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Re: endometriosis in C/S scarFrom: Braun, R. Daniel (rbraun@iupui.edu)Tue Jul 30 11:02:35 2002
OTOH, I havent seen one limited to the subq fat. All of mine have been in the fascia. Dan -----Original Message----- From: Griffiths Malcolm (RC9) Luton & Dunstable Hospital TRTo: Multiple recipients of list OB-GYN-L Sent: 7/30/2002 10:54 AM Subject: Re: endometriosis in C/S scar I too find them too difficult for local anaesthesia, but have not needed mesh. The cases I have seen have all been limited to subcutaneous fat and I have resected down to rectus sheath but not through. Malcolm Griffiths Clinical director & consultant - obstetrics & gynaecology Luton & Dunstable Hospital NHS Trust, Luton, LU4 0DZ, UK Tel:+(44) 1582 497533 Fax: +(44) 1582 497376 -----Original Message----- From: Braun, R. Daniel [mailto:rbraun@iupui.edu] Sent: 30 July 2002 14:54 To: Multiple recipients of list OB-GYN-L Subject: Re: endometriosis in C/S scar How many of these have you done under local ? My experience is that they are at least twice as big as thought and require placement of mesh to close. Dan -----Original Message----- From: Gerald P. RodriguezTo: Multiple recipients of list OB-GYN-L Sent: 7/30/2002 8:41 AM Subject: Re: endometriosis in C/S scar Yes, she has a chance of having endometriosis in the pelvis, appendix, etc. Since you say she has no other symptoms, I would resect what is likely a endometrioma in her C/S scar under local, if the patient is amenable to local, and leave well enough alone. Gerald P. Rodríguez, M.D., FACOG Santa Fe
>----- Original Message ----- Patient is 30 ish G 3 P 3003 all cesarean sections. Had tubal at time of last section. Presents with a 2X3X4 cm lump at the right end of her C/S incision. It swells and becomes tender about the time of her period. No other symptoms at all. The question becomes one of "Since she has endo in her incision, does she have a likelihood of intraperitoneal endo, and if so, should we do a diagnostic scope at the time of excision of the scar endometrioma? If we do and we find endometriosis in this asymptomatic patient, what should we do about that? I would like to heart a lot of opinions. We had a bunch in our morning report. Dan
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