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1.
Anesthesia and Pain Medicine ; : 182-185, 2016.
Artículo en Coreano | WPRIM | ID: wpr-52558

RESUMEN

Pseudo-Meigs syndrome is accompanied with pleural effusion, ascites and a benign or malignant tumor of ovary, tubes, uterus, round ligament or colon. We reported a case of hypoxia in an ovarian cancer patient with moderate ascites after head-down tilt position for central venous catheterization under general anesthesia. Massive pleural effusion was detected on portable chest X-ray, which was not observed in a preoperative radiologic test. The patient had no respiratory symptoms and breath sound was normal in both lungs prior to surgery. The pleural effusion was resolved by a chest tube insertion.


Asunto(s)
Femenino , Humanos , Anestesia General , Hipoxia , Ascitis , Cateterismo Venoso Central , Catéteres Venosos Centrales , Tubos Torácicos , Colon , Inclinación de Cabeza , Pulmón , Neoplasias Ováricas , Ovario , Derrame Pleural , Ligamento Redondo del Útero , Tórax , Útero
2.
The Journal of the Korean Orthopaedic Association ; : 474-482, 2015.
Artículo en Coreano | WPRIM | ID: wpr-652296

RESUMEN

PURPOSE: The purpose of this study is to identify functions of ligamentum teres during multi-planar movement of the hip joint and to evaluate the correlation between arthroscopic findings and preoperative magnetic resonance imaging (MRI) of ligamentum teres rupture. MATERIALS AND METHODS: With four fresh-frozen cadavers that were dissected for removal of all soft tissue from around the hip, leaving only the ligamentum teres intact, tension of ligamentum teres at each position of the hip during multiplanar movement of the hip joint was identified. Among patients who underwent arthroscopic treatment for hip joint lesion from June 2006 to December 2012, arthroscopic findings of 26 patients who showed ligamentum teres rupture on arthroscopy were compared retrospectively with finding of preoperative MRI and visual analogue scale pain score and modified Harris hip score preoperatively and at final follow-up were evaluated. RESULTS: The ligamentum teres was maximal taut at flexion with external rotation. Ligamentum teres rupture was suspected according to preoperative MRI in 20 cases (76.9%). All cases underwent arthroscopic debridement and thermal shrinkage for the ruptured ligamentum teres. At final follow-up, visual analogue scale pain score and modified Harris hip score had improved from 6.1 (4-9) and 63.7 (36.3-86.9) to 2.0 (0-5) and 88.4 (72.6-100), respectively (all p<0.001). CONCLUSION: The ligamentum teres is maximal taut at flexion with external rotation and contributes to internal stability. Ruptured ligamentum teres should be treated by arthroscopic debridement and thermal shrinkage.


Asunto(s)
Humanos , Artroscopía , Cadáver , Desbridamiento , Estudios de Seguimiento , Articulación de la Cadera , Cadera , Imagen por Resonancia Magnética , Estudios Retrospectivos , Ligamento Redondo del Útero , Rotura
3.
Ultrasonography ; : 216-221, 2014.
Artículo en Inglés | WPRIM | ID: wpr-731132

RESUMEN

Round ligament varicosities are rare, and the mass mimics an inguinal hernia. Round ligament varicosities should be considered in the differential diagnosis of a groin swelling in a female, especially during pregnancy. The diagnosis of round ligament varicosities can be established on grayscale and color Doppler ultrasonography. We report two cases of round ligament varicosities in a 33-year-old non pregnant woman and a 28-year-old pregnant woman, and these patients were diagnosed using ultrasonography. We also reviewed the literature on round ligament varicosities including the present cases. Ultrasonography is diagnostic and can prevent unnecessary surgical intervention and associated morbidity.


Asunto(s)
Adulto , Femenino , Humanos , Embarazo , Diagnóstico , Diagnóstico Diferencial , Ingle , Hernia Inguinal , Mujeres Embarazadas , Ligamento Redondo del Útero , Ultrasonografía , Ultrasonografía Doppler en Color
4.
Obstetrics & Gynecology Science ; : 172-175, 2014.
Artículo en Inglés | WPRIM | ID: wpr-97005

RESUMEN

Endometriosis, defined as growth of endometrial stroma and glands outside the uterine cavity, is a chronic and recurrent disease that affects patients' quality of life. Ectopic endometrial tissue can proliferate at any location in the body, but the pelvic organs and peritoneum are the most frequent implantation sites. Among extrapelvic endometriosis, inguinal endometriosis is a very rare gynecologic condition usually associated with previous pelvic surgery. Endometriosis should be preoperatively distinguished from other inguinal masses using computed tomography, magnetic resonance imaging, or ultrasonography. Here, we report a case of right inguinal endometriosis in a patient with no previous history of gynecologic surgery; in addition, we have provided a brief review of relevant literature.


