With pelvic reconstructive surgery becoming more commonplace, knowledge of possible anomalous vessels is important because modification of planned surgical approach may be necessary to avoid short-term and long-term complications.
A 66-year-old female presented with symptoms suggestive of pelvic organ prolapse, history of fibroid uterus, and rectal pressure. Pelvic examination revealed a large pelvic mass filling the posterior cul-de-sac, occupying the rectovaginal septum, and compressing the rectum. There was a stage II pelvic organ prolapse of the posterior vaginal wall with distal vaginal wall extending to the hymen during valsalva. A CT scan confirmed the large pelvic mass distinct from the uterus measuring 9.4 × 9.8 × 6.2 cm. Colorectal workup revealed adenocarcinoma of colon on screening colonoscopy with biopsies. Patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, colon resection, and abdominal resection of the pelvic mass in the rectovaginal septum and inferior to the uterus. The patient did not require any concomitant pelvic reconstruction and the posterior vaginal wall prolapse resolved after resecting the pelvic mass.
Pregnancy-induced osteoporosis is a rare, although wellknown complication of pregnancy. Fractures may result that can cause invalidating pain. We describe a case of a patient who presented on the 39th week with persistent right foot pain and was diagnosed with a stress fracture of the second metatarsal. After complete work-up and elimination of all other pathologies, the fracture was considered to be due to pregnancy-related osteoporosis. The Patient was managed conservatively with reduced weightbearing and protective footwear. Stress fractures during pregnancy related to osteoporosis though rare, should be easily recognised in order to accelerate recovery and prevent complications.
The use of assisted reproduction has caused an increase in the prevalence of twins. Twin pregnancies are high-risk pregnancies : they are associated with prematurity and its manifestations including sepsis, enterocolitis and respiratory complications. These complications increase the mortality rate of twin delivery in comparison to singleton delivery greatly. Knowledge of the appropriate management of the twin delivery is paramount to avoid life-threatening complications and to decrease the mortality of twins. After going through the literature we
The use of assisted reproduction has caused an increase in the prevalence of twins. Twin pregnancies are high-risk pregnancies: they are associated with prematurity and its manifestations including sepsis, enterocolitis and respiratory complications. These complications increase the mortality rate of twin delivery in comparison to singleton delivery greatly. Knowledge of the appropriate management of the twin delivery is paramount to avoid life-threatening complications and to decrease the mortality of twins. After going through the literature we present the latest studies on twin delivery.
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