Bowel endometriosis.

Bowel obstruction accounts for 20% of hospital admissions due to acute abdominal pain. We report a case of acute bowel obstruction in a 31-year-old woman with a history of endometriosis diagnosed on laparoscopy a year before this presentation. Her clinical and biochemical picture suggested peritonitis and CT revealed an irregular soft tissue mass compressing a dilated rectosigmoid.

Parasitic dermoid cyst managed laparoscopically in a 29-year-old woman: a case report.

Introduction: Dermoid cysts are one of the most frequently occurring ovarian cysts; parasitic dermoid cysts, however, are extremely rare.

Case Presentation: We report a case of a 29-year-old Japanese woman with an incidental finding of an adnexal mass on bimanual examination. Sonographic imaging reported an 8 cm mass in the Pouch of Douglas.

Gestational trophoblastic disease: is intensive follow up essential in all women?

Objective: To determine the timescale of the registration process for gestational trophoblastic disease and its impact on hCG level at registration and subsequent need for chemotherapy.

Design: A prospective observational study using a standardised protocol for registration, assessment and treatment for molar pregnancy.

Setting: A supra-regional tertiary referral centre for gestational trophoblastic disease.

Bilateral hematosalpinx in a case of ectopic pregnancy: a clinical dilemma.

A 31-year-old woman with a positive pregnancy test and a transvaginal ultrasound scan result that was suggestive of a right tubal ectopic pregnancy underwent a laparoscopy, which showed bilateral hematosalpinx. In the presence of active bleeding and deteriorating hemodynamic status of the patient, a minilaparotomy was performed that revealed a right-sided hematosalpinx and a left-sided ectopic gestation.

Asymptomatic vasculitis of the uterine cervix in presence of cervical intraepithelial neoplasia grade III.

Case Report: A 34-year-old woman was diagnosed to have a high-grade cervical intraepithelial neoplasia and was treated by large loop excision of the transformation zone. Histology of the excised cone confirmed the diagnosis but also showed evidence of vasculitis of medium-sized vessels of the cervix. The woman was referred to a physician to rule out underlying systemic disease.

Measurement of Brn-3a levels in Pap smears provides a novel diagnostic marker for the detection of cervical neoplasia.

Objectives: We have previously demonstrated that Brn-3a cellular transcription factor activates transcription of the human papillomavirus (HPV) E6 and E7 oncogenes in human cervical cancer cells and that Brn-3a levels are dramatically elevated in biopsies from women with high-grade cervical neoplasia. The aim of this study was to establish the relationship between Brn-3a levels in Pap smears and the histological diagnoses. We also analysed whether Brn-3a levels can be used in combination with Pap smear to predict the presence of cervical intraepithelial lesion.

Triage by HPV-DNA testing: is it useful in women with persistent minor smear abnormalities?

Background: This study was carried out to evaluate the efficacy of HPV-DNA (Human Papilloma Virus) testing as a triage strategy for persistent borderline and mild cytological abnormalities.

Methods: A prospective cross-sectional study involving 321 women registered between January and December 2001 with two smears showing borderline or mild dyskaryosis, taken 6 months apart. This study was undertaken in a colposcopy unit in a large district general hospital in central London.

Tubal migration: a rare complication of an intrauterine contraceptive device leading to formation of a hydrosalpinx.

This is a case report of a unilateral hydrosalpinx caused by tubal migration of a copper intrauterine contraceptive device. A 33-year-old woman underwent laparoscopic right salpingectomy for a hydrosalpinx. During the procedure, a copper intrauterine contraceptive device was found protruding from the distal end of the hydrosalpinx.

Role of hysterectomy in management of gestational trophoblastic disease.

Objective: To evaluate incidence, indications, and outcome of hysterectomy in women presenting with gestational trophoblastic disease.

Methods: A prospective observational study using a standardized protocol for registration, assessment, and treatment of gestational trophoblastic disease. A total of 5976 consecutive new patients registered between January 1986 and December 2000 with a diagnosis of gestational trophoblastic disease.

Case-series report: management of post-menopausal bleeding in the presence of an intrauterine device.

Post-menopausal bleeding in the presence of prolonged use of an intrauterine device should be investigated with hysteroscopy and endometrial sampling to rule out endometrial pathology. Here, we present two cases of prolonged use of intrauterine contraceptive device (IUCD), both associated with endometrial pathology, to illustrate the importance of these investigations.