Asunto(s)
Femenino , Humanos , Endometriosis , Procedimientos Quirúrgicos Ginecológicos , Imagen por Resonancia Magnética , Peritoneo , Calidad de Vida , Ligamento Redondo del Útero , Ultrasonografía
5.
Journal of the Korean Society of Medical Ultrasound ; : 277-280, 2011.
Artículo en Inglés | WPRIM | ID: wpr-725410

RESUMEN

There are various causes of a painful palpable mass in the groin during pregnancy. The differential diagnoses of an inguinal mass include hernia, lymphadenopathy, mesothelial cyst, cystic lymphangioma, neoplasms (lipoma, leiomyoma and sarcoma), endometriosis, embryonic remnants and round ligament varicosities. Among them, round ligament varicosities can be easily misdiagnosed as an inguinal hernia in a pregnant woman. These lesions should be managed conservatively because they resolve spontaneously during the postpartum period. Ultrasonography can help make the diagnosis of round ligament varicosities and so prevent unnecessary surgical intervention and the associated morbidity. Herein we report on a case of round ligament varicosities that presented during pregnancy and this condition was readily diagnosed via Doppler sonography.


Asunto(s)
Femenino , Humanos , Embarazo , Diagnóstico Diferencial , Endometriosis , Ingle , Hernia , Hernia Inguinal , Leiomioma , Linfangioma Quístico , Enfermedades Linfáticas , Periodo Posparto , Mujeres Embarazadas , Ligamento Redondo del Útero , Ligamentos Redondos
6.
Journal of the Korean Surgical Society ; : 437-439, 2011.
Artículo en Inglés | WPRIM | ID: wpr-50868

RESUMEN

Round ligament varicosities during pregnancy are rare, and can easily be mistaken for an inguinal hernia. On physical examination, round ligament varicosities and groin hernia are difficult to distinguish. The diagnosis of round ligament varicosities can be established on gray-scale and color Doppler sonography. We experienced a case of round ligament varicosities in which a 29-year-old woman presented symptoms at 36 weeks gestation. The patient was diagnosed using Doppler sonography, managed with conservative therapy, and had an uncomplicated vaginal delivery at 40 weeks. The symptoms were resolved completely by two weeks postpartum. We report a case of round ligament varicosities that was diagnosed at 36 weeks of gestation with a review of the literature.


Asunto(s)
Adulto , Femenino , Humanos , Embarazo , Ingle , Hernia , Hernia Inguinal , Examen Físico , Periodo Posparto , Ligamento Redondo del Útero , Ligamentos Redondos
7.
Journal of the Korean Society of Medical Ultrasound ; : 69-71, 2010.
Artículo en Inglés | WPRIM | ID: wpr-725599

RESUMEN

Round ligament varices during pregnancy are an important part of the differential diagnosis of inguinal hernia as they may cause symptoms and clinical features that are similar to those of inguinal hernia. When this condition is correctly diagnosed, an unnecessary operation may be prevented. The diagnosis of round ligament varices should be considered for pregnant women who present with a palpable mass in the groin. We describe here a case of round ligament varices that presented during pregnancy and this was readily diagnosed with Doppler sonography.


Asunto(s)
Femenino , Humanos , Embarazo , Diagnóstico Diferencial , Ingle , Hernia Inguinal , Mujeres Embarazadas , Ligamento Redondo del Útero , Ligamentos Redondos , Várices
8.
Korean Journal of Obstetrics and Gynecology ; : 180-183, 2010.
Artículo en Coreano | WPRIM | ID: wpr-223000

RESUMEN

Estimated incidence of round ligament varicosities in pregnancy is not known and often times it is confused with inguinal hernia due to their clinical similarities. When a patient is presented with inguinal mass especially in association with varicosity in the genital region or lower extremity, round ligament varicosity must be considered as a plausible diagnosis. Depiction of "bag of worms" on color Doppler ultrasonography is diagnostic of the round ligament varicosity and it is known to resolve spontaneously following delivery. We report a case of round ligament varicosities that was diagnosed at 29 weeks of gestation with a brief review of the literatures.


