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

The clinicopathological features of 25 cases of peritoneal serous neoplasms histologically identical to noninvasive implants of ovarian serous borderline tumors but with minimal or no ovarian surface involvement were reviewed. The patients ranged in age from 19 to 53 (mean, 31) years; 18 of them were under 35 years of age. Infertility and abdominal pain were the most common presenting complaints. An extraovarian mass was present in two patients; adhesions or granularity of peritoneal surfaces were described in 23 of them. In 21 cases only the pelvic peritoneum was involved; the upper abdominal peritoneum was involved additionally in four cases. Most of the women were treated by hysterectomy, bilateral salpingo-oophorectomy, and omentectomy; six of them received chemotherapy postoperatively and two received both chemotherapy and radiation therapy. Nine women had a more limited operation to preserve their fertility. The 25 patients were followed for 4 to 13.9 (mean, 8) years. There was no clinical evidence of recurrence in 21 women. Borderline tumor recurred in two patients, who remained well for 1.7 and 2 years after excision of the recurrent tumor. Invasive low-grade serous carcinoma of the peritoneum developed in one woman who was living with extensive intra-abdominal tumor at the last follow-up examination. One woman died of disseminated SBT, which was diagnosed cytologically but not confirmed by biopsy.
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PMID:Serous borderline tumors of the peritoneum. 230 29

The relationship between IUD and oral contraceptive (OC) use and tubal infertility of infectious origin was retrospectively studied in 89 French women undergoing operations for tubal infertility between 1978- 87, 178 women who had spontaneously become pregnant regardless of outcome formed the control group, which was matched for age, socioprofessional status, and ethnic origin. Chlamydia trachomatis was responsible for 73% of cases of tubal infertility. 22 of the 89 women had a history of diagnosed salpingitis and 20 had had abdominal pain of unknown origin. 47 had had no symptoms of salpingitis. The average age was 29.68 years for the tubal infertility group and 29.7 for the fertile women. The socioprofessional status of the 2 groups was similar and higher than that of the general French population. 58% in the tubal infertility group and 36% in the fertile group were nulligestes. 60.1% of fertile vs. 47.2% of infertile women had used OCs. More infertile (22.5%) than fertile (14.6%) women had used IUDs, but the difference was not statistically significant. 45% of infertile women who had used IUDs had a history of diagnosed salpingitis, vs. 19% of pill and 18.5% of other contraceptive method users. The rate of chlamydia infection was similar for OC, IUD, and other method users. The rate of use of IUDs was similar for nulliparous fertile and infertile women, but for multiparous women it was significantly higher among infertile women. The finding that the infertile group had used OCs less often than controls suggest that OCs have a protective effect against this type of infertility. The role of the IUD is harder to establish, but a significant relationship was found between infectious tubal infertility and IUD use among multiparas and among women aged 25-34 years. The study also demonstrated that chlamydia infections are not related to contraceptive method used. In the light of this study it appears important to advise OCs rather than IUDs for women who are likely to desire a future pregnancy, even for multiparous women.
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PMID:[Contraception and tubal sterility of infective origin]. 232 37

Fertility and pregnancy outcome among 141 Nigerian women with uterine leiomyomas and 270 married gynaecological subjects matched for age and parity were studied. The preoperative spontaneous abortion incidence and fetal salvage among the 68 women in the study group who had previously been pregnant were 61.8% and 78.8%, respectively. Corresponding figures among women in the comparison group were 5.3% and 95.6%. Macroscopic evidence of pelvic sepsis was found at operation in 36.2% of all the women in the study group, and in 57.7% of those who complained additionally of infertility. The overall pregnancy rate following myomectomy was 37.9%, and 9.6% in those women whose presenting complaints included infertility. The mean operation-to-conception interval in the study group was 15.7 months. The fetal salvage increased to 93.5% in the women who conceived after myomectomy, and their incidence of abortion fell markedly, to 11%. Most of the deliveries (79%) in the women after myomectomy were by cesarean section. A reappearance of uterine leiomyomas occurred in 13.7% of the women. The relatively low incidence of pelvic sepsis in this series may partly be responsible for the finding of menorrhagia, rather than abdominal pain, as the commonest complaint of the women with leiomyoma.
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PMID:Fertility and fetal salvage among women with uterine leiomyomas in a Nigerian Teaching Hospital. 257 94

