Sparganosis is a parasitic infection caused by the plerocercoid larvae of diphyllobothroid tapeworms belonging to the genus Spirometra, as first described by Manson in 1882. The infection is transmitted by ingestion of contaminated water, frogs, and snakes, and contact between a second intermediate host and an open wound or mucus membranes. Humans are accidental hosts in the life cycle, but dogs, cats, and other mammals are definitive hosts. Once a human becomes infected, the plerocercoid larvae migrate to a subcutaneous location, where they typically develop into a painful nodule. We misdiagnosed vulva sparganosis as a Bartholin's gland abscess. The patient was a green consumer, so she may have been infected by consuming health foods. Sparganosis should be considered as a cause of soft tissue masses especially among patients who have ingested health foods.
Abscess ; Animals ; Cats ; Cestoda ; Dogs ; Eating ; Food, Organic ; Humans ; Life Cycle Stages ; Mammals ; Membranes ; Mucus ; Snakes ; Sparganosis ; Sparganum ; Spirometra ; Vulva

The foreign bodies in vagina cause intense inflammation. Genital complaints in patients could indicate the presence of a vaginal foreign object. Vaginal bleeding and blood-stained, foul-smelling discharge are considered to be the main clinical manifestations of vaginal foreign bodies, and toilet tissue reported as the most commonly found foreign body. The insertion of foreign bodies into the vagina is not uncommon but presentation as lower abdominal pain in an gynaecological clinic is rare. The causes of insertion are sexual stimulation, sexual abuse, accident of post-surgery and most cases find a solution after vaginal speculum examination. We describe a case of foreign body in the vagina of a patient presenting with chronic lower abdominal pain but undetectable and unrecognized in general examination.
Abdominal Pain ; Foreign Bodies ; Humans ; Inflammation ; Sex Offenses ; Surgical Instruments ; Uterine Hemorrhage ; Vagina ; Young Adult

Clear cell tumor of borderline malignancy has been reported to account for 5 to 8% of all clear cell neoplasms, and <1% of borderline malignancies of the ovary. Borderline clear cell fibroadenoma with or without microinvasion mostly occurs in women with middle age, and the presenting symptoms associated with this tumor are non-specific. The clinico-pathologic features of borderline clear cell fibroadenoma are not well known because of its rarity. Furthermore, there is no consensus for treating the disease. Thus, we report a case of borderline clear cell fibroadenoma presenting as ovarian fibroadenoma with a review of literature.
Consensus ; Female ; Fibroadenoma ; Humans ; Middle Aged ; Naphazoline ; Ovary

Spontaneous uterine rupture is a rare occurrence, but a catastrophic obstetric complication, associated with high rates of maternal and perinatal morbidity and mortality. Clinicians should make a prompt diagnosis and management in patients presenting with acute abdominal pain, hypovolemic shock, and fetal compromise. We present a case of spontaneous complete rupture of uterus during early labor in term pregnancy after laparoscopic radiofrequency myolysis.
Abdominal Pain ; Humans ; Pregnancy ; Rupture ; Shock ; Uterine Rupture ; Uterus

Pelvic organ prolapse complicating pregnancy is a rare clinical condition and its incidence is one in 10,000~15,000 deliveries. It is associated with multiparity, low socioeconomic status, inadequate perinatal care, maternal malnutrition, previous abdominal surgery, and weakness of pelvic muscular and connective tissue. It can cause cervical dystocia, which leads to cervical laceration, uterine rupture, maternal and fetal death. We experienced a case, first in Korea, of cervical swelling that developed during labor, prolapsed beyond the vaginal introitus and thus obstructed the birth canal. The patient underwent cesarean section and subsequently received MgSO4 topical therapy and resulted in complete resolution. We report this case with a brief review of literature.
Cesarean Section ; Connective Tissue ; Dystocia ; Female ; Fetal Death ; Humans ; Incidence ; Korea ; Lacerations ; Magnesium Sulfate ; Malnutrition ; Parity ; Parturition ; Pelvic Organ Prolapse ; Perinatal Care ; Pregnancy ; Social Class ; Uterine Rupture

OBJECTIVE: To evaluate the effectiveness of transumbilical single-port access laparoscopic surgery of ectopic pregnancy. METHODS: Retrospective analysis was performed on six patients who underwent transumbilical single-port access laparoscopic management of ectopic pregnancies. RESULTS: The median age of 6 cases was 33.5 years (range, 32 to 36), and the median body mass index was 20.6 kg/m2 (range, 16.5 to 28.7). The median largest diameter of G-sac was 4.8 cm (range, 3.0 to 5.4). Intracorporeal rupture and hemoperitoneum were accompanied in all cases. The median time needed for the surgery was 77.5 minutes (range, 59 to 95). The median estimated blood loss was 40 mL (range, 20 to 50). The median postoperative hospital day was 2 days (range, 1 to 3). There were no complications on postoperative course and follow-up. CONCLUSION: Transumbilical single-port access laparoscopic surgery for ectopic pregnancy was feasible and safe. This approach might be reasonable alternative to conventional laparoscopic surgery using 3 or 4 port in the management of ectopic pregnancy.
Body Mass Index ; Female ; Follow-Up Studies ; Hemoperitoneum ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies ; Rupture

