Laparoscopic repair of a uterine fistula

We report a case of fistula between the uterus and broad ligament in a 28-year-old woman after cesarean section. The patient presented with right-sided pelvic pain, which worsened during menstruation. The diagnosis was made at laparoscopy. The patient subsequently underwent successful laparoscopic repair of the fistula confirmed by hysterosalpingography 4 months after surgery.     

Third consecutive complete posterior uterine rupture. A case report

BACKGROUND: Management of pregnancy in a woman who has had a ruptured uterus on more than one occasion presents a great clinical and ethical challenge to the obstetrician. CASE: This appears to be the first report on complete uterine ruptures in three consecutive pregnancies. CONCLUSION: Prolonged hospital admission, intensive antenatal surveillance, antenatal steroid administration and elective premature delivery may give the best chance for a good outcome in these pregnancies. However, despite all these efforts, there is still a high risk of an unfavorable outcome.     

Malignant mesothelioma of the vulva. About one case

Most malignant mesotheliomas are pleural; they rarely occur within the peritoneum and their location in the vulva is exceptional. A case of a malignant mesothelioma of the vulva is reported in a 47-year-old woman. The patient was operated for a tumour of the vulva. The preoperative diagnosis was that of a cyst of the Bartholin's gland or a fibroma. The microscopic and immunohistochemical exam confirmed the diagnosis of a biphasic malignant mesothelioma of the vulva. The computed tomography scan of the chest and the abdomen was normal. A local recurrence of the tumour occurred in spite of the postoperative radiotherapy. Our objective about this particular case is to discuss the clinical and pathologic aspects and the diagnostic problems of this exceptional tumour of the vulva.     

Gunshot uterine rupture: A case report

A case report of gunshot uterine rupture from which the mother and fetus survived is presented for the first time. Management was guided by pre-operative ultrasound diagnosis of traumatic anhydramnios.     

Laparoscopic uterine suspension.

Laparoscopic uterine suspension is an effective method of correcting symptomatic uterine retroversion. Eighty patients with deep dyspareunia reproduced by palpation of their retroverted uterus underwent a modified Gilliam uterine suspension under laparoscopic visualization. There were no intraoperative or postoperative complications requiring laparotomy, and symptoms were relieved in 74 patients.     

About two cases of uterine rupture outside of labour: consequences of an unnoticed previous perforation

The uterine mute perforation following uterine evacuation of pregnancy exists; the obstetrical consequences of these are quite unknown. We report 2 cases of pregnancy complicated by uterine rupture and defect after uterine mute perforation. The physical signs are late and misleading. The notion of perforation during the instrumental evacuation of pregnancy must be mentioned for an adequate follow-up. Management thus remains essentially preventive.     

First-trimester uterine rupture from a placenta percreta. A case report

BACKGROUND: Cesarean scar pregnancy complicated by placenta percreta and uterine rupture is an uncommon gynecologic emergency. CASE: A woman presenting with abdominal pain and shock was found to have a cesarean scar pregnancy complicated by placenta percreta and uterine rupture. CONCLUSION: Implantation within a cesarean scar may cause placenta percreta, leading to uterine rupture in the first trimester and mimicking other gynecologic emergencies.     

Atypical lipomatous tumour of the vulva. About one case

Liposarcoma of the vulva is a rare entity. This unusual localization with atypical clinical and histological appearance may induce diagnostic and treatment delay. We report the 13th case shown in the literature in a 31-year-old woman initially treated for a vulvar lipoma. Arguments based on clinical short term recurrence, histological infiltrating adipocytes, and cytogenentical findings evoked well-differentiated liposarcoma. Even though cytogenetic abnormalities, involving MDM2 and CDK4 genes, have been found, a certainty in malignity diagnosis could be difficult. In these cases, treatment decision may be uneasy. This case report recalls difficulties encountered in uterine hypercellular leiomyomas.     

A case report of destructive mole after uterine rupture

We describe a patient 17 weeks pregnant whose complaints were diagnosed as acute abdomen. The patient underwent a total abdominal hysterectomy and uterine rupture was found with, surprisingly, a live fetus. Pathologic examination indicated destructive mole.     

Spontaneous subserosal venous rupture overlying a uterine leiomyoma. A case report

BACKGROUND: Patient age, parity and leiomyoma size are considered risks for venous rupture overlying a leiomyoma. CASE: A 28-year-old woman presented with abdominal pain and decreasing hematocrit from spontaneous rupture of a uterine leiomyoma vein. CONCLUSION: Congestion of a vein overlying a leiomyoma, irrespective of the patient's age or parity or size of the leiomyoma, is a risk factor for rupture.     

Laparoscopic subtotal hysterectomy in a case of uterine didelphys

Introduction  

Major congenital uterine anomalies present a management dilemma in women who are symptomatic and not responsive to medical therapy. This case report discusses the role of laparoscopic subtotal hysterectomy in a woman with uterine didelphys, who presented with a long-standing history of menorrhagia, which had not responded to medical treatment.