A study of the prevalence of symptoms suggestive of irritable bowel syndrome in 798 women referred to a gynecological clinic is reported; 321 women referred to dermatology and ear, nose, and throat clinics served as controls. Data were collected by a mailed symptom questionnaire. The prevalence of irritable bowel syndrome in the gynecological group was 37.3% compared with 27.7% in controls (P = 0.003). Approximately 50% of women referred with abdominal pain, dyspareunia, and dysmenorrhea had symptoms compatible with irritable bowel syndrome (P less than 0.005), whereas the prevalence in those referred for cervical abnormalities, termination/sterilization or perineal problems was similar to that of controls (28%). Patients referred with urinary symptoms, heavy periods, nonmenstrual bleeding, vaginal discharge, and infertility had an intermediate prevalence of irritable bowel syndrome (35-45%). This study suggests that either many women with irritable bowel syndrome are being wrongly referred to gynecologists or raises the possibility that symptoms currently regarded as indicative of irritable bowel syndrome may be associated with certain gynecological disorders.
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PMID:Irritable bowel syndrome in the gynecological clinic. Survey of 798 new referrals. 259 51

Endometriosis is a disease characterized by the occurrence of ectopic endometrium, most frequently in the pouch of Douglas and the ovaries. The disease is diagnosed at operation and occurs practically exclusively in women of fertile age. The symptoms are, in particular, diffuse low abdominal pain, dyspareunia, infertility and dysmenorrhoea. The prevalence of the disease is unknown but has been estimated as about 1-2%. The etiology is still unknown. The classical theories about 1) retrograde implantation of endometrium from menstruation and 2) metaplasia of the coelom epithelium are still current. A series of recent observations of increased macrophage activity, reduced cellular immunity and deviations in the complement system suggest, however, that special immunological factors also play a causal role. Endometriotic tissue has great morphological and biochemical similarities with endometrium and contains, similarly, receptors for steroid sex hormones but in lower concentrations and with an increased relationship between progesterone and oestrogen receptors. The pathophysiological basis for the infertility correlated with the disease is only partially understood. Apart from obvious anatomical causes, the occurrence of the luteinized unruptured follicle syndrome and alterations in the content of steroid hormones and prostaglandins in the peritoneal fluid are possible causes.
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PMID:[Endometriosis--new perspectives. 1. Pathology and physiopathology]. 267 28

A prospective study was conducted at Muhimbili Medical Centre (MMC) over a 2-year period on 16 patients with advanced abdominocyesis. The incidence of 1 in 3259 deliveries was higher than that of previous years. Infertility prior to index pregnancy was a significant antecedent factor (P less than 0.001). The most consistent symptom both in early and late pregnancy was abdominal pain. Difficulty in fetal palpation and abnormal lies were the most significant signs. The sensitivity of clinical suspicion was 68%, ultrasound 85% and X-ray diagnosis 93%. Sepsis was the leading maternal complication, especially when the placenta was left in situ. Perinatal mortality was 87.5% and maternal mortality was 6.4%. Abdominal pregnancy remains a diagnostic challenge and certain aspects of fetal mortality are ill-understood. Early diagnosis of abdominal pregnancy can be improved upon by more detailed history taking, a high index of suspicion and meticulous interpretation of sonographic and radiological signs. It is suggested that the placenta be removed except in the rarest trying cases and that pregnancy be terminated on diagnosis.
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PMID:Advanced abdominal pregnancy in Muhimbili Medical Centre, Tanzania. 288 Jul 56

Between December 7, 1984 and June, 1986, 34 men with exposure to methylene chloride were evaluated at the Greater Cincinnati Occupational Health Center (GCOHC). Their primary complaint involved problems associated with central nervous system dysfunction. However, 8 of the 34 men complained of testicular, epididymal or lower abdominal pain (found on exam to be prostatic in origin) and had clinical histories consistent with infertility. Semen specimens from four volunteers were found to be in the subfertile or infertile range with regard to motility, morphology and sperm density.
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PMID:Case reports of individuals with oligospermia and methylene chloride exposures. 298 Mar 97

