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Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6 cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue.

The aim of this study was to evaluate every part of the surgical procedure during cesarean section (CS) to prevent complications and improve the clinical outcome. We researched on PubMed, Medline, and Cochrane. The evidence-based research suggests a transverse incision of the skin, blunt dissection of the subcutaneous tissue, omission of the bladder flap, blunt extension of the hysterotomy, prophylactic antibiotics, spontaneous placental removal, leaving the peritoneum open, and suture closure of the subcutaneous tissue when thickness is ≥2 cm. We hope that all evidence-based description will help to perform the CS safer, and for all surgical procedures not yet studied, further research is needed.

Introduction !Pelvic Organ Prolapse (POP) is a disorder which affects millions of women worldwide [1]. POP is a condition that can negatively impact on the quality of life for patients because this condition often coexists with pelvic floor disorders like urinary or faecal incontinence [2]. If conservative treatments have failed, the surgical procedure has proven to be a good way to cure this condition with a high efficacy rate and very low rates of both mortality and morbidity [3]. The usual treatment for a utero-vaginal prolapse is a hysterectomy followed by pelvic support repair [4][5]. In young women suffering from POP, who are at childbearing age, the type of surgical approach is currently unclear. Studies have proven that young women are at high risk of a POP recurrence after surgical treatment but so far no studies have evaluated the impact of surgical POP repair on subsequent pregnancies and types of delivery [6]. This article describes the case of a woman who had an unproblematic pregnancy and delivered without incident 13 months after a laparoscopic sacrohysteropexy. The concerning literature is reviewed and summarized.Case ! A 33-year-old IV-gravida, III-para was referred to our hospital at 38 4/7 weeks of gestation for an elective caesarean section due to foetal breech presentation and history of POP repair. Her obstetrical history consisted of two uneventful vaginal deliveries and a forceps extraction. Thirteen Abstract ! Pelvic Organ Prolapse (POP) is a rare condition during pregnancy. If all conservative treatments fail, the surgical approach has proven to be in non-pregnant women a very good option due to high efficacy and a very low morbidity and mortality rate. We are reporting on the clinical results of a 33-year-old pregnant woman with a past history of laparoscopic sacrohysteropexy who delivered by caesarean section due to a foetal breech presentation. There are only a handful of cases reporting the outcome "pregnancy" after a laparoscopic sacrohysteropexy. Nevertheless, this appears to be a useful intervention for women with a POP unresponsive to conservative treatment and open family planning. Further studies with long-term follow-ups are required to confirm this. Zusammenfassung

imaging techniques. Bilateral diffuse breast involvement by multiple small nodules has been described twice in disseminated RDD, involving the breast parenchyma in addition to other nodal, visceral or non-visceral sites, similar to the findings in our patient.RDD needs to be considered in the differential diagnosis of single or multiple mass lesions in the breast, especially in patients with a history of RDD at other sites. After histologic confirmation of this benign condition, RDD of the breast does not require treatment. It can be self-limiting and has mostly an indolent clinical course; however, disseminated RDD with multi-system involvement portends a poorer prognosis.

Introduction: Chylomicronemia syndrome (CS) is a rare disorder characterized by a high level of triglycerides in plasma. We present a case of a pregnant woman with a severe acute pancreatitis (AP) affected by a CS. Case: A 38-year-old gravida 2, para 0 with an uneventful course of pregnancy was referred with an AP at 37 0/7 weeks of gestation. This diagnosis was made from a nearby hospital where the chemical analysis showed elevated pancreatic enzymes with significant hypertriglyceridemia. Because of a pathological fetal heart tracing a caesarean delivery was performed. The APGAR score of the female newborn was 5/8/8 at 1, 5 and 10 minutes, respectively. The pH from the umbilical cord were 7.26 (artery) and 7.59 (vein). Once transferred to our intensive care unit a computer tomography scan confirmed an onset of a necrotizing AP. A conservative treatment was tried without success. For this reason a surgical debridement of the infected and necrosic parts was performed. After a long hospitalisation the patient could be dismissed after 2.5 months in good general condition. Discussion: Lipid profile changes in normal pregnancy are characterized by an elevation of total plasma cholesterol and triglyceride levels. This is normally caused by an increased liver synthesis of triglycerides in response to elevated estrogen levels. When a CS is diagnosed the main goal is to maintain fasting triglyceride levels at less than 500?mg/dL to reduce the risk for AP. Conclusion: Practitioners have an important role in evaluating chylomicronemic patients and implementing therapeutic lifestyle and pharmaceutic interventions aimed to reduce the risk for AP.

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