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

The first known case of vaginal expulsion of a Hulka clip has occurred in a 35-year-old Ohio woman. The woman, gravida 5, para 4, abortus 1, underwent laparoscopic Hulka clip sterilization in January 1983, with no complications. She was seen again in March 1984 for symptomatic menometrorrhagia, for which dilation and curettage was performed. At her next gynecological visit in June 1987, the patient brought in a clamped Hulka clip that had been passed through the vagina. The uterus was normal in size, the adnexa were not palpable, and no fistula or iatrogenic openings were observed. The patient had not experienced severe abdominal pain, fever, or gastrointestinal disorder. A hysterosalpingogram showed bilateral blockage of the tubes and one clip on the left side. Clip self-migration should be considered an extremely rare complication of this procedure.
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PMID:Vaginal expulsion of a Hulka clip. A case report. 177 39

Described is the second reported case of isolated abdominal wall actinomycosis associated with use of an IUD. The patient, a 24-year-old white woman, presented with lower abdominal pain, dysuria, urgency, and frequency. Ultrasonography revealed a complex mass in the left lower quadrant of the abdomen that was separate from the uterus, left ovary, and tube. At laparotomy, the patient was found to have an anterior abdominal wall abscess and there was free pus within the abdomen. The omentum was inflamed and adherent to the anterior abdominal wall. The appendix, uterus, ovaries, and tubes were not involved in the inflammatory process. Histologic examination of the omentum demonstrated the typical actinomycotic picture of gram-positive filamentous bacteria within the mass and club-like extensions beyond the periphery of the mass. The patient had a copper-7 IUD in place. The only other reported such case also involved an IUD user. That patient had an isolated anterior wall abscess caused by Actinomyces. The fallopian tubes, ovaries, appendix, omentum, and intestines were normal. The possibility of abdominal wall actinomycosis should be considered in IUD users who present with intra-abdominal abscesses of unknown etiology.
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PMID:Abdominal wall actinomycosis associated with use of an intrauterine device: a case report. 183 39

This paper reports the improved technics in 578 abdominal total hysterectomies. After dividing the infundibulo-pelvic ligaments and both layers of the broad ligaments the ovarian vessels were dissected out, cut and ligated, the utero-sacral ligaments revered but not ligated, and if necessary, the bleeding points were tied. After cutting the intervening tissues on both sides of the uterus, the uterine vessels could be identified, clamped and ligated at level below the cervical internal os. The cut edges of the vaginal cuff had to be approximated exactly, avoiding too close and too tight sutures. There was no organ injured during the operations, no abdominal pain nor hemorrhage from the cut edge of vaginal cuff after operation. Of the 520 patients followed up after operation, 518 cases had good healing at the vaginal stumps with granulation in only 2 cases, the effect with this improved method of hysterectomy has been considered satisfactory.
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PMID:[Improved technics in 578 abdominal total hysterectomies]. 191 56

A case is presented of extragenital abdominal choriocarcinoma without uterine lesion in a postmenopausal woman. Nineteen years after her antecedent pregnancy, a legal abortion, and thirteen years after her menopause, the patient was admitted to the hospital because of intermittent abdominal pain. Explorative laparotomy revealed a large tumour mass in the greater omentum, mesosigmoideum, peritoneal implants and metastatic growth to the serosal lining of the uterus and the wall of the stomach. Cytoreductive surgery was performed. The histopathological report showed an extrauterine, nongonadal pure choriocarcinoma. Immunoperoxidase stain was strongly positive for hCG and a raised serum beta-hCG level preoperatively confirmed the diagnosis. A polychemotherapy regimen was administered. However, after six months the beta-hCG levels increased rapidly. Liver, lung and mediastinal metastases were diagnosed. The patient's condition rapidly deteriorated and she expired one month later. The post mortem examination showed a far advanced extragonadal pure choriocarcinoma without any obvious primary origin. The implications for a possible origin of extragonadal nongestational choriocarcinoma are briefly discussed.
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PMID:Postmenopausal extragenital choriocarcinoma. A case report and review of the literature. 191 65

3 cases of IUD-related abdominopelvic actinomycosis diagnosed after surgery are described. A 44-year old woman was admitted with high fever and diffused, strong abdominal pain. She had had an IUD for 4 years. Hypersensitivity all over the pelvis, an enlarged uterus, and peritoneal irritation were found upon vaginal examination. Opening the peritoneum yielded 1 liter of pus, a 6 cm diameter abscess of the right adnexa, and a myomatous uterus in 12 weeks of gestation. The uterus and the right adnexa were removed. Histology confirmed actinomycosis. Penicillin was given iv for 6 weeks, and after release she took oral penicillin for 4 more months. A 33-year old woman was admitted with high fever and excruciating pain in the lower right abdomen that had lasted on and off for months. She had had an IUD for 3 years. Vaginal examination revealed a hypersensitive uterus. enlarged right adnexa, and a firm mass between the vagina and the rectal shelf. Surgery showed the omentum attached to the sigmoid colon and the right fallopian tube with an abscess of 5 cm with cysts. The growth was resected, and the cysts were opened. She received iv erythromycin for 3 weeks and then orally for 2 months leading to full recovery. A 52-year old woman was hospitalized for hysterectomy. She had had abdominal pain radiating to the back for 1 year. She had had an IUD for 15 years. A myomatous uterus in 15 weeks of gestation was detected. Surgery revealed a 15 cm size myomatous uterus with an abscess of 6 cm around it. The uterus, the left adnexa, and the abscess were resected. Histology indicated actinomycosis. She received iv ampicillin for 1 month, and scar tissue from the abscess was treated with oral penicillin for 1 month. Cervical actinomycosis was found in 1-30% of women wearing IUDs. Diagnosis requires histopathological examination. The symptomless presence of cervical actinomycosis may require the temporary removal of the IUD and antibiotic treatment.
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PMID:[IUD-associated abdominopelvic actinomycosis]. 193 47

