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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic pelvic inflammatory disease is a common gynecologic diagnosis in women with chronic pelvic pain. When standard antimicrobial therapy does not improve the clinical status, uncommon diagnoses such as Enterobius vermicularis should be considered. In this case, E vermicularis presented as acute and chronic salpingitis in a patient who had had E vermicularis-related appendicitis 5 years earlier.
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PMID:Enterobius vermicularis salpingitis: a distant episode from precipitating appendicitis. 149 35

The authors describe one case of rectal stenosis complicating chronic salpingitis in a patient carrying an intrauterine device. This observation is peculiar in that the inflammatory fibrous reaction is very intense, spreading all over the pelvis and forming a pseudotumoral mass sheathing the rectum. The clinical signs were mainly digestive, including a rectal syndrome: cramplike pelvic pain before defecation, tenesmus, constipation, abdominal pain and induration of the anterior aspect of the rectum observed during the clinical examination. Radiological examinations (barium enema, ultrasound, CT) show a tissue mass within the pelvis, with considerable thickening of the rectal wall. Ultrasound-guided biopsy in the pelvis yielded only nonspecific inflammatory signs with dominant fibrosis. The diagnosis of rectal stenosis caused by chronic salpingitis complicating the presence of an IUD was made only during surgery.
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PMID:[Rectal stenosis. A rare complication of chronic salpingitis caused by an intrauterine device]. 231 25

Chlamydia are a frequent etiologic agent in the chronic salpingitis that has become more and more of a problem in recent years, with its accompanying pelvic pain, ectopic pregnancies, and tubal sterility. Although public health officials, obstetricians and gynecologists, and sexually transmitted disease specialists all agree that prevention would be preferrable to treatment of the resulting tubal lesions and possible neonatal complications, the change of habits necessary for prevention will be difficult to achieve. Infection can be avoided by discouraging early initiation of sexual activity in adolescents, who are apparently particularly susceptible to chlamydial infection, and by discouraging multiple sexual partners since the risk increases appreciably for those having over 3 partners. Condoms and local spermicides with a benzalkonium chloride base offer protection but are poorly accepted by adolescents. IUDs should not be used by adolescents because of the risk of infection. Diagnosis of chlamydia is difficult because about 60% of cases in women are asymptomatic. Persons at high risk because of their patterns of sexual activity should be examined regularly for chlamydia, and tests should be scrupulously performed at all stages and sent to a competent laboratory. All sexual contacts of the chlamydia patient and all their sexual contacts should be treated. An early diagnosis of tubal involvement is difficult but should be pursued through laparoscopy and taking the necessary samples. The public should be educated about the existence, gravity, consequences, and contagiousness of sexually transmitted diseases in such institutions as schools and the military service. Treatment of chlamydia includes early and intensive antibiotic therapy, complete rest, and prolonged use of corticotherapy. An oral contraceptive can be prescribed to prevent development of functional ovarian cysts. Laparoscopic control is essential to ensure that the cure was effective. Return of the infection is associated with a very poor prognosis.
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PMID:[Prevention of Chlamydia trachomatis infections in women]. 652 58

6 cases of ovarian pregnancy were reviewed and their relationship with the IUD, fibromyoma of the uterus, and previous spontaneous abortion was examined. 5 of the patients had in situ IUDs, and 1 patient was treated in conjunction with a 20 week size fibroid uterus. 1 of the patients with an IUD also had a fibroid uterus. 4 of the women had spontaneous abortions in their past history. All cases met Spiegelberg's requirements for the diagnosis of ovarian pregnancy. The 6 cases are summarized in table form. During the 4 year period that these 6 patients were treated, a total of 59 ectopic pregnancies were treated at the Hasharon Hospital in Petah-Tikva, Israel. 18 or 30.5% occurred in patients with in situ IUDs. Ovarian pregnancies constituted 10.2% of all the ectopic pregnancies and 20% of the ectopic pregnancies in the group of patients using IUDs. The possibility that the IUD may potentiate ovarian nidation must be considered. It has been suggested that the IUD causes changes in the synthesis of prostaglandins so that tubal peristalsis is increased, and this could increase the incidence of both tubal and ovarian pregnancies. 2 of the patients were initially treated for vaginal bleeding and pelvic pain by removal of their IUDs, and the proper treatment was delayed for 14 days. The ovarian pregnancy in the patient with the fibroid uterus was diagnosed only after histological examination of an incidental hemorrhagic mass found at laparotomy. The series of 6 cases of ovarian ectopic pregnancy seems to confirm the association, and it must also be noted that mild chronic salpingitis was reported on histopathological examination in only 1 case. No conclusion can be reached on the basis of such a small group of patients.
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PMID:Ovarian pregnancy: association with IUD, pelvic pathology and recurrent abortion. 733 10

Clinical signs of pelvic inflammatory disease (PID) are not constant and are often limited to slight pelvic pain. Laparoscopy can lead to a rapid and correct diagnosis of PID. Intrapelvic bacteriologic samples can be obtained so as to administer the proper antibiotic. The exact nature of the lesions can be evaluated, and in severe cases, recent abscesses can be treated with good results for fecundity. Because the results in cases of long-standing abscess are not so good, laparoscopy should be performed at the onset of infection and not be reserved until after some weeks of inefficient medical treatment, especially in young women who have not completed their family. In primary chronic salpingitis, the lack of any clinical signs usually leads to a delay in diagnosis until women consult for fertility problems. The ideal point would be to detect some biologic or clinical change that may lead to diagnosis such as a positive anti-Chlamydia trachomatis (CT) serology or, in the future, positive anti-CT Hsp 60 antibody could be the key to detecting and treating silent salpingitis in young women, CT being the main microorganism involved in chronic salpingitis. Screening for C. trachomatis low genital tract infection is mandatory in young people in order to control the epidemic.
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PMID:PID: clinical and laparoscopic aspects. 1081 18

Hysterosalpingography was performed on 175 patients who had gynecological symptoms but negative pelvic findings, in order to test a new method of introducing the contrast medium into the uterus and tubes and to record the incidence of pathology revealed. In 132 patients, an attempt was made to secure a No. 14 Foley catheter in the uterus for introducing the contrast medium. This method was successful in 124 patients and can be recommended as being simple, less painful and more efficient than older methods. Of 156 patients with the complaints of infertility (68), dysmenorrhea (31), pelvic pain (29) or menstrual disorder (28), hysterosalpingography revealed significant abnormality in 58; most of these (47) had chronic salpingitis. One flare-up of pelvic inflammation occurred but no other complications were observed. It was concluded that hysterosalpingography is now sufficiently safe and reliable to merit wider utilization in gynecological diagnosis.
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PMID:THE USE OF HYSTEROSALPINGOGRAPHY IN THE DIAGNOSIS OF INFERTILITY AND OTHER GYNECOLOGICAL CONDITIONS. 1408 22