Although the role of interventional radiology in the field of obstetrical hemorrhage has been widely reported upon recently, the rate of procedure-related complications has not been fully determined. We present the case of a patient who developed an external iliac artery thrombosis, a rarely reported complication associated with prophylactic common iliac artery balloon occlusion (CIABO). After CIABO, we found that the dorsalis pedis artery of the right foot was weak and the foot was cold, despite the fact that the patient had no complaints. Computed tomography demonstrated a linear thrombus in the right external iliac artery. We managed the patient conservatively using a heparin drip without the need for thromboembolectomy. Our experience suggests that it is important to consider the risk of thrombosis formation after CIABO. Physical examination post-procedure is key to identifying this complication early.
Total laparoscopic ovarian cystectomy (TLC) is a common gynecological laparoscopic procedure and is often performed by a novice to this technique. We report a case of reoperation due to abdominal bleeding the day after TLC.A 26-year-old woman, gravida 2 para 2, presented with a 5 cm left ovarian cyst, presumed to be benign. TLC was performed. The next day, the patient's hemoglobin level decreased to 7.7 g/dL, and transabdominal ultrasonography revealed abdominal bleeding from the pelvic cavity to the Morrison's pouch. Laparoscopy was repeated, and suturing was performed to stop bleeding from the left ovary. Abdominal blood loss was 1300 mL. The postoperative course was uneventful, and the patient was discharged after 4 days without extra blood transfusion. Pathological diagnosis was mucinous cystadenoma.Excluding cases of endometrial cyst, the probability of postoperative bleeding and hematoma after TLC was reported to be 0.15% in the 2014-2015 adverse events research of the Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy. We considered the reason for this reoperation from two viewpoints: the technique of ovarian cystectomy and the property of laparoscopic surgery.
Introduction: An endometrial polyp is a benign clinical finding, but distinguishing a polyp from a malignancy, such as endometrial cancer, can be difficult 1) . We report three cases of endometrial cancer, the endometrial cytology was negative, but the definitive diagnosis was established hysteroscopic appearance.Case 1-3: Three women were referred to our hospital for evaluation of an endometrial polyp or endometrial thickening. Every endometrial cytology was negative. We performed a hysteroscopy and suspected endometrial cancer based on nodular or papillary or polypoid tumor with abnormal surface vessels for each patient. We performed a hysteroscopic biopsy of the mass and an endometrial curettage to each patient. Every pathologic diagnosis were endometrioid carcinoma (G1/G2).
Conclusion:For an in utero mass which does not lead to a diagnosis based on images and examinations, such as a MRI of the uterus, hysteroscopy can facilitate the diagnosis.
Laparoscopic surgery has become the standard of care for benign gynecologic conditions. We have performed more than 1300 laparoscopic surgeries since the introduction of the technique to our hospital in 2014 and have adopted the method for total laparoscopic hysterectomy (TLH), using the diamond port position and removing the morcellated uterus through the vagina. Although we have had no recognized ureteral injuries, two patients have unfortunately experienced bladder injury, with different causes, during TLH. Because bladder injury causes significant anxiety and stress for
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