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[Fallopian tube bilharziasis caused by Schistosoma intercalatum disclosed by hemoperitoneum].

Schistosomiasis due to Schistosoma intercalatumis common in Gabon and, since 1971, Schistosoma haematobium has been found in the south of the country. Genital involvement is infrequent: 0.8 per cent of gynecologic specimens sent to the pathology laboratory and ten of 622 fallopian tube specimens (1.5 per cent). We report an unusual clinical case with hemoperitoneum as the first manifestation: the schistosomal lesion was developed within the tubal serosa, and caused a breach in an arteriole responsible for a 2500 cc hemoperitoneum. Genital lesions preferentially involve the vulva, vagina, and cervix. Involvement of the tubes and ovaries is less common and seems to have an incidence on fertility only if bacterial superinfections cause adhesions around the tubes and ovaries. Genital schistosomiasis is usually asymptomatic. Ectopic pregnancies and infertility may occur.

Adult↗

An applicator for the Hulka fallopian tube clip.

Use of the Hulka spring clip has advantages over other methods of occluding the fallopian tubes. Since difficulties were experienced with clip applicators from two manufactures, an improved applicator was designed. A similar applicator for use at minilaparotomy is described also.

Female↗

Fallopian tube carcinoma: recent diagnostic approach by color Doppler imaging.

A case of primary adenocarcinoma of the Fallopian tube is presented. The diagnosis was made preoperatively by transvaginal color Doppler imaging. The tumor revealed areas of neovascularization with characteristic low impedance (resistance index, 0.35) and high blood flow velocity (peak systolic velocity, 16.7 cm/s).

Journal Article↗

Higher pregnancy rates with a simple method for fallopian tube sperm perfusion, using the cervical clamp double nut bivalve speculum in the treatment of unexplained infertility: a prospective randomized study.

The object of this study was to evaluate the efficacy of the newly developed cervical clamp double nut bivalve (DNB) speculum used for Fallopian tube sperm perfusion (FSP) with 4 ml of the inseminate, in comparison with standard intrauterine insemination (IUI) using a volume of 0.5 ml of the inseminate. Couples with unexplained infertility (n = 104), undergoing 202 cycles, were enrolled in this study. Cycles were assigned randomly to either IUI (group A, n = 92) or FSP + DNB speculum (group B, n = 110). Ovarian stimulation was achieved using three different ovarian stimulation protocols in both groups. The age and follicular development of the patients were similar in both groups. The serum hormonal measurements and the endometrial thickness was also similar on the day of human chorionic gonadotrophin (HCG) administration. The mean (+/-SD) number of motile spermatozoa inseminated was 44.83 +/- 16.57 x 10(6) in group A and 42.68 +/- 13.44 x 10(6) in group B. In group A (IUI). 11 clinical pregnancies (presence of gestational sac with heart beats) occurred (11.95% per cycle). In group B (FSP + DNB speculum) 29 clinical pregnancies occurred (26.36% per cycle). These differences were statistically significant (P < 0.001). The results of this study for the treatment of unexplained infertility indicate that this simple, well tolerated, inexpensive method of using the DNB speculum for FSP is more successful than standard IUI.

Adult↗

Fallopian tube prolapse after abdominal hysterectomy.

A 38 year old lady who had total abdominal hysterectomy, for chronic pelvic pain, presented with profuse vaginal discharge per vaginum along with a cystic pelvic mass of 10 week size. There was a polypoidal fleshy growth present in the vault. It was diagnosed to be a fallopian tube on histopathology. Patient was treated with bilateral salpingo-ophorectomy through an open laparotomy.

Adult↗

Clear cell carcinoma of the fimbria of the fallopian tube in a BRCA1 carrier undergoing prophylactic surgery.

We report the case history of a patient with a family history of breast and ovarian cancer who was subsequently found to be a carrier of the BRCA1 gene, in whom a tiny focus of clear cell carcinoma was found at the fimbrial end of one fallopian tube when she underwent prophylactic hysterectomy and bilateral salpingoophorectomy. The implications of this finding are discussed.

Adenocarcinoma, Clear Cell↗

Fibrin glue for anastomosis of the fallopian tube--morphology.

In a morphological study fibrin-glued tubal anastomoses were compared with classical anastomoses using microsutures. In the isthmic-isthmic anastomoses, whether they were glued or sutured, the opposition of the folds and the continuity of the tubal wall were good. Scanning electron microscope studies of Fallopian tubes subjected to anastomosis using fibrin glue or microsurgical sutures showed a break in the fold structure regardless of the technique used, with formation of polyp-like and tuborous structures in some of the anastomoses in the ampullary region. In one case of an ampullar-ampullar anastomosis with fibrin glue, formation of a fistula was observed and in another case of the same type of anastomosis a hydrosalpinx developed as the consequence of intratubal adhesions and stenosis. In glued anastomoses in particular, intraluminal fibrin deposits were observed. Otherwise our scanning and transmission electron microscope investigations of the region of the anastomoses revealed a normal cell picture with abundant cilia-bearing, structurally unremarkable cells. Fibrin glueing can thus be regarded as a possible alternative to the conventional microsurgical suturing technique for the construction of anastomoses in the isthmic segment of the tube. In the case of wide-lumen ampullary anastomoses, however, the danger of fistula formation, dehiscence, development of intraluminal adhesions and stenosis must be regarded as increased. Fibrin glueing also does not appear to be appropriate for anastomoses requiring approximation of differing luminal widths.

Anastomosis, Surgical↗

Elevation of serum CA125 in carcinomas of the fallopian tube, endometrium, and endocervix.

An immunoradiometric assay with the use of a monoclonal antibody can detect an antigenic determinant (CA125) in peripheral blood from more than 80% of patients with epithelial ovarian cancer. In this report elevated levels of CA125 were detected in serum from patients with adenocarcinomas of the fallopian tube, endometrium, and endocervix. Among patients with endometrial cancer, CA125 levels were elevated in recurrent or disseminated disease but not with tumors confined to the uterus.

Adenocarcinoma↗