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1.
Br J Radiol ; 94(1122): 20201386, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33914616

RESUMO

Tubal and peritoneal disease are the main causes of infertility. Tubal pathology can be either congenital malformation or acquired, proximal or distal, unilateral or bilateral and transient or permanent. Several imaging methods such as laparoscopy, fluoroscopy, saline infusion sonography, and hysterosalpingography (HSG) have been used in the assessment of tubal and peritoneal pathology. Although laparoscopy is the modality of choice for investigating tubal patency and pelvic structure in many infertility centers, HSG is usually the initial diagnostic method for infertility workup because of its ease of performance, accuracy, and minimal risk of complications. This method provides useful information about size, contour, and anatomy of the inner surface of the fallopian tubes and is the gold standard for evaluation of tubal lumen. Tubal and peritubal pathology show various imaging manifestations on HSG. This review illustrates the radiographic features of congenital and acquired structural abnormalities of the proximal tubal pathology and along with etiology of proximal obstruction or occlusion will be described.


Assuntos
Doenças das Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/diagnóstico por imagem , Histerossalpingografia , Doenças das Tubas Uterinas/congênito , Doenças das Tubas Uterinas/patologia , Tubas Uterinas/anormalidades , Tubas Uterinas/patologia , Feminino , Humanos , Infertilidade Feminina/etiologia
2.
Sci Rep ; 11(1): 9294, 2021 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-33927274

RESUMO

Transforming growth factor ß (TGFß) signaling plays critical roles in reproductive development and function. TGFß ligands signal through the TGFß receptor type 2 (TGFBR2)/TGFBR1 complex. As TGFBR2 and TGFBR1 form a signaling complex upon ligand stimulation, they are expected to be equally important for propagating TGFß signaling that elicits cellular responses. However, several genetic studies challenge this concept and indicate that disruption of TGFBR2 or TGFBR1 may lead to contrasting phenotypic outcomes. We have shown that conditional deletion of Tgfbr1 using anti-Mullerian hormone receptor type 2 (Amhr2)-Cre causes oviductal and myometrial defects. To determine the functional requirement of TGFBR2 in the female reproductive tract and the potential phenotypic divergence/similarity resulting from conditional ablation of either receptor, we generated mice harboring Tgfbr2 deletion using the same Cre driver that was previously employed to target Tgfbr1. Herein, we found that conditional deletion of Tgfbr2 led to a similar phenotype to that of Tgfbr1 deletion in the female reproductive tract. Furthermore, genetic removal of Tgfbr1 in the Tgfbr2-deleted uterus had minimal impact on the phenotype of Tgfbr2 conditional knockout mice. In summary, our results reveal the functional similarity between TGFBR2 and TGFBR1 in maintaining the structural integrity of the female reproductive tract.


Assuntos
Genitália Feminina/anormalidades , Genitália Feminina/metabolismo , Receptor do Fator de Crescimento Transformador beta Tipo II/metabolismo , Receptor do Fator de Crescimento Transformador beta Tipo I/metabolismo , Animais , Endométrio/anormalidades , Endométrio/metabolismo , Endométrio/patologia , Tubas Uterinas/anormalidades , Tubas Uterinas/metabolismo , Tubas Uterinas/patologia , Feminino , Técnicas de Inativação de Genes , Genitália Feminina/patologia , Hiperplasia , Camundongos , Camundongos Endogâmicos C57BL , Miométrio/anormalidades , Miométrio/metabolismo , Miométrio/patologia , Fenótipo , Receptor do Fator de Crescimento Transformador beta Tipo I/genética , Receptor do Fator de Crescimento Transformador beta Tipo II/genética , Transdução de Sinais , Fator de Crescimento Transformador beta/metabolismo
3.
Medicine (Baltimore) ; 99(46): e23250, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181716

RESUMO

To analyze risk factors associated with heterotopic pregnancy and the uterine pregnant outcome of those patients after surgery.We retrospectively analyzed 22 patients diagnosed as HP after in vitro fertilization (IVF) between January 2015 and December 2018.HP was diagnosed at gestation age of 55.4 ±â€Š11.8 days. HP were presented as irregular vaginal bleeding, abdominal pain, and sometimes no symptoms. 81.8% of ectopic lesion in HP occurred at fallopian tubes, especially ampullary; cornual pregnancy takes up 13.6%. Compared with clinical intrauterine pregnancy (IUP), IVF with tubal infertility factors had higher risks of HP (OR 4.185, 95% CI 1.080- 16.217); IVF with pelvic adhesion also had higher risks of HP (OR 5.552 95% CI 1.677-18.382); IVF with more than 2 embryos transferred increased risks of HP (OR 23.253, 95% CI 1.804-299.767). The abortion rates of surgery-treated HP and IUP after IVF were 27.8% versus 10.3% (P = .042).These results demonstrate IVF with tubal infertility, pelvic adhesion or multiembryos transfer are risk factors of HP. Furthermore, surgery could induce abortion.


