value of laparoscopy in obscured acute lower abdominal pain in females

Obscured acute lower abdominal pain, especially in females in reproductive age, is one of the most difficult challenges facing surgeons in the emergency room. This study included 33 females having this problem in an attempt to evaluate the role of laparoscopy in this field. In 18 cases the problem could be solved by a laparoscopic surgical intervention while in the rest of patients laparotomy was avoided with exception of 2 cases. Through this limited number of patients, laparoscopy proved both effective and safe in this field

High resolution endovaginal ultrasound a non invasive test for assessment of luteal phase adequacy

During routine infertility evaluation, 42 infertile women had undergone midluteal transvaginal ultrasonography [TVS], progesterone assay and endometrial biopsy. Ultrasonographic pictures were classified into three patterns: proliferative, secretory in phase and secretory out of phase endometrium. This was done in an attempt to assess the sensitivity and specificity of TVS in diagnosis of luteal phase defect. There was a tendency towards more thick hyperechoic endometrium in cases of phase endometrium. The presence of a relatively hypoechoic endometrium was more suggestive of out of phase endometrium. The ultrasonographic findings were compared both to histopathologic endometrial dating and midluteal progesterone assays. Sensitivity of TVS in diagnosis of proliferative endometrium was 75%, in phase endometrium 80%, out of phase endometrium 60%, while its specificity was 90, 52.9, and 70%, respectively. A midluteal TVS was suggested to be used as an adjunct with other parameters in assessment of luteal phase adequacy