Clinical advantages of transumbilical single-site laparoscopy in surgery for giant ovariotubal cysts / 中国医师杂志

Objective:To observe the efficacy and safety of single-port laparoscopy for giant ovariotubal cysts.Methods:38 patients with giant ovarian and fallopian tube cysts in Ruijin Hospital Affiliated to Shanghai Jiaotong University Hospital from January 2018 to June 2019 were retrospectively analyzed. They were divided into transumbilical single-port laparoscopy group (18 cases) and traditional laparoscopy group (20 cases). The perioperative related indexes such as operation time, intraoperative bleeding and the number of analgesic cases were compared between the two groups.Results:All 38 patients successfully completed the operation without conversion to laparotomy, and no auxiliary hole was added in the single-port laparoscopy group; There were no postoperative complications and no cystic fluid leakage. In the single-port laparoscopy group, 18 patients were satisfied with the concealment of umbilical scar. There was no statistically significant difference in operation time [(51.67±13.72)min vs (55.50±14.59)min], intraoperative blood loss [(52.22±24.38)ml vs (61.50±28.88)ml] and first postoperative anal exhaust time [(25.77±8.59)h vs (27.60±6.67)h] between single-port laparoscopy group and traditional laparoscopy group (all P>0.05); The number of cases requiring postoperative analgesia in the single-port laparoscopy group (2 cases vs 12 cases) was less than that in the traditional laparoscopy group ( P<0.05); The out of bed activity time [(20.95±3.65)h vs (26.95±5.43)h] and postoperative discharge time [(3.11±0.68)h vs (4.30±1.21)h] were shorter than those in the traditional laparoscopy group (all P<0.05). All 38 patients were followed up in the gynecological clinic for 6-24 months. The incision healed well without recurrence. Conclusions:Transumbilical single-port laparoscopic surgery for giant ovarian and fallopian tube cysts is reliable and safe when the possibility of malignant ovarian and fallopian tube tumors was excluded before operation.

Clinical analysis of congenital tuberculosis in 7 infants / 中国新生儿科杂志

Objective:To study the clinical characteristics of congenital tuberculosis (CTB).Methods:From June 2016 to February 2021, the clinical data of infants with CTB admitted to the neonatal department of our hospital were retrospectively analyzed, including their clinical characteristics, diagnosis, treatment and prognosis.Results:A total of 7 infants with CTB were enrolled into the study. 4 mothers had in vitro fertilization embryo transfer (IVF-ET) due to tubal obstruction and 2 mothers who were diagnosed of tubal tuberculosis. The 7 infants included 1 male and 6 female, 6 preterm and 1 full-term. The median age of onset was 18 d (7~30 d).All of the 7 infants had fever, 6 had shortness of breath and poor response, 5 had apnea, 3 were coughing, 1 showed pale skin colour, 1 had bilateral rales in the lung, 6 had hepatomegaly, 3 splenomegaly and 1 lymphadenopathy. Chest X-ray showed patchy exudation in 3 infants, miliary pattern of opacification in 2 infants, patchy opacification in 1 infant, bilateral increased lung markings in 1 infant. The positive rate of acid-fast bacilli (AFB) was 50% in all sputum samples. Specimens from glottic and subglottic area showed higher positive rate than oropharyngeal specimen. PCR MTB-DNA tests of sputum samples were positive in all 7 cases. 1 infant received invasive respiratory support for 1 d and died after discharge. 2 infants improved significantly after initial treatment, received 1~2 months of anti-TB therapy outside the hospital and died of severe respiratory failure. Of the 4 infants survived, 1 was cured and 3 significantly improved.Conclusions:Mothers with tubal tuberculosis receiving IVF-ET may cause high risk of CTB. Sputum AFB test and sputum PCR MTB-DNA test are preferred diagnostic tests. Genetic test of drug-resistant TB may guide clinical drug use. Glottic or deeper throat specimens can increase the positive rate.

