Document Detail


The significance of detailed examination of hemorrhoids during pregnancy.
MedLine Citation:
PMID:  16433160     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the population of pregnant women in Serbia and Montenegro, hemorrhoids are present in 85% of the cases during the second and third pregnancy. Urged by the complications of non-treated hemorrhoids, we carried out a routine diagnostic procedure to examine hemorrhoids during pregnancy, i.e. a differential diagnosis with other possible complications was performed. Fifty patients, aged between 36 and 38, were examined by anoscope and rectoscope during the second trimester. Rectal carcinoma was found in three cases, which is a disturbing number. The patient with the most serious clinical picture was subjected to urgent artificial fetal lung maturation and surgical delivery. One of the patients had clinical cachexia, and in view of the fact that the magnetic resonance imaging during pregnancy showed infiltration and that the patient was 38 years old, with the patient's consent, surgery was performed together with hysterectomy and salpingo-oophorectomy and immediate removal of the rectum and anus. In the other two cases, the delivery ended vaginally between the 35th and 38th week of gestation, after which the patients were moved to the surgery ward. Besides a positive family history for digestive tract carcinoma (95%), smoking and increased body mass index, there were no significant parameters distinguishing these three patients from others with hemorrhoids. Interesting data were obtained from the fact that there was no increase in body mass during pregnancy which patients correlated with their already present obesity. Moreover, pain was correlated with the fact that the patients did not follow a healthy dietary regime. In all 50 patients, the following procedures were performed: anoscope, rectoscope and digestive tract tumor markers. Observing the results of the biopsies, we found rectal carcinoma Stage C according to Dukes staging (tumor included serosa) in one case. In the other two cases, Stage B1 carcinomas were found (which included all layers except serosa). Magnetic resonance imaging was performed and confirmed progression of the disease. The delivery ended per vias naturalis in two cases in view of the fact that it was the third pregnancy for both patients. Surgery was performed 40 days after delivery. Postoperative recovery was unremarkable in all described cases.
Authors:
M Gojnic; V Dugalic; M Papic; S Vidaković; S Milićević; M Pervulov
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental obstetrics & gynecology     Volume:  32     ISSN:  0390-6663     ISO Abbreviation:  Clin Exp Obstet Gynecol     Publication Date:  2005  
Date Detail:
Created Date:  2006-01-25     Completed Date:  2007-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802110     Medline TA:  Clin Exp Obstet Gynecol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  183-4     Citation Subset:  IM    
Affiliation:
Medical Faculty of Belgrade, Institute of Gynecology and Obstetrics, Clinical Center of Serbia, University of Belgrade, Serbia and Montenegro.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / diagnosis,  surgery
Adult
Age Factors
Biopsy
Diagnosis, Differential
Endoscopy
Female
Hemorrhoids / diagnosis*,  epidemiology,  surgery
Humans
Incidence
Magnetic Resonance Imaging
Pregnancy
Pregnancy Complications / diagnosis*,  epidemiology,  surgery
Pregnancy Trimester, Second
Rectal Neoplasms / diagnosis,  surgery
Rectum / surgery*
Treatment Outcome
Yugoslavia / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Sex-induced cystitis--patient burden and other epidemiological features.
Next Document:  Influence of a decisional tree on the route of hysterectomy for benign disease in Italy: personal ex...