Ultrasound-guided oocyte retrieval is a standard procedure for ovum pick up (OPU) during in vitro?fertilization. Possible complications include tubo-ovarian abscesses (TOAs) in the fallopian tubes, and endometriosis m...Ultrasound-guided oocyte retrieval is a standard procedure for ovum pick up (OPU) during in vitro?fertilization. Possible complications include tubo-ovarian abscesses (TOAs) in the fallopian tubes, and endometriosis may be associated with increasing?the severity of pelvic infection. A 35-year-old?woman who had been treated for infertility and endometriosis presented with abdominal pain that appeared several days after OPU. There were no significant changes in the size of both ovaries and fallopian tubes. A week later, transvaginal echography revealed right oviduct enlargement. Because conservative treatment with antibiotics before this revelation had not been successful, laparoscopy was performed for abscess drainage and/or excision of the adnexa. Intraoperative findings were an abscess in the right adnexa involving the ovary and fallopian tube. Preservation of the right fallopian tube was difficult due to the risk of prolonged infection, and a right appendectomy was performed. The diagnosis was a right TOA. Severe cases of pelvic infection after OPU may cause infertility. The presence of endometriosis may aggravate the infection, but the relationship between the extent of the endometriosis and the severity of the infection is not known. Even if the endometriosis is mild, as it was in this patient, surgical treatment should be considered if a severe infection occurs after OPU and conservative treatment is not effective.展开更多
Described here is an unusual complication of a common condition; diverticulitis resulting in a tubo-ovarian abscess. The etiology of this abscess was clinically unapparent due to atypical presenting symptoms and signs...Described here is an unusual complication of a common condition; diverticulitis resulting in a tubo-ovarian abscess. The etiology of this abscess was clinically unapparent due to atypical presenting symptoms and signs. Furthermore, radiological diagnosis was misleading because of an inflammatory reaction of the colon which prevented visualization of diverticula. Failure to correctly identify the underlying pathology early in the patient's course of treatment led to a perforation of the colon.展开更多
Background: Conservative therapies of pelvic abscess are not highly effective and surgical treatment is usually required. This study reviewed cases of pelvic abscess treated at our hospital over a 3-year period to eva...Background: Conservative therapies of pelvic abscess are not highly effective and surgical treatment is usually required. This study reviewed cases of pelvic abscess treated at our hospital over a 3-year period to evaluate treatment efficacy. The medical records of 20 patients diagnosed with pelvic abscess and admitted to our hospital for treatment between November 2006 and December 2009 were retrospectively examined. Results: Mean age of the patients was 50 ± 16.6 years. Pelvic abscess occurred spontaneously in 13 patients and secondary to surgical manipulation in 7 patients. In the 13 patients with spontaneous abscess, 7 had undergone pelvic surgery and 2 had undergone insertion of an intrauterine contraceptive device. Concomitant endometriosis was present in 5 of the 13 (38.5%) patients. A positive bacterial culture from the abscess was obtained in 16 of 19 (84.2%) patients tested. Causative bacteria included 4 aerobic bacterial species detected in 7 patients and 11 anaerobic bacterial species detected in 10 patients. Although multiple antibiotics were administered in all cases, 19 of the 20 (95%) patients eventually required surgical intervention, which included total hysterectomy plus adnexectomy, drainage under laparotomy or drainage alone. Anaerobic bacteria were frequently detected as the causative bacteria. Conclusion: As treatment with antibiotics alone was ineffective in almost all cases, surgical treatment was required. Drainage might be the first-choice treatment for pelvic abscess to avoid invasive surgery.展开更多
Introduction: Appendicitis is the most common surgical emergency in childhood. It’s a common surgical disease that can be presented with a wide variety of atypical clinical features. Clinical Case: We report a case o...Introduction: Appendicitis is the most common surgical emergency in childhood. It’s a common surgical disease that can be presented with a wide variety of atypical clinical features. Clinical Case: We report a case of a 7-year-old female patient admitted for abdominal pain dating back 20 days, radiological exploration suggested a right ovarian teratoma, while laparoscopic exploration has objective an appendicular abscess. Conclusion: This case has allowed us to clarify an atypical case of complicated appendicitis, and also to show the contribution of laparoscopy.展开更多
文摘Ultrasound-guided oocyte retrieval is a standard procedure for ovum pick up (OPU) during in vitro?fertilization. Possible complications include tubo-ovarian abscesses (TOAs) in the fallopian tubes, and endometriosis may be associated with increasing?the severity of pelvic infection. A 35-year-old?woman who had been treated for infertility and endometriosis presented with abdominal pain that appeared several days after OPU. There were no significant changes in the size of both ovaries and fallopian tubes. A week later, transvaginal echography revealed right oviduct enlargement. Because conservative treatment with antibiotics before this revelation had not been successful, laparoscopy was performed for abscess drainage and/or excision of the adnexa. Intraoperative findings were an abscess in the right adnexa involving the ovary and fallopian tube. Preservation of the right fallopian tube was difficult due to the risk of prolonged infection, and a right appendectomy was performed. The diagnosis was a right TOA. Severe cases of pelvic infection after OPU may cause infertility. The presence of endometriosis may aggravate the infection, but the relationship between the extent of the endometriosis and the severity of the infection is not known. Even if the endometriosis is mild, as it was in this patient, surgical treatment should be considered if a severe infection occurs after OPU and conservative treatment is not effective.
文摘Described here is an unusual complication of a common condition; diverticulitis resulting in a tubo-ovarian abscess. The etiology of this abscess was clinically unapparent due to atypical presenting symptoms and signs. Furthermore, radiological diagnosis was misleading because of an inflammatory reaction of the colon which prevented visualization of diverticula. Failure to correctly identify the underlying pathology early in the patient's course of treatment led to a perforation of the colon.
文摘Background: Conservative therapies of pelvic abscess are not highly effective and surgical treatment is usually required. This study reviewed cases of pelvic abscess treated at our hospital over a 3-year period to evaluate treatment efficacy. The medical records of 20 patients diagnosed with pelvic abscess and admitted to our hospital for treatment between November 2006 and December 2009 were retrospectively examined. Results: Mean age of the patients was 50 ± 16.6 years. Pelvic abscess occurred spontaneously in 13 patients and secondary to surgical manipulation in 7 patients. In the 13 patients with spontaneous abscess, 7 had undergone pelvic surgery and 2 had undergone insertion of an intrauterine contraceptive device. Concomitant endometriosis was present in 5 of the 13 (38.5%) patients. A positive bacterial culture from the abscess was obtained in 16 of 19 (84.2%) patients tested. Causative bacteria included 4 aerobic bacterial species detected in 7 patients and 11 anaerobic bacterial species detected in 10 patients. Although multiple antibiotics were administered in all cases, 19 of the 20 (95%) patients eventually required surgical intervention, which included total hysterectomy plus adnexectomy, drainage under laparotomy or drainage alone. Anaerobic bacteria were frequently detected as the causative bacteria. Conclusion: As treatment with antibiotics alone was ineffective in almost all cases, surgical treatment was required. Drainage might be the first-choice treatment for pelvic abscess to avoid invasive surgery.
文摘Introduction: Appendicitis is the most common surgical emergency in childhood. It’s a common surgical disease that can be presented with a wide variety of atypical clinical features. Clinical Case: We report a case of a 7-year-old female patient admitted for abdominal pain dating back 20 days, radiological exploration suggested a right ovarian teratoma, while laparoscopic exploration has objective an appendicular abscess. Conclusion: This case has allowed us to clarify an atypical case of complicated appendicitis, and also to show the contribution of laparoscopy.
