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

Laparoscopy was used to verify the diagnosis of acute pelvic inflammatory disease (PID) in 112 patients. The patients were all hospitalized and treated with intensive intravenous antibiotics and followed closely postoperatively for as long as 4 years. A follow-up questionnaire concerning pelvic-abdominal pain, menstrual distrubances, pelvic-venereal infection, contraception, and pregnancy was completed and returned by 81 of the 112 patients. The corrected pregnancy rate was 44% during the follow-up period with only 1 ectopic pregnancy occurring. Reinfection was noted in 11%, residual abdominal or pelvic pain in 21% menstrual abnormalities in 15%, and contraceptive use in 20%. The diagnosis, treatment, and prognosis of acute PID is reviewed briefly.
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PMID:Acute pelvic inflammatory disease: follow-up in laparoscopically confirmed cases. 623 Mar 40

102 patients using Trinordiol, a triphasic oral contraceptive (OC) containing ethinyl estradiol and d-norgestrel, were followed for 932 cycles in a study of secondary effects. Follow-up visits were scheduled after 1,3, and 6 months and every 6 months thereafter. 26 patients discontinued use of the pills during the study after using them for a total of 159 cycles. 5 discontinued because of abdominal pain, 1 for breast tenderness, and 1 because of headaches or migraines. 7 discontinued because of metrorrhagia, 4 for weight gain, 3 for amenorrhea, 2 for nausea and vomiting, and 1 each for nervousness, water retention, acne, desire for pregnancy, leaving the country, hypertension, and unknown motivation. the average age of patients was 23.6 years, with a range from 14-48. 76% were aged 15-29 years. 52.9% were nulliparas. 58.8% were Belgian, 21.6% were from Mediterranean Europe, 10.8% were Moroccan, and 7.9% were from black Africa. Only 1 patient, a 37 year old, developed hypertension. 15 patients gained more than 2 kg and 17 lost more than 2 kg. 15.8% complained of spotting during the 1st cycle compared to 3.1% during the 6th cycle, 5.2% during cycle 7-12, and 9.1% during cycle 13-30. Among 35 patients who did not discontinue treatment, 7 complained of amenorrhea and 1 of scanty menstrual bleeding, 14 of pain including 7 cases of pelvic pain, 2 of dysmenorrhea, 3 of breast tenderness, and 2 of headaches, 15 of leukorrhea, 3 of nausea, 2 of dizziness, and 1 each of fatigue, acne, galactorrhea, and cutaneous pruritus. 1 case of myoma at the level of the uterine cornu was identified after 24 cycles of treatment. In all, 61 patients had some complaint, while 41 were totally satisfied. No patient became pregnant during the study.
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PMID:[Clinical study of the secondary effects associated with taking a triphasic anti-ovulatory contraceptive]. 670 4

The incidence of ovarian pregnancies is rare, a ratio of approximately .7 ovarian pregnancies to every 100 ectopic pregnancies. Since 1970, an increasing number of ovarian pregnancies associated with the use of IUDs are reported. A case report of a 34-year old woman, gravida 4, with an IUD in place for 18 months is presented. The patient complained of severe pelvic pain and moderate bleeding 5-6 weeks after her last normal menstrual period. Tissue, grossly ressembling placental tissue was passed, after which the pain stopped and the bleeding became minimal. On recurrence of pain and heavier bleeding, the patient underwent a dilatation and curretage and removal of the IUD, but the pain persisted. Ultrasound revealed a normal uterus and a left adnexal mass. Exploratory laparotomy to correct what was thought to be a hemorrhagic corpeus luteum cyst, resulted in a left oophorectomy. The pathology report showed an apparent gestational sac and a 10 mm embryo. In an analysis of 33 cases of ovarian pregnancy, another author noted the presence of vaginal bleeding, abdominal pain, uterine enlargement, and adnexal masses in a majority of cases on which the data were collected. Although the IUD has been shown to reduce the incidence of uterine implantation by 99.5% and tubal implantation by 95%, it does not reduce the incidence of ovarian pregnancy. Incidence of ovarian pregnancy among IUD users is thought to be 1 for every 7-9 ectopic pregnancies, in the general population, the incidence is 1 to every 150-200 ectopic pregnancies. This is probably due to the local enzyme or chemical action on the endometrial cavity and tubes. This apparent increase in ectopic pregnancies seems to be relevant only to the number of intrauterine pregnancies prevented by the IUD. Patients with IUDs, presenting with positive pregnancy tests, irregular bleeding and abdominal pain should be evaluated by ultrasound.
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PMID:Ovarian pregnancy associated with a copper-7 intrauterine device: report of a case and review of the literature. 711 13

