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

Pelvic endometriosis affects 5 to 10% of all menstruating women, and of these 3% to 34% have intestinal involvement. Commonly, intestinal endometrial lesion affects only the serosa. Although the invading endometrial tissue may extend into the intestinal wall, it does not usually reach the mucosa. The majority of the patients are asymptomatic. The most common symptom is lower recurrent abdominal pain. It has been estimated that 0,9% of women with intestinal endometriosis have obstructive symptoms. Occasionally deeper and more extensive intestinal wall involvement results in cyclic menstrual rectal bleeding. The authors describe a case with obstructive symptoms associated to rectal bleeding. This is an uncommon finding. Histological confirmation of deep muscular and mucosal involvement was obtained. This case led us to some considerations about the diagnostic difficulties and therapeutic possibilities in the present.
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PMID:[Intestinal endometriosis]. 871 9

Acute abdominal pain is a frequent diagnostic and therapeutic challenge in hematologic patients. We report on the very rare case of organ endometriosis with acute abdominal symptoms in a 43-year-old female patient with AML-M5, starting 4 days after induction chemotherapy with idarubicin, ara-C, and etoposide. The patient presented with an acute abdomen with clinical findings of acute cholecystitis, subileus, and local pain in the right upper abdomen accompanied by severe diarrhea. Probably due to impaired intestinal resorption, menstrual bleeding occurred despite regular administration of lynestrenol. Ultrasound examination of the abdomen disclosed a tumor with poor echoes in the pouch of Douglas, a subcapsular splenic hemorrhage, and a thickened gallbladder wall with surrounding edema. A cystic adnex tumor was confirmed by endovaginal ultrasound. Based on history and the findings on ultrasound, an endometriosis was diagnosed, and the LHRH agonist (nafarelin) was administered nasally in combination with lynestrenol. Following this medication the abdominal pain ceased, supporting the diagnosis of endometriosis. Nasal administration of an LHRH agonist in the following cycles of chemotherapy was effective in preventing further abdominal discomfort and vaginal bleeding. LHRH agonists should be given to patients with known endometriosis before starting myeloablative chemotherapy to prevent painful hemorrhage from endometriosis.
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PMID:Acute abdomen due to endometriosis as a diagnostic and therapeutic challenge in the treatment of acute myelocytic leukemia. 903 12

A 44-year-old woman presented with right lower quadrant abdominal pain of three months' duration and history of previous Cesarean section and abdominal hysterectomy. Pelvic examination and vaginal sonography revealed a large unilocular mass. Laparoscopy findings included a fixed, large endometrioma severely attached to the pelvic peritoneum and intestines in the pelvic cavity, and significant adhesions in the upper part of the prior midline abdominal hysterectomy incision. Two days after laparoscopic bilateral adnexectomy, she was readmitted with small-bowel obstruction and underwent prompt adhesiolysis via laparotomy. Thirty-nine days later, she presented with massive urinary ascites. Evaluation revealed right ureteral stricture at the uterine artery level and complete ligation and resection of the left ureter at the pelvic brim near the infundibulopelvic ligament stump. Left ureteral reimplantation with psoas hitch and right ureterolysis were performed. We conclude that, in cases of severe endometriosis with significant ureteral and intestinal involvement, laparotomy should be considered.
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PMID:Intestinal Obstruction and Bilateral Ureteral Injuries After Laparoscopic Oophorectomy in a Patient with Severe Endometriosis and a Large Endometrioma 907 48

A retrospective study evaluated the feasibility and safety of operative gynecologic procedures performed in an ambulatory surgical center. Between July 1993 and December 1995, 5766 women (mean age 36.9 yrs, range 13-95 yrs) who were referred to our center underwent surgery. The most common preoperative diagnoses were dysfunctional bleeding, missed abortion, postmenopausal bleeding, cervical dysplasia, mullerian duct malformation, infertility, endometriosis, adhesions, desire for sterilization, adnexal mass, lower abdominal pain, ectopic pregnancy, and fibroids. A total of 2351 laparoscopies, 2 laparotomies, and 3415 vaginal procedures were performed. The most common procedures were dilatation and curettage, 1455; hysteroscopy, 1051; adnexal surgery, 810; tubal ligation, 679; abdominal myomectomy, 186; operative hysteroscopy, 145; and cone biopsy, 118. The duration of surgery was 10 to 210 minutes. Most patients (99.51%) were discharged between 2 and 8 hours after surgery. Only 28 (0.49%) had to be admitted to the hospital; 18 women had preoperatively planned admissions and 10 were unexpectedly admitted postoperatively. The intraoperative and postoperative complication rate was 0.50% (29). We believe that ambulatory surgery is safe and efficient with proper patient selection and when the surgeon and the anesthetist have significant expertise.
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PMID:Ambulatory Gynecologic Surgery 907 98