Assuntos
Tubas Uterinas/anormalidades , Fertilização In Vitro/normas , Infertilidade Feminina/etiologia , Gravidez Heterotópica/etiologia , Aderências Teciduais/complicações , Adulto , China/epidemiologia , Feminino , Fertilização In Vitro/métodos , Fertilização In Vitro/estatística & dados numéricos , Humanos , Infertilidade Feminina/fisiopatologia , Gravidez , Gravidez Heterotópica/diagnóstico , Gravidez Heterotópica/epidemiologia , Estudos Retrospectivos , Fatores de Risco
4.
Medicine (Baltimore) ; 99(28): e21105, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664132

RESUMO

RATIONALE: The incidence of a unicornuate uterus is 0.2% to 0.3% of the whole population. A unicornuate uterus is closely associated with obstetrical complications such as early miscarriages, ectopic pregnancy, and malpresentation. PATIENT CONCERNS: A 32-year-old patient developed a rare ectopic pregnancy arising at a distal, fimbriated end of the undescended fallopian tube. DIAGNOSES: A transvaginal ultrasound scan revealed hemoperitoneum and no gestational sac in the uterine endometrium. A laparoscopic finding showed that high up in the right abdomen, just below the liver, an ectopic mass could be seen arising at a distal, fimbriated end of the fallopian tube, which was developed adjacent to the undescended right ectopic ovary. INTERVENTIONS: After laparoscopic removal of the right salpinx, we removed it with a bag. OUTCOMES: One day after the operation, she was discharged without problems. Postoperative hysterosalpingography showed the unicornuate uterus with patent left and some right salpinx. Magnetic resonance imaging revealed a unicornuate uterus, right ovary at the right inferior hepatic area, a bilateral normal kidney, and double inferior vena cava. LESSONS: This is the first reported case of its type. It demonstrated that ectopic pregnancy may occur in the upper abdomen, not in the pelvic cavity, in uterine anomaly, and double inferior vena cava; hence, we must thoroughly check the whole abdominal cavity. Additional imaging tests are needed after treatment to see if there are any abnormalities.


Assuntos
Tubas Uterinas/anormalidades , Ovário/anormalidades , Gravidez Ectópica/etiologia , Anormalidades Urogenitais/diagnóstico , Útero/anormalidades , Malformações Vasculares/diagnóstico , Veia Cava Inferior/anormalidades , Adulto , Endossonografia/métodos , Feminino , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Histerossalpingografia , Laparoscopia/métodos , Imageamento por Ressonância Magnética , Gravidez , Gravidez Ectópica/diagnóstico , Gravidez Ectópica/cirurgia , Anormalidades Urogenitais/complicações , Anormalidades Urogenitais/cirurgia , Útero/cirurgia , Vagina
5.
BMJ Case Rep ; 13(7)2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32675118

RESUMO

Persistent Mullerian duct syndrome has been described as a disease of internal male pseudohermaphroditism, a rare autosomal recessive disease, characterised by persistent Mullerian derivatives in patients with male pattern 46, XY karyotype and normal pattern virilisation. We present a case of an elderly man, who on evaluation for bilateral undescended testes was found to have a pelvic mass suggestive of malignant transformation of an undescended testis on imaging. On surgical exploration, uterus with multiple fibroids, bilateral fallopian tubes, cervix and bilateral atrophic testes were identified. Interestingly, in this case, imaging (contrastCT and MRI) had missed Mullerian structures due to varied presentation, but exploration and excision of the structures followed by their histopathology revealed uterine leiomyomas and confirmed other Mullerian structures (bilateral fallopian tubes, cervix) with bilateral testes.


