RESUMO
Resumen ANTECEDENTES: La endometriosis de la pared abdominal implica la coexistencia de tejido endometrial en la superficie peritoneal parietal; la incidencia reportada es de 0.03 a 3.5%. Su causa aún no está debidamente esclarecida. CASO CLÍNICO: Paciente de 35 años, con antecedentes ginecoobstétricos de: tres embarazos, tres cesáreas, última cinco años previos a la intervención, en la que se practicó una histerectomía obstétrica indicada por sangrado transoperatorio. El padecimiento actual se inició 24 horas previas a su ingreso a Urgencias, con dolor espontáneo en la fosa iliaca derecha, de difícil relación con los ciclos menstruales debido al antecedente quirúrgico, acompañado de aumento de volumen y náuseas. En la exploración inicial se identificaron dos masas intraabdominales que se confirmaron en la tomografía computada, situadas por encima de la aponeurosis. Se procedió a la intervención quirúrgica para extirpación de ambas masas. El estudio histopatológico reportó: tumores compatibles con endometriosis. CONCLUSIÓN: La endometriosis es un padecimiento con alta prevalencia en el mundo, no así en su ubicación en la pared abdominal. A pesar de que aún no se conoce con certeza su causa, se sabe que la inoculación directa (muchas veces debida a un procedimiento ginecológico quirúrgico) y la proliferación celular tienen participación relevante en su origen.
Abstract BACKGROUND: Abdominal wall endometriosis is the coexistence of endometrial tissue on the parietal peritoneal surface with a reported incidence of 0.03 to 3.5%. Its cause is not well understood. CLINICAL CASE: 35-year-old female patient with a gyneco-obstetric history of: three pregnancies, three cesarean sections, last five years prior to surgery, in which an obstetric hysterectomy was performed, indicated by transoperative bleeding. The current presentation began 24 hours before her admission to the emergency department with spontaneous pain in the right iliac fossa, difficult to relate to menstrual cycles due to her surgical history, accompanied by increased volume and nausea. Initial examination revealed two intra-abdominal masses, confirmed by computed tomography, located above the aponeurosis. Surgery was performed to remove both masses. Histopathologic examination revealed tumors compatible with endometriosis. CONCLUSION: Endometriosis is a very common disease in the world, but not in the abdominal wall. Although its cause is still not known with certainty, it is known that direct inoculation (often due to gynecologic surgery) and cell proliferation play a relevant role in its origin.
RESUMO
BACKGROUND: With increasing number of female pilots who fly high-performance aircraft, the gender specific factors have become one of the most important aeromedical considerations. It has been raised that the changes of serum female hormone levels by menstrual cycle may affect vasoregulation and female G-tolerance ultimately. However, the exact relationship between serum female hormone levels and G-tolerance is still unknown. Moreover, well-controlled subjects without taking oral contraceptives are needed to examine the possible effect of menstrual cycle on female G-tolerance. The purpose of this study was to determine how female hormones and menstrual cycle affect female relaxed G-tolerance. METHODS: Eight female subjects were studied to test their relaxed G-tolerance. Seven out of 8 subjects had regular menstrual cycle during the study period. Each subject were exposed to human centrifuge once a week for 4 weeks (one complete menstrual cycle) and blood samplings were performed twice at 2nd and 4th week just before exposure to human centrifuge. The profile of centrifuge training consisted of gradual-onset run (0.1 G/sec) acceleration to the visual endpoint. RESULTS: The changes of 4 different serum female hormone levels failed to show any trend related to relaxed G-tolerance including estrogen. There was no significant difference in relaxed G-tolerance in any menstrual cycle time points. CONCLUSION: We conclude that the changes of female hormone levels and the menstrual cycle have no effect on female relaxed G-tolerance.