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1.
J Infect Dev Ctries ; 18(6): 919-924, 2024 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-38990994

RESUMEN

OBJECTIVE: To compare the short and long-term benefits (the length of hospital stay, surgical complications, and early clinical improvement) of adding early ultrasound-guided drainage to broad-spectrum antibiotic treatment. METHODOLOGY: Patients undergoing tubo-ovarian abscess treatment between January 2017 and June 2022 in a tertiary hospital were retrospectively evaluated. Of the patients studied, 50 subjects were treated with antibiotics alone and 63 underwent guided drainage. Twenty-one individuals underwent early drainage within 72 hours of admission, and 42 underwent guided drainage after this period. RESULTS: There was no statistical difference in the length of hospital stay between the groups simultaneously, averaging 6.4 days for the controls, 5.1 days for the early drainage group, and 9.6 days for the late drainage group (p = 0.290). In the multiple linear regression with the length of hospital stay outcome and adjusting for potential confounding factors, there was an average reduction of 2.9 days in the hospital stay (p = 0.04) for the early drainage group (< 72 hours) compared to the controls. Early clinical improvement and an expected drop in CRP were more frequent in patients who underwent drainage. Length of hospital stay increases with abscess diameter: 0.4 [(95% CI 0.1 - 0.7) (p = 0.05)] days per centimeter, regardless of other variables. CONCLUSIONS: Ultrasound-guided drainage of tubo-ovarian abscesses associated with antibiotic therapy is an effective treatment, with few complications, and may lead to clinical improvement especially when performed early.


Asunto(s)
Absceso , Antibacterianos , Drenaje , Tiempo de Internación , Enfermedades del Ovario , Humanos , Femenino , Estudios Retrospectivos , Drenaje/métodos , Adulto , Estudios Transversales , Absceso/terapia , Absceso/diagnóstico por imagen , Absceso/cirugía , Absceso/tratamiento farmacológico , Antibacterianos/uso terapéutico , Enfermedades del Ovario/terapia , Enfermedades del Ovario/diagnóstico por imagen , Enfermedades del Ovario/tratamiento farmacológico , Enfermedades del Ovario/cirugía , Persona de Mediana Edad , Tratamiento Conservador/métodos , Enfermedades de las Trompas Uterinas/terapia , Enfermedades de las Trompas Uterinas/diagnóstico por imagen , Enfermedades de las Trompas Uterinas/cirugía , Ultrasonografía Intervencional/métodos , Resultado del Tratamiento , Ultrasonografía
2.
Zhonghua Bing Li Xue Za Zhi ; 53(6): 541-545, 2024 Jun 08.
Artículo en Chino | MEDLINE | ID: mdl-38825897

RESUMEN

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of pseudocarcinomatous hyperplasia of the fallopian tubes. Methods: Sixteen cases of pseudocarcinomatous hyperplasia of the fallopian tubes diagnosed at Obstetrics and Gynecology Hospital of Fudan University from January 2011 to January 2024 were collected.The pathological sections were reviewed, the clinical and pathological data were consulted, and immunohistochemical examination was conducted along with follow-up. Results: The patients were aged from 19 to 57 years, with an average age of 41 and a median age of 38. Among the 16 cases, 4 were located in the right fallopian tubes, 6 in the left fallopian tubes, while the remaining cases presented bilaterally. The general manifestations were tubal edema, crispness and purulent secretion in the lumen. Morphologically, the fallopian tube mucosa exhibited a significant infiltration of neutrophils, lymphocytes and plasma cells. The epithelial cells of the fallopian tube displayed evident proliferation, stratification and disorganized arrangement leading to formation of small glandular cavity with back-to-back, fissure-like and sieve-like structures. Immunohistochemical analysis revealed positivity for CK7 and WT1, along with wild-type p53 expression, Ki-67 index ranged from 5% to 20%. During the follow-up period ranging from 1 to 156 months, all the patients remained free of disease. Conclusions: Pseudocarcinomatous hyperplasia of the fallopian tube is a rare non-neoplastic lesion, which can lead to epithelial hyperplasia and atypical hyperplasia. The most important significance of recognizing this lesion lies in avoiding misdiagnosis of fallopian tube cancer during intraoperative and postoperative pathological examination. This ensures that clinicians can administer correct clinical interventions.


