictors for prolonged interval from premature rupture of membranes (PROM) to spontaneous onset of labor in women presenting with PROM and low Bishop score at term. A retrospective study of women presenting with PROM and Bishop score receiver-operator characteristic curve of 0.739 (0.631-0.847, p < 0.001) for predicting prolonged PROM. Uterine contractions and cervical examination parameters can be used for prediction of prolonged interval to spontaneous onset of labor in women with term PROM.

  11. [Hysteroscopic polypectomy, treatment of abnormal uterine bleeding].

    Science.gov (United States)

    de Los Rios, P José F; López, R Claudia; Cifuentes, P Carolina; Angulo, C Mónica; Palacios-Barahona, Arlex U

    2015-07-01

    To evaluate the effectiveness of the hysteroscopic polypectomy in terms of the decrease of the abnormal uterine bleeding. A cross-sectional and analytical study was done with patients to whom a hysteroscopic polypectomy was done for treating the abnormal uterine bleeding, between January 2009 and December 2013. The response to the treatment was evaluated via a survey given to the patients about the behavior of the abnormal uterine bleeding after the procedure and about overall satisfaction. The results were obtained after a hysteroscopic polypectomy done to 128 patients and were as follows. The average time from the polypectomy applied until the survey was 30.5 months, with a standard deviation of 18 months. 67.2% of the patients reported decreased abnormal uterine bleeding and the 32.8% reported a persistence of symptoms. On average 82.8% of the. patients were satisfied with the treatment. Bivariate and multivariate analysis showed no association between the variables studied and no improvement of abnormal uterine bleeding after surgery (polypectomy). There were no complications. Hysteroscopic polypectomy is a safe surgical treatment, which decreases on two of three patients the abnormal uterine bleeding in the presence of endometrial polyps, with an acceptable level of satisfaction.

  12. Porous Gelatin Particles for Uterine Artery Embolization: An Experimental Study of Intra-Arterial Distribution, Uterine Necrosis, and Inflammation in a Porcine Model

    International Nuclear Information System (INIS)

    Sone, Miyuki; Osuga, Keigo; Shimazu, Kohki; Higashihara, Hiroki; Nakazawa, Tetsuro; Kato, Kenichi; Tomabechi, Makiko; Ehara, Shigeru; Nakamura, Hironobu; Morii, Eiichi; Aozasa, Katsuyuki

    2010-01-01

    PurposeWe evaluated the location of porous gelatin particles (GP; Gelpart; Nippon Kayaku/Astellas, Tokyo, Japan) within the arterial vasculature and their acute effects on uterine necrosis and inflammation after uterine artery embolization (UAE) in swine.Materials and MethodsAdult nonpregnant pigs (n = 6) were allocated to either 1- (n = 3) or 2-mm GP (n = 3). Superselective and bilateral embolization of the uterine arteries was performed. All animals were killed 1 week after UAE. Macroscopic and microscopic findings, including the level of arterial occlusion and their effect on uterine necrosis and inflammation, were analyzed.ResultsAll UAE procedures were completed without severe complications. The macroscopic necrosis was seen in two animals in the 2-mm group with an extent of <50%. The location of the occluded arteries did not differ significantly between groups. The median diameters of the occluded arteries were 449 μm (95% confidence interval [CI] 417-538 μm) in the 1-mm GP group and 484 μm (95% CI 370-560 μm) in the 2-mm GP group. As for microscopic necrosis, no statistically significant difference was observed. The qualitative inflammatory reaction was significantly greater in the 2-mm GP group than in the 1-mm group (p < 0.001).ConclusionsBoth 1- and 2-mm GP occluded the arteries relevant to the target diameter for UAE in porcine uterus, presumably due to the plastic deformity. Both sizes of GP were associated with limited areas of necrosis; however, evaluation of inflammatory reaction was preliminary. Further study with adequate evaluation of inflammatory reactions is suggested.

  13. Quiste dermoide corneal bilateral

    Directory of Open Access Journals (Sweden)

    Michel Guerra Almaguer

    Full Text Available El dermoide es un tipo de coristoma (tejido embrionario normal en una localización anormal que afecta con frecuencia la córnea. Aparece como una masa sólida, blanca, redonda y elevada. Suele localizarse en el limbo inferotemporal, aunque puede hacerlo en cualquier lugar del globo ocular o de la órbita. Se presenta un paciente masculino, de 8 años de edad, quien desde su nacimiento muestra una mancha blanca en ambos ojos, agudeza visual sin corrección de movimiento de mano a 33 centímetros en el ojo derecho y percepción luminosa en el ojo izquierdo. En la exploración oftalmológica de ambos ojos se apreciaron lesiones blanquecinas sobre la córnea. Se le realizó exéresis del quiste y queratoplastia lamelar de ambos ojos, con resultados visuales satisfactorios. Se concluye que el caso presenta un quiste dermoide corneal bilateral.

  14. Intrapleural rupture of a cystic thymoma.

    Science.gov (United States)

    Haniuda, M; Numanami, H; Kondo, R; Kurai, M; Takashima, S; Amano, J

    2000-10-01

    Although cystic degeneration of a thymoma is not uncommon, rupture of a cystic thymoma is rare. The authors report a patient with sudden chest pain and dyspnea due to rupture of a cystic thymoma into the right pleural space.

  15. Uterine sarcoma Part I—Uterine leiomyosarcoma: The Topic Advisory Group systematic review

    Directory of Open Access Journals (Sweden)

    Kuo-Chang Wen

    2016-08-01

    Full Text Available Uterine sarcomas account for 3–7% of all uterine cancers. Because of their rarity, unknown etiology, and highly divergent genetic aberration, there is a lack of consensus on risk factors for occurrence and predictive poor outcomes as well as optimal therapeutic choices. Tumor types according to the World Health Organization classification include leiomyosarcoma, endometrial stroma sarcoma, and undifferentiated sarcoma. Staging is done using the 2014 Federation International Gynecology and Obstetrics and 2010 American Joint Committee on Cancer tumor, lymph node, and metastases systems. Tumor grade can be classified based on the French Federation of Cancer Centers Sarcoma Group system or the Broder’s system that incorporates tumor differentiation, mitotic count, and tumor necrosis. This review is a series of articles discussing uterine sarcoma, and this is Part I, which focuses on one of the subtypes of uterine sarcomas—uterine leiomyosarcoma. The clinical characteristics, diagnosis, outcome, and recent advances are summarized in this article.

  16. Investigation of small ruptured aneurysms

    International Nuclear Information System (INIS)

    Abiko, Masaru; Ikawa, Fusao; Obayashi, Naohiko; Mitsuhara, Takafumi; Nosaka, Ryou; Inagawa, Tetsuji

    2008-01-01

    Subarachnoid hemorrhage (SAH) patients with ruptured aneurysms smaller than 5 mm in diameter are sometimes encountoied at our hospital. However, the operative indication for unruptured aneurysm is over 5 mm according to the JAPANESE SOCIETY FOR DETECTION OF ASYMPTOMATIC BRAIN DISEASES. We therefore analyzed the characteristics of ruptured aneurysms smaller than 5 mm in diameter. A retrospective review of all SAH patients using digital subtraction angiography (DSA) between April 1999 and March 2004 was conducted. We compared 201 SAH patients with DSA (group A) and 61 with aneurysms smaller than 5 mm (group B). Age, gender, familial history, hypertension, and location of the ruptured aneurysm were examined. In males younger than 40 years old, anterior communicating artery/distal anterior cerebral artery (Acom/DACA) aneurysms were significantly correlated with group B rather than group A. Familial history and hypertension were not found to be characteristic in group B in this study. Small unruptured aneurysms may have a risk of rupture especially in young males with Acom/DACA aneurysms. Further investigations on small aneurysms are needed. (author)

  17. Spontaneous Splenic Rupture in Melanoma

    Directory of Open Access Journals (Sweden)

    Hadi Mirfazaelian

    2014-01-01

    Full Text Available Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.

  18. Endometriosis-related spontaneous diaphragmatic rupture.

    Science.gov (United States)

    Triponez, Frédéric; Alifano, Marco; Bobbio, Antonio; Regnard, Jean-François

    2010-10-01

    Non-traumatic, spontaneous diaphragmatic rupture is a rare event whose pathophysiology is not known. We report the case of endometriosis-related spontaneous rupture of the right diaphragm with intrathoracic herniation of the liver, gallbladder and colon. We hypothesize that the invasiveness of endometriotic tissue caused diaphragm fragility, which finally lead to its complete rupture without traumatic event. The treatment consisted of a classical management of diaphragmatic rupture, with excision of the endometriotic nodule followed by medical ovarian suppression for six months.

  19. Adenocarcinoma of the Uterine Cervix

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Eun Ji; Shin, Hyun Soo; Lee, Hyung Sik; Kim, Gwi Eon; Loh, Juhn Kyu; Suh, Chang Ok [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1991-12-15

    Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents 4.1% of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49years(range, 27-79years) and the peak incidence was in the group 50 to 59years of age. More half of the patients were postmenopausal (46/76=60.5%). Most patients(76%)had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage Iib was 43.4%. There were 4 major histologic subtypes: pure adenocarcinoma(48/76=63.2%), adenosquamous carcinoma(20/76=26.3%), papillary (5/76=6.6%) and clear cell carcinoma(3/76=3.9%). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was 68%, and the 5-year survival rates for stage Ib, II and III were 90%, 66% and 54%, respectively. Control of pelvic tumors was achieved in 938%, 90.2% and 50.0% of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.

  20. Relationship of uterine artery with ureter.

    Science.gov (United States)

    Ara, Z G; Khalil, M; Rahman, M H; Mannan, S; Sultana, S Z; Rahman, M M; Ahmed, M S; Zaman, K S; Islam, M S

    2008-07-01

    The study was done to see the relationship of right and left uterine artery with corresponding ureter. Their distance from lateral border of uterus and site of crossing in relation to internal os in Bangladeshi female were observed. Sixty post mortem specimens containing uterus, uterine tube, ureter and surrounding structures were collected from cadavers of different age groups and fixed in 10% formol saline solution. Gross and fine dissections were carried out to study the relationship and distance of uterine artery where it crosses the corresponding ureter and the site of crossing in relation to internal os. In the present study our findings were compared with those of the standard text books. In this study, there were no variations regarding relations of right and left uterine artery with corresponding ureter. In all cases of all age groups, ureters were found to cross the uterine artery anteriorly on both sides. Site of crossing of uterine artery of both sides with ureter at the level of internal os was 50% in 2-12 years (Group A) 20.45% in 13-45 years (Group B) and 12.50% in 46-80 years (Group C) age group. Below the level of the os was found in remaining cases except one which crosses above the level of the os in group B. In this study mean distance of uterine artery where it crosses the ureter from lateral border of uterus was more on right side in all age groups, which was 1.67 cm, 2.30 cm and 2.11 cm in age Group A, B & C respectively.

  1. Air pollution and risk of uterine leiomyomata.

    Science.gov (United States)

    Mahalingaiah, Shruthi; Hart, Jaime E; Laden, Francine; Terry, Kathryn L; Boynton-Jarrett, Renée; Aschengrau, Ann; Missmer, Stacey A

    2014-09-01

    Air pollution, particularly from vehicle exhaust, has been shown to influence hormonal activity. However, it is unknown whether air pollution exposure is associated with the occurrence of uterine leiomyomata, a hormonally sensitive tumor of the uterus. For 85,251 women 25-42 years of age at enrollment in the Nurses' Health Study II, we examined proximity to major roadways and outdoor levels of particulate matter less than 10 microns (PM10) or 2.5 microns (PM2.5) or between 10 and 2.5 microns (PM10-2.5) in diameter for all residential addresses from September 1989 to May 2007. To be eligible for this analysis, a woman had to be alive and respond to questionnaires, premenopausal with an intact uterus, and without diagnoses of cancer or prevalent uterine leiomyomata. Incidence of ultrasound- or hysterectomy-confirmed uterine leiomyomata and covariates were reported on biennial questionnaires sent through May 2007. Multivariable time-varying Cox proportional hazard models were used to estimate the relationship between distance to road or PM exposures and uterine leiomyomata risk. During 837,573 person-years of follow-up, there were 7760 incident cases of uterine leiomyomata. Living close to a major road and exposures to PM10 or PM10-2.5 were not associated with an increased risk of uterine leiomyomata. However, each 10 μg/m increase in 2-year average, 4-year average, or cumulative average PM2.5 was associated with an adjusted hazard ratio of 1.08 (95% confidence interval = 1.00-1.17), 1.09 (0.99-1.19), and 1.11 (1.03-1.19), respectively. Chronic exposure to PM2.5 may be associated with a modest increased risk of uterine leiomyomata.

  2. Clinical application of uterine artery embolization in treating uterine scar pregnancy

    International Nuclear Information System (INIS)

    Li Tonghuai; Zheng Hongfeng

    2011-01-01

    Objective: To evaluate uterine artery embolization in treating uterine scar pregnancy. Methods: During the period from November 2007 to February 2010, 11 patients with uterine scar pregnancy were encountered in authors' hospital. All the patients had a history of lower uterine segment cesarean section. Four patients had to receive an emergency uterine artery embolization due to acute massive vaginal bleeding. The other 7 patients received intravenous chemotherapy with MTX (0.4 mg/kg/day, every 5 days as a treatment course). Emergency uterine artery embolization had to be carried out in three patients as they developed acute massive vaginal bleeding (blood loss ≥ 100 ml/hour) during the course of chemotherapy, while subsequent uterine artery embolization was performed in the remaining 4 patients after they had completed two courses of treatment when their blood HCG showed no significant decrease. The clinical results were analyzed. Results: Remarkable decrease in serum HCG was seen in all 11 patients after interventional management. The vaginal bleeding in 7 patients was significantly reduced within half an hour after uterine artery embolization. The uterus together with intact fertility was successfully preserved in all 11 patients. Conclusion: For the treatment of uterine scar pregnancy complicated by massive vaginal bleeding (blood loss ≥ 500 ml/24 h) and/or abnormal elevation of serum HCG (blood β-HCG ≥ 20000 IU/L), ectopic pregnancy with the mass diameter ≥ 5 cm, uterine artery embolization treatment is very safe and effective. This technique can well preserve female patient's uterus and fertility ability. It is of value to employ this treatment in clinical practice. (authors)

  3. 46 CFR 64.61 - Rupture disc.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Rupture disc. 64.61 Section 64.61 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs § 64.61 Rupture disc. If a rupture disc...

  4. A Retrospective Analysis of Ruptured Breast Implants

    Directory of Open Access Journals (Sweden)

    Woo Yeol Baek

    2014-11-01

    Full Text Available BackgroundRupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants.MethodsWe performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone, duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management.ResultsForty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case, microfat graft (2 case, removal only (14 case, and follow-up loss (17 case.ConclusionsSaline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

  5. a two-year review of uterine rupture in a regional hospital

    African Journals Online (AJOL)

    2010-09-01

    Sep 1, 2010 ... Conflict of Interest: None declared. SUMMARY ... significant causes. Major complications were: neonatal deaths 34(82.9%), maternal mortality 4(9.8%) and wound infections 15 (36.6%). Subtotal hysterectomy. 10(24.4%) and total ... uterotonics during labour are the most frequent causes in the developed ...

  6. Pre-term Spontaneous Unscarred Uterine Rupture; A Case Report and Review

    Directory of Open Access Journals (Sweden)

    Shima Sheybani

    2014-10-01

    Case:The case we intend to present is a multigravid woman (G3L2 in 28th week of gestation with an unscarred uterus. She had cardiac surgery six months earlier Atrial Septal Defect (ASD device closure with Percutaneous Coronary Intervention (PCI. She presented with severe dyspnea, diminished lung sounds in the right lower zone, chest pain at rest, and radiating pain to her right shoulder from 12 hours earlier. No FHR was detected by auscultation with Doppler. She had generalized abdominal tenderness and rebound tenderness.

  7. Audit of cases with uterine rupture: a process indicator of quality of ...

    African Journals Online (AJOL)

    Roland

    women came from areas within 6 km from the hospital (data lacking in 3 cases). Ninety-nine (90%) of the women were considered at term (≥37 completed weeks of gestation). One UR occurred at only 19 esti- mated weeks of pregnancy after the woman had received repeated doses of misoprostol due to missed abortion.

  8. Uterine biology in pigs and sheep

    Directory of Open Access Journals (Sweden)

    Bazer Fuller W

    2012-07-01

    Full Text Available Abstract There is a dialogue between the developing conceptus (embryo-fetus and associated placental membranes and maternal uterus which must be established during the peri-implantation period for pregnancy recognition signaling, implantation, regulation of gene expression by uterine epithelial and stromal cells, placentation and exchange of nutrients and gases. The uterus provide a microenvironment in which molecules secreted by uterine epithelia or transported into the uterine lumen represent histotroph required for growth and development of the conceptus and receptivity of the uterus to implantation. Pregnancy recognition signaling mechanisms sustain the functional lifespan of the corpora lutea (CL which produce progesterone, the hormone of pregnancy essential for uterine functions that support implantation and placentation required for a successful outcome of pregnancy. It is within the peri-implantation period that most embryonic deaths occur due to deficiencies attributed to uterine functions or failure of the conceptus to develop appropriately, signal pregnancy recognition and/or undergo implantation and placentation. With proper placentation, the fetal fluids and fetal membranes each have unique functions to ensure hematotrophic and histotrophic nutrition in support of growth and development of the fetus. The endocrine status of the pregnant female and her nutritional status are critical for successful establishment and maintenance of pregnancy. This review addresses the complexity of key mechanisms that are characteristic of successful reproduction in sheep and pigs and gaps in knowledge that must be the subject of research in order to enhance fertility and reproductive health of livestock species.

  9. Uterine artery embolization for adenomyosis without fibroids

    International Nuclear Information System (INIS)

    Kim, M.D.; Won, J.W.; Lee, D.Y.; Ahn, C.-S.

