No abstract available.
Douglas' Pouch* ; Stomach Neoplasms*

Multicystic benign mesothelioma (MBM) of the peritoneum is a very rare condition. Since the first description of MBM in 1979, approximately 100 cases have been reported. This is a case report of MBM of the pelvic peritoneum presenting as acute abdominal pain in a young woman. Laparoscopy confirmed multiple grapelike clusters of cysts that originated in the peritoneum of the rectouterine pouch and histopathologic diagnosis was confirmed as MBM of the pelvic peritoneum. We hope to alert gynaecologists of the diagnostic and therapeutic approaches to MBM which can be accomplished by laparoscopy.
Abdominal Pain ; Douglas' Pouch ; Female ; Humans ; Laparoscopy ; Mesothelioma ; Peritoneum

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.
Douglas' Pouch ; Endometriosis* ; Female ; Lymph Nodes ; Metaplasia ; Neoplasm Metastasis ; Ovary ; Peritoneum ; Stem Cells ; Teratoma*

PURPOSE: To evaluete the sonographic features of ovarian mass torsion. MATERIALS AND METHODS: We evaluated the sonographic findings in 22 cases of torsioned cystic ovarian mass, benign teratoma(n=21), and normal ovary (n=l) confirmed surgically on pathologically. We classified the ovarian mass into two groups as sonographic ally cystic (n=15) or non-cystic mass(n=6). The patients were 17-72 years old(mean:36.9). We retrospectively reviewed US examination with respect to (1) free fluid in Douglas pouch, (2)pelvic mass & mass wall thickening, (3)dilated uterine tube, (4)prominent follicles, (5) engorged vessels, and (6)beak-like echo in torsion site. The combined conditions of torsion were uterine myoma(n=l) and intrauterine pregnancy(n=3). RESULTS: In sonogram, sonographic cystic mass (n=15) group showed (1)free fluid in Douglas pouch (9/15), (2)mass wall thickening(6/15), (3)dilated uterine tube(2/15), and sonographic non-cystic mass(n=6) group showed (1) free fluid in Douglas pouch (3/6). In sonogram, torsion of the normal ovary(n=1) showed (1) free fluid in Douglas pouch, and (2) prominent follicles. CONCLUSION: If sonogram of reproductive aged women with acute abdomen show free fluid in Douglas pouch and pelvic mass with wall thickening, ovarian mass torsion is suggested. But clinical features of acute abdomen and clinical diagnosis of torsion are more important than sonographic features.
Abdomen, Acute ; Diagnosis ; Douglas' Pouch ; Fallopian Tubes ; Female ; Humans ; Ovary ; Retrospective Studies ; Ultrasonography*

The mature cystic teratoma is most common in the ovary, and several authors have reported mature cystic teratoma in female genitalia such as fallopian tube, uterus and pouch of douglas. The mature cystic teratoma in the douglas pouch is very rare, which was reported only twice in the world. The pathogenesis of the mature cystic teratoma in the douglas pouch is not established. We experienced a case of mature cystic teratoma in the douglas pouch associated with pregnancy, which was diagnosed by the ultrasonography at the first trimester of pregnancy and remained at the third trimester of pregnancy without change of size. We report the case with a brief review of literature.
Douglas' Pouch* ; Fallopian Tubes ; Female ; Genitalia, Female ; Humans ; Ovary ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Pregnancy* ; Teratoma* ; Ultrasonography ; Uterus

Adolescent ; Chondrosarcoma ; pathology ; surgery ; Douglas' Pouch ; pathology ; surgery ; Female ; Humans ; Peritoneal Neoplasms ; pathology ; surgery ; Soft Tissue Neoplasms ; pathology ; surgery

PURPOSE: Micrometastasis is known as a significant predictor of prognosis in colorectal cancer patients. Recently, reverse transcriptase polymerase chain reaction (RT-PCR) has been applied to detecting micrometastasis. The drainage vein and peritoneum were examined and the micrometastases assessed in a series of colorectal cancer patients. METHODS: 22 patients, who were histologically diagnosed with colorectal cancer, and 8 patients of serosal and peritoneal brushing, were examined using RT-PCR to amplify the mRNAs for two epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20). RESULTS: Among the 22 colorectal cancer patients, the positive rates of CK-20 and CEA mRNAs in the drainage vein were 10 (45%) and 7 (32%), and those of the serosal and peritoneal brushing were 6 (75%) and 5 (63%), respectively. CONCLUSION: These results suggest that the "no touch isolation technique" might be useful for operations in advanced colorectal cancer patients, and the brushing of the serosal or Douglas pouch can represent the micrometastasis status.
Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Douglas' Pouch ; Drainage ; Humans ; Keratin-20* ; Keratins* ; Neoplasm Micrometastasis* ; Peritoneal Cavity* ; Peritoneum ; Prognosis ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; Veins*