Asunto(s)
Trompas Uterinas , Hiperplasia , Humanos , Femenino , Adulto , Hiperplasia/patología , Persona de Mediana Edad , Trompas Uterinas/patología , Trompas Uterinas/metabolismo , Diagnóstico Diferencial , Proteína p53 Supresora de Tumor/metabolismo , Queratina-7/metabolismo , Neoplasias de las Trompas Uterinas/patología , Neoplasias de las Trompas Uterinas/metabolismo , Neoplasias de las Trompas Uterinas/cirugía , Neoplasias de las Trompas Uterinas/diagnóstico , Antígeno Ki-67/metabolismo , Proteínas WT1/metabolismo , Adulto Joven , Células Epiteliales/patología , Células Epiteliales/metabolismo , Inmunohistoquímica , Enfermedades de las Trompas Uterinas/patología , Enfermedades de las Trompas Uterinas/metabolismo , Enfermedades de las Trompas Uterinas/diagnóstico
3.
Pediatr Surg Int ; 40(1): 143, 2024 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-38816521

RESUMEN

PURPOSE: Isolated fallopian tube torsion (IFTT) is defined by rotation of the fallopian tube around itself without involving the ipsilateral ovary. It is a rare cause of acute lower abdominal pain in (adolescent) girls, but is commonly overlooked. Due to its rarity, literature is still scarce. Currently there is no generally accepted management and treatment. METHODS: A retrospective analysis of all IFTT cases treated in our institution was performed. In addition, a systematic literature research on pediatric IFTT was carried out on Medline/ PubMed database according to PRISMA principles using predefined search terms and inclusion criteria. Patient characteristics regarding age, clinical symptoms, diagnostic methods, treatment, and follow-up were analyzed. RESULTS: Three of our patients and fifty-nine reports totaling one hundred seventy girls were included in the analysis. Mean age was 13.0 years. Left tube was slightly more often affected (52.9%). Abdominal pain was present in 99.4% of cases accompanied with nausea in 57.1%. In only 16.4%, correct preoperative diagnosis was made. Salpingectomy was the most common treatment in 111 (66.9%) cases, 55 (33.1%) patients were treated with detorsion of the tube (organ-sparing management). Girls with symptoms longer than 1 day had a significant higher rate of salpingectomy (95% CI, P = 0.0323). CONCLUSION: When IFTT is suspected, emergency laparoscopy should be performed to possibly preserve future reproductive potential. In case of detorsion and reinstated blood supply, organ-preserving management should be performed with simultaneous addressment of concomitant pathology if possible. Sufficient long-term follow-up must be assured to get significant results to introduce guidelines for children and adolescents.


Asunto(s)
Enfermedades de las Trompas Uterinas , Anomalía Torsional , Humanos , Femenino , Adolescente , Niño , Anomalía Torsional/cirugía , Anomalía Torsional/diagnóstico , Enfermedades de las Trompas Uterinas/cirugía , Enfermedades de las Trompas Uterinas/complicaciones , Enfermedades de las Trompas Uterinas/diagnóstico , Estudios Retrospectivos , Dolor Abdominal/etiología , Salpingectomía/métodos , Trompas Uterinas/cirugía , Laparoscopía/métodos
4.
J Pediatr Surg ; 59(8): 1538-1544, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38649311

RESUMEN

BACKGROUND: Isolated fallopian tube torsion (IFTT) is a rare form of adnexal torsion that is more difficult to diagnose, which may lead to delays in treatment. Our objectives were to identify clinical and radiologic factors associated with surgically-confirmed IFTT and compare them with those of patients without torsion and with adnexal torsion (AT) in a large pediatric population. METHODS: We conducted a retrospective chart review of all patients who underwent surgery for suspected adnexal torsion from 2016 to 2019. Torsion was determined intraoperatively, with IFFT defined as those with only tubal but no ovarian torsion and AT defined as those with ovarian torsion, with or without involvement of the ipsilateral fallopian tube. Clinical and radiologic variables were compared between patients with IFTT and those without torsion and with AT using descriptive statistics. A previously-described composite score to predict torsion based on the presence of vomiting and adnexal volume (VVCS) was calculated for each patient. RESULTS: Of 291 patients who underwent surgery for suspected torsion, 168 had confirmed torsion: 33 (19.6%) IFTT and 135 (80.4%) AT. Patients with IFTT were more likely to be younger (12.8 vs. 14.2 years, P = 0.02), premenarchal (29.0% vs. 10.7%, P = 0.009), experience nausea (90.6% vs. 70.9%, P = 0.02) and vomiting (81.3% vs. 32.8%, P < 0.001), have a paratubal cyst on imaging (18.8% vs. 2.5%, P = 0.003), and have larger adnexal volume (143.3 vs. 64.9 ml, P < 0.001) than those without torsion. Higher BMI (26.6 vs. 22.9 kg/m2, P = 0.03), a paratubal cyst on imaging (18.8% vs. 1.5%, P < 0.001), presence of arterial (65.5% vs. 44.1%, P = 0.04) and venous Doppler flow (79.3% vs. 55.9%, P = 0.02), and radiologic impression indicating lack of torsion (37.9% vs. 16.8%, P = 0.04) were more common in IFTT than AT. The accuracy of the VVCS in predicting torsion for the IFFT group was 83.9%. CONCLUSIONS: IFTT has a similar clinical presentation to AT but with a higher likelihood of a paratubal cyst and preserved Doppler flow on imaging. IFTT should be strongly considered in patients who present with pain, nausea, and vomiting and have an adnexal mass separate from the ovary on imaging, regardless of Doppler flow. LEVEL OF EVIDENCE: Level II. TYPE OF STUDY: Prognosis study.


