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Bilateral renal agenesis – A case report
Abstracts / Journal of the Anatomical Society of India 65S (2016) S98–S142
129 A case of hypoplastic uterus with vaginal atresia Fatima Begum ∗ , N.K. Bezbaruah, Fida Hussein, Parmatma Mishra, Anshu Mishra, Prerna Gupta Department of Anatomy, Integral Institute of Medical Sciences & Research, Lucknow, Uttar Pradesh, India Hypo plastic uterus is a rare entity. Study was done to evaluate the anatomy of reproductive system of a woman having hypoplastic uterus along with absent vagina and thereby correlate functional impairments of reproductive capabilities of woman. Study of these types of anomalies of reproductive system is mandatory for planning reconstructive surgery to retain reproductive life. The present case was of a 22-year-old unmarried female with the complaints of primary amenorrhoea, who was evaluated by ultrasonography. The normal size of uterus is 7.5 cm × 5 cm × 2.5 cm, but in this case we observed that there was reduction in thickness and size of uterine wall. On ultrasonography a hypoplastic uterus of size 3.6 cm × 1 cm × 1.5 cm was found with both ovaries normal in size. On pervaginal examination vagina was absent. The secondary sexual characters well developed. The details of this case will be presented in the conference. Normal development of reproductive organ is essential for normal menstrual cycle, pregnancy, normal development of secondary sexual characteristics and normal health. The present case is a rare entity with hypoplasia of uterus and vaginal atresia, which can adversely affect menstruation and pregnancy.
S133
Blood vessel to the pituitary is very narrow to fulfil the demand of hypertrophied pituitary during pregnancy and delivery. Sheehan’s syndrome is well documented is less often concerned to the general physician except at the level of super specialty. There should be proper control of bleeding during delivery to prevent this complication. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.437 131 Bilateral renal agenesis – A case report D. Onkar NKP Salve Institute of Medical Sciences & Centre, Hingna Road, Nagpur, Maharashtra, India
130
Bilateral renal agenesis is a lethal malformation and is incompatible with life. The condition results from lack of induction of metanephric blastema by ureteric bud. Incidence is 1:10,000. Approximately 50% of fetuses with renal agenesis are stillborn or may die shortly after birth. Usually it is sporadic. Recurrance with autosomal dominant inheritance is 50%. Recurrance with autosomal recessive inheritance is 25%. We present a case of bilateral renal agenesis in 34 week stillborn male fetus. Prenatal ultrasound findings were empty renal fossae, nonvisualization of ureter, urinary bladder, oligohydramnios and hypoplastic lungs. No other congenital anomalies were detected. The findings were confirmed by postmortem ultrasound, X-ray and autopsy. Ultrasound is the choice of investigation to detect the anomaly as early as 18 weeks. Autopsy helps in confirming the malformation and counseling for further pregnancy.
Partially empty sella
Conflicts of interest
Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.436
Pankaj Singh 1,2,∗ , N.K. Bezbaruah 1,2 , Hiralal 1,2 1
Department of Anatomy, Integral Institute of Medical Sciences & Research, Lucknow, Uttar Pradesh, India 2 Department of Radiodiagnosis, SGPGI, Lucknow, Uttar Pradesh, India Sheehan’s syndrome is a condition where necrosis of pituitary gland occurs after delivery due to blood loss. Blood supply of the pituitary is the superior hypophyseal artery and Inferior hypophyseal artery which also form hypophyseal portal circulation which is very sensitive for development of Sheehan’s syndrome or other postpartum necrosis. Study evaluates postpartum pituitary necrosis with radio imaging to understand the effect of loss of blood supply of pituitary gland and thereby to suggest formulation of proper intra partum care to avoid this complication with high morbidity. A case of known hypopituitarism was reviewed with MRI and other blood parameters. MRI scans revealed necrosis of 70% of pituitary tissue which on scan looks like partially empty sella. The present case is a replica of true Sheehan’s syndrome. This case was showing low or marginally low level of total T4, cortisol and estradiol hormones. History of the patient revealed lactation failure and on blood investigation showed prolactin level at low limit. Patient is presently receiving thyroid and estrogen supplementation. It suggests that there is no total loss of function of pituitary as may happen in true Sheehan’s syndrome.
