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The Pelvis
Published in Kenneth D Boffard, Manual of Definitive Surgical Trauma Care: Incorporating Definitive Anaesthetic Trauma Care, 2019
The fascia is divided in the midline until the symphysis can be palpated directly (the preperitoneal plane has been reached), protecting against urinary bladder damage. From the symphysis, the pelvic brim is followed laterally and posterior to the sacro-iliac joint (first bony irregularity felt), first on the side of major bleeding (most often the side of sacro-iliac joint disruption).
Pelvis and perineum
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
PelvisPelvic brim: – formed by sacral promontory (post.), iliopectineal lines and pubic symphysis– separates false pelvis (above) from true pelvisPelvic outlet: – formed by coccyx, ischial tuberosities and pubic arch– contains sigmoid colon, rectum, ureters and bladder
Pelvis and perineum
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
The hip bone is formed from three fused bones: the ilium, the ischium and the pubis. Anteriorly the two hip bones join at the pubic symphysis. The pelvic brim (or pelvic inlet) is formed by the superior edge of the sacrum (with the sacral promontory in the midline), the arcuate line of the ilium, the superior ramus and body of the pubis and the pubic symphysis; this is the boundary between the true pelvis or pelvic cavity, inferior to the brim, and the false pelvis, bounded laterally by the wings of the ilium, which is the part above the brim and more properly belongs to the abdominal cavity. Note: When the bony pelvis is correctly orientated, it is tilted forwards so that the anterior superior iliac spines and the superior aspect of the pubic symphysis are in the same vertical plane (as when holding the bony pelvis against a wall with these bony points touching the wall). The pelvic cavity runs posteriorly almost at a right angle to the abdominal cavity.
Successful management of ureteric endometriosis by laparoscopic ureterolysis – A review and report of three further cases
Published in Arab Journal of Urology, 2018
Deepa Talreja, Vivek Salunke, Shinjini Pande, Chirag Gupta
The patient underwent an operative laparoscopy that revealed a complete obliteration of the pelvis with adhesions and endometriosis. Hydrosalpinges were seen on both sides, along with a large right ovarian endometriotic cyst forming a tubo-ovarian mass (Fig. 4a). Bilateral ureters were entirely encased in fibrosis and endometriosis. After extensive adhesiolysis, the bilateral adnexa were released. Bilateral salpingectomy was performed in view of hydrosalpinges with extensive fibrosis of the tubes. This was followed by the bilateral ureterolysis, which was started from normal and healthy tissue at the level of the pelvic brim. Dissection was progressed in the direction of the uterosacral ligament, and the ureter was freed to the level of the crossing of the uterine artery (Fig. 4b and c). Satisfactory ureterolysis was achieved when the ureters were freed from the fibrotic nodules forming constriction bands, resulting in ureteric obstruction or a normal appearing ureter was seen distal to the stricture.
Elective surgery should be considered after successful conservative treatment of recurrent diverticular abscesses
Published in Scandinavian Journal of Gastroenterology, 2020
J. Sigurdardottir, A. Chabok, A. Thorisson, K. Smedh, M. Nikberg
All patients with complicated diverticulitis were diagnosed with computed tomography (CT) scans, with or without intravenous contrast agents. All CT scans were reexamined by an experienced radiologist who was blinded to the clinical outcome of the patients, and abscesses were classified as pericolic (abscesses above the pelvic brim) and pelvic (abscesses below the pelvic brim) [10,22]. Other radiological signs were assessed such as the presence of diverticula, colonic wall thickening > 5 mm, length of the involved colonic segment as well as the part of the colon that was engaged. Radiological features such as the assessment of free fluid and free air, the presence and size of the abscesses measured at the largest diameter, and the possibility of drainage were recorded.
Evaluation of the correlation between insulin like factor 3, polycystic ovary syndrome, and ovarian maldescent
Published in Gynecological Endocrinology, 2018
Although ovaries develop primarily higher up in the abdomen beside kidneys, but their decent put them in their normal position lying below the pelvic brim, between the utero-ovarian and infundibulopelvic ligaments. Undescended or maldscended ovaries occurred infrequently due to partial or complete failure of their normal descent. Ovarian maldescent has a reported world-wide prevalence of 0.3–2%. Evans and Cade reported the first case of undescended ovary, while Walker registered another three cases. Ovarian maldsecnt are more commonly seen in conjunction with Mullerian duct anomalies, with more than 20% appearing in women with Mayer–Rokitansky–Kuster–Hauser syndrome and in 42% with bicornuate and unicornuate uterus [1–3].