Novozymes 2006: Business highlights 2006 – Enzymes for industrial use

Abstract

To report delayed diagnosis in two cases because of subtle manifestations of partially obstructive müllerian anomalies.Case report.Academic medical center.The first case is a 30-year-old woman who was seen initially with irregular vaginal bleeding, dysmenorrhea, and dyspareunia. On physical examination she was noted to have an anterior vaginal mass with a fistulous tract adjacent to the cervix. Blood and mucus issued from the fistulous tract when the anterior blade of the speculum compressed the vaginal mass. In case 2 a 40-year-old nulligravida was seen with infertility and mild dysmenorrhea. Her history was significant for a Strassman’s metroplasty. On examination she was noted to have a bulging at the apex of the vagina adjacent to the cervix.Transvaginal ultrasound, fistulogram, hysterosalpingogram, resection of the longitudinal vaginal septa, and cycle day 3 FSH.Symptoms.In case 1 the subject had resolution of irregular vaginal bleeding, dysmenorrhea, and dyspareunia. In case 2 the patient declined to pursue further therapy.Common gynecologic symptoms resulted from partially obstructed vaginal septa. These cases demonstrate the importance of a high index of suspicion in subjects who do not respond to standard therapies.