Asunto(s)
Humanos , Embarazo , Hernia Inguinal , Incidencia , Extremidad Inferior , Ligamento Redondo del Útero , Ultrasonografía Doppler en Color
9.
Korean Journal of Obstetrics and Gynecology ; : 546-550, 2010.
Artículo en Coreano | WPRIM | ID: wpr-67092

RESUMEN

Disseminated peritoneal leiomyomatosis is rare condition characterized by multiple subperitoneal nodules of benign smooth muscle proliferations. It is associated with high level of estrogen such as pregnancy, oral contraceptives or estrogen producing ovarian tumor, and occasionally associated with operation history of myomectomy or hysterectomy. Clinical course of disseminated peritoneal leiomyomatosis is usually benign, but malignant changes also rarely have been reported. We experienced a case of disseminated peritoneal leiomyomatosis who has history of laparoscopic myomectomy 10 years ago. The patient was a 35-year-old woman, and her chief complaint was palpable masses in lower abdomen. She underwent laparoscopic surgery which revealed numerous solid masses on the surface of peritoneum, descending colon, rectosigmoid colon, uterus, round ligament, and broad ligament. We present it with a brief review of literature.


Asunto(s)
Adulto , Femenino , Humanos , Embarazo , Abdomen , Ligamento Ancho , Colon , Colon Descendente , Anticonceptivos Orales , Estrógenos , Histerectomía , Laparoscopía , Leiomiomatosis , Músculo Liso , Peritoneo , Ligamento Redondo del Útero , Útero
10.
Korean Journal of Obstetrics and Gynecology ; : 1533-1538, 2008.
Artículo en Inglés | WPRIM | ID: wpr-29191

RESUMEN

Inguinal endometriosis is a rare gynecologic disease. A 43-year-old woman had felt small nodular mass, which causing cyclic groin pain and fluctuation with menstrual cycle. CT scan revealed the extraperitoneal inguinal mass connected to the left round ligament. During the operation, infiltrative fibrotic mass around the inguinal mass could only be excised with wide groin dissection. After dissection of the abdominal muscles, the intraperitoneal mass could be pulled out and excised at the level of the intact round ligament. Histological diagnosis at the excised mass was endometriosis. After the surgery, the pain disappeared completely. We have reviewed published articles concerning inguinal endometriosis. The mechanism of development of inguinal endometriosis seems to be to that of indirect hernia with a difference of disappearing hernia sac resulting from inflammation of endometriosis. About half of the patients revealed periodicity such as cyclic pain or fluctuation of pain with menstral cycle. We describe the complete surgical excision of extraperitoneal inguinal endometriosis connected to round ligament endometriosis. Successful treatment can be achieved with understanding of the pathophysiology and anatomy related to the inguinal endometriosis.


Asunto(s)
Adulto , Femenino , Humanos , Músculos Abdominales , Endometriosis , Enfermedades de los Genitales Femeninos , Ingle , Hernia , Inflamación , Ciclo Menstrual , Periodicidad , Ligamento Redondo del Útero
11.
Journal of the Korean Surgical Society ; : 396-398, 2008.
Artículo en Coreano | WPRIM | ID: wpr-92311

RESUMEN

In females, a small evagination of parietal peritoneum accompanies the round ligament through the inguinal ring into the inguinal canal and is called the canal of Nuck; it is homologous to the process vaginalis in males. If it fails to undergo complete obliteration, an indirect inguinal hernia or a hydrocele of the canal of Nuck can occur. We report three cases of this rare developmental disorder, discuss the CT findings and its use in the diagnosis of a hydrocele of the canal of Nuck.