Asunto(s)
Enfermedades de las Trompas Uterinas , Anomalía Torsional , Humanos , Femenino , Estudios Retrospectivos , Niño , Anomalía Torsional/cirugía , Anomalía Torsional/diagnóstico , Adolescente , Enfermedades de las Trompas Uterinas/cirugía , Enfermedades de las Trompas Uterinas/complicaciones , Torsión Ovárica/cirugía , Factores de Riesgo
5.
J Minim Invasive Gynecol ; 31(6): 474, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38460865

RESUMEN

STUDY OBJECTIVE: To show feasibility and techniques used to perform a total hysterectomy, bilateral salpingectomy, endometriosis resection, and ovarian reconstruction in a patient with a frozen pelvis secondary to a history of ruptured tubo-ovarian abscess. DESIGN: Narrated step-by-step video demonstration. SETTING: Single academic institution. INTERVENTIONS: In patients with a history of multiple abdominal surgeries, abdominal mesh, or in the case of this patient, a history of a ruptured tubo-ovarian abscess, a vaginal approach may be safer. Immediate access to the uterine pedicles through the vagina bypasses the need for extensive enterolysis and adhesiolysis when compared to an abdominal approach. With the use of indocyanine green injected into bilateral ureters, we highlight the benefits of immediate identification of the ureters allowing for safer and more efficient dissection. We show rotational uterine maneuvers to aid in rectosigmoid-to- posterior-uterus dissection in a limited space due to dense pelvic adhesions. Lastly, we demonstrate ovarian reconstruction and oophoropexy for the purpose of easier ovarian identification in future surgeries to possibly reduce the risks of ovarian remnant syndrome. CONCLUSION: This video highlights the feasibility and strategies used to perform robot-assisted vaginal natural orifice transluminal endoscopic surgery on a patient with a frozen pelvis.


Asunto(s)
Cirugía Endoscópica por Orificios Naturales , Procedimientos Quirúrgicos Robotizados , Humanos , Femenino , Cirugía Endoscópica por Orificios Naturales/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Vagina/cirugía , Endometriosis/cirugía , Salpingectomía/métodos , Adulto , Histerectomía/métodos , Enfermedades de las Trompas Uterinas/cirugía
7.
Minerva Obstet Gynecol ; 76(2): 151-157, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36847525

RESUMEN

BACKGROUND: Endosalpingiosis is a pathologic diagnosis of ectopic epithelium resembling the fallopian tubes. It has been described with clinical characteristics that are similar to endometriosis. The primary objective is to determine if endosalpingiosis (ES) has a similar association with chronic pelvic pain when compared to endometriosis (EM). METHODS: This is a retrospective case-control analysis of patients with a histologic diagnosis of endosalpingiosis or endometriosis at three affiliated academic hospitals between 2000 and 2020. All ES patients were included, and 1:1 matching was attempted to obtain a comparable EM cohort. Demographic and clinical data were obtained, and statistical analysis was performed. RESULTS: A total of 967 patients (515 ES and 452 EM) were included. ES patients were significantly older than EM patients (median age 52 vs. 48 years, P<0.001), but other demographic variables were similar. Fewer ES patients had baseline chronic pelvic pain than EM patients (25.3% vs. 47%, P<0.001), and patients with ES were less likely to undergo surgery for the primary indication of pelvic pain (16.1% vs. 35.4%, P<0.001). Pelvic pain as the surgical indication remained lower in the ES group in multivariable analysis (OR=0.49, P<0.001). There were similar rates of persistent postoperative pain between ES and EM groups (10.1% vs. 13.5%, P=0.109). CONCLUSIONS: Although endosalpingiosis can be associated with chronic pelvic pain, the incidence of pain is significantly lower than in patients who have endometriosis. These findings suggest that ES is a unique condition that differs from EM. Further research including long-term follow-up and patient-reported outcomes is imperative.


