RESUMO
Spontaneous perforation of pyometra is an extremely rare emergent gynecologic disease. We report a 73-year-old woman with a spontaneously perforated pyometra presenting with acute abdomen in the emergency department. A dedicated computed tomography examination of the abdominal and pelvic regions revealed the diagnosis. The patient recovered well after surgical intervention and antibiotic treatment.
Assuntos
Abdome Agudo/diagnóstico por imagem , Pneumoperitônio/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Doenças Uterinas/diagnóstico por imagem , Perfuração Uterina/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Pneumoperitônio/microbiologia , Pneumoperitônio/terapia , Supuração , Doenças Uterinas/microbiologia , Doenças Uterinas/terapia , Perfuração Uterina/microbiologia , Perfuração Uterina/terapiaRESUMO
We assessed the feasibility of sentinel lymph node detection using technicium-99 radiocolloid lymphatic mapping for predicting lymph node metastases in early invasive cervical cancer. Thirty patients with cervical cancer (stages IA2-IIA) underwent preoperative lymphoscintigraphy using technicium-99 intracervical injection and intraoperative lymphatic mapping with a handheld gamma probe. After dissection of the sentinel nodes, the standard procedure of pelvic lymph node dissection and radical hysterectomy was performed as usual. The sentinel node detection rate was 100% (30/30). There were seven (23.3%) cases of microscopic lymph node metastases on pathologic analysis. All of them had sentinel node involvement. Therefore, the sensitivity of sentinel node identification for prediction of lymph node metastases was 100%, and no false negative was found. Preoperative lymphoscintigraphy, coupled with intraoperative lymphatic mapping, located the sentinel nodes accurately in our study patients. This sentinel node detection method appears to be feasible for predicting lymph node metastases.
