Introduction: Unstable posterior pelvic ring injuries are best treated with operative methods due to better post-op functional score. Our patient cohort was involved in heavy manual laboring frequently required ground level work in their activities of daily living. There are very few outcome studies dealing exclusively with such patients. Materials & Methods: Forty one patients who were treated with percutaneous sacroiliac screw fixation under fluoroscopic guidance and were followed-up for at least one year were analyzed retrospectively for functional outcome using the Majeed score. Results: Twenty one (51.22%) and thirteen (31.70%) patients were found to be in excellent and good categories respectively and majority of the patients (thirty/73.17%) were able to return to their original occupation with or without minor adjustments. Conclusion: Percutaneous ilio-sacral screw fixation for posterior pelvic unstable injuries is an acceptable mode of treatment in patients involved in heavy manual laboring. laboring
Pelvic Infection

OBJECTIVE: One of the most common causative microorganisms in pelvic inflammatory disease (PID) is the chlamydia trachomatis. In many cases chlamydia trachomatis infection has weak and nearly absent symptom, but it's endocervical infection usually disseminates into upper genital tract. In this infection tubal obstruction, infertility, tubal pregnancy, and recurrent pelvic infection has involved. In this study, we investigated the prevalance of chlamydia trochoma infections in symptomatic and asymptomatic women and its relation with Human Papilloma infection. METHODS: From Jan, 1999 to July, 2003, in St. Vincet's Hospital, The Catholic University of Korea, endocervial swabs were obtained in 3416 patients (1137 in Heath Promotion Center, 2226 in OPD) by Amplicor Chlamydia Trahomatis Kits (STD swab specimen collection transprt kits). Chlamydia trachomatis DNA was extracted and amplified by PCR assays to investigate the prevalence. Also in this study we investigated the prevalence of human papilloma virus by hybrid capture method. Women who visted Hospital were received routine gynecologic examination, history taking, and physical examination and information on potential risk factors was obtained by questionnaire. RESULTS: The prevalence rate of Chlamydia trachomatis in symptomatic women was 12.6% and there was a high peak prevalence among the early twenties (66%). The prevalence rate of Chlamydia in asymtomatic women was 8.2% but there was no peak in early twenties. In asymptomatic woman, asymptomatic chlamydia infection can be statistically anticipated by 1) Economic status, 2) Occupation status, 3) Alcohol intake, 4) History of Gynecologic disease, 5) History of STD. Women with chlamydia infection was 1.5 times greater risk of coincidal HPV infection and was statistically significant. CONCLUSION: The prevalence rate of chlamydia infection is higher than any other developed country, especially in asymptomatic women. Although symptoms are weak, the rate of prevalence and complications can be reduced by the screening of chlamydial infection.
Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Developed Countries ; DNA ; Fallopian Tube Diseases ; Female ; Genital Diseases, Female ; Humans* ; Infertility ; Korea ; Mass Screening ; Occupations ; Papilloma* ; Pelvic Infection ; Pelvic Inflammatory Disease ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Prevalence* ; Surveys and Questionnaire ; Risk Factors ; Specimen Handling

OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganism in pelvic inflammatory disease (PID). In this infection tubal obstruction, infertility, tubal pregnancy and recurrent pelvic infection has involved. Also, perinatal infection, spontaneous abortion and preterm labor of pregnant women increased in chlamydia infection. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis in symptomatic women. METHODS: From March, 2003 to March, 2004, in OB-Gyn development, endocervical swab were obtained in 218 patients (137 impatients of PID and 81 outpatients) by Amplicor Chlamydia Transfer Kits and Human papilloma virus kit. They were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. Also, in this study we investigated the prevalence of human papilloma virus and N. gonorrhea in the Chlamydia infection group. RESULTS: The prevalence rate of Chlamydia trachomatis was 27.5% (61/218) in pelvic inflammatory disease. As regarding the age distribution of Chlamydia trachomatis positive group was the high prevalence rate in twenties (52.8%). Chlamydia infection was related to the history of artificial abortion, oral contraception, occupation status, history of gynecologic disease (PID, Ectopic pregnancy). Women with chlamydial infection were 2.5 times greater risk of coincidal HPV infection and 2 times greater risk of coincidal N. gonorrhea infection and both were statistically significant. CONCLUSION: The prevalence rate of Chlamydia infection is higher than any other sexually transmitted disease and Chlamydia infection has serious complication on reproduction. It appears weak symptom and detection is difficult. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.
Abortion, Spontaneous ; Age Distribution ; Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Contraception ; Fallopian Tube Diseases ; Female ; Genital Diseases, Female ; Gonorrhea ; Humans ; Infertility ; Mass Screening ; Obstetric Labor, Premature ; Occupations ; Papilloma ; Pelvic Infection ; Pelvic Inflammatory Disease* ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Pregnant Women ; Prevalence ; Reproduction ; Sexually Transmitted Diseases