Clinical study of Chaichuan Tongren Mixture supplemented with hysteroscopic recanalization for the patients with tubal obstructive infertility of liver depression and qi stagnation type / 国际中医中药杂志

Objective:To evaluate the efficacy of Chaichuan Tongren Mixture supplemented with hysteroscopic recanalization in the treatment of tubal obstructive infertility of liver depression and qi stagnation type.Methods:A total of 60 patients with tubal obstructive infertility of liver depression and qi stagnation type who met the inclusion criteria were selected, between August 2018 and June 2020, and they were divided into the observation group with 31 cases and the control group with 29 cases, according to the random number table method. The control group was treated with hysteroscopic recanalization, while the observation group was given Chaichuan Tongren Mixture on the basis of the control group. Both groups were treated for 4 months and followed up for 12 months. TCM syndromes were scored before and after treatment, and prostaglandin E 2 (PGE 2) was detected by fully automatic biochemical analyzer and levels of TNF-α, CRP and IL-6 were measured by ELISA. The tubal patency of patients after treatment was observed, the pregnancy status was recorded after the end of follow-up and the clinical efficacy was evaluated. Results:The total effective rate was 96.77% in the observation group and that in the control group was 75.86% ( χ2=4.01, P<0.01). The scores of breast distending pain, irregular menstruation, dark purple menstrual flow and lumbosacral pain in the observation group after treatment were significantly lower than those in the control group ( t values were 17.69, 21.67, 20.89, 14.67, 18.20, respectively, all Ps<0.001). After treatment, the levels of serum PGE 2, TNF-α, CRP, and IL-6 were significantly lower in the observation group than those in the control group [(65.31±6.73) ng/L vs. (87.10±8.85) ng/L, t=10.78; (6.90±0.71) ng/L vs. (11.35±1.23) ng/L, t=17.30; (2.47±0.25) mg/L vs. (5.10±0.52) mg/L, t=25.23; (12.38±1.26) ng/L vs. (30.16±3.15) ng/L, t=29.05] ( P<0.01). After treatment, there was statistical significance in the total effective rate of tubal patency of 96.8% (30/31) in the observation group compared to 79.3% (23/29) in the control group ( χ2=4.43, P<0.01). At the end of follow-up, the pregnancy rate was 71.0% (22/31) in the observation group and 44.8% (13/29) in the control group, and the difference was statistically significant ( χ2=4.21, P<0.01). Conclusion:The Chaichuan Tongren Mixture supplemented with hysteroscopic recanalization can reduce the levels of inflammatory mediators and increase the pregnancy rate of patients with tubal obstructive infertility of liver depression and qi stagnation type.

Double Trouble: A case of synchronous high-grade serous carcinoma of the fallopian tube and borderline mucinous tumor of the ovary / Philippine Journal of Obstetrics and Gynecology

@#A 55‑year‑old, Gravida 2 Para 2 (2002), presented with postmenopausal vaginal bleeding. Workups pointed toward ovarian malignancy with distant metastasis (pleural effusion). Exploratory laparotomy, bilateral salpingo‑oophorectomy, surgical staging, and appendectomy were performed. On histopathological examination, synchronous high‑grade serous carcinoma of the right fallopian tube and borderline mucinous tumor of the left ovary were diagnosed. Primary fallopian tube carcinomas are very uncommon, while synchronous tumors of the female genital tract are extremely rare. Furthermore, there is a paucity of literature discussing the occurrence of synchronous primary malignancies arising from the fallopian tube and the ovary. It is crucial to differentiate primary malignancies from metastatic cancers to determine accurate staging and prognosis, as well as to assign appropriate treatment strategies. Immunohistochemistry and molecular testing play vital roles as adjunctive diagnostic tools to histologic examination in determining the origins of these tumors and distinguishing primary tumors from metastasis.

Ultrasound imaging and clinical characteristics of primary fallopian tube carcinoma in peri-and post-menopausal women / 中华老年医学杂志