Asunto(s)
Dolor Crónico , Endometriosis , Enfermedades de las Trompas Uterinas , Femenino , Humanos , Persona de Mediana Edad , Endometriosis/complicaciones , Endometriosis/epidemiología , Endometriosis/cirugía , Estudios Retrospectivos , Enfermedades de las Trompas Uterinas/complicaciones , Enfermedades de las Trompas Uterinas/cirugía , Enfermedades de las Trompas Uterinas/diagnóstico , Dolor Pélvico/etiología , Dolor Pélvico/complicaciones , Dolor Crónico/etiología , Dolor Crónico/complicaciones
8.
Ginekol Pol ; 95(5): 350-355, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38099661

RESUMEN

OBJECTIVES: Tubo-ovarian abscess (TOA) is inflammation of the pelvic organs, mainly originating from the lower genital tract and intestinal tract. Treatment options include antibiotic therapy, surgical drainage, and radiologically guided (interventional) drainage. In our study, we aimed to evaluate the treatment method to be chosen and thus to manage patients with tuba ovarian abscesses (TOAs) most accurately. MATERIAL AND METHODS: This is a retrospective cohort study, and patients who applied to a tertiary center diagnosed with tuba ovarian abscess (TOA) were included. TOA size (cm), pre-treatment C-reactive protein (CRP) value, pre-treatment white blood cell (WBC) value, previous operation type, postoperative complication, and antibiotics used were screened. RESULTS: 305 patients were included in the study, and medical treatment was applied to 140 patients, organ-sparing surgical drainage to 50 patients, and surgical treatment to 115 patients. TOA dimensions measured at the time of diagnosis were significantly lower in patients for whom only medical treatment was sufficient. Pre-treatment CRP levels, WBC levels, and length of stay were significantly lower in patients for whom only medical treatment was sufficient. There was no significant difference between the pre-and post-procedure CRP difference, antibiotics, and hospitalization time. CONCLUSIONS: Preferring minimally invasive treatment in cases requiring invasive treatment reduces the frequency of complications. Treatment of tuba ovarian abscesses (TOA) with minimally invasive methods will be more beneficial in terms of patient morbidity.


Asunto(s)
Absceso , Drenaje , Enfermedades del Ovario , Humanos , Femenino , Estudios Retrospectivos , Adulto , Absceso/terapia , Absceso/cirugía , Drenaje/métodos , Enfermedades del Ovario/cirugía , Enfermedades del Ovario/terapia , Enfermedades del Ovario/tratamiento farmacológico , Persona de Mediana Edad , Antibacterianos/uso terapéutico , Enfermedades de las Trompas Uterinas/cirugía , Enfermedades de las Trompas Uterinas/terapia , Centros de Atención Terciaria , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Resultado del Tratamiento
10.
BMC Womens Health ; 23(1): 678, 2023 12 19.
Artículo en Inglés | MEDLINE | ID: mdl-38115034

RESUMEN

OBJECTIVES: To assess the characteristics of patients with unilateral and bilateral tubo-ovarian abscess (TOA). METHODS: Women diagnosed with TOA during 2003-2017 were included in this retrospective cohort study. TOA was diagnosed using sonography or computerized tomography and clinical criteria, or by surgical diagnosis. Demographics, sonographic data, clinical treatment, surgical treatment, and post-operative information were retrieved. RESULTS: The study cohort included 144 women who met the inclusion criteria, of whom 78 (54.2%) had unilateral TOA and 66 (45.8%) had bilateral TOA. Baseline characteristics were not different between the groups. There was a statistical trend that women with fewer events of previous PID were less likely to have with bilateral TOA (75.3% vs. 64.1%, respectively; p = 0.074). Women diagnosed with bilateral TOA were more likely to undergo surgical treratment for bilateral salpingo-oophorectomy compared to unilateral TOA (61.5% vs. 42.3%, respectively; p = 0.04). There was no difference in maximum TOA size between groups. CONCLUSIONS: This study detected a trend toward increased need for surgical treatment in women diagnosed with bilateral TOA. These findings may contribute to determining the optimal medical or surgical treatment, potentially leading to a decrease in the duration of hospitalization, antibiotic exposure, and resistance. However, it is important to acknowledge that the results of the current study are limited, and further research is warranted to validate these potential outcomes.


Asunto(s)
Enfermedades de las Trompas Uterinas , Enfermedades del Ovario , Enfermedad Inflamatoria Pélvica , Salpingitis , Humanos , Femenino , Absceso/diagnóstico por imagen , Estudios Retrospectivos , Enfermedad Inflamatoria Pélvica/diagnóstico , Relevancia Clínica , Enfermedades del Ovario/cirugía , Enfermedades de las Trompas Uterinas/complicaciones , Enfermedades de las Trompas Uterinas/cirugía
11.
BMJ Case Rep ; 16(12)2023 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-38114297

RESUMEN

Ovarian cysts exhibit variable clinical presentations depending on their size, type and resulting sequelae. Rupture of ovarian cysts is infrequent, and cyst infections are even rarer. Here, we report an unusual case involving a young, non-pregnant woman who presented acutely with features of peritonitis and sepsis and was found to have a complex adnexal mass. Following a rigorous diagnostic evaluation, which included an urgent exploratory laparotomy and salpingo-oophorectomy, common diagnoses including tubo-ovarian abscess, endometriotic cyst and pelvic tuberculosis were ruled out. Instead, she was diagnosed with an ovarian mucinous cystadenoma that had become infected, possibly due to pelvic inflammatory disease, leading to spontaneous rupture. Such a presentation has rarely been reported, especially in a non-pregnant setting. Therefore, we emphasise the importance of considering this rare complication as a potential differential diagnosis in similar clinical presentations and discuss the management implications, including the importance of adequately treating pelvic inflammatory disease.


