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					  Massive ascites as a presentation in a young woman with endometriosis: a
  case report.
  Sait KH.
  Fertil Steril. 2008 Nov;90(5):2015.e17-9. Epub 2008 Sep 7.

Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Saudi

OBJECTIVE: To report a case of endometriosis associated with massive ascites and
an elevated CA-125 level. DESIGN: Case report. SETTING: Tertiary care center.
PATIENT(S): A 26-year-old woman presented with massive ascites and an increased
CA-125 level suggestive of ovarian cancer. INTERVENTION(S): Ultrasonography,
laparotomy, and bilateral ovarian cystectomy and reconstruction. Endometriosis
was diagnosed postoperatively on the basis of histopathology. The patient received
6 months of treatment with a GnRH analogue. MAIN OUTCOME MEASURE(S):
Ultrasound examination 6 months after surgery to evaluate for ascites or recurrent
ovarian cysts. RESULT(S): Frozen sections obtained at laparotomy and ovarian
cystectomy ruled out a malignancy. The final histologic report was compatible with
a diagnosis of endometriosis. After 6 months of treatment with the GnRH analogue,
the patient experienced a progressive reduction of the ascitic fluid and full remission
after 2 years. CONCLUSION(S): Endometriosis associated with massive bloody
ascites is an unusual occurrence. This report draws attention to this condition as a
complication of endometriosis. For this reason, endometriosis should be included in
the differential diagnosis of reproductive-age women presenting with an apparent
ovarian malignancy.

PMID: 18778818 [PubMed - indexed for MEDLINE]
       Hysterectomy for benign conditions in a university hospital in Saudi Arabia.
       Sait K, Alkhattabi M, Boker A, Alhashemi J.
       Ann Saudi Med. 2008 Jul-Aug;28(4):282-6.

     Department of Obstetrics and Gynecology, King Abdulaziz University, Jeddah, Saudi Arabia.

     BACKGROUND AND OBJECTIVE: Hysterectomy is a common surgical procedure
     among women with a lifetime prevalence of 10%. The indications and complications
     of this procedure have not been previously reported from a teaching institution in
     Saudi Arabia. We examined the indications for hysterectomy and the surgical
     morbidity for women undergoing hysterectomy at a university hospital in Saudi
     Arabia. PATIENTS AND METHODS: We reviewed the records of women who
     underwent hysterectomies for benign gynecological conditions between January
     1990 and December 2002, at King Abdulaziz University Hospital (KAUH), Jeddah,
     Saudi Arabia, comparing patient characteristics, indications for hysterectomy and
     the rate of complications in women undergoing abdominal hysterectomy (AH)
     versus vaginal hysterectomy (VH). RESULTS: Of 251 women, 199 (79%) underwent
     AH and 52 (21%) underwent VH. An estimated blood loss of >/=500 mL occurred in
     104 patients (52.3%) in the AH group and in 20 patients (38.5%) in the VH group
     (difference not statistically significant). The most common indications for
     hysterectomy were uterine fibroids (n=107, 41.6%) and dysfunctional uterine
     bleeding (n=68, 27.1%). The most common indication for VH was uterine prolapse
     (n=45, 86.5%). The overall complication rates were 33.5%, 15.4% and 30.4% in
     women who underwent AH, VH and both, respectively. Intraoperative and
     postoperative complications occurred in 24 (9.7%) patients in the AH group and in
     51 patients in the VH group (20.3%). Postoperative infection occurred in 42/199
     (21.6%) in the AH group and 5/52 (9.6%) in the VH group (difference not
     statistically significant). CONCLUSIONS: We describe a large series of
     hysterectomies, which provides information for surgeons on the expected rate of
     complications following hysterectomy for benign conditions. We found that the rate
     of complications was not significantly higher than other centers internationally.

     PMID: 18596405 [PubMed - indexed for MEDLINE]

  Primitive neuroectodermal tumor of the ovary.
  Anfinan NM, Sait KH, Al-Maghrabi JA.
  Saudi Med J. 2008 Mar;29(3):444-6.

Department of Obstetrics & Gynecology, King Abdulaziz University Hospital, Jeddah, Kingdom
of Saudi Arabia.

A 31-year-old woman presented to King Abdulaziz University Hospital complaining
of an abdominal pain and a rapid increase in abdominal girth. An ultrasound and
MRI, revealed a huge cystic ovarian mass without ascites. Ovarian tumor markers
were all within normal range. Exploratory laparotomy showed huge right ovarian
mass with omental mass. Frozen section from the omentum showed metastatic
malignant neoplasm. Total abdominal hysterectomy was carried out with bilateral
salpingooophorectomy and omentectomy with residual tumor of less then one
centimeter. Final pathology assessment showed primitive neuroectodermal tumor
arising from the right ovary. She received post- operative chemotherapy. Four
months later she had recurrence and was given second line chemotherapy, but she
did not respond and died 15 months after the diagnosis due to obstructive

Pseudomyxoma Peritonei: Diagnosis and Management
Khalid H. Sait
The Journal of King Abdulaziz University - Medical Sciences, Vol 13, No 1 (2006)

Pseudomyxoma peritonei is a rare disease characterized by a large amount of mucinous ascites with
peritoneal and omental implants. The etiology of the disease remains unclear. Different histological
categories have been described: the benign, malignant, and the intermediate forms. It is commonly
diagnosed incidentally at laparotomy. Most investigators agree that radical surgical debulking and
appendectomy is the cornerstone of treatment, but the optimal management of the disease remains
controversial. The role of intraoperative and intraperitoneal chemotherapy has been evaluated by a
number of authors. The clinical outcomes vary widely between the different histological types and
treatment modalities.

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