1/4. rupture of noncommunicating rudimentary uterine horn pregnancy.BACKGROUND:We present a rare case of pregnancy in a noncommunicating rudimentary horn that ruptured at 20 weeks.CASE:A 30-year-old woman presented with a history of two spontaneous abortions. An ultrasound scan showed a bicornuate uterus, with one normal and one hypoplastic horn. hysterosalpingography revealed a single uterine cavity with only one tube, suggesting a unicornuate uterus. hysteroscopy and laparoscopy were recommended but declined.She presented again 2 months later at 7 weeks' gestation. A single intrauterine pregnancy in the hypoplastic right horn was diagnosed. A transvaginal scan showed a single cervical canal in continuity with the left uterine horn, which led to the suspicion of a pregnancy in a rudimentary horn. The option of pregnancy termination was offered. A laparoscopy was repeatedly suggested but declined. Excision of a ruptured noncommunicating rudimentary horn and ipsilateral salpingectomy were performed after an emergency laparotomy at 20 weeks because of the sudden onset of abdominal pain and signs of shock.CONCLUSION:Although a rudimentary horn pregnancy had been suspected before the laparotomy, the patient presented as a clinical emergency. This report, like others, indicates that prompt diagnosis and immediate removal of the rudimentary horn is lifesaving.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/4. Recanalization of a fallopian tube after detorsion of twisted adnexa: report of a case with follow-up by repeat hysterosalpingography.BACKGROUND: Detorsion and cystectomy of twisted adnexa have been performed in young women. However, identification was incomplete, and the function of the affected tube was not investigated. CASE: A 23-year-old, nulligravid woman with an acute abdomen was diagnosed with adnexal torsion. An emergency laparotomy revealed that both ovaries were 12x9x9 cm. the right adnexa were twisted and bluish black. Detorsion of the twisted lesion and ipsilateral fallopian tube was performed, with subsequent cystectomy of both lesions. hysterosalpingography on the 14th postoperative day showed right tubal obstruction; 6 months postoperatively, repeat hysterosalpingography revealed patency of the right tube. CONCLUSION: At least several months may be required for functional recovery of an untwisted tube. For that reason, postoperative repeat hysterosalpingography is a useful method for follow-up of function in an untwisted tube.- - - - - - - - - - ranking = 4keywords = canal (Clic here for more details about this article) |
3/4. hematocolpos associated with a remote history of chronic vaginitis and a diagnostic vaginal biopsy: a case report.Bacterial vaginitis is commonly seen in the pediatric population. Severe or recurrent cases may be associated with ulcerative lesions. We report a case of vaginal biopsies of ulcerative lesions in a 9-year-old which led to severe vaginal adhesions, stenosis, and hematocolpos. A vaginoscopy and resection from below were not successful and an exploratory laparotomy with uterine perforation and sounding into the upper vagina were required to reopen the lower vaginal canal. We recommend the limited use of vaginal biopsies in the face of a typical vaginitis presentation, and aggressive treatment to promote mucosa healing when biopsies are required.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
4/4. Abdominal pregnancy following total hysterectomy.This paper reports a case of ectopic abdominal pregnancy following total hysterectomy and reviews the literature. pregnancy following total hysterectomy is a rare event. Ectopic pregnancy following supracervical hysterectomy can be explained in view of the remaining patent cervical canal. In cases of total hysterectomy (abdominal or vaginal) two important factors to be considered are the persistence of a fistulous tract from the vaginal apex to the peritoneum and the prolapse of the fallopian tube into the vagina, creating a patent tract for spermatozoa. As long as some ovaries remain, the possibility of ectopic pregnancy must be entertained in the differential diagnosis of acute abdomen in a female.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |