scholarly journals TOTAL ABDOMINAL HYSTERECTOMY FOLLOWED BY BILATERAL SALPINGO-OOPHORECTOMY AND SUBMUCOUS FIBROID REMOVAL

2021 ◽  
Vol 10 (5) ◽  
pp. 3624-3626
Author(s):  
Sakshi P. Arora
Keyword(s):  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Fallopian Tubes ◽  
Beneficial Effects ◽  
Delivery Technique ◽  
Vertical Incision ◽  
The Us ◽  
Clinical Conditions

There was abnormal uterine bleeding and recurrent lower abdominal pain in a 50 year-old female. A bilateral salpingo-oophorectomy is surgery to extract ovaries and fallopian tubes of both the sides. By the age of 60, more than a third of women in the US have had a hysterectomy. The expected anatomy, the patient's body habits, the degree of pelvic relaxation, the need for concurrent abdominal and vaginal procedures, and the surgeon's expertise all play a role in deciding the uterus delivery technique and route. The hysterectomy and bilateral salpingo-oophorectomy will both be done during one procedure. The uterus, ovaries, cervix & fallopian tubes are remove through surgery. For a large sub mucous fibroid uterus, the patient opted to have a complete abdominal hysterectomy along bilateral salpingo-oophorectomy. Abdominal hysterectomy & bilateral salpingo-oophorectomy were performed in midline vertical incision under general anesthesia. A uterus with sub mucous fibroid (polyps) was confirmed by pathology. The option of surgical method in a hysterectomy based on clinical conditions, the professional skill of the surgeon, and the preference of patients. As this case indicates, for many patients, abdominal hysterectomy is an important choice where the use of other methods may pose a serious danger. This method may be sufficient for the treatment of sub-mucous fibroids. There are broad range of studies that demonstrate beneficial effects in the various therapies created, serving as a basis for guiding physiotherapeutic approaches in hysterectomy, aiming at complementary tools for better treatment of the patient undergoing this procedure.

scholarly journals An Unusual Presentation of Choriocarcinoma: A Case Report with a Long Latent Period

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Fateme Sadat Najib ◽  
Zahra Shiravani ◽  
Mojgan Hajisafari ◽  
Shaghayegh Moradi Alamdarloo ◽  
Atefe Hashemi ◽  
...  
Keyword(s):  
Latent Period ◽  
Case Reports ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Normal Pregnancy ◽  
Abdominal Hysterectomy ◽  
Uterine Bleeding ◽  
Gestational Choriocarcinoma ◽  
Irregular Border

Introduction: Choriocarcinoma (CC) is a rare malignant tumor of trophoblastic tissue. This tends to invade rapidly to the vasculature and metastasis to the lung, vagina, brain, and liver. CC can present with a variety of manifestations, such as hemoptysis, gastrointestinal (GI) bleeding, and abnormal uterine bleeding. Commonly, the latent period to the development of CC is not more than 1 year after the antecedent molar or normal pregnancy. In this report, the patient developed CC about 32 months after her previous known pregnancy. We reported a rare case of gestational CC that occurred about 32 months after her antecedent pregnancy. Case Presentation: A 21-year-old admitted in shock with abnormal uterine bleeding, pain, and lower abdominal pain. The patient had one previous cesarean section 32 months prior to admission. The vaginal examination demonstrated a fused solid cervical mass with an irregular border measuring about 7 × 7 cm. In further workup, there was evidence of a 103 × 94 × 89 mm mass with the hemorrhagic area and central necrosis in the middle and lower segments of the uterus and cervix. The patient underwent a total abdominal hysterectomy and left side salpingo-oophorectomy. The diagnosis of CC was made after microscopic examination. Conclusions: There are few case reports of choriocarcinoma with more than a year latent period after antecedent pregnancy. The strongest hypothesis is having asymptomatic pregnancy during the period between the last pregnancy and the development of CC. However, the possibility of non-gestational choriocarcinoma in such cases should be considered. Treatment with a single- or multiple-agent chemotherapy regimen should be immediately initiated after diagnosis in these cases.

