Lipoma is the most common soft tissue tumor arising from yellow fat deposits. It presents as a mobile, lobular mass that is non-tender and has a characteristic "slip sign" where the mass can slip between the examiner's fingers. Lipomas most commonly occur as encapsulated soft tissue masses but can also be found in various locations throughout the body. While lipomas are generally benign and can be excised, certain histological subtypes or locations carry a higher risk of malignant transformation.
This document discusses necrotizing fasciitis and gas gangrene. It defines necrotizing fasciitis as a necrotizing soft tissue infection along fascial planes that can present with disproportionate pain and swelling. Risk factors include diabetes and immunosuppression. Treatment involves broad-spectrum antibiotics and urgent debridement. Gas gangrene is caused by Clostridium bacteria, often after trauma. It presents with pain, swelling and crepitus, and is treated with antibiotics and radical debridement to remove necrotic muscle. Imaging may show gas in tissues. Both conditions require prompt recognition and aggressive treatment to prevent mortality.
This document describes epidermoid cysts, which are the most common orbital neoplasms in children. They result from ectodermal tissue becoming embedded in bone sutures during development. Epidermoid cysts typically appear as soft, slowly enlarging masses near the superotemporal orbital margin. While usually painless, they can cause cosmetic issues or symptoms like proptosis and diplopia if large or located internally. The document then reports a case study of a 5-year-old girl with an epidermoid cyst that was surgically excised. Histopathology confirmed the diagnosis of an epidermoid cyst.
The document discusses abdominal wall hernias, including definitions, types, causes, symptoms, and treatments. It defines a hernia as a hole in the abdominal wall that allows internal structures to protrude outside. The main types discussed are inguinal, femoral, umbilical, and incisional hernias. Hernias develop due to weaknesses in the abdominal wall from factors like straining, injury, or surgery. Examination may reveal a bulge or pain that can be reduced. Treatment options include open or laparoscopic surgical repair, with mesh increasingly used to prevent recurrence.
The document summarizes key details about the inguinal canal and inguinal hernias. It describes the anatomy of the inguinal canal including its entrance, exit, roof, floor, and walls. It then discusses direct and indirect inguinal hernias, their causes, signs and symptoms, examination findings, and surgical repair techniques like Lichtenstein and Shouldice repairs. Femoral hernias are also briefly covered.
This document describes several different skin conditions:
- Lipoma is a benign fat cell tumor that can occur anywhere there is fat tissue, except the brain. Sebaceous cysts are retention cysts in sebaceous glands containing keratin. Furuncles are hair follicle infections caused by Staphylococcus aureus. Carbuncles are clusters of furuncles caused by S. aureus. Cellulitis is a spreading skin infection typically caused by streptococcus that presents with pain, fever and swelling. Squamous cell carcinoma is a malignant skin tumor arising from keratinocytes, usually occurring on sun exposed areas in elderly patients.
This document provides a detailed examination and classification of ulcers. It describes how to inspect an ulcer, including its size, shape, number, position, edge characteristics, floor, discharge, and surrounding area. It also covers how to palpate an ulcer, assessing tenderness, edge, base, depth, bleeding, and relation to deeper structures. A thorough examination can provide clues to diagnose specific ulcer types, such as tuberculosis, gummatous, or malignant ulcers.
Genital warts are caused by certain types of human papillomavirus (HPV) that infect skin and mucous membranes of the genital area. There are over 100 types of HPV that can cause genital warts. The warts may appear as small bumps or groups of bumps in the genital region and can be itchy or painful. Diagnosis is usually made by visual examination with biopsy needed if uncertain. Treatment focuses on freezing, burning, or cutting off visible warts although they may recur. Prevention through HPV vaccination is recommended.
Lipoma is the most common soft tissue tumor arising from yellow fat deposits. It presents as a mobile, lobular mass that is non-tender and has a characteristic "slip sign" where the mass can slip between the examiner's fingers. Lipomas most commonly occur as encapsulated soft tissue masses but can also be found in various locations throughout the body. While lipomas are generally benign and can be excised, certain histological subtypes or locations carry a higher risk of malignant transformation.
This document discusses necrotizing fasciitis and gas gangrene. It defines necrotizing fasciitis as a necrotizing soft tissue infection along fascial planes that can present with disproportionate pain and swelling. Risk factors include diabetes and immunosuppression. Treatment involves broad-spectrum antibiotics and urgent debridement. Gas gangrene is caused by Clostridium bacteria, often after trauma. It presents with pain, swelling and crepitus, and is treated with antibiotics and radical debridement to remove necrotic muscle. Imaging may show gas in tissues. Both conditions require prompt recognition and aggressive treatment to prevent mortality.
This document describes epidermoid cysts, which are the most common orbital neoplasms in children. They result from ectodermal tissue becoming embedded in bone sutures during development. Epidermoid cysts typically appear as soft, slowly enlarging masses near the superotemporal orbital margin. While usually painless, they can cause cosmetic issues or symptoms like proptosis and diplopia if large or located internally. The document then reports a case study of a 5-year-old girl with an epidermoid cyst that was surgically excised. Histopathology confirmed the diagnosis of an epidermoid cyst.
The document discusses abdominal wall hernias, including definitions, types, causes, symptoms, and treatments. It defines a hernia as a hole in the abdominal wall that allows internal structures to protrude outside. The main types discussed are inguinal, femoral, umbilical, and incisional hernias. Hernias develop due to weaknesses in the abdominal wall from factors like straining, injury, or surgery. Examination may reveal a bulge or pain that can be reduced. Treatment options include open or laparoscopic surgical repair, with mesh increasingly used to prevent recurrence.
The document summarizes key details about the inguinal canal and inguinal hernias. It describes the anatomy of the inguinal canal including its entrance, exit, roof, floor, and walls. It then discusses direct and indirect inguinal hernias, their causes, signs and symptoms, examination findings, and surgical repair techniques like Lichtenstein and Shouldice repairs. Femoral hernias are also briefly covered.
This document describes several different skin conditions:
- Lipoma is a benign fat cell tumor that can occur anywhere there is fat tissue, except the brain. Sebaceous cysts are retention cysts in sebaceous glands containing keratin. Furuncles are hair follicle infections caused by Staphylococcus aureus. Carbuncles are clusters of furuncles caused by S. aureus. Cellulitis is a spreading skin infection typically caused by streptococcus that presents with pain, fever and swelling. Squamous cell carcinoma is a malignant skin tumor arising from keratinocytes, usually occurring on sun exposed areas in elderly patients.
