Bilateral tubal incarceration into the broad ligaments caused by pelvic endometriosis: A case report

2021 ◽  
pp. 228402652110381
Author(s):  
Francesca Massimello ◽  
Andrea Giannini ◽  
Linda Tebache ◽  
Michelle Nisolle ◽  
Tommaso Simoncini
Keyword(s):  
Iliac Fossa ◽  
Broad Ligament ◽  
Rare Event ◽  
Reproductive Period ◽  
Infertile Woman ◽  
Fallopian Tubes ◽  
Assisted Reproductive Technique ◽  
Left Iliac Fossa ◽  
Common Location ◽  
Ablative Surgery

Introduction: Endometriosis is characterised by the presence of functional endometrial tissue outside the uterus. Salpinges are a common location of endometriotic implants. Endometriosis located into the broad ligament is a rare event. Case description: A 38-year-old infertile woman presented to our attention with moderate left iliac fossa pain after menses and intermenstrual bleeding. Transvaginal ultrasounds and pelvic magnetic resonance evidenced the presence of bilateral haematosalpinges. At the laparoscopic pelvic exploration, fallopian tubes were absent. Opening and dissecting the apical portion of the broad ligaments, we identified bilateral haematosalpinges incarcerated in the homolateral broad ligaments. We performed bilateral salpingectomy. Histological examination confirmed the presence of endometriosis. Conclusion: Care must be taken to the diagnostic assessment, counselling about the surgical programme before the intervention especially in patients during the reproductive period when the possibility of ablative surgery and subsequent need for an assisted reproductive technique exists.

scholarly journals Tuboovarian Abscess as Primary Presentation for Imperforate Hymen

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Jeh Wen Ho ◽  
D. Angstetra ◽  
R. Loong ◽  
T. Fleming
Keyword(s):  
Iliac Fossa ◽  
Rare Event ◽  
First Episode ◽  
Left Iliac Fossa ◽  
Imperforate Hymen ◽  
Incision And Drainage ◽  
Tuboovarian Abscess ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Objective.Imperforate hymen represents the extreme in the spectrum of hymenal embryological variations. The archetypal presentation in the adolescent patient is that of cyclical abdominopelvic pain in the presence of amenorrhoea. We reported a rare event of imperforate hymen presenting as a cause of tuboovarian abscess (TOA).Case Study.A 14-year-old girl presented to the emergency department complaining of severe left iliac fossa pain. It was her first episode of heavy bleeding per vagina, and she had a history of cyclical pelvic pain. She was clinically unwell, and an external genital examination demonstrated a partially perforated hymen. A transabdominal ultrasound showed grossly dilated serpiginous fallopian tubes. The upper part of the vagina was filled with homogeneous echogenic substance. Magnetic resonance imaging (MRI) demonstrated complex right adnexa mass with bilateral pyo-haemato-salpinges, haematometra, and haematocolpos. In theatre, the imperforate hymen was opened via cruciate incision and blood was drained from the vagina. At laparoscopy, dense purulent material was evacuated prior to an incision and drainage of the persistent right TOA.Conclusion.Ideally identification of imperforate hymen should occur during neonatal examination to prevent symptomatic presentation. Our case highlights the risks of late recognition resulting in the development of sepsis and TOA.

scholarly journals A case report on ruptured interstitial ectopic pregnancy: diagnostic dilemma

2019 ◽  
Vol 8 (6) ◽  
pp. 2567
Author(s):  
Suman S. Sharma ◽  
A. V. Gokhale ◽  
Shonali Agrawal
Keyword(s):  
Ectopic Pregnancy ◽  
Broad Ligament ◽  
Rare Event ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Radiological Features ◽  
Gestational Sac ◽  
Interstitial Ectopic Pregnancy

