Showing papers on "Uterine Fistula published in 2017"
TL;DR: A 74-year-old woman admitted to the First Aid Station suffering from abdominal pain and foul smelling vaginal discharge and Anatomical specimen confirmed sigmoid-uterine fistula is an extremely rare condition.
Abstract: Neoplastic sigmoid-uterine fistula is an extremely rare condition because the uterus is a thick and muscular organ. A 74-year-old woman was admitted to the First Aid Station suffering from abdominal pain and foul smelling vaginal discharge. Gynaecological examination showed fecal drainage from the cervical orifice, while the uterus was regular in size but very firm and painful. Ovaries and fallopian tubes were not palpable owing to abdominal tenderness. Ultrasounds reveled inhomogeneous thickening of uterine cavity, without detecting fistula. Contrast Medium CT (CMCT) showed Douglas' recto-uterine pouch occluded. The sigmoid wall was very thin exception a site where a fistula was suspected. At the surgery severe adhesions of the sigma-rectum with the posterior uterine wall were observed. After adhesiolysis, 18 cm colon-sigma-rectum was removed. Total hysterectomy with salpingooophorectomy was performed. Lymphadenectomy ended the procedure. Anatomical specimen confirmed sigmoid-uterine fistula. At histology a mildly differentiated adenocarcinoma of sigma-rectum was shown. Postoperative course was uneventful. Such a case of neoplastic sigmoiduterine fistula has not been reported so far.
7 citations
Journal Article•
TL;DR: An uncommon complication of pelvic inflammatory disease, a tubo-uterian fistula is reported, diagnosed by laparoscopy incidentally during assessment of infertility.
Abstract: OBJECTIVE Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women that can include endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian abscess, and peritonitis. The spectrum of the disease ranges from subclinical and asymptomatic infection to severe, lifethreatening illness; squealae include chronic pelvic pain, ectopic pregnancy, and infertility. In this case we report an uncommon complication of pelvic inflammatory disease, a tubo-uterian fistula. Our case was diagnosed by laparoscopy incidentally during assessment of infertility.
2 citations
TL;DR: Six years after caesarean section due to obstructed labour, the 37-year-old woman complained about involuntary loss of urine and haematuria during menstruation and during the course of the subsequent pregnancy the urinary incontinence deteriorated.
Abstract: Six years after caesarean section due to obstructed labour, the 37-year-old woman complained about involuntary loss of urine and haematuria during menstruation. During the course of the subsequent pregnancy the urinary incontinence deteriorated. A vesico-uterine fistula was diagnosed in the 24th week of gestation by transvaginal ultrasound (Fig. 1, marked with white arrows). Gynaecological examination revealed loss of urine through the cervix. Urethrocystoscopically, a 1 cm fistula was confirmed in the posterior bladder wall. At 37 weeks of gestation, a healthy girl was delivered by caesarean section and fistula closure was performed simultaneously. The diameter of the fistula had extended continuously to 3 cm at delivery (Fig. 2, marked with black arrow). A two-layer tension-free closure of the bladder wall and an one layer closure of the cervical wall were performed using a biologic graft interposition between bladder and cervical wall. Since removal of the suprapubic catheter 3 weeks postoperatively, the patient remained continent.
1 citations
TL;DR: Intra-operative diagnosis and appropriate repair of bladder injury during a caesarean section can reduce the likelihood of encountering this iatrogenic complication and its medicolegal repercussions.
Abstract: Vesicouterine fistula (VUF) is rare and accounts for 1-4% of all genitourinary fistulas. Majority [80-90%] are caused during caesarean sections. Rising trend of lower section caesarean sections (LSCS) have led to an increased reporting of this complication. Intra-operative diagnosis and appropriate repair of bladder injury during a caesarean section can reduce the likelihood of encountering this iatrogenic complication and its medicolegal repercussions. An iatrogenic genitourinary fistula is an abnormal communication between the bladder or ureter and the uterus/cervix/ vagina, resulting from a surgical procedure. According to RCOG, the incidence of bladder injuries in caesarean sections is 1 in 1000. Factors involved in the development of VUF secondary to LSCS include inadequate downward mobilization of the bladder, sutures inadvertently placed through the bladder wall, bladder devascularisation during dissection and infection secondary to catheterisation, or haematoma formation. It may have varied clinical picture with early or late presentation.