This document provides a detailed examination and classification of ulcers. It describes how to inspect an ulcer, including its size, shape, number, position, edge characteristics, floor, discharge, and surrounding area. It also covers how to palpate an ulcer, assessing tenderness, edge, base, depth, bleeding, and relation to deeper structures. A thorough examination can provide clues to diagnose specific ulcer types, such as tuberculosis, gummatous, or malignant ulcers.
Genital warts are caused by certain types of human papillomavirus (HPV) that infect skin and mucous membranes of the genital area. There are over 100 types of HPV that can cause genital warts. The warts may appear as small bumps or groups of bumps in the genital region and can be itchy or painful. Diagnosis is usually made by visual examination with biopsy needed if uncertain. Treatment focuses on freezing, burning, or cutting off visible warts although they may recur. Prevention through HPV vaccination is recommended.
This document discusses dermoid and epidermoid cysts. Dermoid cysts can occur in various locations including near the eyes, nose, chin, and chest. Midline dermoids often require CT or MRI before surgery as intracranial extension is found in about 36% of cases. Sebaceous or epidermoid cysts contain fatty secretions and are commonly found on the scalp or face, though they do not originate from sebaceous glands.
A thyroglossal duct cyst is a neck mass that develops from leftover tissue from when the thyroid gland forms during embryonic development. It is most common in preschool-aged children and adolescents. Diagnostic tests include physical examination, ultrasound, and fine needle aspiration to evaluate the mass and rule out thyroid abnormalities. Treatment involves antibiotics if infected or surgical removal (Sistrunk procedure) of the entire cyst and tract to prevent recurrence, which is performed under general anesthesia as an outpatient procedure. Complications can include infection or rare chance of malignancy.
The spleen normally lies under the diaphragm in the left upper abdomen and is not palpable unless it increases to three times its normal size. There are several methods to palpate an enlarged spleen including the classical, bimanual, hooking, and dipping methods. The size of splenomegaly can be classified as mild, moderate, or severe based on the distance of the spleen from the left costal margin. A palpable spleen will have a sharp edge, angular poles, and characteristics like moving with respiration.
A carbuncle is a cluster of boils caused by a Staphylococcus aureus infection entering hair follicles. It presents as a swollen, painful lump with pus-filled openings on the back of the neck, shoulders, or thighs. Carbuncles are deeper infections than single boils (furuncles) and can cause fever and general illness. Treatment involves antibiotics, incision and drainage of large lesions, and preventing further contamination. Complications may include sepsis if bacteria spread through the bloodstream. Noma (cancrum oris) is a rapidly progressing gangrenous infection of the mouth affecting malnourished children in developing countries. It is caused by a combination of malnutrition, poor
This document discusses different types of pigmented cellular nevi:
- Intradermal (intramucosal) nevi occur within the dermis or mucosa and appear as raised or flat dark lesions.
- Junctional nevi are located at the dermal-epidermal junction and appear as flat brown-black macules, most often on the hard palate or gingiva.
- Compound nevi exhibit characteristics of both intradermal and junctional nevi, with nevus cells in the dermis and basal epidermis.
- Blue nevi appear as dark blue papules or macules on the skin or hard palate, composed of pigment
This document discusses keloids, which are non-cancerous growths that form scar tissue beyond the boundaries of the original skin injury or wound. Keloids most commonly affect individuals with darker skin and tend to run in families. While the exact causes are unknown, keloids result from an overactive inflammatory response and abnormal collagen deposition during wound healing. Common symptoms include pain, itching, and restriction of motion, as well as cosmetic concerns. Treatment involves surgical excision followed by radiation therapy within 72 hours, as this combination has shown success with a low recurrence rate. The Oncology and Cancer Center at Nairobi Hospital administers keloid treatment using radiation doses measured in Grays over one to three sessions, starting
Mucoceles are benign cysts caused by mucus extravasation or retention from minor salivary glands. When located in the floor of the mouth, they are called ranulas. Ranulas present as smooth, blue, dome-shaped swellings that can enlarge and elevate the tongue. Treatment involves complete surgical excision of the cyst wall and sublingual gland to prevent recurrence, while preserving nearby nerves like the lingual nerve. Plunging ranulas extend behind the mylohyoid muscle into the neck.
Fournier's gangrene is a necrotizing fasciitis of the genital region that can be caused by various urogenital, anorectal, cutaneous or other infections. It is characterized by pain, swelling and skin necrosis, and can progress rapidly without treatment. The infection involves multiple types of bacteria and causes tissue death through vascular thrombosis. Aggressive surgical debridement and broad-spectrum antibiotics are needed to treat the infection and prevent high mortality rates.
This document discusses ulcers, including their definition, parts, classifications, investigations, and management. It defines an ulcer as a break in the skin or mucous membrane epithelium due to cell death. The key parts of an ulcer are the margin, edge, floor, and base. Ulcers can be classified clinically based on healing status, duration, or etiology. Investigations may include wound cultures, biopsies, and imaging. Management involves treating the underlying cause, wound cleaning, debridement, dressings, and therapies like vacuum-assisted closure or maggot debridement to promote healing.
Acute and chronic paronychia are inflammatory conditions of the fingers or toes. Acute paronychia involves a single digit and results from disruption of the nail fold barrier, presenting with rapid onset pain and inflammation. Treatment depends on severity but may include warm soaks, topical antibiotics, and opening any abscesses. Chronic paronychia involves multiple digits and results from irritant dermatitis. Treatment focuses on removing irritants and controlling inflammation with topical steroids or calcineurin inhibitors. Restoring the natural protective barrier can take weeks to months.
Surgery plays an important role in the treatment of breast cancer. The main goals of surgical treatment are complete removal of the primary tumor and determination of lymph node involvement. Mastectomy is recommended for large or multicentric tumors while breast-conserving surgery such as lumpectomy is preferred when possible. Sentinel lymph node biopsy is the standard method for staging axillary lymph nodes in clinically node-negative patients. Reconstruction options after mastectomy include implants, TRAM flaps, and latissimus dorsi flaps. Overall, mastectomy and breast-conserving surgery have been shown to have equivalent survival outcomes when combined with radiation or chemotherapy.
Papillary thyroid cancer is the most common type of thyroid cancer, accounting for 85% of cases. It is more common in females than males and often spreads to lymph nodes in the neck. Follicular thyroid cancer is the second most common type, making up around 17% of cases. Both types are generally treated with total thyroidectomy followed by radioactive iodine therapy and thyroid hormone suppression treatment. Long term surveillance of thyroid cancer involves monitoring thyroglobulin levels via blood tests and imaging scans to detect any recurrence or metastasis.
