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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One encounters a variety of radiopaque foreign objects when reviewing plain film radiographs of the abdomen. Recognizing such devices can offer important clues about a patient's medical history. Accordingly, intrauterine contraceptive devices (IUCD), tubal sterilization, varicoceles, inferior vena cava (IVC) filtration, and vaginal pessaries are discussed with reference made to an IUD, tubal sterilization clips, embolization coils for bilateral varicoceles, an IVC filter, and a vaginal pessary in five attached anteroposterior radiographs of the lower abdomen and pelvis for five different patients. IUCDs confer long-term, passive, reversible, and inexpensive protection against unwanted pregnancy. They may, however, induce menstrual complications as well as an increased risk of pelvic inflammatory disease and ectopic pregnancy. They can also be spontaneously expelled from the uterus without being noticed by the client. An IUCD increases the risk of spontaneous abortion unless removed in cases where intrauterine pregnancy occurs. Complications at the time of insertion include pain, syncope, and uterine perforation. Tubal sterilization is an effective, though largely irreversible method of contraception. Complications include an increased risk of ectopic gestation in the event of pregnancy and the usual risks of hemorrhage, infection, injury to adjacent structures, and anesthesia-related complications. A varicocele is a dilation of the pampiniform venous plexus of the scrotum. They are more often unilateral than bilateral, occurring in up to 20% of men most often on the left side. Although most cases are probably insignificant, varicoceles can decrease sperm count and motility and cause abnormal morphology. Correction of varicoceles has been shown to improve sperm quality and can increase the chances of fertility. Percutaneous venous embolization techniques have recently been developed to that end. Procedural risks include perforation of the vein, intimal dissection, inadvertent embolization of vessels via collateral channels, and reactions to contrast media. IVC filters are a feasible alternative treatment for deep venous thrombosis and pulmonary embolism among patients in whom anticoagulants are contraindicated or for those in whom anticoagulation therapy has failed. Introduced via the femoral or jugular veins, they are permanent metallic devices placed within the lumen of the IVC to filter thrombi which migrate from the deep veins of the lower extremities. Contraindications to IVC filter insertion include severe coagulopathy and thrombosis involving all venous access routes, while complications include hematoma at the insertion site, migration or tilting of the device due to poor anchoring in the IVC wall, and vena cava obstruction. A pessary is a prosthetic device used to support pelvic structures when their natural support is lacking. They are usually made of plastic or rubber and inserted into the vagina to aid in the non-operative treatment of uterine prolapse, proctoceles, and cystoceles. They must be properly fitted and removed every few months for cleaning.
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PMID:Radiology rounds. Intrauterine contraceptive device. 821 57

In the Netherlands a 34-year old pregnant women presented at the obstetrics and gynecology department of OLVG Hospital in Amsterdam with uterine bleeding. She was at 11 weeks gestation and had an IUD in situ. A vaginal ultrasound revealed that the pregnancy was intact so the physicians could not remove the IUD. She returned 12 days later because she was suffering from an incomplete spontaneous abortion. The physicians removed the IUD and performed an aspiration curettage. They did not administer antibiotics. 10 days after the operation the woman suffered worsening pain in the right thigh and leg and had difficulty walking, a fever, and general sickness. She was breathing very rapidly. Repeated vaginal ultrasounds revealed that she had retained the conceptus. The physicians prescribed respiratory support and antibiotics (claforan, gentamicin, and metronidazole). Blood culture indicated Staphylococcus aureus. Computer tomography revealed a retroperitoneal abscess at the level of the right iliopsoas muscle near the os ilium and the sacro-iliac joint. The physicians performed an extraperitoneal incision and drainage of the abscess and a repeat aspiration curettage. Staphylococcus aureus was isolated from all abscess samples, the conceptus, the cervix, the vagina, the urine, and the sputum. The physicians continued gentamicin and metronidazole treatment. They dismissed her after a complete recovery 16 days after the 2nd aspiration curettage. Possible complications of psoas abscess are sepsis, pulmonary embolism, hemorrhage, and bowel obstruction. Antibiotic prophylaxis in abortion curettage may prevent late sequelae, such as psoas abscess and pelvic inflammatory disease.
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PMID:Psoas abscess related to spontaneous abortion, intra-uterine contraceptive device and curettage. 838 62

