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

A total of 415 women treated for laparoscopically verified pelvic inflammatory disease (PID) were reviewed after 9.5 years. Of these, 88 (21.2 per cent) were involuntarily childless after one or more infection; in 72 cases (17.3 per cent) this was due to tubal obstruction; 263 (63.4 per cent) women became pregnant; 64 (15.4 per cent) were voluntarily childless. Tubal occlusion was diagnosed after one infection in 12.8 per cent, after two infections in 35.5 per cent, and after three or more infections in 75 per cent of the women. Tubal occlusion was more common after nongonorrheal than after gonorrheal salpingitis. Infertility varied with the inflammatory changes seen at laparoscopy. The ratio between ectopic and intrauterine pregnancies after the infections was 1/24. Chronic abdominal pain was reported by 18.1 per cent of the women. Corresponding findings in 100 healthy control subjects were: involuntary childlessness in three despite normal Fallopian tubes, one ectopic in 147 intrauterine pregnancies, and chronic abdominal pain in five cases.
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PMID:Effect of acute pelvic inflammatory disease on fertility. 12 23

Between 1973 and 1976, laparoscopy was performed on 50 girls aged 12 to 18 years old for evaluation of abdominal pain severe enough to warrant hospitalization. In nine patients, a pelvic mass was suspected on physical examination or ultrasonography. Twenty-three patients had histories of previous episodes of salpingitis, but negative cultures at time of admission. Eighteen patients had no significant past medical history and normal physical findings. Laparoscopy established a diagnosis in 28 of the 50 patients, and in the 32 patients in whom a specific preoperative diagnosis was entertained, laparoscopy proved it to be incorrect in 15. In all cases where laparoscopy resulted in specific treatment, the symptoms were relieved. There was no morbidity or mortality.
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PMID:Laparoscopy for diagnosis and treatment of abdominal pain in adolescent girls. 14 23

313 patients with ectopic pregnancy were treated at Chicago Lying-In Hospital in 1968-1975, for a frequency of 1 in 72 deliveries. Historical and physical findings, diagnostic procedures, causative factors, and patient management were reviewed for 284 of these patients. 97.5% of the pregnancies were tubal. 25% of the patients were nulliparas and 31.7% were primiparas. 34.9% had had 1 or more previous abortions. The mean age of the patients was 28. Most had been using no contraception, and only 3.9% had an IUD in situ. The most common symptoms were abdominal pain (96.7%) and amenorrhea (73.6%), while the most frequent abdominal findings were tenderness (83.4%), rebound pain (41.2%), and guarding (28.9%). Adnexal tenderness was found in 72.2% and 30% had distinct adnexal masses. An initial misdiagnosis of pelvic inflammatory disease was made in 132 (46.5%) cases. A culdocentesis and slide latex agglutination inhibition pregnancy test performed in 167 and 102 patients, respectively, gave 82.6 and 73.5% positive rates. Diagnostic laparoscopy was used routinely after 1970 on all nonacute patients in whom ectopic pregnancy was suspected, and this led to a significant drop in the rate of ruptured pregnancies (63% pre-1970 and 45% post-1970). 25% of patients were sterilized, but the treatment of choice was salpingectomy unless the opposite tube was absent or damaged. Gross evidence of pelvic inflammatory disease was noted in 36% of patients and 31% had salpingitis. The most common postoperative complication was fever (42.2%). 3 deaths occurred in the series (2 due to acute pulmonary edema resulting from fluid overload), for a maternal death rate from ectopic gestation of 13.83/100,000 live births. No fetuses survived.
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PMID:Ectopic pregnancy. An eight-year review. 43 84

