Re: Bilateral dermoids
From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au)
Thu Mar 8 14:54:40 2007
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
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From: ob-gyn-l@obgyn.net on behalf of Andrew Folley
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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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