Journal articles: 'Pelvic exams'

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SALLADAY, SUSAN A. "Puzzled about pelvic exams." Nursing 33, no. 12 (December 2003): 24–26. http://dx.doi.org/10.1097/00152193-200312000-00021.

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Palsgaard, Peggy, Rahul S. Yerrabelli, Ashkhan Hojati, and Elsa Whitmore. "Using a condom or glove to improve pelvic exam visualization: A guide." SAGE Open Medicine 10 (January 2022): 205031212211460. http://dx.doi.org/10.1177/20503121221146069.

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Objectives: Pelvic exams are a cornerstone of gynecological care, necessary for both regular screenings and diagnostics. The collapse of lateral vaginal walls during a pelvic exam is a frequently encountered problem in clinical practice. Methods: Practitioners often utilize tools found in a typical clinical setting to counter this issue, such as a condom or glove over the speculum to prevent the lateral vaginal walls collapsing inward and obscuring cervical views. Results: These techniques have been passed down from mentor to mentee over the years, though scarcely described in literature. This article aims to provide instructions on how to use these two methods in clinical practice to improve pelvic exams for the practitioner and the patient. Conclusion: Utilizing a condom or glove to prevent lateral vaginal wall collapse has the potential to improve pelvic exams for both practitioners and patients.

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Tucker, Paula, and Dian Dowling Evans. "Are Pelvic Exams Necessary Anymore?" Advanced Emergency Nursing Journal 41, no. 4 (2019): 282–89. http://dx.doi.org/10.1097/tme.0000000000000269.

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Magudia, Kirti, Christopher P. Bridge, Katherine P. Andriole, and Michael H. Rosenthal. "The Trials and Tribulations of Assembling Large Medical Imaging Datasets for Machine Learning Applications." Journal of Digital Imaging 34, no. 6 (October 4, 2021): 1424–29. http://dx.doi.org/10.1007/s10278-021-00505-7.

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AbstractWith vast interest in machine learning applications, more investigators are proposing to assemble large datasets for machine learning applications. We aim to delineate multiple possible roadblocks to exam retrieval that may present themselves and lead to significant time delays. This HIPAA-compliant, institutional review board–approved, retrospective clinical study required identification and retrieval of all outpatient and emergency patients undergoing abdominal and pelvic computed tomography (CT) at three affiliated hospitals in the year 2012. If a patient had multiple abdominal CT exams, the first exam was selected for retrieval (n=23,186). Our experience in attempting to retrieve 23,186 abdominal CT exams yielded 22,852 valid CT abdomen/pelvis exams and identified four major categories of challenges when retrieving large datasets: cohort selection and processing, retrieving DICOM exam files from PACS, data storage, and non-recoverable failures. The retrieval took 3 months of project time and at minimum 300 person-hours of time between the primary investigator (a radiologist), a data scientist, and a software engineer. Exam selection and retrieval may take significantly longer than planned. We share our experience so that other investigators can anticipate and plan for these challenges. We also hope to help institutions better understand the demands that may be placed on their infrastructure by large-scale medical imaging machine learning projects.

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Magudia, Kirti, Christopher P. Bridge, Katherine P. Andriole, and Michael H. Rosenthal. "The Trials and Tribulations of Assembling Large Medical Imaging Datasets for Machine Learning Applications." Journal of Digital Imaging 34, no. 6 (October 4, 2021): 1424–29. http://dx.doi.org/10.1007/s10278-021-00505-7.

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AbstractWith vast interest in machine learning applications, more investigators are proposing to assemble large datasets for machine learning applications. We aim to delineate multiple possible roadblocks to exam retrieval that may present themselves and lead to significant time delays. This HIPAA-compliant, institutional review board–approved, retrospective clinical study required identification and retrieval of all outpatient and emergency patients undergoing abdominal and pelvic computed tomography (CT) at three affiliated hospitals in the year 2012. If a patient had multiple abdominal CT exams, the first exam was selected for retrieval (n=23,186). Our experience in attempting to retrieve 23,186 abdominal CT exams yielded 22,852 valid CT abdomen/pelvis exams and identified four major categories of challenges when retrieving large datasets: cohort selection and processing, retrieving DICOM exam files from PACS, data storage, and non-recoverable failures. The retrieval took 3 months of project time and at minimum 300 person-hours of time between the primary investigator (a radiologist), a data scientist, and a software engineer. Exam selection and retrieval may take significantly longer than planned. We share our experience so that other investigators can anticipate and plan for these challenges. We also hope to help institutions better understand the demands that may be placed on their infrastructure by large-scale medical imaging machine learning projects.

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DAHER, MURILO TAVARES, RENATO FLEURY DI SOUZA LOPES, RENATO TAVARES DAHER, RICARDO TAVARES DAHER, NILO CARRIJO MELO, VINÍCIO NUNES NASCIMENTO, PEDRO FELISBINO JR, RICARDO VIEIRA TELES FILHO, and MARCELO FOUAD RABAHI. "DESCRIPTION OF A NEW METHOD OF MEASURING THE PELVIC INCIDENCE ANGLE THROUGH COMPUTED TOMOGRAPHY." Coluna/Columna 19, no. 1 (March 2020): 30–33. http://dx.doi.org/10.1590/s1808-185120201901218227.

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ABSTRACT Objective To describe a more accurate method for measuring the pelvic incidence angle using computed tomography, without the influence of the positioning of the pelvis in relation to the X-ray tube. Methods Thirteen CT scans of the lumbosacral region, abdomen or pelvis were randomly assessed, as all these exams include the sacrum and femoral heads. All the exams were performed in multichannel devices with six channels. The technique of overlapping images, already common in other musculoskeletal exams, such as TT-TG, was used. The centered sagittal cut of the left femoral head, the center of S1, and the right femoral head were used. From these, a fourth image was created, analogous to an X-ray of the pelvis, from which measurements were taken using the dedicated software. Results Of the thirteen exams, three were of the lumbar spine and 10 were of the total abdomen, six of them being of males.. The mean age was 56 years. The mean PI was 45°, ranging from 31 to 81 degrees. Among the women, the mean was 52° (31 to 81°) and among the men, 38° (32 to 46°). Conclusion CT can be used to calculate the PI, using the technique of overlapping images common to other musculoskeletal exams, such as TT-TG. Level of Evidence IIIB. Diagnostic study; Retrospective study.

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Bezjian Wallace, Laurie, Patrick Wallace, and Joel Herness. "A Rare Pelvic “Mass-Querader”: Acute Urinary Retention Secondary to Hematocolpos in a Preadolescent Patient." Military Medicine 185, no. 11-12 (November 1, 2020): 2171–72. http://dx.doi.org/10.1093/milmed/usaa166.