2 cases of unrecognized oviduct pregnancy receiving therapeutic abortion by uterine aspiration are reported. A 29-year-old white female, gravida 4, para 2 with a Dalkon Shield in place for 2 1/2 years and with 6 weeks amenorrhea received a therapeutic abortion. 3 days later the patient complained of fever and severe suprapubic cramps. Minocycline was given in the belief that the patient was suffering from endometritis. 17 days after uterine aspiration the pain increased. At laparoscopy a corpus luteum was seen in the left ovary and blood was present in the pelvis. Histological examination of the oviducts revealed signs of an aborted oviduct pregnant. A 2nd case concerned a 26-year-old white female, gravida 2, para 2, using the Ogino-Knaus method of contraception and who had a normal menses 7 weeks previously. 12 days after uterine aspiration the patient complained of continued vaginal bleeding, lower abdominal cramps, and chills. After uterine aspiration was repeated minocycline therapy was initated. 20 days after the initial aspiration the patient reported a return of vaginal bleeding and lower abdominal pain. Laparotomy revealed a ruptured oviduct. Histology showed salpingitis and fusion of the right fimbria and a large blood clot and trophoblastic villi in the lumen of the right ampulla. In the future it is suggested that histological examination of the aspiration should be performed to aid in finding oviductal or ovarian pregnancies.
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PMID:Case reports: unrecognized oviduct pregnancy and therapeutic abortion by uterine aspiration. 97 19

Reported is the rare case of an actinomycosis of the right Fallopian tube. The clinical picture is characterized by a comparatively sudden onset of abdominal pain, obstipation and feaver as well as a markedly increased ESR. Good co-operation between the various clinical disciplines (urology, surgery, internal medicine, gynecology) lead to an exact preoperative localization of the scaring and infiltrating process that is then verified by laparotomy. The right adnexae show massive inflammatory infiltrates and form a conglomerate tumor with the adjacent sigma and appendix. Characteristic actinomycetic druses are found histologically only in the right Fallopian tube. On the left side a florid non-specific salpingitis is antibiotics is withoug complications. Mode of infection, differential diagnosis and prognosis that is dependent on a correct diagnosis at an early stage are discussed.
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PMID:[A case of actinomycosis of the fallopian tube (author's transl)]. 99 15

110 patients suffering from laparoscopical verified salpingitis and desire for a baby, were treated with tetracycline (oxytetracycline or doxycycline; TC)/metronidazole (n = 67), augmentan (n = 22) or cipropfloxacin/metronidazole (n = 21). After an average period of 11.6 weeks, all patients underwent second-look laparoscopy with dye insufflation. In 34 patients treated with TC/metronidazole, the effects of additional physio-therapeutical measures were examined under conditions as they prevail in a Spa. 33 patients without balneotherapy served as controls. All the 4 groups were comparable (p greater than 0.05) in respect of mean age, percentage, share of nulliparous women, salpingitis gonorrhoica, contraceptive behaviour and also of the stage of salpingitis. All antibiotic regimens used resulted in a prompt decrease of inflammatory clinical signs after five days (temperature, blood sedimentation rate, leukocytes). Only 2 of 34 patients treated by additional cure at a Spa reported complaints, whereas complaints were reported by 14 of 33 control patients (p less than 0.01), 7 of 22 (p less than 0.01) treated with augmentan and to 7 of 21 (p less than 0.01) treated with ciprofloxacin/metronidazole. The tubal occlusion rates amounted to 33.3% (TC/metronidazole), 32.3% (TC/metronidazole and balneotherapy), 22.7% (augmentan) and 23.8% ciprofloxacin/metronidazole. The differences did not attain statistical significance (p greater than 0.05). With regard to adhesions, there were, likewise, no significant differences between findings at first laparoscopy and second look-laparoscopy, respectively. It is concluded, that additional physiotherapeutic measures, after antibiotic therapy of acute salpingitis, reduce the frequency of lower abdominal pain, but do not result in an improvement of tubal occlusion and reduction of adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of acute salpingitis with tetracycline/metronidazole with or without additional balneotherapy, Augmentin or ciprofloxacin/metronidazole: a second-look laparoscopy study]. 153 47