Objective:To analyze the characteristic ultrasonographic findings and clinical symptoms of primary fallopian tube cancer(PFTC)in peri-and post-menopausal women, and to provide a basis for the early diagnosis of PFTC via ultrasonography.Methods:A total of 34 patients with PFTC confirmed by surgery and pathology in Beijing Hospital from May 2012 to January 2022 were retrospectively analyzed.Patients aged between 46-85 years, including 1(2.9%)in early menopausal transition(46 years old), 3(8.8%)in late menopausal transition(48 years old, 49 years old, and 50 years old), and 30(88.2%)in post-menopause.The median age was 60 years(60.9±9.7 years). The ultrasound and clinical features were analyzed and compared with pathological results.Results:Irregular vaginal bleeding was the most common clinical symptom in the 34 patients.According to the characteristics of adnexal masses and the involvement of other organs in the pelvis and abdominal cavity, the 34 cases of PFTC were divided into 4 groups.In Group A, 6 cases showed sausage-like cystic masses in the adnexal area, with unsmooth inner walls, medium echo papillary projections on the inner wall, incomplete strip partitions, and rich or relatively rich blood flow signals on the papillary projections and partitions.On ultrasound, 1 case was diagnosed with hydrosalpinx, 2 cases with cysts in the adnexal area, and 3 cases with PFTC.In Group B, 13 cases presented with cystic or solid masses of irregular shapes and sausage-like changes in some areas.The cystic part had poor sound transmission and the solid part exhibited rich or relatively rich blood flow signals.On ultrasound, 2 cases were diagnosed with PFTC and 11 cases with ovarian cancer with 2 showing intrauterine effusion and 3 showing abdominal and pelvic effusion.There were 11 cases in Group C, presenting with hypoechoic irregular solid masses in the adnexal area, with some accompanied by thickening of the peritoneum of the anterior and posterior fornix and the omentum.There were abundant or relatively abundant blood flow signals inside the masses.On ultrasound, 10 cases were diagnosed with ovarian cancer and 1 with pelvic metastatic cancer.There were 4 cases in Group D, who showed no adnexal mass, but 3 cases had ascites and were suspected of having a malignant tumor of unknown origin.Postoperative pathological results of the 34 PFTC cases revealed that 30 had high-grade serous carcinoma, 1 had low-grade serous carcinoma, 2 had serous tubal intraepithelial carcinoma(STIC), and 1 had serous tubal in-situ carcinoma.There were 3 cases with bilateral PFTC, 10 cases with PFTC on the left and 21 cases on the right.There were 4 cases with PFTC plus ovarian cancer.According to FIGO pathological staging, 8 cases were in stage Ⅰ, 9 in stage Ⅱ, 11 in stage Ⅲ and 6 in stage Ⅳ.The accuracy of preoperative diagnosis of PFTC by ultrasound was 50.0% in Group A and 15.4% in Group B. Preoperative ultrasound did not correctly diagnose PFTC in Group C and Group D, and instead suggested pelvic malignant tumor.Conclusions:Clear display of bilateral ovaries, sausage-like masses in the adnexal area, abundant or relatively abundant low resistive index blood flow signals in papillary projections and low-speed neovascularization are helpful ultrasound signs for the early diagnosis of PFTC, but not very useful for predicting the pathological stages of PFTC.Postmenopausal woman with vaginal bleeding, vaginal secretions or lower abdominal pain should be alert to PFTC.

Quistes mesoteliales benignos con posible origen en las trompas de Falopio resecados por laparotomía / Benign mesothelial cysts with possible origin in the Fallopian tubes resected by laparotomy

Introducción. Los quistes mesoteliales benignos son una entidad poco frecuente, que ocurren especialmente en mujeres en edad reproductiva. Se deben a una proliferación anómala del mesotelio que puede ser originada en varias estructuras intraabdominales e inicialmente es asintomática. Caso clínico. Se presenta el caso de una mujer de 20 años con un cuadro sugestivo de neoplasia maligna, en quien se confirmó el diagnóstico de quiste mesotelial originado en la trompa de Falopio derecha. Se realizó tratamiento quirúrgico exitoso. Discusión. A pesar de la estrecha relación de esta entidad con el útero y los ovarios, no se encuentran reportes de quistes mesoteliales originados a partir de las trompas de Falopio. El tratamiento de los quistes mesoteliales es quirúrgico y en el caso de esta paciente se hizo con la finalidad de mejorar los síntomas y erradicar la enfermedad. Las decisiones fueron tomadas basadas en la opinión de expertos en oncología en una junta de tumores gastrointestinales. Conclusiones. Los quistes mesoteliales son neoplasias de baja incidencia, pero se deben tener en cuenta como diagnóstico diferencial de los tumores abdominales. Se presenta el caso de una paciente tratada de forma quirúrgica con resultados exitosos y seguimiento a un año sin recurrencias