Asunto(s)
Cistoadenoma Mucinoso , Quistes , Enfermedades de las Trompas Uterinas , Quistes Ováricos , Neoplasias Ováricas , Enfermedad Inflamatoria Pélvica , Femenino , Humanos , Cistoadenoma Mucinoso/complicaciones , Cistoadenoma Mucinoso/diagnóstico , Cistoadenoma Mucinoso/cirugía , Enfermedad Inflamatoria Pélvica/diagnóstico , Rotura Espontánea/cirugía , Rotura Espontánea/complicaciones , Quistes/complicaciones , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/cirugía , Quistes Ováricos/complicaciones , Enfermedades de las Trompas Uterinas/complicaciones
12.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 54(5): 1035-1039, 2023 Sep.
Artículo en Chino | MEDLINE | ID: mdl-37866965

RESUMEN

Objective: To investigate the impact of endometriosis on the therapeutic effect of hysteroscopic fallopian tube catheterization combined with laparoscopy in infertile patients with proximal tubal obstruction. Methods: We conducted a retrospective analysis of patients who underwent hysteroscopic fallopian tube catheterization combined with laparoscopy for infertility caused by proximal fallopian tube obstruction between January 19, 2016 and March 20, 2020 at the Department of Reproductive Endocrinology, West China Second Hospital, Sichuan University. During the operation, hydrotubation was performed to verify whether there was proximal tubal obstruction. Then, the patients were categorized into an endometriosis group and a non-endometriosis group according to whether their proximal tubal obstruction was combined with endometriosis. The baseline data were balanced by propensity score matching and the rate of successful surgical unblocking of proximal tubal obstruction in infertile patients by hysteroscopic fallopian tube catheterization combined with laparoscopy was calculated. Treating cases lost to follow-up in both groups as non-pregnant cases according to the principle of intention-to-treat analysis, we followed up the pregnancy outcomes after surgery. The primary indicators included overall successful surgical unblocking rate, clinical pregnancy rate, and spontaneous pregnancy rate, while the secondary indicators included live birth rate, miscarriage rate, ectopic pregnancy rate, and the mean time to spontaneous pregnancy after surgery. The primary indicators included overall successful surgical unblocking rate, clinical pregnancy rate, and spontaneous conception rate, while the secondary indicators included live birth rate, miscarriage rate, ectopic pregnancy rate, and the mean time to spontaneous pregnancy after surgery. Results: After propensity score matching, 113 cases were included in each of the two groups, with the overall successful surgical unblocking rate being 72.6%. The successful surgical unblocking rate of patients in the endometriosis group was higher than that of the non-endometriosis group, with the difference being statistically significant (78.8% vs. 66.4%, P<0.05). A total of 38 patients were lost after follow-up matching. Postoperative follow-up was performed to date and, through intention-to-treat analysis, the spontaneous conception rate was found to be higher in the endometriosis group than that in the non-endometriosis group (44.2% vs. 30.1%, P<0.05), while the mean time to spontaneous pregnancy after surgery was shorter in the endometriosis group than that in the non-endometriosis group (46 months vs. 53 months, P<0.05). There was no significant difference in clinical pregnancy rate, live birth rate, miscarriage rate, and ectopic pregnancy rate between the endometriosis group and the non-endometriosis group ( P>0.05). Conclusion: When infertility caused by proximal tubal obstruction is combined with endometriosis, performing hysteroscopic fallopian tube catheterization combined with laparoscopy contributes to the improvement of reproduction outcomes.


