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Radiol Case Rep 2019 Jun 30;14(6):708-710. Epub 2019 Mar 30.

Department of Radiology, Madigan Army Medical Center, 9040A Jackson Avenue, Joint Base Lewis-McChord, WA 98431, USA.

Chylous leaks are an uncommon complication in patients undergoing surgical procedures with the majority of cases responding to conservative therapies. Described is a case of a 23-year-old male who developed debilitating refractory chylous ascites as a complication after retroperitoneal lymph node dissection for testicular cancer. Prior to being evaluated by interventional radiology, he required weekly large-volume paracentesis in addition to standard conservative therapies. Read More

J Clin Med 2019 Apr 5;8(4). Epub 2019 Apr 5.

Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung 40201, Taiwan.

Background: Chylous ascites is an uncommon condition characterized by a white, milky-appearing peritoneal fluid, and is related to disruption of the lymphatic system from any cause. There have been very few previous reports of calcium channel blockers (CCBs) as potential causes of chylous ascites, and most of the patients were undergoing peritoneal dialysis.

Aims: To review the pathogenesis, clinical manifestations, laboratory examinations, treatment options, and prognosis of patients with CCB-related chylous ascites. Read More

Dig Dis Sci 2019 Apr 4. Epub 2019 Apr 4.

Division of Gastroenterology and Hepatology, University of New Mexico School of Medicine Medical Center, MSC 10-5550, 1, Albuquerque, NM, USA.

Oxf Med Case Reports 2019 Mar 29;2019(3):omz019. Epub 2019 Mar 29.

Department of Respiratory Medicine, Yokkaichi Municipal Hospital, Sibata2-2-37, Shibata, Yokkaichi-shi, Mie, Japan.

We present the case of a 53-year-old man with decompensated alcoholic cirrhosis who was referred for right pleural effusion. After investigation, the patient was ultimately diagnosed with cirrhotic chylothorax. Chylothorax is a rare manifestation of cirrhosis, which results from the trans-diaphragmatic passage of chylous ascites. Read More

Eur Radiol 2019 Apr 1. Epub 2019 Apr 1.

Faculté de Médecine Pierre et Marie Curie and Department of Radiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.

This review shows the images obtained with non-contrast MR lymphography in different pathologic conditions affecting the liver. Non-contrast MR lymphography is obtained with a free-breathing 3D high spatial resolution fast-recovery fast spin-echo sequence similar to that used for 3D MR cholangiopancreatography. The liver is the largest lymph-producing organ generating approximately half of the body's lymphatic fluid and is the most important part of the lymphatic system from a functional point of view. Read More

BMJ Case Rep 2019 Mar 22;12(3). Epub 2019 Mar 22.

Department of Internal Medicine, Hospital de Cascais, Cascais, Portugal.

A 29-year-old man with diarrhoea, fever, abdominal pain and multiple purple papular lesions, neither pruriginous nor painful, was diagnosed with HIV-1 infection and disseminated Kaposi sarcoma (KS) with gastrointestinal involvement. He was started on highly active antiretroviral therapy immediately, as well as doxorubicin. Three weeks later, the patient developed bilateral moderate pleural effusion and large-volume ascites compatible with chylothorax and chylous ascites. Read More

Radiol Case Rep 2019 May 7;14(5):608-612. Epub 2019 Mar 7.

University of Kentucky, Department of Radiology, 800 Rose St, Lexington, KY, 40536 USA.

Chylous ascites can be caused by infection, trauma, malignancy, or maybe a complication after major abdominal surgery including liver transplantation. We present a case of a patient who developed chylous ascites following his liver transplantation. He was subsequently treated with direct embolization of lymphatic trunk efferent branches with a mixture of N-butyl cyanoacrylate and lipiodol after the identification of a localized leak on a fluoroscopic lymphangiogram. Read More

Am J Gastroenterol 2019 Feb 26. Epub 2019 Feb 26.

Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Sclerosing mesenteritis is a rare non-neoplastic disorder characterized by fat necrosis, chronic inflammation, and fibrosis typically of the small bowel mesentery. Our understanding of this disorder is limited by its rarity as well as inconsistent terminology used across the literature. While prior abdominal surgery or trauma, autoimmunity, infection, ischemia, and malignancy have been suggested to be involved in the pathogenesis of the disorder, it remains poorly understood. Read More

Urol Int 2019 Feb 20:1-3. Epub 2019 Feb 20.

Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

Chyloretroperitoneum is a rare complication of urological surgery. Here we report a case of chyloretroperitoneum that occurred in a 28-year-old man post living-donor transplantation. Twenty-nine days post transplantation, perirenal fluid collection and hydronephrosis were detected and percutaneous drainage was performed. Read More

Eur J Case Rep Intern Med 2018 26;5(6):000871. Epub 2018 Jun 26.

Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia-Espinho, Portugal.

Chylous ascites is rare and results in accumulation of lymph in the abdominal cavity, due to several mechanisms. The ascitic liquid is milky because of the high concentration of triglycerides (>200 mg/dl). The higher incidence compared to the past is explained by increased survival of patients with cancer and more aggressive surgery. Read More

Tech Coloproctol 2019 Feb 7. Epub 2019 Feb 7.

Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, Hwasun, 58128, South Korea.

Rinsho Ketsueki 2019;60(1):12-16

Department of Hematology, Graduate School of Medicine, Osaka City University.

In allogeneic hematopoietic stem cell transplantation (HSCT), ascites may develop owing to several causes, including sinusoidal obstruction syndrome, infections, malignancies, and malnutrition. However, it is often difficult to determine its precise cause. Here, a 59-year-old male developed chylous ascites three months post allogeneic bone marrow transplantation for relapsed acute myeloid leukemia. Read More

J Surg Case Rep 2019 Jan 24;2019(1):rjy364. Epub 2019 Jan 24.

Division of General Thoracic Surgery, Department of Surgery, Shiga University Medical Science, Setatsukinowa-cho, Otsu, Shiga 5202192, Japan.

To the best of our knowledge, there have been no previous reports of chylothorax developing after pancreatectomy, although chylous ascites can occur. In patients with a pleuroperitoneal communication, ascitic fluid can flow into the thoracic cavity through a small hole in the diaphragm. A 70-year-old woman underwent total pancreatectomy and was referred to our department for treatment of right chylothorax after removal of her abdominal drainage tubes. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):1866-1868

Dept. of Gastroenterological Surgery, Takatsuki General Hospital.

A man in his sixties with a medical history of diabetes and dyslipidemia was detected with a tumor with massive submucosal invasion on colonoscopy. He was diagnosed with sigmoid cancer and underwent laparoscopic sigmoid colectomy with D3 lymph node dissection. An electric surgical knife and an ultrasonically activated device was used to perform D3 lymph node dissection with preservation of the left colic artery(LCA)and division of the S1A and S2A. Read More

Clin Transplant 2019 Mar 3;33(3):e13483. Epub 2019 Feb 3.

Department of Surgery, Columbia University Medical Center, New York, New York.

Chylous ascites is a difficult, albeit uncommon complication of laparoscopic live donor nephrectomy (LLDN). Lymphatic leak is believed to be a result of injury to the cisterna chyli, regional lymph nodes, or other peri-aortic lymphatics intraoperatively. Recommended management with dietary modifications can result in malnutrition and immunodeficiency. Read More

Cardiovasc Intervent Radiol 2019 May 7;42(5):779-783. Epub 2019 Jan 7.

Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.

A patient developed abdominal distension, dyspnea, and nausea due to chylothorax and chylous ascites 1 month after bruising her back. Lymphangiography was unable to identify the site of lymph leakage, and lymphatic duct embolization was impractical. However, lymphangiography showed occlusion of the thoracic duct. Read More

Pract Radiat Oncol 2018 Dec 15. Epub 2018 Dec 15.

Department of Surgery, Oregon Health & Science University, Portland, Oregon.

Purpose: When lymphatic pathways are disrupted via obstruction or traumatic injury, a temporary or chronic chyle leak may result, which is defined as the presence of chyle that collects outside of the lymphatic vessels within the thoracic or abdominal cavities. For a chyle leak that is refractory to surgical repair, no good options exist. Radiation therapy (RT) can result in scarring and fibrosis of the lymphatic fistula. Read More

Eur J Radiol 2018 Dec 25;109:41-47. Epub 2018 Oct 25.

Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, United states.

Objectives: Lymphangiography and thoracic duct embolization are established treatments for post-surgical chylothorax. There is only limited experience in their application to treat post-surgical chylous ascites. A multi-center analysis of the technical and clinical success of lymphangiography and lymphatic interventions in the treatment of isolated, iatrogenic chylous ascites is reported. Read More

Lupus 2019 Feb 8;28(2):244-248. Epub 2018 Dec 8.

1 Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Systemic lupus erythematosus (SLE) is an autoimmune disorder that can affect virtually any organ. Chylous ascites as a presenting manifestation of SLE has been described in a handful of cases in adults. However, to the best of our knowledge this presentation has never been reported in the pediatric age group. Read More

Gynecol Oncol 2019 02 30;152(2):434-435. Epub 2018 Nov 30.

Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, 128 Shen-Yang Road, Shanghai 200090, PR China. Electronic address:

J Med Case Rep 2018 Nov 26;12(1):347. Epub 2018 Nov 26.

Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan.

Background: Chylothorax is the accumulation of chyle within the pleural space. Chylothorax can occur as a complication after multiple different types of surgery, most frequently after thoracic surgery, albeit with an incidence rate of less than 1%. Chylothorax after abdominal surgery is extremely rare, and there are only a few case reports. Read More

Indian Pediatr 2018 Oct;55(10):909-910

Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.

Background: Clinical presentations of intestinal lymphangiectasia include pitting edema, chylous ascites, pleural effusion, diarrhea, malabsorption and intestinal obstruction.

Case Characteristics: An 8-year-old male child presented to the emergency department with clinical features of peritonitis, raising suspicion of appendicular or small bowel perforation.

Intervention/outcome: Diagnosis of chylous ascites with primary intestinal lymphangiectasia made on laparotomy. Read More

Case Rep Nephrol 2018 9;2018:2192043. Epub 2018 Oct 9.

Division of Nephrology, Department of Medicine, Ottawa Hospital, Ottawa, ON, Canada.

Turbid dialysate in a patient on peritoneal dialysis is usually due to peritonitis and almost all these patients are started on empirical antibiotics pending cultures. However, in few of them with culture negative fluid, this could represent other etiologies like chyle, which requires more intensive investigations, and analysis of fluid itself reveals some rare diagnosis. We present one such report of chylous ascites with prompt investigation leading to a diagnosis of malignancy in a peritoneal dialysis patient. Read More

Transplantation 2019 Apr;103(4):e74-e78

Department of Renal Transplant Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background: Chylous ascites (CA) is an extremely rare complication after laparoscopic donor nephrectomy (LDN). It can increase the hospital stay, morbidity in postoperative period and thus negating the benefits of laparoscopic surgery. Most of the cases were managed conservatively, but surgical intervention may be occasionally required. Read More

J Pediatr Surg 2019 Mar 2;54(3):604-607. Epub 2018 Oct 2.

Department of Surgery, Division of Pediatric Surgery, University of Michigan, 1540 E Hospital Dr. SPC 4217, Ann Arbor, MI 48109, United States. Electronic address:

Background: Congenital chylous ascites poses a significant challenge in neonatal care, and often results in prolonged, complex hospital stays and increased mortality. Few effective options exist in refractory cases.

Methods: Patients aged 0 to 12 months with refractory chylous ascites underwent retroperitoneal exploration after medical treatment and minimally invasive therapies were unsuccessful. Read More

Infect Dis (Lond) 2019 Feb 14;51(2):81-90. Epub 2018 Oct 14.

a Infectious Diseases Department , CHU de Caen , Caen , France.

Background: Mycobacterium avium complex (MAC) infection is often disseminated and mainly involves lymph nodes, spleen, liver or bone marrow. Peritonitis due to MAC infection (PMAC) is a very uncommon manifestation.

Methods: In this report, after describing the case of the only PMAC infection in our 10-year retrospective study, which occurred in an AIDS patient who was non-adherent to highly active antiretroviral therapy (HAART), we performed a systematic literature review of documented bacteriological PMAC. Read More

Gynecol Oncol Rep 2018 Nov 1;26:53-55. Epub 2018 Oct 1.

Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara Nishihara, Okinawa 903-0215, Japan.

•Postoperative chylous ascites is an important clinical issue in surgery for gynecological malignancy.•Our patient with refractory chylous ascites after surgery for tubal cancer.•She received great benefit from the microsurgical lymphaticovenular anastomosis. Read More

Fetal Pediatr Pathol 2018 Oct 25;37(5):363-371. Epub 2018 Sep 25.

a Department of Pediatrics , Pusan National University Children's Hospital , Yangsan , Korea.

Background: Thanatophoric dysplasia (TD) results from sporadic de novo mutations in the FGFR3 gene. Upon confirming intrauterine diagnosis of this perinatal disease, pregnancy termination is recommended. There is limited information on the natural history of longer-term survivors with type 1 TD. Read More

Zhejiang Da Xue Xue Bao Yi Xue Ban 2018 May;47(3):278-282

Department of Neonatal Surgery, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.

Objective: To analyze complications after laparoscopic Ladd operation for intestinal malrotation, related causes and possible solutions.

