11/77. Endosalpingiosis-an underestimated cause of chronic pelvic pain or an accidental finding? A retrospective study of 16 cases.OBJECTIVE: The relevance of endosalpingiosis as a cause of chronic pelvic pain is controversial. To examine the clinical presentation of endosalpingiosis, the files of the Institute of pathology at the University of Munster for the years 1994-1999 were screened by keyword search for the diagnosis of endosalpingiosis and the patient files were reviewed. patients: Thirteen patients with the diagnosis endosalpingiosis treated at our institution were identified within the past 6 years. Five patients (38%) presented with pelvic pain, five (38%) with hyper- or dysmenorrhea, five (38%) patients had no complaints at all, one of these had primary and one had secondary infertility, three had persistent ovarian cysts. The diagnosis of endosalpingiosis was confirmed by a second pathologist for all patients included in this study. RESULTS: Mean age at diagnosis was 43 (range 24-82), of the five patients presenting with pelvic pain, the localization of endosalpingiosis was consistent with the localization of pain in only four (30%) patients. Localization and macroscopic appearance of endosalpingiosis and endometriosis seems to be the same in our cases. Five (38%) patients suffered from myomatous uterus, five (38%) had additional endometriosis, five (15%) patients had hydrosalpinx (postinflammatory tubal disease), and seven (53%) had pelvic adhesions. Nine patients had previously been admitted for surgery, only two (15%) patients had tubal surgery, two (15%) had cesarian section and five (38%) had a history of more than two abdominal operations. Eleven (85%) cases of endosalpingiosis were diagnosed by the same pathologist. CONCLUSIONS: Endosalpingiosis seems to be an accidental finding, associated with additional pelvic pathology, rather than being a frequent cause of pelvic pain.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
12/77. Torsion of the fallopian tube in an adolescent female: a case report.BACKGROUND: Torsion of the fallopian tube is an infrequent but significant cause of acute lower abdominal pain in adolescent females that is difficult to recognize preoperatively, although prompt diagnosis and timely surgical treatment are vital to salvage the oviduct. CASE REPORT: A 17-yr-old virgin presented with sudden and severe right-sided lower abdominal pain with guarding and tenderness, fever, nausea, and vomiting at mid-cycle. Ultrasound scan showed a right ovarian cyst measuring 3 cm in diameter and a normal appendix. There was no leucocytosis. Presumptive diagnosis was a cystic ovarian follicle with ovulatory pain. Her condition improved but did not resolve with supportive treatment. At laparotomy, the right fallopian tube was twisted completely, distended with blood, and necrotic, with a small fimbrial cyst. The left tube, ovaries, appendix, and uterus were normal. Right salpingectomy was performed. Histologic examination revealed diffuse hemorrhagic infarction of the tube and a cyst of the hydatid of Morgagni. She remains well at follow-up. CONCLUSION: Unless a high index of suspicion is maintained for torsion of the fallopian tube in adolescent females, this disorder may not be detected until after tubal destruction.- - - - - - - - - - ranking = 1.8995456365554keywords = abdominal pain, pain (Clic here for more details about this article) |
13/77. pseudomonas aeruginosa-infected IUD associated with pelvic inflammatory disease. A case report.BACKGROUND: While pelvic infection is known to be an infrequent complication of intrauterine device (IUD) use, infections are usually related to microorganisms introduced at the time of insertion or by sexual contact. CASE: We diagnosed a 35-year-old woman with an IUD for 6 years with pelvic inflammatory disease (PID) and implemented antibiotic therapy. Her clinical course worsened, and exploratory surgery revealed a right tuboovarian abscess with multiple loculated pelvic abscesses. culture of the IUD found heavy growth of pseudomonas aeruginosa. CONCLUSION: P aeruginosa has not previously been described in association with infections of the upper female genital tract. Double coverage with appropriate antipseudomonal agents is essential for proper treatment of pseudomonal infections.- - - - - - - - - - ranking = 0.00021941998708057keywords = upper (Clic here for more details about this article) |
14/77. Actinomycotic tubo-ovarian abscess mimicking pelvic malignancy.A 39-year-old multipara was admitted to hospital with lower abdominal pain. She had used an intrauterine device (IUD) for 10 years. Three years ago, her tubes were ligated. Ultrasound examination revealed a 9.5 x 6 cm multiloculated cystic mass in the right part of her lower abdomen. CA-125 was also found to be increased. Since ovarian malignancy was suspected, laparotomy was performed. Pathologically, an actinomycotic tubo-ovarian abscess with sulfur granules was disclosed.- - - - - - - - - - ranking = 0.89421726272216keywords = abdominal pain, pain (Clic here for more details about this article) |
15/77. Fallopian tube necrosis after postpartum sterilization.Because it usually presents with nonspecific symptoms and occurs rarely, the diagnosis of fallopian tube torsion and necrosis is usually done at laparotomy. A 32 year-old woman returned to the hospital with right lower quadrant pain three days after a postpartum tubal sterilization procedure. Clinical, laboratory and imaging findings did not assist with the diagnosis. At laparotomy, after dissection of adhesions, a necrotic right fallopian tube was found. A salpingectomy was performed and the patient had an uneventful postoperative course. Fallopian tube torsion should be included in the differential diagnosis of pelvic pain in women. This patient has a good prognosis.- - - - - - - - - - ranking = 0.22222222222222keywords = pain (Clic here for more details about this article) |