The use of oral contraceptives (OC) by an estimated 150 million women worldwide has prompted concern about their potential risks. But, there are also health conditions--medical and surgical disorders, reproductive tract cancers, and menstruation disorders--that oral contraceptives affect beneficially. OC users have a lower risk of iron deficiency anemia, an important consideration for nutritionally deficient women. The risk of developing pelvic inflammatory disease is also decreased in OC users, as is the risk of ectopic pregnancy. This is important for women in developing countries, where access to medical services for a life-threatening ectopic pregnancy might be limited. Using OCs lowers the incidence of surgery for benign breast disease, the incidence of retention cysts of the ovary, the risk of endometrial cancer, the risk of epithelial ovarian cancer, and relieves symptoms of dysmenorrhea and premenstrual syndrome. The risks associated with OC use, including stroke and heart attack, vary among age groups, smoking status, and other cardiovascular risk factors. For example, elevated serum cholesterol is lower among women in developing countries, so the associated risk of heart attack is lower for these women. Other complications associated with OC use are deep-vein thrombosis, pulmonary embolism, gallbladder disease, and hepatic adenoma. There is controversy about whether OC use increases the risk of cervical neoplasia. Studies that have attempted to define this risk are subject to methodological problems, in that increased surveillance of OC users results in a higher rate of detection. Some controversy exists about OC use and an increased risk of breast cancer, but no definitive results are available. Although the risks associated with OC use can be serious, these risks are only slightly higher among OC users compared with non-users. The benefits, such as reduced risk of serious diseases and gynecological disorders, seem to outweigh the risks, pointing to the need for accurate communication between health professionals and the women they advise about contraceptive choices.
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PMID:Beyond contraception: the health benefits and risks of the pill. 1231 33

Modern medicine 1st made the oral contraceptive (OC), a combined OC, available to women in 1960, and much progress in improving OCs and reducing risks associated with them has occurred. Approximately 200 million women have used OCs worldwide and about 60 million women are currently using this contraceptive method. OCs are efficacious because the hormones in the OCs alter the physiology of the hypothalamo-pituitary-ovarian/uterine axis at 6 sites, e.g., altering the endometrium so implantation of the blastocyst cannot occur. Despite the effectiveness of OCs (virtually 100% effective) in comparison with other contraceptive methods, they often cause side effects and complications. Some side effects and complications from estrogen and predominantly estrogen OCs include vomiting, hypertension, and venous thrombosis/pulmonary embolism. Possible progestogen and predominatly progestogen OC side effects and complications are leucorrhea, urinary tract infections, epilepsy aggravation, and cholestatic jaundice. In addition, pregnancy, venous thromboembolism, heart disease, and malignancies of the breast and genital tract are absolute contraindications to OCs. On the other hand, OCs provide health benefits, in addition to preventing unwanted pregnancies, such as lowered incidence of pelvic inflammatory disease, acne improvement, and protection against endometrial carcinoma and ovarian epithelial neoplasia. In order to ensure that health benefits of OCs are maximized and the risks minimized, family planning practitioners worldwide must monitor OC users for side effects. Recent OC formulations now include the progestogen only OCs, multiphase OCs, low dose OC called gestodene, and the "morning after pill".
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PMID:Oral steroidal contraception: scientific basis and recent development. 1234 71

Uterine artery embolization (UAE) is an increasingly performed, minimally invasive alternative to hysterectomy or myomectomy for women with symptomatic uterine fibroids. A growing body of literature documents symptomatic improvement in the majority of women who undergo UAE. Although UAE is usually safe and effective, there are a number of known complications associated with the procedure. Major complications include fibroid passage, infectious disease (endometritis, pelvic inflammatory disease-tubo-ovarian abscess, pyomyoma), deep venous thrombosis, pulmonary embolism, inadvertent embolization of a malignant leiomyosarcoma, ovarian dysfunction, fibroid regrowth, uterine necrosis, and even death. Minor complications include hematoma, urinary tract infection, retention of urine, transient pain, and vessel or nerve injury at the puncture site. As UAE takes its place in the treatment arsenal for women with symptomatic fibroids, radiologists need to be familiar with UAE-associated complications, which may require further treatment and may even be life threatening in some cases. Knowledge of these complications and their imaging features should lead to prompt diagnosis and appropriate treatment.
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PMID:Imaging manifestations of complications associated with uterine artery embolization. 1622 86