TL;DR: VUF is an unusual complication of LCSC, and presentation is very variable, from frank urinary leakage to vaginal discharge, and what makes it unique is a competent cervix, which closes and allows urine to be trapped in to the uterus.
31 Dec 2017
TL;DR: A 2-year-old female Maltese dog was presented with a history of anemia and vaginal hemorrhagic discharge and underwent ovariohysterectomy without complication, and Histopathological diagnosis of the uterine fistula site was adenocarcinoma.
Abstract: A 2-year-old female Maltese dog was presented with a history of anemia and vaginal hemorrhagic discharge. Physical examination revealed severe vaginal hemorrhagic discharge, abdominal pain, pale mucous membranes, low blood pressure and dehydration. Results of serum biochemistry, hematology, venous blood gas, and electrolyte canine C-reactive protein (CRP) test revealed severe normocytic normochromic anemia, severe neutropenia, a high level of CRP, hypoglycemia, and imbalanced electrolytes. Abdominal ultrasound examination showed focal hypoechoic defect with loss of layering in uterine horn wall. A laparotomy revealed a clear reddish fluid in the abdomen, the fistula of left and right uterine horn, the purulent discharge from fistula, and symptoms of septic peritonitis near by the fistula site. The bitch underwent ovariohysterectomy and recovered without complication. Histopathological diagnosis of the uterine fistula site was adenocarcinoma.
20 Oct 2017
TL;DR: Diagnosis is established by a combination of urography, cystoscopy, double dye test, computerized tomography scan (CT) and a hysterogram, and management options include a trial of conservative therapy, endurologic (stented repair), and open surgical ureteroneocystostomy or u retero-ureterostomy.
Abstract: Introduction Uretero-uterine fistulae are rare, but serious conditions. Most of them are iatrogenic injuries occurring during Caesarean Section, when one ureter is inadvertently sutured to uterus. Other causes are uterine malignant disease, endometriosis, and elective abortion [1]. Diagnosis is established by a combination of urography, cystoscopy, double dye test, computerized tomography scan (CT) and a hysterogram.The management options include a trial of conservative therapy (spontaneous healing), endurologic (stented repair), and open surgical ureteroneocystostomy or uretero-ureterostomy.
30 Mar 2017
TL;DR: A 67-year-old woman presented with abdominal distension and difficulty in defecation and had a huge mass in the left lower abdomen and hyperamylasemia with normal pancreatic-type amylase, who developed colorectal-reproductive system fistula with hyperpyrexia.
Abstract: A 67-year-old woman presented with abdominal distension and difficulty in defecation She had a huge mass in the left lower abdomen and hyperamylasemia with normal pancreatic-type amylase (P-AMY) Nuclear magnetic resonance and computed tomography scan revealed a huge pelvic mass, but the origin of mass wasn’t certain After discussion with the multidisciplinary team, ultrasonography guided pathological biopsy of the mass was done Pathological biopsy showed that the mass was poorly differentiated adenocar-cinoma, which may be originated from ovary Patient was on neo-adjuvant chemotherapy After one and a half months of chemotherapy, the patient developed colorectal-reproductive system fistula with hyperpyrexia Laparatomy with resection of mass, sigmoid colon, left ovary and part of uterus, proximal colostomy with closure of the distal rectum and end to end anastomosis of left ureter with DJ tube drainage (left ureter invaded by tumor confirmed intra operation) was done Operative finding: Fistula between sigmoid colon and uterus through the tumor