16/77. brucella pelvic tubo-ovarian abscess mimicking a pelvic malignancy.A 57-y-old woman presented with recurrent abdominal and pelvic pain of 6 months' duration with low-grade fever. A computed tomographic scan indicated an ovarian tumor. laparotomy revealed a pelvic abscess. Her symptoms resolved following surgery and antibiotic therapy. pathology revealed an extensive inflammatory process. Tissue culture grew brucella sp. The diagnosis and management of this previously undescribed pelvic tubo-ovarian abscess present a particular challenge.- - - - - - - - - - ranking = 0.11111111111111keywords = pain (Clic here for more details about this article) |
17/77. Ruptured tubo-ovarian abscess as a complication of IVF treatment: clinical, ultrasonographic and histopathologic findings. A case report.Tuboovarian abscess is a rare complication of IVF treatment, which can be lethal on rupture. Hereby, we present a case of a ruptured tubo-ovarian abscess, following transvaginal ultrasound-guided oocyte retrieval for IVF and transcervical embryo trasfer in a 38-year-old white female patient with five years of primary infertility who underwent aspiration of bilateral hydrosalpinges at the time of oocyte retrieval. This case suggests that the reactivation of latent pelvic infection due to a previous pelvic inflammatory disease (PID) was the possible route of infection after transvaginal ultrasound-directed follicle aspiration--transcervical embryo transfer. We conclude that physicians should consider the diagnosis of tubo-ovarian abscess in the differential diagnosis of abdominal pain, fever and leukocytosis after ovum retrieval and transcervical embryo transfer for IVF treatment. Preservation of the uterus and unaffected uterine adnexa should be attempted in such cases if future pregnancy is desired.- - - - - - - - - - ranking = 0.89421726272216keywords = abdominal pain, pain (Clic here for more details about this article) |
18/77. Neuropathic uterine pain after hysterectomy. A case report.BACKGROUND: Neuropathic pain arises when there is damage to or dysfunction of the nervous system. Diabetic neuropathy, postherpetic neuralgia and phantom limb pain are common types of neuropathic pain. It is not commonly recognized in gynecologic practice. CASE: A patient underwent a hysterectomy for a tuboovarian abscess and underlying endometriosis. Despite maximal dosing with conventional pain medications, she continued to have significant pain that had not been present following prior surgeries. Use of low-dose amitriptyline successfully treated the pain, with no sequelae. CONCLUSION: Persistent pain following gynecologic surgery that does not respond to conventional therapy may have a neuropathic origin. attention to appropriate history and physical examination may lead to an increase in the diagnosis of neuropathic pain in gynecology patients. This may have implications for persistent pain in other gynecologic diseases.- - - - - - - - - - ranking = 1.4444444444444keywords = pain (Clic here for more details about this article) |
19/77. Torsion of para-ovarian cyst: a cause of acute abdomen.Torsion of uterine adnexa is an important cause of acute abdominal pain. Torsion of ovarian masses is quite common and isolated torsion of fallopian tube has also been reported in literature. However, torsion of para ovarian cyst is a very rare. We report a rare case of twisted para ovarian cyst resulting in secondary torsion of the fallopian tube. Torsion of fallopian tube and para ovarian cyst are usually seen in the reproductive age group. physicians need to maintain a high index of suspicion for this uncommon and often difficult to diagnose cause of abdominal pain.- - - - - - - - - - ranking = 1.7884345254443keywords = abdominal pain, pain (Clic here for more details about this article) |
20/77. Xanthelasma or xanthoma of the fallopian tube.We report a case of a 24-year-old woman who presented with abdominal pain, a tense abdomen, and rebound tenderness. A vague, ill-defined mass was palpated, and an ultrasound examination revealed a cystic lesion in the left adnexal region. At laparotomy, a slightly dilated fallopian tube was seen and excised. light microscopy showed intact fallopian tube mucosa, with a diffuse infiltrate of foam cells in the lamina propria. There were no associated inflammatory cells. The foam cells were positive for CD68 and negative for AE1/AE3. Discontinuous areas of the epithelium also showed epithelial cells with "foamy cytoplasm." These cells were negative for CD68 but positive for AE1/AE3. To our knowledge, this represents the first case of a fallopian tube xanthelasma that shows a resemblance to lesions encountered in the stomach. Fallopian tube xanthelasma must be distinguished from xanthogranulomatous salpingitis, which is associated with an inflammatory cell infiltrate, often including giant cells. However, this lesion may share pathogenetic similarities with xanthogranulomatous salpingitis, since both processes are mediated by inflammation.- - - - - - - - - - ranking = 0.89421726272216keywords = abdominal pain, pain (Clic here for more details about this article) |
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