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Results for “DOUGLAS' POUCH”

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At least 145 records · Page 8Linked to original sources
PubMed1999

[Preoperative staging of patients with primary ovarian carcinoma by CT and MRI].

OBJECTIVE: To investigate values and limitations of CT and MRI applied in staging of patients with primary ovarian carcinoma (POC). METHODS: Forty two patients with POC proven by radical surgery, laparotomy, and postoperative pathology were studied. In comparison to surgical and pathological findings, sensitivity, specificity, and accuracy of CT, MRI and CT plus MRI were calculated. Staging by the three imaging methods was obtained according to FIGO's classification. RESULTS: CT and MRI showed higher accuracy in evaluation of invasion to uterus (89.5% and 94.7%) and disease of Douglas pouch (94.7% and 97.4%). CT was to some extent superior to MRI in assessing ipsilateral or bilateral tumor and lesions related to peritoneal seeding; MRI, however, had better capability of diagnosing invasion to ovarian capsule, pelvic organs excluding bowel, nodules in Douglas pouch, and metastasis to lymph nodes. The overall accuracy of staging by CT, MRI, and CT plus MRI was 73.7%, 68.4%, and 70.6%, respectively (P > 0.05). CONCLUSION: CT and MRI are useful imaging modalities in staging of POC, but low sensitivity for detecting involvement in some anatomic regions needs to be improved.

Adult↗
PubMedDate not supplied

Advanced gastric cancer with peritoneal dissemination successfully treated with paclitaxel and doxifluridine: a case report.

A 50-year-old female presenting with severe ascites and anemia and diagnosed with advanced gastric cancer was admitted to our hospital. Endoscopic examination revealed an edematous lesion with redness and a giant fold in the stomach with poor expansion. The histological examination of biopsy specimens from the edematous lesion revealed signet-ring-cell carcinoma. Computed tomography demonstrated a thickening of the gastric wall, severe ascites, and peritoneal dissemination in the Douglas pouch. Paclitaxel (70mg/m2) was administered to the patient on days 1, 8, and 15, with doxifluridine (533mg/m2) for five days per week, on a 28-day cycle. By completion of the first course of treatment, the ascites had disappeared, the tumor in the Douglas pouch had shrunk, and the thickening of the gastric wall had lessened. In addition, the fold in the stomach appeared by endoscopic examination to have resumed its normal thickness, no malignant cells were detected in a biopsy, and the thymidine phosphorylase activity in the tumor tissue was two-fold greater than that before chemotherapy. After three treatment courses, the number of apoptotic cells had apparently increased compared with the prechemotherapy number. The only adverse drug reactions that were observed were grade 2 alopecia and grade 1 myalgia. After thirteen courses of chemotherapy over the past one year, both primary and metastatic lesions seem to be regressing. This case study suggests that paclitaxel plus doxifluridine therapy is effective and well-tolerated in non-resectable gastric cancer patients.

Antimetabolites, Antineoplastic↗
PubMed1998

Transvaginal drainage of ascites as an alternative to abdominal paracentesis in patients with severe ovarian hyperstimulation syndrome, obesity, and generalized edema.

OBJECTIVE: To describe an alternative technique for transvaginal drainage of ascites in a case of severe ovarian hyperstimulation syndrome (OHSS), generalized edema, and obesity. DESIGN: Case report. SETTING: A university-based hospital IVF and Reproductive Medicine Unit. PATIENT(S): A patient hospitalized with severe OHSS after IVF-ET in whom drainage of large amounts of ascitic fluid was necessary. INTERVENTION(S): Ultrasonographic transvaginal insertion of a wire guide through a standard IVF needle into the Douglas pouch. Placement of a "peel-away" set on the wire, which was replaced with a "pigtail" indwelling catheter. MAIN OUTCOME MEASURE(S): Amount of drained ascitic fluid. RESULT(S): Ascitic fluid was drained efficiently, leading to improvement of the patient's condition. CONCLUSION(S): Transvaginal ultrasonography-guided insertion of a pigtail catheter through the Douglas pouch is an efficacious procedure when the abdominal approach for decompression of ascites is difficult.

Adult↗
PubMed1990

[Sequential methotrexate.5FU chemotherapy for gastric cancer--comparison between intra-aortic infusion therapy and intravenous administration therapy].

Sequential low-dose Methotrexate.5FU therapy was conducted on a total 52 cases of advanced or recurrent gastric carcinoma. Intra-aortic infusion therapy was performed in 31 cases and intravenous administrative therapy was employed in the remaining 21 cases. The two groups were compared in terms of the response rate and side effects. Thirty mg/m2 of Methotrexate (MTX) was given by bolus injection into the aorta or venous route, followed by 500 mg or 750 mg of 5FU by bolus injection 3 hours later. Twenty four hours after the injection of MTX, 30 mg of Leucovorin was given intravenously or orally. The major lesion of intra-aortic infusion group was primary site (stomach) in 10 cases, peritoneum and digestive tract in 9 cases, Douglas' pouch in 5 cases, liver in 3 cases, abdominal wall in 2 cases and retro-peritoneal lymph nodes in 2 cases. On the other hand, the major lesion of the intravenous administrative group was the primary site (stomach) in 5 cases, peritoneum and digestive tract in 6 cases, Virchow's lymph-node in one, hepatic hilus in one and lung in one. Response could be evaluated in 31 patients with intra-aortic therapy. Partial response was found in 9 cases and NC in 16. PD was found in 5 and so the rate of response was 29.0% (9/31). The major lesion of 9 responders was inoperable Borrmann's Type 4 gastric cancer in 2 cases, peritoneal recurrence with an abdominal mass in 4, recurrence in the abdominal wall in one, Douglas' pouch in one, and intestinal stenosis in one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

[Ectopic pregnancy: changes in diagnostic procedures? (author's transl)].

