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

2 case reports involving the use of steroid hormones in the treatment of pelvic infections are presented. The first was a young woman with bilateral salpingo-oophoritis. The patient continued to have low abdominal and pelvic pain and to remain febrile following closure of the posterior cul-de-sac and antibiotic therapy. 2 days after cortisone was added to the treatment the patient was afebrile and after 5 days she was discharged and received diminishing doses of corticosteroid. The second case involved a young married woman with acute salpingo-oophoritis who suffered recurring episodes of salpingitis and urinary tract infection and continued to have disabling abdominal pain, especially with her menses. The infection was treated with sulfasoxisole, and menstruation was suppressed with medroxyprogesterone for 1 year. At the time of writing she had been menstruating regularly for 8 months and was free of abdominopelvic pain.
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PMID:Two unusual uses of steroid hoones in pelvic infections. 579 36

Pelvic actinomycosis of the female genital tract is an indolent suppurative inflammation involving the adnexal tissues and occasionally, the endometrium. It is becoming increasingly associated with IUD use, and its diagnosis is seldom made preoperatively. This report presents a case of widespread, unrecognized pelvic actinomycosis involving the rectum in an IUD-wearer. It also illustrates the difficulty in diagnosing and managing this disorder. A 43-year old woman admitted to the University Hospitals presented with a severe process which mimicked a pelvic malignancy. 8 months prior to admission, she had an IUD in place for 11 years removed due to irregular menstrual bleeding; dilatation and curettage revealed tissues associated with acute endometritis and several Actinomyces colonies were observed in a cervical smear. At the University Hospitals, diagnosis of pelvic actinomycosis was not suspected preoperatively. Exploratory laparotomy, hysterectomy, and bilateral salpingo-oophorectomy revealed no gross evidence of malignancy. Modified abdominoperitoneal resection was performed, leaving a sigmoid colostomy in place. Multiple histologic sections necessitated the confirmation of the diagnosis of actinomycosis. Presence of bilateral salpingo-oophoritis and the fact that Actinomyces colonies were observed in cervical smear strongly indicate that the initial focus of infection was related to the IUD rather than an intestinal site. The patient recovered uneventfully and was well at a 3-month follow-up. This case demonstrates also the progression of suppurative disease despite prior removal of IUD. Pelvic actinomycosis should be considered in patients with IUD, or those who have had them removed recently and those who are experiencing abdominal pain, recurrent vaginal bleeding, and adnexal masses.
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PMID:Intrauterine device-associated actinomycosis simulating pelvic malignancy. 723 38

A study to assess the reliability of clinical symptoms and signs in 50 patients with a presumptive diagnosis of acute appendicitis is presented. The male to female ratio was 3: 2, with age ranging from 2 to 15 years. Abdominal pain was present in 42; tenderness was localized in 35, generalized in 11 and diffuse in 4 patients. Total leucocyte count was above 11,000/cu mm in 31, below 11,000/cu mm in 17 and above 18,000/cu mm in 2. Of the 48 operated patients, 8 had normal appendices and the diagnosis in them was Meckel's diverticulitis 3, ruptured ovarian follicle 2, mesenteric adenitis 2, and salpingo-oophoritis 1. Abdominal pain and right iliac fossa tenderness with contributory investigations are the most reliable indicators of acute appendicitis with a false positive rate of 16.66% only.
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PMID:Childhood appendicitis. A clinical profile. 840 25

Most emergency physicians will agree that bleeding and abdominal pain in women of child-bearing age is considered an ectopic pregnancy until proven otherwise. Ectopic pregnancy remains the leading cause of maternal mortality in the United States. A high index of suspicion is necessary for early intervention and reduction in morbidity and mortality. Risk factors for ectopic pregnancy include previous salpingo-oophoritis, ectopic pregnancy, tubal surgery or ligation, use of an intrauterine device, hormonal therapy, and, more recently, in vitro fertilization. In addition, this case emphasizes the possibility of ectopic pregnancy in women with a history of hysterectomy without bilateral oophorectomy.
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PMID:Atypical ectopic pregnancy. 848 65

Tubo-ovarian abscess caused by Morganella morganii is unusual. A 54-year-old menopausal woman visited the emergency room with lower abdominal pain, vomiting, and fever for 4 days. Pelvic examination revealed lifting tenderness over the right adnexum without motion tenderness of the uterus. Pelvic sonogram revealed a cystic lesion with heterogeneous content in the right ovary. Salpingo-oophoritis was suspected. Clindamycin and gentamicin were administered intravenously after obtaining blood cultures. Laparoscopy was done because of sustained fever, and an ovarian abscess was found. Laparoscopic salpingo-oophorectomy was performed. The patient was discharged 5 days later and oral clindamycin was prescribed. However, she was readmitted due to intermittent fever. The result of blood culture obtained before surgery disclosed M. morganii, which was resistant to clindamycin and cefazolin. Her symptoms resolved after administration of intravenous flomoxef. This report highlights the fact that antimicrobial resistance of M. morganii may complicate the management and outcome of this infection.
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PMID:Tubo-ovarian abscess with Morganella morganii bacteremia. 1994 61

Enterobius vermicularis is a common intestinal nematode; however, rare extraintestinal Enterobius infections have been reported from different parts of the world. Here, we present a case of tubo-ovarian abscess in an otherwise healthy young sexually active female with no known comorbids with history of on and off lower abdominal pain for one year and high grade fever for one month. On the basis of further workup and radiological evaluation, a preoperative diagnosis of right sided tubo-ovarian abscess was made and salpingo-oophorectomy was performed laproscopically in July 2015. Histopathology of the resected tissue revealed necrosis and in one area Enterobius vermicularis was identified surrounded by neutrophils and eosinophil rich abscess. A final diagnosis of severe acute and chronic salpingo-oophoritis with abscess formation, secondary to Enterobius vermicularis was made. Signs and symptoms of parasitic involvement in tubo-ovarian abscesses are not much different than usual presentations of pelvic inflammatory diseases and identification of a parasite in a tubo-ovarian tissue sample is a rare clinical finding. A high index of suspicion on the part of histopathologist as well as clinician is important for timely diagnosis and effective management of such cases.
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PMID:Enterobius vermicularis in tubo-ovarian abscess: A rare and interesting incidental finding - A case Report. 2842 Sep 30