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ABSTRACT We report a case of acute urinary retention in an adolescent female secondary to hematocolpos. A 13-year-old female presented to the emergency department with acute urinary retention and suprapubic abdominal pain for 24 hours. She denied menstruation or sexual history. Bedside bladder ultrasound scan revealed 1.2 L of retained urine and a Foley catheter was placed. A formal renal ultrasound detected a debris-filled structure in the abdomino-pelvic cavity. Follow-up computed tomography of the abdomen and pelvis revealed an 8.5 cm × 9.3 cm × 12.1 cm mass-like structure in the pelvis. No formal pelvic exam was completed and the patient was taken to the operating room for exploratory laparotomy due to concern for large pelvic mass versus tubo-ovarian abscess. However, upon entering the abdominal cavity, no mass was found. At that point, an external genital exam was performed, revealing an imperforate hymen. Hymenotomy resulted in the evacuation of 2.5 L of clotted blood from the vagina and uterus. Hematocolpos resulting in acute urinary retention is exceedingly rare; however, it is an important differential diagnosis that can be ruled in or out by physical exam findings. Although it may be uncomfortable for adolescent patients and physicians, external genital exams should be conducted in young females with acute urinary retention and amenorrhea to evaluate for imperforate hymen. This can ensure appropriate treatment and avoidance of unnecessary invasive procedures.

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Horowitz, Jeanne M., Irene M. Hotalen, Emily S. Miller, Emma L. Barber, Shohreh Shahabi, and Frank H. Miller. "How Can Pelvic MRI with Diffusion-Weighted Imaging Help My Pregnant Patient?" American Journal of Perinatology 37, no. 06 (April 12, 2019): 577–88. http://dx.doi.org/10.1055/s-0039-1685492.

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AbstractThe purpose of this review is to explain how diffusion-weighted imaging (DWI) is used during magnetic resonance imaging (MRI) exams in pregnant patients for specific maternal indications, including evaluation of acute pelvic pain, adnexal masses, cancer diagnosis and staging, and morbidly adherent placenta. While ultrasound is often the appropriate initial imaging for evaluating a pregnant patient, MRI can be helpful when a pelvic ultrasound is indeterminate. MRI has advantages in that it does not use ionizing radiation and has shown no known deleterious effects to the fetus. The use of gadolinium-based contrast is controversial during pregnancy. DWI is a functional sequence performed during an MRI exam, which is valuable in the absence of gadolinium contrast, and can increase the visibility of inflammation, abscesses, and tumors. Case examples will be presented to demonstrate the utility and added value of DWI over conventional anatomic T1- and T2-weighted imaging in diagnosis of maternal disease in the pregnant patient's pelvis.

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Misiura, Anne K., Autumn D. Nanassy, and Jacqueline Urbine. "Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?" International Journal of Pediatrics 2018 (October 2, 2018): 1–4. http://dx.doi.org/10.1155/2018/6260954.

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Trauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation when CT of the abdomen and pelvis is also performed, trauma patients who presented to an urban Level I Pediatric Trauma Center between 1 January 2010 and 7 February 2017 in whom pelvic radiograph and CT of the abdomen and pelvis were performed within 24 hours of each other were analyzed. A total of 172 trauma patients had pelvic radiograph and CT exams performed within 24 hours of each other. There were 12 cases in which the radiograph missed pelvic fractures seen on CT and 2 cases in which the radiograph suspected a fracture that was not present on subsequent CT. Furthermore, fractures in the pelvis were missed on pelvic radiographs in 12 of 35 cases identified on CT. Sensitivity of pelvic radiograph in detecting fractures seen on CT was 65.7% with a 95% confidence interval of 47.79-80.87%. Results suggest that there is no added diagnostic information gained from a pelvic radiograph when concurrent CT is also obtained, a practice which exposes the pediatric trauma patient to unnecessary radiation.

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Potera, Carol. "Unneeded Pelvic Exams in Women Seeking Birth Control." AJN, American Journal of Nursing 111, no. 3 (March 2011): 17. http://dx.doi.org/10.1097/10.1097/01.naj.0000395226.64552.63.

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Baraldi, Carole A., and Lucinda R. Webb. "Making the case for pap and pelvic exams." Geriatric Nursing 12, no. 5 (September 1991): 228–30. http://dx.doi.org/10.1016/s0197-4572(06)80009-1.

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Friesen, Phoebe. "Educational pelvic exams on anesthetized women: Why consent matters." Bioethics 32, no. 5 (April 23, 2018): 298–307. http://dx.doi.org/10.1111/bioe.12441.

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Izaías, Italo Cordeiro de Barros, Lucilo S. de A. Maranhão Neto, André Flávio Freire Pereira, Marcus André Costa Ferreira, Rodrigo Castro de Medeiros, Luciano Temporal Borges Cabral, and Túlio Albuquerque de Moura Rangel. "ANATOMICAL STUDY OF THE IDEAL POSITIONING OF THE S2 ILIAC SCREW." Coluna/Columna 20, no. 4 (December 2021): 282–86. http://dx.doi.org/10.1590/s1808-185120212004224997.

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ABSTRACT Objective: To evaluate the morphometry of the pelvis to determine the safe trajectory for the insertion of the S2-iliac screw, and to correlate it with studies reported in the literature for other populations. Method: The computed tomography (CT) pelvic exams of 36 Brazilian patients without congenital malformations, tumors, pelvic ring fractures or dysplasias were selected from the database of a radiological clinic. To define the ideal trajectory of the S2-iliac screw, the following variables were measured: 1- maximum sacroiliac screw length; 2- thickness of the iliac dipole for planning the choice of screw dimensions (length and diameter); 3 - distance between the insertion point of the iliac S2 screw and the posterior sacral cortex; 4 - angulation for insertion of the screw in the mediolateral direction, representing the angle formed between the “iliac line” and the anatomical sagittal plane; 5- Angulation for insertion of the screw in the craniocaudal direction. The Pearson's chi squared and student's t tests were used for statistical analysis. Results: The sample consisted of 36 patients, 50% (18/36) of whom were women. The mean age was 63.7 years, ranging from 23 to 96 years. All the pelvic morphometric variables analyzed presented values similar to those described in the literature for other populations. Conclusion: Prior evaluation of the tomography exams was important for preoperative planning, and there was a statistically significant difference between the sexes only in relation to the variables left craniocaudal and length of the left internal table. Level of evidence III; Observational cross-sectional study.

