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

Heterotopic pregnancy, defined as the coexistence of an intrauterine pregnancy and an ectopic pregnancy, occurs in approximately 1 in 100 pregnancies conceived by in vitro fertilization (IVF), particularly when multiple embryos are transferred into the uterus. The ectopic gestation of the combined pregnancy usually occurs within the ampulla of the fallopian tube. If it implants within the interstitial portion of the fallopian tube, however, the resulting interstitial pregnancy eventually can rupture through the uterus, leading to sudden, severe hemorrhage and maternal death. This article describes the rupture of an interstitial heterotopic pregnancy in a 37-year-old woman conceiving by IVF after bilateral salpingectomy. The interstitial pregnancy was removed by laparotomy to protect the intrauterine pregnancy from damage. Physicians should consider interstitial ectopic pregnancy as a cause of abdominal pain, even when a viable pregnancy occurs by IVF after salpingectomy.
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PMID:Interstitial heterotopic pregnancy in a woman conceiving by in vitro fertilization after bilateral salpingectomy. 1115 22

Primary carcinoma of the fallopian tube is the rarest cancer of the female genital tract with an incidence of 0.5% of all gynecologic tumors. Since the first report in 1847 about 1,500 cases have been published. Due to similarity of the clinical presentation the staging and therapeutic management have been adapted to that of ovarian cancer. We retrospectively evaluated all the 19 patients who had been diagnosed with primary carcinoma of the fallopian tube at the Department of Obstetrics and Gynecology of the University of Zurich between 1977 and 1998. All lesions were staged according to the rules of FIGO adopted in 1991. At the time of diagnosis the median age was 62 (46-87) years. Twelve (63%) women revealed FIGO stage III-IV, whereas four (21%) and three (16%) patients were diagnosed in stage I and stage II, respectively. Eight (42%) women were nullipara. Histology showed serous-papillary carcinoma, in ten (53%) cases. The 5-year survival rate was 22% for all FIGO stages and 80% for stage I. None of the patients with stage III and IV survived 5 years. Ovarian cancer and primary carcinoma of the fallopian tube are similar in many aspects. Both carcinomas have a similar age distribution, show an increase among nulliparous women, are often of serous papillary histology, have a poor prognosis with stage and residual tumor size as important prognostic factors, and respond initially well to platinum-based chemotherapy. Nevertheless, there appears to be a difference between the two diseases: primary carcinoma of the fallopian tube is more often diagnosed in an earlier stage. This many be due to lower abdominal pain resulting from tubal dilatation and to abnormal bloody-watery discharge.
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PMID:Primary carcinoma of the fallopian tube. A report of 19 cases with literature review. 1121 13

The purpose of this study was to review the experience with fallopian tube carcinoma in Queensland and to compare it with previously published data. Thirty-six patients with primary fallopian tube carcinoma treated at the Queensland Gynaecological Cancer Center from 1988 to 1999 were reviewed in a retrospective clinicopathologic study. All patients had primary surgery and 31/36 received chemotherapy postoperatively. Abnormal vaginal bleeding (15/36) and abdominal pain (14/36) were the most common presenting symptoms at the time of diagnosis. Median follow-up was 70.3 months and the median overall survival was 68.1 months. Surgical stage I disease (P = 0.02) and the absence of residual tumor after operation (P = 0.03) were the only factors associated with improved survival. Twenty of the 36 patients (55%) presented with stage I disease and survival was 62.7% at 5 years. No patient with postoperative residual tumor survived. The majority of the patients with fallopian tube carcinoma present with stage I disease at diagnosis, but their survival probability is low compared with that of other early stage gynecological malignancies. If primary surgical debulking cannot achieve macroscopic tumor clearence, the chance of survival is extremely low.
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PMID:Primary fallopian tube carcinoma: the Queensland experience. 1128 36

The differential diagnosis of abdominal pain in women during their childbearing years is still a challenge. Abdominal pain caused by isolated tubal torsion is extremely rare. In the report, we presented a case of isolated tubal torsion caused by benign serous cystadenoma. A 28-year-old married woman (G0) having lower abdominal pain and nausea was referred to our Emergency Room with suspicion of ovarian mass. Physical examination, transvaginal ultrasound and computed tomography showed a 4-cm right adnexal cystic mass. Other laboratory data were all within normal limits. She was managed by laparoscopic examination due to a lack of improvement in her clinical symptoms and inclusive diagnosis after 48-hours' conservative treatment. Laparoscopy showed isolated torsion of right fallopian tube but the right ovary was normal without torsion. Initially, detorsion was performed but necrotic change of the fallopian tube persisted because of permanent darkened color tube without blood flow redistribution, so salpingectomy was performed 30 minutes later. Final pathology showed benign serous cystadenoma of fallopian tube. The present case is the first case of benign serous cystadenoma with resultant necrotic tubal torsion. We reported this case to emphasize the possible value of early performance of laparoscopy in aiding an accurate diagnosis.
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PMID:Torsion of benign serous cystadenoma of the fallopian tube: a challenge in differential diagnosis of abdominal pain in women during their childbearing years--a case report. 1151 66

