scholarly journals A Case of Delayed Diagnosis of Bilateral Ureteral and Bladder Injury after Laparoscopic Hysterectomy: An Unusual Complication

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Maximilien C. Goris-Gbenou ◽  
Nicolas Arfi ◽  
Abdel Mitach ◽  
Sheer Rashed ◽  
Jean-Gabriel Lopez
Keyword(s):  
Unusual Case ◽  
Delayed Diagnosis ◽  
Laparoscopic Hysterectomy ◽  
Ureteral Injury ◽  
Bladder Injury ◽  
Unusual Complication ◽  
Gynaecological Surgery ◽  
Uterine Adenomyosis

The incidence of ureteral and bladder lesions after laparoscopic hysterectomy is the most encountered urinary complication in gynaecological surgery. We report the unusual case of 42-year-old woman who had a delayed diagnosis of bilateral ureteral injury associated with bladder lesion and loose of vaginal suture after undergoing laparoscopic hysterectomy for uterine adenomyosis.

Thermal Bladder Injury at Laparoscopic Hysterectomy

2018 ◽  
Vol 25 (4) ◽  
pp. 562-564
Author(s):  
Aisling A. Clancy ◽  
Duane Hickling
Keyword(s):  
Laparoscopic Hysterectomy ◽  
Bladder Injury

scholarly journals Clinical practice of mininally invasive gynaecological surgeries

2018 ◽  
Vol 21 (2) ◽  
pp. 19-23
Author(s):  
Binaya Raj Bhandari ◽  
Ranjana Shrestha ◽  
Binita Pradhan
Keyword(s):  
Clinical Practice ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Descriptive Study ◽  
Routine Practice ◽  
Gynaecological Surgery ◽  
Patient Demographics ◽  
Common Operation ◽  
Operative Recovery

Introduction: Endoscopic gynaecological surgery which is a routine practice in outer world since last 40 years, is still at earlier phase in Nepal. This study was done to know the clinical practice of minimally invasive gynaecological surgeries in Minimally Invasive Diagnostic and Therapeutic (MIDAT) hospital. Methods: A hospital based descriptive study was conducted in gynaecological department of MIDAT hospital over 16 months period from 1st Bhadra 2071 to 30th Poush 2072 (17th August 2014 to 14th January 2016) among 115 women who underwent minimally invasive gynaecological surgeries (MIGS). Patient demographics, types of surgeries, indications of laparoscopy and hysteroscopy, reason for laparoscopic conversion, complications of surgeries and hospital stay were analyzed. Results: There were total 115 minimally invasive gynaecological surgeries done in MIDAT hospital during study period. Laparoscopic gynaecological surgeries and hysteroscopy were performed in 86 (75%) and in 29 (25%) women respectively. Among laparoscopy, laparoscopic hysterectomy {31 (36%)} was the more common operation. During laparoscopy, conversion to open was done in nine (10.5%) patients. Complications of MIGS were seen in three (3.5%) women. Conclusions: MIGS has acceptable morbidity, smooth post operative recovery and shorter hospital stay. In recent time, MIGS is gradually becoming popular in Nepal.   

scholarly journals Acute presentation of intestinal malrotation in adults: a report of two cases

2010 ◽  
Vol 92 (7) ◽  
pp. e15-e18 ◽  
Author(s):  
Thomas Hanna ◽  
Jacob A Akoh
Keyword(s):  
Case Reports ◽  
Delayed Diagnosis ◽  
Adult Life ◽  
Intestinal Malrotation ◽  
Unusual Complication ◽  
Fetal Life ◽  
Diagnostic Challenge ◽  
Multiple Fractures ◽  
Diagnostic Uncertainty ◽  
First Case

Introduction Intestinal malrotation is a rare developmental abnormality occurring as a result of incomplete rotation during fetal life. It usually presents in the first few weeks of life, but may persist unrecognised into adult life. We report two interesting cases in elderly patients both characterised by a significant diagnostic challenge due to atypical clinical and radiological signs and in one case an unusual complication following laparotomy. Case Reports The first case was a 64-year-old man initially treated for diverticulitis but at laparotomy was found to have malrotation of the midgut and a perforated left-sided appendicitis. The second case was a 76-year-old woman admitted with multiple fractures and increasing abdominal distension following a fall. Ten days after admission, she underwent right hemicolectomy to treat faecal peritonitis due to multiple caecal perforations complicating volvulus in the presence of midgut malrotation. Conclusions These cases illustrate challenges associated with managing patients with undiagnosed intestinal malrotation. Delayed diagnosis is a common feature in several case reports describing atypical presentation of appendicitis in patients with malrotation. While abdominal CT scan can remove much of the diagnostic uncertainty, the diagnosis of malrotation can be missed unless there is a high index of suspicion.

