Red degeneration in a uterine fibroid
A case file
Few days ago, my resident called me for consultation of a referred case from the surgical department. She was a young lady who delivered per vagina four days ago. An acute abdomen was there with severe pain. Ultrasonography revealed "An Ovarian mass" with tissue texture measuring seven by six centimeters. That mass was actually palpable under the skin and severely tender.
I decided to open the case. A vertical skin incision done. After opening the peritoneum, I noticed a large fibroid loosely attached to the right side of the uterus near the fundus. I made the diagnosis of red degeneration of a fibroid. During all my professional life, I did not remove such a fibroid, but I did not know why I decided to do it that time!
After removing the mass, a profound bleeding happened from its bed. I did not enter the uterine cavity and hardly had I controlled the bleeding. Since I left the OR, I still blame myself. Have you had an experience like this before? Please tell something that helps me relieving my sense of being guilty!
الاثنين، 18 أغسطس 2008
myomectomy .... is it logical postnatally?!
Red degeneration in a uterine fibroid
A case file
Few days ago, my resident called me for consultation of a referred case from the surgical department. She was a young lady who delivered per vagina four days ago. An acute abdomen was there with severe pain. Ultrasonography revealed "An Ovarian mass" with tissue texture measuring seven by six centimeters. That mass was actually palpable under the skin and severely tender.
I decided to open the case. A vertical skin incision done. After opening the peritoneum, I noticed a large fibroid loosely attached to the right side of the uterus near the fundus. I made the diagnosis of red degeneration of a fibroid. During all my professional life, I did not remove such a fibroid, but I did not know why I decided to do it that time!
After removing the mass, a profound bleeding happened from its bed. I did not enter the uterine cavity and hardly had I controlled the bleeding. Since I left the OR, I still blame myself. Have you had an experience like this before? Please tell something that helps me relieving my sense of being guilty!
A case file
Few days ago, my resident called me for consultation of a referred case from the surgical department. She was a young lady who delivered per vagina four days ago. An acute abdomen was there with severe pain. Ultrasonography revealed "An Ovarian mass" with tissue texture measuring seven by six centimeters. That mass was actually palpable under the skin and severely tender.
I decided to open the case. A vertical skin incision done. After opening the peritoneum, I noticed a large fibroid loosely attached to the right side of the uterus near the fundus. I made the diagnosis of red degeneration of a fibroid. During all my professional life, I did not remove such a fibroid, but I did not know why I decided to do it that time!
After removing the mass, a profound bleeding happened from its bed. I did not enter the uterine cavity and hardly had I controlled the bleeding. Since I left the OR, I still blame myself. Have you had an experience like this before? Please tell something that helps me relieving my sense of being guilty!
الأربعاء، 13 أغسطس 2008
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