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

Technical difficulty in passing the colonoscope was assessed in 371 patients undergoing 627 colonoscopies during 1989-91 and were graded as 0: no difficulty and cecum reached (71.43%); 1: difficult but cecum reached (20.22%); 2: difficult and cecum not reached although lumen beyond seen (4.85%); and 3: difficult and cecum not reached as lumen beyond could not be seen (3.5%). Frequency of patients with chronic lower abdominal pain and/or disturbed bowel habits in each grade increased as grade of obstruction increased: 0 (25.66%), 1 (36%), 2 (77.77%), and 3 (100%). During 1983-91, 54 patients with lower abdominal pain and/or disturbed bowel habits for a mean of 30.5 months, unresponsive to conventional medical measures, and who also had a grade 2 or 3 sigmoidal obstruction, elected to undergo sigmoid colectomy. Operative and pathologic studies showed that the primary cause was fixation of the sigmoid colon to the pelvis in two or three loops by adhesions from previous pelvic surgery, endometriosis, ovarian cyst, or diverticulitis. All patients had relief of symptoms that was maintained during the 1-9 year follow-up.
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PMID:Technically difficult colonoscopy, a non-radiologic sign of sigmoidal obstruction: value of sigmoid colectomy for intractable symptoms. 803 Aug 15

Ovarian cysts are rare in children but can sometimes become extremely large, leading to difficult therapeutic decisions. There is general agreement that the therapeutic attitude for benign serous cysts less than 5 cm in diameter includes echographic monitoring and possible echo-guided punction. For cysts larger than 5 cm, most authors favour cystectomy via the celioscopic route using either celio-surgery or mini-laparotomy. On the contrary, the clinical manifestations of large cysts greater than 15 cm in diameter may vary greatly, presenting as increased abdominal volume, pain, respiratory impairment. The large size of the cyst should not be allowed to mask an associated torsion of the annexes in cases of paroxysmal abdominal pain. We report our experience of 6 voluminous ovarian cysts with a largest diameter varying between 15 and 40 cm. The children's age varied from 10 to 15 years. There were 3 dermoid cysts, 2 treated by ovariectomy and 1 by celio-surgery, 1 torsion of the annexes on dermoid cyst was treated via laparotomy. There were two cases of mucinous cystadenomas, 1 treated by mini-laparatomy and the other by celio-surgery. Finally one serous cyst with torsion of the annex was treated by annexectomy. The large size of the cysts may impair the surgical approach. Prudent ceilo-surgery should be preferred to wide laparotomy. Introduction should be performed under visual control followed by leak-free punction. The cyst is emptied before exeresis of the ovary via a mini-laparotomy since, in many of these cases of voluminous tumours, cystectomy cannot always be performed and ovariectomy must be preferred.
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PMID:[Voluminous ovarian cyst in children. Therapeutic strategy]. 816 17

The authors review the color Doppler ultrasonographic (US) features of appendicitis and other diseases that can manifest with acute lower abdominal pain. Causes of acute abdominal pain, other than appendicitis, include gynecologic abnormalities (ovarian cyst, ovarian torsion, pelvic inflammatory disease), gastrointestinal abnormalities (infectious enteritis, Crohn disease, mesenteric lymphadenitis, intussusception), and urinary tract diseases. On color Doppler images, inflammatory and infectious processes usually show locally increased blood flow, whereas cysts and twisted masses have absent blood flow. Enlarged lymph nodes also are avascular. Color Doppler US is a useful adjunct to gray-scale US in evaluating acute lower abdominal pain in children and can aid in defining and clarifying gray-scale abnormalities.
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PMID:Color Doppler US of children with acute lower abdominal pain. 829 Jul 24

We used the aromatase inhibitor testolactone (40 mg/kg.day) to treat 12 girls with precocious puberty due to the McCune-Albright syndrome for periods of 0.5-5 yr. In the 7 girls who received testolactone for at least 3 yr, the mean +/- SD serum estradiol level was 618 +/- 268 pmol/L at the start of therapy and fell to 156 +/- 84 pmol/L at 1 yr, 116 +/- 48 pmol/L at 2 yr, and 241 +/- 260 pmol/L at 3 yr (P < 0.05 compared to the start of therapy), with recurrent ovarian cysts at 3 yr in 2 patients. These 7 girls averaged 8 menses/yr before therapy. The average frequency of menses decreased to 2 episodes/yr during the first year of treatment, 3/yr during the second year, and 4/yr during the third year. The mean +/- SD testosterone levels were slightly above the normal prepubertal range (0.51 +/- 0.2 nmol/L) before treatment and did not change significantly during treatment. The mean +/- SD androstenedione levels rose from 1.1 +/- 0.6 nmol/L before treatment to 2.1 +/- 0.1 nmol/L at 2 yr and 2.8 +/- 0.1 nmol/L after 3 yr of treatment (P < 0.05 compared to before treatment) and were consistent with normal adrenarche. The mean predicted adult stature was 143.0 +/- 7.8 cm before treatment and 147.3 +/- 11.5 cm at 3 yr (P = NS). In 3 of 12 girls, all with bone age greater than 12 yr, the gonadotropin responses to LHRH indicated early central precocious puberty after 1-4 yr of treatment. The adverse effects of testolactone were transient abdominal pain, headache, and diarrhea in 3 girls and elevated hepatic enzymes in 1 girl who had abnormal liver function before treatment. Six families acknowledged difficulty in adhering to the daily dosing schedule. We conclude that testolactone can be effective in the treatment of LHRH-independent precocious puberty in girls with McCune-Albright syndrome, but that some patients exhibit an escape from the effects of treatment after 1-3 yr.
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PMID:Long-term testolactone therapy for precocious puberty in girls with the McCune-Albright syndrome. 837 Jun 86

