Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Reference to the literature is made in an account of extragenital external endometriosis, with particular attention to intestinal varieties. A case of ovarian and appendicular endometriosis with the clinical picture of acute abdomen is presented. Lastly, an evaluation is made of the views put forward concerning the aetiopathogenesis of this conditions.
 ...
PMID:[Appendicular ovarian endometriosis with a clinical picture of acute abdomen]. 122 88

The term endometriosis means the presence in an ectopic site of normal functioning endometrial tissue, the ectopic endometrial tissue, as the normal uterine mucosa, undergo hormonal stimulation and follow the proliferative and functional changes along the menstrual course; this evolution, characterize the clinical story of patients affected by endometriosis. Endometriosis is considered to be one of the most common gynecologic disorders, occurring in about 10% of women in fertile age. An involvement of adjacent organs such as the pelvic colon and rectum by endometriosis is not uncommon and may cause symptoms difficult to distinguish from malignant or inflammatory disease located in the pelvic region. The purpose of the following case report is to elucidate certain diagnostic and therapeutic problems of a disease concerning both the surgeon and gynecologists. Our case concerns a 44 year old patient with two children and a negative previous clinical gynecological history; the patients reports the occurrence in the last two years of alterations of colic evacuation consisting in a period of constipation lasting 5-7 days. The patient reached us in emergency with a sub-occlusive state that has lasted for 5 days, in the last 12 hours the appearance of a violent trafictive pain referred to the lower abdomen configure the clinical picture of a acute abdomen. The patient underwent surgery and the laparotomy demonstrated the presence of a perforated tumours located at the recto-sigmoid junction. We proceed to perform an Hartman's resection and a right ovariectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Perforated endometriosis of the sigmoid. Report of a case]. 767 88

A 34-year-old woman with signs and symptoms of an acute abdomen was found to have a hepatic cyst on NMR- and CT-scan. With the tentative diagnosis of a liver hematoma, a right hemihepatectomy was performed. Histologically, an endometrial cyst of the liver was found. A second case of cystic endometriosis in the liver was revealed ultrasonographically in a 62-year-old woman, complaining of rightsided epigastrical pain. A 28-year-old woman was admitted to the hospital because of recurrent epigastric pain. A cystic tumor of the pancreas could be visualized ultrasonographically and was interpreted as a postinflammatory pseudocyst. Histological examination of the distal pancreatectomy specimen revealed cystic endometriosis. The clinicopathological features of hepatic and pancreatic endometriosis are discussed and the literature concerning these extremely rare lesions is reviewed.
 ...
PMID:Cystic endometriosis of the upper abdominal organs. Report on three cases and review of the literature. 873 77

From 1987 to 1991 a total of 5035 pelviscopies were done at the Kiel University Hospital of Gynaecology. More than 90% of these were surgical pelviscopies, whereas less than 10% were diagnostic procedures only. Serious complications requiring laparotomy or repeat pelviscopy or laparotomy within 4 weeks after the original procedure, occurred in 2.0% of the cases and slight complications were seen in 2.9%. Procedures for acute abdomen or adhesiolysis after multiple laparotomies bore the greatest risk of serious complications. Low risk was associated with sterilisations, procedures for female sterility, endometriosis or tubal pregnancy.
 ...
PMID:[Complications in 5,000 pelviscopies at the Kiel University Gynecologic Clinic]. 899 40

Acute abdominal pain is a frequent diagnostic and therapeutic challenge in hematologic patients. We report on the very rare case of organ endometriosis with acute abdominal symptoms in a 43-year-old female patient with AML-M5, starting 4 days after induction chemotherapy with idarubicin, ara-C, and etoposide. The patient presented with an acute abdomen with clinical findings of acute cholecystitis, subileus, and local pain in the right upper abdomen accompanied by severe diarrhea. Probably due to impaired intestinal resorption, menstrual bleeding occurred despite regular administration of lynestrenol. Ultrasound examination of the abdomen disclosed a tumor with poor echoes in the pouch of Douglas, a subcapsular splenic hemorrhage, and a thickened gallbladder wall with surrounding edema. A cystic adnex tumor was confirmed by endovaginal ultrasound. Based on history and the findings on ultrasound, an endometriosis was diagnosed, and the LHRH agonist (nafarelin) was administered nasally in combination with lynestrenol. Following this medication the abdominal pain ceased, supporting the diagnosis of endometriosis. Nasal administration of an LHRH agonist in the following cycles of chemotherapy was effective in preventing further abdominal discomfort and vaginal bleeding. LHRH agonists should be given to patients with known endometriosis before starting myeloablative chemotherapy to prevent painful hemorrhage from endometriosis.
 ...
PMID:Acute abdomen due to endometriosis as a diagnostic and therapeutic challenge in the treatment of acute myelocytic leukemia. 903 12

