The incisional hernia through trocar site is an uncommon complication of gynecologic laparoscopy. Its incidence is less than 1% and most of them are occurring through 10 mm trocar site. Small bowel herniation through 5 mm trocar site is very rare. Furthermore, 5 mm trocar site bowel herniation with drain tube in situ has not yet been reported. We present a case of small bowel herniation through 5 mm trocar site with drain tube in situ and its reduction by laparoscopy with a brief review of literature.
Drainage ; Hernia ; Incidence ; Laparoscopy ; Surgical Instruments

Disseminated peritoneal leiomyomatosis is rare condition characterized by multiple subperitoneal nodules of benign smooth muscle proliferations. It is associated with high level of estrogen such as pregnancy, oral contraceptives or estrogen producing ovarian tumor, and occasionally associated with operation history of myomectomy or hysterectomy. Clinical course of disseminated peritoneal leiomyomatosis is usually benign, but malignant changes also rarely have been reported. We experienced a case of disseminated peritoneal leiomyomatosis who has history of laparoscopic myomectomy 10 years ago. The patient was a 35-year-old woman, and her chief complaint was palpable masses in lower abdomen. She underwent laparoscopic surgery which revealed numerous solid masses on the surface of peritoneum, descending colon, rectosigmoid colon, uterus, round ligament, and broad ligament. We present it with a brief review of literature.
Abdomen ; Adult ; Broad Ligament ; Colon ; Colon, Descending ; Contraceptives, Oral ; Estrogens ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Leiomyomatosis ; Muscle, Smooth ; Peritoneum ; Pregnancy ; Round Ligament of Uterus ; Uterus

To present a case of successful robotic assisted radical trachelectomy. A nulliparous woman with early cervical cancer underwent a laparoscopic radical trachelectomy and pelvic lymphadenectomy with the da Vinci robot (Intuitive Surgical Inc., Sunnyvale, CA). After the pelvic lymph nodes were found negative on frozen section, the parametria, paracolpia and uterosacral ligaments were dissected transabdominally sparing the ascending branches of the uterine arteries. Cervical transection and vaginal closure were performed transvaginally. Surgical time was 450 min. No perioperative complications were noted. Robotic laparoscopic radical trachelectomy may bridge the gap between laparotomy and laparoscopy for radical trachelectomy.
Female ; Frozen Sections ; Humans ; Laparoscopy ; Laparotomy ; Ligaments ; Lymph Node Excision ; Lymph Nodes ; Operative Time ; Uterine Artery ; Uterine Cervical Neoplasms

Hypertriglyceridemia is a rare cause of pancreatitis in pregnancy. Pregnancy is related with hypertriglyceridemia especially in the 3rd trimester due to increase of estrogen. Diabetes is known as a common cause of secondary lipid metabolism disorder and is often associated with hypertriglyceridemia. Shock and sepsis related to pancreatitis in pregnancy result in a relatively high morbidity and mortality rate for both the mother and the fetus. Hypertriglyceridemic pancreatitis complicated in gestational diabetes has not previously been reported. We report a case of 26(+4) weeks gestational aged primigravida with acute pancreatitis induced by hypertriglyceridemia in gestational diabetes. We reviewed the clinical courses and treatments of acute pancreatitis in pregnancy with the literatures.
Aged ; Diabetes, Gestational ; Estrogens ; Female ; Fetus ; Humans ; Hypertriglyceridemia ; Lipid Metabolism Disorders ; Mothers ; Pancreatitis ; Pregnancy ; Sepsis ; Shock

Ectopic pregnancy after total hysterectomy is a very rare event and this could be the reason for the delay in diagnosis. We report a case of a ruptured tubal pregnancy occurred after hysterectomy and diagnosed by ultrasonography, computed tomography, and laparoscopy. A 37-year-old woman visited our emergency department for evaluation of abdominal pain, 31 days after total abdominal hysterectomy. Ultrasonography and computed tomography scan showed a cystic mass on the right adnexa and a large amount of fluid collection in the pelvic cavity. The patient's urine pregnancy test was positive. Laparoscopic findings revealed a ruptured right tubal pregnancy with hemoperitoneum. Ectopic pregnancy should be included in the differential diagnosis of a patient, even after total hysterectomy has been performed.
Abdominal Pain ; Adult ; Diagnosis, Differential ; Emergencies ; Female ; Hemoperitoneum ; Humans ; Hysterectomy ; Laparoscopy ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic ; Pregnancy, Tubal

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