The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.438 132 Acrofacial dystosis – A case report A. Sharma Government Medical College & Hospital, Chandigarh, India Oro facial defects are common congenital defect which can be surgically corrected. The case was reported in a male fetus of 17 wks with congenital malformation, sent for routine autopsy in Anatomy department, GMCH, Chandigarh. Mother was 28 years old primi gravida, married for last five months. Indication for the MTP was CMF detected on u/s at 15 wks as hydrocephalous and anterior abdominal wall defect. Mother took regular antenatal checkup during pregnancy. The family, medical history and drug abuse during the pregnancy was negative. The external examination of the fetus revealed complete midline cleft lip and cleft palate along with large head. Abdominal wall showed protrusion of the intestine without skin covering. The left side fingers were amputated. Ectrodactyly of right little finger was seen. The right foot was underdeveloped as compared to left foot. Internal examination revealed oral and nasal cavity
129 A case of hypoplastic uterus with vaginal atresia Fatima Begum ∗ , N.K. Bezbaruah, Fida Hussein, Parmatma Mishra, Anshu Mishra, Prerna Gupta Department of Anatomy, Integral Institute of Medical Sciences & Research, Lucknow, Uttar Pradesh, India Hypo plastic uterus is a rare entity. Study was done to evaluate the anatomy of reproductive system of a woman having hypoplastic uterus along with absent vagina and thereby correlate functional impairments of reproductive capabilities of woman. Study of these types of anomalies of reproductive system is mandatory for planning reconstructive surgery to retain reproductive life. The present case was of a 22-year-old unmarried female with the complaints of primary amenorrhoea, who was evaluated by ultrasonography. The normal size of uterus is 7.5 cm × 5 cm × 2.5 cm, but in this case we observed that there was reduction in thickness and size of uterine wall. On ultrasonography a hypoplastic uterus of size 3.6 cm × 1 cm × 1.5 cm was found with both ovaries normal in size. On pervaginal examination vagina was absent. The secondary sexual characters well developed. The details of this case will be presented in the conference. Normal development of reproductive organ is essential for normal menstrual cycle, pregnancy, normal development of secondary sexual characteristics and normal health. The present case is a rare entity with hypoplasia of uterus and vaginal atresia, which can adversely affect menstruation and pregnancy.
S133
Blood vessel to the pituitary is very narrow to fulfil the demand of hypertrophied pituitary during pregnancy and delivery. Sheehan’s syndrome is well documented is less often concerned to the general physician except at the level of super specialty. There should be proper control of bleeding during delivery to prevent this complication. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.437 131 Bilateral renal agenesis – A case report D. Onkar NKP Salve Institute of Medical Sciences & Centre, Hingna Road, Nagpur, Maharashtra, India
130
Bilateral renal agenesis is a lethal malformation and is incompatible with life. The condition results from lack of induction of metanephric blastema by ureteric bud. Incidence is 1:10,000. Approximately 50% of fetuses with renal agenesis are stillborn or may die shortly after birth. Usually it is sporadic. Recurrance with autosomal dominant inheritance is 50%. Recurrance with autosomal recessive inheritance is 25%. We present a case of bilateral renal agenesis in 34 week stillborn male fetus. Prenatal ultrasound findings were empty renal fossae, nonvisualization of ureter, urinary bladder, oligohydramnios and hypoplastic lungs. No other congenital anomalies were detected. The findings were confirmed by postmortem ultrasound, X-ray and autopsy. Ultrasound is the choice of investigation to detect the anomaly as early as 18 weeks. Autopsy helps in confirming the malformation and counseling for further pregnancy.
Partially empty sella
Conflicts of interest
Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.436
Pankaj Singh 1,2,∗ , N.K. Bezbaruah 1,2 , Hiralal 1,2 1
Department of Anatomy, Integral Institute of Medical Sciences & Research, Lucknow, Uttar Pradesh, India 2 Department of Radiodiagnosis, SGPGI, Lucknow, Uttar Pradesh, India Sheehan’s syndrome is a condition where necrosis of pituitary gland occurs after delivery due to blood loss. Blood supply of the pituitary is the superior hypophyseal artery and Inferior hypophyseal artery which also form hypophyseal portal circulation which is very sensitive for development of Sheehan’s syndrome or other postpartum necrosis. Study evaluates postpartum pituitary necrosis with radio imaging to understand the effect of loss of blood supply of pituitary gland and thereby to suggest formulation of proper intra partum care to avoid this complication with high morbidity. A case of known hypopituitarism was reviewed with MRI and other blood parameters. MRI scans revealed necrosis of 70% of pituitary tissue which on scan looks like partially empty sella. The present case is a replica of true Sheehan’s syndrome. This case was showing low or marginally low level of total T4, cortisol and estradiol hormones. History of the patient revealed lactation failure and on blood investigation showed prolactin level at low limit. Patient is presently receiving thyroid and estrogen supplementation. It suggests that there is no total loss of function of pituitary as may happen in true Sheehan’s syndrome.
The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.438 132 Acrofacial dystosis – A case report A. Sharma Government Medical College & Hospital, Chandigarh, India Oro facial defects are common congenital defect which can be surgically corrected. The case was reported in a male fetus of 17 wks with congenital malformation, sent for routine autopsy in Anatomy department, GMCH, Chandigarh. Mother was 28 years old primi gravida, married for last five months. Indication for the MTP was CMF detected on u/s at 15 wks as hydrocephalous and anterior abdominal wall defect. Mother took regular antenatal checkup during pregnancy. The family, medical history and drug abuse during the pregnancy was negative. The external examination of the fetus revealed complete midline cleft lip and cleft palate along with large head. Abdominal wall showed protrusion of the intestine without skin covering. The left side fingers were amputated. Ectrodactyly of right little finger was seen. The right foot was underdeveloped as compared to left foot. Internal examination revealed oral and nasal cavity