scholarly journals Cryptomenorrhea Secondary to Past Childhood Pelvic Trauma in Young Adolescent Girls: Case Series

2019 ◽  
Vol 01 (03) ◽  
pp. 119-121
Author(s):  
Syeda Batool Mazhar ◽  
Javeria Mumtaz ◽  
Qurratulain Saeed ◽  
Farzana Nawaz
Keyword(s):  
Abdominal Pain ◽  
Urinary Retention ◽  
Adolescent Girls ◽  
Diagnostic Laparoscopy ◽  
Case Series ◽  
Lower Abdominal Pain ◽  
Pelvic Trauma ◽  
Young Adolescent ◽  
Primary Amenorrhea ◽  
Detailed History

Primary amenorrhea secondary to childhood pelvic trauma is very rare. We report two cases of adolescent girls with cryptomenorrhoea. Case 1 presented at 14 years of age with primary amenorrhea and cyclical lower abdominal pain for 1 year. She was run over by a tractor when she was three years old. Ultrasonography pelvis showed hematometra. Examination under anesthesia with diagnostic laparoscopy proceed laparotomy revealed uterine avulsion at level of isthmus. The second case presented at 13 years of age with urinary retention. Catheterization was not possible due to malpositioning of urethra so suprapubic catheterization was performed by urologists. Ultrasonography pelvis revealed hematocolpos. Detailed history revealed run over injury by a vehicle when she was two years old. Examination under anesthesia showed obstruction due to adhesions high up in vagina which were divided.

scholarly journals A Case Series on Epiploic Appendagitis: An Underdog in Acute Abdomen

2021 ◽  
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Pradeep Joshua Christopher ◽  
Sudha Kanthasamy ◽  
Jeyakumar Sundaraj
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Case Series ◽  
Lower Abdominal Pain ◽  
Surgical Excision ◽  
Epiploic Appendagitis ◽  
Common Causes ◽  
Epiploic Appendage

Epiploic appendagitis is an uncommon yet a significant surgical diagnosis that every surgeon should be aware. It occurs due to the torsion of the epiploic appendage which gives rise to acute abdominal pain that can mimic other common causes of acute abdominal pain like appendicitis or cholecystitis. The treatment of epiploic appendagitis depend on clinical presentation, severity and it varies from conservative management to surgical excision. This case series is about eight patients presented with complaints of lower abdominal pain. After clinical examination they were initially diagnosed to have appendicitis or diverticulitis. The Computed Tomography (CT) -based diagnoses were appendicitis, omental infarct, diverticulitis or epiploic appendagitis. All of them were subjected to diagnostic laparoscopy and found to have an inflammed epiploic appendage which was excised laparoscopically.

scholarly journals LAPAROSCOPY;

2012 ◽  
Vol 19 (01) ◽  
pp. 033-039
Author(s):  
NAZIA MUSSARAT ◽  
SIAMA QURESHI ◽  
AWAIS SHUJA ◽  
Mehnaaz Roohi
Keyword(s):  
Abdominal Pain ◽  
Gold Standard ◽  
Open Surgery ◽  
Diagnostic Laparoscopy ◽  
Data Entry ◽  
Lower Abdominal Pain ◽  
Descriptive Study ◽  
Lower Abdomen ◽  
Patient Case ◽  
Polycystic Ovarian Disease

Introduction: Diagnostic Laparoscopy is considered to be the gold standard for the evaluation of the pelvis and is considered asafe procedure. Diagnostic Laparoscopy is a technique in the routine investigation and treatment of infertility as well as other gynecologicalproblems. Objectives: To determine, Laparoscopic findings in different gynecological conditions, different causes of infertility andcomplications of laparoscopy Design: Retrospective, descriptive study. Material And Methods: We reviewed case records of all patients whounderwent laparoscopy for their different Gynecological problems. Data were collected from patient case records in a data entry sheet Results:In our study a total of Thirty patients under went laparoscopy for investigation of different gynecological problems. There were 17 patients whohave primary infertility and 6 have secondary infertility while 7 presented with Lower abdominal pain. In our study the leading cause of primaryinfertility was Polycystic Ovarian Disease(29%).Other causes were bilateral tubal blockade (23.53 %) ,17% has PID and fibroid uteri, While onepatients shown Endometriosis as well as one patient had no obvious pathology.(5.88 %).On laparoscopic examination of secondaryinfertility 50% shown Tubal blocked while 16.67 shown Fibroid uterus and PID.One patient had normal pelvic findings(16.67). Regardingpatients presented with pain lower abdomen 57.15% has ovarian cyst,28.58% has Ectopic pregnancy while one case(14.29%) had hetrotropicpregnancy. In 24 patients had no complication and recovery was smooth. laparoscopy had to be converted into Laparotomy due to significanthemorrhage in two patient and wound infection was observed in two patients. One patient presented with post operative fever and onepresented with abdominal pain. Conclusions: Laparoscopy is a valuable diagnostic tool for females in different gynecological problems. Thebenefit of the laparoscopy to open surgery include less pain, less scarring, less disability and quicker recovery.

