Re: Bilateral dermoids
From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au)
Thu Mar 8 14:57:19 2007
More weaselling. If you had aspirated them then there would be even greater risk of tubo-ovarian abscess or pelvic peritonitis. At the end of your 12 week re-assessment you would still have to go back and take them out and they would not have been removable laparoscopically without peritoneal soilling.
Steve
________________________________
From: ob-gyn-l@obgyn.net on behalf of Andrew Folley
--
________________________________
Sent: Fri 9/03/2007 1:44 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Bilateral dermoids
Agree it is a judgement call. however keep in mind that you are setting this
patient up for a potentially devastating infection with tubo ovarian abcess
formation and hysterectomy. The risk may be significant. Perhaps a more
prudent course would be to leave alone and reassess in 12 weeks and treat
laparoscopically or with laparotomy. andrew
>From: "R. Daniel Braun" <rd.braun@gmail.com>
>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: Wed, 7 Mar 2007 12:44:24 -0600
>
>Shell the cysts out of each ovary while you are in there.
>Dan
>
>On 3/7/07, Elrod, Darryl G Maj 48 MDOS/SGOBO
><Darryl.elrod@lakenheath.af.mil>
>wrote:
>>
>> 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?
>>
>>(Then I'll tell you what I did-right or wrong)
>>
>>Glen
>>
>>//SIGNED//
>>
>>D. Glen Elrod, Maj., USAF, MC
>>
>>Obstetrician/Gynecologist
>>
>>Chief of Obstetrics
>>
>>48 MDOS/SGOBO
>>
>>RAF Lakenheath, England
>>
>>Telephone DSN: 314-226-8130
>>
>> Comm: +44 (0) 1638 52 8130
>>
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>
>--
>R. Daniel Braun, MD FACOG(L) CMT
>Professor Emeritus
>Dept. of Obstetrics and Gynecology
>Indiana U. School of Medicine
>
>R. Daniel Braun
>
> "The way to health is an aromatic bath and scented massage
>everyday".
> Hippocrates
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