ISSN:1542-5983    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundRupture of the vaginal vault followed by evisceration of bowel through the vagina is a rare complication after hysterectomy and an unforgettable experience for the physicians involved.CaseA 59-year-old white woman underwent abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and periaortic lymphadenectomy for endometrial adenocarcinoma International Federation of Gynecology and Obstetrics Stage IIA grade 3. Three high-dose-rate brachytherapy vaginal insertions with iridium were done 5, 6, and 7 weeks postoperatively. Thirteen days after the third insertion, she presented with a pinkish vaginal discharge, a 4-cm rupture in the vaginal vault, and small bowel loops prolapsed into the vagina. A vaginal repair was done.ConclusionThis is the first reported case of vaginal evisceration related to iatrogenic trauma at high-dose-rate brachytherapy insertion. Prompt surgical treatment can minimize complications.

ISSN:1542-5983    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundGenital self-mutilation is a relatively rare phenomenon and may be associated with generalized self-mutilation, personality disorders, dissociative disorder, or psychosis.Case HistoryA 22-year-old female presented with a vesicovaginal fistula and extraperitoneal bladder injury after a self-inflicted knife wound. This was thought to have occurred secondary to acute psychosis at the time of alcohol intoxication.ConclusionPhysicians caring for female patients need to be aware of the psychopathology of genital self-mutilation and the potential for associated urologic injury.

ISSN:1542-5983    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundThere are many techniques for vaginal hysterectomies. Most of those performed in the United States are variations of the classic Heaney technique. The Döderlein technique of vaginal hysterectomy has not gained wide acceptance but offers advantages in selective cases.MethodsThe authors describe the Döderlein technique for vaginal hysterectomy and discuss the circumstances in which it offers advantages compared with the traditional Heaney technique.ConclusionsThe traditional Heaney technique of vaginal hysterectomy is preferred for the vaginal removal of the uterus with large anterior leiomyomata or a markedly elongated cervix and uteri weighing more than 200 g. The Döderlein technique offers advantages in the vaginal removal of the markedly prolapsed uterus, when uterine descensus is lacking, or for patients with shallow or scarred posterior vaginal fornices. Familiarity with both techniques affords the surgeon the option of using the method best suiting the patient, the disease process, and concomitant conditions to be addressed during the procedure.

ISSN:1542-5983    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1542-5983    

出版商:OVID    

年代:2003

数据来源: OVID