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

Tubal actinomycosis was diagnosed in a 29-year-old patient, 1 month after insertion of a Dana super IUD. The patient presented with lower abdominal pain, and was treated on an outpatient basis. She was admitted to hospital when symptoms did not improve, and was treated with antibiotics. Symptoms improved, and the patient was released, but she was readmitted 2 months later with a diagnosis of acute pelviperitonitis and pyosalpinx. She was treated with chloramphenicol and antibiotics; pyosalpinx was drained twice. Laparotomy revealed bilateral pyosalpinx and right ovarian infection. Both Fallopian tubes and the right ovary were removed. Actinomycosis was identified in the post-operative tissue examination.
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PMID:[Tubal actinomycosis as a complication of intrauterine contraception]. 65 53

A case of salpingitis with pyosalpinx subsequent to tubal ligation is described. The procedure was performed at the time of cesarean section 7 years earlier. The pyosalpinx included the distal portion of the ligated tube, with no evidence of infection in the proximal segment. Although pelvic peritonitis, salpingitis and tubo-ovarian abscess are rare following tubal ligation, they should be suspected in any patient presenting with lower abdominal pain.
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PMID:Pyosalpinx subsequent to tubal ligation. 252 Jul 96

The 15th case of bilateral adnexal torsion, or the fifth case in which the bilateral adnexal torsion did not occur simultaneously, is presented. A review of the cases reported in the world literature reveals that fever (82%), nausea and/or vomiting (73%), and abdominal pain (93%) were the most common symptoms. Previous recurrent attacks of abdominal pain occurred in 53% of patients and may be the one finding that is highly suggestive of this entity. The adnexa were histologically normal in 50% of the specimens, with the remaining adnexal tissues manifesting evidence of tubal infection (ie, hydrosalpinx and pyosalpinx). The diagnosis was suspected preoperatively in only 38% of the cases.
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PMID:Bilateral torsion of the adnexa: a case report and a review of the world literature. 623 87

We report on two laparoscopically sterilised patients who presented with increasing lower abdominal pain and sonographically proven adnexal masses. The first patient, who had been sterilised two years ago, underwent primary laparotomy. The mass was found to correspond to the cystically altered distal part of the right sterilised tube being torquated twice. Standard salpingectomy was performed. On the second patient, sterilised ten years before presentation at our clinic, we performed laparoscopy because of the suspected diagnosis of a pyosalpinx. In this case we found a torsion of the ampullary part of the left tube, which was subsequently removed by laparoscopy.
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PMID:[Acute torsion of hydrosalpinx. 2 cases after laparoscopic sterilization]. 770 18

Transvaginal sonography was used in the evaluation of clinically suspected pelvic inflammatory disease (PID). A total of 86 patients with PID were examined by transvaginal sonography within 1-3 days, 14 days and 90 days after hospitalization. The diagnosis of PID was confirmed in 37% of patients by laparoscopy, laparotomy or positive cervical culture of Chlamydia trachomatis or Neisseria gonorrhoea. In the remainder, the diagnosis was based on tenderness of the uterus, fever and lower abdominal pain that responded rapidly to antibiotics. At the time of admission, 31% of patients had a thick-walled (> or = 5 mm) echogenic tube raising the suspicion of pyosalpinx or pyo-ovary. During the following 3 months, 52% of patients developed tubes that were thin-walled (< 5 mm) and poorly echogenic, and hydrosalpinx was suspected. At the first transvaginal sonographic examination, 64% showed no adnexal mass, but 16% of these developed suspected hydrosalpinx during the following 3 months. Of the total of 86 patients, 6% exhibited a hydrosalpinx for the first time after 3 months. C-reactive protein concentrations and sedimentation rate values correlated positively with the ultrasonically determined volumes of pyosalpinx/pyoovaries, cul-de-sac fluid and ovaries. Transvaginal sonography appears to be very useful in the diagnosis of suspected PID and is recommended at least 3 months after symptoms have subsided for those patients with an adnexal mass at the time of the acute episode and for infertile patients.
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PMID:Transvaginal sonography in suspected pelvic inflammatory disease. 890 20

Pelvic sonography is commonly performed in patients with a clinical diagnosis of pelvic inflammatory disease. Though the study may be normal or sometimes non-specific, there are a variety of findings that are characteristic of this process. Understanding of the sonographic features of pelvic inflammation, salpingitis, pyosalpinx, tubo-ovarian complex and tubo-ovarian abscess will allow the interpreter to make more specific, clinically useful diagnoses. Sonography can also help to distinguish acute from chronic abnormalities in the fallopian tubes. Correlation of sonography with pelvic CT is important as CT is ordered with increasing frequency in patients with unexplained lower abdominal pain.
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PMID:Ultrasound of pelvic inflammatory disease. 1560 19