The ectopic pregnancy occurs when implantation of the blastocyst takes place in a site other than the endometrium of the uterine cavity. Interstitial ectopic pregnancies are gestations that implant within the proximal, intramural portion of the fallopian tubes with high vascularity. Ectopic pregnancy in the interstitial part of the fallopian tubes can be life-threatening considering the thin myometrial tissue surrounding the gestational sac and high vascularization which may result in catastrophic haemorrhage when interstitium is ruptured. Being a hazardous type of ectopic pregnancy, it becomes extremely important to diagnose and manage it. This condition presents a challenge for clinical as well as radiological diagnosis. Generally, a case of interstitial ectopic pregnancy has typical radiological features distinguishing it from other ectopic. The ultrasonographic finding of interstitial line has better sensitivity (80%) and specificity (98%) than eccentric gestational sac location (sensitivity, 40%; specificity, 88%) and myometrial thinning (sensitivity, 40%; specificity, 93%) for the diagnosis of interstitial ectopic pregnancy. Ultrasound is the mainstay of diagnosis, but magnetic resonance imaging can be helpful in unusual or complicated cases. Interstitial ectopic pregnancy rupturing into the leaves of broad ligament and creating a tamponade effect to alter the clinical presentation is a rare event which presents as a diagnostic challenge. Here authors present a case of ruptured interstitial ectopic pregnancy confined to the leaves of broad ligament, with atypical presentation and radiological features which led to difficulty in diagnosing the interstitial ectopic pregnancy. After laparoscopic confirmation of ruptured interstitial ectopic pregnancy, the patient was managed successfully by laparoscopic cornual resection.

scholarly journals Acute Abdomen Revealing an Unusual Case of Intra-Abdominal Testicular Torsion

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Maazou Halidou ◽  
Amadou Roua ◽  
Ibrahim Amadou Magagi ◽  
Harissou Adamou ◽  
Ousseini Adakal ◽  
...  
Keyword(s):  
Germ Cells ◽  
Spermatic Cord ◽  
Testicular Torsion ◽  
Unusual Case ◽  
Iliac Fossa ◽  
Rare Event ◽  
Lateral Mass ◽  
Left Iliac Fossa ◽  
Case Presentation ◽  
Operative Specimen

Introduction. Intra-abdominal testicular torsion is a rare event. We report hereby our experience of the management of a spermatic cord twist on intra-abdominal testis discovered during an acute surgical abdomen. Case Presentation. This was a 42-year-old patient admitted to the emergency department for abdominal pain that had been evolving for a week. The physical examination showed tenderness and guarding in the left iliac fossa with an empty ipsilateral hemiscrotum. Complementary examinations led to the discovery of an intra-abdominal left-lateral mass. The laparotomy found a whitish mass with areas of infarction, which was resected. Anatomopathological examination of the operative specimen identified it as a testis with atrophy of germ cells and necrotic areas without evidence of malignancy. Conclusion. Intra-abdominal testicular torsion should be considered in case of patients with an acute surgical abdomen with vacuity of one of the bursae.

Abdominal apoplexy during pregnancy

2020 ◽  
Vol 13 (10) ◽  
pp. e235946
Author(s):  
Jasmeet Kumari ◽  
Rosemary Harkin
Keyword(s):  
Iliac Fossa ◽  
Unknown Origin ◽  
Breech Presentation ◽  
Sudden Onset ◽  
Left Iliac Fossa ◽  
Safe Delivery ◽  
Uterine Contractions ◽  
Early Labour ◽  
Increased Risk ◽  
High Index Of Suspicion

We report a case of idiopathic spontaneous intraperitoneal haemorrhage (ISIH) in a 31-year-old patient at 37 weeks gestation in her second pregnancy. The patient presented to the labour ward with abdominal pain and uterine contractions. The initial complain was of sudden onset, severe sharp pain in left iliac fossa. She started having uterine contractions within 30 min of her presentation. Examination confirmed early labour with a footling breech presentation. Urgent caesarean section was performed that confirmed peritoneal bleeding of unknown origin with safe delivery of the baby. Mother and baby were safely discharged on day 5. ‘Abdominal apoplexy’ (ISIH), is a rare obstetric emergency with increased risk of fetal and maternal morbidity and mortality. With various clinical presentations as a possibility, diagnosis is challenging. High index of suspicion with prompt management of suspected cases can be pivotal life saving measure for the fetus and mother.

