RESUMO
Ileal penetration by a copper-bearing intrauterine device (IUD) is a rare but serious potential complication. This paper reports the case of a 30-year-old gravida 4 para 3 woman with ileal embedding by an IUD. Laparoscopy was performed on the patient 4 months after the insertion of the IUD. When the tail of the IUD was seen during laparoscopy protruding outside the small bowel, the device was removed through a 1-cm incision in the ileum by laparotomy. This report demonstrates a rare case of ileal embedding of an IUD.
Assuntos
Migração de Corpo Estranho/cirurgia , Doenças do Íleo/etiologia , Doenças do Íleo/cirurgia , Dispositivos Intrauterinos/efeitos adversos , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adulto , Remoção de Dispositivo/métodos , Feminino , Seguimentos , Migração de Corpo Estranho/diagnóstico por imagem , Humanos , Doenças do Íleo/diagnóstico por imagem , Laparotomia/métodos , Medição de Risco , Resultado do Tratamento , Ultrassonografia DopplerRESUMO
Glutathione S-transferase (GST) is a cytosolic enzyme found in high concentrations in the liver. We investigated the value of plasma GST measurements in pre-eclamptic patients. A total of 80 patients (40 in the pre-eclampsia group and 40 in the control group) were recruited. All patients were evaluated for GST, alanine aminotransferase (ALT), aspartate aminotransferase and lactate dehydrogenase. Pre-eclampsia was defined as the occurrence, after 20 weeks' gestation, of a diastolic blood pressure greater than 90 mmHg on two or more occasions at least 4 h apart, and concomitant proteinuria greater than 0.3 g/l over a 24-h urine collection period. There was no statistical difference between the pre-eclampsia and control groups in terms of ALT, gestational age, maternal age or number of previous pregnancies; a significant difference was found between the pre-eclampsia and control groups in terms of GST. Preeclampsia represents a significant cause of maternal and perinatal morbidity and mortality. Accurate assessment of hepatocellular damage is essential in the clinical management of these patients. GST levels in pre-eclamptic patients were found to be much higher (131.98 IU/l) than in control patients (68.67 IU/l), and this high level suggests hepatocellular damage. We concluded that measurement of plasma GST might provide an earlier and much more sensitive indicator of hepatocellular damage than other liver-function tests.
