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

Between April 1988 and June 1991, health workers in Nigeria followed 300 women aged 20-40 who had had a copper releasing IUD inserted during menstruation at the family planning clinic of the University College Hospital in Ibadan. The double blind clinical trial compared the effectiveness and side effects of three copper releasing IUDs: Copper T380A, Multiload 375, and Multiload 250. 75.7% had used no contraception before admission to the study. Pelvic inflammatory disease (PID) occurred more often in the MLCU 250 group than the other two groups. Only two women were hospitalized for PID. These two women used the TCU 380A or MLCU 250. Many IUD users experienced abdominal pain during menstruation and TCU 380A users had the highest rate (27% vs. 21-24%). Heavy bleeding during menstruation was more common in TCU 380A and MLCU 375 users (5% and 4%, respectively, vs. 2%). Pelvic pain/cramps were present in 1-3% of women, but did not contribute to removal. The only case of uterine perforation was in a user of the TCU 380A. None of the MLCU 375 users experienced IUD expulsion, while two TCU 380A users experienced total expulsion and two and one MLCU 250 users experienced total and partial expulsion, respectively. PID was related to IUD removal at 6 months (3.1% vs. 0; p 0.05). The pregnancy rate at 6 months was 1.1% for the TCU 380A group and 0 for the other groups. At 12 months, it was 1.1% for the TCU 380A group and the MLCU 375 group and 0 for MLCU 250. The net 6-month IUD cumulative termination rate was highest in the TCU 380A group (11.1% vs. 3-7%; p 0.05). These differences were no longer significant at 12 months. The net 6- and 12-month IUD continuation rate was 97% and 92% for MLCU 375 compared to 88.9% for TCU 380A and 93% for MLCU 250 and 85.8% for TCU 380A and 87% for MLCU 250, respectively. These findings suggest that these three IUD devices could be used in the hospital's family planning clinic.
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PMID:Performances of copper T 380A and multiload copper 375/250 intrauterine contraceptive devices in a comparative clinical trial. 749 2

The use of serum amylase levels in the diagnosis of acute pelvic inflammatory disease (PID) was investigated prospectively. Eighty-five women presenting with the chief complaint of lower abdominal pain were entered into the study; all patients were examined by one of the principal investigators. In addition to the usual laboratory studies, a serum amylase level was obtained on all patients; the investigators were blinded to the results. Patients were diagnosed with PID if they fulfilled previously published clinical criteria. Forty-eight patients met the criteria for the diagnosis of PID (PID group); 37 patients were diagnosed with other disease processes (non-PID group). The average serum amylase level for the PID group was 62 U/L, with a standard deviation (STD) of 24; for the non-PID group, the average was 76 U/L with an STD of 32. Although there was a statistical difference between the two groups (P < .05), there was no clinically significant difference because both values fell within the normal range of serum amylase. The routine use of serum amylase in the diagnosis of acute PID seems to be of no value.
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PMID:The role of serum amylase in the diagnosis of acute pelvic inflammatory disease. 768 45

Thirty-nine cases of ovarian pregnancy in our hospital from 1982 to 1992 were analyzed, and compared with the tubal pregnancies admitted during the same period. It showed that the incidence of ovarian pregnancy was 2.6% of all ectopic pregnancies with a trend to increase yearly. The clinical features of ovarian pregnancy revealed that abdominal pain was the major symptom, and history of amenorrhea was obscure. The clinical diagnosis of ovarian pregnancy was more difficult than that of tubal pregnancy. The typical histologic characteristics showed the embryo and chorionic villi surrounded by ovarian tissue or the presence of decidual changes. Ovarian pregnancy was closely related with poor uterine environment, pelvic inflammatory disease and/or endometriosis. The preferred therapeutic procedure was partial ovariectomy or wedge resection, preserving the normal ovarian tissue and tube as much as possible.
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PMID:[A clinical study 39 cases of ovarian pregnancy]. 771 73