    2004-01-01

    AIM: To evaluate the potential usefulness of transcatheter uterine artery embolization as a treatment for symptomatic adenomyosis in patients without uterine fibroids. MATERIALS AND METHODS: Uterine artery embolization using polyvinyl alcohol particles sized 250-710 mm was performed in 43 patients (mean; 40.3 years, range; 31-52 years) with dysmenorrhoea, menorrhagia, or bulk-related symptoms (pelvic heaviness, urinary frequency) due to adenomyosis without fibroids. All patients underwent pre-procedural and 3.5 months (range 1-8 months) follow-up magnetic resonance imaging (MRI) with contrast enhancement. Clinical symptoms were also assessed at the time of MRI before and after embolization. RESULTS: Significant improvement of dysmenorrhoea (95.2%) and menorrhagia (95.0%) was reported in most patients. Contrast-enhanced MRI revealed non-enhancing areas suggesting coagulation necrosis of adenomyosis in 31 patients (72.1%), decreased size without necrosis in 11 patients (25.6%), and no change in one patient (2.3%). The mean volume reduction of the uteri after uterine artery embolization was 32.5% (from 321.7±142.9 to 216.7±130.1 cm 3 ). CONCLUSION: Transcatheter uterine artery embolization is an effective therapy for the treatment of symptomatic pure adenomyosis, and may be a valuable alternative to hysterectomy

  10. Uterine biology in pigs and sheep

    Science.gov (United States)

    2012-01-01

    There is a dialogue between the developing conceptus (embryo-fetus and associated placental membranes) and maternal uterus which must be established during the peri-implantation period for pregnancy recognition signaling, implantation, regulation of gene expression by uterine epithelial and stromal cells, placentation and exchange of nutrients and gases. The uterus provide a microenvironment in which molecules secreted by uterine epithelia or transported into the uterine lumen represent histotroph required for growth and development of the conceptus and receptivity of the uterus to implantation. Pregnancy recognition signaling mechanisms sustain the functional lifespan of the corpora lutea (CL) which produce progesterone, the hormone of pregnancy essential for uterine functions that support implantation and placentation required for a successful outcome of pregnancy. It is within the peri-implantation period that most embryonic deaths occur due to deficiencies attributed to uterine functions or failure of the conceptus to develop appropriately, signal pregnancy recognition and/or undergo implantation and placentation. With proper placentation, the fetal fluids and fetal membranes each have unique functions to ensure hematotrophic and histotrophic nutrition in support of growth and development of the fetus. The endocrine status of the pregnant female and her nutritional status are critical for successful establishment and maintenance of pregnancy. This review addresses the complexity of key mechanisms that are characteristic of successful reproduction in sheep and pigs and gaps in knowledge that must be the subject of research in order to enhance fertility and reproductive health of livestock species. PMID:22958877

  11. Bilateral internal laryngoceles mimicking asthma

    Directory of Open Access Journals (Sweden)

    Elif A Aksoy

    2013-01-01

    Full Text Available Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients.

  12. Bilateral Olecranon Tophaceous Gout Bursitis

    Directory of Open Access Journals (Sweden)

    Güzelali Özdemir

    2017-01-01

    Full Text Available In this case, we present a patient with the diagnosis of bilateral olecranon tophaceous gout. After the surgical treatment, there was no limitation of range of motion or wound problem at 6th month control.

  13. Bilateral papillary renal cell carcinoma

    International Nuclear Information System (INIS)

    Gossios, K.; Vazakas, P.; Argyropoulou, M.; Stefanaki, S.; Stavropoulos, N.E.

    2001-01-01

    Papillary renal cell carcinoma is a subgroup of malignant renal epithelial neoplasms. We report the clinical and imaging findings of a case with multifocal and bilateral renal cell carcinoma which are nonspecific. (orig.)

  14. Uterine artery pulsatility index in hypertensive pregnancies: When does the index normalize in the puerperium?

    Science.gov (United States)

    Lee, Seung Mi; Jun, Jong Kwan; Sung, Su Jin; Choo, Sung Il; Cho, Jeong Yeon; Yang, Hye Jin; Park, Chan-Wook; Park, Joong Shin; Syn, Hee Chul

    2016-11-01

    To investigate whether the uterine artery pulsatility index (UtA PI) of hypertensive pregnancies is higher than that of normal pregnancies in the puerperium, as well as in the antepartum period. The UtA PI was measured in hypertensive (group 1) and normal pregnancies (group 2) during antepartum, immediate postpartum or late postpartum periods. Using the transvaginal approach, the bilateral uterine artery indices were measured. One hundred twenty-two women were enrolled: group 1, hypertensive disease in pregnancy (11 cases in antepartum, 13 cases in immediate postpartum and 10 cases in late postpartum period); group 2, normal pregnancies (32 cases in antepartum, 29 cases in immediate postpartum and 27 cases in late postpartum). In antepartum and immediate postpartum periods, the mean UtA PI and the proportion of cases with an early diastolic notch were higher in group 1 than in group 2 (antepartum mean UtA PI, 1.14 in group 1 vs. 0.68 in group 2, P UtA PI, 1.30 vs. 1.08, P UtA PI of group 1 was still higher than that of group 2, although the proportion of cases with an early diastolic notch was not different (mean UtA PI, 1.43 vs. 1.20, P UtA PI in hypertensive pregnancies was still higher than normal pregnancies in puerperal periods, suggesting that more than several weeks are required to resolve increased uterine artery vascular impedance.

  15. Postpartum uterine artery Doppler velocimetry among patients following a delivery complicated with preeclampsia.

    Science.gov (United States)

    Weintraub, Adi Y; Aricha-Tamir, Barak; Steiner, Naama; Hamou, Bat-El; Baron, Joel; Hershkovitz, Reli

    2013-11-01

    To evaluate postpartum uterine artery (UtA) velocimetry in patients following severe preeclampsia (PET) as compared with normotensive controls. Postpartum UtA velocimetry was obtained prospectively during the early postpartum period. The right and left UtA pulsatility index (PI) was measured and the presence of an early diastolic notch was noted. For categorical variables, the χ2 test or Fisher exact was used as appropriate and for continuous variables the t-test was used. The p value one patients following severe PET and 52 normotensive controls were included in the study. Following severe PET, higher rates of intrauterine growth restriction, cesarean delivery, preterm delivery and accordingly lower neonatal birth weight were noted. Postpartum UtA velocimetry measurements were performed on average 51.2 h after delivery (range 8-169). Right and left UtA PI was comparable between patients following severe PET and controls. The presence of unilateral and bilateral early diastolic notches were significantly higher in patients following severe PET. The pathophysiology of uterine involution and the physiologic return of the uterine arteries to the non-pregnant state may be different following severe PET.

  16. MR-guided Focused Ultrasound for Uterine Fibroids

    Science.gov (United States)

    ... Share your patient story here Related Articles and Media Magnetic Resonance Imaging (MRI) - Body Uterine Fibroid Embolization (UFE) Magnetic Resonance Imaging (MRI) Safety Blood Clots Images related to MR-guided Focused Ultrasound for Uterine ...

  17. Vestibuler rehabilitation in bilateral vestibulopaty

    OpenAIRE

    Onur Armağan

    2017-01-01

    Bilateral vestibulopathy is a heterogeneous chronic condition characterized by a bilateral reduced or absent function of the vestibular organs, the vestibular nerves or a combination of both. The vestibular system plays a crucial role in the multisensory control of balance. When vestibular function is lost, essential tasks such as postural control, gaze stabilization, and balance deteriorate and the quality of life of patients is significantly impaired. Nowadays the widely available treatment...

  18. Bilateral Symmetrical Parietal Extradural Hematoma

    OpenAIRE

    Agrawal, Amit

    2011-01-01

    The occurrence of bilateral extradural hematomas (EDH) is an uncommon consequence of craniocerebral trauma, and acute symmetrical bilateral epidural hematomas are extremely rare. We discuss the technique adopted by us for the management of this rare entity. A 55-year-old patient presented with history of fall of branch of tree on her head. She had loss of consciousness since then and had multiple episodes of vomiting. Examination of the scalp was suggestive of diffuse subgaleal hematoma. Her ...

  19. The management of bilateral myelolipoma: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Davide Zattoni

    2015-01-01

    Discussion: In literature, there are 36 cases described. The clinical presentation consisted of symptomatic tumors, incidentally diagnosed lesions or myelolipomas in patients with an associated endocrinal disorder. Symptomatic tumors or those bigger than 7 cm, because of the potential risk of rupture, are usually treated surgically. In smaller (7 cm cases. As far as we know, this is the first review on bilateral myelolipomas.

  20. Simultaneous Bilateral Ophthalmic Artery Chemosurgery for Bilateral Retinoblastoma (Tandem Therapy.

    Directory of Open Access Journals (Sweden)

    David H Abramson

    Full Text Available Report on the 7-year experience with bilateral ophthalmic artery chemosurgery (OAC-Tandem therapy for bilateral retinoblastoma.Retrospective, single institution study.120 eyes of 60 children with bilateral retinoblastoma treated since March 2008.Retrospective review of all children treated at Memorial Sloan Kettering with bilateral ophthalmic artery chemosurgery (Melphalan, Carboplatin, Topotecan, Methotrexate delivered in the same initial session to both naïve and previously treated eyes.Ocular survival, metastatic disease, patient survival from metastases, second cancers, systemic adverse effects, need for transfusion of blood products, electroretinogram before and after treatment.116 eyes were salvaged (4 eyes were enucleated: 3 because of progressive disease, 1 family choice. Kaplan Meier ocular survival was 99.2% at one year, 96.9% at 2 and 3 years and 94.9% for years 4 through 7. There were no cases of metastatic disease or metastatic deaths with a mean follow-up of 3.01 years. Two children developed second cancers (both pineoblastoma and one of them died. Transfusion of blood products was required in 3 cases (4 transfusions, 1.9%. Two children developed fever/neutropenia requiring hospitalization (0.95%. ERGs were improved in 21.6% and unchanged after treatment in 52.5% of cases (increase or decrease of less than 25μV.Bilateral ophthalmic artery chemosurgery is a safe and effective technique for managing bilateral retinoblastoma-even when eyes are advanced bilaterally, and if both eyes have progressed after systemic chemotherapy. Ocular survival was excellent (94.9% at 8 years, there were no cases of of metastatic disease and no deaths from metastatic disease, but children remain at risk for second cancers. In 21.6% of cases ERG function improved. Despite using chemotherapy in both eyes in the same session, systemic toxicity was low.

  1. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse; Conrad, Carsten

    2005-01-01

    STUDY OBJECTIVE: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone breast implants. MATERIAL AND METHODS: The study population consisted of 64 women with 118 implants, who had...... participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture...... (intracapsular or extracapsular), possible rupture or intact implant was then obtained. Strict predetermined rupture criteria were applied as described in this report and findings at surgery were abstracted in a standardised manner and results compared. RESULTS: At MRI, 66 implants were diagnosed as ruptured...

  2. OSTEOPOROSIS AS A NOVEL MARKER OF UTERINE CANCER RISK FACTOR

    OpenAIRE

    Zena Abdul Monim Al-Jawadi; Zainab Mahfoth Al-noaymy

    2014-01-01

    Due to limited available information on the occurrence and treatment of uterine cancer, health institutions in major countries trend to study some factors and diseases that may relation or plays as predisposing factors of the occurrence of uterine cancer and the lack of previous studies on the impact of osteoporosis on the incidence of uterine cancer and the rapid spread of uterine cancer in recent years all over the world and till know the exact mechanism is not fully clear. This study focus...

  3. Imaging before and after uterine artery embolization

    International Nuclear Information System (INIS)

    Kroencke, T.J.

    2008-01-01

    Percutaneous catheter-based embolization treatment of symptomatic uterine fibroids has evolved into the most widely used alternative therapeutic approach to surgical treatment worldwide. Uterine artery embolization (UAE) induces infarction of leiomyomas, resulting in ischemic necrosis, hyaline degeneration, and size reduction with resolution of associated symptoms. Published experience suggests that UAE is an effective and reliable option for treating uterine fibroids with high patient satisfaction. Magnetic resonance imaging (MRI) is superior to ultrasonography for determining the site, size and number of fibroids, which is important for establishing the indication for UAE. Other potential advantages of MRI include the option of performing MR angiography (MRA) and obtaining contrast-enhanced images for monitoring the outcome of UAE and assessing possible complications after UAE. (orig.) [de

  4. Renal allograft rupture: US diagnosis

    International Nuclear Information System (INIS)

    Maklad, N.F.

    1987-01-01

    The US appearances in seven pathologically and/or surgically proved cases of renal allograft rupture are presented. These include a triangular or amorphous echogenic area in the cortex and medulla in a polar location, an echogenic band or wavy, branching anechoic lines in the hyperechoic region, a subcapsular hematoma, and an extrarenal hematoma in direct continuity with the echogenic area. Duplex Doppler examination in renal allograft rupture shows marked reduction of absence of the diastolic component of the velocity waveform in the arcuate and interlobar arteries, with reduction in amplitude of the systolic wave form. Correlation of the US appearances with gross and microscopic pathologic findings indicates that the echogenic area is due to an intrarenal hematoma, while the echogenic band represents the cortical laceration with adherent blood clots. The US-duplex Doppler examination should be the primary diagnostic modality in this life-threatening condition

  5. Plasticité et Rupture

    OpenAIRE

    Marigo, Jean-Jacques

    2016-01-01

    Engineering school; Ce cours a un double objectif:1. renforcer les notions de mécanique des milieux continus;2. présenter les concepts fondamentaux de la plasticité et de la rupture, premiers exemples du comportement irréversible des solides.En conséquence, le cours sera divisé en trois parties: une consacrée à l'élasticité, une deuxième à la plasticité et la troisième à la mécanique de la rupture. Partie Elasticité:On commencera par un rappel sur les concepts fondamentaux de la mécanique des...

  6. Is a history of cesarean section a risk factor for abnormal uterine bleeding in patients with uterine leiomyoma?

    OpenAIRE

    Kinay, Tugba; Basarir, Zehra O.; Tuncer, Serap F.; Akpinar, Funda; Kayikcioglu, Fulya; Koc, Sevgi; Karakaya, Jale

    2016-01-01

    Objectives: To determine whether a history of cesarean section was a risk factor for abnormal uterine bleeding in patients with uterine leiomyomas, and to identify other risk factors for this symptom. Methods: We analyzed retrospectively, the medical records of patients who underwent hysterectomies due to the presence of uterine leiomyomas during a 6-year period (2009 and 2014) at Etlik Zubeyde Hanim Women?s Health Training and Research Hospital, Ankara, Turkey. Uterine leiomyoma was diagnose...

  7. Prediction of preeclampsia by means of Doppler flowmetry of uterine artery and flow-mediated dilation of brachial artery

    Directory of Open Access Journals (Sweden)

    Aline Costa Calixto

    2014-02-01

    Full Text Available Objective To evaluate the association of Doppler of uterine artery and flow-mediated dilation of brachial artery (FMD in the assessment of placental perfusion and endothelial function to predict preeclampsia. Materials and Methods A total of 91 patients considered as at risk for developing preeclampsia were recruited at the prenatal unit of the authors' institution. All the patients underwent FMD and Doppler of uterine arteries between their 24th and 28th gestational weeks. Calculations of sensitivity and specificity for both isolated and associated methods were performed. Results Nineteen out of the 91 patients developed preeclampsia, while the rest remained normotensive. Doppler flowmetry of uterine arteries with presence of bilateral protodiastolic notch had sensitivity of 63.1% and specificity of 87.5% for the prediction of preeclampsia. Considering a cutoff value of 6.5%, FMD showed sensitivity of 84.2% and specificity of 73.6%. In a parallel analysis, as the two methods were associated, sensitivity was 94.2% and specificity, 64.4%. Conclusion The association of Doppler study of uterine arteries and FMD has proved to be an interesting clinical strategy for the prediction of preeclampsia, which may represent a positive impact on prenatal care of patients considered as at high-risk for developing such a condition.

  8. [The percutaneous treatment of uterine fibromas by means of transcatheter arterial embolization].

    Science.gov (United States)

    Golfieri, R; Muzzi, C; De Iaco, P; Maffei, M; Giampalma, E; Amore, B; Muzzupapa, G; Baroncini, S; Bovicelli, L

    2000-01-01

    We report our preliminary experience with arterial embolization of uterine fibroids in seven women, focusing on the technical aspects of the procedure and the clinical and morphological results during the follow-up. February to December 1999 seven women (mean age 47) underwent transcatheter arterial embolization of both uterine arteries as a permanent treatment for fibroids. We included in this study single or multiple, bleeding and/or large fibroids, symptomatic on compression, contraindicated for myomectomy because of high surgical or anesthesiologic risks or myomata in which myomectomy could probably be converted into hysterectomy. Fibroids enlarging the uterus to the size of 25 weeks' pregnancy or more, pedunculated myomata or small submucous fibroids--smaller than 5 cm--were excluded. Uterine arterial embolization was performed bilaterally, till a total blockage of flow, by injecting permanent embolization material: polyvinyl-alcohol (PVA) particles of increasing size from 150 to 500 mu and in varying amounts from 10 to 24 mL, depending on fibroid size and degree of vascularization. A technical success was achieved in all cases and no late complications were seen. At 6-month clinical follow-up all compressive symptoms had disappeared; regular menses had returned in 57% of patients, milder hyper-dysmenorrhea was present in 28% compared to pretreatment symptoms; only in one case (14%) was permanent amenorrhea observed. The 3-month and 6-month US follow-up studies showed an average 40.7% (range 10-50%) and 51% (range 25-83%) reduction in the fibroid size, respectively. All the small myomata (about 2 cm in size) were unidentifiable at 6-month US follow-up. In no cases did new fibroids appear. Surgery is the traditional treatment for symptomatic uterine fibroids (hysterectomy, myomectomy). More recently, hormone therapy and operative endoscopy (laparoscopy and hysteroscopy) have been introduced as alternatives, together with uterine embolization previously applied

  9. Misdiagnosis of a Giant Uterine Leiomyosarcoma: Clinic and Image Challenges

    Directory of Open Access Journals (Sweden)

    Jila Agah

    2017-01-01

    Full Text Available A 41-year-old woman (G3P2L2Ab1 was referred to gynecology clinic with chief complaints of abdominal distension and localized abdominal wall pruritus for three months. She was misdiagnosed with gastrointestinal disorder and ultimately had undergone imaging. Ultrasonography and computed tomography (CT scan disclosed a huge solid-cystic mass originating from the ovary. On clinical examination the patient had no pain or tenderness and no gynecologic complaints. Laboratory tests showed normal tumor markers and hemoglobin at 8 g/dl. Laparotomy was carried out as diagnosis of ovarian serous cyst adenoma, but a huge tumor with attachment to uterus and ovaries and extension to pelvic floor, peripheral tissues of ureter, and upper abdomen was found. Hysterectomy with bilateral salpingooophorectomy was done. Pathology report demonstrated uterine leiomyosarcoma measuring 40 centimeters and weighing 10 kilograms. In conclusion, as pelvic masses even in a large size may present unspecific symptoms misdiagnosis may occur which lead to overgrowth, local invasion, or other complications. So, it is rather to suggest ultrasonography in patients with persistent abdominal or pelvic symptoms and if needed, more exact diagnostic modalities like magnetic resonance imaging (MRI could be offered to avoid misdiagnosis and mismanagement.

