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1.
JNMA J Nepal Med Assoc ; 59(234): 200-203, 2021 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-34506473

RESUMO

Uterine adenosarcoma is a rare variant of mixed Mullerian tumors comprised of neoplastic glands with the benign appearance and sarcomatous stroma. The epithelium most often consists of endometrium- like cells, while the sarcomatous component usually shows low-grade homologous uterine sarcoma. These tumors present as a pelvic mass or an enlarged uterus with abnormal vaginal bleeding. Here, we present a case of 61 years old postmenopausal female patient with chief complaints of excessive vaginal bleeding and urine retention.


Assuntos
Adenossarcoma , Tumor Mulleriano Misto , Neoplasias Uterinas , Adenossarcoma/diagnóstico , Adenossarcoma/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Hemorragia Uterina/etiologia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia
2.
JNMA J Nepal Med Assoc ; 59(239): 635-639, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34508505

RESUMO

INTRODUCTION: Thyroid hormone is known to affect reproductive biology. Abnormal uterine bleeding is one of the common presentations in gynaecology outpatient departments and thyroid dysfunction is known to affect its progression. This study aims to find the prevalence of thyroid dysfunction in diagnosed cases of abnormal uterine bleeding in patients in a tertiary hospital of eastern Nepal. METHODS: A descriptive cross-sectional study was conducted in patients diagnosed with abnormal uterine bleeding in a tertiary care hospital of eastern Nepal from April 2019-March 2020 after taking ethical clearance from the Institutional Review Committee. On basis of inclusion and exclusion criteria, 95 cases of abnormal uterine bleeding were included in the study. A blood sample was taken and a thyroid function test was done by chemiluminescence assay on an automated analyzer. Convenient sampling method was used for sample collection. Statistical analysis was done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of the total cases of abnormal uterine bleeding, 15 (15.79%) (8.46-23.12 at 95% Confidence Interval) had thyroid dysfunction. Among total cases, 80 (84.21%) were euthyroid. The mean age of the patients was 33±8 years. Among thyroid dysfunction, 9 (60.0%) were hypothyroid, 4 (26.66 %) were subclinical hypothyroid, and 2 (13.33 %) were hyperthyroid. CONCLUSIONS: Thyroid dysfunction was common among patients with abnormal uterine bleeding, with hypothyroidism being the most common type.


Assuntos
Glândula Tireoide , Hemorragia Uterina , Adulto , Estudos Transversais , Feminino , Humanos , Nepal/epidemiologia , Centros de Atenção Terciária , Hemorragia Uterina/epidemiologia , Hemorragia Uterina/etiologia
3.
BMJ Case Rep ; 14(9)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497058

RESUMO

A 35-year-old woman (gravida 1, para 0) underwent termination of pregnancy (ToP) at 12 weeks of gestation. One month after ToP, she experienced significant vaginal bleeding and the mass with blood flow was identified on imaging. The presence of a placental polyp with arteriovenous malformation (AVM) was suspected on transvaginal sonography and MRI. Since the bleeding had ceased when she visited our hospital, we decided to treat the placental polyp with AVM with gonadotropin-releasing hormone (GnRH) antagonist therapy instead of surgery. Two months after GnRH antagonist treatment, the mass and blood flow in the uterus disappeared. Menstruation resumed 1 month after the completion of treatment. In our case, we were able to successfully treat placental polyps with AVM using GnRH antagonist therapy.


Assuntos
Malformações Arteriovenosas , Placenta , Adulto , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/tratamento farmacológico , Feminino , Hormônio Liberador de Gonadotropina , Número de Gestações , Antagonistas de Hormônios , Humanos , Placenta/diagnóstico por imagem , Gravidez , Hemorragia Uterina/etiologia
4.
Medicine (Baltimore) ; 100(31): e26844, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397857

RESUMO

RATIONALE: Primary signet ring cell carcinoma of the uterine cervix is extremely rare and the clinical characteristics and prognosis are not well known and there are no specific guidelines for treatment. PATIENT CONCERNS: A 43-year-old woman was referred to our hospital for abnormal uterine bleeding lasting 1 month. DIAGNOSES: Histological examination revealed a signet ring cell carcinoma of the uterine cervix. After evaluation of extragenital origin, the patient was diagnosed International Federation of Gynecology and Obstetrics stage IIIC1 primary signet ring cell carcinoma or the uterine cervix. INTERVENTION: The patient was prescribed concomitant chemo-radiation followed by intracavitary brachytherapy. OUTCOMES: She showed no evidence of disease after treatment but, it recurred after 7 months of last treatment. LESSONS: Different approaches to diagnosis and treatment of this rare disease are needed and molecular pathological studies related to the onset of the disease are required.