This document provides an overview of various types of non-specific ulcers, including their causes, characteristics, and treatments. It discusses ulcers caused by trauma, arterial issues, venous issues, pressure, infection, tropical conditions, frostbite, hypertension, diabetes, mycobacteria, cancer, and more. For most ulcer types, it outlines key features like location, appearance, complications, investigations needed, and management approaches involving wound care, antibiotics, surgery, or other therapies.
Amoebic colitis is an infection of the colon caused by the Entamoeba histolytica parasite. It often causes flask-shaped ulcers in the ascending colon, sigmoid colon, or rectum. The ulcers form as small microulcerations that enlarge over time. Numerous trophozoites can be seen at the ulcer margins. Large ulcers show extensive necrosis with an inflamed, thickened intestinal wall. Complications can include liver abscess, effusions in the pleura or pericardium, or hepatobronchial fistulas. Patients experience abdominal pain, cramping, and bloody diarrhea. Diagnosis involves identifying E. histolytica trophozoites on a PAS stain of
Pleomorphic adenoma is the most common benign tumor of the parotid gland. It consists of both epithelial cells and spindle-shaped mesenchymal cells within an abundant mucoid matrix. On pathology, it displays well-differentiated epithelial cells and spindle/stellate cells in a pleomorphic stroma with mucoid material. The tumor presents as a slow-growing, painless swelling of the parotid gland and is diagnosed by FNAC. The treatment is complete surgical excision via superficial parotidectomy while preserving the facial nerve. Recurrence is possible if there are pseudopods left behind or inadequate margins. Malignant transformation may occur in long-standing tumors.
This document discusses various aspects of bleeding control, including the importance of homeostasis, types and causes of bleeding, and methods for controlling bleeding. It covers the body's natural barriers against hemorrhage as well as its response to injury, including local vasoconstriction, platelet aggregation, and coagulation. It describes different types of hemorrhage and the signs of bleeding. Finally, it outlines various surgical and medical methods for achieving hemostasis, such as mechanical techniques like ligation and suturing, thermal methods like electrocautery and laser surgery, and chemical agents that promote coagulation.
Groin swelling is one of the commonest problem in general surgical practice. A groin swelling is always considered to be synonymous with a hernia. However this does not always hold true. there are a variety of other causes which present as an groin swelling.Awareness of the diferential diagnosis is therefore essential for aproper diagnosis thus preventing mismanagement. The presentation gives abroad outline of the various conditions depending upon the various areas of the groin from which the swelling arises.
Hemangioma is a benign vascular endothelial tumor that is common in girls. It grows rapidly in the first year and 70% involute by 7 years. Hemangiomas can be capillary or cavernous. Capillary hemangiomas appear as strawberry-like lesions and usually resolve by age 7, while cavernous hemangiomas appear bluish and may grow larger. Treatment depends on the type and location but may include corticosteroids, laser therapy, or surgery.
This document discusses lipomas, which are benign soft tissue tumors composed of adipose tissue enclosed in connective tissue. It covers the epidemiology, causes, classification, clinical features, diagnosis, complications and treatment of lipomas. Lipomas most commonly occur in adults aged 40-60 and can be removed surgically, usually via simple excision, for cosmetic reasons or if the diagnosis is uncertain. While generally benign, liposarcomas can rarely develop with similar clinical features and require complete excision and histological examination.
This document discusses different types of incisions used in breast surgery for various conditions. The most common incisions are the inframammary and peri-areolar incisions. The inframammary incision is made at the breast crease and has benefits like good visualization, lower risk of breastfeeding issues, and concealed scarring. The peri-areolar incision is made around the nipple and allows access to internal breast tissue but can increase risk of infection and difficulties with breastfeeding. Incisions are also discussed for treating breast abscesses, removing tumors, and for breast augmentation procedures.
A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...ijtsrd
Uterine fibroids are a major cause of morbidity in women of reproductive age. Hence it is important to evaluate the occurrence of fibroid. An observational retrospective study was carried out in Obstetric and Gynecology Department over a period of 2 months. Each of the cases was scrutinized for sociodemographic, clinical profile and other necessary information. In this study, Fibroid was found to be predominant in premenopausal women. .Parity and number of abortions had no much significance with fibroid diagnosed. The primary management of obese patients were found as weight reduction and diet control. Hysterectomy was done based on large fibroid size. Anju Mam Thomas | Blessy Rachal Boban | Jiya Ann Mathew "A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Tertiary Care Hospital" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd20311.pdf
Paper URL: https://www.ijtsrd.com/pharmacy/pharmacy-practice/20311/a-retrospective-study-on-evaluation-of-patients-with-uterine-fibroid-in-a-tertiary-care-hospital/anju-mam-thomas
This document discusses dermoid and epidermoid cysts. Dermoid cysts can occur in various locations including near the eyes, nose, chin, and chest. Midline dermoids often require CT or MRI before surgery as intracranial extension is found in about 36% of cases. Sebaceous or epidermoid cysts contain fatty secretions and are commonly found on the scalp or face, though they do not originate from sebaceous glands.
A thyroglossal duct cyst is a neck mass that develops from leftover tissue from when the thyroid gland forms during embryonic development. It is most common in preschool-aged children and adolescents. Diagnostic tests include physical examination, ultrasound, and fine needle aspiration to evaluate the mass and rule out thyroid abnormalities. Treatment involves antibiotics if infected or surgical removal (Sistrunk procedure) of the entire cyst and tract to prevent recurrence, which is performed under general anesthesia as an outpatient procedure. Complications can include infection or rare chance of malignancy.
The spleen normally lies under the diaphragm in the left upper abdomen and is not palpable unless it increases to three times its normal size. There are several methods to palpate an enlarged spleen including the classical, bimanual, hooking, and dipping methods. The size of splenomegaly can be classified as mild, moderate, or severe based on the distance of the spleen from the left costal margin. A palpable spleen will have a sharp edge, angular poles, and characteristics like moving with respiration.
