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

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

Five cases of intestinal endometriosis presented with infertility and pelvic pain. Rectal bleeding occurred in two patients and diarrhea in one. A diagnosis was achieved with a barium enema study and colonoscopy. All the patients had pelvic endometriosis as documented by laparoscopy. Endometriosis was present in the sigmoid colon in three patients and in the cecum in one; it was pericecal in the fifth. Bowel resection and pathologic study are necessary to relieve the symptoms and avoid neglecting a malignant tumor or other lesions.
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PMID:Diagnosis and management of intestinal endometriosis. A report of five cases. 319 19

In a patient who presented with pelvic pain and changed bowel habits, barium enema and sigmoidoscopic examinations demonstrated a nonspecific asymmetric narrowing of the colon at the rectosigmoid junction with normal mucosal appearance. Computed tomography revealed the etiology to be retroperitoneal fibrosis with pelvic extension and entrapment of the colon at this level. The importance of CT in diagnosis of this unusual manifestation of retroperitoneal fibrosis is discussed.
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PMID:Retroperitoneal fibrosis presenting as colonic dysfunction: CT diagnosis. 333 60

The radiographic appearance of ring-like densities in the true pelvis, when associated with pain, may suggest the presence of ureteral calculi or phleboliths, leading to either misdiagnosis or oversight by the physician who is unfamiliar with the appearance of fallopian tube occlusion rings. Tubal ligation of any type may be associated with intermittent lower abdominal pain. The recognition of fallopian tube occlusion rings may result in an accurate diagnosis of the cause of pelvic pain. 2 figures illustrate the appearance of the rings. Silicone rubber rings may be placed over a knuckle of the midfallopian tube as a highly reliable sterilization technique. The rings themselves are composed of barium sulfate-impregnated dimethypolysiloxane, an inert siliconized synthetic rubber. They have an outside diameter of 3.6 mm, an inner diameter of 1.0 mm, and are 2.2 mm thick. Foreshortening, obliquity, and film magnification may result in minor variations in dimensions. A review of more than 4000 procedures during the early experience with occlusion ring sterilization, the number of pregnancies was less than 1 in 600. The pregnancies usually occurred because conception occurred before the procedure or because of misplacement of the rings. Lower abdominal pain and bleeding continue as the most serious postoperative complications. Within the true pelvis the fallopian tube occlusion rings may lie close to the course of the pelvic ureters, simulating ureteral calculi. Ureteral calculi rarely have central lucencies. When seen at an angle or on end no central lucency may be visible. The rings may be overlooked amidst pelvic phleboliths. Arterial calcifications are curvilinear yet usually form an incomplete circle, and they rarely appear as sharply marginated as fallopian tube occlusion rings.
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PMID:Fallopian tube occlusion rings: a consideration in the differential diagnosis of ureteral calculi. 712 95

The differential diagnosis for lower abdominal and pelvic pain following Cesarean section includes many causes, such as endometritis, abscess, pelvic hematoma, wound complications, pelvic vein thrombophlebitis, gastrointestinal dysfunction and obstruction. Colonic obstruction secondary to intussusception is a rare cause. We present a case of post-Cesarean section pain in a 26-year-old patient due to obstructing colonic intussusception secondary to colonic adenocarcinoma. Review of the literature failed to identify a previous case report of colonic adenocarcinoma with intussusception presenting early in the postpartum period. The diagnosis was initially made by ultrasound, and later corroborated by computed tomography, barium enema and laparotomy.
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PMID:Post-cesarean section pain secondary to intussuscepting colonic adenocarcinoma. 944 54

