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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tubal actinomycosis was diagnosed in a 29-year-old patient, 1 month after insertion of a Dana super IUD. The patient presented with lower abdominal pain, and was treated on an outpatient basis. She was admitted to hospital when symptoms did not improve, and was treated with antibiotics. Symptoms improved, and the patient was released, but she was readmitted 2 months later with a diagnosis of acute pelviperitonitis and pyosalpinx. She was treated with chloramphenicol and antibiotics; pyosalpinx was drained twice. Laparotomy revealed bilateral pyosalpinx and right ovarian infection. Both Fallopian tubes and the right ovary were removed. Actinomycosis was identified in the post-operative tissue examination.
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PMID:[Tubal actinomycosis as a complication of intrauterine contraception]. 65 53

Actinomycosis of the gallbladder is rare, and the pathogenesis of the infection is poorly understood. The authors report the case of a 77-year-old man admitted to hospital because of abdominal pain. Clinical and laboratory findings suggested the diagnosis of cholecystitis and cholelithiasis. At cholecystectomy the gallbladder was inflamed and contained many calculi. Gram staining of material from the mucosa of the gallbladder demonstrated gram-positive pleomorphic filaments, and Actinomyces israelii grew in pure culture, thus confirming the diagnosis of actinomycosis of the gallbladder. The pathogenesis of the condition is also discussed.
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PMID:Actinomycosis of the gallbladder. 84

Reported is the rare case of an actinomycosis of the right Fallopian tube. The clinical picture is characterized by a comparatively sudden onset of abdominal pain, obstipation and feaver as well as a markedly increased ESR. Good co-operation between the various clinical disciplines (urology, surgery, internal medicine, gynecology) lead to an exact preoperative localization of the scaring and infiltrating process that is then verified by laparotomy. The right adnexae show massive inflammatory infiltrates and form a conglomerate tumor with the adjacent sigma and appendix. Characteristic actinomycetic druses are found histologically only in the right Fallopian tube. On the left side a florid non-specific salpingitis is antibiotics is withoug complications. Mode of infection, differential diagnosis and prognosis that is dependent on a correct diagnosis at an early stage are discussed.
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PMID:[A case of actinomycosis of the fallopian tube (author's transl)]. 99 15

The authors describe the case of a 40-year-old female patient treated for prolonged periods unsuccessfully with several antibiotics on account of a febrile condition of obscure aetiology and subsequently repeatedly subjected to laparotomy on account of intra-abdominal abscesses. The cause of the fever, abdominal pain and gradual cachectization was an abdominal form of actinomycosis. After establishment of the diagnosis the patient was successfully treated by long-term penicillin administration and recovered completely. The authors discuss experience reported in the literature and therapeutic possibilities in actinomycosis.
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PMID:[Actinomycosis of the ovary as a cause of cachexia in a young patient]. 150 96

Upon admission to Box Hill Hospital in Victoria, Australia, a 38-year old woman was pale and febrile (328.6 degrees Celsius) and had a pulse of 88 beats/minute. She had had midabdominal pain for 1 week and severe lower abdominal pain for 2 days. Her menses were heavy. Other than pain during examination, rectal and vaginal examinations were normal. She had considerable neutrophilia (leukocyte count = 21.2 x 1 billion). The X-ray revealed free fluid. Ultrasonography indicated an IUD which she had had for 10 years, a mass with small cystic areas near the right ovary, and fluid in the rectouterine pouch. The physicians suspected peritonitis and administered iv broad spectrum antibiotics (1 mg ampicillin, 80 mg gentamicin, and 500 mg metronidazole) every 8 hours. They did a laparotomy. An abscess containing much green pus, the necrotic right ovary, and the appendix, which appeared normal and later shown not to be infected, occupied the right iliac fossa. The tubes were fine. The surgeons removed the appendix and right ovary. They washed out the abdomen with saline and inserted a drain to the right iliac fossa. The woman improved immediately so the physicians stopped antibiotics 3 days after surgery. Histological tests revealed actinomycosis caused by fast-growing aerobic bacteria which is known to cause necrosis, fibrosis, and suppuration. During recovery, the physicians removed the IUD and performed dilation and curettage. Actinomyces normally just dwell in the mouth and intestines, but, in this case, probably migrated up the IUD tail after spreading from the bowel to the perineum to the vagina. The physicians suspected that the presence of Mycoplasma hominis provided the mucosal breach needed to permit actinomyces' invasion. Physicians should consider actinomycosis in acute abdominal sepsis cases with a longterm use of an IUD. They can treat it with antibiotics since Actinomyces tend to be sensitive to broad spectrum antibiotics.
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PMID:Ovarian actinomycosis presenting as acute peritonitis. 158 8

The first reported case in Thailand of pelvic actinomycosis during pregnancy is presented. It occurred in a 38-year-old Thai female with a history of IUD wearing for 2 years until the symptoms of intermittent lower abdominal pain. She had a history of postcoital bleeding at 16 weeks' pregnancy and bleeding per vagina during labor at 40 weeks' pregnancy. Speculum examination showed an irregular, friable, easily bleeding mass (3-4 cm in diameter). The specimens of the mass at the posterior fornix were obtained for culture and pathological examination. Right tubo-ovarian complex measured 10 x 4 x 4 centimeters in diameter, extending through the cul-de-sac to the vaginal canal at the posterior fornix, was identified during exploratory laparotomy. Low transverse cesarean section was performed. The pathological diagnosis was actinomycosis of right fallopian tube and ovary. The patient was treated with tetracycline.
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PMID:Pelvic actinomycosis in pregnancy: a case report and review of the literature. 160 66

