Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It has been traditional to exclude patients with radiation-recurrent carcinoma of the uterine cervix or other pelvic neoplasms, incapacitating pelvic pain, postirradiation fistulas, hemorrhage, or malodorous draining tumor necrosis from pelvic exenteration if cure of the malignant disease is not achievable. This negative attitude is a direct result of the reported high morbidity, prohibitive mortality, and low salvage rate previously associated with pelvic exenteration, the only acceptable surgical approach to these diseases. A recent experience with eighteen patients who underwent pelvic exenteration for advanced primary or recurrent carcinoma of the cervix, urinary bladder, or rectum has led us to challenge several traditional concepts regarding this operative procedure. We have observed but one operative death and our morbidity has been minimal. This may reflect our belief that an aggressive pelvic lymphadenectomy in those patients with direct visceral involvement from radiation-recurrent carcinoma of the pelvic viscera is not advantageous since no significant survival has ever been documented for patients with pathologic visceral involvement and positive lymph nodes. In addition, significant morbidity has always been associated directly with pelvic lymphadenectomy in the irradiated pelvis, and elimination of this phase of the operation in selected patients with radiation-recurrent carcinoma is indicated. Moreover, the considerable decrease in morbidity and the minimal mortality observed have led us to adopt a very liberal attitude toward preoperative selection criteria, and we regularly now use pelvic exenteration not only for cure but as intentional palliation in selected patients. We strongly believe that elimination of pain, fistulas, pelvic sepsis, hemorrhage, and malodorous areas of tumor necrosis are important for improving the quality of life for both the patient and family.
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PMID:Pelvic exenteration as palliation of malignant disease. 5 24

A 42-year-old woman with recurrent bilateral endometrial ovarian cystoma presented with fever and pelvic pain caused by a tubo-ovarian abscess (TOA), which was resistant to several varieties of intravenous and oral antibiotics for 2 weeks (Case 1). Computed tomography (CT)-guided diagnostic aspiration for a rapid enlarged right ovarian cystoma through a transabdominal route confirmed that it had developed into a TOA. Subsequent percutaneous abscess drainage (PAD) and irrigation for 3 days were successful. One-year follow-up revealed no recurrence of TOA. A 58-year-old woman with recurrent cervical cancer after external radiation therapy (RT) presented with fever, confusion and tremor caused by pyometra (Case 2). Since transvaginal drainage was impossible due to cervical os obstruction, the patient had undergone CT-guided transabdominal PAD and irrigation for a month. Thereafter, the clinical findings improved and a tracheloplasty was performed to prevent recurrence. CT-guided PAD may be a useful treatment option for gynecologic abscess as a diagnostic aspiration, a temporizing procedure until surgery, or an alternative surgery.
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PMID:Gynecologic abscess: CT-guided percutaneous drainage. 1699 96