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Re: Thoughts on management From: Joanne Bulley, MD (islesannie@yahoo.com) Sun Jan 25 17:15:51 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr James Lie: "Re: Erythropoietin" Previous message: art fougner, md: "Re: Erythropoietin" After reading other responses - what about doing a hysteroscopy - to irrigate out a hematoma - especially if it is infected? ?Consent for a hyst at the same time if needed? Does she want to keep her uterus? Either becuase she wants (even if wishful thinking) to carry a child in her womb ... or just because she is one who wants to hang on the that uterus 'cause she was born with it? Also - could this be a degenerating submucous myoma? it could get infected - or as it necroses, couldn't you get temp - discharge etc looking like an infection just from the myolysis? Maybe as it liquifies, it'd "look" like blood on US? Joanne At Sat, 24 Jan 2004, Tami wrote: > >Any suggestions for management with the following patient: >36y G0 long hx of endometriosis on continuous ocps with good control of her pain. Seen with c/o vaginal discharge--in a rainbow of colors (pink brown red orange) with a foul odor. Her "endometriosis doctor" did cultures/wet mount--all negative, then tx'd her with a week of flagyl and then a week of doxy with no improvement. >Exam normal --all vag type testing neg, but with a yellow dc that she says requires changing a pad almost hourly. Us shows an approx 8x7x7cm hematoma located between the endometrium and myometrium connecting to the cavity by a "crack" in the endometrium. No signs of any other myometrial abnormality; mri shows same. Endo bx showed "chronic endometritis, no atypia". >I'm considering a hysteroscopy, although I'm not sure if it will be helpful for diagnosis or treatment. I think she's heading towards a hyst for both diagnosis and treatment, but wanted to hear other thoughts. > >Thanks. >Tami Dairiki M.D. >private practice >Scottsdale, AZ -- Joanne Bulley, MD Keene, NH, USA ----- "It is easier to understand a nation by listening to its music than by learning its language" -Anonymous Next message: Dr James Lie: "Re: Erythropoietin" Previous message: art fougner, md: "Re: Erythropoietin"

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