RESUMEN
BACKGROUND: Mesonephric duct remnants usually do not present any clinical dilemma. However, if the cellular lining remains active, it may lead to cystic lesions that may cause pain or torsion of the adnexa. CASE: This is a 13-year-old female who presented because of severe pelvic pain. Ultrasound and CT scan revealed a large cystic mass in the pelvis. Mini-laparotomy confirmed torsion of the left adnexa due to the mass. The adnexa was untwisted. The cyst and the left tube were removed and the ovary regained its blood flow and was saved. SUMMARY AND CONCLUSION: Mesonephric duct cyst should be considered in the diagnosis of pelvic masses in adolescent girls.
Asunto(s)
Enfermedades de los Anexos/complicaciones , Quistes/complicaciones , Quistes/diagnóstico , Anomalía Torsional/complicaciones , Enfermedades de los Anexos/cirugía , Adolescente , Quistes/cirugía , Femenino , Humanos , Anomalía Torsional/cirugía , Conductos MesonéfricosRESUMEN
OBJECTIVE: To estimate if the time of the menstrual cycle would improve the chance of seeing the squamocolumnar junction at colposcopy. METHODS: A retrospective study was conducted on 1,248 patients with normal menstrual cycles who attended our colposcopy clinic between 2003 and 2007. Timing of colposcopy, parity, contraception, smoking status, and visibility of the transformation zone were recorded for analysis. The transformation zone was classified as type 1 when completely ectocervical and fully visible, type 2 when it was partially endocervical but fully visible, and type 3 when not fully visible. RESULTS: No significant difference was found between the rate of types 1, 2, or 3 transformation zone observed in patients who were examined during the second week of their menstrual cycles and the others (P=.581). Compared with women in the first week of their menstrual cycle, those on the 22nd day or later were significantly more likely to have a type 1 transformation zone at colposcopic examination (odds ratio [OR]=1.6, P=.029, logistic regression using day 1 to 7 as baseline). The probability for a patient to have a type 1 transformation zone declined with age (OR=0.59, P<.001), parity (OR=0.47, P<.001), and smoking status (OR=0.55, P<.001), whereas it increased with the use of combined oral contraception (OR=2.7, P<.001). Adjusting for these factors, we found no statistically significant effect of the time of cycle on the visibility of the transformation zone. CONCLUSION: Timing colposcopy during the menstrual cycle does not improve the visibility of the transformation zone and is not recommended. LEVEL OF EVIDENCE: III.
Asunto(s)
Cuello del Útero/patología , Colposcopía/métodos , Anticonceptivos Orales Combinados/efectos adversos , Ciclo Menstrual/fisiología , Adolescente , Adulto , Factores de Edad , Envejecimiento/patología , Envejecimiento/fisiología , Cuello del Útero/citología , Intervalos de Confianza , Anticonceptivos Femeninos/efectos adversos , Anticonceptivos Hormonales Orales/efectos adversos , Femenino , Humanos , Persona de Mediana Edad , Oportunidad Relativa , Paridad , Embarazo , Estudios Retrospectivos , Fumar , Factores de TiempoRESUMEN
OBJECTIVES: To evaluate how foetal magnetic resonance imaging (MRI) may change the diagnosis in cases of ultrasound (U/S) findings of echogenic bowel (EB). METHODS: Seventeen foetuses with EB underwent serial U/S examinations, foetal MRI, cystic fibrosis screening and maternal viral serologic tests. MRI protocol included T2-weighted half-Fourier acquired single-shot turbo spin-echo (HASTE) sequence and gradient echo (GE) T1-weighted images. Foetal abdominal MRI analyzed patterns were size and signal of small bowel, colon and rectum, ascites and abdominal mass. All neonates had complete clinical examination, abdominal sonography, and a 6 months clinical follow-up. RESULTS: Eleven foetuses with isolated EB had normal MRI and normal outcome. In comparison, all the 6 foetuses whose U/S patterns showed associated signs had abnormal MRI (p < 0.001). Five had proven pathology (83.3%: 5/6) and only 1 (16.7%: 1/6) had no proven pathology and normal postnatal outcome (p = 0.001). For those five, foetal MRI showed bowel abnormalities with one case of bowel duplication and four cases of bowel obstruction. Two out of the four cases of bowel obstruction were genetically diagnosed as cystic fibrosis. The two remaining cases were diagnosed as ileal atresia. CONCLUSION: MRI could provide additive information in cases of EB associated with bowel dilatation.