scholarly journals Primary High Grade Serous Carcinoma of the Fallopian Tube: A Case Report

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Ramesh Dhakhwa ◽  
Anshu Vaidya ◽  
Amrita Giri ◽  
Archana Shakya ◽  
Achala Vaidya
Keyword(s):  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Figo Stage ◽  
Abdominal Hysterectomy ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
High Grade ◽  
Anatomic Site

A 49-year-old, perimenopausal nulliparous woman with lower abdominal pain and abnormal uterine bleeding. Clinical and radiological findings suggested a right adnexal tumor. CA-125 level was moderately elevated. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. Peroperative findings revealed a soft to friable growth arising from right fallopian tube with no involvement of ovaries. Histopathologic examination confirmed it to be a high grade serous carcinoma, FIGO stage IA. The histomorphology resembled high grade serous carcinoma of ovary, however ovaries on both sides appeared unremarkable. Surgery was uneventful and the patient was discharged after seven days of hospital stay. She did not receive postoperative chemotherapy or radiotherapy and is under follow-up. The case is reported for its occurrence in an uncommon anatomic site and preoperative dilemma with relevant review of literature.

scholarly journals ADENEXAL CYSTS

2011 ◽  
Vol 18 (01) ◽  
pp. 32-40
Author(s):  
TEHREEN RIAZ ◽  
SARWAT JABEEN ◽  
WASEEM TALIB ◽  
Nabeela Shami
Keyword(s):  
Demographic Data ◽  
Lower Abdominal Pain ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumour ◽  
Risk Of Malignancy ◽  
Histopathologic Evaluation ◽  
Operative Findings

Objectives: (1) To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neither simple nor complex. (2) To determine the relationship of age with type of ovarian tumour. (3) To categorize the management of these cases according to the intra-operative findings. (4) To analyze the occurrence of various histopathological types of tumour. Date Source: Medline Study Design: Single centered prospective descriptive study of 150 cases. Place and Duration of Study: Department of Obstetrics and Gynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to,31st December 2006. Subject and method: 150 patients presented with adnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD. Results: Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence of malignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain (53%) followed by menstrual disturbances (30%), abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73% masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts with papillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy. Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40% patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cysts were the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants. Conclusions: Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential in determining risk of malignancy and may be advantageous in terms of counseling patients for management.

scholarly journals Subacute uterine inversion following an induced abortion in a teenage girl: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Asiphas Owaraganise ◽  
Leevan Tibaijuka ◽  
Joseph Ngonzi
Keyword(s):  
Rare Complication ◽  
Hypovolemic Shock ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Unsafe Abortion ◽  
Axillary Temperature ◽  
Uterine Inversion ◽  
History Of ◽  
Failed Surgery

Abstract Background Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. Case presentation We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. Conclusion Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.

scholarly journals PERIOPERATIVE MANAGEMENT OF PATENT DUCTUS ARTERIOSIS WITH EISENMENGERS SYNDROME WITH SEVERE PULMONARY HYPERTENSION POSTED FOR NON-CARDIAC SURGERY.

2020 ◽  
pp. 1-3
Author(s):  
S.V. Padma Priya ◽  
Mrunalini Mrunalini
Keyword(s):  
Perioperative Management ◽  
Early Adulthood ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Anaesthetic Management ◽  
Pulmonary Artery Hypertension ◽  
Definition Of ◽  
Patent Ductus Arteriosis ◽  
High Pulmonary Vascular Resistance

