Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The correct diagnosis was initially suspected in 32 (53%) of 60 patients with ectopic pregnancy who attended an accident and emergency department. Incorrect diagnoses were made because ectopic pregnancy was not considered or because relevant symptoms and signs were missed or misinterpreted. Three patients had been 'sterilized'. Twenty-four patients (40%) had abdominal pain or vaginal bleeding for more than 1 week before attending. Fever and leucocytosis were wrongly attributed to pelvic infection. Pregnancy tests were positive in 56% of the patients tested.
 ...
PMID:The diagnosis of ectopic pregnancy in an accident and emergency department. 267 82

The aim of the authors was to investigate reliability of method, used by them, for diagnosis of extrauterine pregnancy EP (EP). 123 women with admission diagnosis: obs. graviditas extrauterine were studied retrospectively. It was established that the abdominal pain together with the triad of symptoms from the vaginal-abdominal examination: congested adnexae, enlarged uterus and painful cavum Douglasi were of great diagnostic significance. The highly predicting value and sensitivity of ultrasound examination women with EP emphasized the substantial contribution of echography for early and exact diagnosis, which together with timely operative intervention could contribute to preserve the reproductive capability of women.
 ...
PMID:[Diagnostic problems in extrauterine pregnancy]. 267 91

We report the case of a 26-year-old woman who presented to our emergency department for evaluation of abdominal pain 24 days after a vaginal hysterectomy. The patient's serum pregnancy test was positive. An ectopic pregnancy of the right adnexa was diagnosed by ultrasound and confirmed by laparotomy. The patient recovered uneventfully. Ectopic pregnancy after a total hysterectomy can occur if the fertilized ovum is in the fallopian tube at the time of the hysterectomy or if a fistulous tract exists between the vagina and the ovaries, enabling fertilization to occur. The diagnosis of ectopic pregnancy after a total hysterectomy is unusual yet must be considered in the presence of intact ovaries to avoid a delay in treatment.
 ...
PMID:Tubal pregnancy after total vaginal hysterectomy. 267 46

A 35-year-old woman presented to the emergency department with abdominal pain 36 hours after a therapeutic abortion. A positive pregnancy test was thought to be related to the recently terminated intrauterine gestation. The patient was admitted for observation. When monitoring revealed intraabdominal hemorrhage, exploratory surgery was performed and a ruptured tubal pregnancy discovered. The patient recovered uneventfully. The incidence, predisposing factors, and diagnosis of simultaneous intrauterine and extrauterine pregnancy are discussed.
 ...
PMID:Heterotopic pregnancy. 270 88

This is a clinical case report of a 23-year-old female admitted to St Paul's district hospital in North-East Zambia with a chief complaint of abdominal pain. Her past medical history included amenorrhea for 7 weeks, no vaginal blood loss, a previous delivery in 1986, postpartum abdominal pains which lasted for 3 months. On physical examination, she presented with slight anemia, normal temperature, normal blood pressure and a normal pulse. Pressure applied to the lower abdominal area was painful. Vaginal examination revealed an enlarged uterus; the rectovaginal pouch was extremely sensitive to pressure. Hemoglobin level was 8.5% and a pregnancy test was negative. On Laparotomy, a left sided ampullar tubal was found, with the right tube exhibiting an intact elastic swelling in the isthmus. Right salpingostomy was done to shell out the ectopic gestinal tissue and the left salpingectomy was performed to clean the recto vaginal pouch. The diagnosis made was bilateral ectopic pregnancy. The likely etiology was simultaneous ovulation from both ovaries, fertilization and subsequently implantation. The fallopian tubes had been previously affected by postpartum salpingitis.
 ...
PMID:Bilateral ectopic pregnancy: a case report. 273 42

A case report of a ligamentary ectopic pregnancy that failed to respond to prostaglandin E2 for induced abortion for sepsis at 24 weeks is presented. The 27-year-old nullipara had normal ultrasound findings for gestational age up to 21 weeks gestation. She had consulted at 5 weeks for abdominal pain and bleeding, at 14 weeks again for abdominal pain, shoulder pain and vaginal bleeding, although both times the pain and bleeding resolved spontaneously. She was seen again at 16 and 21 weeks gestation, when ultrasound scans were normal for dates. At 24 weeks, she experienced vaginal discharge of blood and tissue, and was managed as premature rupture of membranes. She became septic 12 days later. She was treated with transcervical PGE2 and iv oxytocin without response for 3 days. Surgical evacuation was successful, but bleeding persisted. During laparotomy she had a large left broad ligament hematoma, a left ruptured uterus, and open left internal iliac artery and vein. These were repaired, and she received 40 units of blood, 8 platelets and 14 of plasma. Only after histology was the diagnosis of ligamentary pregnancy made. The lack of response to PG for abortion should raise suspicion of ectopic pregnancy, although preoperative diagnosis of ligamentary pregnancy is extremely rare.
 ...
PMID:A rare gynecologic contraindication to the use of prostaglandins and oxytocin to induce abortion. A case report. 279 68

