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

The results of 486 laparoscopic procedures are reported. 70.3% of the procedures were for the purpose of sterilization and 27.9% were performed for fertility studies and diagnostic purposes. There were 3 pregnancies following 342 sterilization procedures. Laparoscopic diagnosis uncovered various contributing causes to abdominal pain: pelvic variocele, ovarian cysts of difficult palpation, uterine myomas, and adherent tissues with endometriosis. There was 1 case of puncture of the inferior vena cava and 2 cases of abscess of the abdominal wall. Preoperative and operative procedures are briefly described.
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PMID:Laparoscopy in Colon, Panama. 13 15

Splenosis is the autotransplantation of splenic tissue that usually follows traumatic rupture of the spleen. Generally, the splenic implants are numerous and are located within the peritoneal cavity; however, extra-abdominal splenosis does occur. The implants are rarely clinically significant and are incidental findings at autopsy or at abdominal operation, unrelated to and distant from the splenic trauma and splenectomy. Splenic implants retain their ability to function, and recurrence of a hematologic disease for which the spleen was previously removed should alter the clinician to the possibility of splenosis. The differential diagnosis includes accessory spleens, endometriosis, hemangiomas and metastatic cancer. We report three cases, two of which represent unusual complications of splenosis: a twisted pedicle of a splenic implant, which apparently caused abdominal pain, and recurrent Felty's syndrome associated with splenosis and an accessory spleen.
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PMID:Splenosis: autotransplantation of splenic tissue. 96 5

Endometriosis is a common disease with 8-15% occurrence in women during their reproductive period. Involvement of the bowel wall occurs rather frequently and probably presents in 12-34% of patient with pelvic endometriosis. However, it is classically asymptomatic and difficult to find out. From 1977 to 1987, we had six patients of colorectal endometriosis with mainly bowel symptoms. Five of them were located at rectum and sigmoid colon, one at the hepatic flexure of colon. All of the cases developed constipation or diarrhea, and four of them had severe abdominal pain. Four cases developed rectal bleeding. Previous operation for pelvic endometriosis was noted in two cases. The detailed examination included digital examination, endoscopy, barium enema and CT scan. Suspected malignancy was the indication for surgery in 4 cases and one in rectal stenosis. Low diagnostic rate was due to the fact that endometrial tissue rarely infiltrates the mucosa. Therefore, pathology of biopsied specimen often reveals non-conclusive finding to prevent differential diagnosis. However bowel resection offers conclusive diagnosis and chances of cure. In our study, only one suspected endometriosis case received bilateral oophorectomy. The stenotic segment of rectum restored to normal caliber after operation.
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PMID:[Experience of surgical treatment for colorectal endometriosis: report of 6 cases]. 131 93

Patients with symptomatic endometriosis of the colon and distal small bowel usually present with crampy abdominal pain, pelvic and rectal pain, constipation, and dyspareunia. Superficial disease can be easily resected laparoscopically with scissors. Deeper lesions require full-thickness resection and closure of the bowel. Occasionally deep, large, or multiple lesions will require segmental resection for adequate control of the disease. Five patients with intestinal endometriosis underwent attempted laparoscopic segmental colon resection. Two patients required conversion to open laparotomy because of difficulty with the anastomosis. No operative complications or deaths occurred in this group. Those patients undergoing laparoscopic colectomy showed return of bowel function within 24 to 48 h and were discharged home on postoperative day 4.
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PMID:Laparoscopic segmental resection of the sigmoid and rectosigmoid colon for endometriosis. 134 16

Physicians examined 216 women who presented at Chittaranjan Seva Sadan College of Obstetrics, Gynaecology, and Child Health in Calcutta, India, and had undergone surgical sterilization at least 2 years earlier. Endometrial biopsies during the late secretory phase in the 32 cases with excessive bleeding during the late menstrual period found proliferative changes: dilated glands in 28 cases and poor secretory phase in 4 cases. The 12 ovarian biopsies revealed cortical stromal hyperplasia in 1 case. None of the control cases (i.e., those with no menorrhagia) had any ovarian changes. Observed pelvic pathologies included in the order of frequency: cystic ovaries, hydrosalpinx, uterine fibroids, pelvic endometriosis, uterine prolapse, chronic cervicitis, and scar endometriosis. Most of the 216 women were 25 to 35 years old and the youngest was 22 years old. Menorrhagia was the most common complaint (59.2%) and 30 to 35 year old women suffered from it the most. Among women who had no pelvic pathology, dysfunctional uterine bleeding was responsible for menorrhagia. Dysmenorrhea was the next most frequent complaint (29.6%). Intermenstrual bleeding, abnormally infrequent menstruation, and secondary amenorrhea were other menstrual disturbances (5.56%, 4.17%, and 1.39%, respectively). Other relatively common symptoms associated with surgical sterilization were abdominal pain (25%), abdominal discomfort and backache (14.8%), and whitish, viscid vaginal or uterine discharge (12.03%). Less frequent symptoms were obesity, painful scar, insomnia, irritability, depression, and regret. Proper preoperative and postoperative counseling would have prevented many of the complications.
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PMID:Aftermaths of surgical sterilisation with special reference to menstrual disturbances. 153 7

