scholarly journals A Case of Gallstones Causing Pelvic Pain

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Aizat Drahman ◽  
Kaushi Arulpragasam ◽  
Lilach Leibenson ◽  
Frank Sardelic
Keyword(s):  
Abdominal Pain ◽  
Pelvic Pain ◽  
Diagnostic Laparoscopy ◽  
Reproductive Age ◽  
Gallbladder Perforation ◽  
Pelvic Cavity ◽  
Surgical History ◽  
History Of ◽  
History Presentation

Introduction. Assessing abdominal pain, particularly in women of reproductive age, requires thorough history taking, clinical examination, and investigations to obtain an accurate diagnosis. Both surgical and gynecological causes need to be considered, particularly previous relevant surgical history. Presentation of case. We report a case of pelvic pain secondary to multiple gallstones found within the pelvic cavity postlaparoscopic cholecystectomy. Thorough investigations have been conducted without any obvious cause found. The pain was debilitating and largely affecting the patient’s quality of life. Therefore, decision to perform diagnostic laparoscopy and gallstones was found all over pelvic cavity and retrieved. Her pain resolved post operatively. Conclusions. Gallbladder perforation and stone spillage are the most common complications of laparoscopic cholecystectomy that arise during the removal and dissection of gallbladder and can cause significant morbidity if not managed early, especially retrieval of the stones intraoperatively. Therefore, patient with history of previous cholecystectomy with stone spillage presenting with undifferentiated abdominal pain and early diagnostic laparoscopy should be considered.

scholarly journals CHC for pelvic pain in women with endometriosis: ineffectiveness or discontinuation due to side-effects

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Paul J Yong ◽  
Najla Alsowayan ◽  
Heather Noga ◽  
Christina Williams ◽  
Catherine Allaire ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Pelvic Floor ◽  
Pelvic Pain ◽  
Health Research ◽  
Reproductive Age ◽  
Surgical Data ◽  
History Of ◽  
Pelvic Floor Myalgia

Abstract STUDY QUESTION What are the use patterns and factors associated with combined hormonal contraception (CHC) ineffectiveness or discontinuation due to side-effects in patients with endometriosis and pelvic pain? SUMMARY ANSWER Worse chronic pelvic pain (CPP) severity and pelvic floor myalgia were associated with continuous CHC ineffectiveness, while poorer quality-of-life was associated with continuous CHC discontinuation due to side-effects. WHAT IS KNOWN ALREADY CHC is a first line of therapy for endometriosis-associated pelvic pain in women. However, some patients state that CHC is ineffective for their pain, while others have to discontinue CHC due to side-effects. STUDY DESIGN, SIZE, DURATION Analysis of a prospective patient database from a tertiary care referral center for patients with endometriosis and pelvic pain between December 2013 and April 2015 was carried out. PARTICIPANTS/MATERIALS, SETTING AND METHODS A total of 373 patients of reproductive age with endometriosis from the database were included in the study. Data included patient self-reported questionnaires, physical examination findings and validated instruments. There were four variables of interest: history of cyclical CHC ineffectiveness (yes/no), history of cyclical CHC discontinuation due to side-effects (yes/no), history of continuous CHC ineffectiveness (yes/no) and history of continuous CHC discontinuation due to side-effects (yes/no). The primary outcome was CPP severity for the past 3 months (score of 0–10), and secondary outcomes were other pelvic pain scores, quality-of-life on the Endometriosis Health Profile 30 (EHP-30) and underlying conditions including irritable bowel syndrome, painful bladder syndrome, abdominal wall pain, pelvic floor myalgia and depression, anxiety and pain catastrophizing. MAIN RESULTS AND THE ROLE OF CHANCE Among the 373 cases in the dataset, prior cyclical CHC use was reported by 228 (61.1%) women, of which 103 (27.6%) stated it was ineffective for their pain and 94 (25.2%) stated they discontinued CHC due to side-effects. Previous continuous CHC use was reported by 175 (46.9%) women, of which 67 (18.0%) stated it was ineffective and 59 (15.8%) stated they discontinued due to side-effects. Worse CPP severity in the last 3 months was associated with a history of continuous CHC ineffectiveness (P < 0.001). Poorer quality-of-life was present in women who reported a history of continuous CHC discontinuation due to side-effects (P = 0.005). Among the underlying conditions, pelvic floor tenderness (as a marker of pelvic floor myalgia) was associated with CHC ineffectiveness. LIMITATIONS AND REASONS FOR CAUTION This study involved patient recall and no longitudinal follow-up. Also, we do not have data on the type of side-effect that led to discontinuation. Medication ineffectiveness was reported subjectively by the patient rather than using standardized criteria. Finally, the diagnosis of endometriosis was based on previous surgery or a current nodule or endometrioma on examination/ultrasound; without prospective surgical data on all the patients, it was not possible to do a sub-analysis by current surgical features (e.g. stage). WIDER IMPLICATIONS OF THE FINDINGS In women with endometriosis, CHC ineffectiveness was associated with worse CPP and pelvic floor myalgia, which suggests myofascial or nervous system contributors to CPP that does not respond to hormonal suppression. A tender pelvic floor, as a sign of pelvic floor myalgia, may be a clinical marker of patients with endometriosis who are less likely to have an optimal response to hormonal suppression. For women who discontinue CHC due to side-effects, research is needed to help alleviate these side-effects as these patients report worse quality-of-life. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by a Canadian Institutes of Health Research (CIHR) Transitional Open Operating Grant (MOP-142273) as well as BC Women’s Hospital and the Women’s Health Research Institute. PY is also supported by a Health Professional Investigator Award from the Michael Smith Foundation for Health Research. MB/CA has financial affiliations with Abbvie and Allergan; the other authors have no conflicts of interest.

