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

While endometriosis is a commonly encountered surgical problem, involvement of the gastrointestinal tract is infrequent and appendiceal involvement rate. Intussusception of the appendix is more frequent. Accordingly, the concurrence of appendiceal endometriosis and intussusception is remarkable. We treated two such patients. The clinical presentation of these patients is varied, with most having abdominal pain, nausea and diarrhea. Asymptomatic cases may be found at surgery for unrelated problems. Correct diagnosis preoperatively is uncommon and most likely when the patients also have a palpable mass.
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PMID:Endometriosis associated with appendiceal intussusception. A report of two cases. 648 17

Endometriosis involving the intestine usually takes the form of asymptomatic, small, superficial serosal implants on segments of bowel lying in the pelvis in proximity to the genital organs. Deeper and more extensive intestinal wall involvement may result in obstruction and occasionally bleeding and requires distinction from a neoplasm or other inflammatory bowel process. Intestinal endometriosis should be considered in the differential diagnosis of recurring lower abdominal pain and other episodic bowel symptoms in women of child-bearing age. The diagnosis may be suspected based on the patient's history and frequently associated gynecologic symptoms. Due to the extramucosal location of the endometrioma, preoperative evaluation is unlikely to establish the diagnosis with certainty. Intestinal involvement by endometriosis, to the degree that it produces symptoms, almost always requires excision. Asymptomatic serosal lesions found incidentally at celiotomy for other disease should be biopsied and the diagnosis confirmed by frozen section. Symptomatic disease should be treated by resection of the involved intestine or by local excision, if the latter is feasible, and primary colon carcinoma can be excluded with confidence. Decisions regarding concurrent treatment for the underlying endometriosis should be made after consultation with an experienced gynecologist and must be based on the patient's menstrual status, age, and desire for future pregnancy.
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PMID:Intestinal endometriosis. 649 59

Recurrent abdominal pain in women during the ovulatory years as well as during the climacteric period may be due to the intestinal form of endometriosis. Rectal discharge of blood and correlation with the menstrual cycle are not common. The clinical symptoms are, depending on the affected parts of the intestines, not typical and radiologic investigation is only warranted to exclude intestinal cancer. The treatment of choice for intestinal endometriosis, in spite of the great success of antigonadotropic therapy, should be surgical resection, a view borne out by the authors' cases. Antigonadotropic therapy is a great success in the case of multiple intestinal localizations, but the secondary, fibromatous-reactive lesions cannot be treated by hormones and may become symptomatic at any time.
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PMID:[Intestinal endometriosis]. 665 34

A total of 212 patients coming for removal of the uterus due to a benign condition were interviewed by the first author before operation. Of these patients 28 had adenomyosis, while 157 had neither adenomyosis nor external endometriosis; these two groups were compared with respect to duration of menstrual bleeding, dysmenorrhea, dyspareunia, urinary symptoms and sacral and lower abdominal pain. There were no inter-group differences in the frequencies of these symptoms. It is concluded that although patients with adenomyosis have many symptoms, none specific to adenomyosis can be found.
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PMID:Non-specificity of symptoms related to adenomyosis. A prospective comparative survey. 673 Sep 38

13 hospitals in the Guangdong province fitted 4321 women with a flower design IUD fabricated of high pressure polyethylene impregnated with 30% barium sulfate. The upper part of the device has 3 laterally flexible petals that overlap to adapt to the shape and size of the uterus. The lower part is narrow, where the petals are bound. Insertion can be done by paramedical personnel. An inserter is used. Expulsion rate in this series was 5.9%; 30% were expelled during menstruation and 48.2% were expelled during the first year. 125 of 4321 users became pregnant (2.9% rate). Most cases were pregnancies with device in situ. Most removals were necessitated by bleeding, pain, or leukorrhea. Removal rate was 7.5%. Severe symptoms which appear right after insertion tended to dissipate with time. Side effects noted were profuse menstrual bleeding, backache, abdominal pain, and increased leukorrhea. Change in uterine bleeding pattern was the most frequent complaint. 338 endometrial specimens were obtained for morphological examination, and changes were slight; only 3 cases showed signs of endometriosis. 209 of 221 IUDs examined after 3-9 years of use were still in good shape. 12 were cracked.
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PMID:Flower intrauterine contraceptive device. 677 3

A 40-year-old woman with a five-month history of intermittent abdominal pain in the right lower quadrant, diarrhea, and signs of small bowel obstruction was thought to have Crohn's disease of the terminal ileum. At operation, endometriosis of the terminal ileum was found and treated by resection. Enteric endometriosis is a rare cause of small bowel obstruction and the correct diagnosis is usually made at surgery.
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PMID:Invasive endometriosis of the terminal ileum: a cause of small bowel obstruction of obscure origin. 682 6

