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

Pelvic actinomycosis has been associated with IUD use. This study assesses the occurence of pelvic actinomycosis in South Glamorgan, Wales, its association with IUD usage, gynecological problems and cervical cytology findings. Cervical cytology smears (Papanicolau) were taken from 1919 family planning clinic patients during the period October 1979 to February 1980. Chi-square analysis was used to test for significance. Of the 1919 women, 147 had IUDs in situ. Actinomyces-like structures were identified in 38 IUD users. 4 had complained of abnormal vaginal bleeding, 5 of vaginal discharge, and 1 of abdominal pain. Of the remaining 109 women with IUD in situ, 9 complained of vaginal bleeding, 17 of vaginal discharge and 6 of abdominal pain. No statistically significant differences in symptomatology or physical signs were observed between the 2 groups. No malignant cells were seen in any of the smears. The differences in cytological findings between the 2 groups is statistically significant (p 0.001). No evidence of pelvic infection or significant increase in gynecological problem was seen in the 38 women, although there was a significant increase in atypical and dyskaryotic cells in their cervical smears. The findings suggest that removal of the IUD or antibiotic treatment is not necessary under the circumstances described. It is recommended however, that there should be continued close observation of IUD users unless pelvic inflammatory disease becomes evident.
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PMID:Actinomyces-like structures and their association with intrauterine contraceptive devices, pelvic infection and abnormal cervical cytology. 727 67

20 cases of pelvic actinomycosis associated with the use of an IUD have been reported. A case of a patient with IUD-associated pelvic actinomycosis, in which the organism was identified by histologic testing and culture, is reported. The 26-year-old woman, gravida 2, para 1, had had a therapeutic abortion in March 1971. She used a Dalkon Shield IUD from 1971 to April 1975. It was removed at that time because of menometrorrhagia. The patient noted pain in the lower left quadrant of her abdomen in June 1975. A mass in the left ovary was palpated on pelvic examination, but the patient refused further evaluation. The patient returned in August 1976 complaining of continued abdominal pain. On physical examination, she had a firm, slightly tender, 7 centimeter mass in the left adnexa, contiguous with the uterus. No other abnormalities were revealed in physical examination. There were 11,200 peripheral blood leukocytes per cubic millimeter with 73% polymorphonuclera cells and 6% band forms. A laparotomy was performed in August 1976, and a 5- by 2.5 centimeter tubo-ovarian abscess on the left side was found. Adhesions and clubbing of the right fallopian tube were observed during the operation. The left ovary and fallopian tube were excised. Inflammatory disease involving the right ovary and fallopian tube was evident, but the right adnexa was left in place in accordance with the patient's preoperative request. In October a 2nd laparotomy was performed, and the ovary and the right fallopian tube were removed.
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PMID:Tubo-ovarian Actinomycosis and the Use of Intrauterine Devices. 740 3

In Australia, physicians admitted a 31-year-old woman with a 1-year history of right upper quadrant abdominal pain that had recently radiated to her right shoulder and a 6-week history of swelling over the right lower ribs. She had used an IUD for a total of 10 years. She had a fever and a fast pulse rate. She had a 20 x 20 cm tender, hot, fluctuant mass over the anterior right costal margin with induration nearby. Air entry was minimal at the right lung base. She had low hemoglobin, a high white blood cell count, and a high platelet count. Liver enzyme levels were high. A chest X-ray revealed minor atelectasis of the right lower lobe and a small right pleural effusion. A CAT scan revealed an 8 x 3 cm fluid collection in the extrapleural space beneath the ribs and a 10 x 5 cm collection of fluid indenting the right lobe of liver. Signs of pelvic inflammation were evident. Prior to surgery, intravenous ampicillin, gentamicin, and metronidazole therapy were started. A surgeon incised the abscess, draining 600 ml pus. A catheter was inserted postoperatively to irrigate the area with normal saline so as to complete the drainage. No sulphur granules were seen in the sinus between the ribs. Many neutrophils and a mix of Gram-positive branching bacilli (Actinomyces israellii) and Gram-negative filamentous bacteria (Porphyromonas asaccharolytica) were in the pus. Actinomyces-like organisms were present on a Papanicolaou stained vaginal smear and on a Gram stain of material on the removed IUD. No cultures grew from blood samples. From 2 days to 6 months after surgery, she underwent therapy of amoxycillin/ clavulanic acid 500/125 mg 3 times a day. P. asaccharolytica is usually part of the anaerobic flora of the urogenital and intestinal tracts. Chest wall actinomycosis was a result of distant spread from an IUD-related pelvic infection.
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PMID:Chest wall actinomycosis in association with the use of an intra-uterine device. 785 30

A laparotomy for hysterectomy was performed in a 46-year-old nulliparous woman who had worn an intra-uterine sterilization device for 8 years. The patient was in poor general health and had had abdominal pain and repeated episodes of fever over the preceding 3 months. An abscess of the abdominal muscle was found peroperatively. No perforations of the small or large intestine were observed. The pathology examination yielded the diagnosis of Actinomycosis. Actinomyces israeli is the most frequency observed Actinomycae in humans. It is a saprophyte organism of the intestinal flora, not usually found in the vagina and observed in 3.5% of cervical swabs of patients wearing an intra-uterine device (Gupta bodies). The frequency increases with the duration of insertion and the pathogenicity appears when the immune responses are deficient and/or when a cofactor is involved. Treatment relies on surgical exeresis and prolonged antibiotics (penicillin G or macrolides). Hyperbar treatment is sometimes used.
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PMID:[A difficult diagnosis: pelvic-abdominal actinomycosis abscess]. 813 59