scholarly journals Bleeding

2020 ◽  
Author(s):  
Kizito Omona
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Abdominal Pain ◽  
Sexual Intercourse ◽  
Pelvic Pain ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Abnormal Bleeding ◽  
Monthly Period

Fibroid, also called leiomyomas, is common tumor of the uterus. Usually, women of reproductive age are at risk of getting it. However, majority of these women develop fibroid (s) by the age of 50 years. This condition usually causes painful and unpleasant symptoms such as; heavy bleeding, prolonged periods, inter-menstrual bleeding, abdominal pain and cramps, anemia, pelvic pain and pain during sexual intercourse, among others. Abnormal bleeding, such as bleeding that occurs with fibroids and heavy periods, often lasts more than 10 days per month. This fibroid symptom involves persistent bleeding between cycles, which can severely impact one’s quality of life. Abnormal bleeding, especially in fibroids, can be taken as missing three or more periods in a woman who had been having regular monthly period, or periods that last less than 21 days or more than 35 days apart from each other. Another indication of an abnormal period is bleeding through multiple pads and tampons in a short amount of time.

Clinical and anamnestic characteristics of patients with adenomyosis, accompanied by pelvic pain syndrome

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 77-80
Author(s):  
M R Orazov ◽  
V E Radzinsky ◽  
M B Khamoshina ◽  
A O Dukhin ◽  
L R Toktar ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Pelvic Pain Syndrome ◽  
Common Disease ◽  
Contributing Factors ◽  
High Prevalence ◽  
Inflammatory Processes ◽  
History Of

Pelvic pain syndrome associated with adenomyosis is a common disease in women of reproductive age. Frequency of detection in the population varies from 10 to 53%. The aim - to study the clinical and anamnestic risk factors of pelvic pain, with adenomiose. Materials and methods. The study included 120 (n=120) patients with diffuse adenomyosis with pain and painless form of the disease who underwent examination and treatment in the gynecological Department of the Central clinical hospital №6 of Russian Railways in Moscow. Each patient was provided with an individual card, which was encrypted 171 sign. The studied parameters reflected the passport and anthropometric data, information about education, social status, presence of occupational hazards, complaints, illness. Results. Burdened gynecological and somatic histories, manifested a low health index, a more pronounced hereditary a family history of neoplastic diseases are contributing factors, and high prevalence of postponed surgeries, chronic, long-term ongoing inflammatory processes of the pelvic organs to create a favorable background for the further progression of chronic pelvic pain syndrome in adenomiose.

scholarly journals Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

2021 ◽  
Vol 18 (12) ◽  
pp. 6606
Author(s):  
Jolanta Nawrocka-Rutkowska ◽  
Iwona Szydłowska ◽  
Aleksandra Rył ◽  
Sylwester Ciećwież ◽  
Magdalena Ptak ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Pelvic Pain ◽  
Predictive Value ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Pelvic Surgery ◽  
History Of Surgery ◽  
Previous Surgery ◽  
History Of

Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.

scholarly journals Managing a Colonoscopic Perforation in a Patient with No Abdominal Wall

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Jayan George ◽  
Michael Peirson ◽  
Samuel Birks ◽  
Paul Skinner
Keyword(s):  
Abdominal Pain ◽  
Incisional Hernia ◽  
Plastic Surgery ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Colonic Perforation ◽  
Conservative Approach ◽  
Wall Defect ◽  
Surgical History ◽  
History Of