Ovarian vein thrombosis (OVT) is a rare cause of abdominal pain that may mimic a surgical abdomen. The differential diagnosis of OVT includes acute appendicitis, endometritis, pelvic inflammatory disease, pyelonephritis, nephrolithiasis, tubo-ovarian abscess, and ovarian torsion. The complications of OVT, including sepsis and pulmonary embolism, are significant. Diagnosis relies on a careful examination of the radiographic findings. This diagnosis should be considered not only in postpartum patients but also in women with pelvic inflammatory disease, recent abdominal surgery, malignancy, or known hypercoagulable state. In this report we present a case of OVT in a 29-year-old woman presenting with 3 days of sharp left-sided abdominal pain, nausea, and vomiting after bilateral salpingectomy. We then discuss the epidemiology, pathophysiology, and clinical management of OVT.
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PMID:Ovarian vein thrombosis: a rare cause of abdominal pain outside the peripartum period. 1819 26

Ovarian vein thrombosis (OVT) is an uncommon entity typically seen in the post-partum, patients with pelvic surgery, infection, or inflammation, and hypercoagulabilty. Concurrent pulmonary embolism (PE) may occur in these patients; however, is an uncommon complication. Treatment commonly involves anti-coagulation and antibiotics in the setting of pelvic inflammatory disease. Presented is a case report of ovarian vein thrombosis leading to pulmonary embolism in the setting of malignancy, underscoring the importance of inspecting the gonadal vein during interpretation, particularly in the emergency setting.
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PMID:One not to miss: ovarian vein thrombosis causing pulmonary embolism with literature review. 2337 85

A young female patient presented to our hospital for massive rectorrhagia associated with clinical signs of peritonitis. The provisional diagnosis was of sigmoid volvolus, but laparatomy demonstrated that the problem originated from Pelvic Inflammatory Disease (PID). Despite prompt and uncomplicated surgery the patient did not survive, probably because of septicaemia or pulmonary embolism.
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PMID:MASSIVE RECTORRHAGIA IN A RURAL HOSPITAL IN KENYA. 2685 9

A 19-year-old woman was admitted to our hospital because of unexplained pain in the right upper abdomen and fever. Her medical history noted a recent uncomplicated pregnancy and birth of a healthy child. Our differential diagnosis included pyelonephritis, pulmonary embolism, pneumonia causing pleural pain, a gastrointestinal cause, or a subphrenic abscess. A vaginal culture was taken as part of a second opinion by a gynaecologist. However, after a few days PCR on the vaginal sample was positive for Chlamydia trachomatis, indicating a case of Fitz-Hugh-Curtis syndrome. This syndrome is a complication of pelvic inflammatory disease caused by a bacterial infection, most frequently Gonococcal or Chlamydia species. The patient was treated with doxycycline and recovered quickly. As a result of ignoring a possible gynaecological cause in this patient, the time to diagnosis and treatment was delayed. Left untreated, this disease might result in infertility and in complications in the newborn. A broad differential diagnosis is therefore important.
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PMID:[A gynaecological cause of upper abdominal pain: Fitz-Hugh-Curtis syndrome]. 2714 99

Septic pelvic thrombophlebitis (SPT) is a rare and severe entity, which may occur after abortion, delivery, gynecological diseases, or surgeries. Diagnosis is challenging when no risk factor is clearly present, since clinically, symptoms are non-specific. Nowadays, with the aid of imaging methods, diagnosis has become more achievable, but the treatment still bears some uncertainties. The authors present a fatal case of SPT in a young woman who sought medical care already presenting signs of septic shock, referring fever and non-characteristic abdominal pain. The patient evolved rapidly to multiple organ failure and respiratory distress, which was also due to septic pulmonary embolism. The autopsy confirmed the computed tomographic findings of a right ovarian vein septic thrombophlebitis and multiple septic pulmonary embolization foci. The patient did not present any of the recognized risk factors; neither did she present signs of pelvic inflammatory disease on admission or at autopsy. However, an intrauterine device was present. The authors call attention to this entity in the differential diagnosis of a woman with fever and abdominal pain, as well as for an empiric broad-spectrum antibiotic regimen in these cases.
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PMID:Septic pelvic thrombophlebitis of unknown origin: an ever threatening entity. 2857 17


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