scholarly journals Total laparoscopic hysterectomy: a retrospective study of 5 years

2019 ◽  
Vol 8 (12) ◽  
pp. 5008
Author(s):  
Suma S. Moni ◽  
Suchith Hoblidar ◽  
Rathnamala M. Desai ◽  
Sunil Kumar K. S.
Keyword(s):  
Retrospective Study ◽  
Demographic Data ◽  
Operating Time ◽  
Laparoscopic Hysterectomy ◽  
Bladder Injury ◽  
Medical Sciences ◽  
Operative Specimen ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Findings

Background: Hysterectomy is one of the most common gynecological surgeries performed around the world. This study was done to review the data of all patients who underwent TLH. With this study a uniform method of performing TLH by a single surgeon was assessed.Methods: A 5 years retrospective study was performed at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital Dharwad, Karnataka India. Demographic data, pre-operative findings, indication for surgery, intra-operative and post-operative complications, duration of surgery were recorded and analyzed.Results: A total of 118 women were included in the study. Mean age of the patients wasMost common indication for the surgery was leiomyoma. Mean operating time was 162.18 minutes. Mean weight of the post-operative specimen was 208.45 grams. Intra-operative urinary bladder injury was seen in 1 patient. Conversion to laparotomy was needed in 2 patients.Conclusions: With improving experience TLH can be performed safely without complications. As number of surgeries done increases duration of TLH reduces. TLH can be effectively used to avoid laparotomy.

scholarly journals Basic Standard Procedure of Abdominal Hysterectomy: Part 1

2019 ◽  
Vol 05 (S 01) ◽  
pp. S2-S10
Author(s):  
Yuji Hiramatsu
Keyword(s):  
Standard Procedure ◽  
Outer Wall ◽  
Total Abdominal Hysterectomy ◽  
Ureteral Injury ◽  
Abdominal Hysterectomy ◽  
Second Step ◽  
Bladder Injury ◽  
Intestinal Damage ◽  
Cardinal Ligament ◽  
Basic Standard

Total abdominal hysterectomy (TAH) is commonly referred to as extrafascial hysterectomy. This article explains the basic surgical procedure of TAH as taught to residents. TAH is an operation to remove the uterus with the outer wall of the uterus, and is a fundamental operation that gynecologists must master. Possible complications during TAH include ureteral injury, intestinal damage, and bladder injury. To avoid operative complications, it is important to follow the correct release layer procedure and ensure that “the uterus has been naturally removed.”The two most important points of the authors' method to avoid complications are as follows: (1) cut sequentially from the ligament away from the ureter which moves the ureter further away from the cervix with each transection stage; (2) cut the parametrial tissue along the circumference of the cervix in the next three steps:First step: clamping and cutting the uterine artery and upper part of the cardinal ligament; second step: clamping and cutting the sacrouterine ligament and the posterior half of the cardinal ligament; third step: clamping and cutting the vesicouterine ligament and anterior half of the cardinal ligament.

The unusual case of neck lymphadenopathy - oculoglandular form of tularemia

2018 ◽  
Vol 7 (2) ◽  
pp. 1-5
Author(s):  
Katarzyna Baranowska-Kempisty ◽  
Jolanta Kluz-Zawadzka ◽  
Sylwia Warzybok-Bajda ◽  
Krzysztof Szuber
Keyword(s):  
Adverse Effect ◽  
Case Report ◽  
Francisella Tularensis ◽  
Unusual Case ◽  
Drug Research ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Elisa Test ◽  
Gram Negative ◽  
The Right

