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

Between 1976 and 1986 laparoscopy was performed in 3,584 patients to establish the cause of acute and chronic lower abdominal pain. The most frequent indications for laparoscopy were lower abdominal pain of unknown etiology, adnexitis, and adnexal tumors. The overall level of agreement between the clinical and laparoscopic diagnoses was 56.8%. In 50% of the cases with unknown etiology there was no correlation with the complaints. It also proved impossible to establish any organic cause in 8% to 32% of the other cases clinically diagnosed. The principal advantage of laparoscopy is, that the diagnosis is definite, rendering medication and laparotomy unnecessary in many cases. This applies in particular, with regard to appropriate treatment for lower abdominal pain of unknown etiology with no organic findings, and the treatment of benign ovarian cysts.
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PMID:[Indications and results of diagnostic laparoscopy in the assessment of lower abdominal pain]. 297 98

The case-study of genital actinomycosis in a 33-year old woman wearing a "Copper T200" IUD is presented. She was hospitalized and treated for lower abdominal pain and non-characteristic signs of adnexitis twice. Adnexectomy on the left side was performed to remove an orange-size cyst. Histo-pathological examination of a prepared tissue sample revealed a colony of Actinomyces. Following the operation the patient was treated with 3 x 500 mg Flagyl (metronidazole) 3 x 80 mg of Gentamicin im. The wound healed in 19 days after operation. This woman had worn the IUD continuously for more than 3 years, thus there was an increased risk of uterine lesions. The most frequent consequences of wearing IUDs for a long time are dysmenorrhea and endometritis and therapeutic approaches are detailed. Since its first description in the literature in 1857 actinomycosis has not been mentioned frequently. However, with the spread of IUDs, the number of actinomycosis-like cases has increased and this justifies the need for improved diagnosis. The frequency of actinomycosis occurring in women wearing IUDs ranges between 1.6% and 19.7%
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PMID:[Adnexal actinomycosis in a woman using an intrauterine contraceptive device (IUD)]. 358 37

Obscure, chronically recurring pains in the lower abdomen and back are common symptoms in the office of the gynecologist or practitioner. Often the cause has never been found. Many are functional or psychosomatic disturbances. There is no objective measurement of the quality or amount of pain. Common diagnoses have been chronic adnexitis, chronic appendicitis, retroflexion of the uterus, or adhesions. Too often surgical operations have been of little benefit. When consultations with other specialists have not helped, laparoscopy is indicated. Endometriosis is a common finding. Cauteriziation of this lesion at laparoscopy is better than hormone therapy. Adhesions may be severed with relief of symptoms. Varicose enlargement of ovarian veins is sometimes seen. Laparotomy may be indicated for conditions not readily treated by laparoscopy. However, indications for surgery should be carefully considered to avoid iatrogenic damage in an already apprehensive patient. Tranquilizers and small doses of cortisone may be adequate. In about 80% of patients complaining of chronic lower abdominal pain, organic disorders may be found by laparoscopy. The procedure should be recommended more frequently.
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PMID:Chronic pelvic disease of unknown origin. 427 10

A 48 year old woman was admitted to our department with sudden onset of pain in the left lower abdominal quadrant and the initial diagnosis of diverticulitis or left sided adnexitis was made. On physical examination she was found to have pain and localized peritonism in the left lower abdominal quadrant. Ischemic signs in the same sided lower limb could not be observed. Further diagnostics (abdominal ultrasonography, transvaginal ultrasonography, angiography and computed tomography) showed a covered perforated aneurysm in the left common or internal iliac artery as the reason for the abdominal pain. Coincidental focal aneurysms were seen in the middle segment of both renal arteries and also in the right common iliac artery. The patient was treated with an aorto-iliac-bypass (Impra-prosthetic graft). Histological examination showed features of fibromuscular dysplasia. We are reporting this case due to the unusual localisation, the atypical symptoms and the difficult diagnostics.
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PMID:[Aneurysms of the iliac artery in fibromuscular dysplasia as differential diagnostic consideration in acute lower abdominal pain]. 933 5

A 20-year-old African female was hospitalized several times for diffuse chronic abdominal pain. The following exclusions were made: Acute adnexitis (by laparoscopy), acute appendicitis (by appendectomy), gastric ulcerations (by esophagogastroduodenoscopy) as well as Crohn's disease and ulcerative colitis. However, once taking a closer microscopical look at the mucosa, that otherwise appeared colonoscopically to be normal, multiple eggs of schistosomiasis mansoni (S. mansoni) were found in the colon as well as the rectum. Thus, the diagnosis of an intestinal bilharziosis was finely established. In retrospect even the sample taken for the appendix could have indicated this diagnosis already earlier on. Both the antibodies (ELISA/IFAT) and the specific immunoglobulins (IgE) for S. mansoni proved significantly positive. Therapy of choice was a single oral dosage of praziquantel. Migration and tourism have considerably increased the range of tropical and infectious diseases that need to be included into differential diagnosis. This case report focuses on intestinal bilharziosis as a potential underlying cause of chronic abdominal pain in immigrants of endemically affected areas. Direct diagnosis is the most important diagnostic method. The adult worms are usually inaccessible, so the method of choice to assess both diagnosis and the degree of activity of a chronic infection is evidence of living eggs in the stool. Alternatively, in case of lack of direct evidence diagnosis can be established by endoscopy and rectal biopsy.
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PMID:[Chronic abdominal pain and eosinophilia in a young African patient]. 1107 77

Two women, aged 31 and 37 years, had abdominal pain and fever several months after giving birth and a few weeks after receiving an intrauterine device. Both patients were admitted and treated under the working diagnosis of pelvic inflammatory disease (PID). They appeared to have pneumococcal adnexitis and pneumococcal peritonitis. Both patients recovered after initiating directed antibiotic treatment. Peritonitis in previously healthy adults is seldom caused by pneumococci. Standard antibiotics that are effective when given empirically for PID may be a suboptimal treatment for pneumococcal peritonitis.
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PMID:[Two adult patients with pneumococcal peritonitis]. 1705 64

A 61-year-old woman with aplastic anemia was admitted to our hospital in October 2009 because of fever and abdominal pain. She had been treated with cyclosporin A without showing any effect. On admission, uterine cancer was diagnosed and the left uterine appendages were swollen. She was treated with cefepime for febrile neutropenia without effect, and left-sided adnexitis was diagnosed. After cefepime was changed to meropenem, marked plasmacytosis was observed in the peripheral blood (23%) and bone marrow (79%) with the appearance of skin eruption. Although the plasma cells were morphologically abnormal, the cytoplasmic immunoglobulin light chain deviation was not detected by flow cytometric analysis, and M protein was not found by serum immunoelectrophoresis. She was diagnosed with reactive plasmacytosis and treated with dexamethasone. The drug eruption and plasmacytosis improved soon after starting the treatment. Although reactive plasmacytosis is observed with a variety of conditions, including infection, neoplasms, autoimmune disorders, and hemolytic anemia, it has not been reported to accompany drug eruption. Reactive plasmacytosis is sometimes not possible to distinguish from plasma cell neoplasms on morphology alone and needs to be diagnosed comprehensively by using flow cytometric analysis and immunohistochemical evaluation.
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PMID:[Marked reactive plasmacytosis accompanied by drug eruption in a patient with aplastic anemia]. 2272 55