Introduction. Benign mesothelial cysts (BMC) are a rare entity that occurs especially in women of reproductive age. It is due to an abnormal proliferation of the mesothelium that can originate from various intra-abdominal structures and it is initially asymptomatic. Clinical case. This is a case of a 20-year-old woman with a suspicious malignant neoplasia, in whom the diagnosis of a mesothelial cyst originating in the right Fallopian tube was confirmed. Successful surgical treatment was achieved. Discussion. Despite the close relationship of this entity with the uterus and ovaries, there are no reports of me-sothelial cysts originating from the Fallopian tubes. The treatment of mesothelial cysts is surgical and in the case of this patient it was performed in order to improve the symptoms and eradicate the disease. The decisions were taken based on the oncologists' expert opinion of the gastrointestinal tumor board. Conclusions. Mesothelial cysts are neoplasms of low incidence, but they should be considered as a differential diagnosis of abdominal tumors. The case of a patient treated surgically with successful results and a one-year follow-up without recurrences is presented

Torsión aislada de la trompa de Falopio, con necrosis de un quiste paratubárico: una urgencia ginecológica infrecuente / Isolated torsion of the Fallopian tube, with necrosis of a paratubal cyst: an infrequent gynecological emergency

INTRODUCCIÓN: La torsión aislada de la trompa de Falopio ocurre en aproximadamente una de cada 50.000 a 1.500.000 mujeres, por ende, es una afección extremadamente rara. Fue originalmente descrita por Bland-Sutton en 1890. El cuadro clínico suele ser inespecífico y puede simular una amplia variedad de dolencias. CASO CLÍNICO: Paciente de 18 años de edad que acude al servicio de urgencias por dolor abdominal intenso, la cual se decide ingresar por cuadro agudo doloroso abdominal de posible etiología ginecológica, se realiza laparoscopía de urgencia por la posibilidad de un cuadro de torsión quística, durante esta se observa una imagen laparoscópica de la trompa izquierda violácea y torcida, además un quiste paratubárico hemorrágico, de color violacio; por las características laparoscópicas de la trompa y el quiste paratubárico que se relacionan con necrosis de estos elementos, se decide realizar a la paciente una anexectomía total izquierda con cistectomía del quiste paratubárico. DISCUSIÓN: La rotación de la trompa alrededor de su pedículo vascular es el evento fisiopatológico descrito, lo que provoca inicialmente la obstrucción del retorno venoso y linfático, con el consiguiente edema, ingurgitación y trombosis. Si la torsión progresa, y no se resuelve, se ve comprometida la vascularización arterial y se desencadena la necrosis del órgano y, finalmente la instauración de peritonitis, la conducta se basa en la viabilidad de la trompa: si no tiene signos de necrosis, la conducta indicada es destorcerla, si ya aparecieron signos de necrosis deberá ser extirpada.

INTRODUCTION: Isolated torsion of the Fallopian tube occurs in approximately one in every 50,000 to 1,500,000 women, therefore, it is an extremely rare condition. It was originally described by Bland-Sutton in 1890. The clinical picture is usually nonspecific and can mimic a wide variety of ailments. CLINICAL CASE: An 18-year-old patient who came to the emergency service for intense abdominal pain, which was decided to enter due to acute abdominal pain of possible gynecological etiology, an emergency laparoscopy was performed due to the possibility of a cystic torsion condition, During this, a laparoscopic image of the violaceous and crooked left tube is observed, as well as, a hemorrhagic paratubal cyst, violet in color; Due to the laparoscopic characteristics of the tube and the paratubal cyst that are related to necrosis of these elements, it was decided to perform a total left adnexectomy with cystectomy of the paratubal cyst. DISCUSSION: Rotation of the tube around its vascular pedicle is the described pathophysiological event, which initially causes obstruction of venous and lymphatic return, with the consequent edema, engorgement and thrombosis. If the torsion progresses and does not resolve, the arterial vascularization is compromised and the necrosis of the organ is triggered and, finally, the establishment of peritonitis, the behavior is based on the viability of the tube: if there are no signs of necrosis, the indicated conduct is to untwist it, if signs of necrosis have already appeared, it must be removed.

