Crohn's disease is known as regional enteritis. Extra-intestinal complications of Crohn's disease are relatively common. Extra-intestinal manifestations include skin ulcers, erythema nodosum, and arthritis. Even cases of the vulva involvement by Crohn's disease have been reported. Gynecologists did not usually consider Crohn's disease as a complication involving the vulva; gynecologists diagnose Bartholin's gland abscess first. Gynecologists have fully to consider history taking about disease characteristics. We reported recto-vulva fistula complicated by Crohn's disease and it is side effects after marsupialization operation.
Abscess ; Arthritis ; Crohn Disease ; Erythema Nodosum ; Fistula ; Skin Ulcer ; Vulva

Ovarian tumors are rare in children. Their incidence is estimated to be about 2.6 cases per 100,000 girls per year. About 1/3 of all childhood ovarian tumors are reported to be malignant. Germ cell tumors are more frequent than epithelial and sex cord stromal tumors in children and teratoma is the most common germ cell tumor occurring in children. In most cases, the presenting symptoms in childhood included abdominal pain, an abdominal mass, abdominal distention and so on. These non-specific symptoms and low incidence lead to suspicions of more common diseases, so the diagnosis of ovarian masses in childhood is difficult. We experienced a rare case of mature cystic teratoma in a 5-year-old girl with urinary frequency without abdominal discomfort despite the large size. The pre-operative magnetic resonance imaging finding showed unusual characteristics, rising suspicion of malignancy. So, we present this case with a brief review of literature.
Abdominal Pain ; Child ; Humans ; Incidence ; Magnetic Resonance Imaging ; Neoplasms, Germ Cell and Embryonal ; Preschool Child ; Sex Cord-Gonadal Stromal Tumors ; Teratoma

Lymphangiomatosis is a condition of lymphatic tissue malformation with multiple or diffuse involvement of soft tissues, visceral organs. Congenital abnormalities of the lymphatic system are very rare, and reports of congenital lymphangiomatosis are even fewer. We experienced a case of congenital lymphangiomatosis detected as edema of the right limb by prenatal ultrasonography and then diagnosed by magnetic resonance imaging. We describe this case with a brief review of the literature.
Congenital Abnormalities ; Edema ; Extremities ; Lower Extremity ; Lymphatic System ; Lymphoid Tissue ; Magnetic Resonance Imaging ; Ultrasonography, Prenatal

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

OBJECTIVE: This exploratory study was undertaken to analyze the anxiety of parents of prenatally diagnosed fetal congenital disease and satisfaction after the multidisciplinary counseling. METHODS: The study included 32 prospective parents of antenatally diagnosed congenital disease fetus who received multidisciplinary counseling at The Catholic Congenital Disease Center (CCDC) for the period from May, 2009 through March, 2010. The Korean version of the Spielberger State-Trait Anxiety Inventory (STAI) was utilized to assess parental anxiety. Categories of satisfaction survey were classified into accessibility, professionalism, empathy, recoverability, satisfaction, and expectation after counseling. RESULTS: The mean time and number of medical professionals for each counseling were 58.0+/-36.9 min and 3.5+/-1.1 persons. Most common congenital diseases were cardiovascular (36.1%) and urogenital diseases (25.0%). STAI scores were significantly decreased after than before counseling (43.5+/-5.9 vs 36.9+/-6.0, P=0.0007). STAI scores after counseling showed significant decrease in prospective mothers who were nulliparous (P=0.0005), less than 35 years old (P=0.0014), had religion (P=0.0014) and counseled more than 40 minutes (P=0.0027). The mean rate of positive satisfactory response about multidisciplinary counseling was 85.6% in satisfaction survey. CONCLUSION: This study provides evidence of the positive impact on the prospective parental anxiety of a multidisciplinary counseling in prenatal management of fetal congenital diseases.
Anxiety ; Counseling ; Empathy ; Fetus ; Humans ; Mothers ; Parents ; Prospective Studies

OBJECTIVE: This study was to evaluate the safety of cesarean delivery through transplacental incision in anterior placenta previa and its effect on mother and neonate. METHODS: We examined 74 cases of placenta previa retrospectively who underwent cesarean section from May 2006 to December 2009, in Chungbuk National University Hospital. They were divided into two groups according to the placental incision. Transplacental incision was made in all cases of anterior placenta previa. We compared postoperative maternal hemoglobin change, neonatal hemoglobin and hematocrit, intra and/or postoperative transfusion volume, neonatal intensive care unit (NICU) admission days between the two groups. RESULTS: There were no differences in maternal characteristics, hemoglobin changes, transfusion volume between the two groups. Nor the neonatal hemoglobin and hematocrit level, Apgar score and admission days were different. There was no neonatal acidosis below pH 7.20. CONCLUSION: The cesarean delivery through transplacental incision in anterior placenta previa seems to be safe because it did not increase maternal and fetal blood loss nor NICU admission days.
Acidosis ; Apgar Score ; Cesarean Section ; Female ; Fetal Blood ; Hematocrit ; Hemoglobins ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Intensive Care, Neonatal ; Mothers ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies