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

Uterine lipoleiomyoma is uncommon and has received little attention from gynecologists. We report a case of uterine lipoleiomyoma with subsequent pelvic abscess after rupture of the appendix. Its clinical picture mimicked uterine malignancy. The patient was a 60-year-old woman, who presented with a 2-week period of lower abdominal pain which was exacerbated 10 days later. After admission, gynecologic examination revealed a large pelvic mass of firm consistency. On a plain film of the abdomen, there was a large calcified mass in the pelvis. Pelvic ultrasound demonstrated a 15 yen 12 yen 12 cm mass with strong echogenicity in the margin, but the central component of the mass was attenuating and revealed a poorly defined echogenic mass. A computed tomography scan of the pelvis demonstrated a well-encapsulated mass that was predominantly the density of fat (-65 Hounsfield unit) in the central part, with calcification present in the peripheral layer of the mass. There was also a cystic lesion measuring 3 yen 2.5 yen 1.5 cm in the right adnexal area. A preoperative diagnosis of uterine lipoleiomyoma with necrosis, liposarcoma of the uterus or teratocarcinoma of the ovary was made by the CT scan. A diagnostic dilatation and curettage (D&C) revealed a uterine cavity length of 12 cm by sounding, and the specimen showed no malignant tissue. Therefore, the preoperative suspicion of ovarian teratocarcinoma could be excluded. The patient underwent an exploratory laparotomy, multiple pockets of pelvic abscess, enlargement of the uterus and induration of omentum surrounding the appendix were found.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Uterine lipoleiomyoma with calcification: report of a case]. 135 16

From Jan 1, 1971 to Dec 12, 1990, 65 cases of abruptio placenta were admitted to our hospital. The incidence was 0.19%. Among them, thirty were complicated by pregnancy induced hypertension (46.2%). The perinatal fetal mortality was 19.7%; perinatal death occurred mostly in the premature group. All babies survived except two abnormalities. Cesarean section rate was 32.3%. All postpartum hemorrhage 29.2%. Couvelaire uterus 6.2%, were cured by conservative treatment. There was neither stillbirth nor newborn death in the thirty three cases treated expectant, but a newborn asphyxia rate of 6.1% and a cesarean section rate of 15.1%. Analysis showed that abruptio placentae should be suspected in cases with abnormal fetal heart rate of unknown cause accompanying signs of labor, premature labor of unknown cause, uterine tongue, ultrasonically visualized liquid from dark area behind the placenta, besides classical signs of abdominal pain and vaginal bleeding. Expectant treatment is appropriate if gestational age is small and no acute symptoms exists so as to minimize the perinatal mortality and cesarean section rate.
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PMID:[Analysis of 65 cases of abruptio placenta]. 139 97

There is a 24% complication rate after first trimester induced abortions using traditional methods. This rate increases significantly in women who have a history of severe gynecological diseases (SGDs), e.g., uterine myoma, scars on the uterus, and developmental defects of the genitals. The goal of this investigation was to shed light on the effectiveness of miniabortion among pregnant women with SGDs. 61 patients aged 21-43 years with SGDs (33 with uterine myomas, 22 with scars, and 6 with uterine developmental defects) who underwent abortion by vacuum aspiration were studied. All women had had 1-3 births and 1-11 abortions. Only one patient with scars required dilatation of the cervix to Hegar 6. 85% of the patients tolerated the operation well, while 15% either had lower abdominal pain or vertigo, which abated soon after the procedure. 3-10 days after the operation slight menstruation reactions developed in 97% women that lasted 1-3 days. In 11% of cases the menstruation reaction was accompanied by pain. In two patients with uterine myoma the bleeding did no stop within 5 days after the abortion. One of these patients had profuse bleeding with clots, and 13 days after abortion she developed postabortal endometritis. One patient with scars became pregnant. The rate of complications amounted to 3.3%. The high risk of postabortal complications owing to the defects of the myometrium necessitated the administration of weak uterine drugs, such as ergotal. Trihopol was also administered for the prevention of inflammation. Starting the fifth day after the beginning of menstruation-like reactions, the patients were started on estrogen-gestagen preparations for contraception for three menstrual cycles. After the end of the menstrual reaction, they were enrolled in rehabilitative physiotherapy: electrophoresis or ultrasound applied to the area of the uterus. Regular menstruation usually resumed 20-30 days after the beginning of the menstrual reaction. The highly effective miniabortion curettage is recommended because of negligible risk of trauma.
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PMID:[A method of vacuum aspiration in early pregnancy in women with a history of severe gynecologic diseases]. 147 26

Intestinal occlusion is a rare pathologic event during pregnancy occurring mostly in the second and third trimenon when increased volume of the uterus and the consequent displacement of abdominal organs cause complications of pathologies which would otherwise escape notice, such as intestinal adhesions, to become manifest. Diagnosis is difficult for a number of reasons. Vomiting during the first trimenon and mild abdominal pain during the third are often neglected or considered to be part of the normal course of pregnancy; pain is sometimes referred to atypical sites due to the displacement of abdominal organs; in other cases, the high endorphin tonus is apt to reduce the customary defence reaction. All this should not cause time to be lost, and whenever intestinal occlusion is suspected all the necessary diagnostic procedures must at once be carried out and appropriate therapy must speedily be started so as to reduce the risk of mortality and morbidity for mother and fetus. Management of ileus in pregnancy is identical to that for the non pregnant woman, except for the need to empty the uterus in cases in which it prevents treatment or if the fetus has reached a sufficient degree of pulmonary maturity. The paper describes a case of ileal volvulus and revisits the literature analyzing the diagnostic and therapeutic options suggested.
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PMID:[Intestinal volvulus in pregnancy]. 149 64

