Tuberculose miliar e meningea em gestante: relato de um caso. / Miliary and meningeal tuberculosis in a pregnant woman: report of a case

E relato um caso de gestante com tuberculose sistemica, no qual ocorreu parto prematuro de feto natimorto, no dia anterior a morte da paciente por meningite

Endoscopic salpingectomy.

A new laparoscopic surgical procedure, endoscopic salpingectomy, is reported. The technique is based on laparoscopic surgical procedures by electrocoagulation, performed with a triple-puncture technique. It is indicated for patients complaining of chronic pelvic pain clinically treated without success and/or who wish to be sterilized and also have chronic pelvic pain, with positive tubal findings of enlargement and/or hyperemia at laparoscopy. Also presented are pre- and postoperative care, instruments, technique, complications, results and follow-up on the first 100 patients who underwent this procedure.

PIP: 100 patients aged 21-49 underwent endoscopic salpingectomy by monopolar electrocoagulation to obtain relief from chronic pelvic pain previously treated unsuccessfully. The new laparoscopic procedure was developed and performed at the Dept., of Obstetrics and Gynecology of the University of Passo Fundo, Brazil. General anesthesia was used in each case; endoscopic salpingectomy was performed in cases of enlarged and/or hyperemic tubes; in cases of very enlarged and/or adnexal adhesions laparotomy was done. The article describes all preoperative, operative, and postoperative procedures. Surgical time was 40-50 minutes; patients who underwent other surgery procedures at the same time had a longer hospital stay; total average hospitalization was 2.87 days. Patients were seen after 1 week, and only 67 returned for a 30-day evaluation. Main complications from the procedure included pain in 9 cases from residual CO2 used in pneumoperitoneum, and bleeding of the mesosalpinx in 1 case. The procedure failed to relieve chronic pelvic pain in 22 patients; 17 of these patients were subsequently clinically treated, 5 had an additional laparoscopic procedure, and 2 cases are still unsolved. The main advantages of this type of laparoscopic salpingectomy are reduction of length of hospital stay, and of surgery time and surgical trauma; the fact that the patient can return more rapidly to normal activities is very important.