Ectopic pregnancy in a case of congenital mullerian anomaly: a diagnostic dilemma

Ectopic or extrauterine pregnancy occurring in a case with mullerian defect is very rare and poses diagnostic challenges. Undescended and non-communicating fallopian tubes are extremely rare mullerian anomalies. Here authors present a case of ectopic pregnancy occurring in an undescended non-communicating fallopian tube in a patient with unicornuate uterus with absent horn, which was managed laparoscopically. A 32-year-old lady, diagnosed case of left unicornuate uterus with absent right horn, was referred to us with the suspicion of ruptured ectopic pregnancy. The abdominopelvic ultrasound showed a soft tissue lesion of size 32×24 mm, towards the right lateral pelvic wall near the iliac vessels, with increased vascularity on colour flow doppler.  The patient underwent laparoscopy which showed left sided unicornuate uterus with normal left tube and ovary. The right uterine horn was absent.  An undescended right ovary and tube were found attached to the peritoneum at the level of pelvic brim along the right lateral pelvic wall.  Right sided tubal ectopic pregnancy with rupture was present along with 300-350 cc of hemoperitoneum. The patient was treated with laparoscopic right sided total salpingectomy. In patients with unicornuate uterus and atypical presentation, ectopic pregnancy should be ruled out in an undescended non-communicating fallopian tube. Salpingectomy of incidentally diagnosed non-communicating fallopian tubes is recommended to prevent future ectopic pregnancy.

Fallopian tube as a cause of intestinal obstruction: a rare case report with review of literature

Adhesive Intestinal obstruction is the most common cause of intestinal obstruction in post-operative period. Diagnosis is based on history, clinical examination, plain X-ray abdomen. Authors here report an interesting case of intestinal obstruction after surgery for chronic calcific pancreatitis with pancreatic duct stone with intractable pain. In post-operative period patient developed features of intestinal obstruction, patient was planned for re- exploration and it was found that band was formed by left fallopian tube with transition point at terminal ileum and treated successfully with left Salpingectomy. Very few cases of fallopian tube as cause of intestinal obstruction have been reported in literature and it should be considered as one of the cause of intestinal obstruction in females presenting with acute abdomen.

A rare case report of recurrent ectopic pregnancy

This case presenting a 30-year-old lady, a case of G4A1E2 who presented with history of 1 month of amenorrhoea, followed by bleeding per vaginum 1 week back for 3 days. Presented to hospital with spotting PV and pain abdomen for 2 days. UPT done at home was positive. USG revealed right ovarian complex haemorrhagic cyst and left adnexal ectopic pregnancy near left ovarian fimbriae. Conservative management by Methotrexate and Folinic acid regimen was tried but as there were no signs of resolution on serial ultrasonography reports and serial human chorionic gonadotropin (hCG) levels did not fall as expected, hence decision of laparoscopy/laparotomy was made and salpingectomy was done. Later patient was followed up with serial hCG levels.

Paratubal Atypical Proliferative Serous Tumour in a Young Adolescent Female - A Diagnostic Dilemma

Introdcution: Paratubal atypical proliferative serous tumoursare rare usually arising from the mesothelium or from theremnants of mesonephric and paramesonephric ducts. Wepresent a rare case of paratubal borderline serous tumour in ayoung adolescent female presenting clinically as an omentalcyst.Case Report: A 14-year old unmarried female presentedwith abdominal pain in right iliac fossa. MRI revealed awell demarcated space occupying lesion in the pelvis almostin midline measuring 12x11x8cm. Lesion was abutting anddisplacing overlying bowel loops with likely adhesionssuggestive of complex omental cyst. The patient underwentcystectomy. The final histopathologic report confirmed thecyst as Paratubal atypical proliferative serous tumour.Conclusion: We experience a rare case of atypical proliferativeserous tumour of paratubal origin. The patient was youngestthan any of the other cases reported in the literature. Fertilitysparing surgery should be considered as a standard treatmentof borderline paratubal tumour, if patient desires futurefertility.

A study of tubal ectopic pregnancy based on the histopathology of fallopian tubes in the age group of 20-35 years

Purpose: Ectopic pregnancy is a life-threatening condition for the mother. Disruptions of the fallopian tube are considered to be important in its pathogenesis. The present study was conducted to observe the histopathology of this dreaded disease which could lead to the development of suitable remedies. Methods: Cases diagnosed with ectopic gestation in the fallopian tube who subsequently underwent salpingectomy were considered for the study. Histopathology of sections from the affected fallopian tubes was studied under the light microscope after staining with H and E. Results: Most cases presented with amenorrhoea, whereas others had dysmenorrhoea, menorrhagia, and menometrorrhagia. Histopathologic findings included the presence of salpingitis (acute and chronic), calcification, sclerosed vessel and. Conclusion: Past history of inflammatory diseases, especially PID plays an important role in the subsequent development of ectopic pregnancy. Its prevention and treatment can lead to a decrease in the incidence of ectopic pregnancy.