The radiographic appearance of ring-like densities in the true pelvis, when associated with pain, may suggest the presence of ureteral calculi or phleboliths, leading to either misdiagnosis or oversight by the physician who is unfamiliar with the appearance of fallopian tube occlusion rings. Tubal ligation of any type may be associated with intermittent lower abdominal pain. The recognition of fallopian tube occlusion rings may result in an accurate diagnosis of the cause of pelvic pain. 2 figures illustrate the appearance of the rings. Silicone rubber rings may be placed over a knuckle of the midfallopian tube as a highly reliable sterilization technique. The rings themselves are composed of barium sulfate-impregnated dimethypolysiloxane, an inert siliconized synthetic rubber. They have an outside diameter of 3.6 mm, an inner diameter of 1.0 mm, and are 2.2 mm thick. Foreshortening, obliquity, and film magnification may result in minor variations in dimensions. A review of more than 4000 procedures during the early experience with occlusion ring sterilization, the number of pregnancies was less than 1 in 600. The pregnancies usually occurred because conception occurred before the procedure or because of misplacement of the rings. Lower abdominal pain and bleeding continue as the most serious postoperative complications. Within the true pelvis the fallopian tube occlusion rings may lie close to the course of the pelvic ureters, simulating ureteral calculi. Ureteral calculi rarely have central lucencies. When seen at an angle or on end no central lucency may be visible. The rings may be overlooked amidst pelvic phleboliths. Arterial calcifications are curvilinear yet usually form an incomplete circle, and they rarely appear as sharply marginated as fallopian tube occlusion rings.
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PMID:Fallopian tube occlusion rings: a consideration in the differential diagnosis of ureteral calculi. 712 95

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 varicocele is a disease recognized and studied in the man. Dilatation of the ovarian veins and the pelvic varicosities secondaries to a varicocele in the woman is a rarely described disease but, if it were researched, it could be more frequent. Diverse syndromes of chronic abdominal pain in the woman with unrecognized etiology and associated with urologic and/or gynecologic symptomatology could be caused by this pathology, but the absence of a clinical description difficult the diagnosis of the most part of cases. The practice of gonadal selective venographies shows a high percentage of dilatation of the gonadal veins associated to a dilatation of the pelvic veins and of the lower limbs veins. The study of the anatomy of the gonadal veins shows diverse anomalies respect to the classical descriptions. Furthermore, the varicocele could be the cause of a high part of the "essential" varicosities presents during the pregnancy. We present a case that instead of being treated by Services of Urology or Gynecology, it was treated by the Vascular Surgery Service. So, the literature about the respect was reviewed. We think that, some entities, like the feminine varicocele, ovarian vein syndrome, pelvic congestion syndrome chronic pelvic pain, pelvic varicosities, vulvar varicosities and some "essential" pregnant varicosities at the lower limbs could be enclosed into the same clinical entity (with a common etiology, physiopathology, clinical presentation and treatment). It should be intending to unify criteria (etiologic, diagnostic and therapeutics criteria) by the different Specialized Unities in such type of pathology.
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PMID:[Female gonadal venous insufficiency]. 831 45