A carbuncle is a cluster of boils caused by a Staphylococcus aureus infection entering hair follicles. It presents as a swollen, painful lump with pus-filled openings on the back of the neck, shoulders, or thighs. Carbuncles are deeper infections than single boils (furuncles) and can cause fever and general illness. Treatment involves antibiotics, incision and drainage of large lesions, and preventing further contamination. Complications may include sepsis if bacteria spread through the bloodstream. Noma (cancrum oris) is a rapidly progressing gangrenous infection of the mouth affecting malnourished children in developing countries. It is caused by a combination of malnutrition, poor
This document discusses different types of pigmented cellular nevi:
- Intradermal (intramucosal) nevi occur within the dermis or mucosa and appear as raised or flat dark lesions.
- Junctional nevi are located at the dermal-epidermal junction and appear as flat brown-black macules, most often on the hard palate or gingiva.
- Compound nevi exhibit characteristics of both intradermal and junctional nevi, with nevus cells in the dermis and basal epidermis.
- Blue nevi appear as dark blue papules or macules on the skin or hard palate, composed of pigment
This document discusses keloids, which are non-cancerous growths that form scar tissue beyond the boundaries of the original skin injury or wound. Keloids most commonly affect individuals with darker skin and tend to run in families. While the exact causes are unknown, keloids result from an overactive inflammatory response and abnormal collagen deposition during wound healing. Common symptoms include pain, itching, and restriction of motion, as well as cosmetic concerns. Treatment involves surgical excision followed by radiation therapy within 72 hours, as this combination has shown success with a low recurrence rate. The Oncology and Cancer Center at Nairobi Hospital administers keloid treatment using radiation doses measured in Grays over one to three sessions, starting
Mucoceles are benign cysts caused by mucus extravasation or retention from minor salivary glands. When located in the floor of the mouth, they are called ranulas. Ranulas present as smooth, blue, dome-shaped swellings that can enlarge and elevate the tongue. Treatment involves complete surgical excision of the cyst wall and sublingual gland to prevent recurrence, while preserving nearby nerves like the lingual nerve. Plunging ranulas extend behind the mylohyoid muscle into the neck.
Fournier's gangrene is a necrotizing fasciitis of the genital region that can be caused by various urogenital, anorectal, cutaneous or other infections. It is characterized by pain, swelling and skin necrosis, and can progress rapidly without treatment. The infection involves multiple types of bacteria and causes tissue death through vascular thrombosis. Aggressive surgical debridement and broad-spectrum antibiotics are needed to treat the infection and prevent high mortality rates.
This document discusses ulcers, including their definition, parts, classifications, investigations, and management. It defines an ulcer as a break in the skin or mucous membrane epithelium due to cell death. The key parts of an ulcer are the margin, edge, floor, and base. Ulcers can be classified clinically based on healing status, duration, or etiology. Investigations may include wound cultures, biopsies, and imaging. Management involves treating the underlying cause, wound cleaning, debridement, dressings, and therapies like vacuum-assisted closure or maggot debridement to promote healing.
Acute and chronic paronychia are inflammatory conditions of the fingers or toes. Acute paronychia involves a single digit and results from disruption of the nail fold barrier, presenting with rapid onset pain and inflammation. Treatment depends on severity but may include warm soaks, topical antibiotics, and opening any abscesses. Chronic paronychia involves multiple digits and results from irritant dermatitis. Treatment focuses on removing irritants and controlling inflammation with topical steroids or calcineurin inhibitors. Restoring the natural protective barrier can take weeks to months.
Surgery plays an important role in the treatment of breast cancer. The main goals of surgical treatment are complete removal of the primary tumor and determination of lymph node involvement. Mastectomy is recommended for large or multicentric tumors while breast-conserving surgery such as lumpectomy is preferred when possible. Sentinel lymph node biopsy is the standard method for staging axillary lymph nodes in clinically node-negative patients. Reconstruction options after mastectomy include implants, TRAM flaps, and latissimus dorsi flaps. Overall, mastectomy and breast-conserving surgery have been shown to have equivalent survival outcomes when combined with radiation or chemotherapy.
Papillary thyroid cancer is the most common type of thyroid cancer, accounting for 85% of cases. It is more common in females than males and often spreads to lymph nodes in the neck. Follicular thyroid cancer is the second most common type, making up around 17% of cases. Both types are generally treated with total thyroidectomy followed by radioactive iodine therapy and thyroid hormone suppression treatment. Long term surveillance of thyroid cancer involves monitoring thyroglobulin levels via blood tests and imaging scans to detect any recurrence or metastasis.
This document provides an overview of various types of non-specific ulcers, including their causes, characteristics, and treatments. It discusses ulcers caused by trauma, arterial issues, venous issues, pressure, infection, tropical conditions, frostbite, hypertension, diabetes, mycobacteria, cancer, and more. For most ulcer types, it outlines key features like location, appearance, complications, investigations needed, and management approaches involving wound care, antibiotics, surgery, or other therapies.
Amoebic colitis is an infection of the colon caused by the Entamoeba histolytica parasite. It often causes flask-shaped ulcers in the ascending colon, sigmoid colon, or rectum. The ulcers form as small microulcerations that enlarge over time. Numerous trophozoites can be seen at the ulcer margins. Large ulcers show extensive necrosis with an inflamed, thickened intestinal wall. Complications can include liver abscess, effusions in the pleura or pericardium, or hepatobronchial fistulas. Patients experience abdominal pain, cramping, and bloody diarrhea. Diagnosis involves identifying E. histolytica trophozoites on a PAS stain of
Pleomorphic adenoma is the most common benign tumor of the parotid gland. It consists of both epithelial cells and spindle-shaped mesenchymal cells within an abundant mucoid matrix. On pathology, it displays well-differentiated epithelial cells and spindle/stellate cells in a pleomorphic stroma with mucoid material. The tumor presents as a slow-growing, painless swelling of the parotid gland and is diagnosed by FNAC. The treatment is complete surgical excision via superficial parotidectomy while preserving the facial nerve. Recurrence is possible if there are pseudopods left behind or inadequate margins. Malignant transformation may occur in long-standing tumors.
This document discusses various aspects of bleeding control, including the importance of homeostasis, types and causes of bleeding, and methods for controlling bleeding. It covers the body's natural barriers against hemorrhage as well as its response to injury, including local vasoconstriction, platelet aggregation, and coagulation. It describes different types of hemorrhage and the signs of bleeding. Finally, it outlines various surgical and medical methods for achieving hemostasis, such as mechanical techniques like ligation and suturing, thermal methods like electrocautery and laser surgery, and chemical agents that promote coagulation.
Groin swelling is one of the commonest problem in general surgical practice. A groin swelling is always considered to be synonymous with a hernia. However this does not always hold true. there are a variety of other causes which present as an groin swelling.Awareness of the diferential diagnosis is therefore essential for aproper diagnosis thus preventing mismanagement. The presentation gives abroad outline of the various conditions depending upon the various areas of the groin from which the swelling arises.
