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Re: Gyn: PMB/pain From: Andrew Folley (agfolley@hotmail.com) Thu Jun 7 11:00:55 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Andrew Folley: "Re: Ob: PP hemorrhage in a VBAC--why do we VBAC, anyway :)?" Previous message: Dr Eberhard Lisse: "Re: Ob: PP hemorrhage in a VBAC--why do we VBAC, anyway :)?" In reply to: Garry E. Siegel, M.D.: "Gyn: PMB/pain" D&C hysteroxcopy to deterine th etiology of the PMB. Plus or minus on the laparoscopy. 1.5 cm cyst on ovary of doubtful significance. Make sure she gets her screening colonoscpy done. >From: garrys@mindspring.com (Garry E. Siegel, M.D.) >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Gyn: PMB/pain >Date: Wed, 6 Jun 2007 18:15:19 -0500 > >60 YO P2002, many years menopausal, old patient not seen in 4 years. > >When last seen then, had simple hyperplasia on HRT corrected or being >corrected with increasing the relative amount of progestin. The last >biopsy, 4 years ago, on HRT, was disordered proliferative endometrium. > >1999 she had H-scope for a large endocervical polyp, negative >curettings. > >A week ago she had malaise, poor appetite, N-V, and the onset of >postmenopausal bleeding (it has been at least 3 years per patient) and >was hospitalized for an internist for a tune up. She has vague back and >lower abdominal pain, and poor appetite. The workup was mostly negative >for heart, etc. problems. She is a petite women whom I remember well, >and she just doesn't look well. > >Her Ca 125 was 9, a pelvic ultrasound showed a 1.5 cm. hypoechoic mass >on one ovary, which as around 1.5 cm., and her endometrium was 9.6 mm. > >Today, I saw her in the office--small, posterior uterus, no adnexal >tenderness or mass, heme negative, and her uterus sounded to 7 cm. and >I did an endo biopsy with two Pipelle passes, and got scant >tissue/blood. > >Of course, I'll await the biopsy, but I'm thinking that if it isn't >diagnostic, then she might need any/all of the following: > >CT >Saline Sono >H-scope--and if I did that, I would likely consider lapscope. > >Consultants, what do you think? > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA Next message: Andrew Folley: "Re: Ob: PP hemorrhage in a VBAC--why do we VBAC, anyway :)?" Previous message: Dr Eberhard Lisse: "Re: Ob: PP hemorrhage in a VBAC--why do we VBAC, anyway :)?" In reply to: Garry E. Siegel, M.D.: "Gyn: PMB/pain"

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