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At least 415 records · Page 23Linked to original sources
PubMed1998

Endometriosis diagnosed by laparoscopy in adolescent girls.

105 adolescent girls with mean age of 17.3 (11-19) years had laparoscopy/pelviscopy between 1996 and 1997. In 37 cases, endometriosis was diagnosed (35.2%). The majority of the girls (32.4%) presented with endoscopic endometriosis classification (EEC) stage I. 2.8% of the girls had stage EEC II. The lesions involved one site or pelvic organ (64.8%) with a mean age of 18.7 (14-19) years. In 35.2% of cases, the lesions were at multiple sites with a mean age of 16.9 (11-19) years. Indications for laparoscopy included chronic or acute pelvic pain and right-sided lower abdominal pain. Endometriotic lesions were found in the pouch of Douglas (64.8%), uterosacral ligaments (37.8%), and ovarian fossa (24.3%), 42.8% of directed biopsies were positive. Endocoagulation of the endometriotic lesions was performed in 91.9% of cases.

Adolescent↗
PubMed2005

Multimedia article. Laparoscopic treatment of chronic sigmoid volvulus in a young adult.

INTRODUCTION: Sigmoid volvulus is responsible for 8% of all intestinal obstructions. The most frequent presentation is in the elderly, with it occurring exceptionally in young people. Surgical resection is mandatory to prevent recurrence. Laparoscopic maneuvers in the long and distended bowel are difficult, and not much experience with these procedures has been reported. MATERIALS AND METHODS, AND RESULTS: A 21-year-old man with antecedents of constipation had two episodes of rectal prolapse, and one episode of acute volvulation treated with decompressive endoscopy. A laparoscopic exploration was performed for definitive treatment. Transanal intubation with a large-bore tube permitted deflation of the bowel. A deep Douglas's pouch was observed with a mobile sigmoid loop that intussuscepted the rectum. A proctosigmoidectomy including the 5 cm of the upper rectum was performed without incident. CONCLUSION: Laparoscopic management of suboclusive colonic volvulus is feasible. Intraopertive transanal intubation permits deflation the loop and facilitates manipulation.

Adult↗
PubMed1975

The bacteriology of acute pelvic inflammatory disease.

The bacteriology of acute pelvic inflammatory disease (PID) was studied in 20 patients by simultaneous cul-de-sac, cervical, and blood cultures with aerobic and fastidious anaerobic techniques. Cul-de-sac cultures were positive in 18 of 20 patients, while all 8 normal control subjects yielded negative results (p less than 0.0005, chi-square analysis). Anaerobic bacteria (predominatly Peptococcus and Peptostreptococcus) were present in 10 patients (59 per cent), and they were the exclusive isolates in 3 patients. N. gonorrhoeae was isolated only once from the cul-de-sac despite its presence in cervical specimens. There was poor correlation between cul-de-sac and cervical cultures. Cervical cultures yielded a variety of aerobic and anaerobic bacteria with an average of 3.8 organisms per specimen. N. gonorrhoeae was isolated in 13 patients (65 per cent). Only 19 per cent of cervical isolates were recovered by culdocentesis; similarly, only 31 per cent of cul-de-sac isolates were simultaneously isolated from the cervix. Blood cultures were uniformly negative. These data suggest that: (1) culdocentesis is a reliable technique for the bacteriologic diagnosis of acute PID, and (2) whereas the gonococcus may be important in initiating acute PID, its primary role appears to be paving the way for secondary invaders from the normal vaginal flora to gain access to the upper genital tract.

Aerobiosis↗
PubMed1976

Cul-de-sac isolates from patients with endometritis-salpingitis-peritonitis and gonococcal endocervicitis.

Neisseria gonorrhoeae was cultured from the cul-de-sac in 11 of 17 patients with bacteriologically documented gonococcal endometritis-salpingitis and identified by Gram stain in one other instance. In five, N. gonorrhoeae was the only isolate. In six other patients, the presence of other aerobic (two) and anaerobic bacteria (three), as well as N. gonorrhoeae, was documented. In the remaining six patients, only aerobic and anaerobic organisms were isolated. The data are interpreted as supporting the concept of anaerobic superinfections following initial infection with N. gonorrhoeae late in the course of this disease entity.

Aerobiosis↗
PubMed1980

Microbiology and pathogenesis of acute salpingitis as determined by laparoscopy: what is the appropriate site to sample?

Acute salpingitis is a polymicrobial disease. Neisseria gonorrhoeae and anaerobic gram-positive cocci were the predominant microorganisms isolated from the fallopian tubes of salpingitis patients. Gonococci were isolated from the fallopian tubes in eight of 35 (23%) patients; anaerobic bacteria were recovered from 10 of 35 (28.5%). Although Chlamydia trachomatis was not recovered from the fallopian tube exudate, there was abundant serologic evidence of chlamydial infection in the salpingitis patients. Twenty-three percent of patients with paired sera had a fourfold rise in IgM and IgG titer, which was consistent with systemic chlamydial infection. Comparison of cultures obtained via laparoscopy and culdocentesis suggested that culdocentesis is not an accurate reflection of the microbial milieu in the fallopian tube.

Ascitic Fluid↗
PubMed1992

Transvaginal ultrasonographic quantitative assessment of accumulated cul-de-sac fluid.

Preoperative quantitative assessment of pelvic fluid is an important diagnostic tool in clinical decision making. In this study, we used high-frequency transvaginal ultrasonography in 10 healthy women to assess both the correlation between various amounts of fluid installed in the cul-de-sac and ultrasonic imaging and to determine whether correct estimation of fluid volume can be reached. No fluid could be ultrasonically detected when the volume was less than 35 to 40 ml. Between 35 and 100 ml there was a clear image of accumulated fluid in the cul-de-sac with good correlation between volume and image, whereas with larger amounts no clear correlation between the amount of fluid introduced and size of fluid area visualized by ultrasonography was possible. Transvaginal ultrasonography may enable quantitative evaluation of certain volumes of pelvic fluid, although amounts less than 35 ml cannot be visualized.

Body Fluids↗
PubMed1980

A new concept for the management of rectal prolapse.

The various modified fixation procedures used for rectal prolapse take into account the pathophysiologic concept of complete prolapse of the rectum as a sliding hernia of the pouch of Douglas. The possibility of intussusception by reinforcement of the wall of the extensively mobilized rectum was successfully prevented by a new technique. The use of this simple technique in another form of prolapse, namely, prolapse of the terminal colostomy, convinced us to its usefulness.

Humans↗
PubMed1990

Laparoscopic observations of pelvic organs in pulmonary tuberculosis.

Sixty-two cases of bacteriologically positive pulmonary tuberculosis were studied in the Department of Tuberculosis and Chest Diseases at the V.S.S. Medical College Hospital, Burla, India. Apart from other investigations, all patients underwent laparoscopy to determine the incidence of genital involvement. Positive findings were observed in 37 women; tubercles were present in the tubes of 15 women. At dilatation and curettage, the endometrium was obtained in 37 women. Tuberculous endometritis was detected in 4 women.

Adolescent↗