Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of intrinsic-type ureteral endometriosis in a 28-year-old woman. She visited our hospital, complaining of lower abdominal pain. Drip infusion pyelography (DIP) showed left hydronephrosis, and left retrograde pyelography revealed a filling defect of the left pelvic ureter. Biopsy under ureteroscopy showed chronic ureteritis. It was difficult to exclude a malignant tumor, and we performed left partial ureterectomy and uretero-ureterostomy. The pathological examination showed endometrial tissue in the submucosal and muscle layer, and we diagnosed it as intrinsic-type ureteral endometriosis judging from the findings of the ureteroscopy and the operation. After the operation, drip infusion pyelography showed the improvement of the left hydronephrosis and ureteral passage, and the right ovarian endometriosis was found by gynecologists. She received hormonal therapy with the luteinizing hormone releasing hormone agonist for about half a year, but the right ovarian endometriosis remained unchanged. This is the ninth case in the Japanese literature reported as intrinsic-type ureteral endometriosis.
 ...
PMID:[Partial ureterectomy in a case of intrinsic-type ureteral endometriosis]. 1209 14

We describe a case of a patient with left flank pain that was caused by a perforation in the splenic flexure of the colon by a toothpick. We conducted a systematic review of the literature to examine the nature of injuries caused by ingested toothpicks. Articles were analyzed for the following outcome variables: presenting complaint, site of injury, recollection of toothpick ingestion, time to presentation, findings from imaging studies, and mortality. Most patients (70%) presented with abdominal pain. Few patients (12%) remember swallowing a toothpick. The onset of symptoms ranged from <1 day to 15 years. Toothpicks caused perforation most frequently at the duodenum and the sigmoid. In some cases, toothpicks migrated outside the gastrointestinal tract and were found in the pleura, pericardium, ureter, or bladder. Toothpicks were apparent on imaging studies in 14% of the cases. The definitive diagnosis was most commonly made at laparotomy (53%), followed by endoscopy (19%). Overall mortality was 18%. Ingested toothpicks may cause significant gastrointestinal injuries, and must be treated with caution.
 ...
PMID:Toothpick injury mimicking renal colic: case report and systematic review. 1221 69

Because of the extraperitoneal location, generally used for renal grafting, intraperitoneal urine leaks are a rare complication after transplantation. We report a patient on peritoneal dialysis who developed ascites, abdominal pain, anuria and shock suddenly after renal transplantation. The patient was immediately taken back to the operating room. An abnormal implantation of ureter into the peritoneum overlying the bladder when carrying out an unstented parallel incision extravesical ureterone-ocystostomy was identified. After correcting ureter implantation the patient had immediate diuresis, renal function rapidly improved, with no further complications. Contributing causes were poor exposure, thickened peritoneum secondary to recurrent peritonitis, and the presence of residual peritoneal dialysis fluid.
 ...
PMID:[Ureteral implantation in peritoneum. Exceptional complication in renal transplantation]. 1244 76

We report herein a rare case of ureteral and sigmoid obstruction caused by pelvic actinomycosis in a patient fitted with an intrauterine contraceptive device (IUCD). A 63-year-old Japanese woman was admitted complaining of lower abdominal pain and slight fever continuing for a month. She had a history of IUCD insertion 30 years previously and had been menopausal for the past 10 years. Ultrasonography and CT scan revealed a solid pelvic mass involving the uterus, sigmoid colon, urinary bladder, and right ureter. The IUCD was detected in the uterine cavity. Right hydronephrosis and hydroureter due to an obstruction of the distal ureter and the extensive stenosis of the sigmoid colon were also observed. Blood analysis showed leukocytosis, thrombocytosis, and elevated C-reactive protein levels. Although pathological and microbiological analysis of the removed IUCD showed negative results for Actinomyces infection, these findings suggested a pelvic abscess caused by actinomycosis. Benzyl penicillin administration was started immediately. Total hysterectomy, bilateral salpingo-oophorectomy, and lysis of adhesion around the ureter were performed. Actinomycosis was diagnosed based on histologic examination. The patient's postoperative course was uneventful except for persistent mild hydroureter and hydronephrosis. The patient is now healthy without evidence of recurrent Actinomyces infection 1 year after treatment. As shown in the present case, pelvic actinomycosis should be considered as a cause of pelvic inflammatory disease in IUCD users, even though Actinomyces was not detected on the IUCD.
 ...
PMID:Ureteral and sigmoid obstruction caused by pelvic actinomycosis in an intrauterine contraceptive device user. 1259 67

