Laparoscopic management of a 20-cm ovarian cyst in a patient with a BMI of 70: a case report

A woman in her mid-40s with a body mass index (BMI) of 70 presented with lower abdominal pain of 24-h duration. The trans-abdominal scan revealed a large cystic ovarian mass. Laparoscopic salpingo-oophrectomy was performed by placing six ports in the upper abdomen; initial Verres needle entry and pneumoperitoneum were established through the left upper quadrant. A low CA-125 and the benign appearance of the ovary allowed the operation to continue laparoscopically with fewer perioperative complications. The histology of the specimen demonstrated a benign epithelial serous cystadenoma of the ovary with torsion.     

Failure of a conservative treatment of a placenta accreta

We report a case of placenta accreta left fully in situ during a cesarean section. Postoperative courses were complicated with a thrombosis of the right external iliac artery after embolization and with a pyometra needing n hysterectomy. We discuss the risks of such conservative treatment of a placenta accreta, compared with classical ablation.     

Ultrasonographic diagnosis of a fetal abdominal mass: a case of a mesenchymal liver hamartoma and a review of the literature

A case of a prenatally recognized hepatic mesenchymal hamartoma is presented and the literature reviewed. These tumors are benign and usually present in early infancy with symptoms that are related to the mass effect on adjacent organs. Radiologic methods used in the past to image this tumor include angiography and ultrasound. However, there is no specific radiologic finding, and, therefore, the diagnosis is usually made during surgery. Once the tumor is removed, the prognosis is generally good. With the increasing use of high resolution ultrasound in prenatal diagnosis, this rare tumor should be considered in the differential diagnosis of any multicystic mass found in the fetal abdomen. The recognition of a mass should then alert the physician to the need for early neonatal intervention.     

Perforation of a pyometra mimicking a perforated peptic ulcer

Summary We report on a patient with a pyometra which leaked into the peritoneal cavity and was mistaken for a perforated peptic ulcer. There was no associated stenosis of the cervical canal.     

Association of asthenozoospermia with a deficiency of a seminal glycoprotein

Two major glycoprotein bands (Rf 0.67 and 0.49) were detected with polyacrylamide disc gel electrophoresis in normal human semen, spermatocele fluid and prostatovesicular fluid. The most rapidly migrating band (Rf 0.67) was either present in only trace amounts or absent in asthenozoospermic semen. The protein moiety of this glycoprotein was present in normal and asthenozoospermic semen, but it was not glycosylated in asthenozoospermic semen. It is suggested that there is a relationship between this glycoprotein and the acquisition of sperm motility.     

Endometrial adenocarcinoma within a single horn of a didelphic uterus: a report of 2 cases

BACKGROUND: Didelphic uterus results from incomplete fusion of the müllerian ducts. CASES: In 2 cases, endometrial adenocarcinoma arose in 1 horn of a didelphic uterus. CONCLUSION: Clinicians should be aware of müllerian anomalies, which may go undetected, resulting in diagnostic delay.     

Management of a woman with a previous preterm birth

Reducing the impact of preterm birth is one of the challenges in modern obstetric practice. This article provides a case-based discussion of management of women with a previous preterm birth. Estimating the risk of a subsequent preterm delivery can be improved by assessment of obstetric history. Primary preventative strategies include lifestyle advice and modification of pre-pregnancy risk factors. Antenatal care involves increased monitoring and supportive care. The usefulness of screening for preterm birth using cervical length ultrasound or biochemical tests of cervicovaginal secretions lie mainly in their negative predictive value, allowing recognition of women in whom subsequent preterm birth is unlikely. Potential prophylactic therapies in high-risk women include marine oils, progesterone pessaries and cervical cerclage, but none have been shown to improve neonatal outcome. The need for further research is highlighted.