  10. Relationship between quadriceps femoris muscle volume and muscle torque after anterior cruciate ligament rupture.

    Science.gov (United States)

    Konishi, Yu; Oda, Toshiaki; Tsukazaki, Satoshi; Kinugasa, Ryuta; Hirose, Norikazu; Fukubayashi, Toru

    2011-04-01

    The purpose of this study was to obtain evidence to support the hypothesis that motor unit recruitment is reduced in the quadriceps femoris (QF) of patients with ACL rupture. We compared muscle torque per unit volume in the QF from injured and uninjured sides to normal subjects. If high-threshold motor unit recruitment is reduced in patients with ACL rupture, this reduction will theoretically lead to a reduction in muscle torque per unit volume compared to the control group. The subjects included 22 patients with ACL rupture and 22 subjects with no history of knee injury. To identify the muscle torque per unit volume, the isokinetic peak torque was divided by QF volume which was obtained by MRI. Tests revealed that the mean muscle torque per unit volume of the uninjured and injured sides was significantly lower than those of the control group. This study demonstrated that the values of the muscle torque per unit volume of both injured and uninjured sides of patients with ACL rupture were significantly lower than those of the control group, thereby providing indirect evidence of the hindrance of motor unit recruitment in these patients. The results of the present study also indicate that there may be bilateral QF weakness in patients with ACL rupture. Since persistent QF weakness is a significant barrier to effective rehabilitation in patients with ACL injuries, a better understanding of the underlying mechanisms will allow clinicians and scientists to develop more effective therapeutic strategies for patient rehabilitation.

  11. Paralisia facial bilateral Bilateral facial paralysis: a case report

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1976-03-01

    Full Text Available É apresentado um caso de diplegia facial surgida após meningite meningocócica e infecção por herpes simples. Depois de discutir as diversas condições que o fenômeno pode apresentar-se, o autor inclina-se por uma etiologia herpética.A case of bilateral facial paralysis following meningococcal meningitis and herpes simplex infection is reported. The author discusses the differential diagnosis of bilateral facial nerve paralysis which includes several diseases and syndromes and concludes by herpetic aetiology.

  12. Bilateral spontaneous hemotympanum: Case report

    Directory of Open Access Journals (Sweden)

    Economou Nicolas C

    2006-10-01

    Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

  13. Radiotherapy for carcinoma of the uterine cervix with short uterine cavity

    International Nuclear Information System (INIS)

    Tsuchida, Emiko; Sugita, Tadashi; Matsumoto, Yasuo; Sasamoto, Ryuta; Sakai, Kunio; Sueyama, Hiroo; Yamanoi, Tadayoshi; Ito, Takeshi; Umetsu, Hisao

    2001-01-01

    We have reviewed 11 patients treated with radiotherapy for carcinoma of the uterine cervix with short uterine cavity less than 3 cm. They consisted of 5 patients with stump cancer and 6 with atrophic uterus. Two patients with stump cancer had local failure and died of tumor progression. The 5-year cause-specific survival was 82%. Rectal and bladder injuries occurred in 5 and 2 patients, respectively. These complications were observed frequently in the patients with atrophic uterus. (author)

  14. Uterine pathologies to be considered before uterus-preserving surgery in cases of uterine prolapse

    OpenAIRE

    Eskicioğu, Fatma; Özyurt, Beyhan

    2016-01-01

    Objective: Investigation of unpredictable risks due to abnormal uterine pathology after the choice of uterus-preserving reconstructive surgical procedure for women who have uterine prolapse and no other complaints was aimed.Methods: The data of 121 women (105 postmenopausal and 16 premenopausal) who underwent vaginal hysterectomy due to pelvic organ prolapse was examined and the post-hysterectomy histopathology results were evaluated.Results: Senile cystic atrophy was the most common endometr...

  15. Case Report: Massive Ascites Complicating Uterine Fibroids ...

    African Journals Online (AJOL)

    A rare case of massive ascites complicating uterine fibroid is presented. At presentation, she was emaciated with grossly distended abdomen and a mass, which corresponded to 36 weeks gestation. At operation a large soft mass attached to the uterus by fibrous strands and to the omentum by large dilated new vessels was ...

  16. Intra-uterine insemination for male subfertility

    NARCIS (Netherlands)

    Bensdorp, A. J.; Cohlen, B. J.; Heineman, M. J.; Vandekerckhove, P.

    2007-01-01

    BACKGROUND: Intra-uterine insemination (IUI) is one of the most frequently used fertility treatments for couples with male subfertility. Its use, especially when combined with ovarian hyperstimulation (OH) has been subject of discussion. Although the treatment itself is less invasive and expensive

  17. Fertility after uterine artery embolization of fibroids

    DEFF Research Database (Denmark)

    Karlsen, K; Hrobjartsson, A; Korsholm, M

    2018-01-01

    for relevant information in PubMed and Embase for randomized controlled trials (RCT), controlled clinical trials, comparative before-after trials, cohort studies, case-control studies and case series where UAE treatment of premenopausal women was performed for uterine fibroids with and where a control...

  18. Dysfunctional uterine bleedings of a climacteric period

    International Nuclear Information System (INIS)

    Prilepskaya, V.N.

    1993-01-01

    Climacteric period of some women is complicated by dysfunctional uterine bleedings (DUB). Bearing in mind the fact that DUBS are caused by disorder of estrin rhysmic secretion, the paper presents the methods of differential diagnostics for investigations into functional disorders in the hypothalamus -hypophysis - ovaries - uterus system. The preference is given to roentgenologic and radioimmunologic diagnostic methods

  19. Uterine inversion complicating traditional termination of pregnancy ...

    African Journals Online (AJOL)

    Abortion services remain cladenstine and unsafe in most parts of Africa. This is a case of a mid-trimester abortion induced by traditional methods which resulted in uterine inversion, a previously unreported complication of induced abortion. Until abortion services are accessible and safe on the continent, morbidity and ...

  20. Intra-uterine hematoma in pregnancy

    DEFF Research Database (Denmark)

    Glavind, K; Nøhr, S; Nielsen, P H

    1991-01-01

    In 60 patients with a live fetus and an intra-uterine hematoma (IUH) proven by ultrasonic scanning the outcome of pregnancy was spontaneous abortion in 12% and premature delivery in 10%. No correlation between the outcome of the pregnancy and the maximum size of the hematoma or the week...

  1. CORRELATION BETWEEN UTERINE ARTERY FLOW VELOCITY ...

    African Journals Online (AJOL)

    CORRELATION BETWEEN UTERINE ARTERY FLOW VELOCITY WAVEFORMS AND ENDOMETRIAL HISTOPATHOLOGY IN WOMEN WITH PERIMENOPAUSAL AND POSTMENOPAUSAL BLEEDING. Dr. Ebtesam Saied, Dr. Ismail El Garhy(MD), Dr. Farid I. Hassan(MD), Dr. Adel-Gamil Abd-Allah, Abd El Shafy Ibrahim ...

  2. Krukenberg Tumour Simulating Uterine Fibroids and Pelvic ...

    African Journals Online (AJOL)

    To report a case of cancer of the colonwhich presented as secondaries to the ovaries. Case report. The case presented is that of a 39 year old female who presented with lower abdominal pain and a multinodular pelvic mass which led to an initial diagnosis of multiple uterine fibroids and pelvic inflammatory disease.

  3. Ovarian function after uterine artery embolisation

    African Journals Online (AJOL)

    2009-08-05

    Aug 5, 2009 ... Premature menopause has been documented in 1 - 2% of patients after UAE and was believed to result from non- target embolisation of vessels to the ovaries from the uterine arteries.8 Doppler studies on ovarian vasculature showed evidence of significant vascular derangements in ovarian arterial ...

  4. Intestinal Infarctus following Dilatation and Uterine Curettage

    Directory of Open Access Journals (Sweden)

    N.M. Ngowe

    2007-03-01

    Full Text Available We present a case of intestinal infarctus through the vagina. This was a consequence of induced abortion done clandestinely. The main objective was to point out the surgical complications of uterine dilatation and curettage by means of this rare case.

  5. Achondroplasia Associated with Bilateral Keratoconus

    Directory of Open Access Journals (Sweden)

    Ammar M. Al Mahmood

    2012-01-01

    Full Text Available We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE. Right eye (RE improved to 20/25. The patient underwent penetrating keratoplasty (PKP in his LE. Twenty-seven months postoperatively, uncorrected visual acuity (UCVA was 20/30. Ophthalmologists should be aware that patients with achondroplasia who complain of poor vision should be suspected of having keratoconus once other more common conditions are ruled out.

  6. Area detection of uterine peristalsis using cine-MR images

    International Nuclear Information System (INIS)

    Sato, Tetsuo; Fujita, Nao; Nakai, Asako; Togashi, Kaori; Kuhara, Shigehide; Okada, Tomohisa

    2011-01-01

    In this paper, a technique for evaluating uterine peristalsis obtained by magnetic resonance images is proposed. Uterine peristalsis is the wavelike movement of uterine muscle contractions with rhythm and direction. Correlation between direction of uterine peristalsis and menstrual cycle has been reported, which is supposed to help sperm transpotation and implantation. While evaluation of uterine peristalsis has been done, they are very subjective and no quantitative evaluation has been established. In the proposed method the peristalsis area and their contraction intensity were calculated. The points of uterine peristalsis was estimated by the spatio-temporal map, which reflect the time series behavior of the intensities around points set on uterine endometrial boundaries. Then peristalsis area was decided as the estimated points. The contraction intensity was defined as the ratio of the signal intensity change in the peristalsis area. (author)

  7. High-flavanol and high-theobromine versus low-flavanol and low-theobromine chocolate to improve uterine artery pulsatility index: a double blind randomized clinical trial

    OpenAIRE

    Bujold, Emmanuel; Leblanc, Vicky; Lavoie-Lebel, Élise; Babar, Asma; Girard, Mario; Poungui, Lionel; Blanchet, Claudine; Marc, Isabelle; Lemieux, Simone; Abdous, Belkacem; Anassour-Laouan-Sidi, Elhadji; Dodin-Dewailly, Sylvie

    2016-01-01

    Objective: To evaluate the impact of high-flavanol and high-theobromine (HFHT) chocolate in women at risk of preeclampsia (PE). Study design: We conducted a single-center randomized controlled trial including women with singleton pregnancy between 11 and 14 weeks gestation who had bilateral abnormal uterine artery (UtA) waveforms (notching) and elevated pulsatility index (PI). Participants were randomized to either HFHT or low-flavanol and low-theobromine (LFLT) chocolate (30 g...

  8. Anastomoses of the Ovarian and Uterine Arteries: A Potential Pitfall and Cause of Failure of Uterine Embolization

    International Nuclear Information System (INIS)

    Matson, Matthew; Nicholson, Anthony; Belli, Anna-Maria

    2000-01-01

    Four women with symptomatic uterine fibroids were treated by uterine artery embolization (UAE). In all cases both uterine arteries were embolized via a single femoral puncture with polyvinyl alcohol using a selective catheter technique. In three cases, the ovarian artery was not visible on the initial angiogram before embolization, but appeared after the second uterine artery had been treated. In one case of clinical failure following UAE, a repeat angiogram demonstrated filling of the fibroids from the ovarian artery. Anastomoses between uterine and ovarian arteries may cause problems for radiologists performing UAE and are a potential cause of treatment failure

  9. Isokinetic profile of subjects with the ruptured anterior cruciated ligament

    Directory of Open Access Journals (Sweden)

    Drapšin Miodrag

    2016-01-01

    Full Text Available Background/Aim. All changes in the knee that appear after anterior cruciate ligament (ACL lesion lead to difficulties in walking, running, jumping especially during sudden changes of the line of movement. This significantly impairs quality of life of these subjects and leads to decrease in physical activity. Knee injuries make 5% of all most severe acute sport injuries. The aim of the study was to determine strength of the thigh muscles in persons with unilateral rupture of the ACL and to evaluate potential bilateral differences between healthy and injured leg. Methods. This study involved 114 male athletes of different sport specialities with the clinical diagnosis of ACL rupture. Each subject had unilateral ACL rupture and the other leg was actually the control for this research. An isokinetic device was used to evaluate the muscle strength of thigh muscles. Testing was performed for two testing speeds, 60º/s and 180º/s. Results. Data analysis showed a statistically significant difference (p < 0.01 between the ACL and the healthy leg in the following parameters: peak torque for thigh extensors (Ptrq_E, angle to peak torque during extension (Ang_E, power of extension (Pow_E and work during extension (Work_E. Analysing hamstrings to quadriceps (H/Q ratio we found the unilateral disbalance of thigh muscle strength in ACL leg. Conclusion. A high level of validity makes isokinetic dynamometry the method for evaluation of thigh muscles strength and leaves this field of research open for new studies in order to improve both diagnostic and rehabilitation of patients with the insufficient ACL.

  10. The rupture in visual language:

    OpenAIRE

    Kula, Ömür; Kula, Omur

    2006-01-01

    The shift of arts from conventional forms of canvas-painting and sculpture to collage, ready-mades, installations and performances as it had occurred in the history of western art follow a linear and natural unfolding in parallel with sociopolitical evolvements. In the case of Turkish visual arts, this kind of a transformation projects to the time period between 1960s to 1990s where the face of arts change not smoothly but rather in the form of a 'rupture' as new tendencies are embraced, prac...

  11. Espaces ruraux et ruptures territoriales

    OpenAIRE

    Hilal , Mohamed; Détang-Dessendre , Cécile; Schaeffer , Yves

    2013-01-01

    Sur une grande partie du territoire métropolitain, villes et campagnes font système et échangent quotidiennement des ressources. Néanmoins, certains espaces restent en creux du maillage urbain, qu’il soit principal ou secondaire. Cet éloignement peut être à l’origine de désavantages dans de nombreuses dimensions de l’existence et c’est de ces ruptures dans l’accès aux avantages urbains que traite ce chapitre. L’éclairage proposé est organisé en trois temps. La première section situe les espac...

  12. Neck curve polynomials in neck rupture model

    International Nuclear Information System (INIS)

    Kurniadi, Rizal; Perkasa, Yudha S.; Waris, Abdul

    2012-01-01

    The Neck Rupture Model is a model that explains the scission process which has smallest radius in liquid drop at certain position. Old fashion of rupture position is determined randomly so that has been called as Random Neck Rupture Model (RNRM). The neck curve polynomials have been employed in the Neck Rupture Model for calculation the fission yield of neutron induced fission reaction of 280 X 90 with changing of order of polynomials as well as temperature. The neck curve polynomials approximation shows the important effects in shaping of fission yield curve.

  13. Traumatic rupture of an intracranial dermoid cyst

    Directory of Open Access Journals (Sweden)

    Raksha Ramlakhan, BMedSc, MBBCh

    2015-01-01

    Full Text Available Intracranial dermoid cysts are congenital tumors of ectodermal origin. Rupture of these cysts can occur spontaneously, but rupture in association with trauma is reported infrequently. The diagnosis of rupture is made by the presence of lipid (cholesterol droplets in the subarachnoid spaces and ventricles. Nonenhanced CT of the head demonstrates multiple foci of low attenuation that correspond with hyperintense signal on T1-weighted MRI. We present a case of an adult patient with rupture of an intracranial dermoid cyst, precipitated by minor trauma.

  14. Acute achilles tendon rupture in athletes.

    Science.gov (United States)

    Longo, Umile Giuseppe; Petrillo, Stefano; Maffulli, Nicola; Denaro, Vincenzo

    2013-06-01

    The incidence of AT rupture has increased in recent decades. AT ruptures frequently occur in the third or fourth decade of life in sedentary individuals who play sport occasionally. Ruptures also occur in elite athletes. Clinical examination must be followed by imaging. Conservative management and early mobilization can achieve excellent results, but the rerupture rate is not acceptable for the management of young, active, or athletic individuals. Open surgery is the most common option for AT ruptures, but there are risks of superficial skin breakdown and wound problems. These problems can be prevented with percutaneous repair. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Is a history of cesarean section a risk factor for abnormal uterine bleeding in patients with uterine leiomyoma?

    Science.gov (United States)

    Kinay, Tugba; Basarir, Zehra O; Tuncer, Serap F; Akpinar, Funda; Kayikcioglu, Fulya; Koc, Sevgi; Karakaya, Jale

    2016-08-01

    To determine whether a history of cesarean section was a risk factor for abnormal uterine bleeding in patients with uterine leiomyomas, and to identify other risk factors for this symptom. We analyzed retrospectively, the medical records of patients who underwent hysterectomies due to the presence of uterine leiomyomas during a 6-year period (2009 and 2014) at Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey. Uterine leiomyoma was diagnosed based on histopathological examination of hysterectomy specimens. Demographic characteristics, and laboratory and histopathological findings were compared between patients with uterine leiomyoma with and without abnormal uterine bleeding. In total, 501 (57.9%) patients had abnormal uterine bleeding and 364 (42.1%) patients had other symptoms. A history of cesarean section was more common in patients with abnormal uterine bleeding than in those with other symptoms (17.6% versus 9.3%, p=0.001; odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.4-3.3). The presence of a submucosal leiomyoma (OR: 2.1; 95% CI: 1.5-3.1) and coexistent adenomyosis (OR: 1.6; 95% CI: 1.1-2.4) were also associated with abnormal uterine bleeding. A history of cesarean section was an independent risk factor for abnormal uterine bleeding in patients with uterine leiomyomas; submucosal leiomyoma and coexisting adenomyosis were also independent risk factors.