We report a 35 years old female with a profound rectosigmoidal endometriosis, who had been subjected to multiple laparoscopic procedures and open surgery due to infertility in the last five years. Main presenting symptoms were cyclic hematochezia during the menstrual periods associated to pelvic pain. Colonoscopy was inconclusive, barium enema showed a marked stenosis of the zone, appearing as an extrinsic compression. CAT scan showed a homogeneous, solid parauterine mass. During surgery, an inflammatory mass with multiple endometriotic foci was found. A low anterior resection with mechanical anastomosis was done, preserving the uterus and left adnexa. Two months later, the patient became pregnant and an elective cesarean section was done at 38 weeks of gestation, giving birth to a healthy newborn. Radical resective surgery for rectosigmoidal endometriosis is indicated in patients with intense and recurrent symptoms in whom hormonal treatment has failed and when a tumor cannot be discarded. The fertility rate, when adnexa and uterus are preserved, is 40% and symptomatic improvement is achieved in 85% of patients.
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PMID:[Radical resective surgery for the management of rectosigmoidal endometriosis. Clinical case]. 1034 82

The efficacy of medical and surgical treatment of endometriosis and pelvic pain is a source of questions and controversies. Complete resolution of endometriosis is not yet possible but therapy has essentially three main objectives: 1) to reduce pain; 2) to increase the possibility of pregnancy; 3) to delay recurrence for as long as possible. In case of moderate and severe endometriosis, operative laparoscopy must be considered as first line treatment. The mean pregnancy rate of 50% reported in the literature following surgery provides scientific proof that operative treatment should first be undertaken to give our patients the best chance of conceiving naturally. In case of rectovaginal adenomyotic nodules, surgery must also be considered as first line therapy, medical therapy being relatively inefficacious. Careful preoperative examination is mandatory (transrectal sonography, magnetic resonance imaging, bowel barium enema or intravenous pyelography) to evaluate potentially severe complications of the disease.
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PMID:Endometriosis is not only a gynecologic disease. 1558 34

The surgical treatment of endometriotic nodules in the recto vaginal septum is aimed at removing the deeply infiltrating fibro muscular and abnormal glandular tissue, in order to relieve pelvic pain. The laparoscopic approach to the recto vaginal septum is difficult and potentially dangerous. We describe a new mode of access using a combination of laparoscopy and colposcopy. A 20-year-old woman presented with dyspareunia and dyschezia. Vaginal examination revealed a tender nodule, measuring 1.5 <FONT FACE="MetaPress 5">&#50</FONT> 2 cm, in the posterior vagina wall. The endometriotic deposit was positioned at the top of the recto vaginal septum, extending into the posterior vaginal fornix. An air-contrast barium enema and vaginogran (lateral view) excluded a lesion that had penetrated the full thickness of the rectal wall. We carried out colposcopic CO<SUB>2</SUB> laser ablation of the nodule under laparoscopic control. 'Chocolate fluid' spilled from the lesion and the entire nodule was vaporised until normal tissue was reached. The patient was reviewed 3 and 6 months following the operation, and her symptoms had resolved. The colposcope allows an approach into an area of the pelvis that is usually difficult to access.
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PMID:A colposcopic approach to an endometriotic nodule in the recto vaginal septum under laparoscopic control. 1675 34

Positive oral contrast agents, including barium suspensions and water-soluble iodinated solutions, have traditionally been used in conjunction with the CT evaluation of patients with abdominal and pelvic pain. Due to continued advancements in CT technology, and due to increasing obesity and correspondingly a general increase in the intra-abdominal and intra-pelvic fat separating bowel loops in North American patients and in patients in other parts of the world over the past few decades, the ability of radiologists to accurately evaluate the cause of acute symptoms has substantially improved. Recent research and evolving imaging society guidelines/systematic reviews increasingly support performing CT scans of the abdomen and pelvis without the need for positive oral contrast in these types of adult patient populations, in most clinical situations. Increased patient throughput, patient preference, patient safety, and most importantly, retention of high diagnostic accuracy, are reasons for this recent change in practice to routinely omit the use of enteric contrast agents for the majority of patients presenting with acute abdominal and pelvic pain whom are undergoing emergency CT.
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PMID:Oral contrast for CT in patients with acute non-traumatic abdominal and pelvic pain: what should be its current role? 2716 63