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Re: Pyometra From: art fougner, md (evsono@pipeline.com) Thu Jun 30 06:59:04 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Eberhard W Lisse: "Re: rapid orgasm" Previous message: GA12L@aol.com: "Re: Circlage at 30 wks" In reply to: Dr. Ainsworth: "Re: Pyometra" Next in thread: Richard Chudacoff, MD: "Re: Pyometra" the difference between pus and saline is the character of the fluid - pus tends to be debris laden. However, a focal lesion would stand out as in a saline sonohyst. why not review the films with the sonographer? as an aside, i attended the annual AIUM meeting which was dominated by 3D presentations. one take home message is the potential to move ultrasound into the realm of cross-sectional imaging ala CT and MRI. if a volume is stored, then reviewing the volume would be almost the same as having the patient right there - far superior situation to reviewing stills. art At Wed, 29 Jun 2005, Dr. Ainsworth wrote: > >Her FP did a pap two weeks ago that was normal, there are no visible >lesions on her cervix and the pathology on her endometrial sampling was >negative. It does concern me a little that a possible polyp was seen on >her ultrasound - it was basically a sonohysterogram minus the saline >because the cavity was distended with pus. Does pus make as good a >distention agent as saline? I can always resample her when I repeat the >sonogram in a month. > >>One of the more common causes is Cervical Cancer. Another is endometrial >>cancer >> >>On 6/29/05, Dr. Ainsworth <ainsron@sbcglobal.net> wrote: >>> >>> I saw a pleasant 82 yo widowed-lady last week. She is not sexually >>> active and was referred because of "recurrent vaginal spotting" over the >>> past two years. No other complaints, in fact she didn't even feel she >>> had a problem, takes no meds, no health problems. Her FP ordered a >>> sonogram before I saw her that showed fluid within the endometrial >>> cavity and possibly a 12mm polyp. I suggested an endometrial biopsy >>> which she reluctantly agreed to. When I introduced the pipelle, which >>> slid in without resistance, much to my suprise, it filled quickly with >>> purulent material. I replaced it with an explorer curette and the >>> syringe filled with 8 cc of pus and was blood tinged. Pathology came >>> back benign with mucopurelent material. The culture showed diphtheroids >>> and enterococcus. I placed her on Doxycycline at the time of the >>> biopsy, when the culture and sensitivity came back the only thing it was >>> sensitive to was Vancomycin. My plan is to finish the current >>> antibiotics and repeat the sonogram in a month. Does anyone feel that a >>> hysteroscopy is necessary at this point? Any ideas on why she would >>> present with this unusual finding? >>> >>-- >>R. Daniel Braun >>Kinky for Governor >> -- art fougner, md "If you don't know where you are going, you will wind up somewhere else." Lawrence Peter Berra Next message: Dr Eberhard W Lisse: "Re: rapid orgasm" Previous message: GA12L@aol.com: "Re: Circlage at 30 wks" In reply to: Dr. Ainsworth: "Re: Pyometra" Next in thread: Richard Chudacoff, MD: "Re: Pyometra"

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