1/27. Successful laparoscopic management of adnexal torsion during week 25 of a twin pregnancy.Adnexal torsion is a rare occurrence during pregnancy. Here we present a case of adnexal torsion during the 25th week of pregnancy, which was managed laparoscopically. The woman had achieved a successful twin pregnancy after in-vitro fertilization/intracytoplasmic sperm injection. She was admitted to the emergency department with acute abdominal pain. Abdominal ultrasound with colour Doppler mapping of the intra-ovarian blood flow showed adnexal torsion. Laparoscopic management was successfully carried out.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/27. Multiple pregnancy with adnexal torsion after in vitro fertilization: case report.Assisted reproductive techniques (art) are widely accepted procedures for infertile couples. Rare complications, like heterotopic pregnancy, bilateral tubal pregnancy, and adnexal torsion during pregnancy, have been diagnosed with increasing frequency after art. We present a case of an early triplet pregnancy complicated with adnexal torsion. The patient was pregnant through in vitro fertilization. Early ultrasound examination revealed a triplet pregnancy within the uterine cavity. At 7 weeks' gestational age, an acute onset of lower abdominal pain, progressive abdominal distension, and massive internal bleeding prompted emergency laparotomy. The right ovary was enlarged, twisted, necrotic and hemorrhagic. Attempts to preserve the ovary failed because of the friable nature of the affected ovary, and an oophorectomy had to be performed. Although the removed ovary contained a corpus luteum, the pregnancy continued smoothly after only short luteal support. A precise pre-surgery diagnosis in our case was difficult based on the patient's initial clinical presentation. However, with high clinical suspicion in addition to color Doppler ultrasound, the physician should be able to make an early decision for an exploratory laparotomy or laparoscopy, gaining the benefit of more conservative treatment.- - - - - - - - - - ranking = 1.4531011050997keywords = pregnancy, gestation (Clic here for more details about this article) |
3/27. Gasless laparoscopy under epidural anesthesia for adnexal cysts during pregnancy.OBJECTIVE: To evaluate laparoscopic adnexal cystectomy during pregnancy using an open technique with a whole abdominal wall-lift method under epidural anesthesia. STUDY DESIGN: Seven cases of adnexal cysts during pregnancy were resected using a gasless laparoscopic (extracorporeal) method with a whole abdominal wall-lift. We performed this procedure without using general anesthesia or CO2 pneumoperitoneum. RESULTS: All operations were performed successfully without complications. All patients resumed normal activity within one week. The subsequent antenatal courses of the patients were uneventful. There were no severe complications during the operations or postoperative courses. Six patients had vaginal deliveries of normal infants at term. No abnormal findings were found in the antenatal course of patient 7 until 30 weeks of gestation. CONCLUSION: Based on our limited experience, this procedure may be safe.- - - - - - - - - - ranking = 0.88167253367116keywords = pregnancy, gestation (Clic here for more details about this article) |
4/27. Prenatal magnetic resonance imaging assisting in differentiating between large degenerating intramural leiomyoma and complex adnexal mass during pregnancy.We present an unusual case in which a 36-year-old patient was referred due to increasing upper left quadrant abdominal pain and a possible left adnexal mass at 22 weeks' gestation. ultrasonography demonstrated a multiseptated cystic mass, with solid components measuring 12 cm in diameter. A thin sonolucency was thought to separate the mass from the uterus and thus the mass was considered consistent with an adnexal mass, possibly a mucinous cystadenoma. A large degenerating leiomyoma could not be ruled out with certainty and magnetic resonance (MR) imaging was performed which depicted a thin band of myometrium encompassing the complex mass and was therefore diagnostic of a degenerating uterine leiomyoma. We discuss the contribution of MR imaging in the noninvasive diagnosis of undetermined solid pelvic masses visualized ultrasonographically.- - - - - - - - - - ranking = 0.59595824795687keywords = pregnancy, gestation (Clic here for more details about this article) |
