Hematometra y hematocervix en paciente postmenopáusica: reporte de caso / Hematometry and hematocervix in postmenopausal patient: case repor

El hematometra es la retención de sangre en el útero y comúnmente se presenta en mujeres jóvenes con anomalías mullerianas pero puede aparecer también en mujeres postmenopausicas por causas secundarias como traumas, tumores, terapia de remplazo hormonal, estenosis cervical, entre otras. En esta presentación de caso interesante se describe una mujer postmenopáusica bajo terapia de remplazo hormonal. Dicha mujer inicia con hemorragia uterina anormal por lo que se le realiza ultrasonido evidenciando hematómetra y hematocervix. Como método diagnóstico y terapéutico de la hemorragia postmenopáusica se le realiza histerectomía abdominal en la cual la patología evidencia leiomiomatosis uterina con endometrio secretor

Hematometra is the retention of blood in the uterus and commonly occurs in young women with Mullerian abnormalities but can also appear in postmenopausal women due to secondary causes such as trauma, tumors, hormone replacement therapy, cervical stenosis, among others. In this presentation an interesting case is described a postmenopausal woman under hormone replacement therapy. She said woman began with abnormal uterine bleeding, so an ultrasound was performed showing hematometer and hematocervix. As a method diagnosis and treatment of postmenopausal hemorrhage, abdominal hysterectomy is performed in which the pathology shows uterine leiomyomatosis with secretory endometrium

Occlusion of upper genital tract following lower segment caesarean section for placenta praevia

Uterine cavity occlusion following caesarean section for central placenta praevia culminating in haematometra and thereby amenorrhoea is one of the rarest long term complications of lower segment caesarean section. We report a case of 28 year old primigravida with Grade 4 placenta praevia who underwent elective caesarean section at 35 weeks gestation. She presented at Nizwa Hospital, Sultanate of Oman, after 7 months with cyclical lower abdominal pain and amenorrhoea. She was treated by hysteroscopic adhesiolysis and an in utero Foley's catheter. She had complete resolution of her condition within 2 months and resumption of menstrual cycles. Multiple haemostatic sutures at caesarean section for placenta praevia can be an causative factor for such a complication along with other risk factors like multiple caesarean sections, chorioamniotis etc. Recognition of these factors, meticulous surgical technique and appropriate post operative care can effectively prevent it

Hemihaematometra with persistent undeveloped Wolffian duct.

A case of hemihaematometra in a non-communicating rudimentary horn of the uterus in a 14 year old girl is presented. Exploratory laparotomy revealed a persistent undeveloped Wolffian duct. This is the second case in world literature where a persistent mesonephric duct without any development is reported.

Dos casos infrecuentes de presentación del cáncer de endometrio / 2 atypical presentation cases of the endometrial cancer

Se analizan dos casos de cáncer de endometrio de presentación atípica, el primero en una mujer con radioterapia pelviana previa por un cáncer cérvicouterino, y el segundo en una paciente con antecedentes de terapia coadyuvante con tamoxifeno por un cáncer de mama. Se discute el riesgo de hacer segundos primarios en pacientes ya tratadas por una neoplasia y la eventual asociación de radioterapia pélvica y tamoxifeno con la subsiguiente aparición de un cáncer de endometrio

Himen imperforado / Imperforate hymen

Se presenta un caso clínico de himen imperforado. Se describe el rol de la ecografía en su manejo y las alternativas terapéuticas actuales

Diagnóstico ecográfico de hidro ou hematométrio associado ou näo a hidro ou hematocolpus: apresentaçäo de 5 casos / Ecographic diagnosis of hydro or hematometra associated or not to hydro or hematocolpos: report of 5 cases

Relatam-se 5 casos de hematométrio e hematocolpus. Discutem-se os resultados ecográficos característicos dessas afecçöes que säo mais freqüentes em grupos mais jovens e em idosos. Recomendam-se incorporar o ultra-som pélvico na pesquisa clínica dessas pacientes e estender o exame a outros órgäos, especialmente o sistema renal infantil