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Batur, Pelin, and Abbey B. Berenson. "Are breast and pelvic exams necessary when prescribing hormonal contraception?" Cleveland Clinic Journal of Medicine 82, no. 10 (October 2015): 661–63. http://dx.doi.org/10.3949/ccjm.82a.15055.

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Gardenier, Donald. "Should NPs Use Chaperones When They Perform Female Pelvic Exams?" Journal for Nurse Practitioners 8, no. 9 (October 2012): 696–97. http://dx.doi.org/10.1016/j.nurpra.2012.08.014.

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Byron, Rhiannon K., Virginia Y. Watkins, Alexandra Stiles, Elissa Trieu, and Mireille D. Truong. "The Utility of Annual Pelvic Exams in Asymptomatic Women [33K]." Obstetrics & Gynecology 133, no. 1 (May 2019): 126S. http://dx.doi.org/10.1097/01.aog/01.aog.0000559227.88685.98.

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Rodriguez Morris, Monica I., and Andrea Hicks. "Life cycle assessment of stainless-steel reusable speculums versus disposable acrylic speculums in a university clinic setting: a case study." Environmental Research Communications 4, no. 2 (February 1, 2022): 025002. http://dx.doi.org/10.1088/2515-7620/ac4a3d.

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Abstract The reusable versus disposable debate is frequently discussed with regards to health care sustainability. Vaginal speculums used in pelvic exams are available in both disposable and reusable material designs. A comparative cradle to grave life cycle assessment (LCA) was conducted to determine and analyze the environmental impacts of using disposable acrylic speculums versus using reusable stainless-steel speculums in a women’s university health clinic where around 5,000 pelvic exams are conducted on a yearly basis. Environmental impacts for the Tool for the Reduction and Assessment of Chemical and other environmental Impacts (TRACI) 2.1 categories were determined using process based LCA. The scope considered for the analysis includes the stages of raw materials, manufacturing, use, and end of life. The functional unit for all analyses is selected as 5,000 pelvic exams, which is equivalent to one year of clinic operation. The reusable stainless steel speculum system outperformed the acrylic speculum system in five impact categories: global warming, acidification, respiratory effects, smog, and fossil fuel depletion. There is one category, ozone depletion, where the acrylic speculum system performs better. When accounting for uncertainty, in the carcinogenics, non-carcinogenics, ecotoxicity, and eutrophication impact categories, there is no speculum system that outperforms the other. Overall, there is no speculum system that outperforms the other consistently across all TRACI impact categories, however, depending on the overall environmental objectives one may be preferable to the other.

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Dubin, A. K., C. Arora, and A. Advincula. "52: Does the integration of pelvic exam simulation into standardized ob/gyn medical student clerkship orientation improve student confidence with pelvic exams?" American Journal of Obstetrics and Gynecology 220, no. 3 (March 2019): S741—S742. http://dx.doi.org/10.1016/j.ajog.2019.01.082.

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Sarma, D., R. Burke, L. Bilello, L. Sanchez, and I. Agarwal. "326 Resident Attitudes Towards Performing Pelvic Exams in the Emergency Department." Annals of Emergency Medicine 78, no. 4 (October 2021): S132. http://dx.doi.org/10.1016/j.annemergmed.2021.09.340.

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McCarthy, M. "Screening pelvic exams are of no benefit, US doctors' group says." BMJ 349, jul01 12 (July 1, 2014): g4342. http://dx.doi.org/10.1136/bmj.g4342.

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Ehrenthal, Deborah B., Neil J. Farber, Virginia U. Collier, and Brian M. Aboff. "Chaperone use by residents during pelvic, breast, testicular, and rectal exams." Journal of General Internal Medicine 15, no. 8 (August 2000): 573–76. http://dx.doi.org/10.1046/j.1525-1497.2000.10006.x.

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Gorski, Justin W., Charles S. Dietrich, Caeli Davis, Lindsay Erol, Hayley Dietrich, Nicholas J. Per, Emily Lenk Ferrell, et al. "Significance of Pelvic Fluid Observed during Ovarian Cancer Screening with Transvaginal Sonogram." Diagnostics 12, no. 1 (January 7, 2022): 144. http://dx.doi.org/10.3390/diagnostics12010144.

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The primary objective was to examine the role of pelvic fluid observed during transvaginal ultrasonography (TVS) in identifying ovarian malignancy. A single-institution, observational study was conducted within the University of Kentucky Ovarian Cancer Screening trial from January 1987 to September 2019. We analyzed true-positive (TP), false-positive (FP), true-negative (TN), and false-negative (FN) groups for the presence of pelvic fluid during screening encounters. Measured outcomes were the presence and duration of fluid over successive screening encounters. Of the 48,925 women surveyed, 2001 (4.1%) had pelvic fluid present during a TVS exam. The odds ratio (OR) of detecting fluid in the comparison group (TN screen; OR = 1) significantly differed from that of the FP cases (benign pathology; OR: 13.4; 95% confidence interval (CI): 9.1–19.8), the TP cases with a low malignant potential (LMP; OR: 28; 95% CI: 26.5–29.5), TP ovarian cancer cases (OR: 50.4; 95% CI: 27.2–93.2), and FN ovarian cancer cases (OR: 59.3; 95% CI: 19.7–178.1). The mean duration that pelvic fluid was present for women with TN screens was 2.2 ± 0.05 encounters, lasting 38.7 ± 1.3 months. In an asymptomatic screening population, free fluid identified in TVS exams was more associated with ovarian malignancy than in the control group or benign ovarian tumors. While pelvic free fluid may not solely discriminate malignancy from non-malignancy, it appears to be clinically relevant and warrants thoughtful consideration.

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Waheed, Shahid, and Tonya A. Linthacum. "Twenty-five year anniversary of a successful rural, community hospital, comprehensive cancer screening program." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e12569-e12569. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e12569.