  16. Comparison of Clinical Outcomes of Intracranial Aneurysms: Procedural Rupture versus Spontaneous Rupture.

    Science.gov (United States)

    Choi, H H; Ha, E J; Lee, J J; Yoo, D H; Cho, W-S; Kim, J E; Cho, Y D; Han, M H; Kang, H-S

    2017-11-01

    Procedural rupture of an intracranial aneurysm is a devastating complication in endovascular treatment. The purpose of this study was to evaluate the clinical outcomes of patients with procedural rupture of unruptured saccular intracranial aneurysms compared with those with spontaneously ruptured aneurysms. A retrospective review was performed for 1340 patients with 1595 unruptured saccular intracranial aneurysms that underwent endovascular coil embolization between February 2010 and December 2014. The clinical outcomes of patients with procedural rupture of unruptured saccular intracranial aneurysms were compared with those of 198 patients presenting with spontaneously ruptured aneurysms. In this series, procedural rupture developed in 19 patients (1.4% per patient and 1.2% per aneurysm), and the morbidity related to procedural rupture was 26.3% (95% confidence interval, 8.5%-61.4%) with no mortality. Hunt and Hess scale grades and hospitalization days of patients with procedural rupture were equivalent to those of patients presenting with spontaneous aneurysm rupture. Subsequent treatment procedures after hemorrhage (including lumbar drainage, extraventricular drainage, decompressive craniectomy, and permanent shunt) showed no difference between the 2 groups. The hemorrhage volumes were smaller in the procedural-rupture group ( P = .03), and the endovascular vasospasm therapies tended to be more frequently required in the spontaneous aneurysm-rupture group ( P = .08). At postictus 6 months, the proportion of modified Rankin Scale scores of ≥2 were lower in the procedural-rupture group (5.3% versus 26.8%, P = .049). In multivariate analysis, spontaneous aneurysm rupture was a significant risk factor for worse clinical outcome (OR = 14.9; 95% CI, 1.2-193.1; P = .039). This study showed better clinical outcomes in the procedural-rupture group. Even though there is a potential chance of aneurysm rupture during treatment, the clinical outcomes after procedural

  17. Umbilical cord prolapsed through urethra: An unusual presentation of a vesico-uterine fistula

    Directory of Open Access Journals (Sweden)

    Aneela G Kamil

    2013-01-01

    Full Text Available Umbilical cord prolapse occurs when a loop of cord is present below the presenting part when the amniotic membranes are ruptured. The incidence is 0.2% of total births. The case presented here is unusual because the definition of cord prolapse cannot be applied to it and the lady did not complain of any history of urinary incontinence or hematuria. The presentation of umbilical cord through maternal urethra led to the speculation of an opening between the anterior uterine wall and the bladder. Fetal demise was diagnosed by abdominal ultrasound. At laprotomy, a communication was found between the bladder and the uterus thus letting the cord traverse through the bladder.

  18. Non-bleeding Spontaneous Rupture of Hepatocellular Carcinoma ...

    African Journals Online (AJOL)

    Non-bleeding Spontaneous Rupture of Hepatocellular Carcinoma. M Islam, P Deka, R Kapur, AM Ansari. Abstract. Rupture of hepatocellular carcinoma (HCC) is not uncommon and most ruptured HCC present with hemoperitoneum and hemorrhagic shock. Management of ruptured HCC is different than non.ruptured one.

  19. Clinical value of magnetic resonance imaging in patients with Mayer-Rokitansky-Kuester-Hauser (MRKH) syndrome: diagnosis of associated malformations, uterine rudiments and intrauterine endometrium

    Energy Technology Data Exchange (ETDEWEB)

    Preibsch, H.; Wietek, B.M.; Claussen, C.D.; Siegmann-Luz, K.C. [University Hospital Tuebingen, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); Rall, K.; Brucker, S.Y. [University Hospital Tuebingen, Department of Gynecology and Obstetrics, Tuebingen (Germany); Staebler, A. [University Hospital Tuebingen, Institute of Pathology and Neuropathology, Tuebingen (Germany)

    2014-07-15

    The aim of this study was to evaluate the accuracy of preoperative magnetic resonance imaging (MRI) in the diagnosis of malformations associated with Mayer-Rokitansky-Kuester-Hauser (MRKH) syndrome and identification of uterine endometrium to optimise the clinical management. We retrospectively reviewed 214 consecutive MRKH patients, mean age 19 years, who underwent laparoscopy-assisted neovagina creation. A total of 115 patients (53.7 %) met the inclusion criterion of sufficient preoperative MRI. In 110 of them (95.7 %), MRI findings were correlated with laparoscopy and associated malformations. In 39 cases (35.5 %) uterine rudiments were removed and analysed histopathologically. Ten per cent (11/110) of the patients showed complete uterine agenesis. The others presented with either unilateral (n = 16; 14.5 %) or bilateral (n = 83; 75.5 %) uterine rudiments. MRI detection of uterine rudiments agreed in 78.2 % (86/110) with laparoscopy. In 85.4 % of the removed rudiments, MRI could correctly diagnose the existence of the endometrium. Compared to laparoscopy, MRI could exactly detect ovaries in 97.3 % (107/110). Renal or ureteral malformations were seen in 32 cases (27.8 %). In 83 % of unilateral renal agenesis and unilateral rudiment, the latter was located at the side of the kidney. MRI is useful for preoperative detection of MRKH-associated malformations and assessment of the endometrium to further optimise MRKH patient treatment. (orig.)

  20. Uterine and chorioallantoic angiogenesis and changes in the uterine epithelium during gestation in the viviparous lizard, niveoscincus conventryi (Squamata: Scincidae).

    Science.gov (United States)

    Ramírez-Pinilla, Martha Patricia; Parker, Scott L; Murphy, Christopher R; Thompson, Michael B

    2012-01-01

    We used immunofluorescent confocal microscopy and scanning electron microscopy to quantify uterine vascularity and to describe uterine surface morphology during gestation in pregnant females of the lecithotrophic lizard Niveoscincus coventryi. As uterine angiogenesis and epithelial cell morphology are thought to be under progesterone control, we studied the effect of a progesterone receptor antagonist (mifepristone) on uterine and chorioallantoic microvasculature and features of the uterine epithelial surfaces. Although intussuceptive angiogenesis was observed in both, uterine and chorioallantoic, vascular beds during gestation, the only significant increases were in the diameters of the uterine vessels. An ellipsoid vessel-dense area grows in the mesometrial hemisphere of the developing conceptus, which parallels the expansion of the allantois to form the chorioallantoic placenta. Uterine surface topography changed during gestation. In particular, uterine blood vessels bulge over the luminal surface to form marked ridges on the uterine embryonic hemisphere, especially during the last stage of pregnancy, and ciliated cells are maintained in the embryonic and abembryonic hemispheres but disappear in both the mesometrial and antimesometrial poles. This distinct regionalization of uterine ridges and ciliated cells in the uterine surface and in the shape of the epithelial component of the chorion might be related to the function of both chorioallantoic and yolk sac placentae during gestation. There was no significant difference between females treated with or without mifepristone, which may be related to the partial function of mifepristone as a progestin antagonist and/or with the function and time of action of progesterone in the uterus during gestation in N. coventryi. Differences in the pattern of angiogenesis and uterine surface morphology during gestation among squamates may be related to the functional diversity of the uterine component of the different

  1. Lamellar Ichthyosis with Bilateral Ectropion

    African Journals Online (AJOL)

    Lamellar Ichthyosis with Bilateral Ectropion. Gunjan Jain, Vaibhav Kumar Jain1, Reena Sharma1, Indra Kumar Sharma, Ganesh Kumar Verma. Departments of Paediatrics and 1Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences and Research, Saifai,. Etawah, Uttar Pradesh, India. CASE REPORT.

  2. Bilateral breast in brothers - abreast

    Directory of Open Access Journals (Sweden)

    Altamash Mohammed Yusuf Shaikh

    2013-01-01

    Full Text Available Gynecomastia is a common occurrence in pubertal age group, and is physiological in up to 65 percent of cases. When occurs in the family it should be investigated in order not to miss on a treatable etiology. Two brothers within the same family, presenting with bilateral gynecomastia of different causes and requiring different treatment are presented.

  3. Bilateral acetabular fracture without trauma

    OpenAIRE

    Rosa, M. A.; Maccauro, G.; D’Arienzo, M.

    1999-01-01

     In the absence of trauma fracture of the acetabulum is an extremely rare injury. We describe a 70 year old man who spontaneously developed fractures in both acetabulae due to bony insufficiency. It was successfully treated by bilateral total hip replacement.

  4. Simultaneous bilateral primary spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Arife Zeybek

    2014-04-01

    Full Text Available Simultaneous bilateral primary pneumothorax is a very rare (1.6 / 100,000 and life-threatening condition. Clinical presentation may vary from mild dyspnea to tension pneumothorax. It may be milder particularly in younger patients, but more severe in patients with advanced age, and tube thoracostomy is a life preserver in the latter group. Since mortality and recurrence rates following tube thoracostomy are high, endoscopic approaches to bilateral hemithorax have been reported in literature. Apical wedge resection and pleural procedures are recommended in video thoracoscopy or mini thoracotomy even if no bulla and/or bleb are detected. Bilateral surgical interventions and additional pleural procedures are associated with increased rate of post-operative complications and longer postoperative hospital-stays. As a first-line approach, the surgical method toward any side of lung with air leakage following a previous tube thoracostomy is considered less invasive, especially in younger patients. Here, we present a case of simultaneous bilateral primary spontaneous pneumothorax (SBPSP in a 21-year old male with no history of smoking and chronic pulmonary disease. A unilateral surgical intervention was performed, and no recurrence was observed during 5-year follow up.

  5. Uterine massage for preventing postpartum haemorrhage.

    Science.gov (United States)

    Hofmeyr, G Justus; Abdel-Aleem, Hany; Abdel-Aleem, Mahmoud A

    2013-07-01

    Postpartum haemorrhage (PPH) (bleeding from the genital tract after childbirth) is a major cause of maternal mortality and disability, particularly in under-resourced areas. In these settings, uterotonics are often not accessible. There is a need for simple, inexpensive techniques which can be applied in low-resourced settings to prevent and treat PPH. Uterine massage is recommended as part of the routine active management of the third stage of labour. However, it is not known whether it is effective. If shown to be effective, uterine massage would represent a simple intervention with the potential to have a major effect on PPH and maternal mortality in under-resourced settings. To determine the effectiveness of uterine massage after birth and before or after delivery of the placenta, or both, to reduce postpartum blood loss and associated morbidity and mortality. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2013). All published, unpublished and ongoing randomised controlled trials comparing uterine massage alone or in addition to uterotonics before or after delivery of the placenta, or both, with non-massage. Two researchers independently considered trials for eligibility, assessed risk of bias and extracted the data using the agreed form. Data were checked for accuracy. The effect of uterine massage commenced before or after placental delivery were first assessed separately, and then the combined for an overall result. This review included two randomised controlled trials. The first trial included 200 women who were randomised to receive uterine massage or no massage following delivery of the placenta, after active management of the third stage of labour including use of oxytocin. The numbers of women with blood loss more than 500 mL was small, with no statistically significant difference (risk ratio (RR) 0.52, 95% confidence interval (CI) 0.16 to 1.67). There were no cases of retained placenta in either group. The mean

  6. Risk factors for incomplete healing of the uterine incision after cesarean section.

    Science.gov (United States)

    Chen, Yan; Han, Ping; Wang, Yi-Jia; Li, Yan-Xia

    2017-08-01

    To analyze related risk factors of post-cesarean scar defects (PCSDs). A retrospective study of full-term women delivered by cesarean with singleton infants at our hospital from April 2014 to December 2015 was performed. 69 cases of diagnosed PCSDs and 107 cases with no PCSD who accepted cesarean were recruited for analysis. Individual medical case and operative report review were retrieved for maternal clinical characteristics analysis. There was no difference in age, gestational age, BMI and baby's weight between the two groups. PCSD group has more cases of anemia, higher neutrophil percentage and more cases of elected cesarean and emergency cesarean than controls (all p cesarean, there were more cases with cervix dilated larger than 3 cm in operation and more cases received cesarean at least one time before. In addition, women with cesarean interval of at least 5 years, women with ultrasonic measured echo longer than 3 cm, women with poor healing in uterine incision, women with retroposition of uterus and women who had intrauterine separation are more prone to develop PCSDs. The occurrence of a defective uterine scar after cesarean section is primarily a by-product of the combination of multiple factors: age ≥30 years, BMI ≥27.30, premature rupture of membranes, elective cesarean section, post-operative anemia, WBC count ≥12.5 × 10 9  g/L and retroposition of uterus. These are high risk factors of PCSDs.

  7. Migraine before rupture of intracranial aneurysms

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Gurary, Natalia M; Sakovich, Vladimir P

    2013-01-01

    Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA.......Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA....

  8. Ruptured Retina Artery Macroaneurysm Presenting with Recurrent ...

    African Journals Online (AJOL)

    A 74-year-old hypertensive presented with recurrent vitreous haemorrhage. Examination showed a ruptured retinal arterial macroaneurysm. Control of systemic hypertension was associated with resolution. Risk factors and management are discussed. Ruptured retinal arterial macroaneurysm should be considered in ...

  9. Spontaneous Achilles tendon rupture in alkaptonuria | Mohammed ...

    African Journals Online (AJOL)

    Spontaneous Achilles tendon ruptures are uncommon. We present a 46-year-old man with spontaneous Achilles tendon rupture due to ochronosis. To our knowledge, this has not been previously reported in Sudan literature. The tendon of the reported patient healed well after debridement and primary repairs.

  10. Spontaneous rupture of choledochal cyst: case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ho Seob; Nam, Kyung Jin; Lee, Jin Hwa; Kim, Chan Sung; Choi, Jong Cheol; Oh, Jong Young [Dong-a University College of Medicine, Pusan (Korea, Republic of)

    2002-11-01

    Spontaneous rupture of a choledochal cyst leading to biliary peritonitis is a rare complication which can be fatal if not promptly diagnosed. The authors report the ultrasound and CT findings of two cases of spontaneous choledochal cystic rupture and the biliary peritonitis which ensued.

  11. Coiling of ruptured pericallosal artery aneurysms.

    NARCIS (Netherlands)

    Menovsky, T.; Rooij, W.J.J. van; Sluzewski, M.; Wijnalda, D.

    2002-01-01

    OBJECTIVE: To assess the technical feasibility of treating ruptured pericallosal artery aneurysms with detachable coils and to evaluate the anatomic and clinical results. METHODS: Over a period of 27 months, 12 patients with a ruptured pericallosal artery aneurysm were treated with detachable

  12. Ruptured hepatoblastoma treated with primary surgical resection

    African Journals Online (AJOL)

    The aim of this study was to review two cases of ruptured hepatoblastoma treated with primary surgical resection. Hepatoblastoma is the most common primary liver malignancy of childhood, although it remains infrequent. A rare, but serious condition is when the tumor presents with spontaneous rupture. This is a ...

  13. Treatment alternative for irreparable rotator cuff ruptures ...

    African Journals Online (AJOL)

    Background: The treatment of massive irreparable rotator cuff rupture has still no consensus among shoulder surgeons. It is assumed that symptomatic rotator cuff tendon rupture is accepted as irreparable if retraction amount of tendon is Patte stage 3 on MRI; degree of fatty atrophy is Goutallier stage 3 or 4; narrowing of ...

  14. Rupture of esophagus by compressed air.

    Science.gov (United States)

    Wu, Jie; Tan, Yuyong; Huo, Jirong

    2016-11-01

    Currently, beverages containing compressed air such as cola and champagne are widely used in our daily life. Improper ways to unscrew the bottle, usually by teeth, could lead to an injury, even a rupture of the esophagus. This letter to editor describes a case of esophageal rupture caused by compressed air.

  15. Uterine sarcoma Part II—Uterine endometrial stromal sarcoma: The TAG systematic review

    Directory of Open Access Journals (Sweden)

    Huann-Cheng Horng

    2016-08-01

    Full Text Available Endometrial stromal tumors are rare uterine tumors (<1%. Four main categories include endometrial stromal nodule, low-grade endometrial stromal sarcoma (LG-ESS, high-grade endometrial stromal sarcoma (HG-ESS, and uterine undifferentiated sarcoma (UUS. This review is a series of articles discussing the uterine sarcomas. LG-ESS, a hormone-dependent tumor harboring chromosomal rearrangement, is an indolent tumor with a favorable prognosis, but characterized by late recurrences even in patients with Stage I disease, suggesting the requirement of a long-term follow-up. Patients with HG-ESS, based on the identification of YWHAE-NUTM2A/B (YWHAE-FAM22A/B gene fusion, typically present with advanced stage diseases and frequently have recurrences, usually within a few years after initial surgery. UUS is, a high-grade sarcoma, extremely rare, lacking a specific line of differentiation, which is a diagnosis of exclusion (the wastebasket category, which fails to fulfill the morphological and immunohistochemical criteria of translocation-positive ESS. Surgery is the main strategy in the management of uterine sarcoma. Due to rarity, complex biological characteristics, and unknown etiology and risk factors of uterine sarcomas, the role of adjuvant therapy is not clear. Only LG-ESS might respond to progestins or aromatase inhibitors.

  16. Effect of uterine arterial embolization on symptomatic uterine fibroids and ovarian function

    Directory of Open Access Journals (Sweden)

    Li Zhang

    2016-04-01

    Full Text Available Objective: To investigate the effect of uterine artery embolization (UAE in the treatment of symptomatic uterine fibroids and the effect on ovarian function. Methods: Clinical data of 20 UAE cases admitted from August 2014 to August 2015 were retrospectively analyzed. They had uterine leiomyoma, and received UAE after menstruation 3-7 d. Seldinger technology was used to puncture the right femoral artery, microspheres was alginated or polyvinyl alcohol particles were injected into the target vessel embolism vascular leiomyoma. Broken Gelfoam embolization of uterine artery was used to stop fibroids blood supply; imaging examination of symptomatic uterine fibroids was performed before and 3 months, 6 months, 12 months after UAE. The volume of uterus myoma volume changes was observed; luteinizing hormone (LH, prolactin (PRL, follicle stimulating hormone (FSH, progesterone (PROG, estradiol (E2 changes were detected before and 3 months, 6 months, 12 months after UAE. Results: Three months, 6 months, 12 months after UAE surgery, all patients were followed up for 3 months. The volume of uterus and tumor volume were significantly reduced, and the degree of reduction was moresignificant (P0.05. Conclusions: UAE has definite efficacy, and it has little effect on ovarian function.