A case of vesical endometriosis with unilateral renal agenesis is reported. A 13-year-old girl complained of difficulty in urination and lower abdominal pain during the menstruation. Detail urological examinations revealed left renal agenesis and intravesical cystic mass. The mass was located in the left vesical lateral wall, obstructing the vesical outlet and containing dark-brown-coloured fluid in it. She finally suffered from urinary retention following the menstruation and underwent a resection of the mass together with a part of the vesical wall. During the operation, the uterus was found to be a bicornate one. The resected mass was diagnosed as an endometriosis based on the histological findings. Eighteen months after the operation she is free from any symptoms during the menstruation and recurrence of endometriosis.
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PMID:[A case of juvenile vesical endometriosis with unilateral renal agenesis and bicornate uterus]. 195 38

Uterine incarceration that manifests during the third trimester or at term is a serious and rare complication of pregnancy. The pregnant patient may complain of low-abdominal pain, low-back pain, urinary retention, and constipation, or the patient may be asymptomatic until labor begins. The diagnosis is difficult, and physical findings can be misleading. Ultrasonography and magnetic resonance imaging can be helpful if the anteriorly displaced cervix is clearly depicted. If incarceration of the retroverted uterus persists until term, a cesarean section is necessary. Recurrent uterine incarceration has been reported; therefore, the patient should be monitored closely during subsequent pregnancies. Herein we describe three cases of uterine incarceration during the third trimester and review the literature with respect to incidence, differential diagnosis, management, and complications of this condition.
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PMID:Uterine incarceration during the third trimester: a rare complication of pregnancy. 204 99

A 17-year-old woman consulted our clinic with the complaint of gross hematuria and lower abdominal pain. Blood examination showed severe anemia and renal failure. Emergent hemodialysis and blood transfusion were performed. CT scanning revealed left retroperitoneal hematoma, right severe hydronephrosis and loss of uterus shadow. Under diagnosis of left renal rupture, left nephrectomy and removal of retroperitoneal hematoma were performed. The area of rupture in the left renal pelvis was identified on its posterior wall. Postoperatively renal function did not improve and periodic hemodialysis has been done.
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PMID:[Spontaneous rupture of the renal pelvis in a female patient with defect of the uterus and hypoplasia of the vagina: a case report]. 206 9

Eleven patients with leiomyosarcoma of the uterus are analysed clinicopathologically. The youngest patient was 36 and the oldest was 61 with a mean of 50.8 years. The common clinical symptoms were menorrhagia or irregular vaginal bleeding, lower abdominal pain and rapidly enlarging abdominal mass. None was diagnosed before operation for lack of specific symptoms. All tumors with 10 or more mitotic figures (MF) per 10 high-power fields (HPF) were diagnosed as malignant whereas for those with less than 10 MF/10 HPF the diagnosis of uterine leiomyosarcoma must depend on cellular pleomorphism, number of giant cells, increase in nuclear-cytoplasmic ratio and presence or absence of boundary between the tumor and normal tissue. The main treatment was total hysterectomy and bilateral salpingo-oophorectomy. The 2- and 5-year survival rates were 36.3% and 27.3%, respectively. Five cases with Stage III and IV lesions died within 11 months after operation. The clinical stage at the initial treatment is the most important prognostic factor. For tumors confined to the uterus, cellular pleomorphism, mitotic figure and boundary between the tumor and normal tissue are the other important prognostic factors.
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PMID:[Leiomyosarcoma of the uterus--a clinicopathologic analysis of 11 cases]. 207 42

The medical literature includes reports of necrotizing fascitis after Bartholin abscesses, vaginal delivery, cesarean section, abdominal hysterectomy, sterilization by bilateral total salpingectomy, and diagnostic laparoscopy. This paper presents the 1st documented report of necrotizing fascitis after sterilization by bilateral partial salpingectomy. The patient, a healthy 41-year-old, presented with severe abdominal pain, nausea, and vomiting 1 day after undergoing bilateral partial resection and ligation of the fallopian tubes through a suprapubic minilaparotomy incision (Pomeroy procedure). Disseminated intravascular coagulopathy developed soon after admission. Surgery, performed once the patient has been stabilized through corticosteroids and broad-spectrum antibiotics, revealed extensive necrotizing fascitis involving the entire abdominal wall. There was no perforation of the bowel or uterus. Escherichia coli was cultured from the patient's abdominal wall, urine, and blood. The patient was treated successfully with piperacillin, gentamicin, and clindamycin. 15 days later, multiple reconstructive procedures were initiated to close the abdominal defect. This patient's good recovery was due to the speed of the diagnosis and wide surgical debridement of all devitalized tissue. Since she showed no evidence of salpingitis at the time of the sterilization procedure, the source of bacterial inoculum in this case was most likely the patient's skin.
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PMID:Necrotizing fasciitis of the total abdominal wall after sterilization by partial salpingectomy. Case report and review of literature. 214 53


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