Successful Management of a Cystic Lesion Which Had Been Caused by Menstrual Blood Above the Dehiscence of Cesarean Incision Scar: Case Report

Cesarean scar dehicence has the incidence of 1.2% after base transverse incisions. Beside causing a situation increasing morbidity and mortility for baby and mother and needing acute intervention in antenatal or intrapartum period by causing uterine rupture, it is an important complication that can cause sudden bleeding, infection and even uterine fistules in postpartum period. In our case, we will mention about the successful management of cyst caused by menstrual blood that develops dehiscence of cesarean scar. A female patient with the age of 40 (Gravida:2, parity:2 (2 C/S) applied to our policlinic because of amenorrhoea. A cystic mass, probably originated from cesarean incision scar, with intense content, smooth borders and the dimensions of 66x24 mm was observed by the help of transvaginal ultrasonography. The evacuation of the cyst content had been decided by performing vacuum aspiration from cervical ostium. Transabdominal ultrasonography guided karman cannula was placed into the cyst from cervical ostium. The content of the cyst had been aspired by negative pressure. Most of the complications after cesarean can be diagnosed by easy ultrasonographic observations and physical examinations, some needs expensive radiologic observations such as magnetic resonance imaging, computerized tomography, while for some of them, second- look procedures can be necessary that increase mortality and morbidity of the patient. The most important thing is how to treat these complications. Some of them can be treated by conservative approaches; while some of them needs severe surgical operations even histerectomy. As in our case, the cyst caused by menstrual blood after causing dehiscence of cesarean scar, was vacuum aspirated easily and treated by conservative approach

A Giant Parasitic Leiomyoma with Blood Supply from Omental Branches: A Case Report

A female patient with the age of 33 having gravida: 3, parity: 2 and D&C: 1, applied to our clinics by pelvic mass that she had. It had been comprehended from the anamnesis of the patient that she applied to a gynecologist because of ongoing inguinal pain and abdominal distension for about 4 months. In the physical examination, a mass that can be palpated in suprapubic region was observed. In transvaginal ultrasonographic examination, a giant leiomyom was determined having the dimensions of 9.5cm x 8.5 cm that was located at fundal uterus with subserous component and enlarged the uterus. Pfannenstiel incision was performed. In intraoperative examination, a fundal subserous located parasitic leiomyoma with around 10 cm diameter, supplied by a vascular structure about 30 cm in length from omentum was diagnosed.It was diagnosed that omentum adhered to leiomyoma partially. Firstly, omentum with its vascular structure was excised. Partial omentectomy was performed. Then, leiomyoma was excised by performing dissection and operation was ended up. Parasitic myomas are indicated as rarely seen myomas in literature. It is crucial to maintain specific diagnosis, careful imaging and serious planning in preoperative preparations.Although parasitic leiomyomas are rarely seen cases, because of abnormal vascularization and adhesion to other organs, one should be careful in preoperative examinations and sufficient blood supply should be maintained in case of bleeding. Additionally, surgical information has to be had for surgical exploration and pelvic anatomy