RESUMO
BACKGROUND: Uterine fibroids are a common cause of abnormal uterine bleeding in adult women, but are extremely rare in the adolescent years. CASE: A 12-year-old nulliparous girl presented with abnormal uterine bleeding and was found to have a prolapsing submucosal fibroid. The fibroid and her symptoms were successfully removed using an Endosnare. SUMMARY AND CONCLUSION: The most common cause of abnormal uterine bleeding in adolescent bleeding is due to anovulation. Though rare, fibroids should remain on the differential as the cause of abnormal uterine bleeding in the adolescent population, particularly if symptoms persist despite initial therapy. Fibroids can be managed successfully with minimally invasive techniques.
Assuntos
Leiomioma/patologia , Neoplasias Uterinas/patologia , Criança , Anticoncepcionais Orais Hormonais/administração & dosagem , Etinilestradiol/administração & dosagem , Feminino , Humanos , Leiomioma/complicações , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Ultrassonografia , Hemorragia Uterina/tratamento farmacológico , Hemorragia Uterina/etiologia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/cirurgiaRESUMO
BACKGROUND: Complications associated with imperforate hymen include cyclical abdominal pain, acute urinary retention, endometriosis, and even iatrogenic infections. CASE: A 14-year-old young woman was diagnosed with an imperforate hymen, hematocolpos, and right hematosalpinx. A hymenotomy was performed, followed by a hymenectomy 3 days later. On postoperative day 7, she was admitted for pelvic inflammatory disease with a right pyosalpinx. The infection was refractory to intravenous gentamicin, ampicillin, and clindamycin so the patient underwent computed tomography-guided drainage of the pyosalpinx. Two days later, she was discharged home in good condition. SUMMARY AND CONCLUSION: Small incisions and punctures into imperforate hymens without immediate definitive management should be avoided because inoculation of the newly introduced bacteria can ascend the gynecologic tract and lead to serious infections.
Assuntos
Colpotomia/efeitos adversos , Hematocolpia/cirurgia , Hímen/anormalidades , Distúrbios Menstruais/cirurgia , Salpingite/etiologia , Adolescente , Anormalidades Congênitas , Drenagem/métodos , Feminino , Hematocolpia/complicações , Humanos , Hímen/cirurgia , Doença Iatrogênica , Distúrbios Menstruais/complicações , Salpingite/cirurgiaRESUMO
BACKGROUND: Emergency procedures have been traditionally taught in live "hands on" workshops, which are expensive (tuition, travel, hotel, and leaving one's practice idle). This study was conducted to compare the teaching efficacy of a traditional live workshop to a procedure-in-a-box toolkit (PBT) method which contains audiovisual instructions and props to practice the procedures. METHODS: Four procedures, zipper release, intraosseous needle placement, fishhook removal, and splinting, were taught to 32 physician volunteers, using both teaching methods. Each participant was asked to evaluate the teaching method after each session. RESULTS: The mean educational quality of each method were not significantly different from each other, but if given a choice study subjects preferred the live workshop more often. CONCLUSION: The live workshop is the preferable method for teaching procedures but when considering expenses, most of the subjects felt that the PBT method is an adequate substitute method for the live workshop.