Methods: Clinical data of 81 neonates who underwent laparoscopic Ladd operations for intestinal malrotation in the Children's Hospital, Zhejiang University School of Medicine between January 2015 and January 2018 were reviewed. The abdominal complications and findings during operation and reoperation were analyzed. Read More

J Surg Oncol 2018 Nov 12;118(6):991-996. Epub 2018 Sep 12.

Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Background And Objectives: This study is aimed to investigate the possibility of preoperative oral oil administration in displaying the chylous tubes and preventing chylous leakage in laparoscopic para-aortic lymphadenectomy.

Materials And Methods: In this retrospective nonrandomized study, of the 30 patients with gynecological malignancies who had indications for laparoscopic para-aortic lymphadenectomy up to renal vessels, 15 were administered preoperative oral oil (oil a administration) (control group) at our hospital between September 2017 and June 2018. The chylous tube displaying rates, incidences of chylous leakage, and other perioperative data of the two groups were compared. Read More

Iran J Public Health 2018 Jul;47(7):1034-1036

Dept. of Obstetrics, Xiamen Maternity and Child Health Care Hospital, Xiamen 361003, China.

Idiopathic chylous ascites in pregnancy is extremely rare. Here, we report a 24-yr-old patient with idiopathic chylous ascites in pregnancy. The patient was hospitalized in Xiamen Maternity and Child Health Care Hospital, Xiamen China in 2014 due to G1P0 intrauterine pregnancy 39+2 week, LOA, and time of labor. Read More

Intractable Rare Dis Res 2018 Aug;7(3):200-203

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Spontaneous bilateral chylothorax and chylous ascites rarely develop in conjunction with systemic venous thrombosis, and the most common cause of non-traumatic chylous effusion is a malignancy. A 23-year-old immunocompetent female presented with a fever of 5 months' duration associated with progressive shortness of breath and abdominal distension. Evaluation revealed bilateral chylothorax, chylous ascites, and multiple venous thrombosis. Read More

Intractable Rare Dis Res 2018 Aug;7(3):177-181

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Chylous ascites is an uncommon entity and infectious etiology is the most common cause in developing countries. However, recently, whether there is any change in trend of etiologies in developing countries is not known. In this study, a retrospective analysis of the data of cases of atraumatic chylous ascites was conducted. Read More

J Vasc Interv Radiol 2018 09;29(9):1290-1292

Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongro-gu, Seoul 110-744, Republic of Korea.

Medicine (Baltimore) 2018 Aug;97(34):e12012

Department of Urology Surgery, Beijing Children's Hospital, National Center for Children's Health.

Rationale: Phacomatosis pigmentovascularis (PPV) is a rare syndrome characterized by capillary malformation and pigmentary nevus. Congenital chylous ascites (CCA) is also a rare disease that results from maldevelopment of the lymphatic system. We report a case of a 5-month-old girl, who had both PPV and CCA. Read More

Mol Clin Oncol 2018 Aug 8;9(2):178-180. Epub 2018 Jun 8.

Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 693-8501, Japan.

Although lymphadenectomy for gynecological cancer is often associated with chylous leakage, the proper management of this complication remains a matter of debate. In the present study a case of chylous leakage successfully treated with lipiodol lymphangiography is described. A 33-year-old patient with ovarian cancer experienced chylous leakage following total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymphadenectomy. Read More

Radiologia 2019 Jan - Feb;61(1):82-84. Epub 2018 Aug 4.

Servicio de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia, España.

Chylous ascites is the presence of lymph from the thorax or bowel in the abdominal cavity. In Western countries, the most common causes of chylous ascites in adults are tumors, cirrhosis, and postoperative leakage, whereas the most common causes in children are congenital lymphatic anomalies and trauma. By contrast, in developing countries, infectious causes are responsible for most cases of chylous ascites. Read More

Int J Surg Case Rep 2018 26;50:80-83. Epub 2018 Jul 26.

Department of General Surgery, Okinawa Prefectural Chubu Hospital, Japan.

Background: Primary aortoduodenal fistula (PADF) is an abnormal connection between the aorta and the duodenum and is a life-threatening condition. It is a very rare cause of gastrointestinal bleeding, which often leads to delay in its diagnosis. Prompt diagnosis and surgical treatment are crucial to improve the outcome of patients with PADF. Read More

Med Microbiol Immunol 2019 Feb 6;208(1):33-37. Epub 2018 Aug 6.

Department of Hematology, Shiga University of Medical Science, Otsu, Shiga, Japan.