  17. Current status, questions and challenges of transcatheter uterine artery embolization for the treatment of uterine fibroids

    International Nuclear Information System (INIS)

    Chen Xiaoming; Luo Pengfei

    2006-01-01

    Current status, questions and challenges of transcatheter uterine artery embolization (UAE) in the treatment of uterine fibroids were summarized and analysed. It has been proved that UAE presents a good effectiveness in controlling the symptoms and shrinkage of fibroid and uterine volumes during follow-up of 4 to 6.9 years domestically and abroad, but relapse of the fibroid may however occur in 2 years or longer after UAE. Generally speaking, UAE is safe in the treatment of uterine fibroids but has a possibility of serious complications. UAE has no damage on normal uterine tissues but may affect pregnancy and delivery of patients significantly later on the cause of hypoxia and inertia of uterus. UAE may cause amenorrhea in the minority of women with ovarian failure and endometrium atrophy. The current questions are how to improve long-term efficiency to reduce relapse of tumor and to insure the safety of UAE. It is our further task to exploit more new effective and safe embolic agents by using animal and clinical study on the basic knowledge of pathology, pharmacology, biochemistry, endocrinology and molecular biology. (authors)

  18. Ruptured non-communicating rudimentary horn of unicornuate uterus at 14 weeks of pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2013-09-01

    Full Text Available Rudimentary horn is one of the rarest congenital uterine anomalies and consists of a relatively normal appearing uterus on one side with a rudimentary horn on the other side. Pregnancy in the rudimentary horn of the uterus is a rare form of ectopic pregnancy of which most of the patients present in second trimester in haemorrhagic shock and severe anaemia due to rupture. We report a case of ruptured rudimentary horn at 14 weeks of pregnancy with shock and severe anaemia. A 30 yr old G2P1L1 with last child birth 4 yrs back reported to casualty with acute abdominal pain since 3 hrs, bleeding PV and vomiting since one hr. Ultrasound done showed haemoperitoneum with fetus of 14 weeks. Emergency laparotomy was done with excision of the rudimentary horn was done.

  19. Expression and prognostic value of lactate dehydrogenase-A and -D subunits in human uterine myoma and uterine sarcoma.

    Science.gov (United States)

    Song, Ke-Juan; Yu, Xiao-Ni; Lv, Teng; Chen, Yu-Long; Diao, Yu-Chao; Liu, Su-Li; Wang, Yan-Kui; Yao, Qin

    2018-04-01

    This study aimed to determine the expression of lactate dehydrogenase (LDH)-A and LDH-D in patients with uterine myoma, cellular leiomyoma (CLM), and uterine sarcoma and to evaluate their prognostic significance. Protein expression levels of LDH-A and LDH-D were determined in tissue samples from 86 patients (26 uterine myoma, 10 CLM, 50 uterine sarcoma) by immunohistochemistry and their associations with clinicopathologic parameters and outcomes were analyzed in patients with uterine sarcoma. The positivity rates for LDH-A and LDH-D were significantly higher in patients with uterine sarcoma compared with those with uterine myoma or CLM (P sarcoma were classified as having uterine leiomyosarcoma (LMS), malignant endometrial stromal sarcoma, and malignant mixed Mullerian tumor, with 5-year overall survival rates of 59%, 71%, and 29%, respectively (P sarcoma. Furthermore, the overexpressions of LDH-A and LDH-D in uterine sarcoma patients may contribute to further understanding of the mechanism of LDH in tumor metabolism in uterine sarcoma. Positive expression of LDH-A in patients with LMS may act as a potential prognostic biomarker in these patients.

  20. Radiation therapy of the uterine cancer

    International Nuclear Information System (INIS)

    Noguchi, Hiroshi

    1999-01-01

    Cervical and endometrial cancer of the uterus, and ovarian cancer are three major malignant diseases in gynecology in Japan. These diagnosis and therapy are almost established. In uterine cervical cancer, radiation therapy and surgery of these diseases are two main treatment methods, and both treatment results are almost the same. And radiation therapy is also used as postoperative treatment to patients with high risk factors. In endometrial cancer, surgery is main therapy. Radiation therapy is undergone only to medically inoperable cases preoperative radiation is widely carried out in Europe and America, but almost none in Japan. Postoperative irradiation is adapted to the cases with high risk factors. But recent advance of chemotherapy changes the importance of radiation therapy in such patients. I review the literatures of radiation therapy of uterine cervical cancer and of endometrial cancer. (author)

  1. Uterine artery embolization for cervical ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Qiao Zhou, MD

    2015-12-01

    Full Text Available A 36-year-old woman with 3 prior C-sections is diagnosed with a caesarean scar ectopic pregnancy. Despite receiving intramuscular and transvaginal methotrexate injection 2 months before presentation, the beta human chorionic gonadotropin was recorded to be 73 mIU/mL at the time of encounter. The patient complained of vaginal bleeding with a significant drop in hematocrit from 40% to 33%. Transvaginal ultrasound confirmed retroplacental hemorrhage and because of the patient's desire to retain fertility, interventional radiology was consulted to perform an uterine artery embolization. The uterine artery embolization was successful in achieving hemostasis and resulted in a decrease of betaHCG to 46 on postprocedure day 1 to <1 mIU/mL by postoperative week 3.

  2. Uterine fibroids: clinical manifestations and contemporary management.

    Science.gov (United States)

    Doherty, Leo; Mutlu, Levent; Sinclair, Donna; Taylor, Hugh

    2014-09-01

    Uterine fibroids (leiomyomata) are extremely common lesions that are associated with detrimental effects including infertility and abnormal uterine bleeding. Fibroids cause molecular changes at the level of endometrium. Abnormal regulation of growth factors and cytokines in fibroid cells may contribute to negative endometrial effects. Understanding of fibroid biology has greatly increased over the last decade. Although the current armamentarium of Food and Drug Administration-approved medical therapies is limited, there are medications approved for use in heavy menstrual bleeding that can be used for the medical management of fibroids. Emergence of the role of growth factors in pathophysiology of fibroids has led researchers to develop novel therapeutics. Despite advances in medical therapies, surgical management remains a mainstay of fibroid treatment. Destruction of fibroids by interventional radiological procedures provides other effective treatments. Further experimental studies and clinical trials are required to determine which therapies will provide the greatest benefits to patients with fibroids. © The Author(s) 2014.

  3. MRI of tibialis anterior tendon rupture

    International Nuclear Information System (INIS)

    Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.

    2004-01-01

    Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)

  4. Triple Achilles Tendon Rupture: Case Report.

    Science.gov (United States)

    Saxena, Amol; Hofer, Deann

    We present a case report with 1-year follow-up data of a 57-year-old male soccer referee who had sustained an acute triple Achilles tendon rupture injury during a game. His triple Achilles tendon rupture consisted of a rupture of the proximal watershed region, a rupture of the main body (mid-watershed area), and an avulsion-type rupture of insertional calcific tendinosis. The patient was treated surgically with primary repair of the tendon, including tenodesis with anchors. Postoperative treatment included non-weightbearing for 4 weeks and protected weightbearing until 10 weeks postoperative, followed by formal physical therapy, which incorporated an "antigravity" treadmill. The patient was able to return to full activity after 26 weeks, including running and refereeing, without limitations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Ruptured gastroepiploic artery aneurysm: A case report

    Directory of Open Access Journals (Sweden)

    Ahmad S. Ashrafi

    Full Text Available Introduction: Gastroepiploic artery aneurysms are extremely rare, with few reported cases in the literature. The risk of rupture however, is high and thus warrants attention. Presentation of case: Here we present a rare case of a women who presented to the emergency department in shock and was found to have a ruptured gastroepiploic artery aneurysm during surgical exploration. Suture ligation of the aneurysm was completed. Discussion: Although rare, gastroepiploic artery aneurysms have up to a 90% rate of rupture and therefore require intervention. A laparoscopic approach has been described however, in cases where rupture has occurred, urgent laparotomy and control of hemorrhage is needed. Conclusion: We describe a rare case of a ruptured gastroepiploic aneurysm that was successfully managed with urgent laparotomy and aneurysmal resection. Keywords: Gastroepiploic, Aneurysm, Hemorrhage, Case report

  6. Tocolysis after preterm premature rupture of membranes and neonatal outcome: a propensity-score analysis.

    Science.gov (United States)

    Lorthe, Elsa; Goffinet, François; Marret, Stéphane; Vayssiere, Christophe; Flamant, Cyril; Quere, Mathilde; Benhammou, Valérie; Ancel, Pierre-Yves; Kayem, Gilles

    2017-08-01

    There are conflicting results regarding tocolysis in cases of preterm premature rupture of membranes. Delaying delivery may reduce neonatal morbidity because of prematurity and allow for prenatal corticosteroids and, if necessary, in utero transfer. However, that may increase the risks of maternofetal infection and its adverse consequences. The objective of the study was to investigate whether tocolytic therapy in cases of preterm premature rupture of membranes is associated with improved neonatal or obstetric outcomes. Etude Epidémiologique sur les Petits Ages Gestationnels 2 is a French national prospective, population-based cohort study of preterm births that occurred in 546 maternity units in 2011. Inclusion criteria in this analysis were women with preterm premature rupture of membranes at 24-32 weeks' gestation and singleton gestations. Outcomes were survival to discharge without severe morbidity, latency prolonged by ≥48 hours and histological chorioamnionitis. Uterine contractions at admission, individual and obstetric characteristics, and neonatal outcomes were compared by tocolytic treatment or not. Propensity scores and inverse probability of treatment weighting for each woman were used to minimize indication bias in estimating the association of tocolytic therapy with outcomes. The study population consisted of 803 women; 596 (73.4%) received tocolysis. Women with and without tocolysis did not differ in neonatal survival without severe morbidity (86.7% vs 83.9%, P = .39), latency prolonged by ≥48 hours (75.1% vs 77.4%, P = .59), or histological chorioamnionitis (50.0% vs 47.6%, P = .73). After applying propensity scores and assigning inverse probability of treatment weighting, tocolysis was not associated with improved survival without severe morbidity as compared with no tocolysis (odds ratio, 1.01 [95% confidence interval, 0.94-1.09], latency prolonged by ≥48 hours (1.03 [95% confidence interval, 0.95-1.11]), or histological chorioamnionitis

  7. Isotope applications on uterine cervix cancer

    International Nuclear Information System (INIS)

    Pinto, A.C.L.C.; Vigna Filho, E. del

    1978-01-01

    Techniques for the treatment of uterine cervix carcinoma are presented with isotopes used in the Instituto de Radioterapia Geral e Megavoltagem de Minas Gerais - Belo Horizonte (Brazil). Gynecological applicators, dosimetry care, diagnostic methods, stage and treatment are described that are the same as in the M.D. Anderson Hospital and Tumor Institute, Houston, Texas. The need for the use of 'After-loading' methods is emphasized, as well as radium substitutes, mainly Cs-137 and accurate dosimetry [pt

  8. Uterine Necrosis Associated with Fusobacterium necrophorum Infection

    Directory of Open Access Journals (Sweden)

    T. Widelock

    2015-01-01

    Full Text Available Fusobacterium necrophorum is infrequently implicated as a pathogenic organism. When pathogenic, the typical clinical presentation is that of pharyngitis, cervical adenopathy, and unilateral thrombophlebitis of the internal jugular vein. Infections caused by Fusobacterium necrophorum within the fields of obstetrics and gynecology have been infrequently reported. We describe a 19-year-old woman who underwent a cesarean delivery complicated by sepsis and purulent uterine necrosis secondary to Fusobacterium necrophorum infection.

  9. Rupture of the meniscofibular ligament

    Directory of Open Access Journals (Sweden)

    Poyanli Oguz

    2010-05-01

    Full Text Available Abstract The meniscofibular ligament is an anatomically defined ligament of the knee in humans. However, there are no data regarding the prognosis following injury to this ligament. Our case was a 42-year-old man who presented at our clinic with pain of the lateral side of his left knee. MRI of his left knee revealed the rupture of the meniscofibular ligament. The mechanism of injury was consistent with anatomical and mechanical studies of the meniscofibular ligament. The patient was treated conservatively for 1 year, but his pain did not resolve completely. A case series of patients with the same injury is required to establish an effective treatment for this rare injury.

  10. Achilles tendon rupture in athletes.

    Science.gov (United States)

    Deangelis, Joseph P; Wilson, Kristina M; Cox, Charles L; Diamond, Alex B; Thomson, A Brian

    2009-01-01

    Achilles tendon ruptures commonly affect middle-aged athletes and can result in considerable functional impairment. While the cause is multifactorial, the greatest risk is present for athletes involved in sports that involve sudden acceleration and deceleration. A thorough history and physical examination can accurately yield a diagnosis, but when question remains, magnetic resonance imaging is superior to ultrasound-guided evaluation. The best evidence available suggests that operative treatment has a lower rate of rerupture, a higher rate of return to the same level of sport participation, and a higher complication rate, if an open technique is used. Percutaneous methods of fixation have lower complication rates without an increase in the rate of rerupture when compared with open methods. Augmentation of an Achilles tendon repair has demonstrated no clinical benefit. Rehabilitation with early mobilization leads to improved patient-reported outcomes.

  11. Earthquake lights and rupture processes

    Directory of Open Access Journals (Sweden)

    T. V. Losseva

    2005-01-01

    Full Text Available A physical model of earthquake lights is proposed. It is suggested that the magnetic diffusion from the electric and magnetic fields source region is a dominant process, explaining rather high localization of the light flashes. A 3D numerical code allowing to take into account the arbitrary distribution of currents caused by ground motion, conductivity in the ground and at its surface, including the existence of sea water above the epicenter or (and near the ruptured segments of the fault have been developed. Simulations for the 1995 Kobe earthquake were conducted taking into account the existence of sea water with realistic geometry of shores. The results do not contradict the eyewitness reports and scarce measurements of the electric and magnetic fields at large distances from the epicenter.

  12. Superpixel Convolutional Networks using Bilateral Inceptions

    OpenAIRE

    Gadde, Raghudeep; Jampani, Varun; Kiefel, Martin; Kappler, Daniel; Gehler, Peter V.

    2015-01-01

    In this paper we propose a CNN architecture for semantic image segmentation. We introduce a new 'bilateral inception' module that can be inserted in existing CNN architectures and performs bilateral filtering, at multiple feature-scales, between superpixels in an image. The feature spaces for bilateral filtering and other parameters of the module are learned end-to-end using standard backpropagation techniques. The bilateral inception module addresses two issues that arise with general CNN se...

  13. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte

    2015-01-01

    The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...... performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery...

  14. Bilateral Primary Lacrimal Gland Lymphoma

    Directory of Open Access Journals (Sweden)

    Kürşad Ramazan Zor

    2016-12-01

    Full Text Available Lymphoma involving the lacrimal gland is rare. Most of the cases are unilateral at presentation. In this case, we present the diagnostic evaluation of a patient with bilateral lacrimal gland lymphoma. At presentation, the patient had inferomedial eccentric proptosis of the right eye. The patient also had limitation in the upper and lateral gaze in this eye. On magnetic resonance imaging, a mass was detected not only in the right but also in the left eye corresponding to the area of the lacrimal gland. Excisional biopsy was performed in the right eye with lateral orbitotomy approach. Histopathological examination revealed extranodal marginal zone lymphoma involving the lacrimal gland. No concurrent systemic lymphoma was detected during systemic evaluation of the patient. The patient was directed to the oncology department for systemic treatment planning. In conclusion, bilateral involvement is rare in lacrimal gland diseases but it can show severe diseases like lymphoma.

  15. Uterine disorders and pregnancy complications: insights from mouse models

    OpenAIRE

    Lim, Hyunjung Jade; Wang, Haibin

    2010-01-01

    Much of our knowledge of human uterine physiology and pathology has been extrapolated from the study of diverse animal models, as there is no ideal system for studying human uterine biology in vitro. Although it remains debatable whether mouse models are the most suitable system for investigating human uterine function(s), gene-manipulated mice are considered by many the most useful tool for mechanistic analysis, and numerous studies have identified many similarities in female reproduction be...

  16. Uterine cancer in the writings of ancient Greek physicians.

    Science.gov (United States)

    Tsoucalas, Gregory; Karamanou, Marianna; Sgantzos, Markos; Deligeoroglou, Efthimios; Androutsos, George

    2015-01-01

    In this article, we present the views on uterine cancer of the ancient Greek physicians. We emphasize on uterine's cancer aetiology according to the dominant in antiquity humoural theory, on its surgical treatment suggested by Soranus of Ephesus, and in the vivid description provided by Aretaeus of Cappadocia. During that period, uterine cancer was considered as an incurable and painful malignancy and its approach was mainly palliative.

  17. BILATERAL SINGLE SESSION URETEROSCOPY FOR URETERAL ...

    African Journals Online (AJOL)

    Objectives: To determine the feasibility, safety and success rate of bilateral single session rigid retrograde ureteroscopy (URS) for bilateral ureteral calculi. Patients and Methods: Thirty-five patients underwent bilateral single session ureteroscopic calculus removal. Results: Out of 70 renal units in 35 patients treated, ...

  18. A Case of Live Birth after Uterine Reconstruction for Recurrent Cornual Ectopic Pregnancy following IVF Treatment

    Directory of Open Access Journals (Sweden)

    Deivanayagam Maruthini

    2013-01-01

    Full Text Available We present a case of recurrent ruptured right cornual ectopic pregnancies conceived after IVF. Following the second episode, a sonohysterography was undertaken to identify possible areas of scar weakness that may rupture with uterine distension in a future pregnancy. The scan revealed asymmetrical muscle thickness in the cornual regions, the right (6 mm being thinner than the left (1.6 cm. Subsequently, an elective laparotomy was undertaken, and the cornua were reconstructed and thickened in several layers by bringing the laterally retracted myometrial fibres onto the reconstruction site. A sono-hysterography after surgery showed satisfactory (3-4 cm myometrial thickness all around. A further cycle of IVF resulted in a singleton pregnancy. Pelvic scans confirmed normal intrauterine pregnancy without any myometrial thinning. She was delivered by an uneventful elective caesarean section at term. We propose that, in those who intend to have further pregnancies after a cornual ectopic pregnancy, a sono-hysterography is possibly the best investigative tool to assess myometrial integrity. This case demonstrates that in women with areas of muscle weakness it is possible to successfully perform an interval elective reconstructive surgery on the uterus that can result in an uneventful pregnancy and birth.

