Archive
Academic OB/GYN Cases – Large Abdominal Wall Endometrioma with Mesh Reconstruction
Case:
41 year old woman with a history of an abdominal myomectomy followed by a pregnancy, ending in cesarean delivery. Over time a firm mass could be felt in the abdominal wall which was swollen with her menses. She had been seen by several physicians who were unable to clearly diagnose the mass. She eventually was diagnosed by a new PCP, and was referred to our office for treatment.
On being seen in our office, we ordered and reviewed MRI images, which demonstrated abdominal wall endometriosis replacing a large segment of the left rectus abdominus muscle and overlying fascia.
These images demonstrated the mass to be approximately 4 x 3 cm in size, with marked gadolinium enhancement in several areas.
A plan was made to do a laparotomy, with expectation that after removal there would be a significant defect in the fascia, likely requiring mesh repair.
Academic OB/GYN Cases: The House of Twins
This is a nice photo of a diamniotic/dichorionic placenta, part of a pregnancy involving two separate embryos in the same uterus.
Note the thick intervening membrane and lack of blood vessels traveling between the two placental discs, both characteristic of a di/di placenta.
Academic OB/GYN Cases: Another Day, Another Dermoid
First blonde one for me. Gotta catch ’em all!
Surgical Video – Large Dermoid Cyst with Abdominal Pain
Case: a 30 year old woman presents to the ED with acute left lower quadrant pain. A CT showed pelvic fluid and a 8 cm teratoma in the right lower quadrant.
Academic OB/GYN Cases: Abdominal Cerclage How-To
I had the opportunity to do an abdominal cerclage with one of my MFM colleagues this week, which was fantastic. This is a procedure that is rarely done, and for me is something pretty new. I had the opportunity to do a few of these in residency, but hadn’t done one for over 5 years and never in a pregnant woman, so that was a great envelope-pushing experience for me.
For my colleagues that haven’t had the opportunity to do one of these procedures, I want to lay out how its done. In short, the goal is to place a cerclage between the ascending and descending branches of the uterine arteries, at the connection of the lower uterine segment and internal cervical os. When you’re done it should look something like this –
Academic OB/GYN 