Described is the second reported case of isolated abdominal wall actinomycosis associated with use of an IUD. The patient, a 24-year-old white woman, presented with lower abdominal pain, dysuria, urgency, and frequency. Ultrasonography revealed a complex mass in the left lower quadrant of the abdomen that was separate from the uterus, left ovary, and tube. At laparotomy, the patient was found to have an anterior abdominal wall abscess and there was free pus within the abdomen. The omentum was inflamed and adherent to the anterior abdominal wall. The appendix, uterus, ovaries, and tubes were not involved in the inflammatory process. Histologic examination of the omentum demonstrated the typical actinomycotic picture of gram-positive filamentous bacteria within the mass and club-like extensions beyond the periphery of the mass. The patient had a copper-7 IUD in place. The only other reported such case also involved an IUD user. That patient had an isolated anterior wall abscess caused by Actinomyces. The fallopian tubes, ovaries, appendix, omentum, and intestines were normal. The possibility of abdominal wall actinomycosis should be considered in IUD users who present with intra-abdominal abscesses of unknown etiology.
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PMID:Abdominal wall actinomycosis associated with use of an intrauterine device: a case report. 183 39

3 cases of IUD-related abdominopelvic actinomycosis diagnosed after surgery are described. A 44-year old woman was admitted with high fever and diffused, strong abdominal pain. She had had an IUD for 4 years. Hypersensitivity all over the pelvis, an enlarged uterus, and peritoneal irritation were found upon vaginal examination. Opening the peritoneum yielded 1 liter of pus, a 6 cm diameter abscess of the right adnexa, and a myomatous uterus in 12 weeks of gestation. The uterus and the right adnexa were removed. Histology confirmed actinomycosis. Penicillin was given iv for 6 weeks, and after release she took oral penicillin for 4 more months. A 33-year old woman was admitted with high fever and excruciating pain in the lower right abdomen that had lasted on and off for months. She had had an IUD for 3 years. Vaginal examination revealed a hypersensitive uterus. enlarged right adnexa, and a firm mass between the vagina and the rectal shelf. Surgery showed the omentum attached to the sigmoid colon and the right fallopian tube with an abscess of 5 cm with cysts. The growth was resected, and the cysts were opened. She received iv erythromycin for 3 weeks and then orally for 2 months leading to full recovery. A 52-year old woman was hospitalized for hysterectomy. She had had abdominal pain radiating to the back for 1 year. She had had an IUD for 15 years. A myomatous uterus in 15 weeks of gestation was detected. Surgery revealed a 15 cm size myomatous uterus with an abscess of 6 cm around it. The uterus, the left adnexa, and the abscess were resected. Histology indicated actinomycosis. She received iv ampicillin for 1 month, and scar tissue from the abscess was treated with oral penicillin for 1 month. Cervical actinomycosis was found in 1-30% of women wearing IUDs. Diagnosis requires histopathological examination. The symptomless presence of cervical actinomycosis may require the temporary removal of the IUD and antibiotic treatment.
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PMID:[IUD-associated abdominopelvic actinomycosis]. 193 47

We analysed the clinicopathologic aspects of 6 cases of pelvic actinomycosis associated with intrauterine contraceptive devices seen and treated at Mackay Memorial Hospital between 1987 and 1989. All of them had IUD for a period from 5 to 20 years. The incidence of pelvic actinomycosis among all our gynecological admission number during the same period was 0.08%. The most frequent presenting symptoms were lower abdominal pain and abnormal vaginal bleeding. An abdominal total hysterectomy with a bilateral or unilateral salpingoophorectomy was performed on all 6 cases due to a tubo-ovarian abscess or a pelvic mass. We do not find any relation between the presence of pelvic actinomycosis and the type of IUD. However, the study number was too small to make a definitive statement, but the length of time of IUD insertion is of greater significance.
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PMID:Pelvic actinomycosis associated with intrauterine contraceptive devices--a review of 6 cases. 217 67

The case is described of a 43-year-old women who developed tubo-ovarian actinomycosis while using an IUD. The patient was hospitalized with right abdominal pain and fever. She had a history of appendectomy and right pulmonary lobectomy for tuberculosis. A pelvic mass about 8 cm in diameter was observed on examination. Emergency laparoscopy and laparotomy were performed. In the course of the laparotomy a voluminous, very irregular, necrotic ovarian tumor was observed. The contralateral tube was highly inflamed and had numerous adhesions. An annexectomy was performed, and the diagnosis of tubo-ovarian abscess was made during histological examination. The woman was placed on antibiotic therapy with penicillin, gentalline, and flagyl, and the postoperative course was uneventful. Bacteriological examination of the IUD showed a group of streptococci, rare colonies of a staphylococcus, and absence of strict anaerobic germs. Macroscopic examination showed the ovary to be almost destroyed by yellowish necrotic masses. The tube was swollen. Actinomycosis is a rare cause of tubo-ovarian abscess and usually is found in women using IUDs. 80% of cases of pelvic actinomycosis in IUD users have been reported in women not changing IUDs for at least 3 years. It is more common in plastic IUDs. Most cases are diagnosed histologically by identification of an actinomycotic grain in the center of the abscess or by cytologic features on Papanicolaou smears. A fluorescent antibody stain is also available. The exact role of actinomyces in tubo-ovarian abscess formation is unclear, since such abscesses are usually polymicrobial. Actinomyces should always be systematically ruled out in the event of serious genital tract infection. Treatment consists of high-dose antibiotics over a sufficiently long period.
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PMID:[Tubo-ovarian actinomycosis]. 223 58


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