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e12569 Background: A 25 year successful comprehensive cancer screening program at a rural community hospital in Mexico, MO, USA, provides a multi-organ cancer detection clinic for asymptomatic women over age of 35. Methods: The Screening Program consists of a Medical Director, day to day oversight by a Family Nurse Practitioner, with nurse practitioner and specialty trained registered nurse examiners. This multi-organ screening program focuses on breast, colon, skin, cervical and prostate cancer early detection. One-hour screening exams for women include detailed cancer risk assessment, prevention education, head-to-toe physical exams including an examination of the skin, clinical breast exam, mammogram, pelvic and Pap test. Additionally, site-specific exams of the abdomen, thyroid, peripheral lymph nodes and rectum are conducted. Male exams include a physical examination of the skin, abdomen, peripheral lymph nodes, thyroid, external genital, digital rectal exam of the prostate and PSA blood education. For all tobacco users, the screening includes an oral examination. Extensive education is provided to participants on prevention modalities, current screening guidelines, and new research findings. Detected abnormalities are referred to the patient’s primary care physician for follow up. A phone call to the patient and the primary care provider four to six weeks after the initial exam obtains the results of the referral visit. Results: 25-year participation rates total 51,223 visits with a ratio of 1 male to 19 females. Return rates over the past year were 94%. 626 cancers have been detected since the inception of the program with 1 breast cancer for every 41 women participating, most identified at early stages. Over 2,500 participants, with a 95% satisfaction rating, from 48 Missouri counties, as well as 21 states of the nation are seen annually for cancer screening. Conclusions: Comprehensive screening programs are effective at decreasing cancer mortality and morbidity through education, prevention, and early detection. Nurse run clinics offer a satisfying, cost effective alternate approach, while continuing to provide competent expertise in the specialized field of cancer prevention.

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Fetohi, Mohamed, Sanaa Errarhay, Aziz Bazine, and Tarikq Namad. "Exophthalmos Revealing a Krukenberg Tumor: A Case Presentation and Review of the Literature." Case Reports in Oncology 9, no. 2 (July 29, 2016): 409–14. http://dx.doi.org/10.1159/000448167.

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Background: Krukenberg tumor is a well-known ovarian metastasis, usually of signet ring cell carcinoma in female patients. In the literature, there are a few documented cases of ocular metastasis in patients with Krukenberg tumor. Case Presentation: We report the case of a 35-year-old single Moroccan woman. She presented chronic pelvic pain, hematemesis and blurring of vision in the left eye. Clinical examination showed a pelvic mass and an exophthalmos with a divergent strabismus in the left eye. Pelvic and abdominal ultrasound showed a right tissular ovarian mass. Computed tomography (CT) scan of the abdomen and pelvis revealed an ovarian tumor and bone metastasis. Orbital magnetic resonance imaging (MRI) showed a hypertrophy of the left inferior rectus muscle behind the exophthalmos. Stomach endoscopy revealed an ulcerated and protruded mass of the antro-fundic junction. Histopathology and immunohistochemistry showed an infiltration of the gastric mucosa by atypically isolated signet ring cells similar to the tumor cells found in the ovarian histopathological exams. Discussion: Krukenberg tumor is an uncommon metastatic tumor of the ovary. This article provides an overview of the major pathological manifestations of Krukenberg tumor, patient characteristics, clinical and laboratory features of the disease, prognostic factors, and current knowledge about its pathogenesis.

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Hope, Kisha T., Anna Everett Strohl, Patricia Smyrniotis, Jeffrey Dungan, Shohreh Shahabi, and Lee P. Shulman. "Elimination of pelvic exams in a high-risk ovarian cancer screening program." Journal of Clinical Oncology 34, no. 15_suppl (May 20, 2016): e13059-e13059. http://dx.doi.org/10.1200/jco.2016.34.15_suppl.e13059.

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White, Ariel, Claudette Shephard, and Sandra Arnold. "Do Pediatric and Internal Medicine/Pediatric Residents Do Pelvic Exams on Adolescents?" Journal of Pediatric and Adolescent Gynecology 30, no. 2 (April 2017): 324. http://dx.doi.org/10.1016/j.jpag.2017.03.122.

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Tagliani, Sara, Silvia Ventresca, Lorenzo Mambelli, Alessandro Cuppari, Stefano Missiroli, and Federico Marchetti. "La malattia infiammatoria pelvica." Medico e Bambino pagine elettroniche 23, no. 8 (October 31, 2020): 207–11. http://dx.doi.org/10.53126/mebxxiii207.

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The paper describes a case of Pelvic Inflammatory Disease (PID) in a fourteen-year-old girl who presented with salpingitis, low abdominal pain, fever, high inflammation indexes and infection by Chlamydia trachomatis and Gardnerella. As guidelines suggest, she was treated with doxycycline, metronidazole and ceftriaxone and her clinical conditions rapidly improved. PID can develop also in teenagers, especially if sexually active, and it must be differentiated from other causes of acute abdomen. The diagnosis can be based on the presence of pain and on at least one criterion between clinical objectivity (fever, vaginal secretions) and laboratory data (vaginal swab, blood exams, vaginal secretion microscopic analysis). Instrumental exams can support the diagnosis but sometimes only laparoscopy and biopsy can reveal a condition of PID. Adequate antibiotic treatment should be performed to avoid complications over future reproductive life.

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Leffelman, Angela, and Sandra Valaitis. "Prolapsing vaginal fibroepithelial polyp." BMJ Case Reports 15, no. 12 (December 2022): e250967. http://dx.doi.org/10.1136/bcr-2022-250967.

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Although uncommon, vaginal fibroepithelial polyps can present as prolapsing vaginal tissue, causing discomfort and anxiety. Surgical excision of the polyps can provide a minimally invasive solution. In this case, we describe a nulliparous female in late adolescence who presented for evaluation of tissue protruding through the vagina. On exam, a 5×4 cm fibroepithelial polyp was extending from the distal posterior vagina on a broad stalk. Successful transperineal surgical excision was performed. Fibroepithelial polyps, although uncommon, can be a cause for prolapsing vaginal tissue and should be part of the differential diagnosis, especially in patients who have no risk factors for pelvic organ prolapse. They can be excised vaginally, alleviating symptoms and distress. Because they sometimes recur, continued surveillance with gynaecological exams is recommended.

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Rifkin, Julie I., Howard Shapiro, Judith G. Regensteiner, Jeanne K. Stotler, and Betty Schmidt. "Why Do Some Women Refuse to Allow Male Residents to Perform Pelvic Exams?" Academic Medicine 77, no. 10 (October 2002): 1034–38. http://dx.doi.org/10.1097/00001888-200210000-00020.

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Iacobellis, Francesca, Antonio Brillantino, Adolfo Renzi, Luigi Monaco, Nicola Serra, Beatrice Feragalli, Aniello Iacomino, Luca Brunese, and Salvatore Cappabianca. "MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position." Gastroenterology Research and Practice 2016 (2016): 1–12. http://dx.doi.org/10.1155/2016/6594152.