In a large, double-blind, multicentre study, 269 patients with confirmed endometriosis were randomly allocated to receive either danazol (200 mg twice daily; n = 137) or gestrinone (2.5 mg twice weekly; n = 132) for 6 months. The two groups were comparable in terms of the staging of endometriosis by the American Fertility Society (1979) score. After the sixth month of treatment, repeat laparoscopy was performed. Clinical assessment, haematological and biochemical investigations were carried out during the 6 months of treatment and for a further 12 months' follow-up and are compared between the two groups. A total of 15 patients from the gestrinone group, including four patients with hirsutism, and 17 patients from the danazol group, including six patients with headache, withdrew because of adverse symptoms. An additional 22 patients, including 10 from the gestrinone group and 12 from the danazol group withdrew because of lack of efficacy, pregnancy, elevated hepatic function tests or for reasons unrelated to the trial. Total American Fertility Society scoring showed an improvement of 73.3% in 101 patients receiving gestrinone and 72.7% in 99 patients receiving danazol. The results showed a significant reduction in the severity of dysmenorrhoea by the third month in the danazol group and at 6 months in both groups. There was a significant (P < 0.001) increase in weight observed in both groups during treatment. Overall, the tolerability of danazol and gestrinone was good; however, significantly more patients with gestrinone complained of hirsutism while significantly more with danazol complained of leg cramps. During the 12 months of follow-up, mild, moderate or severe degrees of lower abdominal pain, dysmenorrhoea and deep dyspareunia all fluctuated, with no statistically significant increase in frequency in either group.
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PMID:Updating the clinical experience in endometriosis--the European perspective. 757 49

The study was undertaken to identify the presenting features of intestinal endometriosis and to evaluate its investigation and surgical management. Twenty-six cases of intestinal endometriosis were identified during a fourteen year period. The commonest site of occurrence was the rectosigmoid region (11 cases) followed by the appendix (9 cases), and ileocaecal region (6 cases). Abdominal pain was the main presenting feature in 20 cases, with associated nausea and vomiting in 12 cases and altered bowel habit in ten. Other presenting features included rectal bleeding, abdominal bloating and tenesmus. Endometriosis was not suspected preoperatively in any of the patients without a past history of this condition. Accurate preoperative diagnosis proved very difficult, with only laparoscopy providing definite evidence of intestinal endometriosis prior to formal surgery. Colonic resections were performed in 12 cases, small bowel resection in six cases and appendicectomy in nine cases, together with resection of adjacent adherent structures. This series illustrates the difficulty of establishing an accurate preoperative diagnosis, and the propensity of intestinal endometriosis to mimic other gastrointestinal diseases, particularly carcinoma and inflammatory bowel disease.
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PMID:Intestinal endometriosis: presentation, investigation, and surgical management. 763 78

A 68-year-old woman presented a one-month history of lower abdominal pain and weight loss, and was admitted to our hospital. On physical examination, a large hard mass was palpated in her right lower abdomen. An ultrasonograph and computed tomographic (CT) scan revealed a right ovarian tumor that measured 6.9 x 4.9 cm in size. A total hysterectomy and bilateral salpingo-oophorectomy were performed. The postoperative diagnosis of the tumor was squamous cell carcinoma (SCC) of the ovary. She died of infection and disseminated intravascular coagulation 5 months after surgery. The clinical and autopsy examinations did not show the primary lesions of SCC except in the right ovary. Mature cystic teratoma, Brenner tumor and endometriosis, which are ordinary regarded as the histogenesis of ovarian SCC, were not found, but a few surface epithelial inclusion cysts with squamous metaplasia were observed in non-cancerous area of the right ovary, and the contiguous transition from the metaplastic cyst wall to SCC was confirmed by stepwise serial sections. The present case suggests that the surface epithelium of ovary could be the fourth possibility in the histogenesis of the ovarian SCC.
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PMID:Squamous cell carcinoma of the ovary--a case report. 770 49

The report is given about 154 patients, who were operated because of chronic abdominal pain in the lower abdomen 27 (17.5%), suspicion of adhesion 43 (27.9%), of an adnexal tumor 56 (33.8%), of endometriosis 5 (3.2%), sterility 11 (10%), or irreversible contraception 16 (7.2%). 112 patients had to be laparotomized once or several times. 105 women had only adhesion; adhesion and an adnexal tumor were found in 27 patients, 22 women had adhesion and endometriosis. Predominant were adhesions of second graduation, 72 women had these adhesions, nine of 105 patients had adhesions of first graduation, adhesions of third graduation had 24 patients. In the last group there was the greatest number of laparotomies. 95 patients answered the questionnaires six months later. 35 (36.8%) were free from pain, 13 (13.8%) stated a clear improvement, 38 (40%) were temporarily free from pain, and 9 (8.2%) stated unchanged pain. One woman complained postoperatively about clear aggravation of pain.
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PMID:[Chronic recurrent abdominal pain--significance and success of laparoscopic/pelviscopic adhesiolysis]. 770 76


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