Asunto(s)
Femenino , Humanos , Masculino , Hernia Inguinal , Conducto Inguinal , Peritoneo , Ligamento Redondo del Útero , Ligamentos Redondos
12.
Journal of the Korean Surgical Society ; : 459-461, 2008.
Artículo en Coreano | WPRIM | ID: wpr-54101

RESUMEN

Laparoscopic cholecystectomy has been widely performed as the gold standard for patients suffering with symptomatic gallstone disease. However, conversion to open cholecystectomy is a dilemma when the surgeon encounters a variant biliary anomaly. A gallbladder lying to the left of the round ligament represents a rare congenital anomaly, which is termed as a left-sided gallbladder. The true left-sided gallbladder, situated on the inferior aspect of the left lobe of the liver, is extremely rare and this represents a truly ectopic gallbladder that may developmentally arise as a second gallbladder from the left hepatic duct. This is accompanied by the disappearance of the normal gallbladder on the right side. We report here on 2 cases of left-sided gallbladder that were successfully treated with laparoscopic cholecystectomy at Hallym Medical Center. In both cases, the true left-sided gallbladders were identified intraoperatively. The round ligament was indeed located in its normal position, and the gallbladder was located to the left of the round ligament, which is a type of malposition known as sinistroposition. The operation was carried out in the usual manner with the trocars placed their usual location. Although operations can be carried out with using the standard port sites, a better arrangement for laparoscopic cholecystectomy consists of more medial positioning of the gallbladder-retracting port and placement of the right hand operating port to the left side of the round ligament.


Asunto(s)
Humanos , Colecistectomía , Colecistectomía Laparoscópica , Decepción , Vesícula Biliar , Enfermedades de la Vesícula Biliar , Cálculos Biliares , Mano , Conducto Hepático Común , Hígado , Ligamento Redondo del Útero , Ligamentos Redondos , Estrés Psicológico , Instrumentos Quirúrgicos
13.
Korean Journal of Obstetrics and Gynecology ; : 217-221, 2007.
Artículo en Coreano | WPRIM | ID: wpr-117914

RESUMEN

Endometriosis is a common gynecological entity and characterized by the presence of endometrial glands and stroma outside the normal location in the uterine cavity. Endometriosis has been reported mostly in the pelvic cavity but anywhere in the body such as umbilicus, appendix, bladder, cervix, pleural cavity, lung, rectum, vagina, vulva and round ligaments. The abdominal wall is one of the most common sites of extrapelvic endometriosis and usually develops in association with a prior surgical scar. However, endometriosis involving the scarless abdomen is rare. We experienced an unusual presentation of a woman with abdominal wall endometriosis in the absence of previous surgery associated with recurrent pneumothorax in menstrual cycle. We report this case with brief review of the literature.


Asunto(s)
Femenino , Humanos , Abdomen , Pared Abdominal , Apéndice , Cuello del Útero , Cicatriz , Endometriosis , Pulmón , Ciclo Menstrual , Cavidad Pleural , Neumotórax , Recto , Ligamento Redondo del Útero , Ombligo , Vejiga Urinaria , Vagina , Vulva
14.
Korean Journal of Obstetrics and Gynecology ; : 134-142, 2005.
Artículo en Coreano | WPRIM | ID: wpr-123813

RESUMEN

OBJECTIVE: To optimize a technique and evaluate the outcomes of total laparoscopic hysterectomy (TLH) performed by conventional intracorporeal suture and ligature under the 3-port method. METHODS: Eighty six patients had TLH at our hospital between July 1998 and June 2000 due to gynecologic benignancies. Operation procedures, the type and number of suture and ligature and the operation time were analyzed through reviewing of their medical records and operation video tapes. RESULTS: Overall operation time was 93.2 +/- 25.3 (mean +/- SD) minutes. The mean lapsed time was 19.8 +/- 8.5 minutes for securing and dividing the round ligaments, infundibulopelivic or ovarian ligaments, 21.39.3 minutes for securing and dividing the uterine vessels, cardinal and uterosacral ligaments, 18.7 +/- 6.2 minutes for vaginal vault support and closure, 12.1 +/- 6.4 minutes for peritoneal approximation and final inspection. Overall number of suture ligature was 26.8 +/- 2.9. The mean number of suture ligature was 5.5 +/- 1.7 for securing and dividing the round ligaments and infundibulopelivic or ovarian ligaments, 4.2 +/- 1.2 for securing and dividing the uterine vessels, cardinal and uterosacral ligaments, 5.2 +/- 0.9 for vaginal vault support and closure, 12.0 +/- 1.8 for peritoneal closure and final laparoscopic inspection. The uterine weight was 205 +/- 100.3 (range: 50.0-530.0) g. No conversion to laparotomy and major operative complications were occurred except for a case of postoperative transient voiding difficulty and a case of postoperative transfusion. CONCLUSION: TLH with the 3-port method can be performed safely and reasonably in the technical aspect and operation time by using conventional intracorporeal suture and ligature. Operation techniques could be optimized more especially in the procedure of vaginal and peritoneal closure to get the shorter operation time.