Assuntos
Carcinoma de Células em Anel de Sinete , Colo do Útero , Quimiorradioterapia/métodos , Cisplatino/administração & dosagem , Neoplasias do Colo do Útero , Esfregaço Vaginal/métodos , Adulto , Antineoplásicos/administração & dosagem , Biópsia/métodos , Braquiterapia/métodos , Carcinoma de Células em Anel de Sinete/patologia , Carcinoma de Células em Anel de Sinete/fisiopatologia , Carcinoma de Células em Anel de Sinete/terapia , Colo do Útero/diagnóstico por imagem , Colo do Útero/patologia , Evolução Fatal , Feminino , Humanos , Recidiva Local de Neoplasia/patologia , Papillomaviridae/isolamento & purificação , Retratamento/métodos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/fisiopatologia , Neoplasias do Colo do Útero/terapia , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/etiologia
5.
BMC Womens Health ; 21(1): 298, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34399742

RESUMO

BACKGROUND: The formation of a uterine artery pseudoaneurysm is rare and isolated cases have been reported in the existing literature following caesarean sections, curettages and cone biopsies. There has been no report of pseudoaneurysm formation following a loop electrosurgical excision procedure. Vaginal bleeding could potentially be life threatening if this diagnosis is not considered following cervical instrumentation or surgery. Management options range from haemostatic sutures, image-guided embolisation to surgical repair. We report the diagnosis and management of a case of uterine artery pseudoaneurysm after a loop electrosurgical excision procedure. CASE PRESENTATION: A 37-year-old woman was diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3) and underwent a therapeutic loop electrosurgical excision procedure. One month after the procedure, the patient presented to the emergency department with repeated episodes of sudden-onset heavy vaginal bleeding associated with hypotension and syncope. A computed tomography angiogram was performed, which demonstrated a pseudoaneurysm of the right uterine artery. Following the diagnosis, image-guided embolisation was performed successfully. Post-embolisation angiograms showed successful embolisation of the pseudoaneurysm and the patient had no further episodes of bleeding. CONCLUSIONS: Loop electrosurgical excision procedures are generally safe but rarely, can be complicated by the formation of uterine artery pseudoaneurysms. The depth of the loop electrosurgical excision procedure and vascular anatomy should be considered to prevent such complications. A computed tomography angiogram appears to be ideal for diagnosis. Image-guided embolisation is safe and effective as a therapeutic measure, with minimal morbidity.


Assuntos
Falso Aneurisma , Neoplasias do Colo do Útero , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Eletrocirurgia/efeitos adversos , Feminino , Humanos , Gravidez , Artéria Uterina/diagnóstico por imagem , Artéria Uterina/cirurgia , Neoplasias do Colo do Útero/cirurgia , Hemorragia Uterina/etiologia
7.
Emerg Med Pract ; 23(8): 1-20, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34310092

RESUMO

Uterine bleeding that is abnormal in timing, duration, or quantity affects nearly one-third of women and carries a substantial financial and quality-of-life burden. An estimated 5% of ED visits are for vaginal bleeding, and 1% of those patients will have a life-threatening cause that must be identified. Emergency clinicians need to have a comprehensive understanding of the pathophysiology and etiologies of abnormal uterine bleeding to manage and treat these patients. This issue reviews the most recent updates on common causes and the approach to abnormal uterine bleeding in the nonpregnant patient, including vaginal bleeding in prepubescent females.


Assuntos
Serviço Hospitalar de Emergência , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/etiologia , Hemorragia Uterina/terapia , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Humanos , Exame Físico , Qualidade de Vida , Triagem
8.
BMJ Open ; 11(7): e050755, 2021 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-34321307

