P575 Uterus didelphus with blind hemivagina and ipsilateral renal agenesis – a rare case report

P575 Uterus didelphus with blind hemivagina and ipsilateral renal agenesis – a rare case report

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Text of P575 Uterus didelphus with blind hemivagina and ipsilateral renal agenesis – a rare case report

  • 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.

    P574

    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.

    P575

    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

    agenesis.

    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

    dysmenorrhea.

    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

    review.

    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.

    P576

    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.

    P577

    Bilateral massive ovarian edema A rare cause of acute

    abdomen

    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