Asunto(s)
Humanos , Histerectomía , Laparotomía , Ligamentos , Ligadura , Registros Médicos , Ligamento Redondo del Útero , Suturas
15.
Korean Journal of Obstetrics and Gynecology ; : 1069-1073, 2005.
Artículo en Coreano | WPRIM | ID: wpr-202922

RESUMEN

Uterine leiomyomas are the most common benign uterine tumor. They may be subserosal, intramural, or submucosal in location within the uterus or located in the cervix, in the broad ligament, or on a pedicle. But leiomyoma of the round ligament of the uterus is a rare condition occurring predominantly in premenopausal middle-age women, which is usually single and unilateral. In 50% of patients, they are associated with similar lesion of the uterus. Recently we have experienced a case of large cystic myxoid leiomyoma of the round ligament of the uterus misdiagnosed as an ovarian tumor in 32 year-old multiparous woman. We report this case with a brief review of literatures.


Asunto(s)
Adulto , Femenino , Humanos , Ligamento Ancho , Cuello del Útero , Leiomioma , Ligamento Redondo del Útero , Útero
16.
Korean Journal of Dermatology ; : 796-799, 2005.
Artículo en Coreano | WPRIM | ID: wpr-190779

RESUMEN

Myolipoma is a rare biphasic, benign neoplasm that consists of mature adipocytes and smooth muscle cells. It is well-demarcated, with a soft to slimy yellow-white cut surface. Clinically it most often occurs within soft tissue in the abdominal cavity or retroperitoneum, but other locations such as the round ligaments, pericardium, and eyelid have been reported. We herein report a rare case of myolipoma which arose on the right upper lip area in a 68-year-old female.


Asunto(s)
Anciano , Femenino , Humanos , Cavidad Abdominal , Adipocitos , Párpados , Labio , Miocitos del Músculo Liso , Pericardio , Ligamentos Redondos , Ligamento Redondo del Útero
17.
An. Fac. Med. Univ. Fed. Pernamb ; 49(2): 136-137, 2004.
Artículo en Portugués | LILACS | ID: lil-427861

RESUMEN

Leiomiossarcomas são tumores mesenquimais pouco comuns, e tornam-se extremamente raros quando sua origem é de tecido estromal gastrintestinal ou de outra musculatura lisa, transformando-se em achado digno de registro. Leiomiossarcoma, ocorrendo no ligamento redondo, tem como origem pressusposta o remanescente da veia umbilical. Por ser afecção rara, o diagnóstico por imagem é difícil e abrange inúmeros diferenciais, necessitando da histologia para confirmá-lo


Asunto(s)
Adulto , Masculino , Leiomiosarcoma , Hígado , Ligamento Redondo del Útero , Biopsia
18.
Korean Journal of Obstetrics and Gynecology ; : 1232-1235, 2004.
Artículo en Coreano | WPRIM | ID: wpr-36283

RESUMEN

Endometriosis generally occurs in the pelvis, particularly in the broad ligament, round ligament, ovaries, fallopian tubes or uterosacral ligament. However, many unusual sites have been described, including the umbilicus, cesarean section scars, hernia sacs, appendix, vagina, vulva, omentum and perineum. We experienced a case of perineal endometriosis diagnosed according to cyclic perineal pain associated with menstration and report it with brief review of literature.


Asunto(s)
Femenino , Embarazo , Apéndice , Ligamento Ancho , Cesárea , Cicatriz , Endometriosis , Episiotomía , Trompas Uterinas , Hernia , Ligamentos , Epiplón , Ovario , Pelvis , Perineo , Ligamento Redondo del Útero , Ombligo , Vagina , Vulva
19.
Korean Journal of Obstetrics and Gynecology ; : 2312-2316, 2003.
Artículo en Coreano | WPRIM | ID: wpr-192056

RESUMEN

Intramural pregnancy is among the rarest forms of ectopic pregnancy. Since it has been first reported by Doederlein in 1913, 37 cases were reported in worldwide literatures. The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament. Because of the difficult early diagnosis of intramural pregnancy, most cases were found after the onset of complications such as uterine rupture, shock and hemoperitoneum. Early detection of intramural pregnancy with the use of transvaginal ultrasonogram is important, and MRI is a useful, noninvasive imaging modality. We report a case of successful conservative chemotherapy for a intramural pregnancy with brief review of literatures.


