Re: Bilateral dermoids
From: Andrew Folley (agfolley@hotmail.com)
Fri Mar 9 07:44:07 2007
Stephen,
as you mature you will come to realize that medicine is both art and science
and there are often times several right ways to approach a problem. I think
you misjudge the american system.
It is still the best medical system in the world. I sense a great deal of
frustration and anger in your thread. Lets use this wonderful internet
exchange tool to be gentleman and colleagues. andrew
>From: "Raymond Stephen" <stephen.raymond@dhhs.tas.gov.au>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: RE: Bilateral dermoids
>Date: Thu, 8 Mar 2007 15:56:25 -0600
>
>There is no doubt from the description that they were dermoids, and
>washings and other hand-wringing grandma type fussing is just weasel
>madness from an American system so stuffed up by the fear of litigation
>that the patients suffer. If you had taken washings and aspirated and then
>left them and had to go back afterwards for them the patient would have
>been quite justified if she had sued you for unnecessary surgery!
>
>I can't believe the absolute lack of clinical acumen and judgement that
>seems to have come out of this thread.
>
>Steve
>
>________________________________
>
>________________________________
>From: ob-gyn-l@obgyn.net on behalf of Andrew Folley
>Sent: Fri 9/03/2007 12:12 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: RE: Bilateral dermoids
>
>More likely these are theca lutein cysts in light of bilaterality and
>pregnancy. Low probalbilty for malignancy at her age. I would obtain
>washings, perhaps biopsy omentum and any nodualrity of peritoneum seen.
>Possibly aspiration of each cyst with thorough irrigation afterwards. If
>any
>hair, teeth present would do cyst resection and preserve ovaries.
>Otherwise close up and look for resolution of cysts in next 12 weeks. If
>still persistent could do laparoscopy and resection then.= andy
>
> >From: "Elrod, Darryl G Maj 48 MDOS/SGOBO"
><Darryl.elrod@LAKENHEATH.AF.MIL>
> >Reply-To: ob-gyn-l@obgyn.net
> >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> >Subject: Bilateral dermoids
> >Date: Wed, 7 Mar 2007 11:19:21 -0600
> >
> >I have just gotten out of the OR with a 26 yo G1 at 39 wks that had a
> >c-section for failure to progress. At the time of the c-section the
> >ovaries were both found to be enlarged to 8-9cm. Neither had previously
> >been noted on her early OB sono nor her anatomy scan at 22 weeks. By
> >the appearance of the fluid seen through the cyst wall my suspicion was
> >that this represented bilateral dermoid cysts.
> >
> >What are the management options with this patient and which would you
> >choose and why?
> >
>
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