OBJECTIVE: To evaluated the result of laparoscopic surgery of adnexal tumors and removing excised tissue through Douglas pouch incision. METHODS: 110 patient who had visited Chosun University Hospital department of Obstetrics and Gynecology between January, 2011 to April, 2012 were involved in the study. Patient had laparoscopic surgery on the adnexal tumor and excised tissue was removed through Douglas pouch incision by single surgeon. RESULTS: The mean age of patients were 41.5 years. The size of the tumor varied from 3 cm to 27 cm in size using ultrasonography. The mean operation time was 61.3 minutes and the mean admission period was 4.2 days. 82 patient had salpingo-oophorectomy or oophorectomy, 19 had ovarian cystectomy, 2 had wedge resection and 4 had tumor enucleation. Histologic result reveal endometriosis in 23 patients (20.9%). teratoma in 21 (19%), serous cystadenoma in 14 (12.7%) and mucinous cystadenoma in 10 (9.1%). Other histologic finding includes hemorrhagic cyst, luteal cyst and paratubal cyst. There was no complication including bladder or rectal injury, suture site infection. CONCLUSION: Laparoscopic surgery of adnexal tumor and removal by Douglas pouch incision is a simple, safe and efficient method that could be considered as an alternative minimally invasive technique.
Cystadenoma, Mucinous ; Cystadenoma, Serous ; Cystectomy ; Douglas' Pouch ; Endometriosis ; Female ; Gynecology ; Hospital Departments ; Humans ; Laparoscopy ; Obstetrics ; Ovariectomy ; Parovarian Cyst ; Sutures ; Teratoma ; Urinary Bladder

PURPOSE: It has been reported that in colorectal cancer, the positive rate of the cytological examination of ascites is low and that the cytologically positive result of the cancer cell influences its prognosis; nonetheless, not many studies on the correlation of the formation of peritoneal effusion and cancer have been done yet. Thus, this study on the correlation of clinico-pathological findings with peritoneal effusion was initiated. METHODS: The study population, includes a total of 191 patients who underwent an operation for colon cancer and rectal cancer from May 1, 2004, to December 31, 2005. Peritoneal effusion considered to be present in cases with more than 10 cc of body fluid retained in the Douglas pouch, and a cytological test was performed on patients whose retained fluid was more than 50 cc. In all patients, the correlation of the clinico-pathological findings with peritoneal effusion was analyzed, and the volume of effusion and the positive result of peritoneal cytology were compared. RESULTS: Among the 191 patients, patients without peritoneal effusion numbered 133 (69.6%) and patients with peritoneal effusion numbered 58 (30.4%). Between the two groups, the presence of intestinal obstruction due to cancer (P<0.001), perineural involvement (P=0.025), lymph node metastasis (P=0.004), lymph-node stage (P=0.001), distal metastasis (P=0.012), macroscopic peritoneal dissemination, and stage (P=0.017) were statistically significantly different. In the multivariate analysis, only the presence of intestinal obstruction and lymph-node disease stage correlated statistically significantly to the formation of peritoneal effusion (P=0.009, 0.004). Twenty patients (34.5%) had peritoneal effusion of more than 50 cc, and among them, malignant cells were detected in 3 patients (15%). Based on 50-cc peritoneal effusion, more or less effusion and the detection of malignant cells by peritoneal cytology did not correlate with the clinico- pathological outcomes (P>0.05). CONCLUSIONS: For colorectal cancer patients with peritoneal effusion, but without co-morbid medical diseases inducing such peritoneal effusion, by regarding peritoneal effusion itself as meaningful, the range of lymphadenectomies, adjuvant chemotherapy, and other additional therapy should be considered.
Ascites ; Ascitic Fluid* ; Body Fluids ; Chemotherapy, Adjuvant ; Colonic Neoplasms ; Colorectal Neoplasms* ; Douglas' Pouch ; Humans ; Intestinal Obstruction ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms

PURPOSE: The benefits of the "no-touch" isolation technique that is usually performed to prevent the circulation of tumor cells are not evident. The aim of this study was to determine whether the no-touch isolation technique for treating gastrointestinal cancers could prevent the circulation of tumor cells detected by reverse transcriptase polymerase chain reaction (RT-PCR). Matrials and Methods: By using RT-PCR to amplify mRNAs for two specific epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20), we examined 34 gastric cancer patients who had been histologically diagnosed and 22 patients had undergone serosal and peritoneal brushing. RESULTS: In 10 (29.4%) of the 34 gastric cancer patients, we detected CK20 mRNA before manipulation, and in 17 (51.5%) of those patients, after we detected it. The density of the CK20 mRNA band was increased in 11 cases (33.3%) and the density was decreased in 2 cases (6.1%). In 16 (48.5%) of the 34 gastric cancer patients, we detected CEA mRNA before manipulation, and in 17 (51.5%) patients after we detected it. The density of the CEA mRNA band was increased in 8 cases (24.2%) and decreased in 3 cases (9.1%). CONCLUSION: These result suggest that the "no-touch isolation technique" might be useful when operating on advanced gastric cancer patients and that serosal or Douglas pouch brushing can be used to determine the status of micrometastasis.
Carcinoembryonic Antigen ; Douglas' Pouch ; Gastrointestinal Neoplasms ; Humans ; Keratin-20 ; Neoplasm Micrometastasis* ; Peritoneum* ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger* ; Stomach Neoplasms*