RESUMEN
Conventional management of uterocutaneous fistula involves open or laparoscopic excision as well as hysterectomy but there is now increasing recognition of successful medical treatment with gonadotrophin releasing hormone agonists. We describe the fourth case in the literature of successful nonsurgical treatment of uterocutaneous fistula and discuss two important factors affect the success of medical management, namely the size of the fistula and the duration of treatment. We would recommend that a trial of gonadotrophin releasing hormone analogues for at least 6 months particularly in cases of uterocutaneous fistula of 5 mm or less in diameter as this conservative treatment is likely to obviate the need for more hazardous surgical intervention.
Asunto(s)
Fístula , Laparoscopía , Femenino , Humanos , Fístula/tratamiento farmacológico , Histerectomía , HormonasRESUMEN
Klippel-Trènaunay syndrome is a rare congenital disorder characterised by vascular malformations, which may be exacerbated during pregnancy and pose considerable thromboembolic and haemorrhagic risk for obstetric patients. We report on a patient with this syndrome who underwent elective caesarean section which was indicated due to previous obstetric anal sphincter injury. We describe her multidisciplinary preoperative planning and successful management of major postpartum haemorrhage with uterine compression sutures and intrauterine balloon tamponade ('uterine sandwich').
Asunto(s)
Síndrome de Klippel-Trenaunay-Weber , Hemorragia Posparto , Complicaciones Cardiovasculares del Embarazo , Cesárea , Femenino , Humanos , Síndrome de Klippel-Trenaunay-Weber/complicaciones , Hemorragia Posparto/etiología , Hemorragia Posparto/terapia , Embarazo , ÚteroRESUMEN
A 74-year-old woman presented with dyspnoea and fever on a background of a large hepatic cyst thought to be stable in size. During her admission, she developed worsening shortness of breath. An echocardiogram revealed severely impaired cardiac output due to external compression by the hepatic cyst, which had grown rapidly. This was drained under ultrasound guidance and cultures of this fluid grew Pseudomonas aeruginosa: the organism responsible for the persistence of this giant hepatic cyst.