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

Physicians examined 216 women who presented at Chittaranjan Seva Sadan College of Obstetrics, Gynaecology, and Child Health in Calcutta, India, and had undergone surgical sterilization at least 2 years earlier. Endometrial biopsies during the late secretory phase in the 32 cases with excessive bleeding during the late menstrual period found proliferative changes: dilated glands in 28 cases and poor secretory phase in 4 cases. The 12 ovarian biopsies revealed cortical stromal hyperplasia in 1 case. None of the control cases (i.e., those with no menorrhagia) had any ovarian changes. Observed pelvic pathologies included in the order of frequency: cystic ovaries, hydrosalpinx, uterine fibroids, pelvic endometriosis, uterine prolapse, chronic cervicitis, and scar endometriosis. Most of the 216 women were 25 to 35 years old and the youngest was 22 years old. Menorrhagia was the most common complaint (59.2%) and 30 to 35 year old women suffered from it the most. Among women who had no pelvic pathology, dysfunctional uterine bleeding was responsible for menorrhagia. Dysmenorrhea was the next most frequent complaint (29.6%). Intermenstrual bleeding, abnormally infrequent menstruation, and secondary amenorrhea were other menstrual disturbances (5.56%, 4.17%, and 1.39%, respectively). Other relatively common symptoms associated with surgical sterilization were abdominal pain (25%), abdominal discomfort and backache (14.8%), and whitish, viscid vaginal or uterine discharge (12.03%). Less frequent symptoms were obesity, painful scar, insomnia, irritability, depression, and regret. Proper preoperative and postoperative counseling would have prevented many of the complications.
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PMID:Aftermaths of surgical sterilisation with special reference to menstrual disturbances. 153 7

This article describes a case in which tubal torsion occurred as a complication of bipolar electrocoagulation via a laparoscope. The patient, a 37-year old woman who had undergone bipolar electroagulation of her fallopian tubes via a laparoscope 11 months earlier, presented with an acute abdomen. A preoperative diagnosis of torsion of an ovarian cyst was made. The right adnexa, including the entire fallopian tube and ovary, was infarcted and presented as a 10 x 7 x 4 cm mass that had undergone a torsion of 540 degrees. A right salpingo-oophorectomy and a left salpingectomy were performed, and microscopic examination confirmed the gross finding of infarction of the right adnexa and a left hydrosalpinx. Altogether, 14 case of tubal torsion following tubal sterilization have been reported since 1956. Of these, this is the 6th case associated with electrocoagulation. The interval between the sterilization procedure and presentation with torsion has ranged from 5 months to 8 years. Many patients present at the middle of their menstrual cycle. There is generally a history of acute onset of abdominal pain which may be generalized or localized to the lower abdomen or either iliac fossa (most commonly the right). The pain is usually not associated with gastroin estinal symptoms. Unlike acute salpin gitis, there is no fever or leucocytosis in early cases. There are signs of peritoneal irritation in the involved iliac fossa and an adnexal mass can usually be palpated on vaginal examination. Abnormal mobility and an abnormal bulk of tube appear to be required before the fallopian tube will undergo torsion. Increased mobility is caused by severing or at least constricting the attachment of the tube to the uterus. The increased bulk of the tube is produced when secretions from the tube can no longer travel into the uterus, resulting in a hydrosalpinx.
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PMID:Torsion of the fallopian tube following tubal sterilization by electrocoagulation via a laparoscope. 316 Jun 15

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

The purpose of this case report is as follows: to attempt to establish an association between the observed increase in hydrosalpinx and the phenomenal increase in surgical sterilization; to present a credible etiology for iatrogenic hydrosalpinx; and to discuss the pathogenesis of a disease process henceforth referred to as post tubal ligation syndrome. A 36-year-old white woman was admitted to Park View Hospital in Nashville, Tennessee on January 7, 1981 for evaluation of continuous lower abdominal pain, abdominal pressure, and dyspareunia for several months. The woman had 2 children who were delivered vaginally. An abdominal tubal ligation was performed for sterilization when she was 27, and vaginal hysterectomy, with anterior and posterior colporrhaphy, was done for symptomatic pelvic relaxation at age 33. Physical examination showed tenderness without palpable masses in the pelvic adnexal areas. Laboratory studies were within normal limits. On January 9, 1981, the patient underwent exploratory laparotomy, and bilateral salpingo-oophorectomy. She was found to have bilateral hydrosalpinx. Historically, hydrosalpinx has been considered an intermediary step in pelvic inflammatory disease. Iatrogenic hydrosalpinx is, in essence, initiated by an initial insult, e.g., tubal ligation, fulguration, or application of a mechanical clip or band. Theoretically, single point interruption of a fallopian tube should produce no ill effects. The popularity and success of tubal ligation attest to single point interruption of an otherwise normal fallopian tube as an innocuous procedure. A schematic drawing is provided of the same tube insulted a 2nd time and consequently the situation is prefactory to development of hydrosalpinx, i.e., a tube lined with secretory epithelium is closed at both ends. Secretion within this closed system will produce dilatation. This "2nd" insult to the normal fallopian tube, post tubal ligation, may take 1 of several forms. The symptoms of iatrogenic hydrosalpinx are not pathognomonic. The most useful diagnostic tools are a high degree of suspicion, history of previous tubal ligation, and history of tubal ligation followed by hysterectomy with conservation of ovarian function.
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PMID:Post tubal ligation syndrome or iatrogenic hydrosalpinx. 731 12