The syndrome of chronic pelvic pain without an obvious pathology has been described as pelvic congestion (Taylor) syndrome. It is frequently associated with continuous bilateral lower abdominal pain and dyspareunia. Pelvic examination reveals tenderness without induration or masses. Although their importance in the pathophysiology of pain is uncertain, prominent enlarged broad ligament veins are observed at laparoscopy. We evaluated the effects of daflon, a venomimetic agent that regulates the circulatory tonus of the venous system, on pelvic pain and investigated the role of enlarged veins in the pathophysiology of Taylor syndrome. Ten women (age 28-35 yrs) with chronic pelvic pain were diagnosed with the syndrome at laparoscopy. They all had prominent broad ligament and ovarian veins without other pathologies such as endometriosis to explain the etiology of pelvic pain. Five women were randomized in a double-blind fashion to receive daflon 500 mg twice/day for 4 months, and five a vitamin pill placebo; they were crossed over for another 4 months. They scored the frequency and severity of lower abdominal pain and dyspareunia on a scale from 0 to 6, and the results were compared with pretreatment values. At the end of the fourth month the frequency and severity of pelvic symptoms began to decrease with daflon compared with pretreatment and placebo. The mean scores were significantly less at the end of 4 months (9.3 &plusmn; 1.1 vs 4.2 &plusmn; 1.4, respectively, p <0.05). Based on our preliminary results, we conclude that venous dysfunction and stasis may be pathophysiologic components of pelvic pain in women with Taylor syndrome. Pharmacologic enhancement of venous tonus may restore pelvic circulation and relieve pelvic symptomatology.
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PMID:The Effects of Daflon on Pelvic Pain in Women with Taylor Syndrome 907 46

A 13-year-old nulligravida girl, 158.5 cm in height and 76.0 kg in body weight, came to our department complaining of continuous right lower abdominal pain. One month earlier, an ovarian cyst in the right ovary, about 3 cm in diameter, was found when she underwent appendectomy at another hospital, but was left untreated. Menarche occurred at the age of 13 years and 1 month, which was after the appendectomy and 24 days before the present operation. Right hematosalpinx with peripheral obstruction and a para-ovarian serous cyst on the same side were diagnosed, and therefore right salpingectomy with para-ovarian cyst resection was performed. The bilateral ovaries and uterus were completely normal by inspection. The post operative histological examination confirmed hematosalpinx and revealed tubal endometriosis.
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PMID:Tubal endometriosis diagnosed within one month after menarche: a case report. 916 54

A 42-year-old pre-menopausal woman complaining of lower abdominal pain was referred to our hospital. A barium enema showed rectal stenosis and colonoscopy revealed that the mucosa at the stenotic site was normal with no cancerous changes. Pelvic computed tomography demonstrated an adhesion between the rectum and uterus and a thickened rectal wall. The patient underwent exploratory laparotomy under a diagnosis of rectal stenosis. The rectum was found to be surrounded by inflammatory fibrous tissue, which caused the stenosis. As no dissection plane was discernible between the rectum and uterus, low anterior resection of the rectum and hysterectomy were performed. Histological examination showed that endometrial-type glands extended circumferentially around the rectum and invaded the rectal submucosal layer and subsequently, endometriosis of the rectum was diagnosed.
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PMID:Endometriosis of the rectum causing bowel obstruction: a case report. 922 76

Endometriosis is rarely found by the general surgeon and sometimes it may seem a surgical disease. Two cases with abdominal pain, requiring surgical treatment, are presented. The first case gave history of dysmenorrhea and dyspareunia, she was admitted with acute abdomen due to acute appendicitis, and laparoscopic appendectomy was performed without complications; she had slight endometriosis at left utero-sacrum ligament and histopathological report showed endometriosis at the appendix. The second patient presented with incomplete obstruction related to ileocecal damage that it was resected with an histopathological report of endometriosis at cecum, ileon and appendix. The patient presented with endometriosis, degree IV, and had medical treatment with gestrinohn, during six months; latter on, HTA+SOB, was done, she received hormonal therapy. Endometriosis may be a cause for acute abdomen in women, and it should be considered in the differential diagnosis.
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PMID:[Intestinal endometriosis as an acute surgical emergency]. 931 16

105 adolescent girls with mean age of 17.3 (11-19) years had laparoscopy/pelviscopy between 1996 and 1997. In 37 cases, endometriosis was diagnosed (35.2%). The majority of the girls (32.4%) presented with endoscopic endometriosis classification (EEC) stage I. 2.8% of the girls had stage EEC II. The lesions involved one site or pelvic organ (64.8%) with a mean age of 18.7 (14-19) years. In 35.2% of cases, the lesions were at multiple sites with a mean age of 16.9 (11-19) years. Indications for laparoscopy included chronic or acute pelvic pain and right-sided lower abdominal pain. Endometriotic lesions were found in the pouch of Douglas (64.8%), uterosacral ligaments (37.8%), and ovarian fossa (24.3%), 42.8% of directed biopsies were positive. Endocoagulation of the endometriotic lesions was performed in 91.9% of cases.
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PMID:Endometriosis diagnosed by laparoscopy in adolescent girls. 954 74

Endometriosis localized in the intestinal wall is not an infrequent finding. Diagnosis is difficult given the diverse symptomatology presented with unspecific abdominal pain being the most common. Implantation of endometrial tissue in the intestinal wall may involve the mucosa and present as rectorhagia, with colonscopic exploration providing diagnosis by biopsy of the affected area. In other cases this may only involve the intestinal wall producing very varied symptomatology. Presentation as a picture of colon obstruction is little reported. The main problem is its difficult differential diagnosis with neoplasm which, in most cases, leads to surgery. A case of colon obstruction provoked by implantation of endometrial tissue in the wall of the sigma which was surgically resolved is herein presented.
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PMID:[Endometriosis: an infrequent cause of colonic obstruction]. 964 75


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