Asunto(s)
Aborto Espontáneo , Endometriosis , Enfermedades de las Trompas Uterinas , Infertilidad Femenina , Laparoscopía , Embarazo Ectópico , Embarazo , Femenino , Humanos , Endometriosis/complicaciones , Endometriosis/cirugía , Trompas Uterinas , Aborto Espontáneo/cirugía , Estudios Retrospectivos , Infertilidad Femenina/etiología , Infertilidad Femenina/cirugía , Laparoscopía/efectos adversos , Enfermedades de las Trompas Uterinas/complicaciones , Enfermedades de las Trompas Uterinas/cirugía , Embarazo Ectópico/cirugía , Cateterismo/efectos adversos
14.
Arch Gynecol Obstet ; 308(4): 1321-1326, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37389642

RESUMEN

PURPOSE: We aimed to compare the results of image-guided drainage in addition to antibiotic therapy (antibiotherapy) with antibiotherapy alone in the treatment of tubo-ovarian abscesses (TOAs) and evaluate C-reactive protein (CRP) levels in predicting the success of antibiotherapy. METHODS: This was a retrospective study of 194 patients hospitalized with TOA. Patients were divided into the following two groups: those who underwent image-guided drainage in addition to parenteral antibiotherapy and those who did not undergo image-guided drainage and received antibiotherapy alone. CRP levels on the day of admission (day 0), day 4 of hospitalization (day 4), and day of discharge (last day) were recorded. The percentage of decrease in CRP levels during day 4 and the last day compared with that on day 0 was calculated. RESULTS: A total of 106 patients (54.6%) underwent image-guided drainage with antibiotherapy, whereas 88 patients (45.4%) did not undergo drainage and received antibiotherapy alone. At admission, the mean CRP level was 203.4 (± 96.7) mg/L and was similar in both groups. The mean decrease in the CRP level on day 4 compared with that on day 0 was 48.5% and was statistically higher in the group that underwent image-guided drainage. Antibiotherapy failed in 18 patients, and a statistically significant difference was observed between treatment failure and the rate of decrease in the CRP level on day 4 compared with that on day 0. According to the receiver operating characteristic (ROC) analysis, if the CRP level measured on day 4 decreased by < 37.1% compared with that on day 0, the probability of treatment failure would increase (area under the curve = 0.755; 95% confidence interval, 0.668-0.841; sensitivity, 73.6%; specificity, 60%). CONCLUSIONS: Image-guided drainage combined with antibiotherapy in the treatment of TOA has high success rates, lower recurrence rates, and lower surgical requirement, and the mean decrease in the CRP level on day 4 can be monitored at treatment follow-up. In patients receiving antibiotherapy alone, if the CRP level on day 4 decreases by < 37.1%, the treatment protocol should be changed.


Asunto(s)
Absceso Abdominal , Enfermedades de las Trompas Uterinas , Enfermedades del Ovario , Salpingitis , Femenino , Humanos , Absceso/tratamiento farmacológico , Absceso/cirugía , Proteína C-Reactiva , Estudios Retrospectivos , Enfermedades del Ovario/tratamiento farmacológico , Enfermedades del Ovario/cirugía , Drenaje/métodos , Antibacterianos/uso terapéutico , Enfermedades de las Trompas Uterinas/tratamiento farmacológico , Enfermedades de las Trompas Uterinas/cirugía
15.
Cell Mol Biol (Noisy-le-grand) ; 69(4): 101-104, 2023 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-37329541

RESUMEN

This experiment was carried out to investigate the effect of combined treatment of tubal obstruction infertility with deacetylated chitosan and two microscopes on the levels of IFN-γ and ICAM-1. In this study, 100 infertile patients with fallopian tube obstruction who were treated in Jiangbei District Hospital of traditional Chinese medicine from January to August 2019 were divided into two groups according to the alternating grouping method, group A (50 cases) received combined surgery, and Group B (50 cases) received combined surgery and chitosan. The curative effect and postoperative pelvic adhesion of the two groups were analyzed, and the levels of IFN-γ, ICAM-1 and IL6(IL-6), laminin (LN), Transforming growth factor beta 1(TGF-ß1) and fibronectin (FN) were observed before and after treatment. Results showed that the total effective rate of Group B was higher than that of Group A (92. 00% vs 76. 00%). The incidence of pelvic adhesion was lower in Group A (4. 00% vs 16. 00%) (P < 0.05). The levels of IFN-γ, ICAM-1, IL-6, LN, FN and TGF-ß1 in Group B were significantly lower than those in group A (P < 0.05). In conclusion, the treatment of tubal obstruction infertility with combined deacetylated chitosan and biendoscopy is effective, which can reduce the levels of IFN-γ and ICAM-1, improve the expression of adhesion-related factors and reduce the occurrence of pelvic adhesion.