Tularemia is anthropozoonosis caused by Bacteria Francisella tularensis a gram negative, non-motile aerobic bacillus.[5][8] The bacteria is transmitted mostly by rabbits, hares, rodents and arthropods. The pathogen penetrates into an organism via damaged skin, conjunctiva or mucosa- either through inhalation or ingestion. The clinical manifestations depend on the route of acquisition. Six forms of the disease can be distinguished: ulceroglandular or glandular, oculoglandular, oropharyngeal, respiratory, typhoidal, and intestinal. [11] We present a case report of the rarest oculoglandular form of tularemia. The patient was admitted to the hospital with right pre-auricular swelling, right sided neck lymphadenopathy, conjunctivitis and a nodule of the right eyelid. After excluding more common differential diagnoses, an ELISA test was performed and Francisella tularensis antibodies were identified. Patient administered proper antibiotic therapy. Tularemia is a rarely occurring disease in Poland and is nearly never taken into consideration by otolaryngologists when diagnosing patients with neck lymphadenopathy. In clinical practice, otorhinolaryngologists should always consider this infectious zoonosis, especially the oculoglandular and oropharyngeal forms, as delayed diagnosis and treatment may causes serious health consequences in patients. In the future new drug research should be conducted because of the adverse effect of widely used medications specially for children and pregnant woman.

scholarly journals URINARY TRACT INJURIES FOLLOWING OBSTETRIC AND GYNECOLOGIC SURGERIES -A PROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL.

2020 ◽  
pp. 67-68
Author(s):  
Khumallambam Ibomcha Singh ◽  
Konsam Jina Devi ◽  
Kangjam Sholay Meitei
Keyword(s):  
Urinary Tract ◽  
Vesicovaginal Fistula ◽  
Tertiary Care ◽  
Ureteral Injury ◽  
Gynecologic Surgery ◽  
Bladder Injury ◽  
Care Hospital ◽  
Ureterovaginal Fistula ◽  
Ureteral Injuries ◽  
Urological Complications

Purpose: Urinary tract injuries occur frequently during surgery in the pelvic cavity. Inadequate diagnosis and treatment may lead to severe complications and morbidities. This study examined the clinical features of urologic complications following obstetric and gynecologic surgery and their management. Materials and Methods: We prospectively analysed 14,678 obstetric and gynecologic surgery cases from May 2015 to May 2019. Twenty-one patients with urological complications were enrolled. This study assessed the etiology and surgical approach, type, and treatment method of the urologic injury. Results: Of these 21 patients, 11 had bladder injury, 1 had ureteral injury, 1 had combined bladder and ureteral injury, 8 had vesicovaginal fistula and 5 had ureterovaginal fistula. With respect to injury rate by specific surgery, radical hysterectomy was the highest with 5 of 21 cases. Out of 11 cases of bladder injury, only one underwent laparoscopic bladder repair and the rest had transabdominal primary repair during surgery with a 100% success rate. Two of 7 ureteral injuries were identified intraoperatively. One underwent ureteroureterostomy and another had ureteroneocystostomy with no major complications. All 8 cases of vesicovaginal fistula had open transabdominal O’ connor repair and all 5 cases of ureterovaginal fistula were cured after ureteroneocystostomy following percutaneous nephrostomy. Conclusions: Urinary bladder injury was the most common urological injury during obstetric and gynecologic surgery, followed by ureteral injury. The types of injured states, diagnostic difficulty, and time to complete cure were much greater among patients with ureteral injuries. Early diagnosis and necessary urologic intervention are important for better outcome.

scholarly journals Trends and patterns in total laparoscopic hysterectomy in tertiary care hospital

2018 ◽  
Vol 7 (6) ◽  
pp. 2170
Author(s):  
Sonali Ingole ◽  
Sameer Darawade
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Bladder Injury ◽  
Care Hospital ◽  
Estimated Blood Loss ◽  
The Mean

Background: Due to technical advances in the field of laparoscopy, there has been an increase in total laparoscopic hysterectomies all over the world in last decade. This study was conducted to analyse the technique and surgical outcome of total laparoscopic hysterectomy in tertiary care hospitalMethods: This is a retrospective cohort (observational) study, which included all patients who underwent Total Laparoscopic Hysterectomy (TLH) for benign conditions from January 2012 to December 2017 at the tertiary Care Hospital. The data so obtained was analysed for various parameters like indication for surgery, mean operating time, length of hospital stay, complications and conversion to abdominal route.Results: Total number of 2307 hysterectomies were performed over a period of 5 years. Of these, TLH were 270 (11.70%). Amongst those undergoing TLH, the mean age was 45±7.84 years. The most common indication for the surgery was fibroid uterus (38.14%), followed by dysfunctional uterine bleeding (28.88%), and adenomyosis (15.1%). The mean estimated blood loss was 106±4.34 ml. Hemorrhage (n = 2) and bladder injury (n = 4) were most common surgical complications.Conclusions: TLH is safe and effective procedure for most of the benign pelvic conditions. With adequate training TLH can be used more widely in tertiary care hospital and teaching institute.

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