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

Classic teaching has stated that women who have undergone bilateral tubal ligation (BTL) are not susceptible to pelvic inflammatory disease (PID). The purpose of this study was to confirm the existence of PID in patients with BTL and to compare clinical parameters of these patients with PID patients who have not had BTL. A retrospective chart review of emergency department (ED) patients diagnosed with PID over a 1-year period at a large urban university hospital found 209 patients who fulfilled the criteria for a definition of PID. Of the 209 patients with PID, 24 (11.7%) had undergone BTL. Patients with and without BTL were compared with respect to age, white blood cell count (WBC), temperature, admission rate, length of hospitalization, prior history of PID, culture results, presence of bilateral abdominal pain, presence of rebound tenderness, and complications of tubo-ovarian abscess (TOA) and hydrosalpinx. Patients with BTL had lower WBCs (11,100/microL v14,700/microL) and were 2.5 times less likely to be hospitalized compared to those patients without BTL. These results show that PID in the setting of a prior BTL not only exists but occurs with surprising frequency and deserves further study. Patients with BTL and PID may have a clinically milder form of PID than those patients without BTL.
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PMID:Pelvic inflammatory disease in patients with bilateral tubal ligation. 914 84

We report on a 12-year-old girl who underwent laparoscopic excision of a left-sided hydrosalpinx. She presented with recurrent lower abdominal pain 8 years after appendectomy and resection of the left ovary. Sonography revealed a large cystic, tubular mass cranial and to the left of the urinary bladder. Laparoscopy demonstrated a left-sided hydrosalpinx which was resected endoscopically using a stapler.
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PMID:Laparoscopic removal of hydrosalpinx in a girl: case report. 929 22

Isolated torsion of fallopian tube is very uncommon during pregnancy. Predisposing factors for torsion are hydrosalpinx, prior tubal operation, pelvic congestion, ovarian and paraovarian masses and trauma. Although the most important clinical symptom is abdominal pain in lower quadrants, the diagnosis is usually established during the operation performed for acute abdomen and salpingectomy is almost always necessary. Two cases of torsion of fallopian tube during pregnancy, one with hydrosalpinx, the other with paratubal cyst are presented and symptoms and predisposing factors are discussed.
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PMID:Isolated torsion of fallopian tube during pregnancy; report of two cases. 930 14

Adnexal cystic lesions in women of reproductive age are common. Most are functional ovarian cysts, followed by paraovarian cysts, hydrosalpinx, and adnexal torsion. A 34-year-old woman experienced mild abdominal pain, nausea, and low-grade fever. She received empiric antibiotics in an outpatient clinic after a diagnosis of tubo-ovarian abscess. After 3 days she was referred to our hospital with no improvement in symptoms or signs. Isolated fallopian tube torsion was diagnosed and successfully treated by laparoscopy. Laparoscopy played an important role in making an accurate diagnosis and avoiding unnecessary delays in treatment.
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PMID:Isolated tubal torsion managed laparoscopically. 1092 43

We describe the pathology of a unique case of Fallopian tube amebiasis, associated with hydrosalpinx, in a 21-year-old woman. She complained of lower abdominal pain, had a foul-smelling green vaginal discharge and fever during one week. There was a discrete increase in body temperature and a painful abdominal palpation at the lower right side, with signs of local peritoneal irritation. Pathological examination showed a marked dilatation of the fallopian tube and hydrosalpinx. Microscopic examination showed a poorly formed granuloma composed of large macrophages with many Entamoeba histolytica trophozoites inside the fallopian tube. Even though it is a rare disease the correct diagnosis of female genital tract amebiasis is of great importance for the indication of proper therapy.
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PMID:Salpingitis due to Entamoeba histolytica. 1198 Jun 11


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