Actinomycosis, a rare disease entity in the upper genital tract, and caused by anaerobic bacteria, Actinomyces israelii, presents some difficulties in establishing a correct preoperative diagnosis. Pelvic actinomycosis has been reported more frequently in women with intrauterine device (IUD). Actinomycosis may be confused with malignancy and other inflammatory diseases due to its infiltrative nature and tendency to invade normal anatomic barriers. So, cervicovaginal smear is recommended for all women wearing IUDs, and actinomyosis should be suspected in such patients suffering pelvic infections. We experienced a case of pelvic and abdominal actionomycosis complicated by tuboovarian abscess in a 52 year-old woman wearing IUD and report it with a brief review of related literatures.
Abscess ; Actinomyces ; Actinomycosis* ; Bacteria, Anaerobic ; Diagnosis ; Female ; Humans ; Intrauterine Devices* ; Middle Aged ; Pelvic Infection ; Rare Diseases

Actinomycosis is a rare entity which presents some difficulties in establishing a correct preoperative diagnosis. Many actinomycotic pelvic infections in women are related to IUD use and the colonization rate appears to increase in accordance with the duration of IUD use. So, all women in IUD use are recommended to make cervicovaginal smear and pelvic infection associated with IUD use should be suspected to have actinomycoses. We report a case which presented painful mass on right upper and lower quadrant of abdomen of a 40-year-old women. We identified sulfur granules by histopathologic exam of surgically resected specimen. Eventually it proved to be pelvic and abdominal actinomycosis associated with the use of an intrauterine device. Because variable clinical pictures and infrequency of the disease make the diagnosis more difficult, increased alertness of clinicians and microbiologists to the presence of anaerobic organism as the cause of infection are needed to make an earlier and more correct diagnosis of actinomycoses and to further avoid any inappropriate treatment.
Abdomen ; Actinomycosis ; Adult ; Colon ; Diagnosis ; Female ; Humans ; Intrauterine Devices ; Pelvic Infection ; Pelvis ; Sulfur

Actinomycosis is a chronic suppurative and granulomatous disease. Actinomyces is a gram positive, anaerobic and non-acid fast bacterium. Many actinomycotic pelvic infection in women used intrauterine device(IUD) with long duration were reported, in contrast, others suggest that actinomycosis develop opportunistic infection irrespective of intrauterine device. One to ten percents of patients with acute pelvic inflammatory disease(PID) develop perihepatic inflammation and adhesion---the Fitz-Hugh-Curtis syndrome. Although in the past Neisseria gonorrhea was thought to be the only etiological agent, recent data indicate that chlamydia trachomatis produces the majority of cases. We have experienced the case of tubo-ovarian actinomycosis(case with IUD(Cu-T)) associated with Fitz-Hugh-Curtis syndrome in a 29years old woman, and reported that with a review of related literatures.
Actinomyces ; Actinomycosis* ; Chlamydia trachomatis ; Female ; Gonorrhea ; Humans ; Inflammation ; Intrauterine Devices ; Neisseria ; Opportunistic Infections ; Pelvic Infection

BACKGROUND: Perineal reconstruction following pelvic exenteration is a challenging area in plastic surgery. Its advantages include preventing complications by obliterating the pelvic dead space and minimizing the scar by using the previous abdominal incision and a vertical rectus abdominis musculocutaneous (VRAM) flap. However, only a few studies have compared the complications and the outcomes following pelvic exenteration between cases with and without a VRAM flap. In this study, we aimed to compare the complications and the outcomes following pelvic exenteration with or without VRAM flap coverage. METHODS: We retrospectively reviewed the cases of nine patients for whom transpelvic VRAM flaps were created following pelvic exenteration due to pelvic malignancy. The complications and outcomes in these patients were compared with those of another nine patients who did not undergo such reconstruction. RESULTS: Flap reconstruction was successful in eight cases, with minor complications such as wound infection and dehiscence. In all cases in the reconstructed group (n=9), structural integrity was maintained and major complications including bowel obstruction and infection were prevented by obliterating the pelvic dead space. In contrast, in the control group (n=9), peritonitis and bowel obstruction occurred in 1 case (11%). CONCLUSIONS: Despite the possibility of flap failure and minor complications, a VRAM flap can result in adequate perineal reconstruction to prevent major complications of pelvic exenteration.
Cicatrix ; Humans ; Myocutaneous Flap* ; Pelvic Exenteration* ; Peritonitis ; Rectus Abdominis* ; Retrospective Studies ; Surgery, Plastic ; Wound Infection

