Pathology 1x6m28

Introduction • • • • • • • •

Gynecological Pathology (Hydrosalpinx) Patient Information Patient History Imaging Modalities Diagnostic Information Patient Prognosis Treatment Options Follow-up Care Preliminary Report

Hydrosalpinx • “Hydrosalpinx is classified as a mechanical condition that occurs when adhesions (internal scars) form to narrow or close the far end of the fallopian tube. The adhesions may first form to combat an infection. Once the infection has ed, the adhesions, which are no longer required after healing, remain in the body and block the far end of the tube” (Clear age, 2012).

Patient • Caucasian, Female • 30 years of Age • Referred to OB/GYN clinic because of sharp constant abdominal pain, and vaginal discharge • Patient has Endometriosis (Tissue Built Up) • History of unstable menstrual cycles

Diagnostic Testing Performed • Hysterosalpingogram or HSG was inconclusive • Vaginal Ultrasound was performed looking to locate any blockages of the fallopian tubes, spots on ultrasound indicates a blockage • Patient is scheduled to undergo a laparoscopy surgery, to locate, any blockages

Hysterosalpingogram or HSG Image

Vaginal Ultrasound Images

Laparoscopy Image

Patient Treatment Options • Option to remove, and repair fallopian tube by way of surgical procedure Neosalpingostomy • “Because of the low changes of success with attempts at surgical reconstruction of the tubes (some studies have shown a 10% pregnancy rate in the year following neosalpingostomy for hydrosalpinges), and because of the increased risk of ectopic pregnancy, most women experiencing significant tubal damage are advised to move directly to IVF” (Pacific Fertility Center,2013) • (IVF) In Virtro Fertilization

Neosalpingostomy (Repair)

Infertility Screening

(IVF) In Vitro Fertilization

Patient Prognosis • Patient’s blockage falls under the category of good prognosis • Physician recommends Neosalpingostomy first to see how the good the results are • Patient’s results came back good, at this time there is no need for an IVF surgery

Patient Follow-Up Care • Patient Stays in Hospital 2-4 days after surgery • Patient must return to hospital if she notices more bleeding then what is normal • Patient must follow-up with OB/GYN office within 1 week of procedure.

Sonographer Preliminary Report • Left Fallopian Tube: “Shows signs of excess scar tissue” • Shadow on Left Fallopian Tube indicates an enlargement or growth • Left Fallopian Tube measures 2 cm larger than the right of 10cm • Recommendations: Possible Exploratory Surgery (laparoscopy) to identify shadow, and reason for enlargment

Multiple Choice Question #1 What causes Hydrosalpinx? a) blood clots b) excess scar tissue c) ectopic pregnancy d) none of the above

Multiple Choice Question #2 What treatment option did the patient choose? a) to take medication b) have a sonogram done c) have a Neosalpingostomy performed d) have a hysterectomy performed

Multiple Question #3 What is one symptom of this disease? a) causes the patient to be ill b) causes abdominal pain c) causes swelling in hands and feet d) None of the above

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References Clearing Hydrosalpinx Without Surgery. (2012). Retrieved from Clearwater age: http://www.clearage.com/what-wetreat/infertility/hydrosalpinx/ Hydrosalpinx. (2013). Retrieved from Pacific Fertility Center: http://www.pacificfertilitycenter.com/infertilitydiagnosis/hydrosalpinx