A rare case report of ovarian torsion with sigmoid volvulus

Ovarian torsion results from twisting of the ovary about the suspensory ligament, which contains the ovarian artery and vein, lymphatic’s, and nerves. Volvulus is a torsion of a segment of the alimentary tract, that often leads to intestinal obstruction. Ovarian torsion leading to sigmoid volvulus is the rarest complication which authors found in this case. Hence the case was presented. A 28-year-old women presented with acute pain in abdomen since 14 hours, followed by 2 episodes of vomiting, abdominal distension since 10 hours. Plain X-ray Abdomen erect was done which showed ‘Coffee bean’ sign with multiple air fluid levels suggestive of sigmoid volvulus. On laparotomy, after opening the peritoneum, large right ovarian cyst around 12×11×10 cm with solid and haemorrhagic content with long pedicle around 8 cm with 3 turns of torsion was noted. Abutting the ovarian mass, sigmoid colon was seen twisted around its mesentery including the twisted ovarian pedicle. Hence, the twisted component included the twisted ovarian pedicle and twisted sigmoid mesentery. Stepwise detorsion of ovarian pedicle followed by oophorectomy was done. For sigmoid volvulus, resection of vascular compromised sigmoid colon and descending colon stoma was done. Reanastomosis was done later after 3 months post operatively.

Study of etiopathogenesis and clinical profile of patients presenting with abnormal uterine bleeding

Background: AUB is a common condition affecting 14-25% of women of reproductive age and may have a significant impact on their physical, social, emotional and material quality of life. AUB can occur at any age in various forms and has different modes of presentation. The key to successful clinical management is to recognize or identify the causative factors responsible.Methods: This study was conducted over 100 patients. Patients with complaints of menstrual irregularity between menarche to premenopausal age group were considered. Data about age, parity, menstrual history, obstetric history, medical history, physical examination, thyroid function test, radiological findings and histopathology were collected and studied.Results: Incidence of AUB is more common in 5th decade of life. Menorrhagia is the most common bleeding pattern. It is concluded that DUB is the most common cause of AUB. Among the other organic pathological causes, fibroid is the commonest. Maximum number of apparently normal patients with abnormal uterine bleeding belong to category of sub clinical hypothyroid.Conclusions: Accurate analysis of endometrial sample is the key to effective therapy and rational approach to treatment of women with abnormal uterine bleeding.

An observational study of maternal and fetal outcome in pregnant women with Hepatitis E

Background: Hepatitis E in pregnancy has been a subject of interest in the recent years as the available research work is very limited and conflicting especially in pregnant women as compared to infection in men and non- pregnant women in which the disease is usually self- limiting. The mechanism of liver injury in hepatitis E is not clear and no conclusive theories about the exact pathogenesis are available. This study was done to gain insight into the effects of hepatitis E virus on pregnancy in terms of maternal and fetal outcome.Methods: Total of 40 pregnant women with Hepatitis E Virus IgM antibodies was included in the study. Hepatitis cases due to other viral and non-infective causes were excluded. Maternal outcomes in terms of mode of delivery, complications like PPH, hepatic encephalopathy, fulminant hepatic failure, coagulopathy and maternal mortality was studied. Fetal outcomes in terms of intrauterine fetal deaths, stillbirth, live births, and neonatal deaths were studied.Results: This study showed high mortality rates (42.5%) in pregnant women with hepatitis E. The most common obstetric complication was IUFD (45%) followed by preterm labor (32.5%) and postpartum hemorrhage (22.5%). Hepatic encephalopathy (62.5%) was the commonest medical complication followed by coagulopathy (25%). A statistically significant association was found between the presence of medical complications and poor maternal outcome.Conclusions: Hepatitis E virus infection in pregnancy often has a fulminant course with poor maternal and fetal outcome. Its management therefore requires an early diagnosis, and a multidisciplinary approach.