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

Primary peritoneal serous micropapillomatosis of low malignant potential, or serous borderline tumor of the peritoneum, is a relatively rare lesion that is histologically indistinguishable from peritoneal "implants" associated with ovarian papillary serous tumors of low malignant potential. We analyzed 17 cases to further define the pathologic features and prognosis of this entity. The ages of the patients ranged from 16 to 67 years (mean, 33 years). Eight patients were symptomatic with chronic pelvic or abdominal pain (five patients), adnexal mass (one patient), small-bowel obstruction (one patient), and possible endometriosis (one patient). In nine cases (53%), peritoneal serous micropapillomatosis of low malignant potential was an incidental finding discovered during evaluation or treatment of other conditions. Grossly, the peritoneal lesions were focal or diffuse. They commonly appeared as miliary granules and often were believed to be peritoneal carcinomatosis. Microscopically, peritoneal serous micropapillomatosis of low malignant potential had all of the patterns seen in superficial ("noninvasive") peritoneal implants of ovarian serous borderline tumors. Psammoma bodies were a prominent feature of all cases. Twelve patients also had typical endosalpingiosis. Most patients were treated by hysterectomy and bilateral salpingo-oophorectomy. Surgical treatment in seven patients consisted only of biopsy. Ten patients had residual unresected disease at the time of their initial operation. Several patients received adjuvant chemotherapy. Follow-up was available for 14 of the 17 patients. One patient died of metastatic breast carcinoma at 3.8 years; another patient died 7 weeks after operation, possibly as a complication of therapy. The other 12 patients were alive at last known contact after follow-up intervals of 8 months to 16.2 years (mean, 7.5 years). Two of these 12 patients developed multiple episodes of small-bowel obstruction due to persistent peritoneal serous micropapillomatosis of low malignant potential; neither received adjuvant chemo- or radiotherapy. Both were alive without progressive disease 10.9 and 16.2 years after initial diagnosis, respectively. This excellent prognosis supports a regimen of conservative therapy for these patients.
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PMID:Peritoneal serous micropapillomatosis of low malignant potential (serous borderline tumors of the peritoneum). A clinicopathologic study of 17 cases. 159 25

Congenital cervico-vaginal atresia is a rare malformation; the presence of a functioning endometrium combined with this anomaly causes a retrograde menstruation and then a greater likelihood of endometriosis. Up to the present literature relates only thirteen cases in which congenital cervico-vaginal atresia was combined with a functioning endometrium. Primary amenorrhea and cyclic, cramping lower abdominal pain was the common symptoms of all the patients. In this work we report a new case of such pathology in a 23 old woman affected also by harmonic nanism. After the review of the literature the embryologic mechanisms involved in lower Mullerian tract malformations, the surgical treatment and the mechanism of formation of endometriosis in association with an outflow tract obstruction are discussed.
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PMID:[Congenital cervico-vaginal atresia and pelvic endometriosis. Clinical case and review of the literature]. 162 41

We report an extremely high serum CA125 value of 1243 units/mL in a 21-year-old-patient with Crohn's disease who developed endometriosis. Such a high CA125 value has not been reported to date in endometriosis or other pathologies except ovarian carcinoma. The pelvic mass of unknown nature in the above patient was discovered by ultrasound during a sudden onset of severe abdominal pain which subsided within two days. The high CA125 value six days after the onset of pain and at the end of menses declined spontaneously to 100 units/mL in 15 to 30 days, and stabilized over the three months prior to colectomy and removal of the left ovarian endometrioma, after which it gradually declined to 7 to 11 units/mL as found a year earlier. Although primary cells from endometrioma produced 113 units/mL of CA125 in the culture medium, the cell line established from it gave a value of less than 7 units/mL even after treatment with interferons. The adherent cells were moderately positive for CA125, cytokeratin and non-specific esterase, were strongly positive for periodic acid Schiff's (PAS) and acid phosphatase, and had epithelioid morphology. In addition to the extremely high CA125 level in our endometriosis patient and the establishment of the cell line, the case illustrates the usefulness of CA125 estimation in helping to determine the nature of abdominal masses in female inflammatory bowel disease patients.
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PMID:An extremely elevated serum CA125 level in a Crohn's patient developing endometriosis and the establishment of a cell line (MD-E) from the endometrioma. 177 Mar 21

A group of 1542 premenopausal Caucasian women were assessed prospectively to investigate the prevalence of endometriosis. The women either underwent laparoscopy because of infertility (n=654), because of laparoscopic sterilization (n=598), because of chronic abdominal and pelvic pain (n=156), or underwent abdominal hysterectomy for dysfunctional uterine bleeding (n=134). Endometriosis was seen more frequently among women being investigated for infertility (21%) than among those undergoing sterilization (6%). For those experiencing chronic abdominal pain, the incidence of endometriosis was 15%, while among those undergoing abdominal hysterectomy it was 25%. In all groups, the total duration of combined pill usage was significantly higher in those who had normal pelvis compared with those with endometriosis. It is suggested that among susceptible women, both fertile and infertile, a prolonged period of regular spontaneous menstruation may play a causative role in the etiology of endometriosis.
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PMID:Prevalence and genesis of endometriosis. 191 5


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