RESUMO

INTRODUCTION: Postmenopausal bleeding (PMB), the red flag symptom for endometrial cancer, triggers urgent investigation by transvaginal ultrasound scan, hysteroscopy and/or endometrial biopsy. These investigations are costly, invasive and often painful or distressing for women. In a pilot study, we found that voided urine and non-invasive vaginal samples from women with endometrial cancer contain malignant cells that can be identified by cytology. The aim of the DEveloping Tests for Endometrial Cancer deTection (DETECT) Study is to determine the diagnostic test accuracy of urine and vaginal cytology for endometrial cancer detection in women with PMB. METHODS AND ANALYSIS: This is a multicentre diagnostic accuracy study of women referred to secondary care with PMB. Eligible women will be asked to provide a self-collected voided urine sample and a vaginal sample collected with a Delphi screener before routine clinical procedures. Pairs of specialist cytologists, blinded to participant cancer status, will assess and classify samples independently, with differences settled by consensus review or involving a third cytologist. Results will be compared with clinical outcomes from standard diagnostic tests. A sample size of 2000 women will have 80% power to establish a sensitivity of vaginal samples for endometrial cancer detection by cytology of ≥85%±7%, assuming 5% endometrial cancer prevalence. The primary objective is to determine the diagnostic accuracy of urogenital samples for endometrial cancer detection by cytology. Secondary objectives include the acceptability of urine and vaginal sampling to women. ETHICS AND DISSEMINATION: This study has been approved by the North West-Greater Manchester West Research Ethics Committee (16/NW/0660) and the Health Research Authority. Results will be disseminated through publication in peer-reviewed scientific journals, presentation at conferences and via charity websites. TRIAL REGISTRATION NUMBER: ISRCTN58863784.


Assuntos
Testes Diagnósticos de Rotina , Neoplasias do Endométrio , Neoplasias do Endométrio/diagnóstico , Endométrio , Feminino , Humanos , Projetos Piloto , Pós-Menopausa , Ultrassonografia , Hemorragia Uterina/etiologia
9.
Eur J Obstet Gynecol Reprod Biol ; 264: 97-102, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34298451

RESUMO

OBJECTIVE: To study the accuracy of frozen section biopsy for endometrial pathology in high-risk women with abnormal uterine bleeding (AUB). STUDY DESIGN: A case-control study was conducted between November 2017 to April 2019, a total of 150 women with postmenopausal bleeding, perimenopausal AUB, and high-risk women of age < 40 years with AUB were recruited. All women underwent transvaginal sonography and Doppler, based on age-appropriate endometrial thickness cut-offs 80 women then underwent hysteroscopy. Based on hysteroscopy, women suspicious of malignancy were taken as cases (n = 40) and those with benign findings as controls (n = 40). All cases and controls underwent dilatation and curettage (D & C) with frozen section (FS) and routine histopathology. RESULTS: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR), negative LR, and overall test accuracy of FS were 90.9%, 93.19%, 83.33%, 96.19%, 13.8, 0.1 and 86.25% respectively for diagnosing endometrial hyperplasia and cancer taking histopathology as the gold standard. Correlation between frozen section biopsy and histopathology was highly significant (p < 0.001) on D & C specimens and the level of agreement was good (K = 0.778). CONCLUSION: In women suspicious of malignancy on hysteroscopy, frozen section has high accuracy on D&C specimen and can be used to diagnose endometrial hyperplasia and cancer in an effort to fast-track investigations and work-up for definitive treatment while awaiting final histopathology.


Assuntos
Hiperplasia Endometrial , Secções Congeladas , Adulto , Biópsia , Estudos de Casos e Controles , Hiperplasia Endometrial/diagnóstico por imagem , Endométrio/diagnóstico por imagem , Feminino , Humanos , Histeroscopia , Gravidez , Sensibilidade e Especificidade , Ultrassonografia , Hemorragia Uterina/etiologia
10.
BMJ Case Rep ; 14(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34281944

RESUMO

McCune-Albright syndrome (MAS), a rare genetic disorder, affects multiple organs and classically presents with the triad of polyostotic fibrous dysplasia (FD), skin hyperpigmentation (café-au-lait spots) and precocious puberty. Diagnosis occurs when patients manifest at least two of these three symptoms. We describe a 4-year-old girl who was admitted to our hospital due to recurrent vaginal bleeding, initially diagnosed as precocious puberty. On brain MRI, abnormalities in the maxillary and occipital bones were compatible with FD. Clinical examination after craniofacial bone lesions and clinical signs indicated MAS revealed abnormally pigmented macules on the neck and back, which were initially overlooked. No abnormal hormone tests were observed. Precocious puberty is the most common MAS-associated symptom that results in the admission to the hospital, whereas the clinical manifestation of FD in the first years of life is usually equivocal and probably has not been discovered by parents. Thus, comprehensive medical examinations are necessary to obtain a prompt and proper diagnosis.