In Nairobi, Kenya, researchers enrolled 35 women at 7-9 days postpartum who delivered vaginally and had clinical endometritis (purulent lochia, fever, uterine tenderness, or uterine subinvolution) and 30 puerperal women without endometritis in a case control study. The study aimed to examine the association between clinical criteria and microbial and histological findings in diagnosing postpartum endometritis and the role of various microorganisms in the etiology of this infection. Cases were significantly more likely to have foul lochia (51.1% vs. 20%; p = .005) and abdominal pain (77.1% vs. 46.7%; p = .02). Laboratory personnel were able to isolate both Neisseria gonorrhoeae and Chlamydia trachomatis significantly more often from the cervices and the endometria of the patients than from the controls. Each of these 2 microorganisms were also isolated more often from the endometria of patients than of controls (3 patients vs. 0 patients for both N. gonorrhoeae and C. trachomatis), but the difference was not significant. The researchers could not determine the etiology of postpartum endometritis in the remaining two-thirds of cases. Isolation rates for Mycoplasma hominis and Ureaplasma urealyticum from the cervices and endometria were essentially the same in both patients and controls. Moderate or severe plasma cell infiltration occurred in 24% of cases and 4.5% of controls (p = .06). No correlation between histology and microbiology existed, however. These findings suggest that controlling maternal sexually transmitted disease would reduce postpartum pelvic infections and secondary infertility.
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PMID:Microbial aetiology and diagnostic criteria of postpartum endometritis in Nairobi, Kenya. 313 52

Data regarding previous pelvic inflammation, abdominal surgery, endometriosis, obstetrical anamnesis, usage of IUD, occurrence of abdominal pain, vaginal discharge and metrorrhagia were obtained from 120 women with tubal infertility and compared to similar data from 126 pregnant women. Previous abdominal surgery, especially pelvic surgery was the most frequent risk factor present in 59% of the infertile women followed by pelvic inflammation (42%) and endometriosis (10%). In 23% of the infertile women there was no history of abdominal surgery, inflammation or endometriosis. Abdominal surgery, inflammation, ectopic pregnancy, salpingectomy and ovarian resection were significantly more frequent among the women with tubal infertility than among the pregnant women. Finally, there was no significant difference in the occurrence of appendectomy, IUD usage, induced or spontaneous abortion.
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PMID:Risk factors for tubal infertility among infertile and fertile women. 319 33

An analysis of the clinical data of 552 patients treated for ectopic pregnancy during 1973-82 in our hospital showed that the prevalence of this complication rose twofold (P less than 0.01) from an annual rate of 10.9 per thousand in 1973 to 20.9 per thousand in 1982. As regards parity distribution, the proportion of the 2-paras increased significantly (P less than 0.05) and this increase was significantly greater (P less than 0.001) than in the total population of parturients during this period. The increasing incidence of ectopic pregnancies had a significant positive correlation (P less than 0.05) with the use of an intrauterine device (IUD), but not with previous or present pelvic inflammatory disease or gynaecological or abdominal surgery. Because the 158 patients with an IUD in situ (34%) had a significantly less frequent past history of salpingitis, pelvic operation, infertility, ectopic pregnancy or spontaneous abortion and had less actual pelvic inflammatory changes than the 259 patients without contraception (57%), the IUD seemed to be directly involved with the increased risk of ectopic pregnancy. In the present study lower abdominal pain occurred in 97% of the patients and menstrual disorders in 93%; pelvic examination revealed adnexal mass in 63% and adnexal tenderness in 90% of the patients. Laparoscopy, a sensitive urinary pregnancy test (detection limit 75 IU/1) and culdocentesis were the most important factors in the diagnosis of ectopic pregnancy as evidenced by positive results in 97, 90 and 83% of the cases, respectively. Due to improved diagnostic procedures the annual rate of an unruptured tube at operation increased from 49% to 73% during the study period.
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PMID:Ectopic pregnancy--an analysis of the etiology, diagnosis and treatment in 552 cases. 348 6


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