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

Serious laparoscopic injury is rare, occurring in less than 1/1000 procedures. To our knowledge, no liver injuries have been reported to date, but avulsion of hepatic adhesions may be a source of postlaparoscopic bleeding. A woman with chronic pelvic pain unresponsive to medical management underwent an uncomplicated diagnostic laparoscopy with extensive pelvic adhesiolysis. Adhesions of Fitz-Hugh-Curtis syndrome were seen over the right lobe of the liver. At the completion of the procedure no bleeding was noted, and the patient was discharged to home in stable condition. She returned 12 hours later with a significant hemoperitoneum necessitating laparotomy. It is important to consider this as a source of bleeding after laparoscopy in a patient with perihepatic adhesions.
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PMID:Postoperative hemorrhage due to avulsion of perihepatic adhesions after pneumoperitoneum. 905 Jul 1

We evaluated the effects of low-dose oral contraceptive (Desolett) in the management of pelvic pain, and its sensitivity in differentiating organic disorders such as endometriosis, in 96 women who were followed for at least 4 to 6 months. The 67 who still complained of pelvic pain with no improvement in severity, or who reported increase in symptoms after 4 to 6 months were examined by laparoscopy. All patients underwent laparoscopy in the follicular phase, under general anesthesia with the three-puncture technique. Fifty-six women (83.6%) were diagnosed as having endometriosis, 19 stage 1, 31 stage 2, and 6 stage 3 disease (American Fertility Society classification). Six (9%) had moderate to severe pelvic adhesions (2 Fitz-Hugh-Curtis syndrome) with no endometriotic implants. One (1.5%) had Taylor syndrome, and the others (6%) were free of disease. Unresponsiveness to low-dose oral contraceptives at the end of 4 to 6 months was highly sensitive and predictive of organic pelvic disorders such as endometriosis as the cause of pelvic pain. Therefore, we conclude that this therapy is effective in evaluating and treating women with obscure findings for particular disorders. In addition to managing mild to moderate endometriosis, it is effective in reducing the severity of midline pelvic pain of uterine origin, which may be of further benefit in pelvic pain of obscure etiology. Finally, a trial of oral contraceptives may be used as initial screening in women with chronic pelvic pain to reduce the number of unnecessary diagnostic and surgical interventions.
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PMID:The Sensitivity of Low-Dose Oral Contraceptives in Differentiating Endometriosis in Patients with Pelvic Pain 907 47

Perihepatic adhesions between the liver capsule and the diaphragm or the anterior peritoneal surface characterizes Fitz-Hugh-Curtis syndrome (FHCS). FHCS is an extrapelvic manifestation of pelvic inflammatory disease and usually refractory to medical treatment and surgical intervention. With the increased incidence of pelvic inflammatory disease, chronic pelvic pain and sequalae of the process are becoming more common. Herein, we report 3 patients with pelvic inflammatory disease in whom medical treatment failed initially and FHCS was diagnosed via laparoscopy. Laparoscopic lysis of pelvic and perihepatic adhesions, irrigation of the abdomino-pelvic cavity, and antibiotics treatment after surgery successfully relieved these patients' symptoms. FHCS is not a new syndrome but most gynecologists might neglect this condition. Laparoscopy is a less invasive procedure than exploratory laparotomy. We recommend laparoscopy in patients with lower abdominal and right upper quadrant discomfort when other organic disease has been ruled out and medical treatment has failed to relieve symptoms.
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PMID:Laparoscopic diagnosis and management of Fitz-Hugh-Curtis syndrome: report of three cases. 1151 71