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Results for “DOUGLAS' POUCH”

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At least 235 records · Page 13Linked to original sources

PubMed1990

[Laparoscopic surgery of gallstones--report of treatment of 157 patients].

From November 1988 to February 1990 157 patients with gallbladder stones haven been treated by a laparoscopic surgical procedure. They are 28 males and 129 females from 13 to 81 years old. 18 have had a cholecystostomy after intracorporeal lithotripsy (Lus Ultrasonic Olympus). They were placed on bue acids during 3 months. The average follow up time is 11 months. The mortality is zero and 2 mild complications occurred medically cured. 3 patients have a recurrent stone 6 months after surgery. 139 patients have had a cholecystectomy 89 after the same lithotripsy procedure seen above, 50 without prior lithotripsy. In 3 cases the laparoscopic procedure was abandoned, twice because of a sever bleeding, one for too compact surrounding adhesions. The mean follow up is 9 months. 123 were drained 1 day 16 had no drain. The mortality is zero. 2 patients without drainage developed a sub hepatic and douglas pouch abscess. They were cured by a lavage drainage laparoscopically made. 1 patient with drainages had a 7 days bile leak, which disappeared spontaneously. The 136 others have had a short stay in the hospital (2-4 days) a painless post operative time. They could go back to work and sport within 1 week. They have minimal scars and no danger of incisional herriae. The magnification of the optical system enables the dissection of the cystic duct and artery easier and safer than it is by mini laparotomy mostly in obese people. At the beginning of our experience only the patients with frequent biliary colics have been selected for the laparoscopic procedure. At that time 13 patients with subacute cholecystitis and 9 patients with stones in the commun bile duct have had a laparoscopic cholecystectomy associated with an endoscopic sphincterotomy in the last cases without complications.

Adolescent↗

PubMed1990

[Cholelithiasis. Laparoscopic treatment with intracorporeal lithotripsy followed by cholecystostomy or cholecystectomy. Personal technique].

From November 1988 to February 1990 157 patients with gallbladder stones have been treated by a laparoscopic surgical procedure. They are 28 males and 129 females from 13 to 81 years old, 18 have had a cholecystostomy after intracorporeal lithotripsy (Lus Ultrasonic Olympus). They were placed on bile acids during 3 months. The average follow up time is 11 months. The mortality is zero and 2 mild complications occurred medically cured. 3 patients have a recurrent stone 6 month after surgery. 139 patients have had a cholecystectomy 89 after the same lithotripsy procedure seen above, 50 without prior lithotripsy. In 3 cases the laparoscopic procedure was abandoned, twice because of a sever bleeding, one for too compact surrounding adhesions. The mean follow up is 9 months. 123 were drained 1 day 16 had no drain. The mortality is zero. 2 patients without drainage developed a sub hepatic and douglas pouch abscess. They were cured by a lavage drainage laparoscopically made. 1 patient with drainage had a 7 days bile leak which disappeared spontaneously. The 136 others have had a short stay in the hospital (2-4 days) a painless post operative time. They could go back to work and sport within 1 week. They have minimal scars and no danger of incisional herniae. The magnification of the optical system enables the dissection of the cystic duct and artery easier and safer than it is by mini laparotomy mostly in obese people. At the beginning of our experience only the patients with frequent biliary colics have been selected for the laparoscopic procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

[The echographic diagnosis of acute appendicitis and its complications].

The authors report their experience with emergency US in patients hospitalized for clinical suspicion of acute appendicitis or presenting with pain in the right lower abdominal quadrant. One hundred fifty-two patients were examined with US: 93/152 had pathologies of the right iliac region; 81 of them underwent surgery (50/81 appendectomies). In 27 of these patients the inflamed appendix presented with a typical US pattern. All of them had surgical confirmation. In 13/50 cases, US findings followed an atypical pattern (6 patients had a periappendiceal mass in the right iliac region, 3 had small amounts of fluid in the Douglas pouch, and 4 had gas-filled bowel loops of the ileum). The false negatives were 10/50. US sensitivity was 80%, and its specificity was 54%. The most common pathologic conditions are described whose symptoms mimic those of acute appendicitis. US role in inflamed acute appendicitis is still to be defined. Nonetheless, the authors suggest that US be performed on all patients with atypical pain in the lower abdominal quadrants, because of its high diagnostic accuracy in many common pathologies mimicking appendicitis, especially urinary and uterine adnexal pathologies.

Acute Disease↗

PubMed1990

[Significance of transvaginal ultrasonic examination in the first pregnancy trimester].