During evaluation of chronic abdominal pain, a 9-year-old male was found to have a horseshoe kidney (HSK) with multicystic dysplasia (MCD) of the left-sided component. Attached to the MCD was a very large, tortuous ureter occupying almost the whole left side of the abdomen. This ureter on dissection was found to end blindly adjacent to the bladder. MCD of one-half of a HSK is an unusual lesion. Its association with a large megaureter with juxtavesical atresia is a unique event. In HSKs, controversy exists about the need to remove a small dysplastic segment. If this segment is associated with a large ureter, as in our case, removal is mandatory in order to avoid pain and infection.
 ...
PMID:Multicystic dysplasia in one-half of a horseshoe kidney with megaureter and lower ureteric atresia. 1259 77

A 42-year-old woman underwent total hysterectomy for multiple myoma uteri. Postoperatively the patient complained of lower abdominal pain and total incontinence. She had also developed left-sided hydronephrosis. Left nephrostomy was constructed and necessary investigations were done. It was diagnosed as a case of left ureteral injury with vesico-vaginal fistula. Repair of vesico-vaginal fistula and reimplantation of the left ureter were performed in a single setting three months after the injury. Subsequently, the nephrostomy was removed. Hydronephrosis was improved with an excellent outcome of fistula repair.
 ...
PMID:[Iatrogenic ureteral injury and the development of vesico-vaginal fistula: a complication of total hysterectomy for multiple myoma uteri]. 1261 9

Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Apart of clinical examination and laboratory tests, an ultrasound examination is sensitive up to 90% and specific up to 95% if graded compression technique is used. Still it is user-depended and requires considerable experience in order to perform it reliably. Meckel's diverticulitis, acute terminal ileitis, mesenteric lymphadenitis and functional bowel disease are conditions that should be differentiated from other causes of low abdominal pain by clinical presentation, laboratory and imaging tests. Dilatation of renal pelvis and ureter are typical signs of obstructive uropathy and may be efficiently detected by ultrasound. Additional thinning of renal parenchyma suggests long-term obstructive uropathy. Ruptured ectopic pregnancy, salpingitis and hemorrhagic ovarian cysts are three most commonly diagnosed gynecologic conditions presenting as an acute abdomen. Degenerating leiomyomas and adnexal torsion occur less frequently. For better systematization, gynecologic causes of acute pelvic pain could be divided into conditions with negative pregnancy test and conditions with positive pregnancy test. Pelvic inflammatory disease may be ultrasonically presented with numerous signs such as thickening of the tubal wall, incomplete septa within the dilated tube, demonstration of hyperechoic mural nodules, free fluid in the "cul-de-sac" etc. Color Doppler ultrasound contributes to more accurate diagnosis of this entity since it enables differentiation between acute and chronic stages based on analysis of the vascular resistance. Hemorrhagic ovarian cysts may be presented by variety of ultrasound findings since intracystic echoes depend upon the quality and quantity of the blood clots. Color Doppler investigation demonstrates moderate to low vascular resistance typical of luteal flow. Leiomyomas undergoing degenerative changes are another cause of acute pelvic pain commonly present in patients of reproductive age. Color flow detects regularly separated vessels at the periphery of the leiomyoma, which exhibit moderate vascular resistance. Although the classic symptom of endometriosis is chronic pelvic pain, in some patients acute pelvic pain does occur. Most of these patients demonstrate an endometrioma or "chocolate" cyst containing diffuse carpet-like echoes. Sometimes, solid components may indicate even ovarian malignancy, but if color Doppler ultrasound is applied it is less likely to obtain false positive results. One should be aware that pericystic and/or hillar type of ovarian endometrioma vascularization facilitate correct recognition of this entity. Pelvic congestion syndrome is another condition that can cause an attack of acute pelvic pain. It is usually consequence of dilatation of venous plexuses, arteries or both systems. By switching color Doppler gynecologist can differentiate pelvic congestion syndrome from multilocular cysts, pelvic inflammatory disease or adenomyosis. Ovarian vein thrombosis is a potentially fatal disorder occurring most often in the early postpartal period. Hypercoagulability, infection and stasis are main etiologic factors, and transvaginal color Doppler ultrasound is an excellent diagnostic tool to diagnose it. Acute pelvic pain may occur even in normal intrauterine pregnancy. This may be explained by hormonal changes, rapid growth of the uterus and increased blood flow. Ultrasound is mandatory for distinguishing normal intrauterine pregnancy from threatened or spontaneous abortion, ectopic pregnancy and other complications that may occur in patients with positive pregnancy test. Incomplete abortion is visualized as thickened and irregular endometrial echo with certain amount of intracavitary fluid. If applied, color Doppler ultrasound reveals low vascular resistance signals in richly perfused intracavitary area. Transvaginal sonography has high sensitivity and specificity in visualization of uterine and adnexal signs of ectopic pregnancy. Color Doppler examination may aid in detection of the peritrophoblastic flow. Furthermore, it facilitates detection of ectopic living embryo, tubal ring or unspecific adnexal tumor. Corpus luteum cysts and leiomyomas are another cause of pelvic pain during pregnancy, which can be correctly diagnosed by ultrasound. Detection of uterine dehiscence and rupture in patients with history of prior surgical intervention on uterine wall relies exclusively on correct ultrasound diagnosis. In patients with placental abruption sonographer detects hypoechoic complex representing either retroplacental hematoma, subchorionic hematoma or subamniotic hemorrhage. In closing, ultrasound has already become important and easily available tool which can efficiently recognize patients with possibly threatening conditions of different origins.
 ...
PMID:[Ultrasonography in acute pelvic pain]. 1276 97

