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

Intermittent partial adnexal torsion after electrosurgical tubal ligation has been suggested as a cause of chronic pelvic pain. Little is present in the literature describing this entity or its characteristics. Unlike complete torsion of the fallopian tube, ovary, or paratubal cyst, intermittent adnexal torsion is more subtle in both clinical features and laparoscopic findings. It appears to be an underrecognized cause of pelvic pain in some women after tubal ligation. Thus these women may be subjected to many diagnostic tests and extensive evaluations with negative findings. It is not uncommon for the diagnosis to be overlooked even at the time of pelviscopic evaluation. A woman experienced the characteristic chronic, intermittent, left lower quadrant pain after electrosurgical tubal ligation. At the time of a third laparoscopic evaluation, the diagnosis of intermittent partial adnexal torsion was made, and she was treated with distal salpingectomy and ovarian fixation. She had complete resolution of her long-standing pain.
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PMID:Intermittent partial adnexal torsion after electrosurgical tubal ligation. 905 Jun 68

A 36-year-old female presented with constant, worsening left lower quadrant pain without associated fever or vaginal discharge. Pelvic and transvaginal ultrasound examinations were performed which demonstrated a large complex cystic structure in the left adnexa with peripheral flow on color Doppler imaging. Given the sonographic appearance and patient symptoms, possibilities included endometrioma or hemorrhagic cyst. Tubo-ovarian abscess (TOA) and other cystic ovarian masses were considered less likely. Two days later, the patient returned with severe pelvic pain as well as fever and leukocytosis. Follow-up ultrasound showed enlargement of the mass and a tubo-ovarian abscess (TOA) was suspected. Ultrasound-guided transvaginal abscess drainage was performed with removal of purulent fluid. The case demonstrates that the radiological features of TOA may mimic those of adnexal cystic masses such as an endometrioma or hemorrhagic cyst. A complementary case is also included which demonstrates similar sonographic findings in a patient with endometrioma. In addition to sonographic imaging, a thorough clinical and laboratory evaluation is important in differentiating these entities. Furthermore, we provide a comprehensive discussion about imaging features of cystic ovarian mass on different imaging modalities.
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PMID:Sonographic features of tubo-ovarian abscess mimicking an endometrioma and review of cystic adnexal masses. 2247 Jul 6