Hemangioma is a benign vascular endothelial tumor that is common in girls. It grows rapidly in the first year and 70% involute by 7 years. Hemangiomas can be capillary or cavernous. Capillary hemangiomas appear as strawberry-like lesions and usually resolve by age 7, while cavernous hemangiomas appear bluish and may grow larger. Treatment depends on the type and location but may include corticosteroids, laser therapy, or surgery.
This document discusses lipomas, which are benign soft tissue tumors composed of adipose tissue enclosed in connective tissue. It covers the epidemiology, causes, classification, clinical features, diagnosis, complications and treatment of lipomas. Lipomas most commonly occur in adults aged 40-60 and can be removed surgically, usually via simple excision, for cosmetic reasons or if the diagnosis is uncertain. While generally benign, liposarcomas can rarely develop with similar clinical features and require complete excision and histological examination.
This document discusses different types of incisions used in breast surgery for various conditions. The most common incisions are the inframammary and peri-areolar incisions. The inframammary incision is made at the breast crease and has benefits like good visualization, lower risk of breastfeeding issues, and concealed scarring. The peri-areolar incision is made around the nipple and allows access to internal breast tissue but can increase risk of infection and difficulties with breastfeeding. Incisions are also discussed for treating breast abscesses, removing tumors, and for breast augmentation procedures.
A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Ter...ijtsrd
Uterine fibroids are a major cause of morbidity in women of reproductive age. Hence it is important to evaluate the occurrence of fibroid. An observational retrospective study was carried out in Obstetric and Gynecology Department over a period of 2 months. Each of the cases was scrutinized for sociodemographic, clinical profile and other necessary information. In this study, Fibroid was found to be predominant in premenopausal women. .Parity and number of abortions had no much significance with fibroid diagnosed. The primary management of obese patients were found as weight reduction and diet control. Hysterectomy was done based on large fibroid size. Anju Mam Thomas | Blessy Rachal Boban | Jiya Ann Mathew "A Retrospective Study on Evaluation of Patients with Uterine Fibroid in a Tertiary Care Hospital" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd20311.pdf
Paper URL: https://www.ijtsrd.com/pharmacy/pharmacy-practice/20311/a-retrospective-study-on-evaluation-of-patients-with-uterine-fibroid-in-a-tertiary-care-hospital/anju-mam-thomas
A Case of Abdominal Pregnancy, Primary vs Secondary – Radiological Workupiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Laparoscopy is useful for diagnosing various gynecologic disorders that cause chronic pelvic pain, including endometriosis, adhesions, ovarian cysts, and pelvic inflammatory disease. It allows for direct visualization of the pelvic organs and structures. While laparoscopy may not find a cause in some cases, abnormalities are detected through laparoscopy in approximately 60% of patients who have undergone other diagnostic evaluations. Laparoscopy is also used therapeutically to treat conditions like ectopic pregnancies and tubo-ovarian abscesses.
REPRODUCTIVE DISORDERS OF SIMPSON, FILAMERshenell delfin
The document discusses several topics related to women's reproductive health including gynecological exams, infertility, abortion, mastitis, breast cancer, cervical cancer, sexually transmitted diseases, and associated nursing diagnoses. It provides information on anatomy, etiology, signs and symptoms, diagnostic testing, treatment options, and nursing care for each topic. Risk factors, stages of disease, and management strategies are described for various conditions.
The document discusses breast anatomy, benign breast diseases, and risk factors for breast cancer. Some key points:
- Breast tissue is composed of lobules that drain into ducts leading to the nipple. Lymphatic drainage is primarily to axillary lymph nodes.
- The most common benign breast condition is fibrocystic changes, which causes breast tenderness and nodularity.
- Studies have found that women with benign breast disease involving atypical hyperplasia have a 2-5x increased risk of developing breast cancer later in life compared to women without these histologic findings. Early detection of breast abnormalities can improve breast cancer prognosis.
This document discusses benign breast diseases. It begins with an introduction that defines benign breast diseases as a heterogeneous group of lesions including developmental abnormalities, inflammatory lesions, epithelial and stromal proliferations, and neoplasms. It then summarizes some of the most common benign lesions seen in clinical practice and discusses their relationship to developing subsequent breast cancer. The document provides detailed information on the classification, diagnosis, and management of various benign breast conditions.
This document discusses the management of infertility in women with endometriosis. It covers topics such as the relationship between endometriosis and infertility, guidelines for treatment, the pathophysiology of endometriosis-related infertility, diagnosing endometriosis, medical and surgical treatment options, assisted reproduction techniques for endometriosis patients, and specific considerations for deep endometriosis, endometriomas, and unexplained infertility. Treatment aims to relieve symptoms, remove or destroy endometrial lesions, and potentially improve fertility outcomes through methods like laparoscopic surgery, hormonal therapies, IUI, and IVF. However, the evidence on most effective approaches is still limited.
This study examined the usefulness of triple assessment (clinical examination, radiology, and fine needle aspiration cytology) in evaluating lumpy breasts in peri-menopausal women. 63 women aged 35-45 with lumpy breasts underwent clinical exams, ultrasound or mammography, FNAC if possible, and excision biopsy. Histopathology found 33 cases of fibrocystic changes, 21 fibroadenomas, and 4 malignancies. Clinical diagnosis agreed poorly with histology, while radiology and FNAC agreed reasonably well, particularly for diagnosing malignancy. The study found triple assessment useful for evaluating lumpy breasts, with radiology and FNAC providing better diagnostic accuracy than clinical exam alone.
Recent trends in the mnagement of fibrioddrmcbansal
This document discusses recent advances in fibroid management. It summarizes that fibroids are benign tumors arising from the uterus that can be single or multiple. Recent research shows specific genetic mutations are associated with fibroids. Treatment options discussed include medical management using drugs like NSAIDs, IUDs, and danazol, as well as surgical options like myomectomy, hysterectomy, and newer minimally invasive procedures like uterine artery embolization and radiofrequency ablation.
The document discusses breast examination techniques and evaluation of breast masses. It describes how to perform a breast exam and evaluate for changes. Common benign breast conditions like fibrocystic changes and risk factors for breast cancer are outlined. The document recommends that any suspicious breast mass initially undergo mammography or ultrasound and be biopsied, as physical exam alone cannot reliably determine if a mass is benign or malignant.
