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

Hyperreactio luteinalis (HL) refers to moderate to marked cystic enlargement of the ovaries due to multiple benign theca lutein cysts and is most often associated with hydatidiform mole or choriocarcinoma. The cause of this condition is unknown, but is believed to be related to elevated levels of, or abnormal ovarian response to, human chorionic and pituitary gonadotropins. Only 47 cases of HL unassociated with trophoblastic disease have been previously reported in the English-language literature, mostly before 1974, and almost exclusively in the gynecologic literature. We present two additional cases of HL unassociated with trophoblastic disease and review the literature. One of our case reports documents the unusual occurrence of unilateral HL. Of the 49 cases described, 11 occurred with fetal hydrops (8 immunologic; 3 non-immunologic), 8 with multiple pregnancies, and 30 in otherwise normal single pregnancies. Hyperreaction luteinalis is most often bilateral and found incidentally at the time of cesarean section. However, HL may present during any trimester as an abdominal mass or acute abdomen. The natural course is postpartum regression. Recognition of HL is important, since misinterpretation at laparotomy or erroneous histologic diagnoses have resulted in unnecessary surgery, often with sterilization in 16 of the cases. A conservative approach is indicated with wedge biopsy and frozen section diagnosis. Oophorectomy is necessary only to remove infarcted tissue or to control hemorrhage.
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PMID:Hyperreactio luteinalis. Benign disorder masquerading as an ovarian neoplasm. 266 98

We describe a case of a 28-year-old Saudi patient, gravida 6, para 5, at 14 weeks' gestation, who had recurrent bilateral theca lutein cysts during her last three pregnancies. The cysts were treated surgically during her fourth pregnancy because of acute abdomen at 20 weeks' gestation. Ovarian biopsy confirmed the diagnosis of theca lutein cysts and her pregnancy continued until term. In the last two pregnancies, the theca lutein cysts were managed conservatively by serial ultrasound examination and they resolved spontaneously. There was no history of molar pregnancy or use of ovulation-inducing drugs. The possibility that there was increased sensitivity of the ovarian tissue to human chorionic gonadotropin is discussed.
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PMID:Recurrent bilateral theca lutein cysts in association with normal pregnancy. 958 49

BACKGROUND: Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. The disease normally spreads to lung and brain. CASE REPORT: A case of malignant trophoblastic disease with brain metastasis, raised intra cranial pressure and small bowel metastasis presenting with acute abdomen is reported. CONCLUSIONS: Malignant transformation in a hydatidiform mole is rare event. Involvement of gastrointestinal tract is rarer even in presence of disseminated disease. Surgery is the treatment of choice for gastrointestinal complications.
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PMID:Unusual presentation of choriocarcinoma. 1277 21

Theca lutein cysts (hyperreactio luteinalis) are benign cysts usually associated with molar pregnancy. We report a case of bilateral theca lutein cysts with normal intrauterine singleton pregnancy presenting as an acute abdomen requiring surgical intervention. Laparotomy revealed bilateral theca lutein cysts one of which was torted, necessitating salpingo-ovariotomy.
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PMID:Bilateral theca lutein cysts: a rare cause of acute abdomen in pregnancy. 1553 14

The classic features of molar pregnancy are irregular vaginal bleeding, hyperemesis, enlarged uterus for gestational age and early failed pregnancy. Less common presentations include hyperthyroidism, early onset pre-eclampsia or abdominal distension due to theca lutein cysts. Here, we present a case of molar pregnancy where a woman presented to the emergency department with symptoms of acute abdomen and was treated as ruptured ectopic pregnancy. The woman underwent laparoscopy and evacuation of retained products of conception. Histological examination of uterine curettage confirmed the diagnosis of a complete hydatidiform mole. The woman was discharged home in good general condition with a plan for serial beta-human chorionic gonadotropin (beta-hCG) follow-up. Complete follow-up includes use of contraception and follow-up after beta-hCG is negative for a year.
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PMID:Atypical presentation of molar pregnancy. 3026 28