Nineteen women with acute lower abdominal pain of uncertain etiology underwent diagnostic laparoscopy during a 2-year period from August 1991 to August 1993 and were retrospectively reviewed. All patients, aged 12 to 44 years, were premenopausal. Laparoscopy provided definitive diagnosis in all 19 patients. Laparoscopic findings included appendicitis (11 cases), pelvic inflammatory disease (five cases), significant ovarian cysts (two cases), and ectopic pregnancy (one case). Successful laparoscopic procedures included appendectomy (five cases), and salpingo-oophorectomy (one case). Five patients required only diagnostic laparoscopy. Eight patients required conversion to an open procedure because of anatomical considerations (six cases) or equipment failure (two cases). Median operative time was 71 min, and median postoperative hospital stay was 2 days. Most diagnostic procedures were performed on the same day as admission, resulting in a median hospital stay of 3 days. Diagnostic laparoscopy performed in premenopausal female patients with acute lower abdominal pain of unknown etiology provides diagnostic accuracy as well as therapeutic capabilities and prevents unnecessary laparotomy.
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PMID:Diagnostic laparoscopy in women with acute abdominal pain. 777 58

A retrospective case series was conducted at a teaching hospital with an emergency department (ED) census of 100,000 patients per year to identify the incidence of, and factors associated with, the misdiagnosis of appendicitis in nonpregnant women aged 15 to 45 years. There were 174 nonpregnant women identified with a pathologic diagnosis of appendicitis. Clinical features were then compared between patients misdiagnosed (seen in prior 10 days and given an incorrect diagnosis) and those who were initially diagnosed correctly. The results showed that 33% of the women with appendicitis were initially misdiagnosed. The most common misdiagnoses included pelvic inflammatory disease, gastroenteritis, and urinary infections. Misdiagnosed women more frequently exhibited diffuse and bilateral lower abdominal pain and tenderness, cervical motion, and right adnexal tenderness. Misdiagnosed women also had a lower incidence of right lower quadrant pain and tenderness, and peritoneal signs. In addition, misdiagnosis was associated with an increased incidence of perforation, abscess formation, and an increase in the total length of hospitalization. In conclusion, the incidence of misdiagnosis of appendicitis in women of childbearing age is high. Women who are misdiagnosed have less typical symptoms and physical findings and more frequent abnormal pelvic findings than those who are diagnosed correctly. Emergency physicians should be aware that atypical signs and symptoms are associated with misdiagnosed appendicitis in nonpregnant women of childbearing age.
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PMID:Misdiagnosis of appendicitis in nonpregnant women of childbearing age. 778 32

Eighty-one women who presented to a genitourinary medicine clinic with mild to moderate acute or chronic abdominal pain were studied in order to compare the clinical features of those who had pelvic inflammatory disease (PID) and those who did not. The diagnosis was made by laparoscopy, and PID was detected in 14%, adhesions in 11% and endometriosis in 16%. Women with PID were clinically indistinguishable from women with other diagnoses or no obvious cause.
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PMID:Abdominal pain in women attending a genitourinary medicine clinic: who has PID? 781 51

The pathophysiology of pelvic inflammatory disease (PID) involves an ascending infection of cervicovaginal microorganisms, of which the most important pathogens are Neisseria gonorrhoeae and Chlamydia trachomatis. The clinician should recognize that not all women with PID will present with abdominal pain and that associated atypical symptoms such as meteorrhagia and dyspareunia should suggest diagnosis. The documentation of lower genital tract inflammation is helpful in making the diagnosis of PID. Treatment with broad spectrum antibiotic regimens is currently recommended. Prevention of sexually transmitted diseases and ascending infection remains of utmost importance to decrease the sequelae, such as tubal factor infertility and ectopic pregnancy associated with PID.
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PMID:Pelvic inflammatory disease. 789 Sep 34

