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Biomedical subjects

L E Smale

Publications and source records attributed to L E Smale.

16 recordsLinked to original sources
PubMed1979

Maternal deaths associated with postpartum vulvar edema.

Reported are three maternal deaths in four patients who presented with a similar syndrome following a normal antepartum course and normal labor and delivery managed by regional or local anesthesia and midline or proctoepisiotomy. Beginning about the second postpartum day, the patients developed unilateral perineal edema and induration which progressed to generalized vulvar, vaginal, perineal, and gluteal edema and induration. These patients developed marked leukocytosis, fever, and ultimately vascular collapse; three of them died. The one patient who survived had a similar course except for vascular collapse. Unilateral vulvar induration and edema associated with fever and marked leukocytosis are ominous signs. Aggressive treatment should include the use of multiple antibiotic, crystaloid, colloid, and steroid drugs and appropriate monitoring. By this report we hope to bring attention to this rare but lethal syndrome.

Adolescent↗
PubMed1978

Salpingo-oophorectomy at the time of vaginal hysterectomy.

Three hundred fifty-five cases of vaginal hysterectomy associated with bilateral or unilateral salpingo-oophorectomy were reviewed to assess the safety and feasibility of adnexa removal when such was necessary or desirable. Other than one instance of hemorrhage from ovarian vessels, no serious complications, including ureteral injuries, could be assigned specifically to the removal of the adnexa. Our opinion is that the techniques for salpingo-oophorectomy at the time of vaginal hysterectomy should be taught to residents and practiced by gynecologic surgeons.

Adult↗
PubMed1975

Female genital coccidioidomycosis.

Three cases of coccidioidomycosis of the female genital tract are reviewed. The diagnosis was made by laparotomy in 2 patients who presented with tender adnexal masses, and by endometrical curettage in a third patient with disseminated coccidioidomycosis. Hysterectomies were performed in all 3 patients; 1 had a bilateral salpingo-oophorectomy and the others a bilteral salpingectomy and unilateral oophorectomy. Two patients received chemotherapy with amphotericin B. One patient died 4 years after her operation from disseminated and meningeal coccidioidomycosis. In a female patient who has resided in an endemic region and who presents with pelvic pain of obscure origin, unexplained infertility, a menstrual disorder, or a chronic, refractory pelvic inflammatory disease, genital coccidioidomycosis should be considered in the differential diagnosis.

Adolescent↗