Victor Eisenmenger's initial definition of Eisenmengers syndrome was redefined by Wood as 'the presence of high pulmonary vascular resistance associated with pulmonary artery hypertension at or close to systemic pressure associated with a reversed or bi-directional shunt at the aortopulmonary, interatrial or interventricular level'. Survival beyond 50 years is unusual, but patients may lead a relatively active and productive life in early adulthood and will therefore present from time to time for noncardiac surgery. Though theoretical risks of anaesthesia are considerable patients are known to do well with a variety of techniques, if pathophysiology of the disease is well understood.We describe the anaesthetic management of the patient with Eisenmengers syndrome with abnormal uterine bleeding with multiple fibroids.She underwent a total abdominal hysterectomy after pre-operative stabilization.Anaesthetizing such a decompensated patient is an anaesthetic challenge.

scholarly journals Laparoscopic approach to hysterectomy

2013 ◽  
Vol 4 (2) ◽  
pp. 117-126
Author(s):  
Hakan Nazik
Keyword(s):  
Laparoscopic Approach ◽  
Abnormal Uterine Bleeding ◽  
Laparoscopic Hysterectomy ◽  
Cost Effective ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Organ ◽  
Uterine Bleeding ◽  
Total Laparoscopic Hysterectomy ◽  
Uterine Leiomyomata

Modern laparoscopic surgery is widely used throughout the world as it offers greater advantages than open procedures. The laparoscopic approach to hysterectomy has evolved over the last 20 years. Hysterectomies are performed abdominally, vaginally, laparoscopically or, more recently, with robotic assistance. Indications for a total laparoscopic hysterectomy are similar to those for total abdominal hysterectomy, and most commonly include uterine leiomyomata, pelvic organ prolapse, and abnormal uterine bleeding. When hysterectomy is going to be performed, the surgeon should decide which method is safer and more cost-effective. This paper aims to make a review of the indications, techniques and advantages of laparoscopic hysterectomy as well as the criteria to be used for appropriate patient selection.

scholarly journals Coriocarcinoma gestacional primario de cuello uterino. Presentación de un caso

2021 ◽  
Vol 81 (04) ◽  
pp. 406-410
Author(s):  
Viviana García ◽  
◽  
Franco Calderaro Di Ruggiero ◽  
Jorge Hoegl ◽  
Carlos Quintero ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Gestational Trophoblastic Disease ◽  
World Health ◽  
Molar Pregnancy ◽  
Trophoblastic Disease ◽  
Gestational Choriocarcinoma ◽  
Gynecology And Obstetrics ◽  
Gynecological Examination

Choriocarcinoma represents a type of malignant tumor of gestational trophoblastic disease. It can develop after a molar pregnancy, miscarriage, normal or ectopic pregnancy. Generally its seat site is the uterine body; infrequent places such as the cervix have been described. We report the case of a 37-year-old patient is reported, VI gestations IV deliveries I cesarean section I molar pregnancy, with abnormal uterine bleeding, which is referred to the Hospital Oncology Service. On gynecological examination, an exophytic mass is observed in the cervix. A biopsy was taken that reported: Gestational choriocarcinoma and plasma levels of β-hCG were verified: 13805 IU / L. A total abdominal hysterectomy was performed with preservation of the ovaries. It was concluded as stage I of the International Federation of Gynecology and Obstetrics and 8, according to the score of the World Health Organization (ST I: 8), for which adjuvant was indicated. Currently no evidence of disease. Keywords: Choriocarcinoma, gestational trophoblastic disease, cervix.

scholarly journals Post Caesarean Vesicouterine Fistula Causing Menouria

2013 ◽  
Vol 25 (1) ◽  
pp. 46-48
Author(s):  
R Sultana ◽  
N Haque
Keyword(s):  
Fistulous Tract ◽  
Bladder Wall ◽  
Rare Event ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
The Body ◽  
Vesicouterine Fistula ◽  
Fibroid Uterus ◽  
Urogenital Fistula