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Introduction. Functional disorders of the pelvic floor represent have a significant impact on the quality of life. The advent of open-configuration systems allowed for the evaluation of defecation with MR imaging in sitting position. The purpose of the present study is to compare the results of static and dynamic pelvic MR performed in supine position versus sitting position, using a new MR prototype machine, in the diagnosis of pelvic floor descent.Materials and Methods. Thirty-one patients with pelvic floor disorders were enrolled, and underwent MR Defecography in supine position with 1.5 T closed magnet (MAGNETOM Symphony, Siemens, Germany) and in sitting position with a 0.25-Tesla open magnet system (G-Scan ESAOTE, Italy).Results. In rest and squeezing phases, positions of bladder, vagina, and ARJ were significantly different when the patient was imaged in supine versus sitting position. In the defecation phase, a significant difference for the bladder and vagina position was detected between the two exams whereas a significant difference for the ARJ was not found. A statistically significant difference exists when the pelvic floor descent is evaluated in sitting versus supine position.Conclusion. Our results show that MR Defecography in sitting position may represent a useful tool to correctly diagnose and grade the pelvic organ descent.

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Kahn, D., GJ Weiner, S. Ben-Haim, LL Ponto, MT Madsen, DL Bushnell, GL Watkins, EA Argenyi, and RD Hichwa. "Positron emission tomographic measurement of bone marrow blood flow to the pelvis and lumbar vertebrae in young normal adults [published erratum appears in Blood 1994 Nov 15;84(10):3602]." Blood 83, no. 4 (February 15, 1994): 958–63. http://dx.doi.org/10.1182/blood.v83.4.958.958.

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Abstract Ten young normal adults had pelvic and lumbar vertebral body bone marrow blood flow examined using [15O]water and positron emission tomography (PET) in a study designed to assess the feasibility and reproducibility of the PET technique for measuring marrow blood flow to various marrow regions. The procedure was well tolerated. Repeated blood flow measurements obtained from two consecutive [15O]water exams on each individual subject were highly reproducible. In addition, there was minimal variation in marrow blood flow from individual to individual and no gender differences were noted. In contrast, mean+/-SD bone marrow blood flows (expressed as milliliters per minute per 100 g) at selected anatomical sites were significantly different and were as follows: lower lumbar vertebral bodies, 17.6+/-3.1; most posterior and superior pelvis (conventional site of percutaneous bone marrow biopsy), 14.3+/-3.1; and total superior pelvis, 11.1+/-2.0. We conclude that PET is a relatively noninvasive, simple, and reproducible technique for measuring bone marrow blood flow. Marrow blood flow is consistent between normal young subjects, but varies significantly between different anatomic regions of the marrow.

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Kahn, D., GJ Weiner, S. Ben-Haim, LL Ponto, MT Madsen, DL Bushnell, GL Watkins, EA Argenyi, and RD Hichwa. "Positron emission tomographic measurement of bone marrow blood flow to the pelvis and lumbar vertebrae in young normal adults [published erratum appears in Blood 1994 Nov 15;84(10):3602]." Blood 83, no. 4 (February 15, 1994): 958–63. http://dx.doi.org/10.1182/blood.v83.4.958.bloodjournal834958.

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Ten young normal adults had pelvic and lumbar vertebral body bone marrow blood flow examined using [15O]water and positron emission tomography (PET) in a study designed to assess the feasibility and reproducibility of the PET technique for measuring marrow blood flow to various marrow regions. The procedure was well tolerated. Repeated blood flow measurements obtained from two consecutive [15O]water exams on each individual subject were highly reproducible. In addition, there was minimal variation in marrow blood flow from individual to individual and no gender differences were noted. In contrast, mean+/-SD bone marrow blood flows (expressed as milliliters per minute per 100 g) at selected anatomical sites were significantly different and were as follows: lower lumbar vertebral bodies, 17.6+/-3.1; most posterior and superior pelvis (conventional site of percutaneous bone marrow biopsy), 14.3+/-3.1; and total superior pelvis, 11.1+/-2.0. We conclude that PET is a relatively noninvasive, simple, and reproducible technique for measuring bone marrow blood flow. Marrow blood flow is consistent between normal young subjects, but varies significantly between different anatomic regions of the marrow.

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Duan, Na, Xiao Chen, Yanyun Yin, Zhongqiu Wang, and Rong Chen. "Comparison between magnetic resonance hysterosalpingography and conventional hysterosalpingography: direct visualization of the fallopian tubes using a novel MRI contrast agent mixture." Acta Radiologica 61, no. 7 (November 4, 2019): 1001–7. http://dx.doi.org/10.1177/0284185119883712.

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Background Magnetic resonance hysterosalpingography (MR-HSG) is a promising technique in the work-up of female infertility. Few existing MR-HSG studies focus on the comparison between MR-HSG with gold standard examination. Purpose To compare the diagnostic value of MR-HSG with conventional HSG in patients receiving both exams in one day. Material and Methods This study included 33 infertile women who completed pelvic MR scanning, HSG, and MR-HSG in that order. A traditional HSG contrast agent (iohexol) and a magnetic resonance imaging (MRI) contrast agent (1 mL gadopentetate dimeglumine (Gd-DTPA) blended with 100 mL iohexol) were used to achieve image enhancement. Inter-observer and inter-modality agreements of HSG and MR-HSG exams were assessed. The results were calculated by using the kappa test. Three radiologists who were blinded to the clinical data independently reviewed the MR images. Extratubal abnormalities were analyzed. Results A total of 62 fallopian tubes of 33 women were included in the study. MR-HSG imaging findings to depict tubal patency were similar to these of HSG (AUC 0.911, sensitivity 0.821, specificity 1.000, positive predictive values 1.000, and negative predictive values 0.872). Pairwise inter-observer agreement among three observers and inter-modality agreement of the diagnosis were excellent (mean kappa 0.863 and 0.835, respectively). In addition, 29 extratubal abnormalities in 21 patients were found on pelvic MR scanning. Conclusion MR-HSG and HSG demonstrated similar results in assessing tubal patency. Because it offers the comprehensive assessment of female pelvic structures, and avoids ionizing radiation, MR-HSG may be used as an alternative imaging technique for evaluation of female infertility.

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Markovic, B. B., H. M. Maksimovic, Z. Markovic, T. Pejcic, J. Hadzi-Djokic, and J. Filimonovic. "Border line cases and diagnostic doubts in definition kidney parenchimal and collecting tract neoplasia." Acta chirurgica Iugoslavica 54, no. 4 (2007): 119–22. http://dx.doi.org/10.2298/aci0704119m.

