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

Pelvic pneumography was performed in 150 children, including those with precocious puberty, suspected pelvic masses, abdominal pain, virilization, ambiguous genitalia, gonadal dysgenesis, Stein-Leventhal syndrome, amenorrhea, and contralateral inguinal hernia detection. Pneumography proved safe, accurate, and easy to perform. However, advances in sonography have limited the use of pneumography primarily to the investigation of infant intersex problems and confirmation of idiopathic precocious puberty in the infant or very young girl.
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PMID:Pneumopelvigraphy in childhood. 10 49

313 patients with ectopic pregnancy were treated at Chicago Lying-In Hospital in 1968-1975, for a frequency of 1 in 72 deliveries. Historical and physical findings, diagnostic procedures, causative factors, and patient management were reviewed for 284 of these patients. 97.5% of the pregnancies were tubal. 25% of the patients were nulliparas and 31.7% were primiparas. 34.9% had had 1 or more previous abortions. The mean age of the patients was 28. Most had been using no contraception, and only 3.9% had an IUD in situ. The most common symptoms were abdominal pain (96.7%) and amenorrhea (73.6%), while the most frequent abdominal findings were tenderness (83.4%), rebound pain (41.2%), and guarding (28.9%). Adnexal tenderness was found in 72.2% and 30% had distinct adnexal masses. An initial misdiagnosis of pelvic inflammatory disease was made in 132 (46.5%) cases. A culdocentesis and slide latex agglutination inhibition pregnancy test performed in 167 and 102 patients, respectively, gave 82.6 and 73.5% positive rates. Diagnostic laparoscopy was used routinely after 1970 on all nonacute patients in whom ectopic pregnancy was suspected, and this led to a significant drop in the rate of ruptured pregnancies (63% pre-1970 and 45% post-1970). 25% of patients were sterilized, but the treatment of choice was salpingectomy unless the opposite tube was absent or damaged. Gross evidence of pelvic inflammatory disease was noted in 36% of patients and 31% had salpingitis. The most common postoperative complication was fever (42.2%). 3 deaths occurred in the series (2 due to acute pulmonary edema resulting from fluid overload), for a maternal death rate from ectopic gestation of 13.83/100,000 live births. No fetuses survived.
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PMID:Ectopic pregnancy. An eight-year review. 43 84

Beta-HCG in serum was analysed in 64 cases of ectopic tubal pregnancy who wree different groups; ruptured ectopic pregnancy, ectopic pregnancy accompanied by amenorrhea or adnexal mass and ectopic pregnancy without palpable adnexal mass and amenorrhea. The mean HCG levels for the three groups were 8 790 IU/l, 2 580 IU/l and 690 IU/l, respectively, which related more to the symptoms than to the estimated length of pregnancy. Eleven per cent of the women had an IUD and five per cent were taking low dose gestagens. Screening of cases with acute lower abdominal pain or irregular vaginal bleeding with beta-HCG in serum will facilitate an early diagnosis of ectopic pregnancy and be of special value in patients with less typical symptoms.
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PMID:Serum beta-human chorionic gonadotrophin levels in the early diagnosis of ectopic pregnancy. 48 13

2 cases of unrecognized oviduct pregnancy receiving therapeutic abortion by uterine aspiration are reported. A 29-year-old white female, gravida 4, para 2 with a Dalkon Shield in place for 2 1/2 years and with 6 weeks amenorrhea received a therapeutic abortion. 3 days later the patient complained of fever and severe suprapubic cramps. Minocycline was given in the belief that the patient was suffering from endometritis. 17 days after uterine aspiration the pain increased. At laparoscopy a corpus luteum was seen in the left ovary and blood was present in the pelvis. Histological examination of the oviducts revealed signs of an aborted oviduct pregnant. A 2nd case concerned a 26-year-old white female, gravida 2, para 2, using the Ogino-Knaus method of contraception and who had a normal menses 7 weeks previously. 12 days after uterine aspiration the patient complained of continued vaginal bleeding, lower abdominal cramps, and chills. After uterine aspiration was repeated minocycline therapy was initated. 20 days after the initial aspiration the patient reported a return of vaginal bleeding and lower abdominal pain. Laparotomy revealed a ruptured oviduct. Histology showed salpingitis and fusion of the right fimbria and a large blood clot and trophoblastic villi in the lumen of the right ampulla. In the future it is suggested that histological examination of the aspiration should be performed to aid in finding oviductal or ovarian pregnancies.
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PMID:Case reports: unrecognized oviduct pregnancy and therapeutic abortion by uterine aspiration. 97 19

Eighteen cases of advanced extra-uterine pregnancy are reported. The difficulty of diagnosis is discussed; the only symptoms of any help were amenorrhoea, lower abdominal pain, postmaturity and failed induction of labour. The physical findings were variable and none were absolutely reliable. In 17 cases the fetus was dead on admission and early laparotomy was performed, and in 17 patients it was possible to remove the placenta completely.
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PMID:Diagnosis and treatment of advanced extra-uterine pregnancy. 119 34