Assuntos
Criptorquidismo , Transtorno 46,XY do Desenvolvimento Sexual , Útero , Transtorno 46,XY do Desenvolvimento Sexual/diagnóstico por imagem , Transtorno 46,XY do Desenvolvimento Sexual/patologia , Tubas Uterinas/anormalidades , Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testículo/anormalidades , Testículo/diagnóstico por imagem , Testículo/patologia , Útero/anormalidades , Útero/diagnóstico por imagem , Útero/patologia
6.
Am J Otolaryngol ; 41(5): 102580, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32536423

RESUMO

OBJECTIVE: The aim of this study is to apply the modified stapedectomy technique in cases with dehiscent and prolapsed facial nerve canal, and to compare the postoperative results with those with normal facial nerve canal anatomy. MATERIAL AND METHOD: 28 patients who underwent primary stapedectomy were included. Of the patients, 17 were in the normal anatomical facial nerve group, and 11 were in the dehiscent and prolapsed facial nerve group. Facial nerve was retracted with micro elevator in dehiscent and prolapsed group. and Titanium-Teflon prosthesis was angled and used in accordance with facial nerve course at this group. RESULT: No facial paresis or paralysis was observed in any patient postoperatively. In the first year, no significant difference was found in terms of air-bone gap. CONCLUSION: It is safe to retract the facial nerve for a limited time in cases of stapedectomy in cases with dehiscent and prolapsed facial nerve canal. In these cases, modifying the stapedial prosthesis in accordance with the facial nerve course does not cause disadvantage in terms of hearing gain.


Assuntos
Doenças do Nervo Facial/cirurgia , Nervo Facial/cirurgia , Prótese Ossicular , Otosclerose/cirurgia , Complicações Pós-Operatórias/cirurgia , Prolapso , Cirurgia do Estribo/métodos , Adulto , Doenças do Nervo Facial/fisiopatologia , Tubas Uterinas/anormalidades , Feminino , Audição , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
7.
BMC Womens Health ; 20(1): 76, 2020 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-32316964

RESUMO

BACKGROUND: Congenital genital tract outflow obstruction may occur at different levels and with different clinical presentations. Winter syndrome was first described in 1968 as an association of renal, genital and middle ear anomalies. This syndrome is characterized by autosomal recessive transmission, unilateral or bilateral renal hypoplasia, distal vaginal atresia, and moderate to severe conductive hearing loss with malformation of the ossicles. The diagnosis is usually made when symptoms of obstruction are obvious. It presents most commonly with primary amenorrhea in a girl with a normal XX genotype, ovarian and hormone function; and cyclical abdominal pain. Ultrasound confirm the physical examination, revealing the presence of a normal uterus and cervix, normal ovaries and fallopian tubes, and a large hematocolpos. CASE PRESENTATION: This case reports Winter syndrome in a 14-year-old girl which vaginal atresia was managed by a trans perineal vaginal pull through. CONCLUSIONS: Winter syndrome is a rare congenital condition whose clinical picture is that of an adolescent girl with primary amenorrhea and cyclic pelvic pain due to vaginal atresia, varying degrees of renal dysgenesis and deafness due to malformation of the ossicles of the middle ear. Diagnosis is based on clinical examination and imaging. Magnetic resonance imaging allows assessing the importance of atresia and thus guiding surgical management. The goals of surgical intervention are to provide relief from pain, ensure normal sexual intercourse and to preserve fertility. A thorough knowledge of embryology, pre-operative imaging with MRI and clinical examination is essential to plan an appropriate surgical management.


Assuntos
Tubas Uterinas/anormalidades , Anormalidades Urogenitais/diagnóstico por imagem , Útero/diagnóstico por imagem , Vagina/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Adolescente , Amenorreia/etiologia , Tubas Uterinas/cirurgia , Feminino , Humanos , Dor Pélvica , Gravidez , Ultrassonografia , Vagina/diagnóstico por imagem , Vagina/cirurgia
8.
Taiwan J Obstet Gynecol ; 59(1): 154-156, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32039786

RESUMO

OBJECTIVE: Mature cystic teratomas are mostly confined to the ovaries, but several authors have reported findings of extragonadal occurrences along the migration pathway of primordial germ cells. Extragonadal mature cystic teratomas are extremely rare; their occurrences and pathogenesis are unknown. CASE REPORT: We report the case of a 26-year-old woman who was admitted for scheduled laparoscopic right ovarian tumor excision. An anterior uterine wall mature cystic teratoma and a pararectal corpus luteum cyst were found intraoperatively with coexistence of left adnexal agenesis. CONCLUSION: The existence of an extragonadal mature cystic teratoma over the anterior uterine serosal layer may be caused by autoamputation and reimplantation as a result of ovarian torsion or displacement of primordial germ cells along their migration path. The existence of an ovarian mass over the sigmoid colon combined with left adnexal agenesis may be the result of ovarian torsion with remnant tissue attached to the sigmoid colon.


