Cullen Sign and Grey Turner Sign Revisited.

Cullen sign and Grey Turner sign, named after Thomas Stephen Cullen, MB, and George Grey Turner, MBBS, respectively, are signs of abdominal wall hemorrhage and are generally associated with acute pancreatitis. However, the research from which these signs arose was documented long before Cullen and Grey Turner made their contributions. The present article examines the history, pathologic mechanisms, and clinical application of these signs in relation to acute pancreatitis and ectopic pregnancy.

Ectopic pregnancy: how the diagnostic and therapeutic management has changed.

Nowadays ectopic pregnancy often can be diagnosed before the woman's condition has deteriorated, which has altered the former clinical picture of a life-threatening disease into a more benign condition. This review describes the historical developments in the diagnostic and therapeutic management of ectopic pregnancy leading up to current clinical practice. The first attempts to diagnose ectopic pregnancy originate from the beginning of the 20th century.

Ectopic pregnancy: History, incidence, epidemiology, and risk factors.

Ectopic pregnancy is directly related to tubal infection, and so prevention of chlamydia and gonorrhea must be the watchword to lower its risk and incidence. With accurate determination of very low human chorionic gonadotropin concentrations and sonography, >85% of women are diagnosed before tubal rupture, which has led to medical therapy and laparoscopic surgery with tubal preservation and the potential for future fertility. Today, early intervention saves lives and reduces morbidity, but ectopic pregnancy still accounts for 4% to 10% of pregnancy-related deaths and leads to a high incidence of ectopic site gestations in subsequent pregnancies.

Of leaves and butterflies: how methotrexate came to be the savior of women.

A little more than half a century ago, young women were frequently dying of reproductive sequelae such as ectopic pregnancies and gestational trophoblastic disease. Mortality from these conditions was as high as 90% in the case of metastatic choriocarcinoma. If lives could be saved, it was in the operating theater and often at the expense of future reproductive potential. By the 1940s, however, targeted chemotherapy was starting to be explored, and the development of methotrexate for the treatment of childhood leukemia in 1949 eventually resulted in an unexpected, but nevertheless long and happy association with the field of gynecology. Here we trace the origins of methotrexate and how it came to be an effective medical treatment for two life-threatening gynecologic conditions. It illustrates how the contributions of many clinicians and scientists from many disciplines, over the greater part of a century, come together to improve the care of a single patient today.

El embarazo ectópico se incrementa en el mundo / The ectopic pregnancy is increasing at world level

Se realizó una amplia revisión bibliográfica, que incluyó los trabajos de unos 50 autores nacionales e internacionales obtenidos de libros impresos y de una acuciosa búsqueda en Internet, con el objetivo de evaluar las causas de la elevada incidencia del embarazo ectópico (EE) en su forma clínica complicada. Igualmente indagar sobre sus elementos histórico-epidemiológicos y clasificar el EE; profundizar sobre su fisiopatología, así como diagnosticarlo y manejarlo terapéuticamente. Se realizó la recopilación de datos que permiten alertar a los médicos de la atención primaria y/o especialistas de Ginecoobstetricia, cuándo sospechar la presencia de un embarazo ectópico y poder hacer el diagnóstico antes de que ocurra su complicación. Esto pudiera redundar en la disminución de la elevada mortalidad que se asocia a esta entidad (AU)

A wide bibliographic review was made including all papers from 50 national and foreign authors obtained of printed books and of deep search in Internet to assess the causes of the high incidence of ectopic pregnancy (EP) in its complicated clinical presentation, to inquire into on its historical-epidemiological elements and to classify the EP, to deepen on the data collection allowing us to alert to primary care physicians and/or Gynecology and Obstetrics specialist when they must to suspect on the presence of an ectopic pregnancy and to made the diagnosis before appearance of a complication. It could to have an effect on decrease of the high mortality associated with this entity (AU)

The early days of ruptured ectopic pregnancy.

Today, when lives are routinely saved by early open or laparoscopic surgery, it is hard to imagine that young women suffering from ruptured ectopic pregnancy were left to their fate or submitted to procedures which had no possibility of dealing effectively with the haemorrhaging fallopian tube. As we shall describe, the first success in dealing with this emergency was not until 1883.

Salpingectomy for ruptured ectopic pregnancy.

Not much more than a century ago, a ruptured ectopic pregnancy was a death sentence. In 1876, John Parry wrote in his book on this subject: 'Here is a wife in the most useful period of her existence, which good authorities have said is never cured; and for which, even in this age when science and art boast of such high attainments, no remedy, either medical or surgical, has been tried with a single success'. When we read that eminent authorities were advising the use of electric shocks, injection of narcotics into the sac and copious and frequent bleeding, one is hardly suprised. Parry himself suggested that the only remedy would be to open the abdomen and either tie the bleeding vessels or remove the sac entirely.

Conception, complicated pregnancy, and labour of gods and heroes in Greek mythology.

Pregnancy and labour are holy moments in a woman's life. Even in Greek mythology we can find descriptions of them. We searched in the Greek myths to find descriptions of labours of ancient heroes and gods. We identified descriptions of extracorporeal fertilization, superfecundation, ectopic pregnancy, preterm labour, prolonged pregnancy and Caesarean section. The use of imagination could help the reader to find similarities in present or future developments in the field of obstetrics. It could be concluded that various aspects of modern obstetrical practice are described in Greek mythology.

[Examples of emergency surgery. Ectopic pregnancy, biliary ileus, appendicitis]. / Exemples de chirurgie d'urgence. Grossesse extra-utérine, iléus biliaire, appendicite.

Surgery was practised at home for a long time during the first half of the XXth century. The improvement of anaesthesia and of the structures of cares provoked the progressive disappearing of these practices after the WWII. Although modern techniques were currently used in the Hospitals of the Universities the conditions of practising remained the same in some countries at the beginning of the century. At the beginning of the 50s before the growing transports surgical emergencies could be taken in charge at home in some areas uneasy to reach.