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

Although an infrequent cause of acute lower abdominal pain, fallopian tube torsion should be considered whenever a woman presents with this complaint. Early diagnosis and surgical intervention may save a tube that has not yet infarcted, yet initial presentation may give little indication of the seriousness of the condition until peritonitis develops. Definitive treatment is removal of the affected adnexa. Diminished fertility and an increased incidence of ectopic pregnancy in the remaining fallopian tube follows unilateral salpingectomy. A case history of fallopian tube torsion is presented.
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PMID:Torsion of the fallopian tube. 4 97

Within a 1 year period, 3 patients presenting to the University of Chicago, Chicago Lying-In Hospital with a complaint of lower abdominal pain were diagnosed at laparotomy to have ovarian pregnancies according to the criteria of Spiegelberg. All of the patients were at the time using the Copper 7 IUD for contraception. There are now 50 known cases of ovarian pregnancies in patients using the IUD. The characteristics of these patients do not differ markedly from those previously reported in studies of tubal pregnancies, with and without the IUD, but the presentation of patients tends to be more variable than in tubal pregnancies. 2 factors appear consistently in the studies on IUD-associated pregnancy. 95.3% of the patients presented with abdominal pain and 87% of the patients had positive pregnancy tests. The latter factor may indicate that the ovary may be better able to incorporate trophoblastic tissue than the fallopian tube. The increasing incidence noted here, in a population already known to be particularly prone to pelvic inflammatory disease and therefore ectopic pregnancies in general, lends further credence to a questioning of the desirability of the IUD in such a population.
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PMID:The intrauterine device and ovarian pregnancy. 45 28

A 32-year-old gravida 4, para 4, was seen at the University of Wisconsin Hospital in 1976 requesting reversal of her tubal sterilization. She had undergone a colpotomy with removal of 1.8 cm of each Fallopian Tube (confirmed histologically) in 1970. A laparotomy in 1975, for abdominal pain, resulted in the removal of a hemorrhagic ovarian cyst, but the pathology report did not mention the distal 1.8 cm of the right Fallopian Tube as being part of the surgical specimen. A short time later, 3 of the patient's children died in a house fire. At laparoscopy, the right tube was unencumbered, measuring 6 cm from the cornu to its blunt end. On the left, a short (less than 5 mm) segment of the tube at the cornu and a normal fimbrial segment were visualized. The intervening portion of the tube was absent. Laparotomy was undertaken with the intent of performing a left cornual-ampullary anastomosis, but, when the cornual segment was shaved, a definitive lumen could not be identified. Anastomosis of the left fimbrial segment to the right proximal fallopian tube as a pedicle graft was performed without the aid of magnification. Five 6-0 Dexon sutures were placed in a through-and-through manner involving secrosa, muscularis, and mucosa. A final 4-0 silk suture brought the two mesosalpinges together at the base of the tube. The patient was treated with dexamethasone and phenergan. 18 months following surgery, the patient conceived. A 9-month pregnancy ended in spontaneous labor and the vaginal delivery of a healthy infant.
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PMID:Tubal anastomosis of a fimbrial segment pedicle graft. 48 39

Carcinoma of the fallopian tube is the least frequent tumor of the female genital tract. It may occur at any age but is more common in the sixth decade. The tumor involves both tubes in 26 per cent of cases. The spread is by direct extension to peritoneum. The symptoms include metrorrhagia, leukorrhea, abdominal pain, singly or in combination. The diagnosis is difficult but could be made more frequently if the causes of abnormal bleeding were thoroughly investigated by means of cytology and endometrial curettage. Treatment is by resection of the tumor, total hysterectomy, and bilateral salpingo-oophorectomy followed by chemotherapy. The 5-year survival rate is 38 per cent.
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PMID:Carcinoma of the fallopian tube. 64 22

Tubal sterilization via laparoscopy and cautery has two distinct disadvantages: 1) the possibility for damaging organs other than the fallopian tubes exists; and 2) the process destroys too much of the tube to make successful reconstruction likely. The Fallope ring overcomes both these difficulties. It is a small silicone band which is placed on a 3cm knuckle of the fallopian tube. The tube is grasped by an attachment of the laparoscope, a knuckle is formed, and the ring is dropped onto the tube by another laparoscopic attachment. The operation is simple, may be performed on an out-patient basis, and can be done under local anesthesia. The author has performed 902 such sterilizations in the years 1973-1975, and 7 women have become pregnant. Only 1 pregnancy was due to method failure. The other women were unknowingly pregnant at the time of the sterilization. The complications encountered were: transection of the tubes (2.5%), abdominal pain (3.9%), free ring in the abdomen (0.9%), application of the Fallope ring to the intestine (0.2%), infection (0.2%), and hematoma of the mesosalpinx (0.2%).
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PMID:[Two-year experience with sterilization using the Falopian ring]. 66 89

A simple, safe, economical and potentially reversible technique for female sterilization via minilaparotomy is evaluated in 204 patients (not recently pregnant and postpartum). Only light general anesthesia is required, and the procedure is performed with only equipment normally available in any hospital or outpatient clinic. A 2cm circumumbilical or suprapubic incision is made, and the physician manipulates the uterus to bring the fallopian tube in line with the incision. As the cornu passes the incision, the release of intraabdominal pressure at the site of the wound usually pushes the tube out of the peritoneal cavity. A majority of the procedures were performed in less than five minutes. No surgical difficulties were encountered, and no immediate complications or complaints were reported. Patients were usually hospitalized for one or two nights. Early postoperative complications or complaints were reported for 8.4% of the not-recently-pregnant patients and for 4.1% of the postpartum patients at the 7-to-21-day follow-up visit. The most frequently reported complications and complaints were fever and lower abdominal pain. Further studies to determine the effectiveness of this type of sterilization and whether the procedure can be performed safely with local anesthetics and on an outpatient basis are being planned.
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PMID:Female sterilization via minilaparotomy. 95 61

