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Mansoure Vahdat, Samaneh Rokhgireh, Ashraf Sadat Mousavi, Kobra Tahermanmanesh, Sepideh Khodaverdi, Leila Nazari, Shahrzad Tehrani,
Volume 5, Issue 4 (10-2016)
Abstract

Introduction

There are different causes of abnormal uterus bleeding. Foreign body is a less common etiology due to the increasing rate of cesarean delivery. We are confronting some uncommon complications of cesarean section. Uterine incision closure is a substantial step in cesarean section. Since suture material hydrolysis is affected by patient different features, impaired suture material degradation in uterus scar may cause some complications like abnormal uterine bleeding.

Case Presentation

We reported a 49-year-old woman who had abnormal uterine bleeding with prior history of multiple cesarean section. During hysteroscopy, abnormal mass was seen in anterior surface of uterine cavity compatible with the level of internal os. Polypectomy and removal of foreign body followed by endometrial curettage were performed. After hormonal assay and sonography evaluation, the patient underwent hysteroscopy and foreign body was observed in anterior surface of uterus. She was followed and visited 6 month after operation and she had no abnormal bleeding. Perhaps this foreign body led to abnormal uterine bleeding.

Conclusions

Patient characteristics has important role in suture material degradation. Impaired suture hydrolysis in uterus incision may cause abnormal uterine bleeding. It is interesting to demonstrate whethersuture degradation in previous cesarean section has a role in formation of placenta accrete or not .This issue needs more investigation. Because there is no similar case in literature, we cannot compare our article with others.



Volume 6, Issue 2 (5-2017)
Abstract

Background

Laparoscopic repair of duodenal perforation using the omental patch is one of the traditional techniques, which gives better postoperative recovery in patients with little chances of abdominal wound infection. This article is about the technique used for the laparoscopic repair of the duodenal perforation by Grahams patch with a twist in the conventional technique.

Methods

In Hanging method of duodenal repair first, an intra-corporeal suture is taken at the upper margin of perforation and both end of the thread is taken out of anterior abdominal wall and duodenum is pulled up. Now under vision the next two parallel sutures are passed, thus avoiding the posterior duodenal wall incorporation. Finally omentum flap is used for the closure of perforation.

Conclusions

The laparoscopic closure of the duodenal perforation by “Hanging Method” is an appropriate Laparoscopic technique, as “hanging” the anterior wall of duodenum gives us better vision of the posterior wall of duodenum, while taking the suture through anterior duodenal wall. Further since the gall bladder is retracted there is an easy available working space for intracorporeal suturing.



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