Case reports are presented on 2 patients to show the importance of following up apparently false positive results of pregnancy tests. In case 1, a 25-year-old woman was admitted to the hospital with severe breathlessness in September 1987. After she had stopped using oral contraceptives (OCs) in 1985 her periods were irregular and on 4 occasions the results of pregnancy tests bought over the counter were positive. She was twice referred for ultrasound examinations, but the uterus was empty each time. In April 1987, dysfunctional uterine bleeding was diagnosed; she was treated with clomiphene. She then experienced intermittent pleuritic chest pain and breathlessness on exertion. In early September she was admitted with acute breathlessness and chest pain. A further pregnancy test was positive; results of laparoscopy of the pelvis were normal. A radioisotope ventilation-perfusion lung scan showed multiple filling defects in the left lung and no perfusion to the right. A presumptive diagnosis of choriocarcinoma was made with the syndrome of tumor growing in the pulmonary arteries. In case 2, a 32-year-old woman was admitted to the hospital in March 1988 with acute lower abdominal pain. A pregnancy test was positive, and she underwent laparoscopy for suspected ectopic pregnancy. A macroscopic tumor was found on the surface of the right ovary and a right salpingo-oophorectomy was performed. A subsequent histological examination showed choriocarcinoma. The 2 cases reported show the importance of seeking a definitive explanation for a false positive result of a pregnancy test. If the test has been performed correctly and proteinuria and drug interference, for instance, are ruled out, then a raised human chorionic gonadotropin concentration, particularly in young women, is virtually certain. In most cases this will be due to a pregnancy that ends in a 1st trimester abortion, but in a small minority it will be due to the hormone producing a tumor such as choriocarcinoma.
 ...
PMID:Don't ignore a positive pregnancy test. 284 5

624 women were referred to an emergency gynaecological ultrasound clinic with a provisional diagnosis of threatened miscarriage based on a history of amenorrhoea and vaginal bleeding with or without abdominal pain. High-resolution abdominal sector scanning was used to assess fetal size and viability, as well as uterine and placental size, to identify features which might indicate imminent fetal death. In 158 women there was no evidence of pregnancy; 60 women had an ectopic pregnancy. In the remaining 406 women ultrasound examination correctly identified the underlying cause of vaginal bleeding at first presentation in all but the 6 who subsequently aborted. 3.9% of the patients had a second empty sac and 5.4% had an intrauterine haematoma; none of these women subsequently aborted. 2 patients had early-onset oligohydramnios and spontaneous abortion occurred in both.
 ...
PMID:Ultrasonic assessment of complications during first trimester of pregnancy. 289 Aug 56

2 cases of functional ovarian cysts are described to illustrate an increasingly common but little studied complication of progestin-only or phasic oral contraceptives. A 20-year-old woman without previous pathology who had used a pill containing .35 mg norgestrienone for 6 months suddenly developed violent lower abdominal pain. Sonography revealed a mass that was believed to result from extrauterine pregnancy, and surgery was performed. In the 2nd case, a 39-year-old woman taking a triphasic containing levonorgestrel and ethinyl estradiol had unexplained lumbosacral pain. Sonography again revealed an ovarian cyst. The triphasic was discontinued and the cyst disappeared over the next several days. A review of the literature suggested that such cysts are common but only about 1 in 6 are painful. They appear to result from the inhibition of pituitary luteinizing hormone by the progestin while follicle stimulating hormone secretion persists. Follicular secretion of estraiol may or may not reach significant levels. The complication should be known by physicians because the pain and adnexal mass should not be mistaken for a surgical emergency. Oral contraceptive package inserts should indicate that functional ovarian cysts may occur in women using progestin or phasic pills.
 ...
PMID:[Follicular ovarian cysts appearing during progestin or estroprogestin oral contraception at low doses]. 305 84

A total of 252 women with amenorrhoea and with abdominal pain or vaginal bleeding, or both, had an emergency high-resolution ultrasound sector scan. In 100 women the symptoms were unrelated to any identifiable abnormal ultrasound finding, none of them was pregnant and their symptoms settled spontaneously; 33 other women had follicular or luteal cysts and 30 had pelvic inflammatory disease. Histological examination confirmed an ectopic pregnancy in 60 women (24%); in seven a live fetus was observed outside the uterus allowing a confident diagnosis of ectopic pregnancy; in 27 the thickness of the endometrium was greater than 10 mm (sensitivity 50%, specificity 84%, positive predictive value 28%, negative predictive value 87%); in 15 the uterine area measurement was less than 20 cm2 (sensitivity 72%, specificity 41%, positive predictive value 20%, negative predictive value 79%); and 43 had an adnexal mass volume greater than 10 ml separate from the ovary (sensitivity 85%, specificity 37%, positive predictive value 23%, negative predictive value 90%). Only three had negative ultrasound findings. The negative predictive value of an ultrasound examination could be increased to 96% by using a combination of these ultrasound features. The addition of hCG (greater than 25 i.u./l) improved the specificity to 98% and the negative predictive value to 100%. These criteria may improve the ultrasound diagnosis of ectopic pregnancy.
 ...
PMID:Can ultrasound reliably diagnose ectopic pregnancy? 306


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>