Pyometra is defined as the collection of pus in the uterine cavity. The main cause of pyometra is cervical canal occlusion usually secondary to carcinoma cervix; however, other benign causes are endometrial polyp, leiomyoma, infection especially senile cervicitis, a forgotten intrauterine device, cervical occlusion after surgery, and radiation . The usual presentation of pyometra is a whitish discharge per vaginum. Sometimes the patients may present with the clinical triad of abdominal pain, purulent vaginal discharge, and postmenopausal bleeding. Nearly more than 50% of nonperforated pyometra patients are asymptomatic [4]. The most frequent preoperative diagnosis are generalized peritonitis, pneumoperitoneum and perforated gastrointestinal (GI) tract [5]. Spontaneously perforated pyometra is difficult to diagnose preoperatively. Clinically it commonly mimics the symptoms of gastrointestinal tract diseases. It is mentioned in prior case reports that, in most cases, a correct and definite diagnosis of spontaneous rupture pyometra was made only by exploratory laparotomy[6]. Abdominal USG has high sensitivity in assessing pyometra, but it plays a limited role in the diagnosis of perforated pyometra because of its inability to demonstrate the uterine breach and the limited sonographic window available due to pneumoperitoneum . However, this limitation can be overcome by TVS for detecting uterine defect and using dynamic TVS for demonstrating the real time movement of the endometrial collection through the defect into peritoneal
complications include hemorrhage, perforation, obstruction (from intessusception or volvulus) and neoplasia. In our case the patient had a proximal small bowel obstruction secondary to gallstone ileus with impaction of two smaller stones at a MD. This is exceptionally rare with only 3 cases having been reported in the literature. The techniques for surgical resection of MD are simple diverticulectomy or a segmental small bowel resection. As far as we know, there are no studies directly comparing these two resection techniques. However, as in our case, if the small bowel lumen is in danger of being narrowed or the neck of the diverticulum is wide, a segmental resection is favored over a simple diverticulectomy. [3]
For many years researchers have endeavoured to enhance current methods in cervical screening which utilises the Papanicolaou smear (also known as a Pap smear). Limitations in the smear have caused major emphasis to increase sensitivity and specificity whilst also creating an automated screening procedure. The Pap smear was initially introduced in the context of cervical screening in the detection of pre-cancerous lesions of the cervix in 1940’s (Koss, 1989). Cervical screens are vital as research has shown 90% of women with invasive cervical carcinoma could be prevented by finding any lesions early (Grace. et al. (2001). Cervical screening in the UK presented with an annual reduction of 7% but the Pap smear also possesses many limitations such as high error rates (Graff. et al. 1987) Figure 1.
Diagnostic medical sonography is a profession where sonographers direct high-frequency sound waves into a patient’s body through the use of specific equipment to diagnose or monitor a patient’s medical condition. As described by the Bureau of Labor Statistics, this examination is referred to as an ultrasound, sonogram, or echocardiogram. The high-frequency sound waves emitted from the handheld device, called a transducer, bounce back creating an echo and therefore produce an image that can be viewed on the sonographers computer screen. This image provides the sonographer and physician with an internal image of the patient’s body that will be used in the diagnosis. The most familiar use of ultrasound is used in monitoring pregnancies and is provided by obstetric and gynecologic sonographers, who also provide imaging of the female reproductive system. Other types of sonography include; abdominal sonography, breast sonography, musculoskeletal sonography, neurosonography and cardiovascular sonography. Due to the vast nature of uses in sonography, most professionals study one field that they choose to specialize in. Diagnostic medical sonography is a rapidly growing field because of the increase in medical advances. The area of Cleveland, Ohio has continued to rise in the medical field with great strides, providing better career prospects with the availability of numerous employment positions.
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning urination, and decreased urine output for three days. Upon admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings.
Hysterectomy is a common surgical procedure in the United States, with approximately 600,000 hysterectomies performed each year (Whiteman et al., 2008). Hysterectomy is the surgical removal of the uterus and may be accompanied by bilateral or unilateral oophorectomy (Appiah, 2015). Rates of hysterectomies increased, from years 1965-2002. Since then a 34% reduction in hysterectomy rates has been reported, in 2010 (Lobo, 2016). Hysterectomy may be accompanied by the removal of one or both of the ovaries to decrease the risk of ovarian cancer and in some cases for an indication other than cancer, such as treating fibroid tumors or excess bleeding (Moorman, 2011).
Women are normally affected during their childbearing years and develop pain in the pelvic region, menstrual cramps (dysmenorrhea), and pain with sexual intercourse (dyspareunia). Other features include infertility and an ovarian mass, which is typically felt on physical examination. Individuals may experiences gastrointestinal or urinary symptoms if ectopic endometrial tissue is next to the bladder or rectum.
Mythology is known as a collection of myths, mainly belonging to a specific religion or cultural tradition. Mythology is known worldwide and is passed down, usually orally, to the youth. Mythology cannot be proven to be completely true, due to the lack of verified written proof. The three in this section include; Hindu, Egypt, and African each has their own way of how the world was created.
Aquila is a constellation found in the Northern Celestial Hemisphere, near the celestial equator, during the summer. The name originates from the Latin word aquila, meaning eagle. It is the 22nd largest constellation in the sky and is best seen high in the south during late summer, especially in September around 9:00 pm. Aquila’s right ascension is 20 hours, its declination is 5 degrees, and it is visible between latitudes 85 and -75 degrees (Dolan). Two meteor showers are connected with Aquila, the June Aquilids and the Epsilon Aquilids. Aquila was originally catalogued by the Greek astronomer Ptolemy in the 2nd century and contains six major stars (“Aquila Constellation”).
Kavoussi, L. R., Moore, R. G., Adams, J. B., & Partin, A. W. (1995). Comparison of robotic versus human laparoscopic camera control. Journal of Urology. doi:10.1016/S0022-5347(01)66715
In addition to affecting the gastrointestinal tract empacho can also involve the pelvic region of the body. When it affects the pelvic area it can result in problems such as vaginitis8. This occurs when there, “Is an inflammation of the vagina that can result in discharge, itching and pain.”12 Symptoms of vaginitis consist of, but are not limited to, pain during urination, discolored vaginal discharge, and intense vaginal itching.
The symptoms of a PPH include uncontrolled bleeding, hematoma or pain and swelling in the tissues around the vagina, decrease in hematocrit, decreased blood pressure and increased heart rate. The rapid loss of blood or loss of too much...
Whereas signs and symptoms to the mother can include: rapid uterine contractions, back and abdominal pain, vaginal bleeding, and uterine tenderness. Direct causes sometimes can correlate with direct injury to abdominal wall, rapid loss or excess of amniotic fluid, the mother’s lifestyle choices, hypertension, advanced maternal age, diabetes mellitus, and prior placental abruption. Although, preventive measures for placenta abruption is uncommon, attention to ongoing medical evaluation of fetal and maternal welfare connected with consideration of risk factors, outcomes can be
“Pyramus was the most handsome of young men and Thisbe was the fairest beauty of the East.” ~Ovid in Metamorphoses
Rumack, C. M., Wilson, S. R., & Charboneau, J. W. (2005). Diagnostic ultrasound (3rd ed.). St. Louis: Elsevier Mosby.
There is also a high-resolution ultrasound scanning that can detect chromosomal and physical abnormalities in the first trimester as opposed to the second trimester. A technology such as this can create many ethical problems. Mcfadyen describes the biggest problem as being informed consent. “They may believe that it will provide information only about gestational age and be unaware of the range of abnormalities that can be detected. Recent research suggests that many women are not told beforehand of the first scan’s potential to detect fetal anomalies.”