We report a case of non-AIDS (acquired immunodeficiency syndrome), non-CAPD (Continuous Ambulatory Peritoneal Dialysis), non-cirrhotic, Mycobacterium avium peritonitis, which is a rare form of mycobacterial infection. A 66-year-old Japanese man who had been treated previously for angioimmunoblastic T-cell lymphoma (AITL), had developed disseminated M. avium infection. Read More

Rofo 2018 08 25;190(8):701-711. Epub 2018 Jul 25.

Department of Radiology, Medical School & Hospital, University of Bonn, Germany.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a non-selective portosystemic shunt created using endovascular techniques. During recent years technical improvements and new insights into pathophysiology have modified indications for TIPS placement. In this article we therefore want to discuss current knowledge. Read More

G Ital Nefrol 2018 Jul;35(4)

Nephrology and Dialysis Unit, "Pugliese-Ciaccio" Hospital of Catanzaro, Italy.

Chylous ascites is rarely observed in patients undergoing peritoneal dialysis Here, we present the occurrence of chyloperitoneum in a peritoneal dialysis patient disappeared immediately after discontinuation of calcium-antagonist. Read More

Medicine (Baltimore) 2018 Jul;97(29):e11555

Department of Orthopedic Surgery.

Rationale: Gorham-Stout syndrome in the spine is extremely rare, and there is no standard curative management thus far. The objective of this article is to report a very rare case of Gorham-Stout syndrome of the lumbar and sacral spine with chylothorax and chyloperitoneum successfully treated by combination of vertebroplasty with cement augmentation and medication treatment. We described the clinical characteristics and postoperative therapy of the patient, and reviewed all of the published cases of Gorham-Stout syndrome of the lumbar and sacral spine. Read More

Pol Przegl Chir 2018 05;90(3):43-48

University Hospital at Magdeburg, Magdeburg (Germany) Dept. of General, Abdominal and Vascular Surgery.

Introduction: Chylous complications, which occur also in the profile of vascularsurgical interventions with considerable frequency, are challenging with regard to their adequate management. Aim & method: Compact short overview on epidemiological, classifying, symptomatic, diagnostic and therapeutic aspects of chylous complications in vascular surgery, based on i) own clinical experiences, ii) a current selection of relevant scientific references and iii) representative case reports from clinical practice. Results (complex patient- & clinical finding-associated aspects): - Basic treatment of lymphedema / postreconstructive edema comprises the complex physical therapy to improve edematous swelling, which need to be usually performed over years. Read More

Ther Adv Infect Dis 2018 Jul 2;5(4):69-75. Epub 2018 May 2.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background: Chylous ascites is an uncommon presentation of mycobacterial infection.

Methods: We report three cases of tubercular chylous ascites, and in addition, we performed a systematic review of the published literature for the clinical presentation, treatment, and outcomes of mycobacterial chylous ascites. We followed the PRISMA guidelines for the systematic review. Read More

Biosci Trends 2018 Jul 15. Epub 2018 Jul 15.

Ahead of Print article withdrawn by publisher. This withdrawal is for above article due to the misoperation of advance online publication. Read More

Int J Surg Case Rep 2018 23;49:149-152. Epub 2018 Jun 23.

Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima City, Hiroshima 734-8551, Japan. Electronic address:

Introduction: Postoperative chylous ascites is a rare complication of colorectal surgery. Conservative management is usually effective in most cases of the postoperative chylous ascites. However, surgical intervention is performed for refractory cases. Read More

Am J Med 2018 Nov 10;131(11):1314-1316. Epub 2018 Jul 10.

Department of Internal Medicine, Division of Hospital Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY. Electronic address:

Int J Rheum Dis 2018 Jul;21(7):1458-1462

Department of Surgery, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.

Vanishing bone disease with multisystemic involvement may mimic systemic autoimmune or autoinflammatory diseases. We present a 19-year-old man who was hospitalized due to chest pain following a progressive osteolysis of the bony thorax. The disease later expanded into the pleura, peritoneum and pericardium in a form of massive chylous polyserositis. Read More

Drugs R D 2018 Sep;18(3):191-198

Monash Newborn, Monash Children's Hospital, & Department of Paediatrics, Monash University, 246 Clayton Road, Clayton, VIC, Australia.

Background And Objective: Octreotide is a somatostatin analogue and has been used off-label for a variety of conditions. There are no specific guidelines for the use of octreotide in neonates and its safety and efficacy have not been systematically evaluated. The objective of this study is to present our experience of using octreotide therapy in neonates. Read More

Cardiovasc Intervent Radiol 2018 Oct 21;41(10):1633-1635. Epub 2018 Jun 21.

Clinique universitaire de gynécologie-obstétrique, CHU de Grenoble, La Tronche, France.