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

Only three cases of adenocarcinoma of the fallopian tube in an adolescent have been reported previously in the literature, and we report the fourth such case. The main presenting symptom in those patients was lower abdominal pain. Type of therapy and outcome of these four cases is reviewed. The small number of patients precludes definitive conclusion on optimal therapy. For this reason, we urge continued reporting of cases to insure the formation of concrete therapeutic recommendations.
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PMID:Primary carcinoma of the fallopian tube in an adolescent. 377 39

This report presents a case of pelvic actinomycotic infection that was accurately diagnosed preoperatively by means of fine needle aspiration. The patient was a 40-year-old black female, gravida 6, para 6, who presented to the emergency room complaining of intermittent, crampy lower abdominal pain of approximately 1 month's duration. She also complained of a recent onset of urinary frequency and urgency without dysuria as well as a change in bowel habits, with recent constipation. Review of the patient's medical history was notable for the placement of a Dalkon Shield IUD 10 years before without subsequent removal, a history of irregular menses in the past year, and treatment for gonorrhea 10 years previously. The patient's last menstrual period was 2 weeks prior to admission. She denied fever and night sweats but had lost 20 pounds in the past 2-3 months. Vital signs were normal. Pelvic examination revealed a firm, fixed uterus, approximately the size of a 14-week pregnancy, and an associated mass extending to the left and inferiorly into the rectovaginal septum. An intravenous pyelogram showed left hydronephrosis and hydroureter, with compression of the ureter at the level of the sacrum. Sigmoidoscopy revealed extrinsic compression of the rectum at 12 cm, the some mucosal edema. A CT scan of the pelvis disclosed an 8 cm mass in continuity with the uterus extending into the lower pelvis, with possible focal erosion of the sacrum. The clinical impression was advanced cervical carcinoma. Transvaginal fine needle aspiration was performed using a 21-gauge spinal needle and a Franzen needle guide. Following a diagnosis of actinomycotic abscess, the patient was placed on tetracycline, due to her penicillin allergy, and taken to surgery. The abdomen was opened and revealed a slightly enlarged uterus. The uterus and cervix were adherent to the left pelvic wall and posteriorly to the rectum by firm, friable tissue. The left fallopian tube and ovary were adherent to this . With some difficulty the uterus was freed, and a total hysterectomy and bilateral salpingo-oophorectomy were performed. The postoperative course was unremarkable, and the patient was discharged on tetracycline. A morphologic diagnosis of actinomycotic infection with abscess formation was made. Sections of the left parametrium revealed multiple microabscesses and sinus tracts surrounded by abundant granulation tissue. Some of the abscesses contained actinomycotic organisms. Chronic endometritis and cervicitis as well as acute and chronic left salpingitis were documented.
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PMID:Diagnosis of pelvic actinomycosis by fine needle aspiration. A case report. 620 95

Over a 2-year period, 190 cases of laparoscopic sterilization were undertaken with thermocoagulation and division of the fallopian tubes employing coagulation forceps (Endotherm coagulation unit, Wolf). In 1 case, laparotomy was necessary the day after sterilization because of bleeding into the abdomen from the incision in the abdominal wall. 1 patient developed an intrauterine pregnancy after misidentification between the fallopian tube and the lig. ovarii proprium. Late complications such as menstrual disorders, abdominal pain, and climacterial symptoms occurred to the same extent as with other methods. Refertilization using a microsurgical technique was carried out successfully in 2 cases. (author's)
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PMID:[Laparoscopic sterilization with thermocoagulation]. 621 Sep 85