Endometriosis is rarely found by the general surgeon and sometimes it may seem a surgical disease. Two cases with abdominal pain, requiring surgical treatment, are presented. The first case gave history of dysmenorrhea and dyspareunia, she was admitted with acute abdomen due to acute appendicitis, and laparoscopic appendectomy was performed without complications; she had slight endometriosis at left utero-sacrum ligament and histopathological report showed endometriosis at the appendix. The second patient presented with incomplete obstruction related to ileocecal damage that it was resected with an histopathological report of endometriosis at cecum, ileon and appendix. The patient presented with endometriosis, degree IV, and had medical treatment with gestrinohn, during six months; latter on, HTA+SOB, was done, she received hormonal therapy. Endometriosis may be a cause for acute abdomen in women, and it should be considered in the differential diagnosis.
 ...
PMID:[Intestinal endometriosis as an acute surgical emergency]. 931 16

Laparoscopy is an important tool for evaluating acute lower abdominal and pelvic pain. Although a complete history and physical examination often provide an accurate diagnosis, laparoscopy can serve as an adjunct in many patients with unclear symptoms. An acute abdomen can be caused by many pelvic sources. Laparoscopy can assist in the diagnosis of abdominal and pelvic pathologies and can often be therapeutic, eg, the treatment of adnexal torsion and endometriosis. The early use of laparoscopy for the diagnosis of acute lower abdominal and pelvic pain of unclear etiology often leads to an earlier diagnosis and allows for definitive treatment using minimal access techniques.
 ...
PMID:Laparoscopy for Acute Diseases of the Lower Abdomen and Pelvis. 1040 Nov 15

The clinicopathologic features of neoplasms arising in gastrointestinal endometriosis have not been well characterized. In this series, we report 17 cases of gastrointestinal endometriosis complicated by neoplasms (14 cases) or precancerous changes (three cases). Four patients, one of whom also had hypermenorrhea, presented with chronic abdominal pain and five had obstructive symptoms; one of these also had rectal bleeding. One patient presented with an acute abdomen and fecal peritonitis, one had vaginal bleeding, and one had a progressive change in bowel habits. Nine patients had a long history of endometriosis, 11 patients had had hysterectomies, and eight of these had also received unopposed estrogen therapy. The lesions involved the rectum (6), sigmoid (6), colon, unspecified (2), and small intestine (3), and comprised 8 endometrioid adenocarcinomas (EA), 4 mullerian adenosarcomas (MAS), 1 endometrioid stromal sarcoma (ESS), 1 endometrioid adenofibroma of borderline malignancy (EBA) with carcinoma in situ, 2 atypical hyperplasias (AH), and one endometrioid adenocarcinoma in situ (ACIS). The tumors ranged in size from 2 to 15 cm and all involved the serosa and muscularis propria. Two tumors extended into the mucosa, with mucosal ulceration in one. Follow-up was available in 11 cases. One patient with EA was dead of disease at 1 year, one had two recurrences at 1 and 2 years, and three were alive with no evidence of disease (ANED) at 9 months to 13 years (mean, 68 mos). The patient with the EBA was ANED at 3 months. Two patients with MAS were ANED at 2 and 3 years. The patient with ESS had a recurrence at 3 years and was ANED 6 years after her original diagnosis. One woman with AH was ANED at 60 months and the patient with ACIS was ANED at 16 months. One of the carcinomas was originally misdiagnosed as a primary intestinal adenocarcinoma. The pathologist should be aware of the possibility of a tumor of genital tract type when evaluating intestinal neoplasms in females, particularly if they have a history of endometriosis and have received unopposed estrogen therapy.
 ...
PMID:Neoplastic and pre-neoplastic changes in gastrointestinal endometriosis: a study of 17 cases. 1075 98

Our patient had a history of chronic endometriosis and pelvic pain and complained of recent onset of right-sided abdominal pain, nausea, and vomiting. Transvaginal ultrasonography revealed a thick-walled mass superior and medial to the right ovary, which was thought to be an inflamed appendix. The woman was not pregnant, and the structure appeared to be anatomically separate from the uterus. Subsequent laparoscopy confirmed the diagnosis of acute appendicitis; uncomplicated laparoscopic appendectomy followed. In the setting of chronic endometriosis, other nongynecologic sources of acute pelvic pain must be considered. Surgical intervention is appropriate whenever clinical suspicion for an acute abdomen is high, and the a priori diagnosis of endometriosis should not result in operative delay.
 ...
PMID:Transvaginal ultrasonographic identification of appendicitis in a setting of chronic pelvic pain and endometriosis. 1121 49

Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Apart of clinical examination and laboratory tests, an ultrasound examination is sensitive up to 90% and specific up to 95% if graded compression technique is used. Still it is user-depended and requires considerable experience in order to perform it reliably. Meckel's diverticulitis, acute terminal ileitis, mesenteric lymphadenitis and functional bowel disease are conditions that should be differentiated from other causes of low abdominal pain by clinical presentation, laboratory and imaging tests. Dilatation of renal pelvis and ureter are typical signs of obstructive uropathy and may be efficiently detected by ultrasound. Additional thinning of renal parenchyma suggests long-term obstructive uropathy. Ruptured ectopic pregnancy, salpingitis and hemorrhagic ovarian cysts are three most commonly diagnosed gynecologic conditions presenting as an acute abdomen. Degenerating leiomyomas and adnexal torsion occur less frequently. For better systematization, gynecologic causes of acute pelvic pain could be divided into conditions with negative pregnancy test and conditions with positive pregnancy test. Pelvic inflammatory disease may be ultrasonically presented with numerous signs such as thickening of the tubal wall, incomplete septa within the dilated tube, demonstration of hyperechoic mural nodules, free fluid in the "cul-de-sac" etc. Color Doppler ultrasound contributes to more accurate diagnosis of this entity since it enables differentiation between acute and chronic stages based on analysis of the vascular resistance. Hemorrhagic ovarian cysts may be presented by variety of ultrasound findings since intracystic echoes depend upon the quality and quantity of the blood clots. Color Doppler investigation demonstrates moderate to low vascular resistance typical of luteal flow. Leiomyomas undergoing degenerative changes are another cause of acute pelvic pain commonly present in patients of reproductive age. Color flow detects regularly separated vessels at the periphery of the leiomyoma, which exhibit moderate vascular resistance. Although the classic symptom of endometriosis is chronic pelvic pain, in some patients acute pelvic pain does occur. Most of these patients demonstrate an endometrioma or "chocolate" cyst containing diffuse carpet-like echoes. Sometimes, solid components may indicate even ovarian malignancy, but if color Doppler ultrasound is applied it is less likely to obtain false positive results. One should be aware that pericystic and/or hillar type of ovarian endometrioma vascularization facilitate correct recognition of this entity. Pelvic congestion syndrome is another condition that can cause an attack of acute pelvic pain. It is usually consequence of dilatation of venous plexuses, arteries or both systems. By switching color Doppler gynecologist can differentiate pelvic congestion syndrome from multilocular cysts, pelvic inflammatory disease or adenomyosis. Ovarian vein thrombosis is a potentially fatal disorder occurring most often in the early postpartal period. Hypercoagulability, infection and stasis are main etiologic factors, and transvaginal color Doppler ultrasound is an excellent diagnostic tool to diagnose it. Acute pelvic pain may occur even in normal intrauterine pregnancy. This may be explained by hormonal changes, rapid growth of the uterus and increased blood flow. Ultrasound is mandatory for distinguishing normal intrauterine pregnancy from threatened or spontaneous abortion, ectopic pregnancy and other complications that may occur in patients with positive pregnancy test. Incomplete abortion is visualized as thickened and irregular endometrial echo with certain amount of intracavitary fluid. If applied, color Doppler ultrasound reveals low vascular resistance signals in richly perfused intracavitary area. Transvaginal sonography has high sensitivity and specificity in visualization of uterine and adnexal signs of ectopic pregnancy. Color Doppler examination may aid in detection of the peritrophoblastic flow. Furthermore, it facilitates detection of ectopic living embryo, tubal ring or unspecific adnexal tumor. Corpus luteum cysts and leiomyomas are another cause of pelvic pain during pregnancy, which can be correctly diagnosed by ultrasound. Detection of uterine dehiscence and rupture in patients with history of prior surgical intervention on uterine wall relies exclusively on correct ultrasound diagnosis. In patients with placental abruption sonographer detects hypoechoic complex representing either retroplacental hematoma, subchorionic hematoma or subamniotic hemorrhage. In closing, ultrasound has already become important and easily available tool which can efficiently recognize patients with possibly threatening conditions of different origins.
 ...
PMID:[Ultrasonography in acute pelvic pain]. 1276 97


1 2 3 Next >>