We describe the case of a 37-year-old gentleman with Crohn’s disease and a complex surgical history including a giant incisional hernia with no abdominal wall. He presented on a Sunday to the general surgical on-call with a four-day history of generalised abdominal pain, nausea, and decreased stoma output following colonoscopy. After CT imaging, he was diagnosed with a large colonic perforation. Initially, he was worked up for theatre but following early senior input, a conservative approach with antibiotics was adopted. The patient improved significantly and is currently awaiting plastic surgery input for the management of his abdominal wall defect.

scholarly journals MODERN METHODS OF COMPLEX CORRECTION OF PSYCHOSOMATIC DISORDERS IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS

2020 ◽  
Vol 73 (12) ◽  
pp. 2623-2626
Author(s):  
Nikolay A. Shcherbina ◽  
Liliya V Potapova ◽  
Irina N. Shcherbina ◽  
Oksana P. Lipko ◽  
Olga V. Mertsalova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Quality Analysis ◽  
Psychological State ◽  
Pelvic Pain Syndrome ◽  
Psychosomatic Disorders ◽  
Pain Mechanisms

The aim: About 10% of socially active women of reproductive age suffer from endometriosis, is determined by the frequent occurrence of menstrual and reproductive functions disorders, and pelvic pain syndrome in patients. The difficulties of therapeutic treatment of chronic pain syndrome in external genital endometriosis (EGE) are associated with polymorphism of pain mechanisms, and delayed diagnosis and treatment. The aim of the study is to improve the effectiveness of the treatment of external genital endometriosis. Material and methods: We examined 60 female patients of reproductive age, 40 – with histologically verified diagnosis of external genital endometriosis and 20 healthy women. We used the following methods of examination: general clinical, instrumental, endoscopic, morphological, the Visual Analogue Scale (VAS) to quantify pain, the Beck Depression Scale and the SF-36 questionnaire. Results: Before the treatment of patients with EGE, VAS scale scores indicated pain in 100% of patients, the indicators of depression and level of anxiety go beyond the normative. The results of the pre-treatment questionnaire indicated lower quality of life scores on the scales of physical and mental health components. As a result of treatment there was significant decrease in the manifestations of pain, depression and anxiety, with women receiving complex therapy (hormone therapy got antidepressants and non-drug correction methods). Сonclusions: Chronic pelvic pain syndrome associated with EGE and accompanied by an unfavorable psychological state, depressive states, anxiety symptoms, and psychosomatic disorders. New approaches to the treatment of clinical manifestations of EGE are needed, taking into account patients’ psycho-emotional status and the life quality analysis. We pathogenetically justified the use of drugs that affect the psychosomatic status of patients with EGE and showed that they could significantly improve the quality of life.

scholarly journals Laparoscopic findings in chronic pelvic pain

2013 ◽  
Vol 1 (2) ◽  
pp. 100-102
Author(s):  
J Bajracharya ◽  
NS Shrestha ◽  
C Karki ◽  
R Saha
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Diagnostic Laparoscopy ◽  
Multidisciplinary Approach ◽  
College Teaching ◽  
Reproductive Age ◽  
Medical College ◽  
Laparoscopic Finding ◽  
Reproductive Age Group ◽  
Pelvic Congestion

Background: Chronic pelvic pain is a common problem in reproductive age group women. Diagnosis of chronic pelvic pain needs multidisciplinary approach. Diagnostic laparoscopy is one of the investigations which can help in reaching the diagnosis. Objective: To know the etiology in chronic pelvic pain. Methods: This was a descriptive study done in the Department of Obstetrics and Gynaecology of Kathmandu medical college teaching hospital from January 2010 to June 2012 (30 months). All the cases of laparoscopic surgery done for chronic pelvic pain were noted and details of these cases were analyzed regarding age, parity and laparoscopic findings. Results: Total 48 cases of Chronic Pelvic Pain underwent diagnostic laparoscopy during the study period. Mean age of cases were 33 years, ranging from 20-46yrs. Almost half of the cases 43.75% were of parity two. Laparoscopic finding was negative in 29.17% and pelvic pathology was present in 70.83% of the cases. Out of the pelvic pathology endometriosis was present in 55.88% followed by pelvic adhesions, pelvic congestion and pelvic inflammatory disease, chronic ectopic in 20.58%, 14.70%, 5.88%, 2.94% respectively. Conclusion: Diagnostic laparoscopy is a useful modality in the diagnosis of etiology and management of Chronic pelvic pain. In our study, Pelvic endometriosis was the most common pelvic pathology in cases of Chronic pelvic pain. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8146 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 100-102

scholarly journals Chronic Pelvic Pain and Associated Clinical Characteristics among Women in a Tertiary Care Center in Indonesia