Treatment of breast cancer by chemotherapy AsifaKanwal1
This document discusses the treatment of breast cancer using chemotherapy. It begins with an introduction to breast cancer, its causes, risk factors, signs and symptoms, diagnosis, and general treatment options. It then focuses on chemotherapy as a treatment, describing the different types of chemotherapy drugs used to treat breast cancer like doxorubicin, cyclophosphamide, fluorouracil, and epirubicin. It discusses how these drugs work and their common side effects. The document provides details on chemotherapy regimens and administration methods like intravenous or oral routes. Overall, it provides a comprehensive overview of chemotherapy as a treatment for breast cancer.
Asymptomatic Uterine Perforation in a Term Pregnancy: A Case Report.iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document compares calcification specificity in digital mammography using soft-copy display versus screen-film mammography. Breast cancer is the most common cancer in women. Digital mammography offers advantages over screen-film mammography like enhanced resolution and contrast. The study aims to compare the specificity of detecting microcalcifications, which can indicate early breast cancer, between the two imaging methods. Sixty female patients undergoing mammography were divided into groups for either screen-film or soft-copy digital mammography. Patient data and mammogram images were analyzed using statistical and imaging software to compare detection of microcalcifications between the methods.
A lecture on endometrial hyperplasia and carcinoma, exploring the etiology, clinical features, types, investigations, management and treatment options and prognosis.
This was presented to undergraduate medical students at Livingstone Central Teaching Hospital, Livingstone, Zambia, department of Obstetrics and Gynecology by Nghitukuhamba T.E Kalipi (final year student) Cavendish University Zambia, School of Medicine.
The document provides information about the International Gynecologic Cancer Society (IGCS):
- It was founded in 1986 and has over 1500 multidisciplinary members from over 80 countries.
- Its mission is to promote women's health related to gynecologic cancers through research, treatment standards, and education.
- It publishes the International Journal of Gynecological Cancer and holds biennial conferences rotating between regions of the world.
Endometrial cancer in a woman undergoing hysteroscopy for recurrent ivf failurecare women scentre
An unsuspected endometrial cancer was found in a 38-year-old woman undergoing hysteroscopy due to repeated failures of in vitro fertilization. The hysteroscopy revealed a small polyp, which was biopsied and found to be endometrial atypia. Further testing showed it was actually endometrial cancer. This case highlights that endometrial cancer can potentially be found in young women with recurrent IVF failure undergoing hysteroscopy. It also raises questions about whether undetected cancers could impact fertility treatment outcomes.
The document summarizes key milestones and advances in assisted reproductive technology (ART) from the 1970s to present day. Some of the major developments include:
- The first "test tube baby", Louise Brown, was born in 1978 using in vitro fertilization.
- Techniques like intracytoplasmic sperm injection (ICSI) and cryopreservation in the 1980s and 1990s improved fertility treatment options.
- New methods to select embryos with the highest implantation potential include preimplantation genetic screening, metabolomic profiling, and time-lapse imaging to observe development.
- Fertility preservation options for cancer patients now include egg, embryo and ovarian tissue freezing with some successful ovarian transplants reported
Surgical Management of Uterine AbnormalityUlun Uluğ
This document discusses the surgical management of uterine abnormalities. It begins by defining congenital genital abnormalities and Mullerian anomalies. It then provides classifications for uterine anomalies and discusses their prevalence. Various uterine anomalies are described in more detail, including their associated symptoms, prevalence, and effects on pregnancy outcomes. The document discusses diagnostic challenges and various treatment approaches for different uterine anomalies, particularly for septate uteri. It concludes that management must be individualized based on each patient's anatomy and clinical situation.
Cervical cancer is the third most common cancer among Malaysian women. It is caused by certain strains of the human papillomavirus (HPV) which can be contracted through sexual activity. Risk factors include early sexual initiation, multiple partners, smoking, and a weak immune system. Symptoms may include abnormal bleeding or discharge. Screening tests like Pap smears can detect pre-cancerous changes, while exams and biopsies confirm cancer. Treatment options depend on stage and severity but may include surgery, radiation, and chemotherapy, with the goal of curing early-stage cancer or relieving symptoms of later-stage cancer. Regular screening and safe sexual practices can help prevent cervical cancer.
Similar to Diagnostic Imaging in Uterine fibroids (20)
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Communicating effectively and consistently with students can help them feel at ease during their learning experience and provide the instructor with a communication trail to track the course's progress. This workshop will take you through constructing an engaging course container to facilitate effective communication.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
2. What are Uterine Fibroids?
Uterine fibroids, also called leiomyomas or myomas are benign tumors made of smooth muscle tissue arising from the
myometrium in the uterus
Fibroids are not associated with an increase risk of uterine cancer however some uterine fibroids can be found to be
cancerous
https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288 https://www.womenshealth.gov/a-z-topics/uterine-fibroids
3. Three major types of uterine fibroids
1. Subserosal : project outside of uterus
(most common)
2. Intramural : grow within uterine wall
(second most common)
3. Submucosal : bulge into uterine cavity
(least common)
Some submucosal or subserosal fibroids may
be pedunculated (having a stalk)
https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/fibroids-and-
fertility/
4. Symptoms
Four symptoms categories:
1. Heavy, or prolonged vaginal bleeding
2. Pelvic pain, including painful menses
3. Bulk symptoms
○ abdominal protrusion
○ bowel or bladder dysfunction
○ early satiety
4. Reproductive dysfunction
○ infertility or recurrent pregnancy loss
Many women who have fibroids don't have any symptoms
In those that do, symptoms can be influenced by the location, size and number of fibroids.
https://www-uptodate-com.york.ezproxy.cuny.edu/contents/uterine-fibroids-leiomyomas-treatment-overview?search=uterine%20fibroid&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
5. What causes uterine fibroids?
Research has not identified cause,
however there are known links with
the following:
●Hormones levels ( estrogen and
progesterone levels)
○ growth is dependent on estrogen and progesterone
●Genetic component
● Environmental factors
Office on Women’s Health. (2018, March 16). _Uterine fibroids._Retrieved June 18, 2018, from https://www.womenshealth.gov/a-z-topics/uterine-fibroids
6. Risk factors for uterine fibroids
● Age: 30s and 40s up until menopause; fibroids shrink in menopause
● Weight: overweight or obese women
● Diet: High intake in processed red meat, alcohol, and soybean milk, low vitamin D intake
● Family history: Having a family member with fibroids increases your risk
● Ethnic origin: African-American women are more likely to develop fibroids than Caucasian women
https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
Setchell, K. Soy isoflavones — benefits and risks from nature’s selective estrogen receptor modulators (SERM). J Am Coll Nutr. 2001;20(5 Suppl):354S-362S.
