[Doppler monitoring of the treatment of inflammatory diseases of the adnexa uteri]. / Dopplerometricheskii monitoring terapii vospalitel'nykh zabolevanii pridatkov matki.

Twenty-five women with acute inflammations of the uterine tubes were examined using Doppler studies of the internal iliac, uterine, and ovarian arteries over the course of therapy. The systolic/diastolic ratio (A/B) and the Pourcelot resistance index were used in analysis of the spectral curves. The findings evidence that the iliac artery blood flow was unchanged over the course of therapy. Dopplerometric curves of the uterine and ovarian arteries were plotted for various periods of therapy for acute salpingo-oophoritis . The authors come to a conclusion of the usefulness of Doppler studies in clinical practice, and these conclusions are supported by the results of statistical data processing.

Case report: pelvic actinomycosis with the development and resolution of a recto-sigmoid stricture.

Actinomycosis is an unusual intra-abdominal infection, often mistaken for other conditions. We report a case associated with bilateral ureteric obstruction in which a recto-sigmoid stricture developed in previously normal bowel, followed by its complete resolution after treatment with antibiotics, as demonstrated by serial barium enema examinations.

Pelvic actinomycosis associated with intrauterine devices.

The authors describe two women with pelvic pain, long-term use of an intrauterine device, and a pelvic mass due to Actinomyces israelii. The diagnostic imaging findings were nonspecific but included mass effect and mucosal irregularity of the rectosigmoid colon at barium enema examination and complex masses and inflammatory changes at computed tomography and magnetic resonance imaging. Radiologists should be aware of the imaging findings of this potentially lethal but curable condition.

PIP: 2 cases of pelvic Actinomycosis both in women 40 years of age, with IUDs in place for 8 and 10 years respectively, were diagnosed with the aid of radiologic techniques including barium enema, computed tomography (CT) and magnetic resonance imaging (MR). The 1st woman had experienced malaise, night sweats and a weight loss of 15 lb. over 2-3 months, then felt an epigastric mass for 5 days. She has endometritis, elevated white blood cell count, and large, tender, bilateral adnexal masses. Inflammatory changes and multilocular fluid collections were demonstrated by enhanced CT. Aspiration of the epigastric mass yielded sulfur granules and anaerobic bacteria. She was successfully treated with penicillin, gentamycin and clindamycin. The 2nd woman had a 2-month history of abdominal pain, a pelvic mass and an elevated white blood cell count. Enhanced CT, barium enema and sigmoidoscopy demonstrated a mass between the uterus and bowel, with mural invasion of the sigmoid colon. A 5 x 6 cm left-sided tubo-ovarian abscess adhering to the colon, bladder and left pelvic sidewall was excised at laparotomy. She remained asymptomatic at 6 months. This lethal but curable condition is caused by Actinomyces israelii, an opportunistic gram-positive bacteria usually introduced by foreign bodies, surgery or trauma. CT and MR were helpful in diagnosing the relatively nonspecific signs and symptoms in these cases.