Prevalencia de embarazo ectópico en el Hospital Carlos Andrade Marín, 2017 a 2019 / Prevalence of ectopic pregnancy in the Carlos Andrade Marín Hospital, 2017 a 2019

RESUMEN: Objetivos: 1) Determinar la prevalencia de embarazo ectópico en el Servicio de Alto Riesgo Obstétrico del Hospital Carlos Andrade Marín. 2) Identificar los factores de riesgo asociados con esta patología. Métodos: se realizó un estudio descriptivo, de corte transversal, retrospectivo, tomando en cuenta a las pacientes ingresadas con diagnóstico de Embarazo Ectópico al Servicio de Alto Riesgo del Hospital Carlos Andrade Marín, en el periodo del 1 de enero del 2017 al 31 de mayo del 2019. Resultados: durante el período comprendido entre el 1 de enero de 2017 y el 31 de mayo de 2019, se registró un total de 7.596 nacimientos en el Servicio de Alto Riesgo Obstétrico del Hospital Carlos Andrade Marín; de ellos, hubo 117 pacientes diagnosticadas de embarazo ectópico. La prevalencia del embarazo ectópico en el Hospital Carlos Andrade Marín, entre los años 2017 y 2019, fue de 1,5%; la tasa de embarazo ectópico es de 15,40 / 1.000 gestaciones. Conclusiones: el análisis de los datos obtenidos de las historias clínicas evidenció que la tasa de prevalencia de embarazo ectópico en el Servicio de Alto Riesgo Obstétrico del Hospital Carlos Andrade Marín es similar a la reportada por diferentes estudios realizados alrededor del mundo.Palabras claves: embarazo ectópico, prevalencia, trompa de falopio, factores de riesgo

ABSTRACT: Objective: To determine the prevalence of ectopic pregnancy in the high-risk obstetric service of the Carlos Andrade Marín Hospital and to know the associated risk factors. Methods: A descriptive, cross-sectional, retrospective study was carried out, taking into account patients admitted with a diagnosis of ectopic pregnancy to the high-risk service of the Carlos Andrade Marín Hospital, from January 1, 2017 to May 31 of 2019. Results: During the period from January 1, 2017 to May 31, 2019, a total of 7596 births were recorded in the High Obstetric Risk Service of Hospital Carlos Andrade Marín. Of all of them, a total of 117 patients were registered diagnosis of ectopic pregnancy. The prevalence of ectopic pregnancies in the Hospital Carlos Andrade Marín in a period between 2017 and 2019 was 1.5%, with an ectopic pregnancy rate of 15.40 per 1000 pregnancies. Conclusions: When performing an analysis of the data obtained from the medical records it was possible to obtain similar results of prevalence rates of ectopic pregnancy in the High Risk Obstetric Service of the Hospital Carlos Andrade Marín in relation to the data obtained by different studies conducted around of the world.Keywords:ectopic pregnancy, prevalence, fallopian tube, risk factors

Construction of microfluidics-based fallopian tube model for mimicking fertilization and early embryo culture in vivo / 中国组织工程研究

BACKGROUND: With the increasing proportion of infertility in the population, more and more attentions have been paid on assisted reproductive techniques. Fertilization and early embryo culture are the significant parts of assisted reproductive techniques; however, they remain unchanged in the last few decades. OBJECTIVE: To design a novel microfluidics-based fallopian tube model that can mimic the microenvironment of fertilization and early embryo culture in vivo. METHODS: Microfluidic device was manufactured by soft lithography method to mimic the anatomical characteristic of fallopian tube in vivo. Mouse oviduct primary epithelial cells were cultured and purified by explants culture method, and then the purified cells were identified by keratin immunofluorescence method. Epithelial cells were then loaded into the channel to mimic the biochemical environment of fallopian tube in vivo. The chip was connected to the automatic liquid changing device to mimic the liquid environment of fallopian tube in vivo. RESLUTS AND CONCLUSION: (1) The channel of this model is cylindrical with 2 cm of height and 1 cm of diameter, which were in accordance with the anatomical characteristic of the isthmus of fallopian tube in shape. (2) The keratin immunofluorescence was positive, which indicated that mouse oviduct primary epithelial cells can be obtained by explants culture method. (3) The cells were loaded into the channel to cover the wall of channel, which provided a biochemical microenvironment similar to that in vivo for fertilization and early embryo culture. After the chip was connected to the automatic liquid changing device, metabolic waste could be taken away and nutrient substance can be replenished in time, which mimics the real fluid environment in vivo. (4) This study combined microfluidics technology and assisted reproductive techniques to design a novel fallopian tube model, which mimics the micro-environment of fertilization and early embryo culture in vivo. This study has laid a foundation for further improvement of assisted reproductive techniques and the rate of fertilization and embryo optimization.