Imperforate hymen should be considered in girls of menarcheal age with a history of amenorrhea and vague abdominal discomfort, particularly if associated with symptoms of urinary obstruction or constipation. Patients may present with severe dysmenorrhea and localized pain mimicking appendicitis if hematocolpometra is due to unilaterally imperforate hymen with duplicate vagina and didelphic uterus. Although this condition is exceedingly rare, the case presented stresses the importance of a careful history and physical examination of an adolescent girl presenting with symptoms of abdominal pain associated with menstruation.
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PMID:Didelphic uterus and unilaterally imperforate double vagina as an unusual presentation of right lower-quadrant abdominal pain. 149 48

Clinical experience with and adverse effects of methotrexate for the treatment of unruptured ectopic pregnancy are described. Ectopic pregnancy is suspected in the presence of the following: positive results on pregnancy test (e.g., test for beta-human chorionic gonadotropin [beta-hCG]), lower abdominal pain, a normal or slightly enlarged uterus, and a mass on either side of the midline. When laparoscopy is required for diagnosis, surgical correction is done at the same time. However, use of serial beta-hCG titers, vaginal ultrasound examinations, serum progesterone concentrations, and dilation and curettage (when the pregnancy is confirmed to be nonviable) allows earlier detection of ectopic pregnancy without laparoscopy. If rupture has not occurred, i.v. or i.m. methotrexate is administered; usually, i.m. leucovorin is given, on alternate days, to prevent hematologic toxicity. Adverse effects of methotrexate include stomatitis, gastritis, and hepatic enzyme elevation. Use of a single-dose regimen of i.m. methotrexate without leucovorin has been associated with a lower frequency of toxicity. Selection criteria for patients are as follows: (1) an unruptured ectopic pregnancy less than or equal to 3.5 cm in greatest dimension on transvaginal ultrasound, (2) no active renal or hepatic disease, and (3) no evidence of leukopenia or thrombocytopenia. Intramuscular methotrexate therapy is a safe and effective alternative to surgery for the treatment of unruptured ectopic pregnancy.
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PMID:Methotrexate for treatment of unruptured ectopic pregnancy. 153 28

In Ohio, a 33-year old woman who had never had an ectopic pregnancy presented at an emergency facility not physically attached to a hospital with abdominal pain over 24 hours which had become more intense during the preceding 4 hours. She did not have vaginal bleeding, diarrhea, vomiting, or pain while urinating. 2 weeks earlier she had a voluntary intrauterine abortion at 8 weeks' gestation. She had intercourse 1 week before coming to the emergency facility. She had widespread tenderness in her abdomen, especially in the lower areas. Blood cell studies suggested an infection. The attending physician presumed her to have pelvic inflammatory disease (PID) as a result of either sexual intercourse or the elective abortion. The physician called for a urinary beta human chorionic gonadotropin test to determine whether placental tissue remained in the uterus. It was positive. 60 minutes after admission, the supine patient's pain increased and her blood pressure dropped to 80/50 mm Hg from 100/60 mm Hg at admission. After administering Ringer's solution, the health team sat her up and she fainted. A repeat cell count indicated sepsis. Her blood pressure decreased to 60 by Doppler and the physician continued to give her fluids and began dopamine. After the team stabilized her, they transferred her to a hospital. Her private physician examined her and then began surgery. The physician found a tubal pregnancy and removed the affected tube and ovary. She recuperated completely. Combined intrauterine and extrauterine pregnancy occurs once in every 30,000 cases. Previous PID, use of ovulation inducing medication, and in vitro fertilization with embryo transfer increases the likelihood of this type of pregnancy occurring. Physicians should consider this possibility if a woman has any of these histories and a combination of abdominal pain, adnexal mass with pain and tenderness, peritoneal irritation, and an enlarged uterus.
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PMID:Ruptured ectopic pregnancy in a patient with a recent intrauterine abortion. 157 Sep 21

A woman presented with abdominal pain, weight loss and a pelvic mass. At the time of laparotomy she had a lower abdominal abscess from perforation of the ileum. Two years later she returned with a tender uterus and purulent cervical discharge. A hysterosalpingogram demonstrated an uteroileal fistula secondary to Crohn's disease, and the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy.
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PMID:Hysterosalpingographic diagnosis of Crohn's disease. A case report. 156 17

True unicornuate uterus is a rare anomaly which is often associated with renal tract anomalies, and may predispose to infertility and pregnancy complications. Three additional cases are reported here. One of the women had associated bony and cardiac anomalies, although there was no good evidence that these were part of a syndrome. The diagnosis in each case was made incidentally during the surgical investigation of abdominal pain, which in one case was caused by an ectopic pregnancy, itself a rare occurrence with unicornuate uterus.
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PMID:Unicornuate uterus. 167 50

Complete duplication of vagina, cervix and uterus, with imperforate hemivagina and renal agenesis is a rare condition with less than 120 cases published. In those articles, urological complications are uncommon with only a 10% of the total. We report 2 cases of uterus didelphys with unilateral hematocolpos and ipsilateral renal agenesis with urological clinical complications. One of them presented a very rare onset complaining of acute urinary retention. The other patient was referred for difficulty in micturition and abdominal pain which is the most common symptom of this entity. A description of both cases and a literature review of this congenital complex syndrome and its urological complications are reported.
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PMID:Urological complications associated to uterus didelphys with unilateral hematocolpos. A case report and review of the literature. 174 40


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