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

A 12-year-old boy presented with a 2-month history of abdominal pain and distention. A diagnosis of Wilson's disease was established, and D-penicillamine therapy was initiated. An associated pancreatitis was diagnosed on presentation, based on elevated serum amylase and an enlarged pancreas ultrasonically. Subsequently, an 18-month follow-up disclosed no abdominal pain, with repeatedly normal serum amylase level and a normal pancreas on ultrasonography. Since abdominal pain is a common symptom in Wilson's disease on presentation, this possibility should be considered in untreated patients. It is concluded that pancreatitis may be associated with Wilson's disease, possibly because of copper deposition in the pancreas, and is probably responsive to copper chelation therapy.
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PMID:Wilson's disease associated with pancreatitis. 319 80

37 consecutive patients who presented with absent or snapped strings and failed attempts at IUD removal by hooks or curette were referred for hysteroscopy/laparotomy following a pelvic x-ray to exclude unrecognized spontaneous expulsion of the device. The IUD was extrauterine in 19 patients and incarcerated in the uterine cavity in the remaining 18 patients. 17 of the 19 extrauterine devices were copper containing and 2 were inert Lippes Loop IUDs. In all cases, copper devices were associated with dense adhesions. Only 2 patients complained of any abdominal pain. The IUD type among the 18 patients with intrauterine translocated devices was the Lippes Loop in 15 cases and the Copper T in the remaining 3 cases. 6 of these patients had complained of excessive bleeding with pain. Hysteroscopy is invaluable to remove embedded and fragmented IUDs. It is suggested that all devices translocated into the abdomen be removed to avoid potential complications. Laparotomy is the method of choice to remove medicated devices given the dense adhesions often associated with bowel loops. Risk factors considered to be associated with translocation include postpartum insertion, inserter skill, insertion technique, and the status and configuration of the cervix and uterus.
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PMID:Management of translocated and incarcerated intrauterine contraceptive devices. 346 43

A case is reported of ovarian pregnancy in a woman wearing a Copper 7 IUD for 2 years. She has 2 weeks of intermittent vaginal bleeding, followed by acute onset of severe lower abdominal pain, abdominal rigidity, rebound tenderness, and shock. Laparoscopy revealed blood and clots in the pelvis. On laparotomy, the right ovary was bleeding from a lesion later shown to be the gestational sac. The right fallopian tube was normal. The 4 criteria of Speigelberg for ovarian pregnancy was satisfied: normal fallopian tube on the affected side; gestation sac in the normal position in the ovary; sac connected to the uterus by the ovarian ligament; and ovarian tissue histologically demonstrated in the wall of the sac.
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PMID:Ovarian pregnancy in association with a Copper 7 intrauterine contraceptive device. 361 30

The incidence of pelvic inflammatory disease (PID) attributable to IUD use has been increasing, especially after the removal of the Dalkon shield from the market, but this relationship has not been settled conclusively. In recent decades PID included a variety of infections, but lately the definition of PID has meant acute ascending infections of the female genital tract. Its most common risk factors include promiscuity of IUD use, although this can be reduced to one fourth by regular checkups and proper hygiene. The frequency of PID is estimated at 2-5% of IUD users. Microorganisms contributing to PID include Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Escherichia coli, Proteus, Staphylococcus epidermis, Haemophilus influenzae, Bacteroides, Peptococcus, Peptostreptococcus, Clostridium, and Actinomyces israelii, The differentiation of actinomycosis (AC) and pseudoactinomycosis (PAC) is well advised. The potential of IUD use in increasing the risk of AIDS should not be discounted. The clinical picture of PID is varied, it can be mild requiring conservative drug therapy; with medium severity requiring removal of the IUD and drug therapy; severe necessitating removal, antibiotics and sulfonamide treatment and laparotomy; and very severe with potentially fatal generalized sepsis. In addition to antibiotics, e.g., penicillin, treatment can include the so called catastrophy combination of Mandokef- Metronidazol-Gentamycin. An analysis of the data of 8536 IUD fittings in Debrecen, Hungary showed 1.4% removals due to PID after 4 years, 694 patients (8.1%) had lower abdominal pain 73 of which (0.9%) had palpable resistance, and suppuration occurred in only 30 cases (0.4%). Treatment included Semicillin or Tetran, or removal of the IUD, and even surgery if no improvement resulted. Prevention of PID include elimination of risk factors, the careful selection of IUD users, regular checkups, the use of copper (Cu) T device, and strict adherence to professional standards.
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PMID:[The role of intrauterine contraceptive devices in the development of inflammatory processes in the small pelvis]. 376 5