Necrotizing dermohypodermitis of abdominal wall in obese is a rare disease with high mortality. We report two cases of 50 and 62years old patients whose intra-abdominal infectious pathology (appendicular abscess for one and pyosalpinx for the other) was revealed by a necrotizing dermohypodermitis of the abdominal wall. The diagnosis has been established on the basis of converging clinical arguments (abdominal pain, crackles and necrotic appearance of abdominal wall in a septic shock context), linked with a CT-scan. The treatment consisted of a large excision of the abdominal wall necrosis and surgical eradication of deep infection source, with an intensive care and a broad spectrum antibiotic therapy. Both these patients present morbid obesity (BMI>40) whose implication must be taken into consideration in the way the disease appears. Indeed, the necrotizing dermohypodermitis of abdominal wall in these patients must lead first in looking for a deep infection with few symptoms. It must be identified quickly to propose an early and multidisciplinary surgical treatment.
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PMID:[Necrotizing dermohypodermitis of the abdominal wall in obesity. Two cases indicative of abdominopelvic deep infection]. 2341 Jul 21

Case Presentation. Mrs. X, 35 years old, case of primary infertility, was diagnosed to have genital tuberculosis on the basis of PCR positive and hysterolaparoscopy findings and received category I ATT for 6 months. Following ATT completion, her USG revealed no evidence of tuboovarian mass or hydrosalpinx. Since her tubes were patent, she underwent 3 cycles of ovulation induction and 2 cycles of IUI. The women presented with acute PID, five days after IUI, and was conservatively managed. She again presented 24 days after IUI with persistent low grade fever and abdominal pain. Suspecting relapse of genital tuberculosis, she was started on category II ATT. She had acute episodes of high grade fever with chills 2 weeks after starting ATT and MRI revealed bilateral TO masses suggestive of pyosalpinx. Emergency laparotomy was done, pus was drained, and cyst wall was removed and HPE was suggestive of chronic inflammation with few granulation tissues. ATT was continued for one year and the woman improved. Conclusion. The possibility of flare-up of PID (pelvic inflammatory disease) in treated case of tuberculosis undergoing infertility management should be kept in mind and aggressive management should be done.
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PMID:A Rare Case of Flare-Up of PID in Infertility Treatment. 2660 Sep 59

Pelvic inflammatory disease (PID) is an ascending infection of the female genital tract caused by the spread of bacteria from the vagina to the pelvic reproductive organs and occasionally the peritoneum. The most common causative organisms are sexually transmitted. PID is a significant source of morbidity among reproductive age women both as a cause of abdominal pain and as a common cause of infertility. Its clinical presentation is often nonspecific, and the correct diagnosis may first come to light based on the results of imaging studies. MRI is well suited for the evaluation of PID and its complications due to its superior soft tissue contrast and high sensitivity for inflammation. MRI findings in acute PID include cervicitis, endometritis, salpingitis/oophoritis, and inflammation in the pelvic soft tissues. Acute complications include pyosalpinx, tuboovarian abscess, peritonitis, and perihepatitis. Hydrosalpinx, pelvic inclusion cysts and ureteral obstruction may develop as chronic sequela of PID. The pathophysiology, classification, treatment, and prognosis of PID are reviewed, followed by case examples of the appearance of acute and subclinical PID on MR images.
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PMID:MRI in pelvic inflammatory disease: a pictorial review. 2793 78

A case of heterotopic triplet pregnancy after frozen-thawed embryo transfer is presented. The patient conceived after transfer of three frozen-thawed embryos at a fertility clinic where she had previously undergone laparoscopic left salpingectomy due to pyosalpinx. Approximately 4 weeks after the embryo transfer, she presented with a complaint of abnormal genital bleeding and was diagnosed by ultrasound as having a dichorionic twin pregnancy. One week later, she was referred to our hospital because of lower abdominal pain. Hematoperitoneum was suspected based on findings of low blood pressure and tachycardia. Diagnostic emergent laparoscopy demonstrated an ectopic pregnancy in the remnant isthmic portion of the left tube. Laparoscopic excision of the remnant fallopian tube was performed, but the procedure resulted in early-pregnancy loss of one of the twins. The risk of heterotopic pregnancy is not small under assisted reproductive technology. Attention should be paid to the risk of tubal pregnancy after transferring more than two embryos or controlled ovarian hyperstimulation, even after salpingectomy has been performed.
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PMID:Heterotopic triplet pregnancy: report of a patient with remnant tubal ectopic and intrauterine twin pregnancy after frozen-thawed embryo transfer. 2969


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