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Re: Surg/Gyn: One case SOLUTION From: Bernard Cristalli (bcrist@club-internet.fr) Mon Apr 13 12:21:21 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Bernard Cristalli: "Re: New one from Malcolm - part 2" Previous message: William J Faulkner: "Re: Sickle cell screening" Maybe in reply to: Bernard Cristalli: "Surg/Gyn: One case SOLUTION" Douglas Krell MD wrote: > > Dr. Cristalli wrote: > > >- 3cms, sub-serosal Tumoral/endometriosic appendix > >I performed a classic McBurney appendectomy. > > Nice case Bernard, 1. > You had us all thinking of post operative complications. > The pneumoperitoneum must have been from the prior surgery after all. > 2. > I think that the physical examination may have given away the diagnosis in > this case. > Didn't you suspect an appendix or was the patient's condition 48 hours after > surgery too confusing? > 3. > I think in this patient, I would have done the appy the 1st time around, > despite concern about fertility. I wonder how others feel about this? > > Douglas Krell MD -- Douglas, 1. I was the first thinking of post op complications 2. Physical examination was in favour of something running. RLQ was as painful as the rest of abdomen. I thought of a bowel perforation when I went back in. 3. I'm rather a quick guy on appies, this time I didn't see it was endometriosic, I was too focused on the pelvic endo. Assuming I saw it I think I would have left it alone (big & subserous), and would probably have planned something after a GnRh analog course. -- Bernard Cristalli MD CNGOF AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm Next message: Bernard Cristalli: "Re: New one from Malcolm - part 2" Previous message: William J Faulkner: "Re: Sickle cell screening" Maybe in reply to: Bernard Cristalli: "Surg/Gyn: One case SOLUTION"

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