There is a wide variety of pathologies associated with the presence of urachal remnants. We describe a case of infected urachal cyst in a young adult male, with classical symptoms of dysuria, lower abdominal pain, and fever. Ultrasound, cystography and CT are described, ultrasound being often the modality of choice. Differential diagnosis of acute abdominal and pelvic pain or a midline lower abdominal mass at this age should include infection of an urachal remnant.
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PMID:[Infected urachal cyst]. 832 Jan 87

Obscure Auditory Dysfunction (OAD) is explained by a combination of hearing-related deficits and personality factors Saunders & Haggard (1992). In this study, we determine which factors are associated specifically with OAD and which are associated with the seeking of medical attention in general. We achieved this by obtaining a second patient group with a parallel syndrome to OAD, called "chronic pelvic pain without obvious organic pathology" (CPPWOOP). CPPWOOP patients complain of lower abdominal pain that is not explainable by conventional medical tests. Fifteen CPPWOOPs underwent the OAD test battery. For the analyses they were retrospectively matched to 15 of the original OADs and their matched controls. The three groups were compared by analysis of variance and Kruskall-Wallis analyses. The CPPWOOPs and controls performed significantly better than OADs on hearing-related variables, but did not differ from each other, whereas the OADs and CPPWOOPs were significantly more anxious than the controls, but did not differ from each other. We conclude that anxiety-related traits are associated with the seeking of medical attention in general, whereas the hearing-related deficits we measured are associated specifically with OAD. Anxiety-related traits should, therefore, be considered when dealing with marginal pathologies, but in depth investigation may also reveal an organic basis; therefore, patients should not be dismissed as simply neurotic.
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PMID:The influence of personality-related factors upon consultation for two different "marginal" organic pathologies with and without reports of auditory symptomatology. 840 28

Ectopic pregnancy is an increasingly common and potentially catastrophic condition in which the patient often presents to the ED with abdominal pain or vaginal bleeding. Recent developments in the laboratory (sensitive beta hCG assays, progesterone assays), in ultrasonography (transvaginal probes, Doppler ultrasonography), and in the combination of modalities (discriminatory zone of beta hCG for ultrasonographic evidence of IUP) have allowed the earlier diagnosis of ectopic pregnancy, with the potential for a reduction in maternal mortality and morbidity. Understanding the strengths and limitations of the variety of diagnostic modalities available will allow the clinician to formulate a rational strategy for the early diagnosis of ectopic pregnancy. Numerous algorithms have been developed. All begin with high clinical suspicion for women of reproductive age with abdominal/pelvic pain or vaginal bleeding. Pregnancy testing with a sensitive beta hCG qualitative test is next. For stable patients found to be pregnant, sonography generally follows (often first transabdominally then transvaginally). Unstable patients require immediate resuscitation and gynecology consultation; invasive diagnostic methods may supplant laboratory studies and sonography. Unclear cases may necessitate the use of quantitative beta hCG (discriminatory zone), other pregnancy hormones (progesterone), invasive procedures (laparoscopy, culdocentesis, D&C), or observation (serial beta hCGs). A suggested algorithm incorporating these elements is shown (Fig. 1).
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PMID:Ectopic pregnancy--Part II: Diagnostic procedures and imaging. 859 21

The aim was to prospectively study the relationship between pelvic pain of otherwise unknown origin and laxity in the posterior vaginal fornix. Twenty-eight patients with negative laparoscopy findings, lower abdominal pain and laxity in the posterior ligamentous supports of the uterus underwent surgical approximation of their uterosacral ligaments. At 3-month review, 85% of patients were cured, and at 12 months, 70%. Nonorganic pelvic pain has frequently been attributed to psychological factors. However, the results suggest that this may be a T12-L1 parasympathetic pain referred to the lower abdomen, perhaps due to the force of gravity stimulating pain nerves unable to be supported by the lax uterosacral ligaments in which they are contained. It was concluded that laxity in the posterior ligaments of the vagina should first be excluded before referring patients with pelvic floor discomfort or pain for psychiatric care.
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PMID:Severe chronic pelvic pain in women may be caused by ligamentous laxity in the posterior fornix of the vagina. 888 67


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