RESUMO
Ovarian hyperthecosis and ovarian stromal hyperplasia (OSH) are two uncommon non-neoplastic causes of ovarian hyperandrogenism, whose etiology is still unknown. These conditions are characterized by obesity, hyperinsulinemia, acanthosis nigricans, and even virilization, mainly in postmenopausal women. Here we have reported the case of a 67-year-old patient with a diagnosis of OSH, which was resolved after bilateral laparoscopic oophorectomy. In this case report, we have discussed two different conditions posing a diagnostic challenge and requiring a high index of suspicion.
RESUMO
Objetivo. Evaluar la incidencia, la evolución y el riesgo de recurrencia en casos de inversión uterina puerperal en nuestro centro. Material y métodos. Estudio retrospectivo. Veintidós casos de inversión uterina puerperal entre enero del 1993 y diciembre del 2013. Se analizan los diferentes riesgos. Resultados. Pacientes: edad media: 28 años (18-41); 19 nulíparas (86%); 4 pacientes presentaban cirugía uterina anterior (18%). Trabajo de parto: 6 finalizaron la gestación mediante cesárea (27%), y 16 (73%) vía vaginal. Peso medio de los recién nacidos: 3.111 g (2.130-3.950); 8 casos de retención de placenta (36,4%) y 3 atonías uterinas (13,6%). Tipo inversión: 100% aguda. Complicaciones y manejo: hemorragia severa en 7 pacientes; 20 casos (91%) se resolvieron mediante maniobra de Johnson; 2 histerectomías (9%). No hubo muertes ni recurrencias. Conclusiones. La nuliparidad y la retención de placenta fueron factores de riesgo importantes en nuestro estudio. La precocidad en el diagnóstico y el tratamiento es de vital importancia. La cirugía debe ser la última opción (AU)
Objective. To assess the incidence, outcomes, and risk of recurrence of puerperal uterine inversion in our hospital. Material and methods. A retrospective study was carried out in 22 cases of puerperal uterine inversion from January 1993 to December 2013 in our hospital. We analyzed different risk factors. Results. The mean age of the patients was 28 years (18-41). Nineteen (86%) were nulliparous. Four (18%) had undergone previous uterine surgery. Delivery was through cesarean section in 6 patients (27%) and through the vaginal route in 16 (73%). The mean birthweight was 3111 grams (2130-3950). Retained placenta occurred in 8 patients (36.4%) and uterine atony in 3 (13.6%). Uterine inversion was acute in all patients. Complications and management consisted of severe hemorrhage in 7 patients, 20 cases (91%) were resolved by the Johnson procedure, and 22 hysterectomies (9%) were performed. There were no deaths and no recurrences. Conclusions. In our study, important risk factors were nulliparity and placenta accreta. Early diagnosis and treatment are of the utmost importance. Surgery should be the last option (AU)
Assuntos
Humanos , Feminino , Período Pós-Parto , Inversão Uterina/diagnóstico , Inversão Uterina/etiologia , Inversão Uterina/terapia , Hemorragia Uterina/etiologia , Hemorragia Uterina/mortalidade , Hemorragia Uterina/prevenção & controle , Inércia Uterina/etiologia , Inércia Uterina/prevenção & controle , Estudos Retrospectivos , Trabalho de Parto , Útero/lesões , Mortalidade Materna/tendênciasRESUMO
El síndrome de Berdon es un síndrome muy poco frecuente de carácter congénito, caracterizado por megavejiga, microcolon e hipoperistalsis intestinal, cuyo pronóstico es infausto en la mayoría de las ocasiones y cuyo manejo supone un reto que requiere un abordaje multidisciplinar. Revisamos una serie de casos diagnosticados en nuestro centro entre 1997 y 2010, comentando el diagnóstico, manejo y evolución de estos pacientes(AU)
Berdon syndrome is a rare congenital syndrome characterized by megacystis, microcolon and intestinal hypoperistalsis. It has an ominous prognosis in most cases, and its management requires a multidisciplinary approach. We review a series of cases diagnosed in our center between 1997 and 2010, and discuss the diagnosis, management and outcomes of these patients(AU)
