Intraoperative radio-guided identification of parathyroid adenomas with the gamma probe: initial experiences in a community hospital.

Previous radiological imaging studies for identification of parathyroid adenomas have generally been unreliable. Currently, preoperative administration of Tc-99m sestamibi improves detection of parathyroid adenomas. Combining preoperative administration of sestamibi radionuclide with the gamma probe intraoperatively can successfully identify the exact location of parathyroid adenomas in a community hospital setting and facilitate a safe and efficient operation.

Placenta percreta.

A patient with an unsuspected placenta percreta presented with intraperitoneal bleeding at 33 weeks' gestation. Because of the clinical picture and a lecithin/sphingomyelin ratio of 1:1, this patient was treated conservatively until 38 weeks' gestation when an L/S ratio test indicated fetal maturity. The pregnancy was successfully terminated by cesarean hysterectomy.