Martin CL, Huber LR, Thompson ME, Racine EF. Serum micronutrient concentrations and risk of uterine fibroids. J Womens Health (Larchmt). 2011;20(6):915-922.
7. Diagnostic Imaging
1. Primary Imaging: Ultrasound (transabdominal, transvaginal)
● Hysterosonography or Sonohysterogram
1. Secondary Imaging: MRI
2. Other imaging: X-ray, CT Scan
● Hysterosalpingography (Procedure using x-ray imaging with contrast)
Woo J, & Scott R.K. (2020). Leiomyoma of the uterus (fibroidtumor). PapadakisM.A., & McPhee S.J.,& Rabow M.W.(Eds.), Current Medical Diagnosis and Treatment 2020. McGraw-Hill. https://accessmedicine-mhmedical-
com.york.ezproxy.cuny.edu/content.aspx?bookid=2683§ionid=225051071
8.
9. Transvaginal VS Transabdominal Ultrasound
● Transabdominal providers a panoramic view of abdomen and pelvis
● Transvaginal provides a more focused thus limited view “zoomed in”
● Consideration: TVU method requires placing a probe into the vagina which is more invasive for the patient
Case courtesy of Assoc Prof Craig Hacking, Radiopaedia.org, rID: 43471
Transabdominal Transvaginal
10. Presentation of Leiomyoma ultrasound:
● Usually hypoechoic (darker), but can be isoechoic (normal) or hyperechoic (lighter) as well compared to normal myometrium
● echogenic foci with shadowing indicates calcification
● cystic areas of necrosis or degeneration may be seen
● Venetian blind artifact may be seen but edge shadowing +/- dense posterior shadowing from calcification is also typically seen
https://radiopaedia.org/articles/uterine-leiomyoma?lang=us
17. Hysterosonography
Water is inserted into the uterus for
better visualization during US
When would you use?
● Indicated for better visualization of
submucosal fibroids
https://www.med.unc.edu/obgyn/migs/our-services/unc-fibroid-center/
Also called sonohysterogram or hydrosonogram
19. X-Ray of calcified uterine fibroid
Case courtesy of Dr Vikas Shah, Radiopaedia.org, rID: 49719
Calcifications often have patchy “popcorn”
appearance
20. Calcified Fibroid on CT Scan
http://www.lumen.luc.edu/lumen/meded/Radio/curriculum/OBGYN/Fibroids1.htm
21. General Treatment Considerations
Asymptomatic patients with no fertility considerations may not warrant treatment
Hysteroscopicfibroidresectionor radiofrequency ablation
● Outpatient, rapid recovery, virtually no risk of future uterine rupture during pregnancy
● Only works for mucosal fibroids
SymptomManagementwithPharmacologytherapy(Goodoptionsfor non-mucosalfibroids)
● Estrogen-Progesteron Contraceptives (OCP, vaginal ring, transdermal patch)
○ Pt must be appropriate candidate for estrogen use
● Progesteron-only contraceptives: Mirena IUD, Nexplanon arm implant
● Transexamic Acid: Take while on menses
● Gonadotropin Releasing Hormone Antagonist: Orilissa(Elagolix)
● Gonadotropin Releasing Hormone Agonist
OtherSurgicalProcedureOptions
● Uterine artery embolization **Interventional
● MRI guided ultrasound ablation **Interventional
● Hysterectomy
○ Extreme consideration for non-menopausal women
26. Summary
Who is most at risk: premenopausal women, in 30’s-40’s, more common in black women than Caucasian
Commonsymptoms: heavy menstrual bleeding, pelvic pain, possible anemia from prolonged bleeding
Goldstandarddiagnostic: Ultrasonography is the standard confirmatory test because it can easily and
inexpensively differentiate a fibroid from a pregnant uterus or an adnexal mass
Treatments are symptomand fibroid location/size-based
● Important to remember there are minimally invasive treatments that are safe for future pregnancy, with virtually no
risk for uterine rupture in subsequent pregnancy
Goal outcomes: Reduction of symptoms and increased fertility if goal
https://www.aafp.org/afp/2017/0115/p100.html#afp20170115p100-b7
27. Resources
● Stewart, E. A., Cookson, C. L., Gandolfo, R. A., & Schulzeath, R. (2017). Epidemiology of uterine fibroids: A systematic
review. BJOG: An International Journal of Obstetrics & Gynecology, 124(10), 1501–1512. Retrieved July 30, 2018,
from https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.14640
● Pavone, D., Clemenza, S., Sorbi, F., Fambrini, M., & Petraglia, F. (2018). Epidemiology and risk factors of uterine
fibroids. Best Practice & Research Clinical Obstetrics & Gynecology, 46, 3–11. Retrieved July 30, 2018,
from https://www.sciencedirect.com/science/article/pii/S1521693417301372?via%3Dihub
● Emma Giuliani, Sawsan As‐Sanie, Erica E. Marsh, Epidemiology and management of uterine fibroids, International
Journal of Gynecology & Obstetrics, 10.1002/ijgo.13102, 149, 1, (3-9), (2020)
● Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015 Apr 23;372(17):1646-55. doi:
10.1056/NEJMcp1411029. PMID: 25901428.
● Mayo Foundation for Medical Education and Research (MFMER). (2019, December 10). Uterine fibroids - Symptoms and
causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-
20354288
● NCH Healthcare System. (2019, October 12). Uterine fibroids. Uterine Fibroids.
https://www.nchmd.org/education/mayo-health-library/details/CON-20198832
● U.S. Department of Health and Human Services: Office on Women’s Health. (2019, April 1). Uterine fibroids |
Womenshealth.gov. Womenshealth.Gov. https://www.womenshealth.gov/a-z-topics/uterine-
fibroids#:%7E:text=Rarely%20(less%20than%20one%20in,of%20developing%20a%20cancerous%20fibroid
28. Resources
● Stewart, E. A. (2015). Uterine fibroids. New England Journal of Medicine, 372, 1646–1655. Retrieved October 25,
2018, from https://www.nejm.org/doi/full/10.1056/NEJMcp1411029?page=&sort=oldest
● AAAHC (Accreditation Association for Ambulatory Health Care). (2020, September 10). Fibroids: What are Uterine
Fibroids? USA Fibroid Centers. https://www.usafibroidcenters.com/uterine-fibroids/
● Azura Vascular Care. (2018, November 28). Understanding Uterine Fibroid Causes, Risk Factors and Treatment
Options. https://www.azuravascularcare.com/infoufe/understanding-uterine-fibroid-causes-risk-factors-treatment-
options/
● Practice Committee of the American Society for Reproductive Medicine, Society of Reproductive Surgeons (2008).
