Cholelithiasis of the ovary after laparoscopic cholecystectomy: A case report
Department of Pathology, Baystate Medical Center, Tutts University School of Medicine, Springfield, Massachusetts, USA. The Journal of reproductive medicine
(Impact Factor: 0.7).
Laparoscopic cholecystectomy may result in spilled bile and dropped gallstones. Although there are usually no consequences, occasionally this can lead to serious complications, including those requiring surgical procedures. Very few cases have been reported documenting the consequence of spilled biliary contents on or near the female genital tract.
A cholelith became embedded in the ovary of a 53-year-old woman and was detected >7 years after laparoscopic cholecystectomy.
The complications of cholelithiasis of the ovary may include chronic pelvic pain, dysmenorrhea, infection, adhesions, ectopic pregnancy and infertility. Ovarian choleliths may be an incidental finding or can mimic a primary ovarian tumor.
Available from: Luis Ruso Martinez
Available from: Pamela Mangu
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To update guidance for health care providers about fertility preservation for adults and children with cancer.
A systematic review of the literature published from March 2006 through January 2013 was completed using MEDLINE and the Cochrane Collaboration Library. An Update Panel reviewed the evidence and updated the recommendation language.
There were 222 new publications that met inclusion criteria. A majority were observational studies, cohort studies, and case series or reports, with few randomized clinical trials. After review of the new evidence, the Update Panel concluded that no major, substantive revisions to the 2006 American Society of Clinical Oncology recommendations were warranted, but clarifications were added.
As part of education and informed consent before cancer therapy, health care providers (including medical oncologists, radiation oncologists, gynecologic oncologists, urologists, hematologists, pediatric oncologists, and surgeons) should address the possibility of infertility with patients treated during their reproductive years (or with parents or guardians of children) and be prepared to discuss fertility preservation options and/or to refer all potential patients to appropriate reproductive specialists. Although patients may be focused initially on their cancer diagnosis, the Update Panel encourages providers to advise patients regarding potential threats to fertility as early as possible in the treatment process so as to allow for the widest array of options for fertility preservation. The discussion should be documented. Sperm and embryo cryopreservation as well as oocyte cryopreservation are considered standard practice and are widely available. Other fertility preservation methods should be considered investigational and should be performed by providers with the necessary expertise.
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The purpose of this article is to describe the diagnostic pitfalls caused by dropped gallstones left in situ after laparoscopic cholecystectomy.
Dropped gallstones may rarely become symptomatic, causing recurrent abscesses. Diagnosis is challenging due to unusual clinical presentations, myriad locations, and radiologically occult calculi. Even asymptomatic dropped gallstones may cause diagnostic confusion by masquerading as intraperitoneal neoplastic deposits. Radiologists should be aware of techniques for identifying and retrieving dropped gallstones and be wary of their complications and imitations in patients who have undergone laparoscopic cholecystectomy.
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