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

Perforation of the uterus by an intrauterine contraceptive device (IUD) is a rare, and serious complication, occurring in 1/350 to 1/2500 insertions. Perforation by IUDs can involve several neighboring organs such as the bladder and rectosigmoid. We report two cases of IUD perforations involving the appendix, both inserted during lactation. The first case is an asymptomatic patient in early pregnancy and the second is a woman whose original presentation was chronic lower abdominal pain. The presence of copper in the abdominal cavity can lead to adhesion formation and subsequent abdominal pain, bowel obstruction or infertility. Thus, we believe that when an IUD is located in the abdominal cavity it should be removed even in an asymptomatic patient. In addition, these cases might suggest postponing the use of this contraceptive method in lactating women.
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PMID:Appendix perforation by an intrauterine contraceptive device. 1069 Jun 69

We reported the reproductive outcome of 65 patients with varying degrees of IUAs who underwent hysteroscopic adhesiolysis between August 1994 and December 1996 at Ramathibodi Hospital. Of the 65 patients treated, 29 had mild adhesions, 26 had moderate adhesions, and 10 had severe adhesions. Adhesions were lysed with hysteroscopic scissors in 25, with biopsy forceps through hysteroscope in 10, with electrosurgery using a monopolar probe in 22 patients, and with resectoscope in 8 patients. The mean duration of the procedure was 15 +/- 2.1 minutes. The mean follow-up was 12 +/- 1.4 months. Of the 44 patients who originally presented with secondary amenorrhea, 40 (90.9%) have normal menses, 4 (9.1%) have hypomenorrhea. Of the 6 patients who had hypomenorrhea, 5 (83.3%) have normal menses. Cyclic abdominal pain disappeared after treatment in all patients. Of the 45 patients with IUAs and infertility, 16 (35.6%) conceived. Two (20%) of the infertile patients with initially severe adhesions conceived. Of the 5 patients with RPL treated, delivered a full term baby and the other delivered a premature baby at 29 weeks of gestation. All 18 patients who delivered, had live births. Adhesion reformation was absent in patients with initially mild and moderate adhesion but occurred in 2 out of 10 (20%) patients with severe adhesions. These two patients initially suffered from secondary amenorrhea but reported hypomenorrhea after surgery. Both of them had tuberculosis of the genital tract. There were no serious complications occurring in all 65 procedures. All 65 patients were discharged a few hours after the operation.
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PMID:Reproductive outcome following hysteroscopic lysis of intrauterine adhesions: a result of 65 cases at Ramathibodi Hospital. 1071 Aug 68

We conducted a prospective, longitudinal study to assess the efficacy of a new laparoscopic hysteropexy technique in alleviating pelvic pain. Subjects were 50 women of reproductive age with chronic pelvic pain or dyspareunia in whom the only clinical finding was uterine retroversion who underwent laparoscopic uterine suspension using three-stitch technique. There were no intraoperative complications. The only postoperative complication was abdominal pain in one woman. The technique was effective in relieving symptoms in these patients. Of the 22 women who had associated infertility for longer than 3 years, 10 became pregnant within 1 year after surgery. This benefit, however, is likely due to couples' improved sex life rather than change in surgical axis of the uterus.
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PMID:Laparoscopic uterine suspension using three-stitch technique. 1080 68

A report is given about 486 patients, who were operated because of suspicion of adhesion in 74 cases (15.2%), of an adnexal tumor 116 (23.9%), endometriosis 9 (1.9%), infertility 24 (4.9%), irreversible contraception 42 (8.6%) or chronic abdominal pain in the lower abdomen 221 (45.5%). 89.1% of them suffered preoperatively of chronic abdominal pain. 350 (72%) patients had to be laparotomized once or several times. 326 women only had adhesions; adhesions and an adnexal tumor were found in 107 patients; 53 women had adhesions and endometriosis. Among the 326 women with adhesions only were about 45% with adhesions of first and just as many with second graduation, adhesions of third graduation were found in 10% of the patients. Adhesions of first graduation were solved completely in all cases, such of second graduation could be solved in 43% of cases completely and in 54% at least incompletely. Adhesions of third graduation were solved in most of the cases (74%) incompletely. 221 (67.8%) of the patients with adhesions only answered the questionnaires 8-10 months later. Two third of them were free from pain or stated a clear improvement. After complete adhesiolysis 70% of the women stated a positive result of operation, 57% after incomplete adhesiolysis.
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PMID:[Retrospective study of pelviscopic adhesiolysis for treatment of chronic lower abdominal pain (January 1996-December 1997)]. 1095 7

