S576 Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729

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) significantly higher and HDL (p =0.039) significantly

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) significantly 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 first 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 descriptive–analytical 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 files of the population were randomly selected.

A questionnaire including two parts was used for data collection:

the first 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 coefficient were among the

statistical measures which rendered figures and tables of relatives

and absolute frequency.

The study findings indicated that the client’s education, parent”s

occupations, history of drug abuse in client and family and number

of family members showed significant relationship with average

runaway age also between clients’ history of drug abuse, mothers

occupation, clients’ runaway frequency with average arresting age.

In addition, a significant relationship was found between clients’

history of drug abuse and alcohol, marital status and raising

out problems with the average runaway duration. However, no

significant 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 classification 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 difficult 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 significant cause

of acute lower abdominal pain in adolescent girls. This is difficult

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 fluid 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 findings 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 fluid 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