[Amenorrhea of uterine origin].
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Biomedical subjects
Publications and source records attributed to J B Truc.
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OBJECTIVE: Fibrothecomas of the ovary are mesenchymal tumors representing 4-5% of all ovarian neoplasms. The purpose of this study is to describe a large series of CT findings in this type of tumor. MATERIALS AND METHODS: We reviewed retrospectively the CT examinations in 25 unilateral cases confirmed by surgery and pathology. Unenhanced and enhanced CT scans were performed in all cases and dynamic CT scans were performed in nine cases. These findings were compared to ultrasound in all cases. RESULTS: Computed tomography detected all but two small ovarian tumors (< 2 cm). Eighteen of 23 fibrothecomas were solid, with significant (> 10 HU) enhancement between precontrast and delayed CT scans. In all eight uncomplicated cases, nonincremental dynamic CT scan did not visualize arterial vessels; in seven of nine cases examined dynamically, early uptake of contrast material was visualized. Three of 23 fibrothecomas were partly cystic, partly solid. Two cases with torsion were mainly cystic with thickening and hemorrhage of the tube. CONCLUSION: In conclusion, 79% of ovarian fibrothecomas appeared as solid masses with delayed accumulation of contrast medium. On dynamic CT, the absence of arterial vessels and absence or slight early uptake of contrast enhancement could be useful findings for preoperative diagnosis. When partly or mainly cystic (21% of cases), ovarian fibrothecomas could not be easily differentiated from other ovarian masses.
OBJECTIVE: Our goal was to determine the CT and US aspects of the fallopian tube in adnexal torsion. MATERIALS AND METHODS: The CT scans and US studies of 10 patients with surgically proven unilateral torsion of the adnexa were reviewed. RESULTS: On CT the fallopian tube on the involved side was identified in eight cases as an almost tubular or comma-shaped structure extending from the uterine cornua and covering partially the adnexal mass. This tube was significantly thickened and measured 20-40 mm. Hemorrhage (density > or = 50 HU on precontrast CT scans) was present in the tube in six patients. A heterogeneous contrast agent uptake was detected in the tube in five patients. An adnexal mass was visualized on the involved side in all patients, with hemorrhage in the mass in four patients. Peritoneal fluid and/or ileus were present in six patients. On US an echogenic structure that corresponded to the enlarged tube visualized on CT was detected in three cases and an adnexal mass in all cases. CONCLUSION: Thickening of the fallopian tube with hemorrhage could be detected by CT and is suggestive of torsion especially if associated with an adnexal mass.
Early diagnosis of a developing hydatidiform mole gives an opportunity to evacuate this by intrauterine suction. This atraumatic procedure which is sure in its outcome has considerably lowered the indications for curettage, for hysterectomy and for hysterotomies. On the other hand, when trophoblastic disease persists chemotherapy is indicated so long as the indications are strictly grounded on biological criteria. The real indication for surgery is found when an isolated focus is resistant to medical treatment.
Extensive commissural tears in the region of the isthmus accompanied by incompetence of the cervix can be easily and successfully treated by an original procedure carried out through the vagina. The technique uses at the same time the general ideas and advantages of the freshening of the surfaces technique uses at the same time the general ideas and advantages of the freshening of the surfaces technique of Emmet, the repair of the isthmus technique of Lash and of Palmer and Shirodkar's cerclage technique for stitching the isthmus of the uterus.