Uterine leiomyomata are among the most common of human neoplasms and are associated with abnormal uterine bleeding, infertility, and abdominal pain. Uterine leiomyosarcomata are presumed to be the malignant counterpart to uterine leiomyomata and are very rare. Transformation of uterine leiomyoma (ULM) into uterine leiomyosarcoma (ULMS) is yet to be conclusively confirmed, and each type of tumor may represent a distinct genetic entity. We used comparative genomic hybridization (CGH) to evaluate DNA sequence copy-number changes in 12 specimens of ULM and 8 of ULMS. CGH analysis of ULM demonstrated chromosomal imbalances in 8 of 12 (66. 7%) specimens. The most frequent ULM gains were observed at 9q34 (a novel finding) and on chromosome 19. Other ULM imbalances included gains and losses of chromosome 1p, losses on 7q, and gains on 12q. All ULMS specimens demonstrated chromosomal aberrations. Chromosome 1 imbalances were very prominent. The most frequent losses were detected on 14q and 22q. Losses on 14q are rarely seen in other types of leiomyo-sarcoma and may be a distinctive feature of ULMS. Gains on chromosomes 8, 17, and X were observed in half the cases and were accompanied by high-level amplification. Other chromosome arms overrepresented included 12q and 19p. The absence of specific anomalies common to all ULM and ULMS argues against their being benign-malignant counterparts.
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PMID:Molecular cytogenetic analysis of uterine leiomyoma and leiomyosarcoma by comparative genomic hybridization. 1095 33

Endometriosis of the intestinal tract may mimic a number of diseases both clinically and pathologically. The authors evaluated 44 cases of intestinal endometriosis in which endometriosis was the primary pathologic diagnosis, and evaluated them for a variety of gross and histologic changes. Cases with preneoplastic or neoplastic changes were excluded specifically because they were the subject of a previous study. The patients ranged in age from 28 to 56 years (mean age, 44 years), and presenting complaints included abdominal pain (n = 15), an abdominal mass (n = 12), obstruction (n = 8), rectal bleeding (n = 2), infertility (n = 3), diarrhea (n = 2), and increasing urinary frequency (n = 1). The clinical differential diagnoses included diverticulitis, appendicitis, Crohn's disease, tubo-ovarian abscess, irritable bowel syndrome, carcinoma, and lymphoma. Forty-two patients underwent resection of the diseased intestine and two patients underwent endoscopic biopsies. In 13 patients there were predominantly mural masses, which were multiple in two patients (mean size, 2.6 cm). In addition, 11 cases had luminal stenosis or strictures, six had mucosal polyps, four had submucosal masses that ulcerated the mucosa (sometimes simulating carcinoma), three had serosal adhesions, one had deep fissures in the mucosa, and one was associated with appendiceal intussusception. Involvement of the lamina propria or submucosa was identified in 29 cases (66%) and, of these, 19 had features of chronic injury including architectural distortion (n = 19), dense lymphoplasmacytic infiltrates (n = 7), pyloric metaplasia of the ileum (n = 1), and fissures (n = 1). Three cases had features of mucosal prolapse (7%), ischemic changes were seen in four (9%), and segmental acute colitis and ulceration were seen in four and six cases (9% and 13%) respectively. In 14 patients, endometriosis formed irregular congeries of glands involving the intestinal surface epithelium, mimicking adenomatous changes. Mural changes included marked concentric smooth muscle hyperplasia and hypertrophy, neuronal hypertrophy and hyperplasia, and fibrosis of the muscularis propria with serositis. Follow-up of 20 patients (range, 1-30 years; mean, 7.8 years) revealed that only two patients had recurrent symptoms. None of the patients developed inflammatory bowel disease. Endometriosis can involve the intestinal tract extensively, causing a variety of clinical symptoms, and can result in a spectrum of mucosal alterations. Because the endometriotic foci may be inaccessible to endoscopic biopsy or may not be sampled because of their focality, clinicians and pathologists should be aware of the potential of this condition to mimic other intestinal diseases.
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PMID:Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. 1125 18

