Broad ligament hernia-associated bowel obstruction.

BACKGROUND AND OBJECTIVE: We present the case of a female patient 29 years of age with antecedents of laparoscopic laser ablation for endometriosis, laparoscopic appendectomy, and umbilical hernioplasty. METHODS: The patient was admitted to the hospital's emergency room for abdominal pain in the epigastrium, transfixing, irradiating to both upper quadrants and to the lumbar region, accompanied by nausea and gastrobiliary vomiting. Lipase determination was 170 mg/dL. Other laboratory findings were normal. Plain abdominal films on the patient's admission were normal, and computed tomography (CT) showed data compatible with acute pancreatitis. Without improvement during the patient's hospital stay, pain and vomiting increased in intensity and frequency. RESULTS: New abdominal x-rays revealed dilatation of small bowel loops. Management was begun for intestinal obstruction, with intravenous hydration and placement of a nasogastric tube without a good response. At 48 hours, a diagnostic laparoscopy was performed, revealing a 3-cm internal hernia in the left broad ligament in which a 20-cm segment of terminal ileum was encased. We performed liberation of the ileal segment and closed the hernial orifice by using the laparoscopic approach. CONCLUSION: The patient's evolution was excellent.

[Laparoscopic findings in patients with pelvic pain, dysmenorrhea and sterility]. / Hallazgos laparoscópicos en pacientes con dolor pélvico, dismenorrea y esterilidad.

Endometriosis is a frequent gynecologic disease and is associated with dysmenorrhea, pelvic pain and infertility. We evaluated 71 patients who had any of these entities and were treated with laparoscopic procedures. We found a higher frequency of endometriosis in these groups in comparation with the reports of the literature but, there was no direct relation between the severity of endometriosis and the three groups (Revised Classification of the American Fertility Society). The organic pathology was the principal factor associated with the pelvic pain in most cases. Finally, we established the utility of laparoscopy in the diagnosis stading and treatment of endometriosis.

[Laparoscopic treatment of dermoid cyst. First report in Mexico]. / Tratamiento laparoscópico de quiste dermoide. Primer informe en México.

The laparoscopic treatment of adnexal masses has been controversial; however, the study of the case with the judicious use of the laboratory and ultrasound permit the laparoscopic approach of the most of the adnexal masses, including the dermoid cyst or mature cystic teratomas, and offer to the patient the benefits of the laparoscopic surgery with low morbidity. However, it should be do it in medical centers with the human and technics recourse need it for the performance. It present the first report in Mexico of laparoscopic treatment in contrast with a group of patients with laparotomy. The results of this study, are in conformity with the reports on the literature and suggest the initial laparoscopic approach of the dermoid cyst.

[Cytologic-colposcopic-histopathologic correlations in preinvasive cervical lesions and cervical Human Papillomavirus infections]. / Correlación cito-colposcópica-histopatológica de lesiones cervicales preinvasoras e infección cervical por virus del papiloma humano.

Cervico-uterine cancer is the most frequent gynecological neoplasia in Mexico and cervico-vaginal cytology is the most practical and dependable resource in lesions detection. During the last years precursory lesions detection (NIC and HPV infection) has increased. So, every patient presenting with an abnormal cytology should be included in an evaluation program, that includes a colposcopic study with biopsy of suspicious lesions, in order to know cellular abnormality degree, as these studies combination increases diagnosis certainty. Ninety three patients were evaluated by colposcopy, as the Papanicolaou showed abnormality ICN type in any degree or HPV infection data, during the first three years of the Unidad de Colposcopia de la Beneficiencia del Hospital ABC. In 49 patients histopathological study, was done. A correlation of all studies was carried out. There was a correlation cytology-histopathology of 59.18%; and colposcopy-histopathology of 89.79%. It was concluded that evaluation by cytology is insufficient to establish a final diagnosis and treatment, and that colposcopic study is fundamental in the evaluation of the patient with abnormal exfoliative cytology.

[Analysis of the predictive value of prolactin concentration in the umbilical cord as an evaluation parameter for respiratory insufficiency in the newborn]. / Análisis del valor predictivo de la concentración de prolactina en cordón umbilical como parámetro evaluatorio de la insuficiencia respiratoria del recién nacido.

In fetal pulmonary development several substances and hormones which directly participate, have been involved. One of these is prolactin, which by raising concentrations through a complex mechanism seems to participate in pulmonary maturation. Due to the importance of product's pulmonary maturity producing respiratory failures of the newborn, some progress has been made in opportune diagnosis, and mainly in prophylaxis of this condition. In this study, serum samples were taken from the umbilical chord to know perinatal evolution after analysis of the evolution of each of the 37 cases, the results corresponded to previous results as published in literature for different conditions as toxemia, diabetes mellitus or prematurity, as well as the relationship between hormonal serum concentrations, and gestational age and weight.

[Early diagnosis of heterotopic pregnancy with viability of the intrauterine fetus. Report of two cases and review of the literature]. / Diagnóstico temprano de embarazo heterotópico con viabilidad del producto intrauterino. Informe de dos casos y revisión de la literatura.

Heterotopic pregnancy, or coexistence of intrauterine and extrauterine pregnancy, is a rare entity, with a difficult pre-operative diagnosis, and potentially dangerous for the mother and for the intrauterine pregnancy. There are risk factors that are increased by this entity, so it should be taken into consideration if assisted reproduction techniques are used. The use of ultrasonography and laparoscopy is fundamental for detection, in order to implant an opportune treatment. Two cases of heterotopic pregnancy with viability of intrauterine gestation, are presented.

[Acute myocardial infarct and pregnancy. Report of a case and review of the literature]. / Infarto agudo del miocardio y embarazo. Presentación de un caso y revisión de la literatura.

We present the case of a 39 year old woman with 36 weeks pregnancy and acute myocardial infarction seen at the Hospital ABC. Acute myocardial infarction during pregnancy is not very common and it's incidence has been calculated in 1:10,000 pregnancies it takes place more often during the third trimester, so we have to keep it in mind for early diagnosis. Mortality increases when it occurs during the third trimester close to delivery, during labor or in the first 7 days post delivery. Initial management of this high risk patients has to be done in a intensive care unit and requires of the intervention of multiple specialists, to decrease maternal and fetal mortality.

[Hypertrophic cardiomyopathy and pregnancy. Presentation of a case and review of the literature]. / Cardiomiopatía hipertrófica y embarazo. Presentación de un caso y revisión de la literatura.

We present the case of a 31 year old woman with primary hypertrophic myocardiopathy associated with term pregnancy seen in the Department of Gynecology and Obstetrics at the Hospital ABC. Pregnancy, labor and delivery coursed without obstetric and perinatal complications. We comment the classification, etiology, diagnosis and treatment of this cardiopathy that has been reported in pregnancy in few publications.

[Aortic stenosis and pregnancy: presentation and physiopathology of a case]. / Estenosis aórtica y embarazo: presentación de un caso y revisión fisiopatológica.

This is the case of a female patient, 31 years of age with the diagnosis of aortic stenosis, prolapse of mitral valve, aortic insufficiency, with pregnancy. The literature is reviewed and the management of this type of condition is analyzed.