Assuntos
Displasia Fibrosa Poliostótica , Puberdade Precoce , Manchas Café com Leite/diagnóstico , Pré-Escolar , Feminino , Displasia Fibrosa Poliostótica/diagnóstico , Displasia Fibrosa Poliostótica/diagnóstico por imagem , Humanos , Puberdade Precoce/diagnóstico , Puberdade Precoce/etiologia , Hemorragia Uterina/etiologia
11.
J Obstet Gynaecol Can ; 43(7): 864-868, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34253305

RESUMO

A 39-year-old woman presented with bleeding 4 months after a surgical termination of pregnancy. Persistent beta-human chorionic gonadotropin levels were suggestive of retained products of conception (RPOC). However, multimodal imaging revealed a concurrent uterine arteriovenous malformation (AVM). Although most stable AVMs can be managed conservatively, the need for surgical management of chronic RPOC and consequential hemorrhage risk complicates this approach. Patient-determined management prioritized blood conservation while minimizing risks to fertility. This case is discussed with respect to the rare concurrent existence of RPOC and AVM. Little is known regarding the optimal tandem therapeutic approach. As depicted, successful treatment requires careful diagnostic workup and a multidisciplinary approach.


Assuntos
Malformações Arteriovenosas , Anormalidades Urogenitais , Adulto , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico por imagem , Feminino , Humanos , Gravidez , Hemorragia Uterina/etiologia
12.
J Forensic Leg Med ; 80: 102176, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33975177

RESUMO

OBJECTIVE: To investigate the difference in selected variables between children with and without hymenal transection, which is a healed defect that extends through the entire depth of the posterior hymenal membrane to the vaginal wall. MATERIALS AND METHODS: All female children from Southern Denmark who were examined by photocolposcopy in a six-year period were included in a retrospective cohort study. Statistical analyses included a chi-square test and a logistic regression analysis. RESULTS: Eighty girls under 15 years of age who were suspected to have been sexually abused were included. Sixteen of the girls had hymenal transections. There was a statistically significant correlation between the presence of hymenal transections and reported fresh bleeding after the assault. CONCLUSION: Bleeding after an assault could indicate more severe lesions, which might explain why these patients did not heal completely.


Assuntos
Abuso Sexual na Infância , Colposcopia , Hímen/lesões , Hemorragia Uterina/etiologia , Cicatrização , Adolescente , Criança , Estudos de Coortes , Feminino , Humanos , Fotografação , Estudos Retrospectivos
13.
Obstet Gynecol ; 137(6): e100-e115, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34011888

RESUMO

Uterine leiomyomas (fibroids) are the most common solid and symptomatic neoplasm in women. They are the leading indication for hysterectomy (1, 2), which is a definitive and effective surgical treatment for leiomyoma. However, many patients benefit from and seek out management options other than hysterectomy because they desire future childbearing or wish to retain their uterus. The purpose of this Practice Bulletin is to provide updated evidence-based recommendations for the medical, procedural, and surgical management of symptomatic leiomyomas. Discussion of the use of morcellation in the surgical management of leiomyomas is beyond the scope of this document and is addressed in a separate American College of Obstetricians and Gynecologists (ACOG) publication (3).


Assuntos
Contraceptivos Hormonais/uso terapêutico , Hormônio Liberador de Gonadotropina , Dispositivos Intrauterinos Medicados , Leiomioma/terapia , Levanogestrel/uso terapêutico , Neoplasias Uterinas/terapia , Antifibrinolíticos/uso terapêutico , Técnicas de Ablação Endometrial , Etinilestradiol/uso terapêutico , Feminino , Hormônio Liberador de Gonadotropina/agonistas , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Humanos , Histerectomia , Leiomioma/complicações , Leiomioma/diagnóstico , Leiomioma/epidemiologia , Ácido Tranexâmico/uso terapêutico , Embolização da Artéria Uterina , Hemorragia Uterina/etiologia , Hemorragia Uterina/terapia , Miomectomia Uterina , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/epidemiologia , Conduta Expectante
14.
BMJ Case Rep ; 14(4)2021 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-33820806

RESUMO

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a spectrum of anomalies arising from incomplete development of the Müllerian ducts, is characterised by congenital aplasia of the uterus and upper part of the vagina, often in the absence of other phenotypical abnormalities. We report the case of a 13-year-old girl referred to our endocrinology unit after an incidental finding of uterine agenesis during laparoscopy to correct suspected ovarian torsion. Initial transabdominal ultrasonography found no uterus. Given her normal secondary sex characteristics, karyotype and hormone profile, MRKH syndrome was initially diagnosed. However, after vaginal bleeding compatible with menstruation, repeat transabdominal ultrasonography and MRI revealed a left-deviated unicornuate uterus.