Asunto(s)
Quitosano , Enfermedades de las Trompas Uterinas , Infertilidad , Femenino , Humanos , Trompas Uterinas/cirugía , Factor de Crecimiento Transformador beta1 , Quitosano/uso terapéutico , Laparoscopios , Histeroscopios , Molécula 1 de Adhesión Intercelular , Interleucina-6 , Enfermedades de las Trompas Uterinas/complicaciones , Enfermedades de las Trompas Uterinas/cirugía , Interferón gamma
16.
BMC Pediatr ; 23(1): 282, 2023 06 06.
Artículo en Inglés | MEDLINE | ID: mdl-37280586

RESUMEN

BACKGROUND: Upstream infection with vaginal flora can develop into tubal endothelial damage and tubal edema, which can lead to tubal obstruction and fallopian tube abscess if left untreated. Fallopian tube abscess in adolescent virgins is very rare, it may lead to long-term or even lifelong complications once it occurred. CASE PRESENTATION: A 12-year-old adolescent virgin with no history of sexual intercourse and previous physical fitness who presented with lower abdominal pain with nausea and vomiting for 22 h, body temperature up to 39.2 °C. Laparoscopic surgery revealed an abscess in the left fallopian tube, the left fallopian tube was surgically removed, successfully treated, and the pus was cultured for escherichia coli. CONCLUSION: It is important to consider possibility of tubal infection in young.


Asunto(s)
Enfermedades de las Trompas Uterinas , Laparoscopía , Femenino , Adolescente , Humanos , Niño , Trompas Uterinas/cirugía , Absceso , Enfermedades de las Trompas Uterinas/complicaciones , Enfermedades de las Trompas Uterinas/cirugía , Dolor Abdominal/etiología , Laparoscopía/efectos adversos
17.
Am Surg ; 89(9): 3917-3919, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37204787

RESUMEN

Isolated fallopian tube torsion is a rare cause of acute abdominal pain in adolescent females. It is known to be a surgical emergency as it may lead to ischemia of the fallopian tube which can result in necrosis, infertility or infection. Presenting symptoms and radiographic findings are vague making diagnosis difficult, often requiring direct visualization in the operating room to make the definitive diagnosis. There has been an increase in this diagnosis at our institution in the previous year prompting compilation of cases and a literature review.


Asunto(s)
Abdomen Agudo , Enfermedades de las Trompas Uterinas , Femenino , Adolescente , Humanos , Niño , Enfermedades de las Trompas Uterinas/diagnóstico por imagen , Enfermedades de las Trompas Uterinas/cirugía , Anomalía Torsional/diagnóstico por imagen , Anomalía Torsional/cirugía , Trompas Uterinas/diagnóstico por imagen , Trompas Uterinas/cirugía , Dolor Abdominal/etiología , Abdomen Agudo/complicaciones
18.
Br J Radiol ; 96(1146): 20220889, 2023 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-37066809

RESUMEN

OBJECTIVE: To evaluate the diagnostic accuracy of MRI-hysterosalpingogram (HSG) with semiquantitative dynamic contrast-enhanced perfusion, against the virtual multislice CT hysterosalpingogram (VHSG) as a reference standard. METHODS AND MATERIALS: In this prospective study, 26 women (age >18 years) searching for infertility causes and with VHSG physician request. Thereafter, the assessment performance of both techniques was determined by two reader analyses. k statistics were used for the assessment of tubal patency. Receiver operating characteristic (ROC) analysis was used to compare the capability for tubal patency assessment between both exams on a per-patient and per-tube basis. The McNemar test was used to compare the diagnostic accuracy measures. RESULTS: Tubal patency, uterine morphological, ovarian, and extrauterine abnormalities were evaluated through both exams in all 26 women. There was no significant difference between diagnostic performance measurements between the methods. The ROC curve of VHSG was 0.852 for both per-patient and per-tube analyses, and one and 0.938 for MRI-HSG. Sensitivity and specificity for per-patient and per-tube for VHSG were 95.2 and 97.7, 80 and 87.5%, and for MRI-HSG 100% for both analyses and 100 and 87.5%, respectively. CONCLUSION: This study demonstrates the feasibility of diagnosing tubal patency through MRI, using a semi-quantitative dynamic contrast-enhanced perfusion sequence, and the satisfactory diagnosing of the uterine morphology, ovarian abnormalities, and ovarian and deep endometriosis. ADVANCES IN KNOWLEDGE: Multiparametric MRI with a perfusion real-time sequence as a HSG method can be used in the evaluation not only for uterine and ovarian abnormilities but also tubal patency.