  19. Bilateral Stereotactic Thalamotomy for Bilateral Musician's Hand Dystonia.

    Science.gov (United States)

    Horisawa, Shiro; Goto, Shinichi; Nakajima, Takeshi; Kawamata, Takakazu; Taira, Takaomi

    2016-08-01

    Focal hand dystonia in musicians, also known as musician's dystonia, is a task-specific movement disorder characterized by unwanted involuntary muscle contractions occurring only when playing a musical instrument. Case 1 was a 50-year-old female professional pianist who underwent staged bilateral ventro-oral (Vo) thalamotomy, with an interval between the first and second surgery of 4 years. The first surgery (right Vo thalamotomy) led to significant improvements in dystonic symptoms without any complications. Pre- and postoperative Tubiana's musician's dystonia scale (TMDS) scores were 2 and 5, respectively. The second surgery (left Vo thalamotomy) also led to significant improvements in dystonic symptoms, with dysarthria and verbal recall disturbance resolving within 3 months. Pre- and postoperative TMDS scores were 2 and 5, respectively. The patient was subsequently able to return to live-stage performances. Case 2 was a 48-year-old male clarinet repair technician who underwent staged bilateral Vo thalamotomy, with an interval between the first and second surgery of 13 months. The first surgery (right Vo thalamotomy) led to dramatic improvements in symptoms without any complications. Pre- and postoperative TMDS scores were 2 and 5, respectively. The second surgery (left Vo thalamotomy) also led to significant improvements in symptoms with transient hypophonia. Pre- and postoperative TMDS scores were 2 and 5, respectively. The patient was subsequently able to return to work without difficulty. The findings in these 2 cases indicate the utility of bilateral stereotactic Vo thalamotomy in the treatment of medically intractable musician's dystonia affecting both hands. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. One-stage bilateral anterior cruciate ligament reconstruction with use of hamstring tendon autografts: a case report

    Directory of Open Access Journals (Sweden)

    Matjaž Sajovic

    2007-12-01

    Full Text Available Background: Bilateral ACL rupture is not a common clinical problem, but the incidence of the bilateral knee injuries is increasing especially within highly sports active population. Mechanism of the injury rarely causes simultaneous bilateral ACL tear. Usually unilateral injury of the knee has occurred and later on contralateral injury has taken place.Patient and methods: Case report presented an unusual problem of a patient with chronic bilateral ACL – deficient knees and constitutionally very thin patellar tendons. Author decided to perform onestage bilateral ACL reconstructions using hamstring tendon autographs so as not too weaken his quadriceps muscles by compromising his extensor mechanism.Results: At three years follow-up the patient’s opinion was that both ACL reconstructed knees had normal function, and he had returned to his preinjury activity level. The overall result of the Lysholm knee score for left knee was 100 and for right one 95. Both knees had full range of motion, Lachman and pivot shift signs were negative.Conclusions: Two-stage bilateral ACL reconstruction is much more time consuming for the patient and expensive for health insurance, so one-stage bilateral ACL reconstruction is a logical solution of the problem.

  1. The influence of adjuvant radiotherapy on patterns of failure and survivals in uterine carcinosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hae Jin; Kim, Hak Jae; Wu, Hong Gyun; Kim, Hans; Ha, Sung Whan; Kang, Soon Beom; Song, Yong Sang; Park, Noh Hyun; Kim, Jae Won [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery. Between October 1998 and August 2010, 19 patients with stage I?III uterine carcinosarcoma received curative hysterectomy and bilateral salpingo-oophorectomy with or without PORT at Seoul National University Hospital. Their hospital medical records were retrospectively reviewed. PORT and non-PORT groups included 11 and 8 patients, respectively. They were followed for a mean of 22.7 months (range, 7.8 to 126.6 months). At 5 years, the overall survival rates were 51.9% for entire, 61.4% for PORT, and 41.7% for non-PORT groups, respectively. There was no statistical difference between PORT and non-PORT groups with regard to overall survival (p = 0.682). Seven out of 19 (36.8%) patients showed treatment failures, which all happened within 12 months. Although the predominant failures were distant metastasis in PORT group and loco-regional recurrence in non-PORT group, there was no statistically significant difference in loco-regional recurrence-free survival (LRRFS) (p = 0.362) or distant metastasis-free survival (DMFS) (p = 0.548). Lymph node metastasis was found to be a significant prognostic factor in predicting poor LRRFS (p = 0.013) and DMFS (p = 0.021), while the International Federation Gynecology and Obstetrics (FIGO) stage (p = 0.043) was associated with LRRFS. Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients.

  2. Axillary lymph nodes siliconoma in a woman with intracapsular implant rupture

    International Nuclear Information System (INIS)

    Plachkov, I.; Cvetankov, K.; Hadjidekov, G.

    2013-01-01

    Full text: Introduction: Siliconoma, or silicone granuloma is the migration of silicon particles in the axillary lymph nodes, muscle and other non- ruptured or intact silicone implant. The latter is a relatively rare finding, and usually occurs in patients with extracapsular rupture of silicone prosthesis and has a typical ultrasound image. We present a case of a young woman with bilateral silicone prostheses placed 5 years ago, where in the right axilla are enlarged, structurally altered lymph nodes in the clinical and ultrasonography studies. Subsequent magnetic resonance examination shows intracapsular rupture ipsilateral silicone prosthesis and migration of silicon particles in the axillary lymph nodes. What you will learn: In this case we present twenty-three year old woman who reported pain and ‘swelling’ in the right axilla. The patient is with bilateral silicone prosthesis, she is not febrile and not reported other illness. After physical examination enlarged and tender lymph nodes in the right axilla was found. Several structurally altered and enlarged lymph nodes were visualized by ultrasound. These lymph nodes are hypoechogenic with obliterated fatty hilus. Due to the suspicion of silicone ‘extravasation’ in axillary lymph nodes, a magnetic resonance study of both mammary glands was performed. The images show intracapsular rupture of the right prosthesis without reliable data on silicone gel outside the fibrous capsule. Discussion: Siliconoma is a complication after plastic surgery of the breast and can affect both the axillary lymph nodes, and other lymphatic chains and also muscle and lung. Most frequently it occurs at damage of the extracapsular silicone prostheses. More rarely siliconoma occurs in siliconoma intracapsular damage, as in the presented case or in a silicone gel microbleed. Conclusion: The presence of siliconoma in axillary lymph nodes is relatively rare complication in plastic surgery of the breast. Methods of imaging diagnostic

  3. Efficacy of transcatheter uterine artery embolization for treating emergency hemorrhage obstetrics and gynecology

    International Nuclear Information System (INIS)

    Li Hongwei

    2011-01-01

    Objective: To evaluate the efficacy of selective iliac artery embolization (TAE) or uterine artery embolization (UAE) for treatment of emergency hemorrhage in obstetrics and gynecology. Methods: Selective bilateral TAE or UAE were performed on 59 patients with acute cervical hemorrhage from postpartum hemorrhage (30), cervical cancer (16), endometrial cancer (8), and choriocarcinoma (5). Gelfoam particles were used in postpartum hemorrhage; chemotherapeutics and Iodipin suspension were used in malignancy. Results: Bleeding was stopped completely in all 59 patients with TAE or UAE procedure time of 30-50 minutes (mean: 42.17±4.78 minutes). There were no serious complications. Conclusion: TAE or UAE are effective for treating emergency hemorrhage in obstetrics and gynecology. (authors)

  4. Patellar tendon: From tendinopathy to rupture

    Directory of Open Access Journals (Sweden)

    Federica Rosso

    2015-10-01

    Full Text Available Patellar tendinopathy is very common in patients complaining of anterior knee pain. Its aetiology is still unclear, but neovascularisation seems to play a role. Different treatments have been proposed overtime, from rehabilitation to platelet-rich-plasma injections, but there is no agreement on the best treatment protocol. The final stage of patellar tendinopathy is patellar tendon rupture. In these cases surgical treatment is often required. The aim of this literature review is to focus on the aetiology, diagnosis, and treatment of both patellar tendinopathy and rupture. We report the conservative treatments proposed for patellar tendinopathy and the surgical techniques described for its rupture.

  5. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    Science.gov (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  6. Uterine Artery Embolization: A Systematic Review of the Literature and Proposal for Research

    National Research Council Canada - National Science Library

    Broder, Michael

    1999-01-01

    .... The objective of this project was to review and synthesize the existing literature on a minimally invasive technique for reducing symptoms from uterine leiomyomata, uterine artery embolization (UAE...

  7. Complications and Reinterventions in Uterine Artery Embolization for Symptomatic Uterine Fibroids: A Literature Review and Meta Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Jason, E-mail: Jason.martin@medportal.ca; Bhanot, Kunal, E-mail: Kunal.Bhanot@medportal.ca [Michael G. DeGroote School of Medicine, McMaster University (Canada); Athreya, Sriharsha, E-mail: harshavbs@yahoo.com [St. Joseph' s Health Care Hamilton, McMaster University, Faculty of Health Sciences (Canada)

    2013-04-15

    To perform a literature review of the spectrum of complications associated with UAE relative to surgery and compare the risk of reintervention as well as minor, major, and overall complications. Literature review was conducted in PubMed, MEDLINE, Cochrane, and CINAHL databases, and meta-analysis was performed. In randomized clinical trials, common complications were discharge and fever (4.00 %), bilateral uterine artery embolization (UAE) failure (4.00 %), and postembolization syndrome (2.86 %). Two trials showed a significantly decreased risk in major complications with UAE, with odds ratios (ORs) of 0.07143 (0.009426-0.5413) and 0.5196 (0.279-0.9678). None of the trials showed a significant difference in OR for minor complications of UAE. None of the trials showed a significant difference in risk for overall complications of UAE. Three trials showed a significantly increased risk for reintervention with UAE with ORs of 10.45 (2.654-41.14), 2.679 (1.289-5.564), and 9.096 (1.269-65.18). In 76 nonrandomized studies, common complications were amenorrhea (4.26 %), pain (3.59 %), and discharge and fever (3.37 %). In 41 case studies, common complications were discharge and fever (n = 22 cases), repeat UAE (n = 6 cases), and fibroid expulsion (n = 5 cases). Overall, UAE has a significantly lower rate of major complications relative to surgery, but it comes at the cost of increased risk of reintervention in the future. Educating patients about the rate and types of complications of UAE versus surgery, as well as the potential for reintervention, should help the patient and clinician come to a reasoned decision.

  8. Complications and Reinterventions in Uterine Artery Embolization for Symptomatic Uterine Fibroids: A Literature Review and Meta Analysis

    International Nuclear Information System (INIS)

    Martin, Jason; Bhanot, Kunal; Athreya, Sriharsha

    2013-01-01

    To perform a literature review of the spectrum of complications associated with UAE relative to surgery and compare the risk of reintervention as well as minor, major, and overall complications. Literature review was conducted in PubMed, MEDLINE, Cochrane, and CINAHL databases, and meta-analysis was performed. In randomized clinical trials, common complications were discharge and fever (4.00 %), bilateral uterine artery embolization (UAE) failure (4.00 %), and postembolization syndrome (2.86 %). Two trials showed a significantly decreased risk in major complications with UAE, with odds ratios (ORs) of 0.07143 (0.009426–0.5413) and 0.5196 (0.279–0.9678). None of the trials showed a significant difference in OR for minor complications of UAE. None of the trials showed a significant difference in risk for overall complications of UAE. Three trials showed a significantly increased risk for reintervention with UAE with ORs of 10.45 (2.654–41.14), 2.679 (1.289–5.564), and 9.096 (1.269–65.18). In 76 nonrandomized studies, common complications were amenorrhea (4.26 %), pain (3.59 %), and discharge and fever (3.37 %). In 41 case studies, common complications were discharge and fever (n = 22 cases), repeat UAE (n = 6 cases), and fibroid expulsion (n = 5 cases). Overall, UAE has a significantly lower rate of major complications relative to surgery, but it comes at the cost of increased risk of reintervention in the future. Educating patients about the rate and types of complications of UAE versus surgery, as well as the potential for reintervention, should help the patient and clinician come to a reasoned decision.

  9. Long-Lasting Response to Trabectedin in a Patient with Metastatic Uterine Leiomyosarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Viktoria-Anna Nteli

    2018-02-01

    Full Text Available Background: Uterine leiomyosarcoma (uLMS is a rare tumor that accounts for 1% of all uterine malignancies. In spite of adequate surgical resection of uLMS, even in the early stage, patients remain at high risk for local and distant recurrence. Therefore, the treatment of advanced uLMS represents a considerable challenge. Methods: We report the case of a 47-year-old woman who presented with uLMS with abnormal vaginal bleeding. Results: The patient underwent a total hysterectomy and bilateral adnexectomy, which was followed by 1 year progression-free survival without adjuvant therapy. Thereafter, new lung metastases and local progression at the vaginal stump were observed. Chemotherapy with ifosfamide and doxorubicin was administered. However, after 4 cycles, a CT scan revealed disease progression in the lung metastases. Subsequently, the patient was treated with trabectedin at a dose of 1.5 mg/m2 for 6 cycles resulting in complete remission of the lung metastases as well as partial remission of the mass in the vaginal stump after 9 cycles of trabectedin. The patient is currently on maintenance therapy with trabectedin and has no recurrence. Conclusion: Trabectedin seems to be an efficient option for patients with uLMS as demonstrated by a long-lasting response in a pretreated patient with an acceptable safety profile with no signs of cumulative toxicity.

  10. Ovarian Artery: Angiographic Appearance, Embolization and Relevance to Uterine Fibroid Embolization

    International Nuclear Information System (INIS)

    Pelage, J.P.; Walker, W.J.; Le Dref, O.; Rymer, R.

    2003-01-01

    Purpose: To describe the angiographic appearance of the ovarian artery and its main variations that may be relevant to uterine fibroid embolization. Methods: The flush aortograms of 294 women who had been treated by uterine artery embolization for fibroids were reviewed. Significant arterial supply to the fibroid, and the origin and diameter of identified ovarian arteries were recorded. In patients with additional embolization of the ovarian artery, the follow-up evaluation also included hormonal levels and Doppler imaging of the ovaries. Results: A total of 75 ovarian arteries were identified in 59 women (bilaterally in 16 women and unilaterally in 43 women). All ovarian arteries originated from the aorta below the level of the renal arteries with a characteristic tortuous course. Fifteen women had at least one enlarged ovarian artery supplying the fibroids. Fourteen women (14/15, 93%) presented at least one of the following factors: prior pelvic surgery, tubo-ovarian pathology or large fundal fibroids. Conclusion: We advocate the use of flush aortography in women with prior tubo-ovarian pathology or surgery or in cases of large fundal fibroids. In the case of an ovarian artery supply to the fibroids, superselective catheterization and embolization of the ovarian artery should be considered

  11. Patient, Physician, and Nurse Factors Associated With Entry Onto Clinical Trials and Finishing Treatment in Patients With Primary or Recurrent Uterine, Endometrial, or Cervical Cancer

    Science.gov (United States)

    2016-10-26

    Recurrent Cervical Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Uterine Corpus Cancer; Stage I Uterine Sarcoma; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Uterine Sarcoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Uterine Sarcoma; Stage IV Uterine Corpus Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  12. Real-Time Detection of Rupture Development: Earthquake Early Warning Using P Waves From Growing Ruptures

    Science.gov (United States)

    Kodera, Yuki

    2018-01-01

    Large earthquakes with long rupture durations emit P wave energy throughout the rupture period. Incorporating late-onset P waves into earthquake early warning (EEW) algorithms could contribute to robust predictions of strong ground motion. Here I describe a technique to detect in real time P waves from growing ruptures to improve the timeliness of an EEW algorithm based on seismic wavefield estimation. The proposed P wave detector, which employs a simple polarization analysis, successfully detected P waves from strong motion generation areas of the 2011 Mw 9.0 Tohoku-oki earthquake rupture. An analysis using 23 large (M ≥ 7) events from Japan confirmed that seismic intensity predictions based on the P wave detector significantly increased lead times without appreciably decreasing the prediction accuracy. P waves from growing ruptures, being one of the fastest carriers of information on ongoing rupture development, have the potential to improve the performance of EEW systems.

  13. Hydraulic bilateral construction robot; Yuatsushiki bilateral kensetsu robot

    Energy Technology Data Exchange (ETDEWEB)

    Maehata, K.; Mori, N. [Kayaba Industry Co. Ltd., Tokyo (Japan)

    1999-05-15

    Concerning a hydraulic bilateral construction robot, its system constitution, structures and functions of important components, and the results of some tests are explained, and the researches conducted at Gifu University are described. The construction robot in this report is a servo controlled system of a version developed from the mini-shovel now available in the market. It is equipped, in addition to an electrohydraulic servo control system, with various sensors for detecting the robot attitude, vibration, and load state, and with a camera for visualizing the surrounding landscape. It is also provided with a bilateral joy stick which is a remote control actuator capable of working sensation feedback and with a rocking unit that creates robot movements of rolling, pitching, and heaving. The construction robot discussed here, with output increased and response faster thanks to the employment of a hydraulic driving system for the aim of building a robot system superior in performance to the conventional model designed primarily for heavy duty, proves after tests to be a highly sophisticated remotely controlled robot control system. (NEDO)

  14. Arterial hemorrhage from cesarean scar: a rare cause of recurring massive uterine bleeding and successful surgical management.