The authors report their results obtained by performing transvaginal sonography in 180 patients in the first trimester of pregnancy. It has been found that both normal and pathological cases could be diagnosed 1 week earlier than had been possible with transabdominal method. Minimum size of the intrauterin gestational sac was found to be 3 mm. Cardiac activity could be evaluated in embrios with a size of 7 mm or greater in all cases. According to them the diagnosis of blighted ovum and missed abortion seems to be confirmed when an "empty sac" is larger than 20 mm, or the absence of heart motion is detected in an embrio greater than 10 mm, without repeated scan. High sensitivity was found in ectopic pregnancies especially in unruptured cases. The possibility of qualitative analysis of "free fluid" in Douglas pouch and diagnosis of congenital anomalies in very early pregnancy are promising. Transvaginal sonography is recommended in all cases when transabdominal technique is equivocal.

Female↗

PubMedDate not supplied

[Injuries of the genital organs in young girls and adolescents (1959-1988)].

In the 30-year period from 1959 to 1988, there were 112 young and adolescent girls admitted and treated at the Department of Obstetrics and Gynecology in Novi Sad, i.e. 3-4 per year. Young girls most often suffered from accidental injuries (41-36.6%) while older girls suffered from intracoital injuries (71-63.4%). The most frequent accidental injuries were the injuries of the vulva, perineum, hymen, vagina and sphincter ani, as well as one case of a severe injury of Douglas pouch followed by intestine injury. Colporrhexis was the most frequent intracoital injury.

Adolescent↗

PubMed1989

[Diagnosis of ectopic pregnancy].

The diagnosis of ectopic pregnancy rests on the results of plasma beta-HCG hormone assays and on those of ultrasonography. If the plasma level of beta-HCG is lower than 10 m IU/ml, the woman is not pregnant; if it is higher than 10 IU/ml, ectopic pregnancy is excluded when ultrasounds show a gestation sac within the uterine cavity from the 5th week of amenorrhoea onward. The diagnosis of ectopic pregnancy is certain when ultrasounds show a gestation sac outside the uterine cavity; it is highly probable when they show an inhomogeneous masson the side of the uterus or a collection of blood in Douglas' pouch.

Chorionic Gonadotropin↗

PubMed1989

Ultrasonographic evaluation of pelvic inflammatory disease.

The relative frequencies of various sonographic patterns and features of pelvic inflammatory disease (PID) were examined in retrospective analyses of sonograms in 36 proven cases. The original sonographic reports correctly predicted PID in 34/36 patients (sensitivity = 94.4%). Two cases were found to be tubo-ovarian abscess although at first they were reported to be ovarian neoplasia. The most frequent finding was dilatation of the fallopian tube (72.2%). String sign within the dilated tube that would reflect increased interface within the endosalpinx was found in 50.0%, fluid collection in the Douglas' pouch in 47.2%, which was confirmed by the culdocentesis and aspiration in 16 cases, and/or tumor formation at the adnexal region in 38.9%. These findings were characteristic but not specific in PID. Careful sonographic scrutinization should improve the diagnostic accuracy of PID in patients with low abdominal pain, high temperature and low back pain.

Female↗

PubMedDate not supplied

Myomectomy during pregnancy: uncommon case report.

A case of myomectomy during pregnancy is presented. Generally myomectomy is contraindicated during this period. On the 14th week of pregnancy our patient presented with progressive lower abdominal pain and a tender mass of nearly 12 centimeter diameter in the pouch of Douglas. Therefore an exploratory laparotomy was performed to exclude torsion of an adnexal mass or pedunculated subserous myoma. A dorsal degenerating myoma with short thick pedicle (4 cm diameter) was found. It was compressed between the promontory of the sacrum and the uterus. Myomectomy was performed and pregnancy progressed without complications.

Adult↗

PubMed1987

[Uterine retroversion. A simple surgical cure].

In 20% of the cases, painful symptoms which cannot be dismissed in general practice are experienced by women with uterine retrodeviation. The technique described here is based on anatomical reduction of Douglas' pouch with restoration of tension in the uterosacral ligaments. It is simple and rapid as expected for a minor anatomical defect. The creation of two perpendicular peritoneo-ligamentous planes ensures its solidity. The effectiveness and safety of this technique has been confirmed by a series of more than 70 patients 50% of whom were examined at regular intervals for more than 5 years after surgery.

Female↗

PubMedDate not supplied

[Treatment of epithelial cancer of the ovary. In favor of primary radical and regional surgery before chemotherapy and radiotherapy].