A rare case of isolated fallopian tube torsion

Isolated torsion of fallopian tube is a rare occurrence. Diagnostic difficulty gets compounded in adolescents because the most commonly used imaging study in young, usually sexually inactive, population is transabdominal ultrasonography which may show normal ovaries, leading clinicians to abandon a diagnosis of adnexal torsion. Other imaging modalities such as CT scan or MRI are less useful for a rapid diagnosis because of the risk of radiation exposure, cost, or lack of ready availability. Delays in diagnosis may increase the likelihood of necrosis of the fallopian tube which would result in salpingectomy as was the case in our case report. Here authors present one such case, wherein one 12 year old girl who attained menarche at 10 years of age presented with acute paraumblical pain and vomiting without any fever, bowel and bladder disturbances. On examination there was tenderness in right iliac fossa. Her USG report was unremarkable. She initially was put-on broad-spectrum antibiotics but without any amelioration of symptoms. Diagnosed as appendicitis by surgeon, she was taken up for laparoscopic appendicectomy. However, it turned out to be a case of fallopian tube torsion, wherein the tube had become gangrenous for which salpingectomy was done.

Primary Fallopian Tube Carcinoma: A Review Of A Single Institution Experience

Background: Primary fallopian tube carcinoma (PFTC) is rare. Herein, we investigate the clinico- pathological characteristics and response to cytoreductive surgery & appropriate therapies for PFTC. Materials and Methods: Aretrospective observational study of 5 women with a histopathologic diagnosis of PFTC from January 2004 to Dec 2018. Results: The mean age at diagnosis was 53 years (range, 46 to 62 years), and the mean follow-up period was 51 months. All (100%) patients were postmenopausal. Eighty percent had an ECOG score of 0-1.The most common clinical presentation was nonspecific pelvic pain (100%), followed by abnormal vaginal bleeding (80%), and adnexal mass of unknown origin (40%). Three (60%) patients were assumed preoperatively as primarily in the ovary. All patients were diagnosed postoperatively; Primary optimal cytoreductive surgery was achievable in 4/4 (100%) in advanced disease. Only 1 (20%) patient was in Stage IIA& four (80%) in Stage IIB - IIIB. The serous type histology was predominant (60%), 60 % were of grade 2 and 40% of high grade. All showed complete response (CR) to adjuvant paclitaxel and carboplatin (P+C).The mean progression-free survival (PFS) rate was 43.6 months and mean Overall survival (OS) was 51 months. Conclusion: PFTC is infrequently diagnosed preoperatively or intraoperatively due to its rarity, and has nonspecific presentation. Radical cytoreductive surgery, followed by postoperative adjuvant chemotherapy P+C is a standard treatment by which the survival potential of PFTC can be greatly enhanced.

Femoral hernia containing the right fallopian tube: a rare finding / Hérnia femoral contendo a trompa de falópio direita: um achado raro

Abstract Femoral hernias comprise a small proportion of all groin hernias. They are more common in women and have a high rate of incarceration and strangulation, leading to emergency repair. A 61-year-old female patient was admitted to the emergency department complaining of a 2-day painful lump in the right groin, that had become more intense in the last 24 hours. Physical examination suggested the presence of a strangulated femoral hernia, and the patient underwent emergency surgical repair. Intraoperatively, the right fallopian tube was observed in the hernia sac. Since there were no signs of ischemia, the tube was reduced back into the pelvic cavity and the hernia was repaired. The postoperative period was uneventful, and the patient was discharged without complications, 3 days after surgery.