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Aim of this work is to present cases of renal neoplasms where all available diagnostic modalities and control exams were applied, still explorative surgery was needed. Asymptomatic tissue mass with diagnostic findings of hypovascular renal cell carcinoma and renal pelvic carcinoma were inconclusive. While percutaneous CT guided biopsy is advisable in such cases, it was not performed due to central, hilar localization of the lesions and its small dimensions. In rare cases, such ours are diagnosis is achieved by surgery-histology examination.

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Williams, Adrienne A., and Mozella Williams. "A Guide to Performing Pelvic Speculum Exams: A Patient-Centered Approach to Reducing Iatrogenic Effects." Teaching and Learning in Medicine 25, no. 4 (October 2013): 383–91. http://dx.doi.org/10.1080/10401334.2013.827969.

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Paparella, Maria Teresa, Ilaria Gangai, Chiara Porro, Laura Eusebi, Ferdinando Silveri, Aldo Cammarota, and Giuseppe Guglielmi. "Osteopoikilosis in the ribs, pelvic region and spine: a case report." Digital Diagnostics 2, no. 4 (February 10, 2022): 481–87. http://dx.doi.org/10.17816/dd79504.

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Osteopoikilosis is a rare inherited benign bone dysplasia incidentally found on radiological exams. It is characterized by a specific radiological pattern: diffuse, round or oval, symmetrically shaped sclerotic bone areas distributed throughout the skeleton. It is essential to do a correct diagnosis because these lesions could be easily confused with bone metastasis. We reported a case of an osteopoikilosis patient presenting to our clinic with transient loss of consciousness and without any numbness, tingling and weakness in the legs or other parts of the body. The computed tomography scan showed multiple small sclerotic foci bone islands, scattered throughout the thoracic and lumbar spine, ribs, pelvic bone, sacrum and bilateral proximal femur. No significant increase in the activity was detected in technetium-99m whole-body bone scintigraphy. The patient was diagnosed with characteristic radiological findings of osteopoikilosis and was followed up.

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M, Diaby, Traoré M, Bérété Z. C, Diarra S, Guindo B, and Sima M. "Hysterosalpingography and Coelioscopy in the Exploration of Tubal Patency during Infertility Assessment." Scholars Journal of Applied Medical Sciences 10, no. 10 (October 2, 2022): 1591–96. http://dx.doi.org/10.36347/sjams.2022.v10i10.002.

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Introduction: Infertility can have serious psychological and social repercussions on the life of a couple. Hysterosalpingography and laparoscopy are necessary exams for the exploration of tubal infertility. The aim of this study was to determine the concordance between these two exams in our daily practice. Patients and Methods: Our study was retrospective, cross-sectional, descriptive and comparative. It took place from January 2020 to August 2022 at the 'GRACE' medical clinic. Data were collected using a survey form and obtained from the patients' records, hysterosalpingography results and operative reports. Data were analyzed with SPSS version 20.0 software. Results: A total of 33 patients met our inclusion criteria. They had a mean age of 29.61+/-6.11 years with a minimum age of 18 years and a maximum of 42 years. Pelvic adhesions were the most common lesions found at laparoscopy. Hysterosalpingography was more specific (Sp=83.33%) than sensitive (Se=60%) in the diagnosis of proximal tubal obstructions. The sensitivity of hysterosalpingography was higher (Se=72.22%) than its specificity (Sp=20%) in the diagnosis of distal tubal obstructions. The concordance rate between the two exams (kappa) was 44% in the diagnosis of proximal tubal obstructions and 8.1% in the case of distal tubal obstructions. Conclusion: Our results corroborate those of the literature. Rather than substituting one for the other, hysterosalpingography and laparoscopy remain complementary examinations in the diagnosis of tubal infertility.

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Guedaoura, S., S. Pelletier, W. D. Foulkes, P. Hamet, J. Simard, N. Wong, Z. El Haffaf, J. Chiquette, and M. Dorval. "No evidence of excessive cancer screening in female noncarriers from BRCA1/2 mutation–positive families." Current Oncology 24, no. 6 (December 20, 2017): 352. http://dx.doi.org/10.3747/co.24.3759.

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Background In families with a proven BRCA1/2 mutation, women not carrying the familial mutation should follow the cancer screening recommendations applying to women in the general population. In the present study, we evaluated the cancer screening practices of unaffected noncarriers from families with a proven BRCA mutation, and we assessed the role of family history in their screening practices.Methods Self-report data were provided retrospectively by 220 unaffected female noncarriers for periods of up to 10 years (mean: 4.3 years) since disclosure of their BRCA1/2 genetic test result. A ratio for the annual frequency of breast and ovarian cancer screening exams (mammography, breast ultrasonography, breast magnetic resonance imaging, transvaginal or pelvic ultrasound, cancer antigen 125 testing) was calculated as number of screening exams divided by the number of years in the individual observation period.Results The annual average for mammography exams was 0.15, 0.4, 0.56, and 0.71 in women 30–39, 40–49, 50–59, and 60–69 years of age respectively. The uptake of other breast and ovarian cancer screening exams was very low. Mammography and breast ultrasonography and magnetic resonance imaging were generally more frequent among participants with at least 1 first-degree relative affected by breast cancer.Conclusions In most noncarriers, screening practices are consistent with the guidelines concerning women in the general population. When noncarriers adopt screening behaviours that are different from those that would be expected for average-risk women, those behaviours are influenced by their familial cancer history.Impact Decision tools might help female noncarriers to be involved in their follow-up in accordance with their genetic status and their family history, while taking into account the benefits and disadvantages of cancer screening.

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Budenholzer, Brian. "Guideline: USPSTF makes no recommendation for pelvic exams to screen for gynecologic conditions in asymptomatic women." Annals of Internal Medicine 166, no. 12 (June 20, 2017): JC63. http://dx.doi.org/10.7326/acpjc-2017-166-12-063.

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McCarthy, M. "Johns Hopkins Health System agrees to pay $190m to women filmed by doctor during pelvic exams." BMJ 349, jul23 16 (July 23, 2014): g4775. http://dx.doi.org/10.1136/bmj.g4775.

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Biolato, Marco, Maria Letizia Gabrieli, Antonella Gallo, Luca Miele, Laura Riccardi, Massimo Montalto, Giovanni Gasbarrini, and Antonio Grieco. "A case of inflammatory ascites." Clinical Management Issues 2, no. 1 (March 15, 2008): 25–36. http://dx.doi.org/10.7175/cmi.v2i1.582.

