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

Recurrent abdominal pain in the left fossa often mimicking attacks of subileus is described in a woman aged 48 with extensive adhesions caused by multiple surgical procedures. Repeated examinations with conventional abdominal radiography and barium meals were negative with regard to mechanical intestinal obstruction. A cystic lesion varying in size from 2 to 8 cm in diameter was seen adjacent to the left ovary on repeat US examinations and also on CT. Pain episodes were sometimes correlated to increasing size of the lesion which was finally thought to be either a peritoneal inclusion cyst (fluid trapped between pelvic adhesions) or, as was finally confirmed at surgery, a true ovarian cyst (corpus luteum cyst) similarly trapped.
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PMID:Entrapped ovarian cyst. An unusual case of persistent abdominal pain. 220 30

During the period from 1984 through 1986, 72 ultrasound-guided cyst punctures were performed in 60 young women (less than or equal to 40 years). Thirty-one punctures were performed using the transabdominal route and 41 punctures under the guidance of endovaginal scanning. General or local anesthesia were used in 97% of the transabdominal punctures while the corresponding figure for the endovaginal technique was 49%. Seventy-seven percent (46/60) of the women developed no new cysts within one year of the last puncture. Thirteen percent (8/60) had to be punctured twice and 3% (2/60) three times. No complications occurred in any of the 72 punctures. Of those women with cyst relapses and/or persistent abdominal pain, 7 were subjected to laparotomy and 5 to laparoscopy. Ultrasound-guided puncture of cystic tumors in the lower pelvis of young women seems to be an alternative to laparoscopically guided puncture or laparotomy. As compared to surgery, the ultrasound-guided technique may mean less risk for pelvic adhesions in young women with unproven fertility.
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PMID:Ultrasound-guided puncture of cystic tumors in the lower pelvis of young women. 249 57

A consecutive series of 49 women (50 procedures), whose conditions were haemodynamically stable, presenting with acute lower abdominal pain, pelvic tenderness, and either a urine concentration of greater than 50 U/l beta human chorionic gonadotrophin or a pelvic mass shown by ultrasonography were treated with operative laparoscopy under video monitoring (videopelviscopy) as an alternative to laparotomy. Ectopic pregnancy, ovarian and non-ovarian cysts, pelvic adhesions, endometriosis, and fibroids were found, for which salpingotomy, salpingectomy and salpingo-oophorectomy, cystectomy, adhesiolysis, thermocoagulation, and myomectomy were carried out by laparoscopy. In one patient pelviscopy was repeated because of persistent tubal pregnancy after the fimbria was expressed. Laparotomies were carried out on three patients because treatment was not possible by laparoscopy and on a further patient two days after adhesiolysis had been attempted. These were the only serious complications. For the 46 cases (45 patients) in which operative laparoscopy was successful the mean stay in hospital was 1.9 days after operation, and this group of patients returned to normal activities and to work after an average of 2.3 and 2.6 weeks respectively. Most gynaecological emergencies that are managed by laparotomy can be treated by laparoscopy and benefit both patients and the health service.
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PMID:Managing gynaecological emergencies with laparoscopy. 252 9

We report the case of a 70 year-old woman who presented with clinical tetanus following a four day history of abdominal pain and vomiting. The source of Clostridium tetani was an infarcted loop of ileum resulting from pelvic adhesions. The treatment of tetanus and the incidence of endogenous sources of Clostridium tetani are reviewed. Health Department figures for the decade 1973-1982 show that 70% of reported cases of clinical tetanus occur in those aged 45 years or older.
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PMID:Ileal infarction: a rare cause of tetanus in the elderly. 333 May 99

The clinical and pathological features of six cases of a rare, hitherto unreported type of pelvic cyst are described. The cysts occurred in female patients (15-51 years of age) who presented with lower abdominal pain and evidence of a pelvic mass. All but one of the patients had a history of prior pelvic surgery. Laparotomy revealed dense pelvic adhesions and a cystic lesion that was interpreted by the surgeon as ovarian in origin. On gross examination, the cysts measured up to 15 cm in diameter, were uni- or multilocular and thin-walled, and contained bloody or serous fluid. They were adherent to the surface of the ovaries, but did not involve the ovarian parenchyma. On microscopic examination, the cyst walls were composed of markedly inflamed granulation and fibrous tissue in which were embedded mesothelial cells arranged in glands, nests, cords, and single cells. Because of this infiltrative pattern, as well as cytological atypia and mitotic activity within the mesothelial cells, a diagnosis of cancer was considered in several cases. All patients are alive with no evidence of disease at postoperative intervals of 6 months to 5 years. We propose that these cysts represent peritoneal inclusion cysts (benign cystic mesotheliomas) in which the histological appearance has been altered by an unusual degree of inflammation, fibrosis, and entrapment of mesothelial cells.
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PMID:Peritoneal inclusion cysts with mural mesothelial proliferation. A clinicopathological analysis of six cases. 378 51