We report two cases of bilateral massive ovarian edema occurred in a concentration hospital in the last five years. This condition was first described by Kalstone et al. in 1969. It may be uni or bilateral, the last one is very uncommon, until the moment of this work there have been reported only ten cases in the world literature. The main symptoms are: abdominal pain or distention, menstrual irregularity and infertility. Two features are characteristic of this pathology: 1) Fast growing in size and volume of the ovary, and 2) Abscense of neoplastic changes with extensive edema of the stroma particularly in the medulla. The current treatment is oophorectomy. In bilateral cases may be intended a conservative management with wedge resection and fixation of the ovaries to the uterus in order to prevent further torsion. We conclude that massive ovarian edema is an uncommon pathology more frequent as a cause of abdominal pain and fast growing anexial mass in young women.
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PMID:[Bilateral ovary massive edema. Unusual gynecologic pathology. Report of 2 cases]. 1133 77

The diagnosis of salpingitis based solely on clinical criteria is inaccurate, with both low specificity and sensitivity. Laparoscopy has therefore become a valuable diagnostic tool in clinical practice and essential in clinical research on salpingitis. Different types of evidence indicate that atypical salpingitis without abdominal pain and discrete or absent symptoms is a common etiology of tubal factor infertility. A low threshold for suspecting salpingitis has been recommended to augment the sensitivity of clinical diagnosis. This leads to lower specificity and thereby a greater number of false positive diagnoses and unnecessary antibiotic treatment. Outpatient biopsy from the endometrium for histopathology and chlamydia testing might augment the specificity in cases with discrete symptoms, and should be investigated further. The sensitivity of laparoscopy is low for endosalpingitis without affection of the serosa, and might be augmented by using minibiopsies and chlamydia PCR from the tubal mucosa. The most significant measure toward reducing the sequelae of salpingitis is the combatting of chlamydia infection through screening programs and qualified partner management.
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PMID:[Silent salpingitis. Does it exist?]. 1140

Postoperative adhesions are an almost invariable consequence of abdominal and pelvic surgery. Their most important morbidity is small-bowel obstruction, but other sequelae include female infertility and dyspareunia and increased risk of visceral injury at subsequent laparotomy or laparoscopy. Whether chronic abdominal pain is truly a consequence of adhesions is debatable, although it is likely to be accepted as an entity by both patients and their legal advisors. Of 14 successful claims dealt with by a British medical defence organization, 5 were for perforations after laparoscopic division of adhesions, 2 for adhesions after laparoscopic surgery, 1 for infertility as a result of adhesions and 6 for delayed diagnosis of obstruction. General practitioners, surgeons and gynaecologists need to be aware of the increasing burden of medicolegal claims arising from these complications.
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PMID:Medicolegal consequences of postoperative intra-abdominal adhesions. 1158 68

Infertility, ectopic pregnancy, and chronic abdominal pain are frequent complications of genital infections with Chlamydia trachomatis. In an attempt to produce a vaccine to protect against this pathogen we purified and refolded the C. trachomatis mouse pneumonitis (MoPn) major outer membrane protein (MOMP). This preparation, mixed with Freund's adjuvant using vortexing or sonication, was used to immunize BALB/c mice that were subsequently challenged in the upper genital tract. Vaginal cultures were taken on a weekly basis, and mice were mated 6 weeks after the challenge. Gels of the vortexed MOMP showed a predominant band with a molecular size of 62 kDa and weaker bands at 42 and 132 kDa, while the sonicated MOMP had a single band with a molecular size of 42 kDa. Following immunization with these two preparations, strong humoral and cell-mediated immune responses were detected in the mice inoculated with the vortexed MOMP. On the other hand, mice immunized with the sonicated MOMP had a strong humoral immune response but a relatively weak cell-mediated immune response, as determined by a T-cell lymphoproliferative assay and level of cytokine production by splenocytes. Vaginal cultures showed that the mice immunized with the vortexed MOMP were significantly protected, as determined by a decrease in the number of animals with positive cultures, the length of time the mice shed viable organisms, and the number of inclusion-forming units recovered per mouse. Animals immunized with the sonicated MOMP, on the other hand, showed a weaker level of protection based on the same three parameters. After mating, the number of fertile animals and number of embryos per mouse were significantly higher for the mice immunized with vortexed MOMP, but not for the mice immunized with sonicated MOMP, compared to those of the control groups. In conclusion, immunization with a purified and refolded preparation of the C. trachomatis MoPn MOMP confers a significant level of protection in mice against a genital challenge.
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PMID:Immunization with the Chlamydia trachomatis mouse pneumonitis major outer membrane protein can elicit a protective immune response against a genital challenge. 1155 66


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