Vesicouterine fistula is an uncommon urogenital fistula. The incidence is on the rise because of increasing incidence of Caesarean sections. Cyclical Haematuria or Menouria is an important clinical feature of this fistula which may or may not be associated with urinary incontinence depending on the location of the fistulous tract. We present a case report of Post caesarean section Vesicouterine fistula following 2 Caesarean sections. This was successfully managed by laparotomy with repair of fistulous tract in bladder wall and Total Abdominal Hysterectomy for multiple Fibroid uterus done. Menouria is a rare event in Gynecology and one should always keep this possibility in mind when there is cyclical haematuria. A 42 year old Bangladeshi woman was hospitalized with complaints of menorrhagia, lower abdominal pain for last 8 years, cyclical hematuria for last 20 years. She was mildly anemic, haemodynamically stable and regularly menstruating women. The primary Ultrasound scans suggested multiple fibroid with cystic ovary in left side. Cystoscopy was done and findings are a fistulous opening in the bladder measuring around 7mm in size. It was supratrigonal in position. The patient had no history of Endometriosis, Pelvic irradiation therapy, Inflammatory disease, Trauma or Malignancy. Initially there was dilemma in her diagnosis and the patient was diagnosed as a case of bladder Endometriosis besides fibroid uterus. So surgery was planned and Total Abdominal Hysterectomy & bilateral salphingo-oophorectomy done. There was a fistula about 3cm × 2cm in the lower part of the body of uterus connecting with the base of Bladder. Fistula repaired after dissection, patient follow up done and catheter removed after 14 days without any complications. Vesicouterine fistula can be prevented if care is taken to separate the bladder from the uterus during repeat Caesarean sections. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.16072 Medicine Today 2013 Vol.25(1): 46-48

scholarly journals Rare Presentation of Chorioadenoma Destruens as Acute Haemoperitoneum Mimicking Ruptured Ectopic Pregnancy

2015 ◽  
Vol 12 (4) ◽  
pp. 288-291 ◽  
Author(s):  
M Sinha ◽  
R Kaur ◽  
R Gupta ◽  
R Rani ◽  
A Aggarwal
Keyword(s):  
Ectopic Pregnancy ◽  
Lower Abdominal Pain ◽  
Myometrial Invasion ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Acute Onset ◽  
Rare Presentation ◽  
Placental Site ◽  
Invasive Mole

Gestational trophoblastic neoplasms (GTN) are proliferative degenerative disorders of placental elements and include complete or partial mole (90%), invasivemole (5-8%), choriocarcinoma (1-2%) and placental site tumor (1-2%). Chorioadenoma destruens is a trophoblastic tumor, characterized by myometrial invasion through direct extension or via venous channels. We present a case of invasive mole eroding uterus and uterine vasculature, causing sudden rupture of uterus with massive haemoperitoneum mimicking ectopic pregnancy. A 20 year old G1P0 at 6 weeks gestation presented in Casualty of Kasturba Hospital complaining of severe acute onset lower abdominal pain for one hour. Clinical examination revealed shock. Sonography suggested ectopic pregnancy and immediate exploratory laparotomy was decided. On laparotomy, 2000cc of haemoperitoneum was noted. Grape like vesicles protruding through fundal perforation with profuse active bleeding was seen. Bleeding persisted despite evacuation. Step wise uterine devascularisation failed to achieve haemostasis. Total abdominal hysterectomy was performed as a life saving measure.Kathmandu University Medical Journal Vol.12(4) 2014; 288-291

scholarly journals Clinico-Pathological Study of Hysterectomy Specimens in Kathmandu Medical College Teaching Hospital

2018 ◽  
Vol 3 (2) ◽  
pp. 423-426
Author(s):  
Sailesh Bahadur Pradhan ◽  
Mamata Sedhain ◽  
Sneh Acharya ◽  
Sailuja Maharjan ◽  
Samikchhya Regmi
Keyword(s):  
Teaching Hospital ◽  
Histopathological Examination ◽  
College Teaching ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Medical College ◽  
Chronic Cervicitis

Introduction: Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.Objective: To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings.Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.Results: A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.Conclusion: Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426.

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