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Even ascites appears mainly as sign of portal hypertension in patiens with liver cirrhosis, in some case depends on a different lying condition such as right congestive heart failure, peritoneal carcinomatosis or tuberculosis. In these cases, paracentesis represents the key tool for diagnosis. We report a case of cardiac ascites in a 71-years-old woman who developed in four-month an abdominal distension. Preliminary exams showed exudative ascites related to portal hypertension, a pelvic mass with caseous apparence, and inflammatory status ad an elevation of CA-125. Successive evaluation exluded peritoneal carcinomatosis or tuberculosis, underlyng a tricuspidal regurgitation. The literature on ascites has also been reviewed.

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Galeno, Lygia Silva, Thiago Martins Souza, Alex Cardoso de Melo, Bruno Martins Araújo, and Tiago Barbalho Lima. "Tratamento conservativo de Genu recurvatum bilateral em cão – relato de caso." Revista Agraria Academica 4, no. 1 (January 1, 2021): 77–83. http://dx.doi.org/10.32406/v4n12021/77-83/agrariacad.

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We report the case of a dog, 2 months old, who had hyperextension of the pelvic limbs and impossibility of joint flexion since birth. Based on clinical findings and complementary exams, a diagnosis of Genu recurvatum was established, from which, using moderate clinical signs, a conservative treatment was chosen, which consisted of immobilization, which were changed every four days. The patient achieved functional recovery of the limbs with 12 days of bandaging, with a favorable result, as he restored the functionality of the limbs. Adequate knowledge of the technique for making the bandage is important for the success of the treatment and to avoid complications related to immobilization.

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Crawford, Judy, and Fred Shaffer. "A Progress Report from the BCIA Neurofeedback Certification Task Force." Biofeedback 42, no. 4 (December 1, 2014): 135–36. http://dx.doi.org/10.5298/1081-5937-42.4.03.

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Professional certification programs must continuously assess and improve their blueprints, exams, and reading lists to stay relevant. In 2009, the Biofeedback Certification International Alliance (BCIA) revised its biofeedback and neurofeedback certification programs under the leadership of Randy Neblett and Leslie Sherlin. In 2012, BCIA revamped the Pelvic Muscle Dysfunction Biofeedback program under the guidance of Debbie Callif. For the past 8 months, BCIA's Neurofeedback Task Force, led by Genie Davis, has collaborated with its stakeholders to revise the entire neurofeedback certification program to continue to reflect current science, technology, and practice standards. This article explains the goals and process that guided this herculean effort.

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Kongnyuy, Michael, Thomas Frye, Arvin K. George, Amichai Kilchevsky, Amogh Iyer, Meet Kadakia, Akhil Muthigi, Baris Turkbey, Brad J. Wood, and Peter A. Pinto. "A Case of In-Bore Transperineal MRI-Guided Prostate Biopsy of a Patient with Ileal Pouch-Anal Anastomosis." Case Reports in Urology 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/676930.

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Ulcerative colitis (UC) is an inflammatory disease that specifically affects the colon. Ulcerative colitis is primarily treated medically and refractory disease is treated with proctocolectomy and ileal pouch-anal anastomosis (IPAA). Gastroenterologists advise against digital rectal exams, pelvic radiation therapy, and transrectal ultrasound (TRUS) biopsies of the prostates of ileal pouch-anal anastomosis patients. Any form of pouch manipulation can lead to severe bleeding, inflammation, and pain. Urologists are therefore faced with the challenge of doing a prostate biopsy without a transrectal ultrasound. We report the rare case of a patient with an ileal pouch-anal anastomosis who underwent in-bore transperineal MRI-guided biopsy of the prostate.

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Fernandes Ferro, Ricardo Alexandre, Giuliano B. Guglielmetti, Fernando Mello Fróes da Fonseca, and Renata Leal Barroso Ferro. "Ceacal Appendage Incarceration through the 8 mm Portal after Salvage Robotic Pelvic Lymphadenectomy." European Journal of Medical and Health Sciences 4, no. 6 (December 25, 2022): 22–23. http://dx.doi.org/10.24018/ejmed.2022.4.6.1576.

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Background: Biochemical relapse after radical prostatectomy can be found in a large number of cases. Salvage lymphadenectomy is a safe procedure that has been proposed through years in patients with nodal recurrence. We aim to present an unusual post operative complication in this scenario. Case Report: A patient has been submitted to robotic salvage lymphadenectomy. At the fifth post operative day started with drainage of high volume serous liquid through portal trocars. TC scan was performed and shows appendage herniation through trocar incision, with normal laboratory findings. Attempts were made to reduce the tip of the appendix into the abdominal cavity, without success. opted to perform laparoscopic appendectomy. Conclusion: Our case shows a different complication after robotic salvage lymphadenectomy. Radiologic exams help in diagnosis and treatment planning. In such cases, surgical procedure is mandatory with good outcomes.

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Sakala, Elmar P. "A comparative study of fears and anxieties of student physicians anticipating the female pelvic and cardiac exams." Journal of Psychosomatic Obstetrics & Gynecology 7, no. 1 (January 1987): 19–26. http://dx.doi.org/10.3109/01674828709019587.

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Georgescu, Doina, Mircea Stefan Iurciuc, Izabella Petre, Liviu Andrei Georgescu, Florin Szasz, Ioana Ionita, Oana Elena Ancusa, Mihai Ionita, and Daniel Lighezan. "Chronic Pelvic Pain and Irritable Bowel Syndrome: Is Subclinical Inflammation Bridging the Gap?" Revista de Chimie 70, no. 10 (November 15, 2019): 3634–37. http://dx.doi.org/10.37358/rc.19.10.7611.

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Irritable bowel syndrome (IBS) is characterized by a multitude of symptoms digestive and extra- digestive that need at some point a multidisciplinary approach. This study aimed at profiling IBS associated with chronic pelvic pain (CPP) in young females. A cross sectional observatory study on 40 consecutive young female patients (under 45 years) with IBS (Rome III) was performed. Patients were assigned in two groups, as matched pairs, based on the presence of chronic pelvic pain (CPP) symptoms: cystalgia, urinary urge and dyspareunia: CPP(+) vs. CPP(-) and undertook clinical examinations with special protocols related to migraine disability, fibromyalgia, temporo-mandibular joint dysfunction, as well as assessment of anxiety and severity of abdominal pain. Laboratory work-up (blood, urine and stool) as well as multiple exams: digestive endoscopy, abdominal and pelvic ultrasound//CT were performed. Results: CPP (+) group displayed higher CRP, TNF-alpha, gut dysbiosis (DB) and abdominal pain severity, as well as associated fibromyalgia, migraine and anxiety mood disorder. DB positively correlated with inflammatory markers and symptoms characterizing CPP. In conclusion, young female IBS patients with concurrent CPP symptoms often experienced other associated functional pain conditions like FM and migraine along with anxiety, more severe abdominal complaints as well as higher gut DB and consecutively subclinical pro-inflammatory status. Strong positive correlations of gut DB to inflammatory markers as well as to CPP symptoms give the relationship IBS-CPP a new perspective.