5/27. Ectopic pregnancy after cesarean hysterectomy.BACKGROUND: Ectopic pregnancy after a total abdominal hysterectomy is rare and, for this reason, delay in diagnosis may occur when such a patient presents with abdominal pain. CASE: A multiparous patient with a history of cesarean hysterectomy 12 years before presented to the emergency department with abdominal pain and incidental positive urine beta-human chorionic gonadotrophin (hCG). A computed tomography scan revealed a loculated left cystic mass in the pelvis. laparotomy findings revealed a left adnexal mass; pathology revealed chorionic villi consistent with pregnancy. CONCLUSION: Ectopic pregnancy may occur after hysterectomy, but typically presents near the time of surgery and is more commonly associated with vaginal hysterectomy. However, because ectopic pregnancy is possible after hysterectomy, it should be considered in the differential diagnosis of adnexal mass in such a patient.- - - - - - - - - - ranking = 1.1428571428571keywords = pregnancy (Clic here for more details about this article) |
6/27. Diagnostic challenge of abdominal pain in late pregnancy--a case of adnexal torsion.Clinical evaluation of pregnant patients with abdominal pain can be confusing, because the examination is usually hampered by the anatomical displacement of abdominal organs by the gravid uterus, and difficulty in localisation of pain. Delayed surgical intervention could result in increased maternal morbidity and poor fetal outcome. We report on a case of recurring acute abdominal pain in pregnancy, which led to diagnostic difficulties and resulted in a diagnostic laparotomy and caesarean delivery.- - - - - - - - - - ranking = 0.71428571428571keywords = pregnancy (Clic here for more details about this article) |
7/27. Small bowel incarceration in a broad ligament defect.We report the case of a 33-year-old woman whose medical history included three normal pregnancies without previous abdominal or pelvic surgery. She presented with small bowel obstruction. An abdominal computed tomography (CT) scan study revealed air fluid levels in the pelvis. Laparoscopic exploration revealed a viable ileal loop incarcerated through the mesoligamentum teres. The intestinal loop was reduced and the broad ligament defect was closed with a laparoscopic absorbable clip. Among internal hernias, hernias through a defect in the broad ligament represent only 4-7%. Defects within the broad ligament can be either congenital (ruptured cystic structures reminiscent of the mesonephric or mullerian ducts) or secondary to operative trauma, pregnancy and birth trauma, or prior pelvic inflammatory disease. CT scan may be diagnostic by showing incarceration of a dilated intestinal loop in the Douglas pouch with air fluid levels. This is the first reputed case of a totally laparoscopic repair of a bowel incarceration through a broad ligament defect.- - - - - - - - - - ranking = 0.14285714285714keywords = pregnancy (Clic here for more details about this article) |
8/27. The natural history of an hematosalpinx.A patient who had experienced an actopic pregnancy and subsequent salpingectomy was found to have an ectopic pregnancy, presenting as an hematosalpinx, in the remaining fallopian tube. The diagnosis was made at the time of laparoscopy, and the patient refused definitive surgery. Fourteen months later she achieved an intrauterine pregnancy, and repeat laparoscopic examination revealed an essentially normal pelvis and fallopian tube. This is evidently the first case report of a pregnancy occurring through a fallopian tube that had had a previous ectopic gestation and in which no surgical procedure was performed on the affected tube.- - - - - - - - - - ranking = 0.59595824795687keywords = pregnancy, gestation (Clic here for more details about this article) |
9/27. Adnexal torsion during pregnancy -- management and literature overview.We present a patient in the 30th week of gestation with adnexal torsion, which was treated by laparotomy with oophorectomy. After 2 days, we had to perform a cesarean section because of bowel obstruction. We discuss the diagnosis and treatment of adnexal torsion in pregnancy and compare laparoscopic management with laparotomy. By reviewing the literature, we evaluate the conservative therapy by detorsion employing Doppler sonography.- - - - - - - - - - ranking = 0.73881539081401keywords = pregnancy, gestation (Clic here for more details about this article) |
10/27. Hemorrhagic corpus luteum cyst torsion in term pregnancy: a case report.hemoperitoneum during pregnancy resulting from spontaneous rupture of adnexal torsion is a rare cause of fetal and maternal death. Presenting symptoms include severe abdominal pain, followed rapidly by maternal shock and fetal distress. It is hard to localize the adnexae in advanced pregnancy. Here, we present a case of spontaneous rupture of hemorrhagic corpus luteum cyst torsion that had not been previously diagnosed by ultrasound during term pregnancy. The patient was sent to our emergency room for sudden onset of severe low abdominal pain. Treatment consists of maintenance of adequate circulating intravascular volume and rapid surgical intervention. Preoperative diagnosis of adnexal torsion during term pregnancy is very difficult, although it is always identified during surgery.- - - - - - - - - - ranking = 1.1428571428571keywords = pregnancy (Clic here for more details about this article) |
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