    Science.gov (United States)

    Wang, Chun-Feng; Hu, Min

    2015-02-01

    Abnormal uterine bleeding and other gynecologic complications associated with a previous cesarean section scar are only recently being identified and described. Herein we report a rare case of a woman with recurring massive uterine bleeding after 2 cesarean sections. Curettage and hormone therapy were unsuccessfully used in an attempt to control the bleeding. After she was transferred to our hospital, she had another episode of vaginal bleeding that was successfully managed with oxytocin and hemostatic. Diagnostic hysteroscopy performed under anesthesia revealed an abnormal transected artery in the cesarean section scar with a thrombus visible. In the treatment at the beginning of laparoscopic management, we adopted temporary bilateral uterine artery occlusion with titanium clips to prevent massive hemorrhage. Secondly, with the aid of hysteroscopy, the bleeding site was opened, and then the cesarean scar was wedge resected and stitched interruptedly with 1-0 absorbable sutures. The postoperative recovery was uneventful. It would seem that the worldwide use of cesarean section delivery may contribute to the risk of gynecologic disturbances including some unrecognized and complex conditions as seen in this case. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  15. Advanced papillary serous carcinoma of the uterine cervix: a case with a remarkable response to paclitaxel and carboplatin combination chemotherapy

    Directory of Open Access Journals (Sweden)

    Tomoyuki Shirase

    2012-01-01

    Full Text Available Papillary serous carcinoma of the uterine cervix (PSCC is a very rare tumor, and is a recently described variant of cervical adenocarcinoma. We experienced a case of stage IV PSCC. The main tumor existed in the uterine cervix and invaded one third of the inferior part of the anterior and posterior vaginal walls. Furthermore, it had metastasized from the para-aortic lymph nodes to bilateral neck lymph nodes. Immnoreactivity for CA125 was positive, whereas the staining for p53 and WT-1 were negative in both the original tumor and the metastatic lymph nodes. We administered six courses of paclitaxel and carboplatin combination chemotherapy against this advanced PSCC. The PSCC therefore dramatically decreased in size. The main tumor of the uterine cervix showed a complete response by magnetic resonance imaging (MRI, and more than 95% of the tumor cells in the cervix had microscopically disapperared. This is the first report of PSCC in which combination chemotherapy was used and showed a remarkable response.

  16. Uterine fibroid embolization efficacy and safety: 15 years experience in an elevated turnout rate center.

    Science.gov (United States)

    Di Stasi, Carmine; Cina, Alessandro; Rosella, Francesco; Paladini, Andrea; Amoroso, Sonia; Romualdi, Daniela; Manfredi, Riccardo; Colosimo, Cesare

    2018-01-22

    To evaluate effectiveness and safety of UFE as alternative to surgery, in treatment of uterine fibromatosis. 255 patients (aged 26-55) with symptomatic UF, indication for surgery, followed in our center (2000-2014), single or multiple fibroids, pain and/or functional/compressive disorders, underwent embolization: injection of PVA particles (150-900 μm) from distal portion of uterine arteries (ascending section). Primary end-point: flow-stop distally to injection site, disappearance of lesion design, preservation of flow in main trunk of UA. Secondary end-point: control of pain and functional/compressive disorders during follow-up (2-7 years). Procedure was performed bilaterally in 250 patients (98%). Mean duration: 47 min (average fluoroscopy: 10:50 min). Post-embolization pelvic pain (according with VAS score) was on average 2.2 at discharge (24 h). Follow-up at 2 years: resolution of menstrual disorders in 78% of patients and improvement in 14%; pain disappeared in 66%; significant improvement of menstrual flow and HCT/HB levels, decrease in total uterine (57.7%)/dominant fibroid (76.1%) volume. Recurrence in 18 patients. UFE represents an excellent alternative to surgical treatment: it is safe, tolerable and effective both in short and long term, with evident advantages in economic and social terms.

  17. Spontaneous second-trimester ruptured pregnancy of rudimentary horn: a case report in Yaounde, Cameroon.

    Science.gov (United States)

    Fouelifack, Florent Ymele; Fouogue, Jovanny Tsuala; Messi, John Owoudou; Kamga, Danielle Tiako; Fouedjio, Jeanne Hortence; Sando, Zacharie

    2014-01-01

    Rudimentary uterine horn pregnancy is rare and, to our knowledge, has not been previously reported in Cameroon. We herein report the case of a 22 year old second gravida referred for acute abdominal pain at 17 weeks of gestation. Physical examination revealed hemoperitoneum with hypovolemic shock. After resuscitation, an emergency exploratory laparotomy was done and we found hemoperitoneum of 3,500 milliliters, a bicornuate uterus with a ruptured right rudimentary communicating horn containing a non viable foetus. There were no other abnormalities. We performed an excision of the rudimentary horn with ipsilateral salpingectomy. Post-operative course was uneventful and the woman was discharged seven days later. This case emphasizes the importance of good antenatal care to avoid complications.

  18. Synergy and interactions among biological pathways leading to preterm premature rupture of membranes.

    Science.gov (United States)

    Lannon, Sophia M R; Vanderhoeven, Jeroen P; Eschenbach, David A; Gravett, Michael G; Adams Waldorf, Kristina M

    2014-10-01

    Preterm premature rupture of membranes (PPROM) occurs in 1% to 2% of births. Impact of PPROM is greatest in low- and middle-income countries where prematurity-related deaths are most common. Recent investigations identify cytokine and matrix metalloproteinase activation, oxidative stress, and apoptosis as primary pathways to PPROM. These biological processes are initiated by heterogeneous etiologies including infection/inflammation, placental bleeding, uterine overdistention, and genetic polymorphisms. We hypothesize that pathways to PPROM overlap and act synergistically to weaken membranes. We focus our discussion on membrane composition and strength, pathways linking risk factors to membrane weakening, and future research directions to reduce the global burden of PPROM. © The Author(s) 2014.

  19. Uterine uptake of iodine-123 metaiodobenzylguanidine during the menstrual phase of uterine cycle

    International Nuclear Information System (INIS)

    Bomanji, J.; Britton, K.E.

    1987-01-01

    Radioiodinated I-123 metaiodobenzylguanidine (MIBG) has been used for diagnostic purposes for detection of apudomas. In this paper normal physiological uptake of I-123 MIBG by the uterus during the menstrual phase of the uterine cycle is reported. It is likely that I-123 MIBG can be used to evaluate some of the problems in this context

  20. Uterine uptake of iodine-123 metaiodobenzylguanidine during the menstrual phase of uterine cycle

    Energy Technology Data Exchange (ETDEWEB)

    Bomanji, J.; Britton, K.E.

    1987-08-01

    Radioiodinated I-123 metaiodobenzylguanidine (MIBG) has been used for diagnostic purposes for detection of apudomas. In this paper normal physiological uptake of I-123 MIBG by the uterus during the menstrual phase of the uterine cycle is reported. It is likely that I-123 MIBG can be used to evaluate some of the problems in this context.

  1. Law 16.097 Prevention program of uterine cervix cancer in Uruguay: Uterine cervix cancer

    International Nuclear Information System (INIS)

    2004-01-01

    Every year in Uruguay, is diagnosed around 600 new cases of cancer of uterine cervix. Next important information was related on this cancer and the evolution that will have the carrying of this illness, it was informed about the prevention, symptoms, I diagnose and treatment of the same one

  2. Bilateral cleft lip nasal deformity

    Directory of Open Access Journals (Sweden)

    Singh Arun

    2009-01-01

    Full Text Available Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it′s management both at the time of cleft lip repair

  3. Comparison of clinical outcomes and spectral Doppler indices of uterine and ovarian stromal arteries in women undergoing myomectomy with or without hypogastric arterial ligation.

    Science.gov (United States)

    Fu, H-C; Huang, K-H; Tseng, C-W; Liang, H-M; Lin, H; Chou, Y-J; Kung, F-T

    2006-11-01

    To compare clinical outcomes and hemodynamic alterations of uterine and ovarian stromal arteries between patients with symptomatic myomas undergoing myomectomy preceded by arterial ligation and those undergoing myomectomy alone. In this prospective, non-randomized comparative study, myomectomy was performed on 69 women with symptomatic myomas. Myomectomy alone was performed in 31 patients (Group I) and myomectomy with concomitant bilateral hypogastric arterial ligation was performed in 38 patients (Group II). In both groups, surgical results and clinical outcomes were evaluated by peripheral hemoglobin levels, a pictorial blood-loss assessment chart, and visual analog scales. Spectral Doppler indices of uterine and ovarian stromal arteries, including peak systolic velocity, end-diastolic velocity, pulsatility index and resistance index were performed preoperatively, and 1 day and 1 or more months postoperatively. Twenty-two patients in Group I and 31 patients in Group II received regular follow-up examinations for a mean follow-up period of 10.1 months. Menstrual flow, dysmenorrhea and hemoglobin levels improved significantly after surgery in both groups. Blood loss during surgery was less in Group II than it was in Group I (P=0.02). Doppler indices of uterine and ovarian stromal arteries from preoperation to mean follow-up point were not significantly different between the groups, except for a significantly lower uterine artery pulsatility index in Group II (P=0.01). Myomectomy with hypogastric arterial ligation for symptomatic myomas is as efficient as is myomectomy alone and reduces blood loss during surgery. Serial Doppler studies showed that hypogastric ligation does not block uterine and ovarian perfusion, and even reduces the impedance of the uterine arteries. The long-term recurrence rate after myomectomy with hypogastric arterial ligation remains to be determined. Copyright (c) 2006 ISUOG.

  4. Spontaneous rupture of ovarian cystadenocarcinoma: pre- and post-rupture computed tomography evaluation

    Directory of Open Access Journals (Sweden)

    Priscila Silveira Salvadori

    2015-10-01

    Full Text Available AbstractEpithelial ovarian tumors are the most common malignant ovarian neoplasms and, in most cases, eventual rupture of such tumors is associated with a surgical procedure. The authors report the case of a 54-year-old woman who presented with spontaneous rupture of ovarian cystadenocarcinoma documented by computed tomography, both before and after the event. In such cases, a post-rupture staging tends to be less favorable, compromising the prognosis.

  5. Spontaneous rupture of ovarian cystadenocarcinoma: pre- and post-rupture computed tomography evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Salvadori, Priscila Silveira; Atzingen, Augusto Castelli von; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Bomfim, Lucas Novais [Universidade Tiradentes (UNIT), Maceio, AL, (Brazil)

    2015-09-15

    Epithelial ovarian tumors are the most common malignant ovarian neoplasms and, in most cases, eventual rupture of such tumors is associated with a surgical procedure. The authors report the case of a 54-year-old woman who presented with spontaneous rupture of ovarian cystadenocarcinoma documented by computed tomography, both before and after the event. In such cases, a post-rupture staging tends to be less favorable, compromising the prognosis. (author)

  6. Bilateral diffuse uveal melanocytic proliferation

    DEFF Research Database (Denmark)

    Klemp, Kristian; Kiilgaard, Jens Folke; Heegaard, Steffen

    2017-01-01

    Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic intraocular disease that causes progressive visual loss in patients driven by an IgG factor associated with an underlying malignancy. Characteristic ocular findings include exudative retinal detachment, rapid...... cataract formation and uveal melanocytic tumours. The awareness and documentation of BDUMP has increased during the past decade, and the increasing amount of data collected demonstrates the effect of treatment with plasmapheresis and the value of diagnostic tools in BDUMP such as genetic and immunologic...

  7. Bilateral peroneal palsy after weightlifting.

    Science.gov (United States)

    Kyavar, Leila; Heckmann, Josef G

    2013-09-01

    In a 48-year-old otherwise healthy man, a bilateral common peroneal palsy was diagnosed clinically and neurophysiologically. He reported on strength training with weights in both arms, lifting the weights and his upper body from a deep squatting position with broadly positioned legs akimbo in a hitherto unusual intensity. Regarding the pathophysiological mechanisms, 2 options are considered: first, stretching of the nerve at the fascia of the peroneal longus muscle and along the fibula neck, and second, compression of the nerve during squatting with weights loaded and with strongly activated anterior tibial and peroneal muscles.

  8. Interstitial heterotopic pregnancy in a woman conceiving by in vitro fertilization after bilateral salpingectomy.

    Science.gov (United States)

    Dumesic, D A; Damario, M A; Session, D R

    2001-01-01

    Heterotopic pregnancy, defined as the coexistence of an intrauterine pregnancy and an ectopic pregnancy, occurs in approximately 1 in 100 pregnancies conceived by in vitro fertilization (IVF), particularly when multiple embryos are transferred into the uterus. The ectopic gestation of the combined pregnancy usually occurs within the ampulla of the fallopian tube. If it implants within the interstitial portion of the fallopian tube, however, the resulting interstitial pregnancy eventually can rupture through the uterus, leading to sudden, severe hemorrhage and maternal death. This article describes the rupture of an interstitial heterotopic pregnancy in a 37-year-old woman conceiving by IVF after bilateral salpingectomy. The interstitial pregnancy was removed by laparotomy to protect the intrauterine pregnancy from damage. Physicians should consider interstitial ectopic pregnancy as a cause of abdominal pain, even when a viable pregnancy occurs by IVF after salpingectomy.

  9. [Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors].

    Science.gov (United States)

    Luz, Rita; Ferreira, Joana; Rocha, Mara; Jorge, Ana Francisca; Félix, Ana

    2016-10-01

    Uterine carcinosarcoma is a rare and aggressive biphasic malignancy and is currently included in the high risk endometrial carcinoma group. The aims of this study were to determine the clinicopathological profile, treatment, recurrence/progression patterns, survival and prognostic factors. Retrospective study of 42 patients, surgically staged and followed-up at a cancer centre, between 2005 and 2013. Clinical data was retrieved from records and pathological characteristics were reviewed for this study. Median age was 72 years (61 - 78) and the majority presented comorbid diseases. Stage distribution as follows: 13 (31.0%) stage I; eight (19.0%) stage II; nine (21.4%) stage III; and 12 (28.6%) stage IV. Chemotherapy was instituted in 12 patients and 21 received radiotherapy. Disease progressed in 16 patients and recurred in nine after a short interval. Median overall survival was 18 months (6.8 - 40) and median disease-free survival was 6 months (0 - 22.8). The only independent prognostic factor related with poor survival was serosal invasion (p = 0.02; HR adjusted 4.22; IC 95% 1.29 - 13.79). In accordance to other studies, diagnosis of uterine carcinosarcoma is frequently done with advanced disease and presents a high rate of progression/recurrence. The variable which has been consistently identified as main prognostic factor is stage, but in this study the only independent factor was serosal invasion. The present study represents the larger series of uterine carcinosarcoma studied in Portugal and reflects the clinical presentation, histopathological characteristics and stage at diagnosis and confirms the aggressiveness of this rare tumor.

  10. Reevaluation of chest radiography in aortic rupture

    International Nuclear Information System (INIS)

    Lee, F. Jr.; Gutierrez, O.H.; Burgener, F.A.; Yee, W.K.; Katzberg, R.W.; Morris, T.W.

    1989-01-01

    Mediastinal widths in 50 volunteers with varying inspiration and positioning were compared with values obtained in 17 patients with known aortic rupture. Mediastinal width was significantly affected by the degree of inspiration and positioning in control subjects. Mediastinal width after rupture was outside normal 95% confidence limits in 12 of 17 cases (71%), as compared with inspiration-matched controls. Fourteen of seventeen patients with rupture (82%) had mediastina wider than 8.0 cm, but so did 23 of 150 controls (15%), all on expiratory films. On average, patients with rupture had wider mediastina for all degrees of inspiration, but deeper inspiration helped accentuate differences in width between these patients and normal controls

  11. Right Diaphragm Spontaneous Rupture: A Surgical Approach

    Directory of Open Access Journals (Sweden)

    Duilio Divisi

    2011-01-01

    Full Text Available We present a case of spontaneous rupture of the diaphragm, characterized by nonspecific symptoms. The rapid diagnosis and appropriate surgical approach led to a positive resolution of the pathology.

  12. Surgical treatment of distal biceps rupture.

    Science.gov (United States)

    Sutton, Karen M; Dodds, Seth D; Ahmad, Christopher S; Sethi, Paul M

    2010-03-01

    Rupture of the distal biceps tendon accounts for 10% of all biceps brachii ruptures. Injuries typically occur in the dominant elbow of men aged 40 to 49 years during eccentric contraction of the biceps. Degenerative changes, decreased vascularity, and tendon impingement may precede rupture. Although nonsurgical management is an option, healthy, active persons with distal biceps tendon ruptures benefit from early surgical repair, gaining improved strength in forearm supination and, to a lesser degree, elbow flexion. Biomechanical studies have tested the strength and displacement of various repairs; the suspensory cortical button technique exhibits maximum peak load to failure in vitro, and suture anchor and interosseous screw techniques yield the least displacement. Surgical complications include sensory and motor neurapraxia, infection, and heterotopic ossification. Current trends in postoperative rehabilitation include an early return to motion and to activities of daily living.

  13. Medical management of ruptured appendicitis in pregnancy.

    Science.gov (United States)

    Young, Brett C; Hamar, Benjamin D; Levine, Deborah; Roqué, Henry

    2009-08-01

    Ruptured appendicitis in pregnancy is an advanced stage of appendicitis that imposes significant maternal and fetal morbidity; the best treatment for the obstetric patient in this situation is unclear. In the first case, a nulliparous woman at 32 weeks of gestation presented with ruptured appendicitis. She was treated nonsurgically with intravenous antibiotics and had an uncomplicated vaginal delivery at term. In the second case, a nulliparous woman presented at 27 weeks of gestation with ruptured appendicitis and was treated nonsurgically with intravenous antibiotics. She had a recurrence of appendicitis at 32 weeks of gestation, and again was treated with medical management. She delivered a viable infant by cesarean at 34 weeks of gestation for breech presentation and preterm labor. Similar to in the nonpregnant population, medical management of ruptured appendicitis in pregnancy may be a reasonable treatment option.

  14. Cognitive frames in psychology: demarcations and ruptures.

    Science.gov (United States)

    Yurevich, Andrey V

    2009-06-01

    As there seems to be a recurrent feeling of crisis in psychology, its present state is analyzed in this article. The author believes that in addition to the traditional manifestations that have dogged psychology since it emerged as an independent science some new features of the crisis have emerged. Three fundamental "ruptures" are identified: the "horizontal" rupture between various schools and trends, the "vertical" rupture between natural science and humanitarian psychology, and the "diagonal" rupture between academic research and applied practice of psychology. These manifestations of the crisis of psychology have recently been compounded by the crisis of its rationalistic foundations. This situation is described in terms of the cognitive systems in psychology which include meta-theories, paradigms, sociodigms and metadigms.