Imperforate hymen mimicking acute appendicitis in an adolescent woman: a rare presentation

2021 ◽  
Vol 14 (3) ◽  
pp. e238547
Author(s):  
Victoria Rose Russell ◽  
Mohamed Ibrahim ◽  
Georgina Phillips ◽  
Tom Setchell ◽  
Sanjay Purkayastha
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Female Genital Tract ◽  
Delayed Diagnosis ◽  
Rare Presentation ◽  
Left Iliac Fossa ◽  
Imperforate Hymen ◽  
Retrograde Menstruation ◽  
Low Incidence

Imperforate hymen is a rare congenital malformation of the female genital tract. The condition poses several diagnostic challenges owing to its low incidence and often atypical presentation. Classical symptoms include amenorrhoea and cyclical abdominal pain. Delayed diagnosis leads to potentially irreversible and lifechanging sequelae including infertility, endometriosis and renal failure. A premenarchal 13-year-old girl with a background of chronic constipation presented with symptoms mimicking acute appendicitis. The underlying cause was imperforate hymen and retrograde menstruation. The diagnosis was made during diagnostic laparoscopy. As with this patient, pre-existing symptoms are often troublesome long before the true diagnosis is made. This case report highlights the importance of recognising imperforate hymen as a potential cause of acute abdominal pain in premenarchal adolescent girls. The clinical picture may present as right or left iliac fossa pain. Early identification reduces the risk of adverse complications and avoids unnecessary and potentially harmful interventions.

scholarly journals A case of successful surgical management of primary retroperitoneal mucinous cystadenoma

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Zeeshan Afzal ◽  
Weronika Stupalkowska ◽  
Maria B Mahler-Araujo ◽  
David Bowden ◽  
Richard J Davies
Keyword(s):  
Iliac Fossa ◽  
Mucinous Cystadenoma ◽  
Surgical Excision ◽  
Mass Effect ◽  
Rare Tumour ◽  
Left Iliac Fossa ◽  
Female Population ◽  
Midline Laparotomy ◽  
Complete Surgical Excision ◽  
Primary Retroperitoneal

Abstract Primary retroperitoneal mucinous cystadenoma (PRMC) is a rare tumour. It was first reported in 1965, and since then, less than 100 cases have been reported. It is cystic in nature and most commonly affects the female population. It becomes symptomatic in later stages due to its mass effect, making the diagnosis challenging in its early asymptomatic stage. We report a case of a 32-year-old female who presented with abdominal pain and a mass in left iliac fossa. Diagnostic imaging revealed a large cystic lesion in retroperitoneum. A midline laparotomy was performed, and a complete surgical excision was accomplished without any spillage. Surgical histology confirmed the diagnosis of PRMC. The patient was discharged on postoperative day 2. There was no evidence of tumour recurrence on repeat imaging at 90-day follow-up. Surgical approach, with complete resection and without any spillage, remains the most effective and appropriate treatment for this tumour.

Herniography: A Prospective, Randomized Study Between Midline and Left Iliac Fossa Puncture Techniques

2001 ◽  
Vol 56 (5) ◽  
pp. 389-392 ◽  
Author(s):  
Sanjay Nadkarni ◽  
Peter W.G. Brown ◽  
Edwin J.R. van Beek ◽  
Michael C. Collins
Keyword(s):  
Iliac Fossa ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Left Iliac Fossa

scholarly journals Tubocutaneous Fistula due to Endometriosis – A Differential Diagnosis in Cutaneous Fistulas with Cyclic Secretion

2017 ◽  
Vol 39 (01) ◽  
pp. 31-34
Author(s):  
Edinari Lopes ◽  
Lia Damásio ◽  
Laio Passos
Keyword(s):  
Differential Diagnosis ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Iliac Fossa ◽  
Main Diagnosis ◽  
Significant Morbidity ◽  
Cutaneous Fistula ◽  
Left Iliac Fossa ◽  
Surgical Scar ◽  
Hormonal Therapies

The development of a tubocutaneous fistula due to endometriosis in a post-cesarean section surgical scar is a rare complication that generates significant morbidity in the affected women. Surgery is the treatment of choice in these cases. Hormonal therapies may lead to an improvement in symptoms, but do not eradicate such lesions. In this report, we present a 34-year-old patient with a cutaneous fistula in the left iliac fossa with cyclic secretion. Anamnesis, a physical examination, and supplementary tests led us to suggest endometriosis as the main diagnosis, which was confirmed after surgical intervention.

Sign in / Sign up

Export Citation Format

Share Document