In the two years - 1st January, 1973 to 31st December, 1974 - 533 patients had operation for tubal pregnancy at the Gynaecology Unit of the Korle-Bu Teaching Hospital. About five cases per week were seen during this period. The incidence was 44 for every thousand deliveries at the Hospital. The case notes of 404 of the 533 patients have been reviewed. The age range was 15 to 44 years; 78% were in the 21 to 35 years age group. 81.4% had had pregnancies which went beyond 28 weeks. Only 13.7% had never had an intrauterine pregnancy. Tubal pregnancy is therefore not a disease of the primarily infertile as is commonly thought. There was no significant difference between the incidence on the right side and the incidence on the left side. The ampulla was the commonest site of implantation in the tube (45%). Tubal rupture (89.6%) was commoner than tubal abortion (10.4%). The principal signs and symptoms were abdominal pain, amenorrhoea, abdominal tenderness, abdominal distension, and signs of free fluid in the abdomen, syncope, anomalous vaginal bleeding, pallor and vomiting. The absence of amenorrhoea does not rule out the possibility of an ectopic. On pelvic examination the major signs were tenderness in a fornix and cervical excitation pain. Abdominal paracentesis and culdocentesis if positive are useful in diagnosis; negative results prove nothing. Laparascopy is of great value and should be employed in the difficult case. Beware of the patient in the reproductive age with anomalous vaginal bleeding, vague abdominal pains, syncopic attacks and anaemia. The mortality rate in the series was 0.7%.
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PMID:Tubal pregnancy: a review of 404 cases. 123 87

A 14 1/2-year old girl with menometrorrhagia followed by amenorrhea and abdominal pain had a pelvic resistance with limited mobility. Histology of a left ovarian tumour showed gonadoblastoma turning to dysgerminoma and associated with choriocarcinoma (M-9073/1, M-9060/3, M-90101/3). Genuine ovarian tissue was hypoplastic on both sides. In the right ovary, there were additional thecalutein cysts. The patient's karyotype was 46 XX. She has been without any relapse 2 1/2 years after chemotherapy and actinotherapy.
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PMID:[An ovarian tumor with structural gonadoblastoma, dysgerminoma and choriocarcinoma]. 134 Apr 2

Imperforate hymen should be considered in girls of menarcheal age with a history of amenorrhea and vague abdominal discomfort, particularly if associated with symptoms of urinary obstruction or constipation. Patients may present with severe dysmenorrhea and localized pain mimicking appendicitis if hematocolpometra is due to unilaterally imperforate hymen with duplicate vagina and didelphic uterus. Although this condition is exceedingly rare, the case presented stresses the importance of a careful history and physical examination of an adolescent girl presenting with symptoms of abdominal pain associated with menstruation.
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PMID:Didelphic uterus and unilaterally imperforate double vagina as an unusual presentation of right lower-quadrant abdominal pain. 149 48

During the past decade, the development of various gonadotrophin-releasing hormone (Gn-RH) agonists, which induce reversible hypo-oestrogenism has opened a new area in the medical management of endometriosis. In an open, multicentre phase III study, the efficacy, tolerance and safety of the Gn-RH agonist leuprorelin acetate were tested. The preliminary results of 104 women treated in seven German centres are presented. Pelvic endometriosis was diagnosed by laparoscopy and classified according to the American Fertility Society scoring system: 33% of patients had minimal, 22% mild, 28% moderate and 8% severe endometriosis and in 9% no pathological results were obtained. The patients' mean age was 30 +/- 6 years and 66 had infertility problems. Treatment was started within the first 3 days of the menstrual cycle and consisted of a subcutaneous injection of leuprorelin acetate 3.75 mg, repeated once monthly over 24 weeks. A follow-up period of 12 months after the last injection has been completed in 70 patients, including a second laparoscopy. At all visits, symptoms were evaluated, physical examinations performed, and blood samples collected for haematological screening, serum chemistry determinations and measurement of the gonadotrophins oestradiol and progesterone and leuprorelin acetate. The median score at laparoscopy fell from 12 before operation to 8 after operation and 2 after treatment with leuprorelin acetate. Of the total number of patients, 89% had improvements in their endometriosis, 8% a deterioration and 3% no change. Patients reported improvement in the following: dysmenorrhoea 93%, dyspareunia 62% and pelvic pain 70%. However, all women complained of at least one of the following symptoms: hot flushes 86%, sleep disturbance 62%, sweating 61%, headache 41%, nausea 32% and depression 20%. Fifty-five percent of patients reported additional side effects such as vaginal dryness, fatigue and lower abdominal pain. After the third injection, amenorrhoea persisted in 94% of the women. Four weeks after the first leuprorelin acetate injection median concentrations of oestradiol fell from 45 pg/ml to 11 pg/ml, follicle-stimulating hormone from 7 U/L to 3 U/L and luteinising hormone from 5 U/L to 1 U/L and remained almost unchanged over the observation period. During the 6 months' treatment, laboratory parameters showed no significant deviations from normal; only total cholesterol, high-density lipoprotein cholesterol and alkaline phosphatase increased. Treatment results were judged as good and satisfactory in 82% and 11% of cases, respectively. On the basis of this study, it can be concluded that leuprorelin acetate treatment is safe, well tolerated and effective in the medical management of endometriosis and endometriosis-related complaints.
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PMID:Treatment of endometriosis with leuprorelin acetate depot: a German multicentre study. 153 21

Risk factors for ectopic pregnancy include previous ectopic pregnancy, current intrauterine device use, prior fallopian tube surgery, previous pelvic inflammatory disease and a prior history of infertility. Abdominal pain is the most common symptom, followed by amenorrhea or vaginal bleeding, nausea, vomiting, syncope and dizziness. Referred shoulder pain following the onset of abdominal pain is characteristic of intraperitoneal bleeding and, in the appropriate clinical setting, strongly suggests a ruptured ectopic pregnancy. A coordinated evaluation includes measurement of serum human chorionic gonadotropin concentration and transabdominal or, preferably, transvaginal ultrasonography. Treatment is primarily by one of a variety of surgical techniques. Medical therapy with methotrexate or other drugs is currently under investigation.
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PMID:Management of ectopic pregnancy. 218 38


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