Myomas and reproductive function. Fertility and Sterility, 90(3): S125–S130.
● Stewart, E., Barbiera, R., & Chakrabarti, A. (2020). Uterine fibroids (leiomyomas): Treatment overview.
UpToDate. Retrieved Oct 28, 2020 from https://www-uptodate-com.york.ezproxy.cuny.edu/contents/uterine-
fibroidsleiomyomastreatmentoverview?search=uterine%20fibroid&source=search_result&selectedTitle=1~150&usa
ge_type=default&display_rank=1
● De La Cruz, M.S. & Buchanan E.M. (2017, January 15). Uterine Fibroids: Diagnosis and Treatment. American Family
Physician. https://www.aafp.org/afp/2017/0115/p100.html#afp20170115p100-b7
Venetian blind artifact literally looks like window blinds (appears sideways because of ultrasound angle)
Some predictors of malignancy on magnetic resonance imaging include age older than 45 years (odds ratio [OR] = 20), intratumoral hemorrhage (OR = 21), endometrial thickening (OR = 11), T2-weighted signal heterogeneity (OR = 10), menopausal status (OR = 9.7), and nonmyometrial origin
L & R white spaces are hip bones. Rectum is visualized posteriorly.
In the past, the only uterine fibroid treatment available was surgery which would remove either part or all of a woman’s uterus. This influenced a lot of women to do the “watch and wait” method. It’s important to remember that fibroids will not go away without treatment. When left untreated, they will continue to cause uncomfortable or painful symptoms. Over time this chronic pain and discomfort may decrease as a woman gets closer to menopause, but this is not a guarantee.
https://www.usafibroidcenters.com/blog/what-happens-if-fibroids-go-untreated/
The patient's desire for immediate or future childbearing is also assessed prior to choosing any fibroid treatment as the therapies have differing impacts on fertility.
Terminology: Ablation means heat/radiofrequency, embolization means cutting off blood supply
Image-guided interventions
Performed while you're inside an MRI scanner equipped with a high-energy ultrasound transducer for treatment. The images give your doctor the precise location of the uterine fibroids. When the location of the fibroid is targeted, the ultrasound transducer focuses sound waves (sonications) into the fibroid to heat and destroy small areas of fibroid tissue.
Radiofrequency ablation
In this procedure, radiofrequency energy destroys uterine fibroids and shrinks the blood vessels that feed them. This can be done during a laparoscopic or transcervical procedure. A similar procedure called cryomyolysis freezes the fibroids.
With laparoscopic radiofrequency ablation, also called Lap-RFA, your doctor makes two small incisions in the abdomen to insert a slim viewing instrument (laparoscope) with a camera at the tip. Using the laparoscopic camera and a laparoscopic ultrasound tool, your doctor locates fibroids to be treated.
After locating a fibroid, your doctor uses a specialized device to deploy several small needles into the fibroid. The needles heat up the fibroid tissue, destroying it. The destroyed fibroid immediately changes consistency, for instance from being hard like a golf ball to being soft like a marshmallow. During the next three to 12 months, the fibroid continues to shrink, improving symptoms.
Because there's no cutting of uterine tissue, doctors consider Lap-RFA a less invasive alternative to hysterectomy and myomectomy. Most women who have the procedure get back to regular activities after 5 to 7 days of recovery.
The transcervical — or through the cervix — approach to radiofrequency ablation also uses ultrasound guidance to locate fibroids.
Woo J, & Scott R.K. (2020). Leiomyoma of the uterus (fibroid tumor). Papadakis M.A., & McPhee S.J., & Rabow M.W.(Eds.), Current Medical Diagnosis and Treatment 2020. McGraw-Hill. https://accessmedicine-mhmedical-com.york.ezproxy.cuny.edu/content.aspx?bookid=2683§ionid=225051071
Uterine artery embolization is a minimally invasive treatment for uterine fibroids. In uterine artery embolization, the goal is to block the blood vessels supplying the fibroids, causing them to shrink.
Uterine artery embolization. Small particles (embolic agents) are injected into the arteries supplying the uterus, cutting off blood flow to fibroids, causing them to shrink and die.
This technique can be effective in shrinking fibroids and relieving the symptoms they cause. Complications may occur if the blood supply to your ovaries or other organs is compromised. However, research shows that complications are similar to surgical fibroid treatments and the risk of transfusion is substantially reduced.
Woo J, & Scott R.K. (2020). Leiomyoma of the uterus (fibroid tumor). Papadakis M.A., & McPhee S.J., & Rabow M.W.(Eds.), Current Medical Diagnosis and Treatment 2020. McGraw-Hill. https://accessmedicine-mhmedical-com.york.ezproxy.cuny.edu/content.aspx?bookid=2683§ionid=225051071
Ultrasonography is the standard confirmatory test because it can easily and inexpensively differentiate a fibroid from a pregnant uterus or an adnexal mass.
https://www.nejm.org/doi/full/10.1056/NEJMcp1411029?page=&sort=oldest
Hysterectomy remains a treatment option for women who have completed childbearing. It is the only treatment that prevents the common problem of new fibroid formation (which is typically termed recurrence)15 and also treats concomitant diseases, including adenomyosis and cervical neoplasia. Observational data suggest that women who have undergone hysterectomy have improvements in quality of life over the next 1 to 10 years.15,27
https://www.nejm.org/doi/full/10.1056/NEJMcp1411029?page=&sort=oldest
Fibroids return after surgery in 10 to 50 out of 100 women, depending on the original fibroid problem. Fibroids that were larger and more numerous are most likely to recur.
footnote
2 Practice Committee of the American Society for Reproductive Medicine, Society of Reproductive Surgeons (2008). Myomas and reproductive function. Fertility and Sterility, 90(3): S125–S130.
Hysteroscopic resection of submucosal fibroids — For patients with HMB, the first step is determining if there is a submucosal fibroid because of the safety and efficacy of hysteroscopic myomectomy as a treatment [6]. Submucosal fibroids amenable to hysteroscopic resection include International Federation of Gynecology and Obstetrics (FIGO) type 0, type 1, or type 2