The treatment of epithelial carcinoma of the ovary (90% of malignant ovarian tumours) has largely benefited from chemotherapy, notably since the advent of cisplatinum. Radiotherapy may be an important adjuvant treatment to sterilize the pelvis. Both chemo- and radiotherapy are effective mainly on small residual diseases, hence the importance of initial surgery with maximal cell reduction, notably in carcinomas classified as stage III according to the International Gynaecology and Obstetrics Federation system. Regional surgery of the ovary must be pelvic and abdominal: from Douglas' pouch to the diaphragmatic domes. This therapeutic approach requires the resolution of two problems: intensive care and post-operative feeding. It has 2 major advantages: it avoids second-look operations or reduces their number, and it increases the survival rate at 5 years.

Carcinoma↗

PubMed1986

[Occult uterine perforation caused by an intrauterine device].

This article reports on a patient who had an asymptomatic perforation of the uterus by an intrauterine contraceptive device. Six and eight years later, the woman had normal pregnancies and deliveries. Ten years later an exploratory laparotomy was performed because of abdominal pain of unknown origin. The intrauterine device was surgically removed from Douglas' pouch. We summarize and discuss the complications due to a perforation of the uterus by an intrauterine contraceptive device and appropriate diagnostic procedures.

Adult↗

PubMedDate not supplied

[Abdominal pregnancy located in the greater omentum].

A patient aged 23, clinically suspected to have an extrauterine pregnancy, underwent puncture of the Douglas' pouch and the blood was obtained. During the operation, about one liter of blood was found in the abdomen and on the edge of the greater omentum a molla cruenta, the size of a small egg. Part of the omentum with the molla cruenta was redissected. Histological analysis verified pregnancy and endometriosis.

Adult↗

PubMed1985

[Treatment of stage I and II ovarian cancer (interim report of intraperitoneal chemotherapeutic perfusion and postoperative prophylactic intracavitary irradiation)].

74 cases of primary ovarian cancer treated here previously were classified into three groups, no residual (corresponding to Stage Ia, Ib), cell residual (Ic-IIc) and mass residual (III, IV), and prognoses were compared. The 5 year survival rates were 83.3%, 29.4% and 12.6% respectively. In Stage I and II cases, almost all of the tumor mass would be removed by operation. Therefore the target of postoperative treatment should be the residual cancer as cell units spread widely throughout the abdominal cavity. For this purpose, IPCP has been performed on 35 cases of Stage I and II since 1977. The 3 year survival rate for this series is as good as 88.6%, and the sites of recurrence were localized in the small pelvic cavity adjacent to the Douglas pouch in 5 out of 6 relapsed cases. This fact suggests that IPCP is capable of controlling the cancer cells in the upper abdominal cavity, but still insufficient to control them in the pelvic cavity where deeper invasion is suspected. In order to improve the local control ability, utilization of the uterus as the applicator for prophylactic intracavitary irradiation came to be considered. The spread of cancer to the uterus was found in 5 out of 38 cases in Stage I and II(13.2%), but silent invasion was found in only one case. These results suggests that the utilization of the uterus as the applicator for prophylactic intracavitary irradiation would be feasible if no macroscopical cancer extention to the uterus exists and the uterus is suitable for application. Several combinations with Tandem and Ovoid have been tested and an adequate method has been proposed.

Brachytherapy↗

PubMed1977

[Simplfied technique of lumbar subarachnoid-peritoneal shunt (author's transl)].