The case of a 32-year old woman (gravida 3 para 2) in whom a Copper-7 IUD perforated the uterus, lodging both within the myometrium and the lumen of the small intestine is described. The patient presented in the emergency room 18 months after IUD insertion with heavy vaginal bleeding and passage of tissue. A diagnosis of spontaneous abortion was made. In this case, the small bowel had to be resected and side-to-side anastomosis was performed. This patient was asymptomatic until 3 weeks prior to admission. Other cases demonstrate acute symptoms of peritonitis and intestinal obstruction or more chronic complaints of vague abdominal pain and diarrhea. An IUD string that is not visible at the external os of the cervix generally reflects upward retraction of the string or unnoted spontaneous expulsion of the IUD. However, on occasion it can be associated with uterine or even intestinal perforation, as occurred in this case. Pain on insertion, also noted in this case, can serve as a warning sign of perforation. In this patient, the device was inserted 5 weeks after delivery, lending support to the recommendation that puerperal insertion be avoided. It is important to know the exact location of an ectopic IUD to prevent dangerous attempts at removal through the vagina. Laparoscopy and ultrasound are generally helpful in localizing the IUD and preparing the patient for laparotomy and possible bowel resection.
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PMID:Asymptomatic perforation of the small intestine by a copper-7 intrauterine device. 386 28

A total of 33 nulliparous women aged between 18 and 35 have been observed for related symptoms following insertion of an intrauterine contraceptive device. Seventy-five percent suffered some abdominal pain initially but this was reduced to 1% by the end of the week. The symptoms of cramp and backache showed a similar trend. There was no relationship between symptoms and the day of the cycle on which insertion was performed. It is concluded that careful insertion of the Copper-7 in this group of patients is well tolerated irrespective of the day of cycle on which insertion is performed. The initial dynamic response following IUCD insertion may be an additional factor in the assessment of the performance of an individual intrauterine contraceptive device.
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PMID:Pain response following insertion of a Gravigard (Copper-7) intrauterine contraceptive device in nulliparous women. 611 10

2 cases of primary ovarian pregnancy associated with an IUD occurred at the Rothschild University Hospital (Haifa, Israel) within a 1-year period. This report describes the 2 cases and summarized the 53 cases that were reported until now. In case 1, a 23-year old woman, gravida 1, para 1, abortus 0, presented with lower abdominal pain and faintness 1 hour after a curettage. Her past history revealed no pelvic inflammations or operations. Her period was reported to be regular every 28 days. She had been using a Cu-7 IUD for 24 months. A curettage to terminate the pregnancy had been performed outside the hospital, revealing no gross pregnancy tissue. At the same time the Cu-7 IUD had been removed. 1 hour later the patient had urgently been sent to the hospital because of fainting and severe abdominal pain. Pelvic examination revealed slight vaginal bleeding, external os open to the tip of a finger, a normal sized uterus, normal adnexa, and a tender bulging cul-de-sac. A culdocentesis was performed and revealed blood with clots. The suspected diagnosis was perforation of the uterus. On laparotomy the uterus was found to be of normal size with no signs of perforation. On the right ovary a bleeding mass of 2 x 2 cm was seen. A wedge resection of the right ovary was performed, with preservation of most of the ovarian tissue, and the patient received 1000 ml of whole blood. The postoperative course was uneventful. Histological examination revealed an ovarian pregnancy: within ovarian tissue a large corpus luteum was found with blood clots, and trophoblasts. A decidual reaction of the ovarian stromal tissue was diagnosed. The tissue from the curettage was diagnosed to be endometrium with decidual changes, without chorionic villi or trophoblasts. The 2nd patient, a 34-year old woman, gravida 4, para 3, abortus 1, presented with abdominal pain and vaginal bleeding for 7 days. She had carried a Lippes loop IUD for 18 months. The IUD had been removed on the 3rd day of the bleeding because of abdominal pain and her desire for another child. Culdocentesis revealed dark blood with clots. On laparotomy about 100 ml of blood were found in the peritoneal cavity. The uterus, both tubes, and the left ovary were normal. The right ovary was a 6 x 6 x 6 cm enlarged cystic hemorrhagic mass. A right oophorectomy was performed. The postoperative course was uneventful. Histologic examination revealed an ovarian pregnancy: within ovarian tissue blood clots, chorionic villi and corpus luteum were found. There are no specific clinical signs of ovarian pregnancy. Abdominal pain, irregular vaginal bleeding, and faintness are similar to those of other ectopic pregnancy. The type of IUD associated with ovarian pregnancy varies. The increasing association of ovarian pregnancies with copper IUDs seems simply to be related to the increasing prevalence of this type of IUD in recent years.
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PMID:Ovarian pregnancy in association with an intrauterine device. 613 96