Objective: To investigate the causes and management of long-term persistent pelvic presacral space infection. Methods: Clinical data of 10 patients with persistent presacral infection admitted to the Cancer Hospital of Zhengzhou University from October 2015 to October 2020 were collected. Different surgical approaches were used to treat the presacral infection according to the patients' initial surgical procedures. Results: Among the 10 patients, there were 2 cases of presacral recurrent infection due to rectal leak after radiotherapy for cervical cancer, 3 cases of presacral recurrent infection due to rectal leak after radiotherapy for rectal cancer Dixons, and 5 cases of presacral recurrent infection of sinus tract after adjuvant radiotherapy for rectal cancer Miles. Of the 5 patients with leaky bowel, 4 had complete resection of the ruptured nonfunctional bowel and complete debridement of the presacral infection using an anterior transverse sacral incision with a large tipped omentum filling the presacral space; 1 had continuous drainage of the anal canal and complete debridement of the presacral infection using an anterior transverse sacral incision. 5 post-Miles patients all had debridement of the presacral infection using an anterior transverse sacral incision combined with an abdominal incision. The nine patients with healed presacral infection recovered from surgery in 26 to 210 days, with a median time of 55 days. Conclusions: Anterior sacral infections in patients with leaky gut are caused by residual bowel secretion of intestinal fluid into the anterior sacral space, and in post-Miles patients by residual anterior sacral foreign bodies. An anterior sacral caudal transverse arc incision combined with an abdominal incision is an effective surgical approach for complete debridement of anterior sacral recalcitrant infections.
Humans ; Reinfection ; Rectum/surgery* ; Rectal Neoplasms/surgery* ; Drainage ; Anal Canal/surgery* ; Pelvic Infection

Puerperal sepsis is one of the leading causes of maternal morbidity and mortality worldwide. Postpartum pelvic infections can cause various complications, including wound infections and necrotizing fasciitis. Several microorganisms are known to cause such infections; however, no study has reported on Staphylococcus caprae, a coagulase-negative staphylococcus that is isolated frequently from animals and infrequently from human specimens, as a causative agent. Here, we report a rare case of septic shock complicated by necrotizing fasciitis after a cesarean section. This is the first report of a human isolate of S. caprae in association with puerperal sepsis and necrotizing fasciitis.
Animals ; Cesarean Section ; Escherichia coli ; Escherichia ; Fasciitis, Necrotizing ; Female ; Goats ; Humans ; Mortality ; Pelvic Infection ; Postpartum Period ; Pregnancy ; Puerperal Infection ; Sepsis ; Shock, Septic ; Staphylococcus ; Wound Infection

Between June 1990 and May 1994, 350 laser conization and 200 LEEP were performed. Indications of conization were that directed biopsy specimen was proved CIN II, III or suggests possible microinvasion. In all the cases the procedures were carried out with the patients under local anesthesia. Excisional cone sections(6,600) were evaluated for lesion length,depth and margin status. Invasive cancer was found in 5(1.4%) women of laser group. Operative time was shorter LEEP group than laser group significantly. In laser group, 25(8.3%) women had bleeding that required treatment. One case(0.3%) of pelvic infection and 7 cases(2.3%) of cervical stenosis were observed. In LEEP group, 10(5.3%) women had bleeding, 3(1.6%) patients became cervical stenosis. The diameter of bumed tissue was 0.28mm in laser group and 0.25mm in LEEP group. Success rate were 97.4% in former and 96.3% in later. This study demontrated that CO2 laser conization and LEEP were effective methods for treating high grade cervical intraepithelial neoplasia and added benefit of preserving reproductive function and rule out invasive carcinoma.
Anesthesia, Local ; Biopsy ; Cervical Intraepithelial Neoplasia* ; Conization* ; Constriction, Pathologic ; Female ; Hemorrhage ; Humans ; Lasers, Gas* ; Operative Time ; Pelvic Infection