BACKGROUND: Isolated twisted fallopian tube is an uncommon event, isolated twisted fallopian tube in pregnancy is also very rare. The diagnosis is often difficult and established during the operation. The right fallopian tube is most common affected. CASE PRESENTATION: We report an uncommon twisted left fallopian tube in pregnancy. A 34-year-old G3P2 28 weeks pregnant woman presented with acute left lower abdominal pain. The clinical and ultrasonographic findings led to diagnosis of twisted left ovarian cyst. Emergency exploratory laparotomy was performed. A twisted left fallopian tube and paratubal cyst was noted and left salpingectomy was performed. The postoperative course was uneventful and the pregnancy continued until term without complication. CONCLUSIONS: Although isolated twisted fallopian tube during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity and may allow preservation of the fallopian tube.
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PMID:Twisted fallopian tube in pregnancy: a case report. 1171 91

We describe the pathology of a unique case of Fallopian tube amebiasis, associated with hydrosalpinx, in a 21-year-old woman. She complained of lower abdominal pain, had a foul-smelling green vaginal discharge and fever during one week. There was a discrete increase in body temperature and a painful abdominal palpation at the lower right side, with signs of local peritoneal irritation. Pathological examination showed a marked dilatation of the fallopian tube and hydrosalpinx. Microscopic examination showed a poorly formed granuloma composed of large macrophages with many Entamoeba histolytica trophozoites inside the fallopian tube. Even though it is a rare disease the correct diagnosis of female genital tract amebiasis is of great importance for the indication of proper therapy.
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PMID:Salpingitis due to Entamoeba histolytica. 1198 Jun 11

Fallopian tube prolapse is a rare complication of hysterectomy, characterized by vaginal discharge, abdominal pain, pelvic inflammatory disease and vaginal bleeding. The diagnosis is often delayed, and is usually done after an histopathological examination identifies fallopian tube on biopsy. The advised treatment is surgical resection, which can be done through vaginal incision, abdominally or by laparoscopy. We report a case of fallopian tube prolapse after vaginal hysterectomy in 47-year-old patient in whom the prolapsed-tube was successfully resected vaginally, and review the presentation and surgical methods to correct this rare complication.
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PMID:[Fallopian tube prolapse after hysterectomy]. 1211 69

Reports from throughout the world consistently reveal an increasing incidence of ectopic pregnancy that appears to be linked to pelvic inflammatory disease, previous tubal surgery, and IUD use. Ectopic pregnancy generally presents with pelvic or lower abdominal pain, amenorrhea, and vaginal bleeding. Methods of establishing the diagnosis include ultrasonography and laparoscopy; before 5-6 weeks of gestation, these methods may no t be sufficiently sensitive and use of serial monitoring of the beta-chain of human chorionic gonadotropin concentrations in plasma is recommended. Salpingectomy is indicated if the ectopic pregnancy has ruptured and the tube is very swollen. Conservative surgery is a possibility when there has not been rupture and damage to the tube is minimal. A comparison of data from England's Jessop Hospital for Women shows that, while more ectopic pregnancies were treated in 1988-90 than in 1977-79 (109 and 49, respectively), this complication is being diagnosed at an earlier stage, before there is extensive damage to the fallopian tube. The mean gestation of ectopic pregnancies in 1977-79 was 8.1 + or - 2.8 weeks compared to 7.4 + or - 1.7 weeks in 1988-90. As a result, only 4% of the ectopic pregnancies in the earlier period compared to 14% in the more recent period could be treated by conservative surgery.
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PMID:Ectopic pregnancy. 1231 82

Some 250 million cases of sexually transmitted disease (STD) occur each year, and in some countries 1 or even 2 women in every 10 are infected with an STD. STDs are likely to reach an advanced stage before women notice them. The consequences of STDs are devastating, according to a report by the Population Information Program of the Johns Hopkins School of Public Health, and they include stillbirths, blinding eye infections in the newborn, chronic female abdominal pain, ectopic pregnancy, and infertility. There are social consequences for women such as divorce, and husbands may abandon infertile wives. Gonorrhea and chlamydia can cause both severe inflammation of the pelvis with acute pain and possible infertility. Pelvic inflammatory disease can permanently scar the fallopian tubes, increasing the risk of ectopic pregnancy, which can be fatal when the fallopian tube ruptures. Babies born to mothers with gonorrhea and chlamydia are likely to develop eye infections that may make them blind. Chlamydia infection in pregnant women may also cause premature rupture of the membranes, sepsis, and the death of premature neonate. Infection may spread to the lungs of newborns, leading to chlamydial pneumonia. Syphilis can cause spontaneous abortion, stillbirth, neonatal death, or congenital syphilis in the infant. Trichomoniasis and herpes can also be transmitted from mother to fetus. And infection with an STD increases the risk of infection with the human immunodeficiency virus (HIV). The World Health Organization (WHO) recommends that prenatal care should always include checks for STDs. A WHO Technical Working Group on Care of Mother and Baby has stressed the importance of detecting and treating STDs in pregnant women. The working group urged training of health workers to distinguish between STDs and other infections. The group, which met July 5-9, 1993, outlined health center strategies for prevention and treatment.
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PMID:STDs infect 250 million a year. 1234

Torsion of uterine adnexa is an important cause of acute abdominal pain. Torsion of ovarian masses is quite common and isolated torsion of fallopian tube has also been reported in literature. However, torsion of para ovarian cyst is a very rare. We report a rare case of twisted para ovarian cyst resulting in secondary torsion of the fallopian tube. Torsion of fallopian tube and para ovarian cyst are usually seen in the reproductive age group. Physicians need to maintain a high index of suspicion for this uncommon and often difficult to diagnose cause of abdominal pain.
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PMID:Torsion of para-ovarian cyst: a cause of acute abdomen. 1294 94


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