Subject(s)
Abnormalities, Multiple/diagnosis , Laparoscopy , Uterus/abnormalities , Vagina/abnormalities , 17-Ketosteroids/analysis , Adult , Female , Follicle Stimulating Hormone/analysis , Humans , Karyotyping , Luteinizing Hormone/analysis , Physical Examination , Syndrome , Testosterone/analysisABSTRACT
PIP: In 1971, a 30-year-old woman underwent a culdoscopic tubal ligation with the application of tantalum clips. She was healthy on first examination and 3 weeks after the operation. Procedure included local anesthesia, meperidine and diazepam analgesia, Weck-Gutierrez clamp for delivering the fallopian tubes, and Weck Hemo-clips applied to the mid ampullae. The patient failed to appear for hysterosalpingogram after her first menses, but returned for abdominal complaint 7 months later. Eleven months after the operation she reported with 5 weeks of amenorrhea, followed 3 days later by cramps and bleeding. Pelvic exam, culdocentesis, and laparoscopy showed a mass in the left fimbria. Pathology revealed a slit lumen on the left, and flat epithelium, attenuated muscle layer bilaterally. The failure to obtain hysterosalpingography and to reveal incomplete occlusion of the tube in this case suggest a need for meticulous follow-up care. The role of epithelium and of muscularis in pregnancy is unclear.^ieng