scholarly journals Primary Amenorrhoea - A review of 26 Cases

2016 ◽  
Vol 20 (3) ◽  
Author(s):  
Farhat Iqbal ◽  
Naheed I
Keyword(s):  
Abdominal Pain ◽  
Clinical Examination ◽  
Lower Abdominal Pain ◽  
Imperforate Hymen ◽  
Detailed History ◽  
Primary Amenorrhoea ◽  
Secondary Sex Characters

This is a study of twenty six subjects who presented to Sir Ganga Ram Hospital, Lahore 1999-2001 and were cases of primary amenorrhoea 20(76.9%) of patient presented between 15-25 years of age. Five (19.2%) had lower abdominal pain. Secondary sex characters were developed in 69.2%. Uterus was absent in 4(15.5%) and ovaries were present in 17(65.5%). FSH was high >40mIU in 12(46.5%) and low <3mIU in 2(7%), 14(53.5%) were put on HRT 1(3.8%) had gonadectomy. 5(19.3%) patients had imperforate hymen, where excision was done. It was concluded that detailed history, through clinical examination and minimal investigations are required to diagnose cases of primary amenorrhoea.

The importance of a thorough clinical examination in adolescent girls presenting with acute urinary retention

2021 ◽  
Vol 14 (2) ◽  
pp. e240378
Author(s):  
Oman Rai ◽  
Sanju Lama ◽  
Sanjay Wazir Pandita
Keyword(s):  
Urinary Retention ◽  
Adolescent Girls ◽  
Acute Urinary Retention ◽  
Lower Abdominal Pain ◽  
Paediatric Ward ◽  
Common Causes ◽  
History Of ◽  
The Common ◽  
Time Of Presentation ◽  
New Onset

We present an adolescent girl with a 1-day history of acute urinary retention and lower abdominal pain. She was admitted to the paediatric ward for ongoing treatment and investigations. Due to a myriad of factors including pain and anxiety, challenges posed included an incomplete initial abdominal and external genital examination. This case report highlights the importance of a focused history and performing an appropriate sensitive examination at the time of presentation. Furthermore, we explore the common causes of new onset urinary retention and unravel the case as it unfolds. We also highlight differential diagnoses (however, uncommon), which must be considered and not overlooked to avoid unnecessary investigations and to ensure timely management.

Hydrosalpinx in adolescent girls: What did two cases teach?

2021 ◽  
Author(s):  
Ahmet Hikmet Şahin
Keyword(s):  
Abdominal Pain ◽  
Adolescent Girls ◽  
Cystic Lesion ◽  
Lower Abdominal Pain ◽  
Fallopian Tubes ◽  
Abdominal Ultrasonography ◽  
Palpable Mass ◽  
Abdominal Magnetic Resonance Imaging ◽  
First Case ◽  
Abdominal Exploration

Hydrosalphinx is the fallopian tubes getting filled with fluid due to their blockage. It usually occurs with obstruction of fallopian tubes after infection in women of sexually active age. The aim of this article is to draw attention to hydrosalpinx in adolescent girls because of two adolescent cases. First case; a cystic lesion of 38x51x76 mm in the right adnexal region was detected in the lower abdominal magnetic resonance imaging of a 13-year-old girl who presented with the complaint of abdominal pain and vomiting. Right tubal torsion and hydrosalpinx were detected during abdominal exploration. The tube was detorsioned and marsupialization was applied to the hydrosalpinx. Second case; a cystic lesion with dimensions of 24x12x35 cm was detected in the abdominal ultrasonography of a 16-year-old girl who presented with the complaint of abdominal pain and a palpable mass. On abdominal exploration, a right hydrosalpinx filling the entire abdomen was detected. Tubal excision was performed. Both cases have not been undergone any intraabdominal surgery previously. Hydrosalpinx is very rare in adolescent girls. Hydrosalpinx also should be considered in lower abdominal pain. Cases should be examined in terms of preventing infertility problems in future carefully, development of adhesion should be curtailed and parents should be informed in detail.

Appendectomy for Vague Symptoms and Equivocal Physical Findings on Physical Exam and Computed Tomography

2021 ◽  
pp. 000313482110505
Author(s):  
Meaghan Flatley ◽  
Kyle K. Sokol ◽  
Eric M. Balent ◽  
Sara B. Placek ◽  
Joshua S. Ritenour ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Diagnostic Laparoscopy ◽  
Treatment Algorithm ◽  
Case Series ◽  
Signs And Symptoms ◽  
Imaging Characteristics ◽  
Laboratory Results

Background: Appendicitis is a common condition affecting 7-8% of the general population. With the improvement of noninvasive imaging, the diagnostic approach and treatment algorithm for patients with clear signs and symptoms suggestive of acute appendicitis are well agreed-upon. However, patients without pathognomonic signs and symptoms, but with equivocal imaging pose a diagnostic dilemma. These patients may still have acute appendicitis and could potentially benefit from laparoscopic appendectomy. This may be especially true in the subset of patients with appendicoliths. Methods: Our case series exams a group of patients with atypical symptoms who eventually underwent appendectomy and were followed after surgery for at least a month. This case series consists of eight patients with abdominal pain accompanied by a variety of other signs and symptoms in addition to laboratory results and imagining characteristics which were nondiagnostic. These patients had initial Alvarado scores ranging from 0-6. Results: All of these patients were subsequently taken to the operating room for diagnostic laparoscopy and laparoscopic appendectomy. Of these patients, six were known to have appendicoliths based on computed tomography obtained during initial diagnostic workup. Conclusions: All patients underwent a diagnostic laparoscopy and appendectomy. Four had appendicitis and four also had resolution of their symptoms. There exist atypical presentations of appendiceal disease. Patients with abdominal pain/tenderness, even without diagnostic laboratory results or imaging characteristics, may benefit from laparoscopic appendectomy.

