S576 Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413S729
In the statistical analysis of the differences in clinical and
laboratory variables between the groups, it was observed that G-1
presented insulin 120 (p =0.001), HOMA (p=0.035) and Triglyceride
(p = 0.028) signicantly higher and HDL (p =0.039) signicantly
lower than G-2. Analysis of the clinical/laboratory categorical
variables presented: G-1 with family history for diabetes mellitus
(p = 0.041), POS (p =0.008), MS (p =0.024) and insulin 120 75
(p =0.033) signicantly higher than G-2.
Conclusions: The clinical evaluation of the adolescents should
include an assessment of the menstrual cycle, in which the
alterations in pattern might represent the rst sign of a
systemic and evolutionary disease such as the MS, whose clinical
manifestation may occur only at adult age. We believe that this
can be an opportunity for an early diagnosis of the MS and the
beginning of effective preventive actions.
Survey of the factors affecting delinquent adolescent girls
running away from their homes
M. Hashemian. University
This descriptiveanalytical study was intended to survey the
familial factors affecting delinquent runaway girls, 12 to 18 years of
age, temporarily residing in the reformative traning center of Tehran
in 1379 (2000). 75 les of the population were randomly selected.
A questionnaire including two parts was used for data collection:
the rst part (13 questions) dealt with personal characteristics, and
the second (21 questions) dealt with familial factors. Descriptive
and inferential statistics were used for data analysis. One-way
ANOVA t-test and Pearson correlation coefcient were among the
statistical measures which rendered gures and tables of relatives
and absolute frequency.
The study ndings indicated that the clients education, parents
occupations, history of drug abuse in client and family and number
of family members showed signicant relationship with average
runaway age also between clients history of drug abuse, mothers
occupation, clients runaway frequency with average arresting age.
In addition, a signicant relationship was found between clients
history of drug abuse and alcohol, marital status and raising
out problems with the average runaway duration. However, no
signicant relationship was found to exist between other variables.
Uterus didelphus with blind hemivagina and ipsilateral renal
agenesis a rare case report
J. Faria1, S. Soares2, M. Bernardo, C. Ferreira, S. Coutinho, R. Mira.1Dona Estefania Hospital, Lisbon, Portugal, 2Faro Hospital, 3
Objective: To report our procedure for symptom-relief related
to uterus didelphus (UD) with obstructed hemivagina and renal
Design: Case study.
Patient: A 14-year-old adolescent referred for evaluation of a
suspected Mullerian anomaly in the setting of 1 year of secondary
Interventions: Clinical, imagiologic, combined laparoscopic-
hysteroscopic treatment and follow-up assessments.
Main outcome measure: Categorization of the anomaly according
to the standard Mullerian classication system and literature
Results: Hemi-vaginotomy, by hysteroscopic approach, with
successful unilateral hematometrocolpos drainage; hematosalpinx
drainage after right salpingostomy by laparoscopy; The patient has
been asymptomatic in a 2-year follow-up.
Discussion: Mullerian duct system malformations represent a wide
spectrum of anomalies of the female reproductive tract, usually
detected at birth or years after menarche. UD result from a lack
of fusion of the Mullerian ducts and subsequently duplication of
corpus and cervix. Occasionally, UD is associated with an obstructed
hemivagina (often with ipsilateral renal agenesis) known as
the rare Herlyn-Werner-Wunderlich syndrome. Early and accurate
diagnosis is important but difcult due to its rarity and variable
clinical pictures. An adequate radiological study is mandatory to
assess the anatomic conformation and to optimize the therapeutic
procedures. Endoscopic excision of the obstructed vaginal septum
is the gold-standard treatment that can completely relieve the
symptoms and prevent further sequelae.
Torsion of a peritubal cyst with associated tubal infarction
in an adolescent girl Case report
M. Ramalingam, F. Crichton. NHS Forth valley
Background: Torsion of a peritubal cyst with associated fallopian
tube torsion and infarction is an infrequent but signicant cause
of acute lower abdominal pain in adolescent girls. This is difcult
to recognize preoperatively, although prompt diagnosis and timely
surgical treatment are vital to salvage the oviduct.
Case report: A 13 year old, adolescent girl presented with sudden
onset abdominal pain, fever and vomiting. Clinical examination
revealed a diffusely tender abdomen with guarding. Ultrasound
showed a cyst measuring 6x8 cm mass posterior to the uterus
with free uid in the pouch of Douglas. A laparoscopy performed
revealed a haemorrhagic mass on the left side with tube torted
5 times surrounded by adhesions. Left ovary appeared normal. In
view of the ndings and adhesions, laparotomy was performed. Left
tube was mobilised and detorted, but necrotic and no prospect of
revitalisation and a left salpingectomy performed and the mass was
removed. The left ovary, right tube, ovaries, appendix, and uterus
were normal. Histological examination revealed torsion and diffuse
hemorrhagic infarction of a peritubal cyst and the fallopian tube.
The post operative course was uneventful.
Conclusion: Although torsion of a peritubal cyst with associated
fallopian tube torsion and infarction is very rare it should
be included in the differential diagnosis of acute abdomen in
adolescent girls. Early surgical intervention may allow preservation
of the fallopian tube in young girls.
Bilateral massive ovarian edema A rare cause of acute
R. Ruprai, J. Shetty, P. Kumar, L. Rao
Introduction: During the reproductive years ovarian masses are
commonly benign in nature, often presenting with abdominal
distention, pain, discomfort, or symptoms of hormonal imbalance
in a hormonally active tumor. It notoriously mimics acute abdomen
when it undergoes torsion, bleeding, or rupture of the cyst.
Malignant change is noted in 1 in 15 young individuals that maybe
associated with bilaterality, solid areas and associated ascites. We
are present here a case of bilateral massive ovarian edema, a rare
cause of ovarian enlargement with acute abdomen secondary to
unmonitored drug therapy for neurocysticercosis.
Case report: 19 year girl, a known case of neurocysticercosis
on carbamazepine, was referred for evaluation of acute onset of
vomiting, abdominal pain with distension, ascites with enlarged
ovaries, pleural effusion and renal failure. Ultrasound revealed
bilateral homogenously enlarged ovaries with peripheral multiple
follicles and increased stromal volume. Ascitic uid evaluation
was transudate in nature and negative for malignancy. Despite
multiple tapping, there was rapid re-accumulation of ascites. A
differential diagnosis of sertoli-leydig cell tumor/pseudo-Meigs
syndrome was made following a raised serum testosterone level.
With clinical suspicion of malignancy, laparotomy was performed
which revealed bilateral massively enlarged ovaries: measuring, 30
and 17 cm. She underwent removal of both apparently diseased
ovaries. Histopathology revealed massive ovarian edema with