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Pediatric Hematocolpos
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Omar M. Abuzeid, Mostafa I. Abuzeid
In patients who are asymptomatic, the only presenting feature may be a large paravaginal mass that can be misdiagnosed as a pelvic mass, such as an endometrioma (Figure 17.13) [39]. If the patient presents with acute abdomen, examination may show bilateral lower quadrant tenderness, rebound tenderness, guarding, or rigidity, which can lead to a possible diagnosis of appendicitis. Occasionally, patients with pyocolpos, pyometra, and pyosalpinx may present with symptoms and signs suggesting pelvic inflammatory disease, such as fever, purulent vaginal discharge, signs of peritonitis, and leukocytosis. Rarely, the patient may have a small opening in the hemivagina that may lead to ascending infection in the hematocolpos (Figure 17.10) [42].
Companion Animals Models of Human Disease
Published in Rebecca A. Krimins, Learning from Disease in Pets, 2020
There has been an overall decrease in deaths before 10 years of age, with an increase in the percentage of dogs with at least one veterinary care event in 1999–2002 compared with 1995–1998. How much this reflects owner/societal attitudes about accessing care can only be hypothesized. Deaths due to traumatic causes decrease with age. Inflammatory problems are high in the very young, lower in dogs 2–4 years of age, and then increase with age. In the Swedish dog population, pyometra is the most common cause of disease in female dogs and accounts for some of this pattern. However, diseases such as outer ear infection and pyoderma have rather similar patterns. The decrease at the highest ages is likely due, at least partly, to owner decisions about care. Patterns of disease also vary by body system. Dogs display a similar U-shaped pattern for respiratory disease as is seen in man and other species with younger and older animals at an increased risk of infectious respiratory disease as the result of immunoincompetency.
DRCOG MCQs for Circuit C Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Wertheim's hysterectomy for cervical carcinoma includes removal of local lymph nodes and a cuff of vagina. Transcervical ablation of the endometrium by laser or diathermy may be used as an alternative to hysterectomy, but it is associated with pyometra as a complication. Scarring from opposed ablated surfaces results in adhesions at the cervical canal and resultant pyometra if a small focus of endometrial tissue is left behind. Treatment then involves a hysteroscopy and cervical dilatation to allow the 'hidden blood' to escape from the uterine cavity and prevent reoccurrence.
The Manchester operation – is it time for it to return to our surgical armamentarium in the twenty-first century?
Published in Journal of Obstetrics and Gynaecology, 2022
Ronen S. Gold, Hadar Amir, Yoav Baruch, David Gordon, Mordechai Shimonov, Asnat Groutz
There were four cases of late postoperative complications that required surgical intervention: vesicovaginal fistula, hematometra, pyometra and transvaginal small bowel evisceration. All four patients underwent uneventful Manchester operation. Three of the four patients underwent concomitant anterior and posterior colporrhaphy, two of whom also underwent TVT-O. The first patient (age 67 years, BMI 29.5) had vesicovaginal fistula that was diagnosed two months postoperatively. The second patient (age 45 years, BMI 22.6) underwent drainage of hematometra three months postoperatively with complete recovery thereafter. The third patient (age 67 years, BMI 24.2) presented with abdominal pain and fever 6 months after surgery. The presumed diagnosis following physical examination, pelvic sonography and lab tests was pyometra. The patient underwent total abdominal hysterectomy after a failed hysteroscopic attempt to drain the pyometra. The forth patient (age 57 years, BMI 19) presented 9 days after surgery with small bowel evisceration through the posterior vaginal fornix. Her past medical history has been unremarkable, with the exception of underweight and a trans urethral removal of bladder tumour (TURBT) for early stage bladder cancer 5 years earlier. The patient underwent emergency laparotomy in which the intestine was inspected and the posterior vaginal fornix was sutured. Her postoperative follow up was unremarkable.
The development of a silicone vaginal ring with a prostaglandin analogue for potential use in the treatment of canine reproductive disorders
Published in Pharmaceutical Development and Technology, 2019
Veronika Nováková Tkadlečková, Jakub Vysloužil, Kateřina Kubová, Jan Elbl, Darja Bučková, Jan Muselík, David Vetchý, Robert Novotný, Pavel Proks, Josef Jančář, Petr Poláček
Prostaglandins and other drugs are used for the treatment of canine pyometra. It is a common and life-threatening disease of the bitches’ reproductive system affecting almost 25% of all female dogs before they reach ten years of age (Rootwelt-Andersen and Farstad 2006; Baithalu et al. 2010). Treatment with subcutaneously or intramuscularly administered prostaglandin F2α was successfully reported by several authors (Nelson et al. 1982; Gilbert et al. 1989; Arnold et al. 2006). Prostaglandin induces myometrium contraction and cervical relaxation, which leads to the expulsion of the uterine content. It is administered once or twice daily and the therapy usually takes 3–5 days (Verstegen et al. 2008). Despite the lipophilic character, prostaglandins exhibit a certain degree of water solubility (Stehle 1982; Cirit et al. 2007). Therefore the addition of channel-forming excipients into the silicone matrix might be a good possibility for optimisation of their release behaviour in order to reduce the potential costs of veterinary products.
An unusual complication of LEEP cervical conisation with a retained intrauterine device (IUD): a case report
Published in Journal of Obstetrics and Gynaecology, 2019
Ayhan Gül, Ayşe Gül Kebapçılar, Gözde Şahin, Serra Akar, Çetin Çelik
In the present case, it is not known how the LEEP procedure was performed. A cervical stenosis after the procedure is thought to be the reason for fluid accumulation and the abscess formation due to a decreased drainage. Pyometra is a condition that can have poor gynaecological results and it can be fatal. Often tumoral masses or iatrogenic cervical stenoses cause this condition (Kim and Kim 2008). A hysterectomy had been offered in another hospital, but our patient did not want the removal of her uterus. For this reason, we made our operation through the cervical ostium recanalisation and removed the IUD that created a foreign body reaction. At the same time, an organ-protective approach was taken.