ABSTRACT
BACKGROUND: To study the possible association between endometriosis and ovarian varices. These diseases manifest with similar symptomatologies and the hormone estradiol is implicated in both. METHODS: The sample consisted of 48 female patients between the ages of 18 and 50 years old. There were 25 patients who had been diagnosed with endometriosis. Fifteen had been confirmed by surgery and histopathology, and 10 by nuclear magnetic resonance. There were also 23 patients without endometriosis who were considered to be the control group. The diagnosis of ovarian varicose veins were made through ultrasound system with endovaginal transducer of 4 to 8 MHz. This study was conducted from May 2013 to September 2014. The researchers attempted to identify the anechoic, circular, linear, and non-pulsatile structures in the broad ligament of the uterus. Varices with dilation of equal to or greater than 5 mm in the longitudinal cut, with tortuous veins with reflux in the adnexal region. RESULTS: The prevalence of ovarian varices in patients with endometriosis was 80%, whereas the control group was only 26.1%. The elevated percentage of ovarian varices in patients with endometriosis is highly significant, with a difference of 53.9% and 95% confidence interval of 30%-78%. The criterion for the determination of significance that we adopted was the level of 5%. The statistical analysis was processed using the statistical software SAS system, version 6.11 (SAS Institute, Inc., Cary, North Carolina). CONCLUSIONS: Our results suggest that ovarian varices may play a very important role in the physiopathology of endometriosis. Ovarian varices may evolve with oxidative stress in the function of the ovary, provoking an imbalance in its genetic, hormonal, and immunologic aspects and provoking the chronic inflammatory process particular to endometriosis.
Subject(s)
Endometriosis/epidemiology , Ovary/blood supply , Varicose Veins/epidemiology , Adult , Brazil/epidemiology , Case-Control Studies , Dilatation, Pathologic , Endometriosis/diagnosis , Female , Humans , Middle Aged , Prevalence , Ultrasonography, Doppler, Color , Ultrasonography, Doppler, Pulsed , Varicose Veins/diagnostic imaging , Varicose Veins/physiopathology , Veins/diagnostic imaging , Veins/physiopathologyABSTRACT
Objetivo: Relatar nossa experiência com varizes do nervo ciático e indicar que tipo de paciente é mais provável de ser acometido por essa patologia. Método: A amostra foi constituída de 2.400 pacientes, selecionando-se 80 deles (3,3%) como possíveis portadores de varizes do nervo ciático. Foram considerados pacientes suspeitos: pacientes portadores de varizes na face lateral da perna, coxa e oco poplíteo; pacientes com recidiva anárquica de varizes após safenectomia; pacientes com sintomas e exames positivos para varizes pélvicas; pacientes com história prévia de trombose venosa profunda; pacientes com queixas de dores ciáticas e aumento do diâmetro de um membro com relação ao outro. Esses pacientes foram submetidos a exames detalhados e rigorosos do losango poplíteo com objetivo de identificar varizes dentro da bainha do nervo ciático e na face lateral da perna. Desses, 10 foram submetidos à angiografia venosa para detalhar a relação anatômica com o nervo ciático. Resultados: De 80 pacientes previamente selecionados, encontramos 21 (26,3%) casos positivos para varizes do nervo ciático ao exame ecográfico. Dez pacientes tinham varizes do nervo ciático associadas a recidiva anárquica de varizes após safenectomia e outros 10 associadas a varizes pélvicas. A dor ciática esteve presente em 100% dos pacientes positivos para VNC. Conclusão: Varizes do nervo ciático são pouco conhecidas pela medicina. Se o médico fizer uma seleção prévia conforme descrito em ?pacientes e métodos? e concentrar-se no exame ecográfico do losango poplíteo e face lateral da perna, irá se surpreender com o elevado número de casos de varizes do nervo ciático que diagnosticará.
Objective: To report our experience with patients with sciatic nerve varices (SNV) and to indicate which type of patient is more likely to be afflicted with this particular pathology. Method: The sample consisted of 2,400 patients, selecting 80 (3.3%) as possible sufferers of SNV. Patients with the following conditions were highly suspected: patients with varices on the lateral aspect of the leg, the thigh, and oco politeo; patients with uncontrolled variceal recurrence after a safenectomy; patients with symptoms of and who tested positive for pelvic varices; patients with a history of deep vein thrombosis; and patients complaining of sciatic pain along with an increase in the diameter of one limb in relation to the other. These patients underwent detailed and rigorous examination of the ?losango popliteo? with the objective of identifying varices inside the sheath of the sciatic nerve and on the lateral aspect of the leg. Of these, 10 underwent venous angiography to detail the anatomical relationship with the sciatic nerve. Results: Of the 80 patients previously selected, we found 21 (26.3%) cases that were positive for SNV through ultrasound. Ten patients had SNV associated with uncontrolled variceal recurrence after safenectomy, while the other 10 were associated with pelvic varices. Sciatic pain was present in 100% of the patients who tested positive for SNV. Conclusion: SNV are not well known in Medicine. If the doctor makes a examination as described in the ?patients and methods? section and concentrates on the ultrasound scan of the ?diamond popliteal? and lateral aspect of the leg, he or she will be surprised by the high number of cases of SNV that will be diagnosed.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged, 80 and over , Nerve Compression Syndromes , Sciatic Neuropathy , Varicose Veins/diagnosis , Varicose Veins/pathologyABSTRACT
Os autores apresentam um caso de infestaçäo maciça das vias biliares Ascaris Lumbricóides em criança, no qual foi encontrado vinte e dois espécimes vivos. Tecem consideraçöes sobre o achado correlacionado com a literatura
