1.Inferior Vena Cava Filter: Is It a Way Out of Pulmonary Embolism in Gynaecological Cancer? - Case Report
Shafiee MN1 ; Ani Amelia Z 1 ; Rozman Z2 ; Nur Azurah AG
Journal of Surgical Academia 2011;1(2):64-66
Venous thromboembolism has a strong association with pelvic malignancy, whereby a failure in recognizing this event will lead to mortality. The best intervention depends on the individual basis with the availability of supporting service. We illustrate a case of gynaecological malignancy with concurrent deep vein thrombosis undergoing staging laparotomy and debulking surgery. Inferior vena cava filter was inserted after initial thrombolytic therapy and subsequently a long term treatment. Death from massive pulmonary embolism and major bleeding was prevented and synchronous primary ovarian and endometrial cancer prognosis was reassured in this case
2.Morbidly Adherent Placenta at Extreme Prematurity: Can Major Haemorrhage and Hysterectomy be Prevented?
Shafiee MN1 ; Lim PS1 ; Rahana AR1 ; Nor Azlin MI1 ; Wan Faraliza ZA1 ; Isa MR2 ; Mohd Hashim O1
Journal of Surgical Academia 2011;1(1):56-60
Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage.
3.Case Review: Post Partum Vulvo-vaginal Haematomas and Options of Management
Lim PS 1 ; Nirmala CK1 ; Shafiee MN1 ; Lim YH1 ; Rozman Z2 ; Mohd Hashim O1 ; Zainul RAZ1 ; Muhammad Abdul Jamil MY1
Journal of Surgical Academia 2011;1(1):52-55
Vulvo-vaginal haematomas are not an uncommon obstetric complication. Despite advances in obstetric care, practice and technique, vulvo-vaginal haematomas do occur especially in complicated vaginal deliveries. Various management options are available for vulvo-vaginal haematomas. We describe three cases of vulvo-vaginal haematomas with different severity and presentations which were managed in different manners i.e. local haemostasis control, laparotomy with hysterectomy, and transarterial embolisation. The choice of treatment options would mainly depend on the clinical presentations, availability of expertise as well as facilities. Early identification is crucial.