[Serous cystadenoma in supernumerary ovary. Case report and literature review]. / Cistoadenoma seroso en ovario supernumerario. Reporte de un caso y revisión de la bibliografía.

BACKGROUND: The ovaries accessories, ectopic and supernumerary represent a rare gynecological disorder; incidence ranges from 129,000 to 1:700,000 cases. CLINIC CASE: Patient 55 years of age who arrived at by diffuse abdominal pain 2 weeks of evolution, nausea and vomiting, with no history of chronic degenerative diseases or surgical. Palpation abdomen soft depressible globoso palpable mass at the expense of 30x20 cm, painless to superficial and deep pressure. Bimanual: anteversoflexion uterus 9 cm, 20 cm tumor, soft, fixed, mild pain in the cervical mobilization funds free bag. Laboratory tests and tumor markers for ovarian unchanged. The abdominopelvic ultrasound ecomixta reported prodomain cystic mass of 28x13x26 cm, volume 5,470 mL, with papillary projections, septa and caps 6 mm thick. Contrasted abdominal tomography: nodular image of 20 cm, heterogeneous, predominantly cystic, with septa, uptake of contrast medium in the pelvic cavity of probable ovarian origin. laparotomy was performed and found: 8 cm uterus, normal, both atrophic ovaries; 30x20 cm tumor, smooth edges, with neovascularization and areas of calcification with serous content of 5,000 cc, attached to the handles of the jejunum and ileum; transverse colon, back and tail of the pancreas; It was dissected into the retroperitoneum and great vessels, apparent root of the prevertebral fascia. CONCLUSION: The supernumerary ovary is an extremely rare disorder, but should be considered in patients with abdominal tumors.

[Modification of the obstetric hysterectomy in placental acretism]. / Modificación de la histerectomía obstétrica en acretismo placentario.

Acretismo is a condition of abnormal placentation, in which the villi invade the myometrium at the implantation site, Representing a risk of massive obstetric hemorrhage with possible alterations of the coagulation, besides to the damage to other organs. Moving forward even to his death, so it is a challenge for the obstetric services, to make a correct diagnosis and in a timely manner, along with the programming of the interruption of pregnancy, as well as the utilization of proper surgical techniques and the involvement of a multidisciplinary team to the possible complications. The following describes a surgical technique modified for patients with a diagnosis of acretismo placentario, used in the Hospital General de Occidente in Jalisco, Mexico from 1 year ago, presenting two clinical cases of patients who underwent surgery with this technique, considering it necessary to present up to the moment a significant decrease in the amount of bleeding, zero days stay of patients in intensive care, any complications in the mother as well as in the product, and more importantly, it has remained at the hospital with no maternal death by this pathology in the last year, considering the nature of being a referral hospital for the whole entity by the Servicios de Salud Jalisco. It is necessary to consider the risks/benefits in the short, medium and long term for the institution, the mother and the product, allowing present good practices that will impinge on the permanent reduction of the maternal death by this pathology.