Pelvic fluid

Fig. 8.10. Ovarian ligament on MRI. The right ovarian hga-ment is identified as a short band extending between uterus and ovary (arrow). The thickening of the endometrium is caused by endometrial cancer. A small amount of physiologic pelvic fluid is noted...

Ascites alone is nonspecific with small amounts of pelvic fluid typically detected in the cul-de-sac (Fig. 9.3). Only larger amounts of pelvic fluid may be... 

Ascites alone is generally nonspecific, and small amounts of pelvic fluid are commonly detected in the... 

In difficult-to-access and deep abdominal/pelvic fluid collections, the direction of the guiding needle can be exactly controlled with respect to adjacent neurovascular structures and bowels... 

Depending on the location of a pelvic fluid collection, different access paths determined by the surrounding pelvic ring are suitable the presacral approach (patient in prone position) is especially useful in patients who develop a presacral abscess after an abdominoperineal resection (Fig. 37.13). Using a sUght (double) angula-... 

Fig. 3.6a-d. Urinary leak secondary to ureteral ischemia. Ultrasonography (a) shows a fluid collection between the lower pole of the transplant and the bladder, b On contrast-enhanced CT, fluid is noted around the graft and within the peritoneal cavity. The pelvic fluid collection ( ) has a water density at the early phase after contrast injection (c) but enhances at the late phase (d) due to the urinary leak of contrast medium... 

The most significant mechanism for primary dysmenorrhea is the release of prostaglandins in the menstrual fluid and possibly vasopressin-mediated vasoconstriction.5,17 Causes of secondary dysmenorrhea may include cervical stenosis, endometriosis, pelvic infections, pelvic congestion syndrome, uterine or cervical polyps, and uterine fibroids.20... 

This 67-year-old patient was optimally debulked and completed six cycles of paclitaxel/carboplatin after her surgery. HerCA-125 normalized (12 U/mL, 12 kU/L) on completion of her chemotherapy treatment, and her CT scan was negative. This patient returns to your clinic for her first 3-month follow-up appointment. Her CA-125 is (45 U/mL, 45 kU/L), and she reports some mild bloating. CT scan report states mild fluid accumulation in the pelvic cavity. 

Seminal emission and ejaculation are under control of the sympathetic nervous system. Emission results from a-adrenergic-mediated contraction of the epididymis, vas deferens, seminal vesicles, and prostate, which causes seminal fluid to enter the prostatic urethra. Concomitant closure of the bladder neck prevents retrograde flow of semen into the bladder, and antegrade ejaculation results from contraction of the muscles of the pelvic floor including the bulbocavemosus and ischiocavernosus muscles. 

The endometrium is the tissue that lines the inside of the uterus. Endometriosis is a condition where endometrial tissue is found outside the uterus. It is trapped in the pelvic area and lower abdomen. The exact cause is unknown. A reflux of menstruation occurs in many women but in endometriosis refluxed cells implant in the pelvis, bleed in response to cyclic hormone stimulation and increase in size. Patches of endometriosis can cause adhesions and form into cysts which can fill with thick fluid and are known as chocolate cysts. 

Thapar, M. Parr, E. Parr, M. Secretory immune responses in mouse vaginal fluid after pelvic, parenteral or vaginal immunization. Immunology 1990, 70, 121-125. 

Large-colon impaction is characterized by distention of the large intestine with desiccated digesta. All segments of the large colon can be involved but the pelvic flexure and right dorsal colon are the most frequent sites of impaction. Impactions of the large colon are probably a combination of motility and fluid-balance disorders and most cases are treated with laxatives or hydration solutions. 

According to Dr. John H. Clarke, in his Dictionary of Materia Medica, homeopathic Silica and Pulsatilla are contraindicated in a patient taking saw palmetto, as they antidote the remedy. An early homeopathic physician, Elias C. Price, M.D., recorded several unusual case histories in which Serenoa was used. One patient was a very nervous woman with chronic inflammation of the bladder. She had frequent and painful urination, 10 to 20 times per night and every 15 to 30 minutes during the day. A rectal examination revealed a hard fleshy tumor the size of half a hen s egg on the posterior of the uterus. She was given Sabal (Serenoa) fluid extract, five drops, three times per day. In two months the tumor was reduced in size by half, and after another three months the tumor and the urinary problem were entirely resolved. In other cases. Dr. Price successfully used Sabal for pelvic cellulitis peritonitis puerperal fever inflammation of the uterus, fallopian tubes, and ovaries and even appendicitis. 

Although the basic pathophysiology is similar for the various causes of hypovolemic shock, there are unique considerations relative to each. For example, whereas isolated head injuries associated with trauma typically do not result in substantial blood loss or shock, pelvic fractures may sequester several liters of blood as hematoma formation. Patients with traumatic or thermal injuries, as well as postoperative patients, may have substantial fluid accumulation in sites where it cannot be readily transferred back into blood vessels (i.e., third-spaced fluid) for maintaining pressure. With these types of injuries, prompt control of compressible bleeding sources with rapid patient transfer to the hospital for definitive treatment may preclude the cascade of events leading to shock. Indeed, with trauma patients, a scoop and run approach is used in most urban hospitals that places a priority on rapid transport to a hospital. ... 

After the agent is released into the mucus, the fluid production produces a flow that moves the agent towards the base of the pelvic cavity. It was assumed that no elimination of the agent from the reproductive tract took place along the y-axis (this assumption was valid in the mouse [42, 44]). The concentration in the well-mixed portion of the tract was related to the concentration emerging from the vagina ... 

The drug is injected into the subarachnoid space, i.e., into the cerebrospinal fluid, to paralyse the roots of the spinal nerves. This method is used to induce anaesthesia for abdominal or pelvic surgical operations. 

Plain film shows numerous dilated loops of bowel occupying the entire abdominal cavity, including the pelvic portion, and multiple air-fluid levels in upright film (Fig. 1.19). With this degree of distension the mucosal pattern of the small bowel is effaced and it is impossible to differentiate the small bowel from the colon (Winters et al. 1992). Examination of the colon is then warranted to disclose the presence or absence of a colonic lesion. In ileal atresia, the colon is normally placed but has an abnormally small caliber, the so-called functional microcolon typical of distal small bowel obstruction (Dalla Vecchia et al. 1998) (Fig. 1.19d,e). The presence of pneumoperitoneum indicates that perforation has occurred and a colon examination is contraindicated. Intraperitoneal calcifications, indicative of meconium peritonitis, are not uncommon in ileal atresia. 

The differential diagnosis of pelvic pain is wide and includes ovarian vein varices, pelvic infection and endometriosis. Untreated pelvic infections are an absolute contraindication to UAE. They are a known cause of a hydrosalpinx a collection of fluid in the fallopian tube and a recognized cause of infertility. This diagnosis is best established on hystero-salpingography. 

Peritoneal inclusion cysts (pseudocysts) are acciunu-lations of fluid produced by the ovaries that become entrapped by peritoneal adhesions. These lesions are typically encountered in patients with previous surgery, endometriosis, or pelvic inflammatory disease (PID). They are of variable size and tend to adhere to adjacent structures. Pseudocysts have an irregular shape because the outer surface is not a true wall but... 

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