The authors have developed a simplified technique of lumbar subarachnoid peritoneal shunt in which the spinal tube is easily introduced through a puncture needle without doing a laminectomy. Seventeen cases of communicating hydrocephalus of various orgin have been treated by this procedure. In this paper, we reported our shunting system and the technique of precedures, and discussed the clinical results and some advantages of this method. The spinal tube is a custom made Silastic tube with small side holes 2 mm apart from each other at slanting tip located within the first 1.0 cm of the end. French No. 5 tube is available for older children and for adults, and French No. 3.6 tube for infants. Total length of the tube measures 30 cm with 4 black markers at 5 cm intervals from the tip for assisting in positioning. The puncture needle is a modified Touhey needle. Two needles different in size are prepared according to the size of the tube. Outer diameter of these needles is 2.1 mn & 1.8 mn. Our operative procedures are divided into following three steps. 1) Puncture of the lumbar subarachnoid space and insertion of the spinal tube through the needle. 2) Introduction and placement of the peritoneal tube into some point of the peritoneal cavity. Concerning to this point, we have the three candidates, namely into the Douglas pouch, the suprahepatic space, and the bursa omental cavity. 3) Connection of the spinal tube and the peritoneal catheter end. We used a kind of flushing device only in some exceptional cases, and recently, we feel that it is not so necessary for this shunting. We have employed this technique in a total of 17 cases. Eleven cases of them are adults and the other 6 cases are children less than 2 years of age. Postoperative follow up period varied from 13 months to 1 month, and all the cases except two had good result, suggesting the shunt system is working well with no evidence of complications such as low pressure syndrome or radicular irritation. Some troubles occurred in two children. One was a disconnection between the spinal and the peritoneal tube, and the other was an obstruction at the peritoneal tube end. The authors believe that our L-P shunt has several advantages as listed below, 1)Procedure is very simple, in other words, there is no need of laminectomy. 2) The entire system is short. 3) No need to pass the catheter into the brain tissue. 4) Obstruction of the spinal catheter end is very unusual. 5) Alteration of communicating hydrocepalus into non communicating one by secondary obstruction of aqueduct of Sylvius is less likely with this shunting system. 6) Siphon effect might be minimal, if present. 7) As compared to V-A shunt, severe complication like septicemia will not occur in the L-P shunt. With this simple method and good material, we hope that this L-P shunt is employed more widely for the patients with communicating hydrocephalus.

Cerebrospinal Fluid Shunts↗

PubMed1978

Vaginal evisceration after forcible coitus with intraabdominal ejaculation.

An unusual case is presented of vaginal evisceration after forcible coitus in a healthy young woman with no anatomic defects or history of previous pelvic surgery. Intraabdominal ejaculation, documented cytologically, provided evidence of penile penetration of the pouch of Douglas. Etiologic mechanisms and management are discussed.

Abdomen↗

PubMed1981

Arterial chemoembolization with microencapsulated anticancer drug. An approach to selective cancer chemotherapy with sustained effects.

Selective intra-arterial infusion of ethylcellulose microcapsules containing mitomycin exerts its therapeutic effects through infarction and sustained drug action--ie, chemoembolization. Sixty primary or secondary carcinomas in the kidney, liver, urinary bladder, prostate, cervix, vagina, sigmoid colon, Douglas' pouch, and bone were treated with single or repeated chemoembolizations using microcapsules delivered through percutaneous catheterization as a preoperative or palliative measure. Substantial tumor reduction of greater than 30% in measurable maximum diameter was found in 65% of the tumors, pain relief occurred in 80% and hemostasis in 100%. Preoperative chemoembolization remarkably facilitated radical surgery in 18 (82%) of 22 patients. The summed response rate was 77%. Systemic toxic effects were mild, and all patients tolerated the treatment. Though the follow-up periods are less than two years, 37 patients are alive with or without tumor.

Clinical Trials as Topic↗

PubMed1981

[Laboratory and clinical studies on cefotaxime in obstetrics and gynecology (author's transl)].

The following results have been obtained in our basic and clinical studies to examine a new cephalosporin derivative, cefotaxime (CTX). For basic study purpose, we injected 1 g of CTX to 6 patients who had received simple total hysterectomy and measured its level in elbow vein, uterine artery, corpus uteri, cervix uteri, endometrium, oviduct and ovary. Any definitive conclusion should not be drawn from these results, since they have too big variation. However, slightly higher levels were achieved cervix uteri and oviduct than in other organs in a same patient. For clinical evaluation, we tried this drug to 12 cases of female genital infections and 91.7% response rate was obtained. Our studied population includes 8 cases of adnexitis, 2 with pelvioperitonitis, 1 with panperitonitis, and 1 patient with BARTHOLIN abscess. Organisms were detected only in 3 cases, including S. aureus in one patient, Micrococcus sp. in one, and mixture of Klebsiella sp. and B. fragilis in 1. Puncture of DOUGLAS pouch was performed in 3 cases after the completion of therapy and all had negative results. No side effect was observed, and no significant difference was noted between pre- and post-therapy examinations of peripheral blood, hepatic function and renal function.

Adult↗

PubMed1983

Our technique of combined renal and segmental pancreas transplantation.

This case, however, confirms our hypothesis that intraperitoneal positioning of a segmental pancreatic graft into the Douglas' pouch and an end to side arterial anastomosis bring several advantages as far as venous thrombosis and tryptic lesions are concerned.

Arteriovenous Shunt, Surgical↗