Assuntos
Transtornos 46, XX do Desenvolvimento Sexual , Anormalidades Congênitas , Hemorragia Uterina , Transtornos 46, XX do Desenvolvimento Sexual/complicações , Transtornos 46, XX do Desenvolvimento Sexual/diagnóstico , Adolescente , Anormalidades Congênitas/diagnóstico por imagem , Erros de Diagnóstico , Feminino , Humanos , Ductos Paramesonéfricos/anormalidades , Ductos Paramesonéfricos/diagnóstico por imagem , Hemorragia Uterina/etiologia , Útero/diagnóstico por imagem , Vagina/diagnóstico por imagem
15.
N Z Med J ; 134(1533): 61-70, 2021 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-33927424

RESUMO

AIMS: To evaluate the approach to diagnosis and management of caesarean scar pregnancy (CSP) at a regional New Zealand hospital. METHODS: A retrospective case series of ten patients between June 2015 and May 2020. The data review included demographic information, ultrasound findings, human chorionic gonadotropin (HCG) levels, primary and subsequent treatment, outcomes and complications. RESULTS: Nine women were diagnosed with CSP at a gestational age between four and ten weeks. One of these women was treated twice for two separate CSP within the study period. Treatment varied according to clinical presentation, HCG levels, gestational age, ultrasound findings and patient preference. Two thirds of women were successfully treated with primary management, with one third requiring multiple treatment modalities. We report one severe life-threatening haemorrhage and three cases resulting in hysterectomy. We also show a disproportionate number of Maori women presenting with CSP. CONCLUSION: We present a series of ten cases of CSP and demonstrate similar challenges in regional New Zealand to those reported elsewhere. Management is heterogeneous with little guidance from the literature, and primary management was successful in seven out of ten cases. We report a disproportionately high number of cases in Maori women. Our results would support the development of a national register for caesarean scar pregnancy to improve diagnosis and management across New Zealand.


Assuntos
Cesárea/efeitos adversos , Cicatriz/patologia , Gravidez Ectópica/patologia , Gravidez Ectópica/terapia , Dor Abdominal/etiologia , Abortivos não Esteroides/uso terapêutico , Adulto , Cicatriz/etiologia , Dilatação e Curetagem , Feminino , Humanos , Histerectomia , Metotrexato/uso terapêutico , Misoprostol/uso terapêutico , Nova Zelândia , Grupo com Ancestrais Oceânicos , Gravidez , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/etnologia , Estudos Retrospectivos , Ultrassonografia Pré-Natal , Hemorragia Uterina/etiologia
16.
J Adolesc Young Adult Oncol ; 10(3): 355-358, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33835857

RESUMO

Choriocarcinoma is an aggressive malignant trophoblastic neoplasm. The rapid growth of neoplastic tissue and myometrial invasion can cause uterine perforation. It is important to quickly diagnose the disease and plan treatment because these tumors are nearly always curable, and fertility can be preserved in most cases with proper management. The outbreak of novel coronavirus disease has affected the whole world since January 2019 and caused delays in treatment and follow-up of patients all over the world. In this study, we report a case of choriocarcinoma who postponed her admission to the hospital after diagnosis because she was afraid of the pandemic and lost her fertility due to uterine rupture and massive intra-abdominal hemorrhage.