Assuntos
Tubas Uterinas/anormalidades , Cistos Ovarianos/patologia , Ovário/anormalidades , Teratoma/patologia , Neoplasias Uterinas/patologia , Adulto , Feminino , Humanos , Útero/patologia
9.
Pathobiology ; 87(1): 37-44, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31972564

RESUMO

The fallopian tube is thought to be the site of origin of most high-grade serous carcinomas (HGSCs). However, how often the tube is abnormal in the setting of other ovarian tumors is unknown. The aim of this study is to define the frequency of tubal abnormalities in the tumoral (n = 245) and nontumoral (n = 184) setting. We found that in ovarian tumors, 52.2% of the tubes were normal, while 39.2% were affected by the tumor. Abnormal tubes were found in 80% of HGSCs, in 21% of mucinous carcinomas, in 83.3% of seromucinous carcinomas, in 33.3% of endometrioid carcinomas, in 20% of clear-cell carcinomas, and in 10.5% of borderline tumors. Among normal tubes, almost 70% were histologically normal; transitional metaplasia was present in 17.4%, endometriosis in 8.1%, and adenofibroma in 2.2%, and 1.1% had an incidental serous intraepithelial tubal carcinoma. To conclude, the fallopian tube is abnormal in most serous carcinomas, and in a smaller number of endometrioid, clear-cell and mucinous carcinomas as well as borderline tumors. It is often abnormal in seromucinous tumors, but larger series are needed to study this rare subtype.


Assuntos
Tubas Uterinas/anormalidades , Tubas Uterinas/patologia , Neoplasias Ovarianas/patologia , Carcinoma in Situ , Cistadenocarcinoma Seroso/patologia , Neoplasias das Tubas Uterinas , Feminino , Humanos , Achados Incidentais
11.
Saudi Med J ; 40(10): 1067-1071, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31588489

RESUMO

OBJECTIVES: To highlight and compare spectrum of hysterosalpingography (HSG) findings in primary and secondary infertility patients. Methods: This retrospective record-based cross-sectional study was performed in the Radiology Department, King Fahad Military Medical City, Dhahran, Kingdom of Saudi Arabia between August 2016 and 2018. All patients (N=303) who underwent successful HSGs were included, and grouped under primary and secondary infertility cases. Patients with failed, limited or incomplete studies were excluded. Imaging findings were documented as N (Normal) or Ab (Abnormal). Abnormal HSG findings were further categorized as: C=congenital malformation, I=infection or inflammation, S=surgery, T=tumor or tear. Abnormal findings were confirmed on further imaging or intervention. Chi-square test was used to determine any association of HSG findings with type of infertility, and p-value less than 0.05 was considered significant. Results: Of the 303 patients, 166 patients (54.8%) had primary infertility while the rest had secondary infertility. Abnormal studies were found in less than one-third of patients (n=93, 30.7%). Primary infertility patients exhibited more congenital (C) malformations, while surgery (S) was seen more in secondary infertility patients (p=0.01).  Conclusion: Congenital malformations are commonly found abnormalities on HSGs in primary infertility patients, while surgery related findings are seen in secondary infertility cases.


Assuntos
Histerossalpingografia/estatística & dados numéricos , Infertilidade Feminina/diagnóstico por imagem , Adulto , Estudos Transversais , Doenças das Tubas Uterinas/complicações , Doenças das Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/anormalidades , Tubas Uterinas/diagnóstico por imagem , Feminino , Humanos , Infertilidade Feminina/etiologia , Estudos Retrospectivos , Arábia Saudita , Doenças Uterinas/complicações , Doenças Uterinas/diagnóstico por imagem , Útero/anormalidades , Útero/diagnóstico por imagem
12.
Ned Tijdschr Geneeskd ; 1632019 01 25.
Artigo em Holandês | MEDLINE | ID: mdl-30719886

RESUMO

A 19-year old woman with acute pain in the lower right quadrant of the abdomen was seen in the emergency room. Because we suspected an anomaly of the appendix, we performed a laparoscopy. We unexpectedly found a torsion of a Hydatid of Morgagni, a stalked cyst of the fallopian tube.