Asunto(s)
Enfermedades de las Trompas Uterinas , Infertilidad Femenina , Imágenes de Resonancia Magnética Multiparamétrica , Femenino , Humanos , Adolescente , Histerosalpingografía/efectos adversos , Histerosalpingografía/métodos , Estudios Prospectivos , Infertilidad Femenina/diagnóstico por imagen , Infertilidad Femenina/etiología , Enfermedades de las Trompas Uterinas/diagnóstico por imagen , Pelvis/diagnóstico por imagen , Tomografía Computarizada por Rayos X/efectos adversos
19.
Int J Gynaecol Obstet ; 163(1): 44-50, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37014527

RESUMEN

Endosalpingiosis is characterized by the presence of ectopic, benign glands with a fallopian tube-like ciliated epithelium. Florid cystic endosalpingiosis (FCE) is a rare type of endosalpingiosis and presents with tumor-like lesions. In general, FCE has no specific clinical features. In this case, extensive pelvic multiple Müllerian cysts were first observed and removed during the patient's second cesarean section. Lesions relapsed after a year. Therefore, the patient underwent total hysterectomy and bilateral salpingectomy; pathology revealed that the patient had FCE. According to imaging studies during the follow up, recurrent and progressive multiple pelvic and extra-pelvic cysts were observed. The patient had no obvious symptoms, and the results of her laboratory tests were within normal limits. Ultrasound-guided aspiration and lauromacrogol sclerotherapy were performed, and in the past year, the cysts have stabilized without progression. This is the first reported case of recurrent FCE after total hysterectomy and bilateral salpingectomy with a 5-year follow up. A literature review and novel ideas for diagnosing and managing FCE based on this case are also presented.


Asunto(s)
Quistes , Enfermedades de las Trompas Uterinas , Embarazo , Humanos , Femenino , Enfermedades de las Trompas Uterinas/diagnóstico , Cesárea , Estudios de Seguimiento , Trompas Uterinas/cirugía , Trompas Uterinas/patología , Quistes/diagnóstico por imagen , Quistes/cirugía
20.
Eur Rev Med Pharmacol Sci ; 27(7): 2980-2986, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-37070899

RESUMEN

OBJECTIVE: To determine the concentrations of the nuclear factor kappa B (NF-κB), tumor necrosis factor-alpha (TNF-α) and interleukin-7 (IL-7) in midluteal phase endometrial samples of infertile patients diagnosed with uni or bilateral hydrosalpinx (HX). PATIENTS AND METHODS: A total of 24 patients who decided to undergo laparoscopic salpingectomy were included in the study. Salpingectomy indications consisted of patients with a diagnosis of hydrosalpinx (n=12) or ectopic pregnancy (n=12). Twelve healthy patients who underwent Pomeroy-type tubal ligation were considered as the second and healthy control group. The diagnosis of hydrosalpinges was made by transvaginal 2D ultrasonography or HSG. All patients in the hydrosalpinges or ectopic pregnancy group underwent laparoscopic salpingectomy. Just before salpingectomy, endometrial samples were obtained from all patients by Pipelle cannula. Endometrial sampling was performed 7-9 days after the LH surge in the control group. IL-7, NF-κB and TNF-α concentrations were measured by ELISA method in the endometrial samples of all three groups. RESULTS: The endometrial IL-7 concentration before salpingectomy of the patients in the hydrosalpinx group was 44.6±6.65 ng/mg wet-tissue. The IL-7 levels of the HX group were significantly higher than those of the patients in the ectopic pregnancy group (19.3±3.06 ng/mg wet tissue versus 44.6±6.65 ng/mg wet tissue, p<0.04). Similarly, IL-7 levels of the HX group were significantly higher than those of the tubal ligation group (6.08±1.48 ng/mg wet tissue versus 44.6±6.65 ng/mg wet tissue, p<0.03). The endometrial TNF-α concentration of the patients in the hydrosalpinx group was 33.20±5.40 ng/mg wet-tissue. The TNF-α value detected in the hydrosalpinx group was significantly higher than both the TNF-α value in the ectopic pregnancy group (11.8±1.07 ng/mg wet-tissue vs. 33.20±5.40 ng/mg wet-tissue, p<0.01) and the TNF-α value in the tubal ligation group (5.30±1.22 ng/mg wet-tissue vs. 33.20±5.40 ng/mg wet-tissue, p<0.01). The pre-salpingectomy endometrial NF-κB concentration of the patients in the hydrosalpinx group was 6.38±1.40 ng/mg wet-tissue. This value is higher than endometrial NF-κB levels in the ectopic pregnancy group (3.67±0.41 ng/mg wet-tissue vs. 6.38±1.40 ng/mg wet-tissue, p<0.02) and NF-κB levels in the tubal ligation group (1.07±0.38 ng/mg wet-tissue vs. 6.38±1.40 ng/mg wet-tissue, p<0.01). CONCLUSIONS: The presence of hydrosalpinx prevents successful implantation by increasing the levels of endometrial proinflammatory cytokines TNF-α, IL-7 and NF-κB.


Asunto(s)
Enfermedades de las Trompas Uterinas , Infertilidad , Embarazo Ectópico , Embarazo , Femenino , Humanos , FN-kappa B/metabolismo , Factor de Necrosis Tumoral alfa , Interleucina-7 , Enfermedades de las Trompas Uterinas/cirugía , Transducción de Señal
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