  15. Micromechanical properties and collagen composition of ruptured human achilles tendon

    DEFF Research Database (Denmark)

    Hansen, Philip; Kovanen, Vuokko; Hölmich, Per

    2013-01-01

    The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive.......The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive....

  16. Aortic ruptures in seat belt wearers.

    Science.gov (United States)

    Arajärvi, E; Santavirta, S; Tolonen, J

    1989-09-01

    Several investigations have indicated that rupture of the thoracic aorta is one of the leading causes of immediate death in victims of road traffic accidents. In Finland in 1983, 92% of front-seat passengers were seat belt wearers on highways and 82% in build-up areas. The mechanisms of rupture of the aorta have been intensively investigated, but the relationship between seat belt wearing and injury mechanisms leading to aortic rupture is still largely unknown. This study comprises 4169 fatally injured victims investigated by the Boards of Traffic Accident Investigation of Insurance Companies during the period 1972 to 1985. Chest injuries were recorded as the main cause of death in 1121 (26.9%) victims, 207 (5.0%) of those victims having worn a seat belt. Aortic ruptures were found at autopsy in 98 victims and the exact information of the location of the aortic tears was available in 68. For a control group, we analyzed 72 randomly chosen unbelted victims who had a fatal aortic rupture in similar accidents. The location of the aortic rupture in unbelted victims was more often in the ascending aorta, especially in drivers, whereas in seat belt wearers the distal descending aorta was statistically more often ruptured, especially in right-front passengers (p less than 0.05). The steering wheel predominated statistically as the part of the car estimated to have caused the injury in unbelted victims (37/72), and some interior part of the car was the most common cause of fatal thoracic impacts in seat belt wearers (48/68) (p less than 0.001). The mechanism of rupture of the aorta in the classic site just distal to the subclavian artery seems to be rapid deceleration, although complex body movements are also responsible in side impact collisions. The main mechanism leading to rupture of the ascending aorta seems to be severe blow to the bony thorax. This also often causes associated thoracic injuries, such as heart rupture and sternal fracture. Injuries in the ascending

  17. Pregnancies complicated by uterine fibroids: A case series on ...

    African Journals Online (AJOL)

    handling, speed but careful closure/hemostasis in addition to judicious post operative care can guarantee a successful pregnancy sparing myomectomy. Key words: Early pregnancy; infertility; myomectomy; pregnancy loss; uterine fibroids. Introduction. Myomectomy is a form of surgical management for uterine fibroids when ...

  18. Reduction of subacute uterine inversion by Haultain's method: A ...

    African Journals Online (AJOL)

    Reduction of subacute uterine inversion by Haultain's method: A case report. ... South African Journal of Obstetrics and Gynaecology ... Abstract. Uterine inversion is a rare but potentially life-threatening obstetric emergency of unknown aetiology, which is often associated with inadvertent traction on the umbilical cord before ...

  19. Endometriosis and uterine malformations: infertility may increase severity of endometriosis.

    Science.gov (United States)

    Boujenah, Jeremy; Salakos, Eleonora; Pinto, Mélodie; Shore, Joanna; Sifer, Christophe; Poncelet, Christophe; Bricou, Alexandre

    2017-06-01

    The aim of our study was to compare the stage and severity of endometriosis in fertile and infertile women with congenital uterine malformations. We performed an observational study from September 2007 to December 2015 in a tertiary care university hospital and assisted reproductive technology center. A total of 52 patients with surgically proven uterine malformations were included. We compared 41 infertile patients with uterine malformations with 11 fertile patients with uterine malformation. The main outcome was the stage, score and type of endometriosis in regard to infertility and class of uterine malformation. The rate of endometriosis did not differ between the two groups (43.9 vs. 36.4%). The mean revised American Fertility Society score was higher in infertile patients with uterine malformations (19.02 vs. 6, p endometriosis (43.9 vs. 37.5%). Endometrioma and deep infiltrating endometriosis were associated with uterine malformations in infertile women, respectively 14.6 and 0%. No difference in the characteristics of endometriosis was found regarding the class of malformation. The association of uterine malformations and infertility may increase the severity of endometriosis and raise the issue of their diagnosis and management. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  20. Control for Uterine Fibroid Embolisation- An Initial Experience in ...

    African Journals Online (AJOL)

    Uterine fibroid embolisation (UFE) generates moderate to severe post-procedural pain. We present a case series of 24 patients who underwent UFE during our first experience in managing the sometimes excruciating pain that accompanies embolisation of the uterine arteries. We also show the evolution of our protocol for ...

  1. Presentation and Management of Uterine Fibroids at the Lagos ...

    African Journals Online (AJOL)

    To review the clinical presentation and management of uterine fibroids at the Lagos University Teaching Hospital, Idi-Araba, Lagos. women with uterine fibroids that presented at the Gynaecological outpatient clinic were followed up till surgery and data on sociodemographic profile, parity, presenting signs and symptoms, ...

  2. Non-Puerperal Uterine Inversion Following a Prolapsed Leiomyoma ...

    African Journals Online (AJOL)

    Non-Puerperal Uterine Inversion Following a Prolapsed Leiomyoma in a Cameroonian Woman. ... F Fouelifack Ymele, P Nana, JH Fouedjio, E Bechem, RE Mbu. Abstract. Non-puerperal uterine inversion is a rare condition that occurs as a complication of intrauterine tumors, especially giant submucosal leiomyomas.

  3. Acute Uterine Inversion: A Simple Modification of Hydrostatic ...

    African Journals Online (AJOL)

    Acute Uterine Inversion: A Simple Modification of Hydrostatic Method of Treatment. ... P Gupta, RL Sahu, A Huria ... Repositioning of acute uterine inversion in six patients in emergency was done using trans.urethral resection of prostate set (TURP set), used in endoscopic resection of prostate, and two 3 L saline bags.

  4. Surgical findings at laparatomy for uterine fibroid in University of ...

    African Journals Online (AJOL)

    A palpable abdominal swelling represents the commonest symptom of uterine fibroid in this study and as was present in sixty nine point nine. Other factors found to be associated with uterine fibroid are the numbers, size, location and associated pelvic inflammatory disease, which are common in low resource countries.

  5. Ultrasound Evaluation of the Uterine Scar Thickness after Single ...

    African Journals Online (AJOL)

    Background: The degree of the lower uterine segment (LUS) thinning and the risk of uterine scar defect have been studied. However, the relationship between the methods of closure and the degree of thinning needs further elucidation. Aim: The aim of this study was to determine whether a LUS transverse cesarean section ...

  6. Acute puerperal uterine inversion : Case report | Mbaluka | East ...

    African Journals Online (AJOL)

    Acute puerperal uterine inversion is a rare potentially life-threatening complication of the third stage of labour that should be expeditiously managed to avert maternal mortality. A 21-year primigravida who was admitted in labour had a spontaneous vertex delivery and her third stage of labour was complicated by uterine ...

  7. Symptomatic Uterine Leiomyoma in a 65-year old Postmenopausal ...

    African Journals Online (AJOL)

    She presented with constipation suggestive of intestinal obstruction with no history of previous surgery, and investigations confirmed a calcified uterine leiomyoma. She had exploratory ... Symptomatic uterine leiomyoma in an elderly postmenopausal woman is rare, and its coexistence with CIN III in a virgin, is even rarer.

  8. Non-Puerperal Uterine Inversion: A Case Report

    OpenAIRE

    Fofie, C O; Baffoe, P

    2010-01-01

    Non-puerperal uterine inversion is rare. A 42-year old woman presented with lower abdominal pain, offensive vaginal discharge and a huge protruding mass per vaginum. A clinical diagnosis of non-puerperal uterine inversion was made and she successfully underwent vaginal hysterectomy. A high index of suspicion is required to make a prompt diagnosis.

  9. Non-puerperal uterine inversion: A case report | Fofie | Ghana ...

    African Journals Online (AJOL)

    Non-puerperal uterine inversion is rare. A 42-year old woman presented with lower abdominal pain, offensive vaginal discharge and a huge protruding mass per vaginum. A clinical diagnosis of non-puerperal uterine inversion was made and she successfully underwent vaginal hysterectomy. A high index of suspicion is ...

  10. Epidemiology of Uterine Leiomyomata at the Lagos University ...

    African Journals Online (AJOL)

    ... Diabetes mellitus, family history of fibroid and history of infertility. Future studies are recommended to expand the existing knowledge base of uterine fibroid as well as other inconsistent and potential risk factors with a view to identifying preventive measures. Keywords: Uterine Leiomyomata, Diabetes Mellitus, Infertility.

  11. Monitoring of fetal heart rate and uterine activity

    NARCIS (Netherlands)

    Graatsma, E.M.

    2010-01-01

    In this thesis a renewed monitoring technique for fetal heart rate (FHR) and uterine activity has been investigated. Through non-invasive measurements of electrical signals as recorded from the maternal abdomen, both the fetal-electrocardiogram (fECG) and uterine electrohysterogram (EHG) can be

  12. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    Science.gov (United States)

    Polzer, Stanislav; Gasser, T Christian

    2015-12-06

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. © 2015 The Author(s).

  13. A pilot study of robotic uterine and vaginal vault manipulation: the ViKY Uterine Positioner™.

    Science.gov (United States)

    Akrivos, Nikolaos; Barton-Smith, Peter

    2013-12-01

    A pilot study of uterine and vaginal vault manipulation using a new surgical robot-The ViKY Uterine Positioner™--enrolled 36 cases comprising 31 hysterectomies, two myomectomies, two sacrocolpopexies and one excision of severe endometriosis performed between July 2010 and February 2012 in a tertiary referral District General Hospital in the UK. Mean age was 48 years, body mass index 25.7 kg/m(2) and uterine weight 231 g. Nine cases were foot-controlled and 27 by Bluetooth voice control. ViKY UP™ docking time once V-Care™ was inserted was 4.3 min. The device caused no peri-operative complications. Adequate mobilization, visualization and range of movement was possible in 81, 78 and 61 % of cases, respectively, with most of the problems arising in cases with uterine weight >350 g. ViKY UP™ was detached and an assistant was required in three cases, whilst V-Care™ came out of the uterus in one case. The learning curve led to various adjustments including optimizing patient position, increasing the device range of movement and adjusting device sensitivity. As a result, problems were minimized in our last nine cases. Adding robotic uterine manipulation is the obvious next step to give the gynecologist the ultimate control and stability of the uterus during robotic-assisted surgery without having to lift their head from the viewfinder or rely on a remotely situated perineal assistant. ViKY UP™ is the first device to deliver this. Pilot study results did not demonstrate compromised safety, and the device appears to be effective and easy to learn.

  14. Dynamic rupture activation of backthrust fault branching

    Science.gov (United States)

    Xu, Shiqing; Fukuyama, Eiichi; Ben-Zion, Yehuda; Ampuero, Jean-Paul

    2015-03-01

    We perform dynamic rupture simulations to investigate the possible reactivation of backthrust branches triggered by ruptures along a main thrust fault. Simulations with slip-weakening fault friction and uniform initial stress show that fast propagation speed or long propagation distance of the main rupture promotes reactivation of backthrust over a range of branch angles. The latter condition may occur separately from the former if rupture speed is limited by an increasing slip-weakening distance towards the junction direction. The results suggest a trade-off between the amplitude and duration of the dynamic stress near the main rupture front for backthrust reactivation. Termination of the main rupture by a barrier can provide enhanced loading amplitude and duration along a backthrust rooted near the barrier, facilitating its reactivation especially with a high frictional resistance. The free surface and depth-dependent initial stress can have several additional effects. The sign of the triggered motion along the backthrust can be reversed from thrust to normal if a deeply nucleated main rupture breaks the free surface, while it is preserved as thrust if the main rupture is terminated by a barrier at depth. The numerical results are discussed in relation to several recent megathrust earthquakes in Sumatra, Chile, and Japan, and related topics such as branch feedbacks to the main fault. The dynamic view on backthrust fault branching provided by the study fills a gap not covered by quasi-static models or observations. A specific examined case of antithetic fault branching may be useful for indicating a barrier-like behavior along the main fault.

  15. Diagnostic Modalities in Premature Rupture of Membranes

    OpenAIRE

    Fatma Eskicioğlu; Esra Bahar Gur

    2015-01-01

    Objectives: Rupture of membranes prior to the onset of labor is known as Premature Rupture of Membranes (PROM). Early and correct diagnosis is crucial in order to prevent fetal and maternal risks that can be life threatening. We aimed to investigate the diagnostic ability of the tests in PROM. Materials and Methods: Nitrazine test, fern test, amnio-dye test, biochemical tests (insulin-like growth factor binding protein-1 and placental alpha microglobulin-1) were evaluated in terms of effec...

  16. Blunt cardiac rupture in a toddler

    Directory of Open Access Journals (Sweden)

    Peep Talving

    2016-08-01

    Full Text Available Blunt cardiac rupture is typically a fatal injury with overall mortality exceeding 90%. Most of the patients never reach the hospital alive. In pediatric patients, only 0.03% of cases following blunt trauma admissions have a cardiac injury. This report presents a rare survivor of 16-months old toddler injured in a domestic accident suffering a right atrial rupture repaired through a median sternotomy. To the best of our knowledge this is the youngest case reported in the literature.

  17. Serial ultrasonographic appearance of postpartum uterine involution in beagle dogs.

    Science.gov (United States)

    Yeager, A E; Concannon, P W

    1990-09-01

    Postpartum changes in uterine shape, architecture, echogenicity and diameter were determined during the serial examinations of five beagle bitches. During postpartum Week 1, the uterine horns were tubular structures composed of multiple layers of various echogenicity and had multiple, discrete enlargements with hypoechoic centers at placental sites. Diameters ranged from 1.1 to 3.8 cm at placental site enlargements, and 0.5 to 1.4 cm between enlargements. Uterine involution appeared to be completed by 15 wk post partum. At 15 weeks the uterine horns of each dog were uniform hypoechoic, tubular structures without enlargements and had a reduced diameter of 0.3 to 0.6 cm. These ultrasonographic findings are similar to previously reported gross and light microscopic descriptions of canine uterine involution.

  18. Bilateral Monteggia fracture in adults

    Directory of Open Access Journals (Sweden)

    Ristić Dejan

    2011-01-01

    Full Text Available Introduction. In 1814 Giovanni Monteggia first described two cases of fractures of the proximal third of ulna with dislocation of the radial head. These fractures are more common in children than in adults, and mutual Monteggia fracture is a rare complication. This study presents a treatment course of a patient with bilateral Monteggia fracture. Case report. A 55- year-old patient was injured by falling in the yard. Radiography showed bilateral Monteggia fracture type II (by the Badon classification. Operative treatment of fracture was done by a compression plate on the right side and by the zuggurtung technique on the left one. Closed repositioning of the radial head was done on both sides. The patient was wearing a plaster splint for the upper arm for 21 days. After removing the fixation, the function of the elbow was determined by the Broberg Morrey score (BM which was on the right side 45.5 and on the left side 47.5. After the proper physical therapy, four months after the surgery, BM score was 100 on the right side, and 93 on the left one. Conclusion. Surgical treatment and early rehabilitation is the key for the return of good function of both elbows.

  19. Antibiotic Therapy for Premature Rupture of Membranes and Preterm Labor and Effect on Fetal Outcome

    Science.gov (United States)

    Seelbach-Goebel, B.

    2013-01-01

    In Germany almost 10 % of children are born before the end of 37th week of gestation. In at least one quarter of these cases, ascending infection of the vagina plays a causative role, particularly during the early weeks of gestation. If, in addition to the decidua, the amniotic membrane, amniotic fluid and the umbilical cord are also affected, infection not only triggers uterine contractions and premature rupture of membranes but also initiates a systemic inflammatory reaction on the part of the fetus, which can increase neonatal morbidity. Numerous studies and meta-analyses have found that antibiotic therapy prolongs pregnancy and reduces neonatal morbidity. No general benefit of antibiotic treatment was found for premature uterine contractions. But it is conceivable that a subgroup of pregnant women would benefit from antibiotic treatment. It is important to identify this subgroup of women and offer them targeted treatment. This overview summarizes the current body of evidence on antibiotic treatment for impending preterm birth and the effect on neonatal outcomes. PMID:24771902

  20. Indocyanine green fluorescence imaging for evaluation of uterine blood flow in cynomolgus macaque.

    Directory of Open Access Journals (Sweden)

    Iori Kisu

    Full Text Available BACKGROUND: Uterine blood flow is an important factor in uterine viability, but the number of blood vessels required to maintain viability is uncertain. In this study, indocyanine green (ICG fluorescence imaging was used to examine uterine hemodynamics and vessels associated with uterine blood flow in cynomolgus macaque. METHODS: The uterus of a female cynomolgus macaque was cut from the vaginal canal to mimic a situation during trachelectomy or uterine transplantation surgery in which uterine perfusion is maintained only with uterine and ovarian vessels. Intraoperative uterine hemodynamics was observed using ICG fluorescence imaging under conditions in which various nutrient vessels were selected by clamping of blood vessels. A time-intensity curve was plotted using imaging analysis software to measure the T(max of uterine perfusion for selected blood vessel patterns. Open surgery was performed with the uterus receiving nutritional support only from uterine vessels on one side. The size of the uterus after surgery was monitored using transabdominal ultrasonography. RESULTS: The resulting time-intensity curves displayed the average intensity in the regions of the uterine corpus and uterine cervix, and in the entire uterus. Analyses of the uterine hemodynamics in the cynomolgus macaque showed that uterine vessels were significantly related to uterine perfusion (P=0.008, whereas ovarian vessels did not have a significant relationship (P=0.588. When uterine vessels were clamped, ovarian vessels prolonged the time needed to reach perfusion maximum. Postoperative transabdominal ultrasonography showed that the size of the uterus was not changed 2 months after surgery, with recovery of periodic menstruation. The cynomolgus macaque has got pregnant with favorable fetus well-being. CONCLUSION: Uterine vessels may be responsible for uterine blood flow, and even one uterine vessel may be sufficient to maintain uterine viability in cynomolgus macaque. Our