This article examines causal factors of ectopic pregnancy, discusses management with emphasis on tubal conservation, and updates information on diagnosis, fertility maximization, and minimization of risks of recurrent ectopic gestations. The common factor in ectopic gestations appears to be a delay in the transport of the fertilized ovum to the uterus, allowing the embryo to develop invasive trophoblast. Factors that appear to have increased the incidence of ectopic pregnancy over the past include increased sexual exposure, more effective theraphy for pelvic inflammatory disease, IUDs, tubal surgery, and surgical sterilization reversals. 77% of extrauterine gestations occur in the middle and distal thirds of the fallopian tube, with clinical manifestations largely determined by the site of implantation. Abdominal pain, amenorrhea/vaginal bleeding, and a pelvic mass are the classic signs of an ectopic pregnancy. Newer diagnostic procedures including serum human chorionic gonadotropin-beta subunit assay pregnancy testing supported by ultrasonography and laparoscopy have allowed the vast majority of tubal pregnancies to be diagnoses before rupture, permitting surgery to be undertaken more for the purpose of preserving fertility than for saving the mother's life. Factors in selecting candidates for conservative surgery include medical stability of the patient, parity, desire for future pregnancy, age under 35, mid or distal tubal gestation, prior ectopic gestation or tubal surgery. Considerations influencing the surgical approach for appropriate candidates include location of the pregnancy, condition of the involved and contralateral tube and ovary, pelvic anomalies, previous surgery, and need for ancillary procedures. If the ectopic gestation is located in the mid to distal segment of the fallopian tube, a segmental resection or salpingostomy using microsurgery should give a good anatomic and functional result. A review of the literature indicates that, contrary to prevailing opinion, recurrent etopic gestations are not more common in patients undergoing tubal conservation than in those undergoing more radical procedures. Recent data have shown term pregnancy rates of 40-55% and recurrent ectopic pregnancy rates of 5% in patients with conservative procedures, the improved rate being attributed to availability of microsurgical techniques, finer suture and minimal surgical trauma, which lead to less adhesions and scarring. tudies have indicated that use of Dextran minimizes pelvic adhesion formation, decreasing anatomic distortion leading to subsquent infertility or ectopic pregnancy.
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PMID:Tubal conservation with ectopic gestations. A reappraisal. 623 72

2 case reports, thought to be the first of their kind, describe an uncommon complication of hysterectomy, prolapsed fallopian tubes, and an even more unusual surgical remedy for the condition, laparoscopy. Case 1 was a 26-year-old female, gravida 3, para 2, who presented with extreme abdominal pain and dyspareunia lasting for several months. 4 years previously she had a complicated therapeutic abortion and sterilization, which led to a total hysterectomy. 8 months postoperatively she complained of abdominal pain, and biospy revealed fimbriated fallopian tube. 1 year after that, the patient returned with similar symptoms, and a histologic report of the vaginal apex was fallopian tube. 2 years later, on physical examination, a 2-cm bright red polypoid mass was visualized at the right side of th vaginal apex, and it was extremely tender. The patient was admitted to the hospital, and a diagnostic laparoscopy under general anesthesia was performed. The prolapsed fallopian tube was seen, and it was excised from the vaginal vault and returned to the peritoneal cavity during the diagnostic procedure. The operation took 40 minutes with minimal blood loss. Postoperatively the patient reports relief of abdominal pain and absence of dyspareunia. Case 2, a 44-year-old woman, complained of lower abdominal pain 4 weeks after a hysterectomy. Again, visual examination showed a bright red polypoid mass which was tender to touch. Because of the success of Case 1, a diagnositic laparoscopy was done, and, using the same techniques as Case 1, the patient had her prolapsed tube returned to the peritoneal cavity. 3 months postoperatively, Case 2 has no complaints.
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PMID:Laparoscopic repair of the prolapsed fallopian tube. 644 94

A case of torsion of the pregnant fallopian tube is presented. Although uncommon, this entity should be considered in the differential diagnosis of abdominal pain in a young female patient. Early surgical intervention is recommended in order to salvage the affected tube by microsurgical techniques.
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PMID:Case report. Torsion of pregnant fallopian tube--a rare case. 651 45

