|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
GYN: Adenomyosis Dx vs Tx ( Was Re: Abdominal pain)From: Marco A. Pelosi, III, MD (marcop@tao.agoron.com)Sun Dec 14 11:02:18 1997
At Sun, 14 Dec 1997, rbraun@iupui.edu wrote: > >If she has adenomyosis, what will you see on laparoscopy ??????? If she has advanced adenomyosis you'll see an enlarged globular fundus and what I refer to ex cathedra as "pitting edema of the fundus." This brings me to my tangential comment: Assume you have a 30-40 year-old patient with chronic heavy bleeding and moderate uterine enlargement who fails hormonal therapy with a working dx of fundal myoma vs adenomyosis on clinical exam. She wants the heavy bleeding to stop. Hysterectomy is the obvious recommendation regardless of what the pathology shows and confirmatory tests and diagnostic procedures are academic save for endometrial biopsy to exclude cancer. If hysterectomy doesn't mesh with her reproductive agenda you may offer myomectomy if its a myoma and stack the odds of diagnostic certainty with an MRI. But what if you find that the MRI is wrong when you slice into the fundus over the prominence of "the myoma" and find obvious adenomyosis? Will you merely take a biopsy and tell her "tough luck" or will you make a surgical effort to treat her bleeding with a Jones-like wedge excision?
-- M.A. Pelosi, III, MD
|
|
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: Mon Nov 2 05:26:04 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.