Tuesday, April 10, 2012

OB/GYN: Fibriods

So i Finally got to see a very awesome surgery... the only surgery of the day (but don't worry, that doesn't mean a day off for me, it means more ob).

It was a partial hysterectomy with a known 10cm fibroid.  A 36 y.o. woman who wanted this surgery because of extreme abdominal pain and significant bleeding during menses. This was presumed be because the fibroid, which was outside of the uterus. She tried for seven years to conceive and finally decided to accept her fate. And decided on the surgery.  She wanted to keep her cervix and ovaries which is why it is only a partial hysterectomy. When we opened the abdomen, we found the fibroid- which is a ball made entirely of excess muscle. Before you ask, we have no idea why some women get them and others don't. We do know that obesity is a very high risk factor, though.  Anyhow below is the fibriod I'm holding. It is shaped like a heart.... see


However, the real surprise was her uterus. It was very large and there were so many blood vessels.  We had to cut the uterus in half to get it out of the incision so, when we cut we found that the uterus was filled with nothing but fibroid tissue. It filled the uterus so completely there was no way she was ever going to conceive or come close to stop bleeding.  If we hadn't already cut out a fourth of the uterus we could have cut out the fibroid and allowed her to try for a kid. But she had already signed the consent and we had already cut off the uterine blood supply.

For those that don't know: the uterus gets up to a quart of blood a minute.  So imagine cutting that artery and the sheer amount of bleeding. Women can and do die because the uterus breaks (during labor, trauma, etc). So cutting the uterus results in significant amounts of bleeding and with fibriods, this lady was no exception. She ended up getting two bags of blood because we kept getting bleeders. It was crazy fun.

Anyway, below are the pieces of the uterus... look at how thick and almost meaty it is.  Believe it or not, the strongest muscle in the body.... the uterus. Yeah. Take that. 


EDIT: I just went back and updated a few of the previous posts by adding more pictures, etc. And I added a few new posts, check out the general surgery section.

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