A 54-year-old woman was admitted to our hospital for oliguria and left lower abdominal pain. She had renal dysfunction with a serum creatinine of 9.1 mg/dl and blood urea nitrogen of 96.5 mg/dl. Plain computed tomography and magnetic resonance imaging revealed right dwarf kidney and left giant hydronephrosis with extravasation of urine. MR-urography revealed left dilated ureter caused by ureterovesical junction (UVJ) stenosis. Therefore, percutaneous nephrostomy was immediately performed to treat postrenal failure, with resulting collection of approximately 1,650 ml of urine. Subsequently, left ureterocystoneostomy was performed for the treatment of UVJ stenosis because improvement of left UVJ stenosis had not been confirmed by nephrostography during follow-up. Judging from the past history of myoma operated and reactive fibrosis of stump of left ureter histopathologically, it was considered that acquired UVJ stenosis had led to giant hydronephrosis.
 ...
PMID:[A case of unilateral giant hydronephrosis with contralateral dwarf kidney]. 1289 39

A 26 year old pregnant woman with antithrombin III deficiency developed recurrent septicaemia with Serratia marcescens. In spite of the administration of antibiotics, high grade fever persisted. She subsequently manifested lower abdominal pain, and spontaneous abortion occurred. After the abortion, she became completely afebrile. The amnion was turbid, and microscopic examination of the placenta showed haemorrhage and massive infiltration of neutrophils, suggestive of infectious chorioamnionitis. Pulsed field gel electrophoresis showed that isolates from the blood, urine, and vaginal discharge were genetically identical. Intravenous pyelography revealed that she had a bilateral completed double ureter. It was thought that a urinary tract anomaly caused infection with S marcescens, and the pathogen spread to the chorioamnion via the bloodstream. This is the first report of chorioamnionitis caused by S marcescens in a non-immunocompromised host. In addition, these findings indicate that the chorioamnion can serve as a site for persistent infection in normal pregnancies.
 ...
PMID:Chorioamnionitis caused by Serratia marcescens in a non-immunocompromised host. 1460 Jan 37

Extensive abdominal infections with Actinomyces were diagnosed in two women aged 35 and 33 years respectively, who suffered from the nonspecific symptoms fever and abdominal pain. These infections occur more often in women with an intrauterine device. Development of an abdominal mass with ureter or bowel obstruction may cause hydronephrosis and mechanical ileus. The patients underwent a laparotomy and a double-J catheter was inserted, which could be removed later on (temporary stoma). Treatment included high-dose penicillin i.v. followed by oral amoxicillin. Both patients recovered. It may be difficult to establish this diagnosis: the first patient was diagnosed by histopathological examination, in the second Actinomyces had been found in a routine cervical smear a few years earlier.
 ...
PMID:[Unavoidable surgical intervention in two women with severe actinomycosis during IUD use]. 1467 75


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>