62. The Utility of Pelvic Ultrasounds in Adolescents Presenting to the Emergency Department with Heavy Menstrual Bleeding
This work has been previously published.
Conclusion: Noninvasive HIFU ablation of muscle may not require a coagulation profile within normal limits. PMID: 32491939 [PubMed - as supplied by publisher]
Calster B, Timmerman D Abstract OBJECTIVE: To describe the ultrasound features of different endometrial and other intracavitary pathologies in pre- and postmenopausal women presenting with abnormal uterine bleeding using the International Endometrial Tumor Analysis (IETA) terminology. METHODS: Prospective observational multicenter study of 2856 consecutive women presenting with abnormal uterine bleeding. Unenhanced ultrasonography with color Doppler was performed in all cases and fluid instillation sonography in 1857. Endometrial sampling was performed according to each center's local protocol. In 2216 ...
Cholecystectomy is the gold standard for most gallbladder related disease. However, many patients with gallbladder disease are poor surgical candidates. Current non-surgical gallbladder drainage (GBD) methods include percutaneous GBD, endoscopic transpapillary GBD with endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound-guided transluminal GBD (EUS-GBD). The success rates and adverse events for these methods have been documented. The outcomes for EUS-GBD for acute cholecystitis have been studied, with adverse event rates up to 38.6%, including stent migration, occlusion, infection, and bleeding.
Gastric variceal (GV) bleeding is among the most morbid sequelae of portal hypertension, with mortality ranging from 30-50%. GV bleeding is commonly managed by interventional radiology-guided embolization/shunting, with significant associated radiation exposure. Pediatric data focused on endoscopic approaches to management are needed. Cyanoacrylate injection has been described, however, hemostasis rates are variable and re-bleeding occurs in up to 50% of patients. Furthermore, concerns surrounding cyanoacrylate embolization and glue retention within endoscopes have limited its use.
Bleeding from gastric varices (GV) is associated with a high mortality rate. Injection of cyanoacrylate (CYA) using endoscope is known to achieve higher hemostasis and lower rebleeding rates compared to band ligation or sclerotherapy. But CYA treatment is known to be associated with significant adverse events. Pulmonary embolism due to CYA injection is one of the fatal complications reported. Currently, endoscopic injection of CYA can be performed by direct visualization guided by Endoscopic Ultrasound (EUS) with injection of CYA alone or in combination with coils.
Gastric variceal (GV) bleeding carries significant mortality in the setting of portal hypertension. Among the endoscopic treatment options, endoscopic ultrasound (EUS) guided glue and/ or coil injection is a novel approach and its role in the treatment of GV is not established due to lack of robust data.
CONCLUSIONS: Accidental artery puncture during central venous catheterization is an uncommon situation but can be effectively managed by using percutaneous vascular closure device. It is a reliable alternative that should be considered as a first-line approach before endovascular or open surgery, specially in patients with unstable conditions in which it is possible to be performed without transfer to an operation room. PMID: 32437239 [PubMed - as supplied by publisher]
Authors: Ciebiera M, Łoziński T Abstract Uterine fibroids (UFs) are the most common benign tumours of the female reproductive system and the most frequent reason for hysterectomy worldwide. UFs are reported in 20%-70% of women of reproductive age depending on a study group. Although most women with UFs are asymptomatic, over 30% of them will present with different symptoms. Abnormal uterine bleeding, pain, pressure and infertility are the most common. Lesions that cause these kinds of symptoms may require medical intervention. Trends in UF treatment change along with patient awareness and the introduction of new ...
Conclusions. The choice of the method of treating visceral artery aneurysms and visceral artery pseudoaneurysms depends on the location, size, anatomic features of the visceral arteries and the clinical course of the disease. Both endovascular and surgical treatment demonstrate good postoperative outcomes. Visceral ischemia is one of the most serious complications in the postoperative period, which can complicate both the diagnosis and the choice of treatment tactics. PMID: 32422115 [PubMed - in process]