scholarly journals Imperforate Hymen: A Comprehensive Systematic Review

2019 ◽  
Vol 8 (1) ◽  
pp. 56 ◽  
Author(s):  
Keum Lee ◽  
Ji Hong ◽  
Hyuk Jung ◽  
Hyun Jeong ◽  
Seo Moon ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Urinary Retention ◽  
Case Reports ◽  
Female Genital Tract ◽  
Case Series ◽  
Treatment Modalities ◽  
Vaginal Septum ◽  
Imperforate Hymen ◽  
Ascending Infection ◽  
Surgical Methods

Imperforate hymen (IH) is an uncommon congenital anomaly of the female genital tract, with the hymen completely obstructing the vaginal opening. Despite the simple diagnosis and treatment of IH, missed or delayed diagnosis is often a clinical problem owing to its low incidence, nonspecific symptoms, or insufficient physical examination. The aim of this study is to identify the characteristics, clinical presentations, treatment modalities, and outcomes of imperforate hymen patients. In this study, a literature search of PubMed databases was performed for sources published up to 3 July 2018 for English-language studies with the term “imperforate hymen”. The literature review identified 251 citations and 155 articles (143 case reports, 12 case series) containing 253 patients who were finally included (two papers were not written in English). Among 236 postnatal patients, the mean age of the patients was 10.7 ± 4.7 years. Abdominal pain (54.2%), urinary retention (20.3%), abnormal menstruation (14.0%), dysuria (9.7%), increased urinary frequency (5.1%), severe presentation of renal failure (n = 5, 2.1%), and urinary tract infection (n = 1, 0.4%) were presented. Most patients diagnosed with the condition underwent surgical treatment (83.5%), most of whom were treated via a hymenotomy (35.2%) and hymenectomy (36.4%), and the use of prophylactic antibiotics were only used in 7 patients. There were no differences in outcomes between two surgical methods. In addition, 141 (59.7%) patients showed improvement and 5 deceased patients were not related to IH or the operation itself; Complications, such as vaginal adhesion, were only noted in 6.6% of patients. In addition, among 17 cases of newborns with a diagnosis of IH before birth, hymenectomy (n = 5, 29.4%) and hymenotomy (n = 9, 52.9%) were the main treatment modalities and showed improved prognosis in 52.9% of newborns. Because IH diagnosis is easy and postsurgical prognosis is good, clinicians should carefully examine every female patient at birth. IH should be considered regarding adolescent girls with abdominal pain, lower back pain, or urinary retention, and perform appropriate physical examinations of the genital introitus. In addition, accurate diagnosis as IH, not misdiagnosing as vaginal septum or agenesis, is important to prevent severe complications such as stricture and ascending infection.

A prospective observational study of the utility of early diagnostic laparoscopy for right lower abdominal pain: a safe and effective diagnostic and therapeutic tool

2019 ◽  
Vol 64 (2) ◽  
pp. 49-55
Author(s):  
Graeme JK Guthrie ◽  
Thomas Johnston ◽  
Anne Ewing ◽  
Russell Mullen ◽  
Stuart A Suttie ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Negative Impact ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Emergency Setting ◽  
Positive Finding ◽  
Therapeutic Tool ◽  
Surgical Trainees ◽  
Early Diagnostic

Background and aims Diagnostic laparoscopy is commonly performed for diagnosis of right lower abdominal pain and its use is increasing in the emergency setting. Some studies have reported that diagnostic laparoscopy and laparoscopic appendicectomy have advantages over conventional surgery. Many emergency surgeons now perform diagnostic laparoscopy for both clinically diagnosed appendicitis and when the diagnosis is in doubt. The aim of the present study was to assess whether the use of diagnostic laparoscopy is justified and safe for those admitted with right lower abdominal pain. Methods and results Data were collected prospectively on consecutive patients attending the acute surgical receiving unit with right iliac fossa pain or a suspected diagnosis of acute appendicitis. A total of 284 patients underwent diagnostic laparoscopy. Of them 233 (82%) had a positive finding at laparoscopy, 207 (88%) underwent appendicectomy, the majority of which were carried out laparoscopically. Surgical trainees performed the majority of operations and this did not have a negative impact on operative findings (p 0.856), operation performed (0.642), or operative duration (0.831). No intra-operative complications were sustained. Ultrasound examination was carried out in 49 patients, while CT was carried out in 24. Conclusion The results of the present study highlight the utility of early diagnostic laparoscopy as both a diagnostic and therapeutic tool in the acute setting.

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