摘要:

BACKGROUNDComplex wound failures are a source of significant morbidity and mortality. They are costly and time consuming to treat, and may evolve into chronic, debilitating conditions. Vacuum-assisted closure is a novel wound healing technique applying subatmospheric pressure to wounds to expedite healing.CASESWe report the successful use of vacuum-assisted closure therapy on three patients on a gynecologic oncology service with complex wound failures of various chronicity. In all cases, vacuum-assisted closure therapy was well tolerated and demonstrated efficacy within 48 hours of initiation.CONCLUSIONWe conclude that vacuum-assisted closure therapy should be included in the armamentarium of the gynecologist addressing complex wound failures.

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BACKGROUNDIt has been estimated that worldwide, over 125,000 women die of postpartum hemorrhage each year. The traditional management of this condition includes the use of oxytocics, such as oxytocin, ergometrine, and prostaglandins, before proceeding to ligation of the internal iliac arteries and even hysterectomy. The B-Lynch technique is a surgical procedure that may be used to arrest postpartum hemorrhage resulting from uterine atony.CASESThis paper describes simple modifications of this technique that make this procedure less complex to perform. Three clinical case scenarios illustrate the context in which the sutures may be used.CONCLUSIONCompression sutures placed into the postpartum uterus may provide a simple first surgical step to control bleeding when routine oxytocic measures have failed. We suggest that the technique we have described is a simple procedure and should be tried before more complex interventions are used.

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BACKGROUNDThe square suture technique to achieve hemostasis for postpartum hemorrhage has been described in the medical literature. In a prior report of 23 cases, there were no complications from the technique.CASEA young woman with an gravida 1 para 0 with an uncomplicated prenatal course presented at 40 weeks' estimated gestational age in active labor. Cesarean delivery was performed for arrest of dilatation and was complicated by postpartum hemorrhage unresponsive to medical therapy and uterine artery ligation. Several hemostatic square sutures were placed, obtaining hemostasis. The patient presented 4 weeks postpartum with pain and mucopurulent discharge. Pyometrium was discovered at the time of dilation and curettage.CONCLUSIONPyometrium may result from the use of hemostatic square suture technique for control of postpartum hemorrhage.

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BACKGROUNDHysteroscopy to evaluate abnormal uterine bleeding is gaining popularity. The standard methods of evaluation, endocervical curettage, and endometrial biopsy frequently diagnose adenocarcinoma without determining location. Because the treatments of endometrial and endocervical cancers are different, knowing the neoplastic origin is desirable.CASESTwo postmenopausal women were referred for abnormal uterine bleeding. Endometrial biopsies were consistent with mucinous adenocarcinoma without distinction between cervical and endometrial sites. Endocervical curettages were inconclusive. Both patients underwent hysteroscopy at the time of exploratory laparotomy, which revealed the location of the adenocarcinomas, one in the endocervix and one in the uterine fundus.CONCLUSIONThe location of adenocarcinoma may be further clarified by the use of intraoperative hysteroscopy, which can aid in determining surgical treatment.

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BACKGROUNDMidtrimester laparoscopic surgery is considered safe; however, both maternal and fetal complications can occur. We report a case of midtrimester pregnancy loss with pneumoamnion after laparoscopic appendectomy.CASEA young woman presented at 21 weeks' gestation with a 3-day history of nausea and severe abdominal pain. Diagnostic laparoscopy was performed with normal appendix and pelvic anatomy noted. Worsening pain prompted a repeat laparoscopic evaluation. A small defect in the uterine serosa was noted, which presumably resulted from inadvertent Veress needle injury. Abdominal computerized tomography was performed, which demonstrated a pneumoamnion. Spontaneous rupture of membranes and labor ensued, resulting in the delivery of a stillborn fetus.CONCLUSIONInadvertent introduction of the Veress needle into the gravid uterus with subsequent pneumoamnion represents a catastrophic complication of midtrimester laparoscopic surgery.

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:2002

数据来源: OVID