Dilek Acar

Swollen labia majora: An unusual presentation of occult inguinal hernia secondary to ovarian hyperstimulation syndrome

A 23-year-old woman was admitted to our clinic with a diagnosis of moderate ovarian hyperstimulation syndrome (OHSS). After 2 days of uneventful hospitalization, severe fluid accumulation developed at her left labium majus within a few hours. Inspection revealed a swollen labium with skin discoloration and thinning of the overlying skin (Figure 1). She was pain free while stationary, however, movements were associated with mild discomfort. Inguinal hernia was suspected and an examination was performed with Voluson E6 Ultrasound System (GE Healthcare, Little Chalfont, UK) using a convex 1e5-MHz probe. Inguinal scan revealed small bowel segments herniating through a defect in the abdominal fascia (Figure 1). A diagnostic conundrum was faced due to leukocytosis and mild abdominal pain; both being common symptoms of strangulated hernia and OHSS. Physical findings did not support incarceration, as she was pain free while stationary. Leukocytosis (leukocyte count: 23.434/mm3) was present due to OHSS and it was deemed to be unrelated to hernia. After diagnosis, she was placed on bed rest with mild elevation of the hip to avoid further accumulation of ascites underneath the labia majora. Skin necrosis and breakage of skin integrity were a concern. Speculatively, this would have resulted in free flow of ascites fluid through ruptured abdominal fascia

Gebelikte İleri Evre Kolon Kanseri: Olgu Sunumu

Reproduktif donemde kolorektal kanser cok nadir bir durumdur ve kolon kanseri ile komplike gebeliklerde tani genellikle ileri evrede olmaktadir. Bizim vakamiz 36 yasinda ve 3.trimesterde tanisi konabilen ileri evre bir kolon kanseri vakasidir. Hastaligin ilk donemi asemptomatik olarak seyretmistir. Karaciger metastazi olduktan sonra bulgu vermistir. Tani sonrasinda tedavi icin dogum gerceklestirilmistir ve hasta postoperatif donemde kemoterapi almaya baslamistir. Kolon kanseri reproduktif donemde kolon kanserinin az gorulmesi ve gebeligin kolon kanserinin semptomlarini taklit etmesi nedeniyle erken tanida sansi cok dusuk olan bir hastaliktir, genellikle ileri evrede tani almaktadir. Bundan dolayi kotu prognozludur. Bizim hastamizda ileri evrede yakalanabilen bir hastaydi. Bundan dolayi tani sonrasinda kisa surede gebelik sonlandirilip tedavisi baslanmis olsa bile prognozu kotu olmustur ve hasta kisa sure icinde terminal doneme gecmistir. Sonucta kolon kanserinin her ne kadar erken tani sansi olsa da genc yasta ve gebelikle birlikte olan vakalarda bu sans daha da azalmaktadir