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Query: UMLS:C0423647 (iliac fossa pain)
 157 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the present study was to elucidate the gastrointestinal manifestations of yersiniosis. During the period 1974 to 1983, Yersinia enterocolitica infection was diagnosed in 458 patients, by isolation from fecal samples or by antibody response. At first admission, 184 patients had abdominal pain; 200, diarrhea; 45, vomiting; and 36, weight loss. Ulcerative colitis was diagnosed in 7 patients, Crohn's disease in 2, and unspecific colitis in 11. Mesenteric lymphadenitis or ileitis were found in 43 of 56 patients at laparotomy. The patients were followed for 4 to 14 years (1987). Thirty-eight patients were readmitted with abdominal pain and 28 with diarrhea; these symptoms were significantly correlated with the corresponding symptoms at first admission. Chronic colitis was diagnosed in 4 patients, chronic weight loss in 12. A follow-up inquiry (380 patients) indicated that patients with right iliac fossa pain during the acute infection less frequently developed chronic abdominal complaints. Gastrointestinal symptoms are common in both the acute and chronic states of yersiniosis. The correlations between acute and chronic symptoms indicate that yersiniosis is a chronic disease. Immunologically competent individuals may profit by fighting the infection in the right iliac fossa. The relationship between yersiniosis and inflammatory bowel diseases may still not be settled.
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PMID:Acute and chronic gastrointestinal manifestations associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. 154 97

C-reactive protein (CRP) and full blood counts were performed on 60 consecutive patients admitted with right iliac fossa pain. Of these, 31 patients had appendicitis and six had a negative appendicectomy. The CRP was raised in 29 (94%) patients with appendicitis and was not raised in five (83%) patients who underwent a negative appendicectomy. In the cases of appendicitis the CRP was significantly raised more often than the white blood cell count (WBC) (P less than 0.05, chi 2 = 3.98). In 30 (97%) patients who had appendicitis the CRP or white blood cell count was elevated. CRP is of value in indicating acute pathology and its routine performance may decrease the negative appendicectomy rate.
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PMID:C-reactive protein in right iliac fossa pain. 194 40

In a prospective study 152 consecutive patients presenting with acute abdominal pain were assessed clinically and an ultrasonographic examination was performed immediately. Of these, 16 (11 per cent) patients would normally have had an immediate ultrasonographic scan requested; routine (within 24 h of admission) ultrasonographic examination would have been requested in a further 66 (43 per cent) patients. In 70 (46 per cent) patients an ultrasonographic examination would not have been requested. Ultrasonography altered the diagnosis in one patient from probable appendicitis to cholecystitis. Ultrasonography missed one abdominal aortic aneurysm and one empyema of the gallbladder. Ultrasonography had a sensitivity of 96 per cent, a specificity of 94 per cent, a positive predictive value of 96 per cent, a negative predictive value of 94 per cent and an accuracy of 95 per cent in diagnosing appendicitis. Exactly the same values were found for the clinical diagnosis of appendicitis. The study shows that routine immediate ultrasonographic examination of the acute abdomen is rarely helpful, with the possible exception of appendicitis. Where an urgent ultrasonographic scan is necessary on clinical grounds the expertise of a radiologist is probably required, whereas in specific areas, for example in the diagnosis of right iliac fossa pain, there may be a place for training the surgical trainee.
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PMID:Ultrasonography in the acute abdomen. 195 78

An interesting case of bifid blind-ending ureter occurring in a young Indian girl is reported. She presented with severe recurrent right iliac fossa pain for which she underwent appendicectomy which did not resolve her symptoms. Subsequent urological investigation--IVU and retrograde pyeleogram--revealed the genuine diagnosis. Surgical excision of the blind-ending branch was successful in relieving the intractable pain. A review of the literature on this uncommon congenital urological problem is outlined stating its clinical significance and treatment options.
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PMID:Bifid blind-ending ureter--a case report. 201 15

Four cases of primary torsion of the greater omentum are reported. The most common clinical picture in this condition mimics acute appendicitis. Primary torsion with spontaneous derotation of the greater omentum may be an important cause of right iliac fossa pain of obscure origin. Scrutiny of the omentum during negative appendiceal exploration is extremely important. Treatment is excision of the twisted, infarcted omentum.
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PMID:Primary torsion of the greater omentum. Case report. 233 Jul 96

Eleven cases of diverticular disease of the colon were seen in a review of 603 adult barium enema examinations carried out over a 2-year period (January 1984-December 1985) at the University College Hospital, Ibadan, Nigeria--a prevalence of 1.85%. All the cases were clinically unsuspected and the diagnosis was established only at barium examination. Five of the 11 patients presented with rectal bleeding, six with alteration in bowel habit, six with abdominal pain and associated fever and one with right iliac fossa pain and tenderness mimicking appendicitis. Although an uncommon disease in Nigerians, clinicians are urged to suspect diverticular disease in their differential diagnoses of disorder of the colon in Africans in order not to miss a potentially lethal but treatable condition.
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PMID:Diverticular disease of the colon in Ibadan, Nigeria. 255 53