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Serhal, Ali, Bradley Adams, Imarn Omar, and Swati Deshmukh. "Fascia lata attachment at the iliac crest: refining our diagnostic criteria of injury on magnetic resonance imaging." British Journal of Radiology 93, no. 1111 (July 2020): 20200187. http://dx.doi.org/10.1259/bjr.20200187.

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Objective: The objective of this study was to determine the prevalence and spectrum of pathology of the fascia lata attachment at the iliac crest (FLAIC) on MRI in asymptomatic patients in order to refine our diagnostic criteria for clinically relevant FLAIC injury. Methods and material: Two readers retrospectively evaluated the FLAIC on each side on coronal large field-of-view short tau inversion recovery images on 100 musculoskeletal pelvic MRI exams performed in patients without hip pain (total n = 200). Pathology of the FLAIC was graded using a 3-point Likert scale and discrepancies were resolved by consensus. Results: Of the 200 FLAIC included in the study, 72.5% demonstrated normal size and signal intensity. Low to moderate grade pathology of the FLAIC was identified in 27% and high-grade partial thickness pathology was seen in 0.5%. No cases of complete FLAIC rupture were identified. Inter rater agreement between the two readers was good (k=0.660, p < 0.001). There was no statistical difference in FLAIC scores according to gender or age. FLAIC score was positively correlated with higher body mass index. Conclusion: Incidental low to moderate grade FLAIC pathology is commonly seen on MRI in asymptomatic patients. Abnormal MRI findings of the FLAIC should hence be correlated with explicit clinical symptoms and physical exam findings. Advances in knowledge: The Fascia lata is a complex anatomic structure. Its attachment to the iliac crest is an under recognized pathology and sometimes overlooked during evaluation for pelvis and lateral hip pain. Evaluation of the FLAIC is easily done with MRI and abnormality should be correlated to the clinical symptomatology as low grade abnormality is frequently seen in asymptomatic population.

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Martin, Allison N., Kelly-Mariella Kaneza, Amol Kulkarni, Pacifique Mugenzi, Rahel Ghebre, David Ntirushwa, André M. Ilbawi, Lydia E. Pace, and Ainhoa Costas-Chavarri. "Cancer Control at the District Hospital Level in Sub-Saharan Africa: An Educational and Resource Needs Assessment of General Practitioners." Journal of Global Oncology, no. 5 (December 2019): 1–8. http://dx.doi.org/10.1200/jgo.18.00126.

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PURPOSE The WHO framework for early cancer diagnosis highlights the need to improve health care capacity among primary care providers. In Rwanda, general practitioners (GPs) at district hospitals (DHs) play key roles in diagnosing, initiating management, and referring suspected patients with cancer. We sought to ascertain educational and resource needs of GPs to provide a blueprint that can inform future early cancer diagnosis capacity–building efforts. METHODS We administered a cross-sectional survey study to GPs practicing in 42 Rwandan DHs to assess gaps in cancer-focused knowledge, skills, and resources, as well as delays in the referral process. Responses were aggregated and descriptive analysis was performed to identify trends. RESULTS Survey response rate was 76% (73 of 96 GPs). Most responders were 25 to 29 years of age (n = 64 [88%]) and 100% had been practicing between 3 and 12 months. Significant gaps in cancer knowledge and physical exam skills were identified—88% of respondents were comfortable performing breast exams, but less than 10 (15%) GPs reported confidence in performing pelvic exams. The main educational resource requested by responders (n = 59 [81%]) was algorithms to guide clinical decision-making. Gaps in resource availability were identified, with only 39% of responders reporting breast ultrasound availability and 5.8% reporting core needle biopsy availability in DHs. Radiology and pathology resources were limited, with 52 (71%) reporting no availability of pathology services at the DH level. CONCLUSION The current study reveals significant basic oncologic educational and resource gaps in Rwanda, such as physical examination skills and diagnostic tools. Capacity building for GPs in low- and middle-income countries should be a core component of national cancer control plans to improve accurate and timely diagnosis of cancer. Continuing professional development activities should address and focus on context-specific educational gaps, resource availability, and referral practice guidelines.

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Tahri, A., M. El Hattaoui, N. Charei, M. El Belghiti, L. Mahmal, F. Tahiri, and N. Bouras. "Deep venous thrombosis and cancer (about 68 cases)." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 19672. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.19672.

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19672 Background: The association between cancer and deep venous thrombosis (DVT) has been known for a century. The goal of this retrospective study is to evaluate the risk factors and the characteristics of patients presenting with a DVT to determine the interest of a malignancy work up. Methods: This is a monocentric retrospective study of 405 DVT’s ± pulmonary embolism reported between January 2003 and July 2006, confirmed by sonogram and spiral CT. The risk factors for the embolic events as well as the diagnosis work up done to determine the origin of the embolism were analyzed. Results: In our population the mean age was 50 years, 300 patients (74 %) presented with at least one risk factor for thrombosis event, 68 cases were found to have a malignancy (16.8%) from which 9 were occult malignancies (found among 109 cases of idiopathic DVT’s).The mean age of the patients diagnosed with cancer was significantly higher with a female predominance. These malignancies were distributed as follow: 50% gynecologic origin, 25% gastrointestinal, 10% pulmonary, 9 % urologic and 6% of hematologic origin. The risk factors identified were: Surgery (OR = 4) and Chemotherapy (OR=6). The occult malignancies were mentioned during the encounter with 6 patients. The physical exam, abdomino-pelvic sonograms were sufficient for the etiologic diagnosis in 8 cases. Other exams like (tumor markers, gastrointestinal endoscopies) were non contributive, a part of the clinical orientation they provided. Conclusions: DVT’s do occur more frequently in operated cancer patients or those who received chemotherapy. The malignancies are more frequently of gynecologic or gastrointestinal origin. It appears that an extensive diagnosis work up is not cost effective, a basic work up including: a thorough history, a complete physical exam, simple blood tests (inflammatory markers and CBC) as well as a abdomino-pelvic sonogram are sufficient for the screening of a malignancy, extensive work up should be done as a second option. No significant financial relationships to disclose.

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Journal articles on the topic 'Pelvic exams'

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