The value of sonography in assessing chronic abdominal pain (CAP) in children, the characteristics of CAP, and the local pediatrician's practice in evaluating CAP are reported. Fifty-seven patients with CAP had abdominal and/or pelvic sonography; 56 were normal. One sonogram showed an ovarian cyst on the side opposite the CAP; the cyst later resolved. Pain was usually localized in the periumbilical area (56%). Follow-up data were obtained from referring physicians and patients' medical records. No serious diagnosis related to CAP was missed. After six months, CAP had resolved in 43% of patients. Of the responding physicians, 61% indicated they would have used more and costlier contrast studies if ultrasonography had been unavailable.
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PMID:Use of abdominal and pelvic ultrasound in the evaluation of chronic abdominal pain. 845 30

It's perform a descriptive study about a series of events with the purpose of discover the own characteristics of ovarian cysts and which characteristics determine its treatment. In the 41 patients (10 newborn, 14 prepubertal females and 17 post-menarchal females) we analyzed their symptoms, pathological findings, ecographics details, treatment, diagnostic and follow-up. The predominant symptom has been the abdominal pain (18 patients). In 8 newborn the cyst was find before born by prenatal sonography. The cyst was palped like abdominal mass in 22 patients and it was like a picture of acute abdomen in 11. It was found in the right ovary in 24 patients and bilaterally in 7. By pelvic ultrasonography was observed a superior size of 5 cm of diameter in 28 occasions, in 17 there were imagine of complex and in 3 there were hemorrhagic. In 16 patients the suspicion diagnostic was of torsion and in 5 of appendicitis. The torsion was confirmed in 11. In 16 patients it was a follicular cyst, in 9 was a dermoidal and in 9 hemorrhagic. Was realized a surgical treatment (cystectomy or ooforectomy in 36 girls, in 4 was realized a puncture and evacuation (bigger of 5 cm with clear liquid) and in 7 was hope the spontaneous evolution (clear liquid and infer size of 5 cm). There were not relapses. The clinic manifestations are presents with own characteristics depending of the cyst affected to newborn, premenarchal or menarchal females. The indications of surgery are: symptoms which are not resolved after a observation time (24-49 hours) and cysts of big volume associated a complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ovarian cysts in childhood]. 852 12

A 12-year-old girl with massive hemoperitoneum caused by a ruptured hemorrhagic ovarian cyst (HOC) is described. Although HOC is not common in early adolescence, it should be included in the differential diagnosis of any adnexal mass or lower abdominal pain in a girl.
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PMID:Hemorrhagic ovarian cyst in childhood: a case report. 881 73

We report a case of 54 years old female who presented an acute onset of abdominal pain after physical training. Left rectus sheath haematoma may clinically mimic torsion of ovarian cyst. Case was treated surgically, haematoma was found, peritoneal cavity was also controlled.
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PMID:[Hematoma of the rectus sheath as a gynecologic problem]. 913 91

A 13-year-old nulligravida girl, 158.5 cm in height and 76.0 kg in body weight, came to our department complaining of continuous right lower abdominal pain. One month earlier, an ovarian cyst in the right ovary, about 3 cm in diameter, was found when she underwent appendectomy at another hospital, but was left untreated. Menarche occurred at the age of 13 years and 1 month, which was after the appendectomy and 24 days before the present operation. Right hematosalpinx with peripheral obstruction and a para-ovarian serous cyst on the same side were diagnosed, and therefore right salpingectomy with para-ovarian cyst resection was performed. The bilateral ovaries and uterus were completely normal by inspection. The post operative histological examination confirmed hematosalpinx and revealed tubal endometriosis.
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PMID:Tubal endometriosis diagnosed within one month after menarche: a case report. 916 54

Hemorrhagic ovarian cyst (HOC) which is one of the functional cysts, is often involved in acute abdomen leading to laparatomy intervention. The reason for this mainly lies in the fact that it is easily misdiagnosed as an organic mass because of the presence of lower abdominal pain and the variable appearance of ultrasonographic images at presentation. We analyzed 15 cases of HOC associated with acute abdomen, of which in 2 cases the disease was confirmed by laparotomy. The remaining 13 cases were followed-up clinically and by daily transvaginal sonography (TVS) from the first detection of the cyst until complete resolution. The TVS images showed a variety of changes; however, when the images or their magnified views were observed precisely, important diagnostic characteristics were found which were classified into 3 categories: type 1 images showed mixed hypoechoic and hyperechoic areas, the demarcation line between which appeared as a thin or thick septum-like echo of smooth formation; type 2 images showed hypoechoic background and vertical, horizontal, or lamellar thin or thick thread-like echoes with an overall reticular-like or sponge-like pattern; and type 3 images showed an overall hyperechoic and solid pattern. Type 1 and 2 images occurred more frequent (93.3%), and only 1 case had a type 3 image. In all image types, septum-like or thread-like echoes were seen, TVS type 1 and 2 images showed a clear division into hyperechoic and other areas with the passing of time which was finally changed into a cystic pattern and disappeared. Severe lower abdominal pain was present for 1 to 3 hours in 12 cases (80%), 4 to 6 hours in 2 cases (13.3%), and 11 hours in 1 case (6.7%). Other characteristics of HOC may be its most frequent occurrence in the young age group (10 to 20 years old, 80.0%) and in the luteal phase (84.6%). With operative cases, histopathological diagnosis was HOC. The clinical and particularly TVS findings described in the present study are of significant value in differential diagnosis of HOC with acute abdomen from other disorders presenting with acute abdomen.
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PMID:Sonographic appearance of hemorrhagic ovarian cyst with acute abdomen by transvaginal scan. 936 44


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