Asunto(s)
Femenino , Embarazo , Quimioterapia , Diagnóstico Precoz , Trompas Uterinas , Fertilización , Hemoperitoneo , Imagen por Resonancia Magnética , Embarazo Ectópico , Ligamento Redondo del Útero , Choque , Ultrasonografía , Rotura Uterina
20.
Korean Journal of Obstetrics and Gynecology ; : 323-330, 2003.
Artículo en Coreano | WPRIM | ID: wpr-84064

RESUMEN

OBJECTIVE: To review the safety and effectiveness of a new vaginal hysterectomy method, Minilaparatomically Assisted Vaginal Hysterectomy (MAVH), tried on benign diseases with indication of abdominal hysterectomy. MATERIALS AND METHODS: The analysis of the safety and the effectiveness of MAVH is based on randomized consecutive 75 patients who received the operation from Feb. 1, 2002 to Jul. 10, 2002 in the department of Obstetrics and Gynecology at Gacheon Medical University Hospital. OPERATION TECHNIQUE: Access to the pelvic cavity was obtained by the traditional suprapubic minilaparotomical incision that is 2-2.5 cm long and parallel to the pubic hair line. Through this incision site, the adnexa and other pelvic organs around the bladder were brought into sight by manipulating the uterine elevator that was already inserted into the uterine cavity. By this method, the round ligament, uteroovarian ligament, and the fallopian tube were exposed at the incision site, then clamped, cut, sutured and divided. The dissection of the bladder peritoneum was performed and then followed by the traditional transvaginal approach. RESULTS: The MAVH was successful in 73 cases (97.3%) out of 75 attempts. The mean age, parity, weight, and body mass index of the subjects of the 73 cases were 42.6 (+/-7.8) years, 2.0 (+/-0.7), 59.5 (+/-7.5) kg, and 23.6 (+/-2.6). Forty subjects (54.8%) had a previous surgical history. The operational indications were 44 cases (60.3%) of uterine myoma, 19 cases (26.0%) of uterine bleeding, 7 cases (9.6%) of dysmenorrhea, and 3 other cases (4.1%). There were 6 cases (8.2%) of cumulative complication. In terms of pathologic diagnosis, 54 cases (74.0%) were uterine myoma with adenomyosis, 12 cases (16.4%) adenomyosis, 2 cases (2.7%) endometrial polyp, 1 case (1.4%) endometrial hyperplasia, 1 case endometrial cancer, and 3 other cases. The weights of uteri ranged from 75 gm to 1150 gm with an average of 286.8 (+/-217.5) gm. The average operation time for MAVH from skin incision to the completion of suture was 75.8 (+/-21.8) minutes. The average bowel function recovery time was 45.9 (+/-12.9) hours. The external bleeding loss was 337.0 (+/-306.8) ml, 11.0% (8/73) required transfusion with an average amount of 1.5 pint. No subject of this study needed reoperation or expired. CONCLUSION: The technique of MAVH is simple and easy to learn. The MAVH involves a relatively small size of incision and less pain and complication with fast recovery and small wound. The method requires a little bit of practice but not an expensive equipment. The MAVH is considered as a safe and effective operational method which could replace the abdominal hysterectomy in most cases.


Asunto(s)
Femenino , Humanos , Adenomiosis , Índice de Masa Corporal , Diagnóstico , Dismenorrea , Ascensores y Escaleras Mecánicas , Hiperplasia Endometrial , Neoplasias Endometriales , Trompas Uterinas , Ginecología , Cabello , Hemorragia , Histerectomía , Histerectomía Vaginal , Leiomioma , Ligamentos , Obstetricia , Paridad , Peritoneo , Pólipos , Recuperación de la Función , Reoperación , Ligamento Redondo del Útero , Piel , Suturas , Vejiga Urinaria , Hemorragia Uterina , Útero , Pesos y Medidas , Heridas y Lesiones
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