Re: Ultrasound as part of the normal exam
From: Elrod Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)
Thu Mar 17 06:45:29 2005
Just to finish this, I operated today with both general surgery and
urology as none of us seemed to know what it was (although with
everyone's help it seemed much more like it was going to be a paratubal
cyst). We put in a trocar between the umbilicus and the xyphoid and saw
that it was paratubal. I put a needle in through the anterior abdominal
wall and then finished the case laparoscopically.
Thanks for the help!
Glen
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Robert
J. Carpenter, Jr. MD
Sent: Tuesday, March 15, 2005 1:53 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Ultrasound as part of the normal exam
I have seen a unilateral 20cm paraovarian cyst. In Indiana everything
grows big!
Have a great week Dan!!!
On 14 Mar 2005 at 19:35, R. Daniel Braun wrote:
> I have seen bilateral 20 cm Parovarian cysts. The tubes were stretched
> out across them and adherent to them. If there is a mass in the
> pelvis, you won't know what it is until it is in the pathologists
> hands and occasionally not even then. Once you know it is there, it
> need s to be removed, not radiated. I have had adnexal masses that
> turned out to be CA of Colon metastatic to ovary, lymphoma in the
> mesosigmoid, peritoneal inclusion cysts, and of course all of the
> usual GYN characters that we see so often. I have had fibroids called
> Ovarian ca and ovarian ca called fibroid on CT Scan and MRI. Only
> histology will tell youu what ti is so don't try all those other tests
> and waste the money.
>
> On Mon, 14 Mar 2005 19:01:01 -0600, Elrod Darryl G MAJ 48 MDOS/SGOBO
> <Darryl.elrod@lakenheath.af.mil> wrote: > I just had one of that very
> scenario and it took 5 months for a 23 yo > with a 18cm adnexal mass
> to hit my doorstep from the first time it was > identified (as an
> enlarged uterus). Ultrasound inconclusive, recommend > CT. Ct
> inconclusive, recommend MRI. > Unfortunately for her, her ovaries were
> both normal by ultrasound, CT > and MRI. The urologist and I are
> operating this week, still not exactly > sure what we are dealing
> with. > > Anyone ever seen a paratubal cyst be that large? It is
> complete simple > and fluid filled. > Glen > > > -----Original
> Message----- > From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On
> Behalf Of R. > Daniel Braun > Sent: Monday, March 14, 2005 11:41 PM >
> To: Multiple recipients of list OB-GYN-L > Subject: Re: Ultrasound as
> part of the normal exam > > No that is :"A CT Scan may be helpful."
> Then the last line of the CT > Scan report is: "An MRI may be
> helpful." > > Dan > > On Mon, 14 Mar 2005 17:19:39 -0600,
> RModugno@aol.com <RModugno@aol.com> > wrote: > > > > In a message
> dated 3/13/2005 10:47:40 PM Eastern Standard Time, > >
> dahmd@cfl.rr.com writes: > > Joe- > > > > Good points. A different,
> and in my experience more common, scenario > is > > that a patient has
> a sonogram done in the radiology department after > > seeing her
> primary physician. The report was one of those "it may be > > this
> and it may be that, so please correlate clinically, because we > >
> can't exclude any of the following conditions." The patient is > >
> terrified. You repeat the sono on the spot in your office, and find a
> > > 4cm simple cyst correlating with her menstrual dates, thus saving
> her > > from unnecessary surgery. I'll bet that insurers would save a
> bunch > of > > money if pelvic sonograms were done by gynecologists
> instead of > > radiologists, since we are able to provide clinical
> correlation > > immediately. > > > > Ashley > > > > Ashley, you
> forgot to add to the radiologist's report "an MRI or CT > scan > > may
> be helpful" > > :+) > > > > Robert Modugno MD MBA FACOG > > Marietta,
> GA > > http://www.novaobgyn.yourmd.com > > -- > R. Daniel Braun > Kinky
> for Governor >
>
> --
> R. Daniel Braun
> Kinky for Governor
>
Robert J. Carpenter, Jr. MD
6624 Fannin, #2720
St. Luke's Medical Tower
Houston,TX 77030-2339
713-795-4600
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