Nederlands tijdschrift voor geneeskunde

A 34-year-old woman had a recurrent bleu colored painful swelling in the episiotomy scar. Pathological examination showed endometriosis. Six months later, a second recurrence occurred. The lesion was again removed with a larger margin, the …

For many people, including health care providers, endometriosis is an unknown disease. It can present in many different ways, making it difficult to diagnose. As a result the diagnosis is often missed and the right treatment cannot be start…

Natural orifice transluminal endoscopic surgery (NOTES) is a minimally invasive surgical technique that uses the natural orifices of the human body such as the vagina (vNOTES) in order to access the abdominal cavity. Currently, the vNOTES h…

A 39-year-old woman was referred to the Dermatology outpatient clinic with a bleeding umbilical nodule. A Sister Mary Joseph's nodule - an ominous sign of periumbilical cutaneous metasasis - was in the differential diagnosis. However, punch…

In 2010 the first report of the application of the flexible transanal port ('operation platform') for the excision of rectal tumours was published. Due to the enhanced vision it provides, adenomas and small malignant rectal tumours can be r…

BACKGROUND: Thoracic endometriosis (TE) is one of the causes of secondary pneumothorax in women. According to the literature, 1 in 3 premenopausal women with pneumothorax can be diagnosed with 'catamenial pneumothorax'. The diagnosis is oft…

A 31-year-old woman presented at the fertility department with primary subfertility since one year. Last year she had had progressive dysmenorrhea and pain in her right leg and groin during her menstrual period. MRI showed extensive pelvic …

BACKGROUND: Endometriosis is a common disease, especially in subfertile women. The most common location is in the pelvis, but extragenital locations are also possible. This far less common condition has been described in almost all tissues …

A 44-year-old woman came to the emergency department with severe pain in the right upper abdomen. Her medical history mentioned a low anterior resection 8 years ago because of severe endometriosis. The CT scan showed a ruptured right hemidi…

BACKGROUND: Endometrial tissue is present outside the uterine cavity in 6-10% of fertile women. Associated symptoms such as dysmenorrhoea, dyspareunia and abdominal discomfort are non-specific. For this reason, endometriosis is not always c…

A 33-year-old woman complained of a tumor in her umbilicus with bleeding during her menstrual periods. The diagnosis was made after surgical excision of the tumour: endometriosis of the umbilicus, also known as 'Villar's node'.

Petronella van Heerden (1887-1975) was born in South Africa. She studied medicine in Amsterdam from 1908 to 1915 and then worked as the first female doctor in her native country for 4 years before specialising in gynaecology in London. She …

Three nulliparous women, aged 39, 34 and 26 years, who were treated for fertility problems and who were affected by endometriosis, presented with ureteral obstruction caused by deep infiltrating endometriosis. The first two patients had com…

Endometriosis is a chronic condition that can cause severe pain and have a significant effect on the quality of life. The currently available hormonal treatments with analogues of gonadotrophin releasing hormone (GnRH) and oral progestation…

OBJECTIVE: To determine the frequency of defecation symptoms after hysterectomy. DESIGN: Prospective multicentre study, 3 year follow-up. METHODS: 404 patients from 13 teaching or non-teaching hospitals in The Netherlands, who underwent h…

A 52-year-old woman with known endometriosis was treated with a levonorgestrel-containing IUD for irregular vaginal blood loss. Two weeks later she was admitted with signs ofpelvic inflammatory disease (PID) and was treated with antibiotics…

A number of unusual conditions was diagnosed in 6 patients with inguinal pain. A 30-year-old man had iliopectineal bursitis on the right as well as a recurrent left inguinal hernia; many years after a Pfannenstiel incision a woman aged 57 h…

Within one year three patients, women aged 31, 28 and 26 years, presented with a cyclic painful small mass in the inguinal region. Histopathological examination of the resected specimen showed a pattern consistent with an extra-abdominal lo…

A woman aged 36, who two years previously had undergone a caesarean section, developed a painful swelling of the scar attributed to cicatricial endometriosis. This is a rare disorder brought about by peroperative displacement of normally or…

Five women, aged 31, 26, 31, 34, and 28 years, became pregnant after oocyte donation and in-vitro fertilization. One was a carrier of Leber's optical atrophy, three had had an early menopause (in two because of chromosomal abnormalities), a…

In a 35-year-old gravida II para I at 8 weeks gestation a structure of approximately 5 cm across with varying echogenicity was identified by accident at the side of her right ovary. The findings were believed to be related to previously dia…

Intestinal endometriosis is a diagnostic and therapeutic problem. In case the rectal wall is involved the physical signs of the endometriosis may mimic rectal carcinoma. Suspicion of the correct diagnosis can be aroused by a thorough histor…

Two cases of catamenial pneumothorax are described. This syndrome is characterized by recurring right-sided pneumothorax associated with menstruation. In one of our patients endometriosis of the diaphragm could be diagnosed in a biopsy, tak…