J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Jan 1997
[Poor vaginal access: excellent indication for laparoscopic hysterectomy].
The great majority of hysterectomies in patients without previous vaginal delivery have been carried out via laparotomy. The purpose of this study was to establish whether laparoscopic surgery can be of use in an attempt to reduce the number of laparotomies for patients with no previous vaginal delivery who underwent an hysterectomy indicated for benign pathologies. ⋯ These results demonstrate that laparoscopic surgery decreased significantly the number of laparotomies necessary for patients without previous vaginal delivery who require hysterectomy. When vaginal access is poor, simple laparoscopic preparation is inadequate and the only possibility of avoiding laparotomy is to carry out the hysterectomy entirely via laparoscopic route.
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J Gynecol Obst Bio R · Jan 1997
Review Case Reports[Vertebral hemangioma symptomatic during pregnancy. A case report and review of the literature].
Vertebral hemangioma is a relatively frequent but rarely symptomatic tumor. Physiologic changes during pregnancy may lead to spinal cord compression due to tumor expansion. We report a case of vertebral hemangioma during pregnancy: a 28-year-old woman, third trimester, third gestation, consulted for paraplegia of rapid onset; Magnetic resonance imaging showed a lesion of the 9th thoracic vertebra; a cesarean section was done, followed by laminectomy with partial symptom relief; pathology showed a benign vertebral hemangioma and treatment was completed with radiotherapy.
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J Gynecol Obst Bio R · Jan 1997
Review Case Reports[Peritoneal tuberculosis. Value of laparoscopy].
We report 6 cases of tuberculous peritonitis, focusing on the contribution of laparoscopic exploration. The initial diagnosis was erroneus in all cases: the polymorphous clinical presentations suggested another infectious disease or cancer disease. Laparoscopy was performed in 5 patients who had ascitis and in 1 with plastic peritonitis. ⋯ Bacteriological analyses of the ascitic fluid were positive in only one case. The diagnosis was confirmed after culture of biopsy specimens and identification of the Kock bacilli or on the basis of objective evidence of an epithelioid giant-cell granuloma with caseous necrosis. Outcome was favorable after appropriate antibiotic therapy.
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J Gynecol Obst Bio R · Jan 1997
Review[Infectious complications after peridural obstetric anesthesia].
Infective complications after epidural anesthesia for delivery are uncommon. We reviewed 21 cases of epidural abscesses, 7 cases of meningitis and one spondylitis reported in the literature. These infections usually occurred in debilitated patients either by direct contamination at puncture or indirectly from a neighboring infection or from the blood stream. ⋯ The first manifestations are spinal stiffness or local pain. Signs of neurological deficiency come later at a stage when complete recovery is compromised. This emphasizes the importance of the clinical examination before delivery in search for skin or deep infections.