Re: Amazing case - follow-up

From: art fougner, md (evsono@pipeline.com)
Wed Nov 12 08:53:17 2003


i don't have access to the full article but this reference seems worth reviewing -

: Abdom Imaging. 1995 Sep-Oct;20(5):486-8. Related Articles, Links

Gravid uterine dehiscence: MR findings.

Hamrick-Turner JE, Cranston PE, Lantrip BS.

Department of Radiology, University of Mississippi Medical Center, Jackson 39216-4505, USA.

Gravid uterine rupture can be a difficult diagnosis, both clinically and radiologically. Ultrasound has been successful in detection of some indirect signs of uterine rupture but thus far has shown little success in demonstrating the myometrial defect. We present the MR findings in a case of gravid uterine dehiscence in which the actual uterine wall defect was well demonstrated. Gross pathologic correlation is provided.

art

At Tue, 11 Nov 2003, art fougner, md wrote: >
>was the case reviewed with the radiologist subsequent to the delivery?
>would be interested in their opinion as to what caused this image of a
>protrusion.
>
>art
>
>At Tue, 11 Nov 2003, Terrence.Jones@kp.org wrote:
>>
>>This is a multipart message in MIME format.
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>>So much for hypothetical image specificity. What caused the 'protrusion' -
>>incisional or Spigelian hernia? What caused the pain? Why deliver if, upon
>>opening, no defect was encountered? S'pose the defect on MRI was below the
>>VUPR ('bladder flap'). S'pose the lower segment was a mass of adhesions,
>>and the decision was made to enter higher (after all, She's had two prior
>>classical incisions). Is it possible that, following delivery,
>>involutional changes due to myometrial contractility might have 'sealed
>>the diagnosis'? Winter approaches. [Oh; single layer closure? >:) tj]
>>
>>"Lynn D. Montgomery, M.D." <apgar10@montanadsl.net>
>>Sent by: ob-gyn-l@obgyn.net
>>11/11/2003 08:25 AM
>>Please respond to ob-gyn-l
>>
>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>> cc:
>> Subject: Amazing case - follow-up
>>
>>A decision was made to go to section based on the MRI. At the time of
>>surgery, no defect found. 26 weeker in the nursery.
>>
>>Remember, it ain't my case...
>>Lynn
>>
>>Lynn D. Montgomery, M.D.
>>Rocky Mountain Women's Health
>>2835 Fort Missoula Rd., Suite 303
>>Missoula, Montana, 59804
>>406-549-0978
>>fax 406-549-0987
>>e-mail: apgar10@montanadsl.net
>>
>>------ Attachment(s) have been removed ------
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>><br><font size=2 face="sans-serif">So much for hypothetical image specificity. What caused the 'protrusion' - incisional or Spigelian hernia? What caused the pain? Why deliver if, upon opening, no defect was encountered? S'pose the defect on MRI was below the VUPR ('bladder flap'). S'pose the lower segment was a mass of adhesions, and the decision was made to enter higher (after all, She's had two prior classical incisions). Is it possible that, following delivery, involutional changes due to myometrial contractility might have 'sealed the diagnosis'?  Winter approaches. [Oh; single layer closure?    >:)   tj]   </font>
>><br>
>><table width0%>
>><tr valign=top>
>><td>
>><td><font size=1 face="sans-serif"><b>"Lynn D. Montgomery, M.D." <apgar10@montanadsl.net></b></font>
>><br><font size=1 face="sans-serif">Sent by: ob-gyn-l@obgyn.net</font>
>><p><font size=1 face="sans-serif">11/11/2003 08:25 AM</font>
>><br><font size=1 face="sans-serif">Please respond to ob-gyn-l</font>
>><br>
>><td><font size=1 face="Arial">        </font>
>><br><font size=1 face="sans-serif">        To:        Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net></font>
>><br><font size=1 face="sans-serif">        cc:        </font>
>><br><font size=1 face="sans-serif">        Subject:        Amazing case - follow-up</font></table>
>><br>
>><br><font size=3 face="sans-serif">A decision was made to go to section based  on the MRI.  At the time of surgery, no defect found.  26 weeker in  the nursery.</font>
>><br><font size=3 face="sans-serif"> </font>
>><br><font size=3 face="sans-serif">Remember, it ain't my case...</font>
>><br><font size=3 face="sans-serif">Lynn</font>
>><br><font size=3 face="sans-serif"> </font>
>><br><font size=3 face="sans-serif">Lynn D. Montgomery, M.D.</font>
>><br><font size=3 face="sans-serif">Rocky Mountain Women's Health</font>
>><br><font size=3 face="sans-serif">2835 Fort Missoula Rd., Suite 303</font>
>><br><font size=3 face="sans-serif">Missoula, Montana, 59804</font>
>><br><font size=3 face="sans-serif">406-549-0978</font>
>><br><font size=3 face="sans-serif">fax 406-549-0987</font>
>><br><font size=3 face="sans-serif">e-mail: apgar10@montanadsl.net</font>
>><br>
>><br><font size=3 face="sans-serif"> </font>
>><br>
>><br><font size=2 face="sans-serif"><br>
>></font><font size=3 color=#800080><tt><b>------ Attachment(s) have been removed ------</b></tt></font>
>><br>
>
>--
>art fougner, md
>ich bin ein New Yorker
>

--
art fougner, md
ich bin ein New Yorker




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