OBJECTIVE: Adenomatoid tumors of female genital tracts are benign lesions derived from mesothelium, occurring most commonly during the reproductive years. The aim of this study was to evaluate the overall incidence of adenomatoid tumors in Korean women and to analyze the clinical characteristics. METHODS: One hundred and ninety five patients with adenomatoid tumors were found in a retrospective medical records review of pathologic reports for 44,984 benign uterine diseases at Cheil General Hospital, from January 1995 to April 2009. RESULTS: The overall incidence rate was 0.42% of all benign uterine disease. Among them, 149 patients received hysterectomy, and 46 patients received uterine conservative surgery. Main symptoms of the patients were pain (25.1%), bleeding (30.2%), and palpable mass (18.5%). Most common associated pathologies were leiomyoma (46.6%), adenomyosis (25.1%) and endometriosis (13.1%). Most of the diagnosis was made postoperatively. Among 46 patients with conservative treatment, 13 patients showed successful pregnancy outcome. No recurrence occurred during the follow up period. CONCLUSION: Adenomatoid tumors are associated with fibroids and tend to mimic them clinically, making pre-operative diagnosis difficult. The recurrence is rare even after conservative operation. Our data about this benign neoplasm may be helpful for counseling patients after operations.
Adenomatoid Tumor ; Adenomyosis ; Counseling ; Endometriosis ; Epithelium ; Female ; Follow-Up Studies ; Hemorrhage ; Hospitals, General ; Humans ; Hydrazines ; Hysterectomy ; Incidence ; Leiomyoma ; Medical Records ; Mesothelioma ; Pregnancy ; Pregnancy Outcome ; Recurrence ; Retrospective Studies ; Uterine Diseases

OBJECTIVE: This study was performed to compare the pharmacokinetics of methotrexate (MTX) in unruptured ectopic pregnancy according to the injection route. METHODS: Between May 2005 and August 2009, thirty-five patients of unruptured ectopic pregnancy in Chungbuk National University Hospital were treated medically either by intramuscular (IM) or intraamniotic (IA) injection of MTX according to the presence of fetal heart beat. Serum concentration of MTX was measured by fluorescent immunoassay using the blood samples withdrawn serially after its injection. RESULTS: The peak plasma MTX level was achieved at the 30-minute after injection sample in both groups. The mean peak plasma level of MTX in IM group was significantly higher than that of IA in 60-minute (2.296+/-0.64 umol/L vs 1.535+/-0.31 umol/L; p<0.006), 90-minute (1.9+/-0.51 umol/L vs 1.225+/-0.21 umol/L; p<0.002), and 240-minute (1.443+/-0.33 umol/L vs 1.077+/-0.18 umol/L; p<0.011) samples. The mean pretreatment plasma beta-hCG level was significantly higher in IA group, both tubal pregnancy (48,405+/-37,811.7 IU/L vs 18,452.05+/-19,205.34 IU/L; p<0.007) and cervical pregnancy (94,574.2+/-45,037.1 IU/L vs 42,446+/-34,778.12 IU/L; p<0.037), than those of IM group. But neither plasma MTX level nor pretreatment beta-hCG level were related to the treatment outcome. CONCLUSION: The plasma level of MTX increased rapidly in both IM and IA groups; the peak level reached at 30 minutes, and decreased to less than 1 umol/L after 240 minutes. Moreover, it was higher in IM group than IA group. Nevertheless, IA injection may be useful in patients who had high beta-hCG level or fetal heart beat, which are not usually indicated to medical treatment.
Female ; Fetal Heart ; Humans ; Immunoassay ; Methotrexate ; Plasma ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Treatment Outcome

Pelvic actinomycosis is well-known to be associated with the longstanding use of intrauterine devices, sometimes related with a pregnancy history and an obstetric and/or gynecologic surgery. It can extend to the retroperitoneum and may also be associated with ureteral obstruction. In this case, pelvic actinomycosis in the form of bilateral tubo-ovarian abscess extending to the retroperitoneum resulting in bilateral hydronephrosis occurred in a nulligravida woman who had only few prior sexual intercourses. Apparently, pelvic actinomycosis can occur without any specific history. Moreover, such could possibly give rise to hydronephrosis by direct extension to the retroperitoneum.
Abscess ; Actinomycosis ; Female ; Gynecologic Surgical Procedures ; Humans ; Hydronephrosis ; Intrauterine Devices ; Reproductive History ; Ureteral Obstruction

Acardiac twin is a rare anomaly that occurs 1% in monochorionic twins and 1 in 35,000 pregnancies overall. Acardiac twin, also known as twin-reversed arterial perfusion (TRAP) sequence, involves a "pump" or donor twin perfusing a recipient or "acardiac" twin through vascular (usually arterial-arterial and venous-venous) anastomoses. Perinatal mortality rate for the pump twin has been reported to be 50~75%, mainly as a result of polyhydramnios, preterm labor, and congestive heart failure. Therefore, occlusion of the circulation to the acardiac twin has been recommended to improve perinatal outcome of the pump twin. Radiofrequency ablation of the acardiac twin effectively protects the pump twin from high-output cardiac failure and death. We report our experience in the treatment of patients with TRAP sequence using radio frequency ablation to stop perfusion to the acardiac twin.
Female ; Fetus ; Heart Failure ; Humans ; Obstetric Labor, Premature ; Perfusion ; Perinatal Mortality ; Polyhydramnios ; Pregnancy ; Pregnancy, Twin ; Tissue Donors ; Umbilical Cord