|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Looking for listers' recommendationsFrom: Atkinson, Samuel M, Jr (ATKINSONS@ecu.edu)Thu Feb 26 08:56:17 2009
As is well known, copper is highly inflammatory. Thus it is highly likely that it is encased in "The watch Dog of the abdomen" i.e. the omentum and will probably not cause a problem. However the continuing presence of copper leaves a source of future inflammation, just as does , say an appendix. So does she need an appendectomy? Removing a copper IUD by laparoscopy can be challenging. Make sure you have a full informed consent as Gordon states so well. If it was a Mirena, leave it alone. Thus I would recommend removal only if the patient was in a developing country or warehoused in one of NC's mental institutions of neglect. sAm ________________________________ From: ob-gyn-l@obgyn.net [ob-gyn-l@obgyn.net] On Behalf Of Gordon Goldman [= ________________________________ obgyndoc@swbell.net] Sent: Wednesday, February 25, 2009 5:09 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Looking for listers' recommendations It is very likely that she will not experience any problems. However, if she does and you have not made any attempt to retrieve it, you could incur liability. If she declines the procedure, "document the hell out of it". If you attempt to retrieve it laporascopically and fail, you are obliged to proceed with open laparotomy, and she should be aware of this. I would also have a general surgeon available if complications should arise. Gordon On Feb 25, 2009, at 2:17 PM, jsbowpat@aol.com<mailto:jsbowpat@aol.com> wrote: My collaborative OB/GYN asked me to post this case and ask for listers' input .... A 35 yo G1P1, who has a guardian secondary to developmental disability, was referred to our office secondary to a "lost" copper-T IUD. The device was placed by another OB/GYN in 2004, and strings were not visualized on follow-up exam in 2005. At that time, it was found to be migrated to the RUQ, close to the spleen. The patient is not currently menstruating secondary to psych meds. She is not experiencing any abdominal pain at this time. Repeat CT of the abdomen and pelvis revealed the IUD lies just inferior to the distal colon in the left mid-abdomen. My partner's question - leave well enough alone or consider exploratory laparascopy to retrieve it? The general surgeon was consulted, and he was not helpful. Thanks! Susan Paterson CNM MS Center for Women's Care 835 S Main St., Suite 2 Oconto Falls WI 54154 ________________________________ Looking for work? Get job alerts, employment information, career advice and= -- ________________________________ job-seeking tools at AOL Find a Job<http://jobs.aol.com/?ncid=emlcntuscare00000001>.
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 05:13:23 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.