The ilioinguinal nerve entrapment syndrome is an abdominal muscular pain syndrome, characterized by the clinical triad of muscular type iliac fossa pain with a characteristic radiation pattern, an altered sensory perception in the ilioinguinal nerve cutaneous innervation area, and a well-circumscribed trigger point medial and below the anterosuperior iliac spine. Relief of pain by infiltration of a local anaesthetic confirms the diagnosis. This report describes retrospectively the clinical picture of ilioinguinal nerve entrapment in 32 mainly non-surgical patients. In 14 cases a definite diagnosis was established and in 18 patients the diagnosis was considered probable. The mean delay in diagnosis was 12.8 months. Better knowledge of this syndrome may avoid invasive investigations and be cost saving.
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PMID:Ilioinguinal nerve entrapment: a little-known cause of iliac fossa pain. 260 91

This article describes a case of ovarian pregnancy without the presence of an IUD. The patient, a 33-year old Indian woman para 4, presented with right iliac fossa pain and 8 weeks of amenorrhea. There was no history of contraceptive use. The initial diagnosis was twisted ovarian cyst; however, ultrasonography revealed an enlarged uterus with a gestational sac. At laparotomy, a right solid ovarian mass was found anterior to the uterus and adherent to the uterus, bladder, and the rectosigmoid junction. The mass was mobilized and a right salpingo-oophorectomy was performed along with left ovarian cystectomy and tubal ligation. Microscopic examination indicated a developing embryo of 6 weeks gestation. Ovarian pregnancy has been reported in 1/10,000-40,000 pregnancies and represents 0.5-2.0% of all ectopic pregnancies. 12-20% of ectopic pregnancies in the presence of an IUD are ovarian as are 0.5% of all pregnancies occurring in IUD users. It is speculated that, in this case, fertilization took place outside the ovary and reimplantation occurred. Diagnosis of ovarian pregnancy generally requires 4 criteria: 1) the tube on the affected side must be intact; 2) the fetal sac must occupy the normal position of the ovary; 3) the ovary and sac must be connected to the uterus by the utero-ovarian ligament; and 4) definite ovarian tissue must be present in the sac wall.
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PMID:Ovarian pregnancy--a case report. 383 57

A 32-year-old mother presented at King Edward Memorial Hospital for Women in Subiaco, Western Australia, with a 30-day history of strong, perpetual epigastric pain with nausea and a 14-day history of light vaginal bleeding. Even though she had a positive pregnancy test (human chorionic gonadotropin [hCG] level = 18,000 IU/l), ultrasound found no intrauterine pregnancy and suggested a left adnexal mass. She had a normal sized uterus, closed cervical os, and no cervical excitation. Laparoscopy revealed normal Fallopian tubes, a corpus luteal cyst on the left ovary, about 20 ml of old blood in the pouch of Douglas, and no apparent ectopic pregnancy. She was discharged 2 days after the nausea had subsided. She returned the day after discharge with right iliac fossa pain and syncope. Her hemoglobin value was down to 10.5 g/l from 11.8 g/l. Ultrasound revealed a small mass (2.2 x 2.3 cm) in the caudate lobe of the liver near the neck of the gallbladder. A laparotomy was performed. The surgeon explored and divided the fibrinous adhesions posterior to the neck of the gallbladder. An unruptured ectopic pregnancy (1.5 cm in diameter with an embryo within the sac) was implanted on the inferior surface of the liver and the structures of the porta hepatis. Since surgical removal of the ectopic pregnancy would be dangerous, the surgeon infiltrated the ectopic bed with POR-8 diluted with normal saline and injected 20 mg of methotrexate directly into the sac. The woman was discharged 10 days postoperatively. By day 26 postoperatively, hCG levels had fallen to 20. Hepatic ectopic pregnancy is very rare and is difficult to diagnose. This case was managed differently from hepatic ectopic pregnancy cases in the literature, which necessitated omental grafts, oversewing of the liver, and ligature of the right hepatic artery. Direct injection of methotrexate has the advantage of a reduced dosage and reduced risk of toxicity.
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PMID:A hepatic ectopic pregnancy treated with direct methotrexate injection. 767 99

A young woman presenting with right iliac fossa pain was found to have a palpable mass. Ultrasound and computed tomography demonstrated a calcified solid mass, which was extraintestinal on barium enema. Laparotomy confirmed an infarcted left ovarian cyst due to torsion of an attenuated but intact fallopian tube. To our knowledge, this is the first documented case of ovarian autoamputation in evolution. A migrating left ovary should be added to the differential diagnosis of a painful right iliac fossa mass.
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PMID:Painful right iliac fossa mass caused by a migrating left ovary. 792 41


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