Assuntos
Abdome Agudo/diagnóstico , Doenças das Tubas Uterinas/diagnóstico , Tubas Uterinas/anormalidades , Cisto Parovariano/diagnóstico , Anormalidade Torcional/diagnóstico , Abdome Agudo/etiologia , Apêndice , Serviço Hospitalar de Emergência , Doenças das Tubas Uterinas/complicações , Feminino , Humanos , Achados Incidentais , Laparoscopia , Cisto Parovariano/complicações , Anormalidade Torcional/complicações , Adulto Jovem
13.
J Obstet Gynaecol Can ; 41(2): 214-216, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30385208

RESUMO

BACKGROUND: Müllerian duct abnormalities are common and may be related to pregnancy complications. Few cases of ectopic pregnancy within an undescended Fallopian tube have been reported, and they present a diagnostic challenge. CASE: A 32-year-old pregnant woman had three presentations to the emergency department for increasing left upper abdominal pain, chest pain, shortness of breath, and eventual hemodynamic instability in the setting of right unicornuate uterus and undiagnosed undescended left adnexa. CONCLUSION: This case presents a rare diagnosis in the differential diagnosis of chest pain and shortness of breath, as well as pregnancy of unknown location. If intraperitoneal hemorrhage is present in a woman with a positive pregnancy test but pregnancy is not detected within the pelvis, it is advisable to investigate the upper abdomen for ectopic pregnancy.


Assuntos
Tubas Uterinas/anormalidades , Gravidez Ectópica/etiologia , Útero/anormalidades , Adulto , Feminino , Humanos , Gravidez
14.
Pediatr Med Chir ; 40(2)2018 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-30514074

RESUMO

Isolated tubal torsion (ITT) is a rare cause of acute abdominal pain. Preoperative diagnosis is difficult because of a lack of specific signs. Surgery is recommended to preserve the integrity of the tube. Seven patients of median age of 13 years (range 9 to 15) came to our observation for worsening abdominal pain, nausea and vomiting. On admission, all girls had blood tests and ultrasound. Laparoscopy was performed for diagnosis in all cases. The girls had one-month and one-year ultrasound and clinic follow up. In all cases diagnosis was delayed, median 66 hours after the onset of symptoms and laparoscopy showed necrosis of the Fallopian tube. In five girls a laparoscopic salpingectomy was performed. In the other two, an open salpingectomy was necessary because of pelvic adhesions. Histology showed a hemorrhagic infarction of the Fallopian tubes. At follow up all patients were asymptomatic with normal ovaries, but one ovarian cyst. In the differential diagnosis of acute abdominal pain in children or female adolescents the possibility of ITT should be considered for a conservative treatment. Laparoscopy allows for definitive diagnosis and treatment.


Assuntos
Doenças das Tubas Uterinas/diagnóstico , Tubas Uterinas/cirurgia , Salpingectomia/métodos , Anormalidade Torcional/diagnóstico , Dor Abdominal/etiologia , Adolescente , Criança , Diagnóstico Tardio , Diagnóstico Diferencial , Doenças das Tubas Uterinas/cirurgia , Tubas Uterinas/anormalidades , Feminino , Seguimentos , Humanos , Laparoscopia/métodos , Náusea/etiologia , Estudos Retrospectivos , Anormalidade Torcional/cirurgia , Ultrassonografia/métodos , Vômito/etiologia
15.
BMJ Case Rep ; 20182018 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-30131412

RESUMO

In this report, we describe an 18-year-old nulliparous virgo, with no medical history, who presented herself at the emergency department with symptoms of lower abdominal pain and nausea with vomiting. On examination, an echogenic unilocular cyst with possible relation to the right ovary was found. The working diagnosis was an ovarian torsion. She underwent a diagnostic laparoscopy which revealed a quadruple torsion of the fallopian tube with hydrosalpinx. Detorsion of the tube was performed, and the tube was drained using diathermic incision. After the surgery, the patient recovered rapidly. Ultrasonic evaluation 38 days later showed an echogenic area measuring 2×3 cm suspected for persistent hydrosalpinx. Because of the asymptomatic postoperative period, the patient was treated conservatively, and no further treatment was performed.


