TY  - CHAP
M1  - Book, Section
TI  - Gynecology
A1  - Hamilton, Chad
A1  - Stany, Michael
A1  - Gregory, W. Thomas
A1  - Kohn, Elise C.
A2  - Brunicardi, F. Charles
A2  - Andersen, Dana K.
A2  - Billiar, Timothy R.
A2  - Dunn, David L.
A2  - Hunter, John G.
A2  - Matthews, Jeffrey B.
A2  - Pollock, Raphael E.
PY  - 2015
T2  - Schwartz's Principles of Surgery, 10e
AB  - Gynecologic  causes  of  acute  abdomen  include  pelvic  inflammatory  disease,  tubo-ovarian  abcess,  ovarian  torsion,  ruptured  ectopic  pregnancy,  and  septic  abortion.  Pregnancy  must  be  ruled  out  early  in  assessment  of  reproductive-age  patients  presenting  with  abdominal  or  pelvic  pain.The  general  gynecology  exam  must  incorporate  the  whole  physical  examination  in  order  to  adequately  diagnosis  and  treat  gynecologic  disorders.Benign  gynecologic  pathologies  that  are  encountered  at  the  time  of  surgery  include  endometriosis,  endometriomas,  fibroids,  and  ovarian  cysts.It  is  critical  that  abnormal  lesions  of  the  vulva,  vagina,  and  cervix  are  biopsied  for  diagnosis  before  any  treatment  is  planned;  postmenopausal  bleeding  should  always  be  investigated  to  rule  out  malignancy.Early-stage  cervical  cancer  is  managed  surgically,  whereas  chemoradiation  is  preferred  for  stage  IB2  and  above.Pregnancy  confers  important  changes  to  both  the  cardiovascular  system  and  the  coagulation  cascade.  Trauma  in  pregnancy  must  be  managed  with  these  changes  in  mind.Pelvic  floor  dysfunction  (pelvic  organ  prolapse,  urinary  and  fecal  incontinence)  is  common;  11%  of  women  will  undergo  a  reconstructive  surgical  procedure  at  some  point  in  their  lives.Radical  hysterectomy  has  unique  risks  of  ureteral  fistula  and  bowel  dysfunction.Risk-reducing  salpingo-oophorectomy  (RRSO)  should  be  considered  in  women  with  BRCA1  or  BRCA2  mutations;  RRSO  and  complete  hysterectomy  should  be  considered  in  women  with  Lynch  syndrome.Optimal  debulking  for  epithelial  ovarian  cancer  is  a  critical  element  in  patient  response  and  survival.  The  preferred  primary  therapy  for  optimally  debulked  advanced-stage  ovarian  epithelial  ovarian  cancer  is  intraperitoneal  chemotherapy.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1117753410
ER  -