Patients with ectopic pregnancy and those suspected having ectopic pregnancy were reviewed in a twenty years interval (1957-59, 1977-79). These patients were evaluated with regard to medical history, clinical and laboratory findings, diagnostic procedures, and clinical course. The diagnostic usefulness of symptoms and diagnostic procedures is expressed in terms of sensitivity and specificity. According to our results laparoscopy is an ideal procedure for early diagnosis of ectopic pregnancy. Nevertheless, puncture of the Douglas pouch in our experience has its place as a diagnostic tool in the diagnosis of ectopic pregnancy.

Curettage↗
PubMedDate not supplied

Ciliated bodies in gynecologic cytopathology: parasite or cellular debris?

Ciliated bodies, similar to the ones described originally by Gaudefroy and Coliche, were discovered in fluid from an ovarian cyst and fluid in the Douglas pouch. These were reproduced experimentally by mucosal scraping of Fallopian tubes. In fact, they were of cellular origin from desquamation of the ciliated apical portion of columnar cells.

Adult↗
PubMed1992

[A rare cause of ureterohydronephrosis].

The authors report about the exceptional observation of a left ureterohydronephrosis caused by a cluster of loops trapped inside Douglas'pouch, as was clearly visible on CT. The surgical treatment cured the patient. Regressive renal insufficiency complicated the postoperative period. This case belongs to the category of pelvic hernias through an abnormal opening.

Acute Kidney Injury↗
PubMedDate not supplied

[The Allen-Masters syndrome].

The authors present 18 cases of the Allen-Masters syndrome diagnosed from 1978 to 1985. The pelvic peritoneal defect was diagnosed by laparoscopy in 15 cases, by laparotomy in 3 cases. There was some doubt about the presence of the syndrome in 4 cases. The syndrome was diagnosed by chance in 11 cases while investigating causes of sterility. The locations of peritoneal laceration were distributed between broad ligaments in 13 cases and the other areas of the Douglas pouch in 5 cases. In 3 cases there were no previous gynaecological and obstetrical traumas that might explain the cause of the presence of the syndrome. The treatment was surgical in 5 cases, i.e. the sutural of the ligament-peritoneal scarred laceration.

Adnexa Uteri↗
PubMed1983

[Intratumor chemotherapy of patients with cancer of the ovaries].

The paper presents the results of intratumoral chemotherapy of 32 cases of single metastases of stage III-IV ovarian cancer into the Douglas pouch. The metastases were detected at different stages after primary treatment. Thiotepa, cyclophosphamide, sarcolysin and methotrexate were administered in 81.2, 9.4, 6.2 and 3.1% of cases, respectively. A clinically-significant effect was recorded in 14 out of 32 cases (43.7%); tumor process was arrested in 15 cases (46.9%); treatment failed in 3 cases (9.4%). Toxic side-effects were less frequent and pronounced than in patients given standard systemic monochemotherapy.

Adenocarcinoma↗
PubMed1983

[Puncture of the posterior vault in the cytological diagnosis of malignant ovarian tumors].

To confirm diagnosis, 4,614 punctures of the Douglas pouch through the posterior vault of the vagina have been performed in cases of suspected tumor located in the small pelvis since 1969. Further cytological examination established ovarian cancer in 871 cases, reactive changes in the mesothelium--186 and inflammatory lesions in the small pelvis--in 486 cases. Cytological data and the results of histological examination of resected tumors were compared: diagnosis was false-negative in 5.9% and false-positive--in 1.5% of cases. The said method was shown to be completely safe and highly instrumental both in cases of tumor in the small pelvis and detection of recurrences. Therefore, it may be recommended for application in out-patient service.

Biopsy, Needle↗
PubMed1981

Arterial chemoembolization with mitomycin C microcapsules in the treatment of primary or secondary carcinoma of the kidney, liver, bone and intrapelvic organs.

Selective intraarterial infusion of the ethylcellulose microcapsules of mitomycin C (MMC-mc) exerts its potential therapeutic effects through both infarction and prolonged local, drug activity, i.e., chemoembolization. Twenty patients with intractable primary, recurrent or metastatic carcinoma were treated with single or fractionated infusion of MMC-mc via percutaneous arterial catheterization. The target sites were the kidney, liver, prostate, urinary bladder, uterus, sigmoid colon, Douglas' pouch and bone. Fourteen patients had over 30% reduction in measurable maximum tumor diameter, 5 had 10 to 30% reduction and 1 showed less than 10% reduction, but concurrent 2 bone lesions had no reduction. Improvement of symptoms and signs such as pain, massive hemorrhage, dysuria, anorexia and hydronephrosis was observed at an early stage of the treatment in all patients. Eight patients with highly invasive carcinoma of the kidney, urinary bladder and cervix were initially treated with MMC-mc followed by successful radical operation. Systemic toxicity was mild and all patients tolerated the treatment. Although the follow-up periods are less than 21 months, 12 patients are alive with or without tumor and 11 of them are doing well. The present results indicate that chemoembolization with MMC-mc is effective as a preoperative or palliative measure in the treatment of invasive carcinoma of various organs.

Adult↗