Assuntos
Tubas Uterinas/anormalidades , Anormalidade Torcional/patologia , Dor Abdominal/etiologia , Adolescente , Tubas Uterinas/cirurgia , Feminino , Humanos , Náusea/etiologia , Anormalidade Torcional/complicações , Anormalidade Torcional/cirurgia , Vômito/etiologia
16.
G Chir ; 39(4): 245-247, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30039793

RESUMO

AIM: According to the so far published literature, only one case of endometrial cancer in a patient with unicornuate uterus has been reported. This is a case report study, presenting a rare case of complex atypical endometrial hyperplasia in a woman with unicornuate uterus and multiple genitourinary anomalies. CASE REPORT: A 43-year old G1P1 woman presented with episodes of menometrorrhagia and anemia. She had previous surgical history of laparoscopy due to infertility, in which she was diagnosed with unicornuate uterus with a rudimentary left uterine horn and ipsilateral ectopic ovary in the anatomic place of the left kidney. Dilatation and curettage was performed. Histology showed complex atypical endometrial hyperplasia. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, in an extremely interesting operation due to the multiple genitourinary anomalies. The uterus with a 6-centimeter uterine myoma and the adnexae were removed en block. Great effort was put into dissecting the left fallopian tube which arised from the cervix and via the rudimentary horn led to the left ectopic ovary that was located at the left kidneys' anatomic space. The patient recovered well and final histology was negative for malignancy. DISCUSSION: All necessary imaging examinations have to be scheduled prior to surgical intervention in order to give valuable anatomic information in cases of women diagnosed with Mullerian abnormalities.


Assuntos
Anormalidades Múltiplas/cirurgia , Coristoma/complicações , Endométrio/patologia , Histerectomia/métodos , Rim , Mioma/cirurgia , Ovário , Salpingo-Ooforectomia/métodos , Neoplasias Uterinas/cirurgia , Útero/anormalidades , Anormalidades Múltiplas/embriologia , Adulto , Colo do Útero/anormalidades , Tubas Uterinas/anormalidades , Feminino , Fertilização In Vitro , Humanos , Hiperplasia , Infertilidade Feminina/etiologia , Infertilidade Feminina/terapia , Menorragia/etiologia , Metrorragia/etiologia , Ductos Paramesonéfricos/anormalidades , Ductos Paramesonéfricos/embriologia , Mioma/patologia , Pelve , Neoplasias Uterinas/patologia
17.
BMJ Case Rep ; 20182018 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-29735499

RESUMO

Unilateral adnexal agenesis is a rare entity. Most of these cases are reported in reproductive age group. A case of a 10-year-old premenarchal girl is reported who presented with acute abdominal pain and vomiting. BothUltrasonography (USG) and MRI suggested right ovarian mass with torsion. Laparoscopic evaluation revealed an enlarged right ovary with torsion and contralateral agenesis of uterine tube and left ovary. Detortion of the ovary and an ovarian fixation to the ovarian pedicle was done. This is the first reported case of a premenarchal girl presenting with an acute abdomen due to adnexal torsion along with contralateral tubo-ovarian agenesis.


Assuntos
Doenças dos Anexos/congênito , Tubas Uterinas/anormalidades , Doenças Ovarianas/congênito , Ovário/anormalidades , Anormalidade Torcional/diagnóstico por imagem , Abdome Agudo/diagnóstico , Abdome Agudo/etiologia , Doenças dos Anexos/diagnóstico por imagem , Doenças dos Anexos/patologia , Doenças dos Anexos/cirurgia , Criança , Diagnóstico Diferencial , Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/patologia , Feminino , Humanos , Laparoscopia/métodos , Imageamento por Ressonância Magnética/métodos , Doenças Ovarianas/diagnóstico por imagem , Doenças Ovarianas/patologia , Doenças Ovarianas/cirurgia , Ovário/diagnóstico por imagem , Ovário/patologia , Doenças Raras , Anormalidade Torcional/cirurgia , Resultado do Tratamento , Ultrassonografia/métodos , Vômito/diagnóstico , Vômito/etiologia
18.
J Ultrasound Med ; 37(10): 2387-2393, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29573346