A prospective study was performed with 25 patients with ectopic pregnancies (EPs) who underwent treatment with transvaginal administration of methotrexate. Nineteen patients (76%) had positive responses to this treatment, and six (24%) had to undergo surgery: five because of increasing abdominal pain and one because of vaginal bleeding. The ultrasonographic (US) resolution of the EP was long and lagged behind the resolution at testing of levels of beta subunit of human chorionic gonadotropin (beta-hCG) in all patients. The fallopian tube in 12 (63%) of the responding group initially increased in diameter from a mean of 2.22 cm to a mean of 3.84 cm. In 13 (68%) of the responding group, it became more vascular at color Doppler examination. Eleven (92%) of the 12 EPs that increased in size also became more vascular. The increase in tubal size and vascularity, in spite of the falling beta-hCG level, represents a healing process and should cause no concern about the follow-up of these patients.
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PMID:Ectopic pregnancy: evolution after treatment with transvaginal methotrexate. 127 40

A 30-year old primigravida with a history of drug addiction came to the Rigshospitalet in Copenhagen, Denmark for prenatal care at 15 weeks gestation. Physicians did an amniocentesis because of family history of trisomy 21. Ultrasound examinations in the 17th and 18th weeks of gestation indicated a living fetus with the placenta on the right lateral wall of the uterus, but there was an insufficient amount of amniotic fluid. Maternal alpha fetoprotein serum levels were extremely high (298 kIU/L). Physicians predicted a poor fetal prognosis and advised the woman to undergo an abortion. On the first day, they inserted 4 vaginal pessaries of 1 mg gemeprost and administered 25-30 mg bupivacain through an epidural catheter to control abdominal pain. 8 hours after first insertion, they began intravenous (IV) administration of oxytocin. Her cervix remain closed and uterine tension did not increase. 2 hours after beginning the oxytocin IV, she suffered from an abrupt severe abdominal pain which was transferred to the right shoulder. Heart rate and blood pressure remained normal. 4 hours later, her body temperature rose, so she received 500 m pivampicillin 3 times/day. She experienced no vaginal bleeding and no uterine contractions. Her cervix had still no opened. On the third day, health workers inserted 5 more pessaries. On the fourth day, they administered 75 ml isotonic saline/hour transcervically, but she still did not abort. Her temperature vacillated even though she received antibiotics and the pain continued despite epidural analgesics. On day 5, health workers administered 3.75 mcg prostaglandin F2 alpha/minute transcervically. After 6 hours of no progress, they performed a laparotomy and observed a macerated, malodorous fetus in the peritoneal cavity which continued 1200 ml of blood. The medial part of the left fallopian tube an the left uterine corner had ruptured. They removed the fetus via wedge resection; it had no malformations. Physicians should consider ectopic pregnancy when attempts at induced abortion do not succeed.
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PMID:Misdiagnosis of interstitial pregnancy followed by uterine cornual rupture during induced midtrimester abortion. 132 30

The first reported case in Thailand of pelvic actinomycosis during pregnancy is presented. It occurred in a 38-year-old Thai female with a history of IUD wearing for 2 years until the symptoms of intermittent lower abdominal pain. She had a history of postcoital bleeding at 16 weeks' pregnancy and bleeding per vagina during labor at 40 weeks' pregnancy. Speculum examination showed an irregular, friable, easily bleeding mass (3-4 cm in diameter). The specimens of the mass at the posterior fornix were obtained for culture and pathological examination. Right tubo-ovarian complex measured 10 x 4 x 4 centimeters in diameter, extending through the cul-de-sac to the vaginal canal at the posterior fornix, was identified during exploratory laparotomy. Low transverse cesarean section was performed. The pathological diagnosis was actinomycosis of right fallopian tube and ovary. The patient was treated with tetracycline.
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PMID:Pelvic actinomycosis in pregnancy: a case report and review of the literature. 160 66

Chlamydia trachomatis is a well-known cause of acute and chronic salpingitis, accounting for approximately half of all cases of pelvic inflammatory disease. Typically, patients with acute chlamydial salpingitis present with acute lower abdominal pain, tenderness on bimanual pelvic examination, or vaginal discharge. We describe a case of acute chlamydial salpingitis with marked ascites and an adnexal mass that simulated a malignant neoplasm. Microscopically, a severe lymphofollicular salpingitis and a marked lymphofollicular hyperplasia of the omentum and retroperitoneal lymph nodes were found. Chlamydial inclusions in the fallopian tube epithelium were demonstrated by immunohistochemistry using a mouse monoclonal antibody to a genus-specific outer membrane lipoprotein. Chlamydial infection may cause marked ascites and a palpable adenexal mass and should be considered whenever marked chronic inflammation with a lymphofollicular hyperplasia involves the fallopian tube or other female genital tract sites.
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PMID:Acute chlamydial salpingitis with ascites and adnexal mass simulating a malignant neoplasm. 177 10


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