The ovarian remnant syndrome, a complication of bilateral salpingo-oophorectomy, is progressively receiving more attention in the gynecological surgery literature. The syndrome is manifested by pelvic pain and a palpable or sonographic finding of a pelvic mass. However, in rare cases, patients can present with large masses and radiographic suggestion of malignancy. We present the case of a 76-year-old white female, 23 months after bilateral salpino-oophorectomy at the same institution, complaining of 3.5 months of right flank and abdominal pain. Clinical and radiological evidence of a right ovarian remnant was discovered. Subsequent laparoscopic resection was consistent with a well-encapsulated mucinous adenocarcinoma in a right ovarian remnant. Curiously, this patient had no history of endometriosis, dense pelvic adhesions, pelvic inflammatory disease, or difficulty encountered during the original hysterectomy. This is the seventh published case report in the international literature about carcinoma developing in an ovarian remnant. However, this case differs in that the patient had no preexisting gynecologic conditions at the time of hysterectomy and bilateral salpingo-oophorectomy to account for residual ovarian tissue. Additionally, the oophorectomy was performed vaginally, in contrast to multiple previous case reports.
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PMID:Mucinous adenocarcinoma in an ovarian remnant. 1530 67

Primary fallopian tube carcinoma (PFTC) is the rarest gynecologic malignancy. We present the first documented case of this rare neoplasm in Ethiopia, in a 50 years old perimenopausal woman. The patient complained of irregular menses, on and off vaginal discharge and longstanding lower abdominal pain. She had longstanding infertility for which she did not seek medical help. The patient was subjected for laparotomy with the preoperative diagnosis of chronic pelvic inflammatory disease. Huge bilateral hydrosalpinges were found with pelvic adhesions involving the ovaries. Total hysterectomy with bilateral adnexectomy was performed following adhesiolysis. The diagnosis of low-grade papillary tubal carcinoma was made postoperatively when the specimen from total abdominal hysterectomy and bilateral salpingoopherectomy was examined histologically. The patient declined relaparatomy for proper staging or further adjuvant treatment. She was free of clinically demonstrable recurrence five months after discharge. Challenges in the detection of PFTC relating to its signs and symptoms, diagnostic difficulties, choice of treatment and factors that may influence survival are outlined It is prudent to perform histopathologic examination on all surgically excised specimens however obvious the clinical findings appear to be.
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PMID:Primary fallopian tube carcinoma (PFTC) comorbidity with infertility and bilateral hydrosalpinx. 1764 64

We report the case of 23 year-old woman with OHVIRA syndrome (obstructed hemivagina and ipisilateral renal anomaly) discovered during management for right renal failure. Non-specific symptoms such as lower abdominal pain, dysmenorrhea, and genital bleeding sometimes occur with congenital uterine anomalies such as this. It is very difficult to diagnose OHVIRA syndrome accurately without ultrasound and magnetic resonance imaging, and patients can develop severe complications as a result of delays in diagnosis: endometriosis, pelvic adhesions, or infertility can occur through backflow of genital bleeding because of vaginal septum. In our patient we managed to avoid severe complications by surgically resecting the vaginal septum. She was treated within an appropriate time frame and without complications. Fortunately, after the surgery she managed to become pregnant in the left side of the uterus.
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PMID:[Case of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome]. 2500 Jun 61

Isolated fallopian tube torsion (IFTT) is a rare occurrence characterized by the rotation of the fallopian tube on its own axis, without twisting the ipsilateral ovary. Pre-operative diagnosis is difficult due to the lack of specific clinical symptoms and radiological signs. The etiology is to date unknown and only some pre-disposing factors have been reported. The history, clinical presentation, laboratory findings and surgical treatment of five patients aged 12-16 with IFTT were evaluated. All patients came to be examined for worsening abdominal pain, nausea or vomiting. 75% of them practiced sports involving sudden changes in body position. They all underwent blood tests, ultrasound and Magnetic Resonance and then laparoscopy for the persistence of acute symptoms. Laparoscopic salpingectomy was performed in three patients. Another two needed a conversion to open salpingectomy due to the presence of pelvic adhesions. During the follow-up period, every girl was fine. The cause of IFTT is undetermined. In this series, a close association between IFTT and sports causing rapid body movements was found. The possibility of IFTT should be considered in the differential diagnosis of acute abdominal pain in children or adolescent females, especially if they practice sports.
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PMID:A possible association between sports and isolated fallopian tube torsion in children and adolescent females. 2629 7

Ovarian pregnancy is a rare entity. Making a definitive preoperative or even intraoperative diagnosis of ovarian pregnancy is difficult and the diagnosis is usually established by the pathologist. Rupture in the first trimester is the usual rule in ovarian ectopy. Thus, it continues to challenge practicing clinicians. The literature shows an association between intrauterine device usage and ovarian gestation. We present a case of ovarian pregnancy in a secundipara complaining of abdominal pain that also has pelvic adhesions. This case meets the four criteria of Spiegelberg and is interesting because of its rarity and association with adhesions, which makes diagnosis more difficult.
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PMID:Ovarian pregnancy associated with pelvic adhesions. 2652 22


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