RESUMO

OBJECTIVES: To report the preoperative ultrasound (US) signs of isolated fallopian tube torsion in surgically verified cases and to estimate whether preoperative US detection of this condition can be improved. METHODS: The charts of 27 women with a surgical diagnosis of isolated fallopian tube torsion at a tertiary medical center from 2005 to 2016 were retrospectively reviewed. Data were collected from the electronic database of the US unit and compared with the surgical findings. RESULTS: Isolated fallopian tube torsion was correctly diagnosed by US before surgery in 8 of the 27 women (29.6%). In the remainder, the US signs were attributed to torsion of the ovary or the entire adnexa (n = 13), or no torsion was suspected (n = 6). Fallopian tube edema was listed as a US finding in 7 patients, of whom 5 had a correct diagnosis of isolated fallopian tube torsion. The presence of a paraovarian cyst concomitant with normal-appearing ovaries was assumed by US in 5 of the 8 cases that were accurately diagnosed as isolated fallopian tube torsion. The most misinterpreted US finding was an ovarian cyst (suspected in 10 patients and verified at surgery in 2). Absence of blood flow was described in 12 women, of whom 5 had an accurate diagnosis of isolated fallopian tube torsion. Six of the patients with a correct US diagnosis were adults (37.5% of total adults), and 2 were adolescents (18.2% of total adolescents). CONCLUSIONS: The US diagnosis of isolated fallopian tube torsion is challenging. A high index of suspicion is necessary to improve its detection, especially when there are possible US signs of torsion in the presence of a normal-appearing ovary.


Assuntos
Doenças das Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/anormalidades , Tubas Uterinas/diagnóstico por imagem , Anormalidade Torcional/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
20.
Clin Radiol ; 72(7): 612.e7-612.e15, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28283284

RESUMO

AIM: To outline the anatomical variations of obstructive reproductive tract anomalies (ORTA) using magnetic resonance imaging (MRI) and its role in preoperative evaluation. MATERIALS AND METHODS: MRI and treatment of 21 paediatric patients with ORTA were reviewed and analysed. MRI findings were correlated with ultrasound and surgical findings. RESULTS: Patients presented in two distinct ways: primary amenorrhoea with cyclic pelvic pain, or progressive dysmenorrhoea. MRI showed haematocolpos, haematocervix, haematometra, and/or haematosalpinx; it also provided detailed information regarding uterine morphology, ipsilateral kidney absence, and endometriosis. Diagnosis at MRI of the obstruction sites correlated completely (100%) with the surgical diagnosis. Obstruction occurred at different levels of the genital tract, and surgical treatment was given based on the obstruction sites. One patient underwent excision of the hymen tissue for imperforate hymen. Four cases of lower vaginal atresia were treated with vaginoplasty. Three patients with typical Herlyn-Werner-Wunderlich (HWW) syndrome underwent resection of the vaginal septum, and one patient with concurrent post-partum placenta increta was treated accordingly; one patient with atypical HWW syndrome had the left uterus resected. There were 11 cases of cervical agenesis or cervicovaginal dysgenesis, eight of which were complicated with uterine anomalies, and in all cases the uterus was removed. Among the 10 obstructive cervical anomalies, there were three cases of cervical agenesis and seven cases of cervical dysgenesis, including five obliterated cervical os (cervical obstruction), one cervical fibrous cord, and one cervical fragmentation. CONCLUSION: ORTA can occur from the hymen to the lower segment of the uterus and requires surgical intervention. The preoperative evaluation is vital to guide proper surgery. MRI, with its imaging advantages, is the imaging technique of choice to assess the obstructed sites and complicated anomalies of ORTA.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Genitália Feminina/anormalidades , Genitália Feminina/diagnóstico por imagem , Imageamento por Ressonância Magnética , Anormalidades Múltiplas/cirurgia , Adolescente , Criança , Anormalidades Congênitas , Tubas Uterinas/anormalidades , Tubas Uterinas/cirurgia , Feminino , Genitália Feminina/cirurgia , Humanos , Hímen/anormalidades , Hímen/diagnóstico por imagem , Hímen/cirurgia , Distúrbios Menstruais/diagnóstico por imagem , Distúrbios Menstruais/cirurgia , Anormalidades Urogenitais/diagnóstico por imagem , Anormalidades Urogenitais/cirurgia , Útero/anormalidades , Útero/diagnóstico por imagem , Útero/cirurgia , Vagina/anormalidades , Vagina/cirurgia
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