Chlamydia trachomatis is a well-known cause of acute and chronic salpingitis, accounting for approximately half of all cases of pelvic inflammatory disease. Typically, patients with acute chlamydial salpingitis present with acute lower abdominal pain, tenderness on bimanual pelvic examination, or vaginal discharge. We describe a case of acute chlamydial salpingitis with marked ascites and an adnexal mass that simulated a malignant neoplasm. Microscopically, a severe lymphofollicular salpingitis and a marked lymphofollicular hyperplasia of the omentum and retroperitoneal lymph nodes were found. Chlamydial inclusions in the fallopian tube epithelium were demonstrated by immunohistochemistry using a mouse monoclonal antibody to a genus-specific outer membrane lipoprotein. Chlamydial infection may cause marked ascites and a palpable adenexal mass and should be considered whenever marked chronic inflammation with a lymphofollicular hyperplasia involves the fallopian tube or other female genital tract sites.
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PMID:Acute chlamydial salpingitis with ascites and adnexal mass simulating a malignant neoplasm. 177 10

Pelvic inflammatory disease continues to be a common finding in young women with lower abdominal pain. Typical emergency room pelvic inflammatory disease, with classic symptoms of pain, fever, and a history of high-risk sexual behavior, is easily diagnosed with a high degree of specificity. However, the majority of patients with pelvic inflammatory disease have atypical symptoms, and their condition may be incorrectly diagnosed and treated. Careful attention to the physical signs of pelvic infection and the evaluation of the vaginal secretions for leukocytes improves diagnostic accuracy. Liberal use of diagnostic laparoscopy to confirm the possibility of acute salpingitis is recommended in young women, who have much to lose from a case of untreated salpingitis. Outpatient treatment with a beta-lactam antibiotic followed by a course of doxycycline adequately treats patients with N. gonorrhoeae and C. trachomatis infections. However, patients with suspected anaerobic upper genital tract infection such as those infections associated with tubo-ovarian abscess or IUD use should be admitted for parenteral antibiotic therapy and observation. Laparotomy and extirpative surgery should be reserved for seriously ill patients with generalized peritonitis associated with rupture of a tubo-ovarian abscess and for patients who do not respond to antibiotic therapy. Sound judgment regarding the extent of extirpative surgery, taking into consideration the wishes of the patient with respect to future fertility and hormone production, will lead to an acceptable outcome.
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PMID:Surgical considerations in the diagnosis and treatment of pelvic inflammatory disease. 183 38

Comparing the characteristics of the two groups young women: one with laparoscopically confirmed pelvic inflammatory disease (PID) and the other with no PID (control group) but corresponding to the first group by age, marital status and number of pregnancies, it has been found that the patients with PID are below 25 years of age, have a lower degree of education (p less than 0.05), and 25.5% of them do not use any contraceptive method (p less than 0.01). It has also been observed that in their gynecologic history they mention an episode of lower abdominal pain (p less than 0.01). A further comparison of this finding with laparoscopically confirmed adnexal changes has shown that in 50% of the study group patients there exist sequelae of an earlier PID episode (asymptomatic salpingitis). The results obtained point to the need for carefully connecting the characteristics of the population regarding the risk of PID and the minimal clinical symptoms in diagnosing PID.
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PMID:[Characteristics of patients with laparoscopically verified pelvic inflammation]. 183 45

23 women with lower abdominal pain and Chlamydia trachomatis in the cervix, urethra, or both sites were studied. Laparoscopy was done with sampling of the endometrium and fallopian tubes for detection of C trachomatis. 11 women had laparoscopic evidence of pelvic inflammatory disease (PID); C trachomatis was detected in the upper genital tract of 8, but not in the upper tract of 5 who had laparoscopy again after treatment. The organism was also found in the upper genital tract of 9 of the 12 women without laparoscopic evidence of PID. Most of the women with abdominal pain or tenderness had tubal or endometrial C trachomatis infection, although only half had laparoscopic evidence of salpingitis. This finding suggests that antibiotic treatment should be given as soon as chlamydial infection is detected in the cervix and that pain does not necessarily point to C trachomatis in the upper genital tract. Laparoscopy may miss important pathogens in the upper genital tract, unless the procedure is complemented with detailed microbiological investigation.
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PMID:Chlamydia trachomatis in the fallopian tubes of women without laparoscopic evidence of salpingitis. 197 3


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