Assuntos
COVID-19 , Coriocarcinoma/complicações , Refugiados , Tempo para o Tratamento , Hemorragia Uterina/etiologia , Neoplasias Uterinas/complicações , Ruptura Uterina/etiologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , COVID-19/epidemiologia , Quimioterapia Adjuvante , Coriocarcinoma/tratamento farmacológico , Coriocarcinoma/cirurgia , Feminino , Humanos , Histerectomia , Pandemias , SARS-CoV-2 , Hemorragia Uterina/cirurgia , Neoplasias Uterinas/tratamento farmacológico , Neoplasias Uterinas/cirurgia , Ruptura Uterina/cirurgia , Adulto Jovem
17.
J Obstet Gynaecol Res ; 47(6): 2215-2219, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33843094

RESUMO

Twin-twin transfusion syndrome (TTTS) complicates approximately 10% of monochorionic twin pregnancies and is associated with almost 90% mortality if left untreated. Fetoscopic laser photocoagulation (FLP) is the first-line therapy for TTTS, and an overall twin survival rate of 75% and at least one survival rate of 90% have been established. We report a case of TTTS complicated with bleeding from the uterine wall by inserting the procedure after FLP. The patient consequently underwent emergency caesarean section. The bleeding was uncontrollable due to atonic bleeding and emergency hysterectomy was performed. To detect the possibility of amniotic fluid embolism (AFE), biochemical blood samples demonstrated that there was no inflow of fetal ingredients in blood vessels of uterine tissue. There was no evidence of damage to any specific vessels by histopathological staining. These findings indicated that the cause of massive bleeding was unlikely to have been AFE. It was concluded that atonic bleeding was likely caused by uncontrollable hemorrhage from an injury lesion where an endoscope had been inserted.


Assuntos
Transfusão Feto-Fetal , Cesárea/efeitos adversos , Feminino , Transfusão Feto-Fetal/cirurgia , Fetoscopia , Idade Gestacional , Humanos , Histerectomia/efeitos adversos , Fotocoagulação a Laser , Lasers , Gravidez , Gravidez de Gêmeos , Hemorragia Uterina/etiologia , Hemorragia Uterina/cirurgia
19.
Medicine (Baltimore) ; 100(13): e24922, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33787579

RESUMO

RATIONAL: Ovarian sertoli-leydig cell tumor (OSLCT) is extremely rare. We reported a OSLCT case in whom postmenopausal vaginal bleeding was the first symptom. PATIENT CONCERNS: The patient came to our hospital due to postmenopausal vaginal bleeding. DIAGNOSES: Serum tumor markers and color Doppler ultrasound for her pelvic cavity were negative. The patient was finally diagnosed with left OSLCT by pathology. It was difficult to make a definite diagnosis before operation, the diagnosis of OSLCT required postoperative pathology in the patients. INTERVENTIONS: the patient underwent laparoscopic hysterectomy+bilateral adnexectomy+lysis of pelvic adhesions. OUTCOMES: Postoperative laboratory examinations were normal. The patient was discharged from our hospital on the seventh day after operation and came to our hospital for follow-up check in April 2020. Physical and laboratory examinations were normal. LESSONS: OSLCT can show different endocrine abnormalities, which are related to the various types of tumor tissues. Missed diagnosis and misdiagnosis are likely to occur in the patients who only have elevated serum testosterone. For the menopausal women with elevated serum testosterone, ovarian tumor shoule be highly suspected after excluding adrenal gland-related diseases.


Assuntos
Neoplasias Ovarianas/complicações , Tumor de Células de Sertoli-Leydig/complicações , Hemorragia Uterina/etiologia , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Neoplasias Ovarianas/cirurgia , Pós-Menopausa , Tumor de Células de Sertoli-Leydig/cirurgia , Hemorragia Uterina/cirurgia
20.
Medicine (Baltimore) ; 100(8): e24632, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33663072

RESUMO

RATIONALE: Postpartum ovarian vein thrombophlebitis (POVT) is a rare condition, and it can lead to severe complications and mortality. Here we report a patient who presented with vaginal bleeding and the diagnosis of POVT was confirmed by imaging. PATIENT CONCERNS: A 38-year-old postpartum woman without remarkable medical history presented with vaginal bleeding and lower abdominal pain. DIAGNOSES: The diagnosis was confirmed by computed tomography scan marked by a thrombus mass involving the right ovarian vein and inferior vena cava. INTERVENTIONS: The patient was treated with intravenous antibiotics and low-molecular-weight heparin. OUTCOMES: The patient recovered smoothly without complications. LESSONS: We should pay high attention to the recognition and management of POVT to prevent morbidity and mortality.


Assuntos
Ovário/irrigação sanguínea , Transtornos Puerperais/patologia , Tromboflebite/patologia , Adulto , Antibacterianos/uso terapêutico , Feminino , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Transtornos Puerperais/tratamento farmacológico , Tromboflebite/complicações , Tromboflebite/tratamento farmacológico , Hemorragia Uterina/etiologia
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