A 25-year-old woman ingested a quarter. Three days later, lower abdominal pain, fever, chills, and physical findings compatible with pelvic inflammatory disease developed. Radiographic examination showed the coin in the middle pelvis. Persistent abdominal complaints, abnormal physical examination, and failure of the coin to progress through the gastrointestinal tract despite conservative management led to surgical intervention. Exploration revealed an inflammatory process in the posterior uterine culde-sac with multiple omental, small bowel, and uterine adhesions due to perforation of a Meckel's diverticulum. Excision of the Meckel's diverticulum was done, and the patient recovered satisfactorily.
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PMID:Perforation of a Meckel's diverticulum caused by ingestion of a coin. 805 93

Between September 1988 and January 1989 in Kenya, health care providers recruited 150 infertile women, 15-39 years old, who had gone to a gynecological outpatient clinic at Kenyatta National Hospital in Nairobi to undergo hysterosalpingography to determine the condition of the uterus and fallopian tubes. The aim of the study was to determine whether there was an association between hysterosalpingography and pelvic inflammatory disease (PID) and the determinants for PID. Most women were between 20-29 years old, married, and had a primary education (67.3%, 90.7%, and 55.3%, respectively). One week after hysterosalpingography, 44% developed acute PID, defined as having at least 2 of the following signs or symptoms: lower abdominal pain, rebound tenderness, cervical/adnexal tenderness, foul smelling vaginal discharge, adnexal mass(es), and fever of at least 38 degrees Celsius. The most frequent signs and symptoms were lower abdominal pain and tenderness. Married women were more likely to have PID than unmarried women (47.1% vs. 14.3%). The small numbers of unmarried women made it difficult to determine the significance of the difference, however. Sexual intercourse within the 1st week after hysterosalpingography was not associated with PID (45.2% for PID cases vs. 42.1% for non-PID cases). The researchers believed that hysterosalpingography pushed existing pathogens in the vagina into the uterus, or the women already had asymptomatic PID. They recommended further studies to determine whether physicians should administer prophylactic antibiotic therapy to all women undergoing hysterosalpingography.
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PMID:Acute pelvic infection following hysterosalpingography at the Kenyatta National Hospital, Nairobi. 818 34

Staff of the infertility clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, cared for a Yemeni woman who had a poor obstetric history. She had had pelvic inflammatory disease. Her 1st pregnancy concluded in a full term vaginal delivery, but gastro-enteritis caused the infant's death at 4 months. She delivered her 2nd child at 32 weeks gestation and the infant died 3 days later. Her 3rd and 4th pregnancies occurred in the right tube. A laparotomy, conservative evacuation of the conceptus from the right tube, and peritoneal lavage were used to treat the ectopic pregnancies. She experienced spontaneous abortion of the 5th pregnancy at 10 weeks. The woman presented at the hospital's gynecology clinic at 40 days amenorrhea with low abdominal pain and a small amount of vaginal bleeding. She had not passed any clots or tissue. The general examination was normal. The pregnancy test was positive. Since she had past ectopic pregnancies, the physicians conducted an ultrasound, which revealed no intrauterine pregnancy and a heterogenous 4.5 cm x 5.5 cm mass near the left tube. Laparoscopy confirmed a normal size uterus, a mass on the left tube, and bleeding into the peritoneum. Laparotomy was performed to remove the unruptured left ampullary ectopic pregnancy in such a way as to preserve the patency of the tube and therefore fertility. The surgeons also conducted peritoneal lavage with dextran saline to remove the blood in the peritoneum. The surgeons lysed the adhesions they found between the omentum, abdominal wall, and the uterus. Both ovaries were in good condition. The right tube was in good condition. She did fine postoperatively and was released 7 days after operation. The physicians could not determine the patency of the left tube, because she was lost to follow up. This case shows that conservative management of the tubes to retain tubal patency was successful, since she was able to conceive, but recurrent ectopic pregnancies may damage the tubes.
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PMID:Three consecutive recurrent ectopic pregnancies. 818 45


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