Avendaño BRA, Cruz MVP

Language: Spanish
References: 10
Page: 100-103
PDF size: 43.26 Kb.

ABSTRACT

Hysteroscopy has become an essential technique in the gynecologic practice. Is a reliable procedure for the direct visualization of the uterine cavity, by making possible the diagnosis and treatment of multiple intrauterine pathology without the use of other more invasive techniques. There are multiple indications for surgery and one of them is the myomectomy of the submucous myoma, which looks like espheric white masses covered by fragile vessels with thin walls by hysteroscopy. In order to distend the uterine cavity for visualization of the endometrium, we dispose of different solutions, each one with potential collateral effects. We present the case of a 38 years old female with abnormal uterine bleeding, unresponsive to medical treatment. Hysterography shows evidence of 3 cm submucous myoma. The treatment was hysteroscopy approach under glicine 1.5%, for distension media. No complications during the procedure, in the recovery room there was hyponatremia and disseminated intravascular coagulation. She was treated in the ICU, with a favorable evolution. The authors conclude that hysteroscopy is a useful tool for the treatment of various intrauterine abnormalities. As in any surgical produce, the surgical team must be prepared for possible complications.

REFERENCES

1. Witz C, Silverberg K, Burns W, Schenken R, Olive D. Complications associated with the absortion of hysteroscopic fluids media. Fertil Stil 1993; 60: 745-756.

2. Wallwinwr D. Rimbach S, Aydeniz B, Pape M, Posten J. Surgical hysteroscopy: Complications, safety aspects, education, training. Zentrabl Gynakol 1994; 116: 509-608.

3. Konin M, Meyer A, Aydeniz B, Kurek R, Wallwiener D. Hysteroscopic surgery: Complications and their prevention. Contrib Gynecol Obstet 2000; 20: 161-170.

4. Ravi B, Schiavello H, Chandra P, Takeshige T. Safety and efficacy of hysteroscopic endometrial resection ablation for menorrhagia. J Reprod Med 2001; 46 (8): 717-723.

5. Pasini A, Belloni C. Intraoperative complications of 697 hysteroscopies. Minerva Ginecol 2001; 53 (1): 13-20.

6. Fernandez H, Kadoch O, Capella Allouc S. Hysteroscopic resection of submucous myomas: Long term results. Ann Chir 2001; 126 (1) 58-64.

7. Murdoch J, Gan TJ. Anesthesia for hysteroscopy. Anesthesiol Clin N Am 2001; 19 (1): 125-141.

8. Galka E, Goldfarb HA. Disseminated intravascular coagulation as a complication of intrauterine balloon tamponade for posthysteroscopic acute uterine bleeding. J Am Assoc Gynecol Laparos 2001; 7 (4): 573-576.

9. Jansen FW, Vredevoogd CB, Van Ulzen K, Hermans J. Complications of hysteroscopy: A prospective, multicenter study. Obstet Gynecol 2000; 96 (2): 266-270.

10. Stotz M, Lampart A, Kochli O, Schnnider M. Intraabdominal bleeding masked by hemodilution after hysteroscopy. Am Soc Ansthesiol 2000; 93 (2).