We report a case of isolated hepatic actinomycosis and review 35 previously reported cases. Three-fourths of the reported patients were male, and more than one-half were between 30 and 50 years of age. Although some patients had oral disease or intraabdominal infections, the majority of cases were cryptogenic. Common presenting symptoms included fever, abdominal pain, and anorexia with weight loss. Findings on physical examination included pyrexia, abdominal tenderness, and hepatomegaly. Leukocytosis with a left shift, anemia, an elevated serum erythrocyte sedimentation rate, and an elevated level of alkaline phosphatase were almost universally present. Diagnosis was frequently made at the time of exploratory laparotomy, but percutaneous diagnostic procedures obviated the need for surgery in many recent cases. Microbiological diagnosis involved visualization of branching gram-positive Actinomyces organisms or recovery of organisms in anaerobic culture. Treatment most commonly consisted of prolonged administration of penicillin or tetracycline and was associated with an excellent outcome in the majority of cases.
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PMID:Pyogenic liver abscess involving Actinomyces: case report and review. 805 54

Abdominal actinomycosis is a severe and progressive peritoneal infection, due to an anerobic gram-positive bacterium, Actinomyces israelii. The presence of a long-standing intrauterine device (IUD) is a well-known risk factor in young women. We report two cases of pelviperitoneal actinomycosis appearing in two young women with acute low abdominal pain. Abdominal CT demonstrated multiple solid or encapsulated peritoneal masses with marked contrast enhancement and infiltration of the adjacent mesenteric fat. Laparoscopy confirmed the presence of intraperitoneal abscesses which contained Actinomyces israelii. High doses of amoxicillin and clavulanic acid (Augmentine) were given and following CT scan after 2 and 6 weeks showed a slow, but complete, resolution of the lesions. Although the radiologic presentation of actinomycosis is nonspecific, the diagnosis should be raised in the presence of pseudotumoral mesenteric infiltration, particularly in young women with an IUD. Abdominal CT is a useful method for diagnosis and for follow-up.
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PMID:Abdominal actinomycosis associated with intrauterine device: CT features. 893 33

A case of abdominal actinomycosis is described in a woman with recurrent right lower abdominal pain and low-grade fever without history of appendectomy. Past history included the use of an intrauterine device (IUD) until 10 years before manifestation of these symptoms. We followed up the patient, via diagnostic imaging, for 7 months. On initial barium enema, a polypoid lesion was visualized at the bottom of the cecum and there was constriction of the sigmoid colon; the appendix was not seen. Seven months later, poor extension at the cecum, severe constriction in the sigmoid colon, and narrowing of the terminal ileum were also visualized. On computed tomography (CT), the lesion was initially localized only in the ileocecal region adjacent to the sigmoid colon. After 7 months, the lesion had infiltrated adjacent anatomic components and showed direct infiltration of the pelvic space. Differential diagnosis was difficult, as it was not obvious whether this was a pelvic abscess due to inflammation or appendiceal carcinoma. Laparotomy was performed. Macroscopically, the lesion was not limited to the ileocecal region, but involved the right ureter, tubes the Fallopian and ovary, bladder, psoas muscle, and abdominal wall. Pathology findings showed, chronic inflammatory tissue with evidence of actinomycosis. Although previous reports have described a lack of specific findings in this disease. When actinomycosis is suspected, CT is recommended to define its extent.
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PMID:Abdominal actinomycosis: barium enema and computed tomography findings. 905 1

We report a case of abdominal actinomycosis in a young woman wearing an intrauterine contraceptive device. The patient presented with right lower abdominal pain. A diagnostic laparoscopy was performed. Intraoperatively two perforations of the sigma were detected, a sigmoidectomy was performed. Postoperatively no problems occurred. Histology revealed an abdominal actinomycosis. In the literature only some case reports are published dealing with abdominal actinomycosis. Women wearing intrauterine contraceptive devices seem to have a higher risk of actinomycosis. In unproblematic cases antibiotic therapy is the treatment of choice. In cases of doubt as in our case surgery is recommended to confirm the diagnosis.
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PMID:[Actinomycosis of the sigmoid colon as the etiology of lower abdominal pain]. 1114 17

We report the case of a 6-y-old boy with actinomycosis, presenting as xanthogranulomatous pyelonephritis (XGP), hepatic pseudotumor and abdominal abscess. Symptoms included intermittent fever, abdominal pain and significant weight loss. Hepatic and renal tumor masses were suspected on sonography and computerized tomography. XGP and actinomycosis were proven by pathology. The patient recovered well with antibiotic alone.
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PMID:Intra-abdominal actinomycosis with hepatic pseudotumor and xanthogranulomatous pyelonephritis in a 6-y-old boy. 1151 70

Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans. Actinomyces israelii rarely cause abdominal infections or actinomycosis. Abdominal actinomysosis is characterised by fistulae and abscesses and may mimic cancer or inflammatory bowel disease. Abdominal actinomycosis is difficult to diagnose preoperatively, and often require surgical removal of the diseased tissue, allowing pathologists for giving the definitive diagnosis, revealed by characteristic "sulfur granules". The authors report herein the case of a 47-year-old man who presented with diarrhoea and abdominal pain. Abdominal computed tomography evoked complicated inflammatory bowel disease and surgical procedure was decided. Laparoscopic exploration did not provide further significant information, and laparotomy with diseased bowel resection was performed. Pathology demonstrated "sulfur granules" and allowed the diagnosis of abdominal actinomycosis. This case demonstrated that abdominal actinomycosis should be included in the differential diagnosis when computed tomography shows an infiltrative and inflammatory mass.
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PMID:Ileo-caecal actinomycosis: report of a case simulating complicated inflammatory bowel disease. 1188 35


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