ABSTRACT
Abstract Recurrent adnexal torsion is a rare gynecological emergency. We report a case of recurrent ipsilateral adnexal torsion in a woman with polycystic ovaries, previously submitted to a laparoscopic plication of the utero-ovarian ligament. Due to the recurrence after the plication of the utero-ovarian ligament, the authors performed a laparoscopic oophoropexy to the round ligament, which is an underreported procedure. The patient was asymptomatic for 1 year, after which she had a new recurrence and needed a unilateral laparoscopic adnexectomy. Since then, she regained the quality of life without any gynecological symptoms. Oophoropexy to the round ligament may be considered when other techniques fail or, perhaps, as a first option in selected cases of adnexal torsion, as it may allow the prevention of recurrence without increasing morbidity while preserving the adnexa.
Resumo A torção anexial recorrente é uma emergência ginecológica rara. Os autores descrevem um caso de torsão anexial unilateral recorrente em uma paciente com síndrome de ovário policístico, previamente submetida a plicatura do ligamento utero-ovárico por laparoscopia. Nesta circunstância, os autores decidiram realizar uma ooforopexia laparoscópica ao ligamento redondo, uma técnica pouco descrita na literatura. A paciente manteve-se assintomática durante 1 ano, período após o qual teve nova recorrência, tendo-se decidido realizar uma anexectomia laparoscópica unilateral. Desde então, ela recuperou a qualidade de vida sem qualquer sintoma ginecológico. A ooforopexia ao ligamento redondo é uma técnica que deverá ser considerada quando outras falham e, em casos selecionados de torsão anexial recorrente, poderá ser considerada a primeira abordagem, para prevenir a recorrência e preservar o anexo.
Subject(s)
Humans , Female , Adult , Torsion Abnormality/surgery , Adnexal Diseases/surgery , Ovary/surgery , Gynecologic Surgical Procedures , Round Ligaments/surgeryABSTRACT
Objective To explore the main factors of the medical communication between physicians and nurses in gynecological emergency treatments. To evaluate the function of SBAR communication mode in enhancing communication skills and to explore the countermeasures of promotion. Methods Totally 18 gynecological physicians and nurses were selected as the subjects in this study,and semi-structured interviews were conducted. After the establishment of coding and archiving system, the collected information was extracted and analyzed. Results The factors that affect gynecologic emergency medical staff effective communication included assessment of the patients′ condition, the limitation of communication conditions,the different concerns between doctors and nurses,the differences of medical communication training degree,seniority,experience and knowledge reserve,the medical team consciousness. Conclusion The effective communication of gynecologic emergency care can be promoted by improving professional levels of medical care personnel,strengthening the cultivation of the health care team,using communication skills,to ensure the accurate transfer of key information.
ABSTRACT
Este artigo trata de paciente com 54 anos, atendida no Hospital Júlia Kubitschek, com relato de ter sido vítima de violência sexual. O agressor armado invadiu sua casa e a obrigou, mediante ameaça de morte, a manter com ele sexo vaginal, anal e oral, sem uso de preservativo. Apresentava-se ansiosa e chorosa. Havia lesão contusa em região escapular esquerda e leve hiperemia de grande lábio direito. O exame especular e a inspeção da região anal não apresentavam alterações. Foram realizadas avaliação laboratorial e profilaxia para doenças sexualmente transmissíveis (DSTs), incluindo administração de antirretrovirais. Foi encaminhada ao ambulatório de vítimas de violência sexual.
This article is about a 54-year-old female patient, assisted at Júlia Kubitschek Hospital, who reported having been victim of sexual violence. According to her, the armed aggressor broke into her house and forced her by threat of death to have vaginal, anal and oral sex with him without using condom. The patient was anxious and tearful. There were blunt injury in the left scapular region (shoulder blade area) and mild hyperemia of the right labium. Speculum examination and inspection of the anal region showed no alterations. The treatment included laboratory tests and prophylaxis for Sexually Transmitted Diseases (STDs), including administration of antiretroviral medication. The patient was referred to an outpatient center for victims of sexual violence.