Resumo As hérnias femorais representamuma pequena fração de todas as hérnia da região inguinal. Elas são mais comuns entre as mulheres e estão associadas a elevadas taxas de complicações, como encarceramento e estrangulamento, com necessidade de cirurgia urgente. Uma paciente do sexo feminino, de 61 anos, recorreu ao serviço de emergência por quadro de dor e tumefação da região inguinal direita com 2 dias de evolução e agravamento nas últimas 24 horas. O exame objetivo sugeria a presença de uma hérnia femoral encarcerada, e a paciente foi submetida a cirurgia urgente. Intraoperatoriamente, confirmou-se o diagnóstico de hérnia femoral encarcerada, que continha a trompa de falópio direita no interior do saco herniário. Uma vez que a que a trompa não apresentava sinais de isquemia, o conteúdo da hérnia foi reduzido, e procedeu-se à sua reparação. O período pós-operatório decorreu sem intercorrências, e a paciente teve alta no 3° dia após a cirurgia.

Primary Serous Papillary Adenocarcinoma Fallopian Tube: A Rare Case Report

Introduction: Primary fallopian tube carcinoma is a rare tumour accounting to almost 0.1-1.8% of all genital malignancies and difficult to diagnose preoperatively, because of its non-specific presentation as well as simulation with ovarian carcinoma. It is usually an intraoperative finding or a histopathological diagnosis. Case Report:The study present a case of 48 yr old post menopausal women who underwent abdominal hysterectomy with unilateral salpingo-oopherectomy for hydrosalpinx and ovarian cyst. Histopathological examination revealed, primary serous papillary adenocarcinom of fallopian tube. Conclusion: Primary tubal cancer is rare, mostly mistaken for ovarian carcinoma. Histopathological examination is the gold standard for final diagnosis

The study of hysterosalpingogram as an investigation tool performed among the infertile women of Al Bahah city of Saudi Arabia - A retrospective study

Background: Hysterosalpingogram (HSG) is one of the diagnostic patterns used for infertility. The diagnostic criteria associated with vital information of details of fallopian tubes, uterus anatomy, and any other congenital abnormalities. Objectives: The objective of this study was to assess the value of HSG performed among the women of Al Bahah city. Materials and Methods: A retrospective study conducted at the Government Hospital of Al Bahah city. The data with women diagnosed for infertility were considered during the period between January 2014 and November 2018 in the inclusion criteria. The data included ethnicity, details of fallopian tube, uterus cavity details, and endometrium thickness. The collected data were tabulated in an Excel sheet and were analyzed using IBM Statistical Package for the Social Sciences Inc. using version 20 software. Results: The study comprised a total of 98 cases of infertile women, in which, 25.5% of women suffered from uterine cavity defect and 73.8% suffered from tubular obstruction. It was observed that 29.5%, 16.3%, and 27.5% had left, right, and bilateral tubular blockages, respectively. Conclusion: The retrospective study of HSG images among the infertile women showed the pattern of HSG based on fallopian tube and uterine cavity. The data showed the increase in fallopian tube pathology than in uterine cavity defects. The cultural and social barriers of Saudi women in this region with associated dependence for accessibility to health care might be the reason for the increase in tubular blockage.

Preventable gynecological surgeries in hysterectomized women : a review of causes and measures of prevention

Background: Hysterectomy, the most common gynaecologic surgery performed around the world. however, repeat gynaecologic intervention / surgery may be required for some conditions, adding cost and morbidity for patients and posing a burden on healthcare systems. The objective of the present study was to find out the incidence of  and types of surgical intervention required post hysterectomy.Methods: A retrospective analysis of hospital records was done for gynecologic operative procedures done in post hysterectomy patients 2014-2016.Results: Out of a total of 1028 in the year 2014-2016 in our centre, 75 (7.3%) surgeries were performed for benign conditions in hysterectomized women.  Hydrosalpinx(29%) was most common condition for surgery, followed by endometriosis(24%) with   31-40 years age group women   undergoing  the maximum surgeries. Vault prolapse(16%) in elderly and vaginal vault  granulation(16%)  in younger women  also underwent a repeat gynecological procedure post hysterectomy.Conclusions: Some measures can be taken during the primary surgery(hysterectomy) to prevent a repeat gynaecological surgery in these women. Concurrent salpingectomy can prevent  benign and malignant fallopian tube lesions and ovarian cancer . Endometriosis surgery should be precise to prevent any remnant ovarian or endometriotic foci. McCall’s culdoplasty  in primary hysterectomy is proven to prevent vaginal vault prolapse. Most  genitourinary  fistulas can be prevented by detailed  knowledge  of pelvic anatomy, preoperative risk stratification of patients at higher risk of ureteric and urinary bladder injuries,  meticulous surgical technique and judicious use of electrosurgical energy. Prevention is always  better than a repeat surgery.