Three of four family members reported recurrent episodes of gastrointestinal illness while residing in a house in a small northwestern Vermont village. The father and two daughters repeatedly experienced episodes of emesis and abdominal pain after drinking water drawn from their kitchen faucet. One early-morning water sample taken from the family household contained a copper level of 7.8 mg/L, which is above the standard for drinking water (1.0 mg/L). Values for the second daughter's copper in hair analysis (1,200 micrograms/g) and copper in nail analysis (100 micrograms/g) were elevated (normal range 11 to 53 micrograms/g). The household was at the end of a 3/4-in (19.05-mm) copper main, and it is suspected that copper levels increased in water when the water remained stagnant in the main. All symptoms of the family resolved when they stopped drinking water in their home. This is the first report of copper-induced gastrointestinal illness attributable to a public supply of drinking water.
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PMID:Drinking-water-induced copper intoxication in a Vermont family. 650 31

A case of uterine perforation by an IUD with acute and chronic irritation of the appendix is presented. The patient, a 30-year old gravida 4, para 4, was admitted to the hospital with severe abdominal pain, fever, and diarrhea. A Lippes loop IUD had been inserted 3 years previously. The device could not be visualized at laparoscopy. At laparotomy the IUD was palpable within a large inflammatory mass in the right lower abdomen . Dissection of the adhesions revealed the IUD twisted around the appendix, and appendectomy was performed. This is the 1st reported case of a perforated, nonmedicated IUD causing appendicitis. The 2 cases of IUD appendicitis previously described in the literature involved Copper-7 devices, which have been shown to cause considerable tissue response when placed in the peritoneal cavity. Abdominal signs and symptoms associated with a missing IUD string should alert physicians to the possibility of IUD appendicitis.
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PMID:IUD appendicitis. 668 97

A 27-year old woman admitted to the hospital after 5 days of vaginal bleeding at 12 weeks gestation had had a copper-T IUD inserted 10 months previously. The IUD string was no longer visible at pregnancy testing. Prior to admission she had experienced lower abdominal pain, increasingly heavy vaginal bleeding, fever, malaise, chills, and vomiting. Intravenous ampicillin and metronidazole were commenced and the uterus was evacuated under a general anesthetic. The copper-T was removed from the uterine cavity. A uterine swab at operation and preoperative blood cultures grew E. coli. A moderate degree of disseminated intravascular coagulation (DIC) was indicated by a coagulation profile. The case demonstrates that the copper-T may be associated with intrauterine sepsis and DIC. In the 1st trimester the risk of abortion following removal of a device is near 30%, while the rate of abortion for women in whom the string is no longer visible is near 48%. Patients presenting with pregnancy in the presence of an IUD and symptoms of sepsis should have the uterus evacuated under suitable antibiotic cover.
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PMID:Septic abortion in an IUCD user. 676 7


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