Seventy-one cases of primary adenocarcinoma of the fallopian tube treated at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston were reviewed. The most common presenting symptoms were abdominal pain, abnormal uterine bleeding, and vaginal discharge. The most common physical finding was a palpable abdominal or pelvic mass. The preoperative diagnosis was correct for two patients. Initial therapy consisted of surgery alone, surgery plus radiation therapy, surgery plus chemotherapy, and a combination of surgery, chemotherapy, and radiation therapy in 10, 32, 21, and eight cases, respectively. The median survival for patients in these treatment groups was 33, 22, 27, and 22 months, respectively; the median survival for all patients was 23 months. No statistically significant differences emerged among the survival curves of patients treated with each of the above regimens.
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PMID:Fallopian tube carcinoma. 654 28

Inflammatory pelvic disease secondary to infection with Enterobius vermicularis is rare in that pinworms are usually asymptomatic inhabitants of the terminal small bowel and cecum. When these parasites do cause symptoms, however, there is a spectrum of gastrointestinal and genitourinary complaints. A case is presented of a woman with bilateral abdominal pain that was found to be due to a combination of parasitic and bacterial (Bacteroides fragilis) infection. The parasitic fallopian tube infection may have predisposed the fallopian tubes to a microbial tuboovarian abscess.
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PMID:Bilateral enterobius vermicularis salpingo-oophoritis. 684 94

A case is described wherein a 27 year old woman with a breast lump and an IUD in situ for 12 months complained of a prolonged menstrual period which the physician suggested was caused by the IUD. A dilatation and curettage was performed to remove the IUD and the woman then experienced severe lower abdominal pain. A laparoscopy showed an ectopic pregnancy of 6 weeks in the left fallopian tube; salpingectomy was performed. The author suggests caution in diagnosing a patient with these symptoms for the following reasons: 1) women of childbearing age with lower abdominal pain and unusual menstrual bleeding, even if they have been sterilized, can have an ectopic pregnancy; 2) the absence of amenorrhea can be a trap in failing to disguise pregnancy; 3) ectopic pregnancy should be suspected in a patient with vaginal bleeding, an enlarged uterus, and an IUD, especially if there is pain; and 4) performing a dilatation and curettage does not necessarily mean that the problem has been dealt with.
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PMID:IUDs and IOUs. 711 16

The radiographic appearance of ring-like densities in the true pelvis, when associated with pain, may suggest the presence of ureteral calculi or phleboliths, leading to either misdiagnosis or oversight by the physician who is unfamiliar with the appearance of fallopian tube occlusion rings. Tubal ligation of any type may be associated with intermittent lower abdominal pain. The recognition of fallopian tube occlusion rings may result in an accurate diagnosis of the cause of pelvic pain. 2 figures illustrate the appearance of the rings. Silicone rubber rings may be placed over a knuckle of the midfallopian tube as a highly reliable sterilization technique. The rings themselves are composed of barium sulfate-impregnated dimethypolysiloxane, an inert siliconized synthetic rubber. They have an outside diameter of 3.6 mm, an inner diameter of 1.0 mm, and are 2.2 mm thick. Foreshortening, obliquity, and film magnification may result in minor variations in dimensions. A review of more than 4000 procedures during the early experience with occlusion ring sterilization, the number of pregnancies was less than 1 in 600. The pregnancies usually occurred because conception occurred before the procedure or because of misplacement of the rings. Lower abdominal pain and bleeding continue as the most serious postoperative complications. Within the true pelvis the fallopian tube occlusion rings may lie close to the course of the pelvic ureters, simulating ureteral calculi. Ureteral calculi rarely have central lucencies. When seen at an angle or on end no central lucency may be visible. The rings may be overlooked amidst pelvic phleboliths. Arterial calcifications are curvilinear yet usually form an incomplete circle, and they rarely appear as sharply marginated as fallopian tube occlusion rings.
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PMID:Fallopian tube occlusion rings: a consideration in the differential diagnosis of ureteral calculi. 712 95


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