2017 ◽  
pp. 154
Author(s):  
Kanadi Sumapradja ◽  
Thomas Chayadi
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Clinical Characteristics ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Domain Score ◽  
Health Clinic ◽  
Common Diagnosis ◽  
Hs Crp

Objective: To determine the prevalence and various aspects associated with female chronic pelvic pain. Methods: During the period of January to March 2016, a crosssectional study was conducted at the Women’s Health Clinic of Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Subjects were female who complained of pelvic pain for more than 6 months. We performed history taking, physical examination, and laboratory investigations including hs-CRP serum examination. We calculate the prevalence and describe the clinical characteristics and diagnosis of the patient. Quality of life and levels of hs-CRP were compared between the group of mild and severe pain. Results: In this study, the prevalence of CPP was 9.78%. We found 96.9% of gynecological disorders, 1% of urological disorders, and 2.1% of musculo-skeletal disorders. The most common diagnosis is endometriosis. The Clinical characteristics of patients were found 62.9% suffer for 6 months - 1 year with the intensity of pain (VAS) 7-10 as much as 51.5%. Levels of hs-CRP serum was around 1.99 (0.00 - 404, 53). We found a decreased in the quality of life of the patient. The physical domain score was 56 (38-81); the psychology domain score was 56 (31-100); the domain of social relationships was 59 (25-75); and the environmental domain score was 56 (31-94). Conclusion: Endometriosis is the most common diagnosis in female chronic pelvic pain of reproductive age. The pain causes a decreased in quality of life who suffer from it. [Indones J Obstet Gynecol 2017; 5-3: 154-159] Keywords: chronic pelvic pain, hs- CRP, intensity of pain, quality of life

scholarly journals Migrated Tubal Ligation (Filshie) Clip as an Uncommon Cause of Chronic Abdominal Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Sahil Sharma ◽  
Radek Martyniak ◽  
Vladislav Khokhotva
Keyword(s):  
Abdominal Pain ◽  
Fertility Control ◽  
Left Lobe ◽  
Tubal Ligation ◽  
Chronic Abdominal Pain ◽  
Pathology Report ◽  
Patient Reported ◽  
Surgical History ◽  
History Of ◽  
Gastrohepatic Omentum

Tubal ligation (TL) is an effective and common method of fertility control. In the year 2009, over 24,000 were performed in Canada alone. Migration of Filshie clips used during TL is estimated to occur in 25% of all patients; 0.1-0.6% of these patients subsequently experience symptoms or extrusion of the clip from anatomical sites such as the anus, vagina, urethra, or abdominal wall. Migrated clips may present as chronic groin sinus, perianal sepsis, or chronic abdominal pain. These symptoms can occur as early as 6 weeks or as late as 21 years after application. We present the case of a 49-year-old female with a 3.5-year history of intermittent dull nonradiating left upper quadrant (LUQ) pain lasting on average 2-3 days. There were no other associated symptoms, and the longest pain-free period was 4 days. Her past medical history includes COPD, GERD, IBS, and depression. Current medications are only remarkable for Symbicort. Pertinent past surgical history includes laparoscopic tubal ligation with Filshie clips in 1999, followed by a vaginal hysterectomy in 2013. Migrated tubal ligation clip was noted on an abdominal X-ray. The patient was then referred for surgical management. Subsequent CT scan confirmed a solitary clip present adjacent to the left lobe of the liver. No other abnormalities were reported. Patient underwent laparoscopy for removal of the clip, which was identified to be underneath the left lobe of the liver embedded in the gastrohepatic omentum. Please see the video link provided. Postoperative pathology report confirmed the presence of a Filshie clip. Patient reported complete resolution of her LUQ pain at a 5-week and 3.5-month follow-up. This case shows that although symptomatic clip migration is a rare phenomenon, it should be given special consideration in women with unexplained chronic abdominal pain and a history of TL. Additionally, removal of clip can provide resolution of symptoms.

scholarly journals Clinical picture and diagnosis of genital endometriosis

2016 ◽  
Vol 65 (5) ◽  
pp. 4-21 ◽  
Author(s):  
Maria I Yarmolinskaya ◽  
Elena I Rusina ◽  
Armine R Khachaturyan ◽  
Margarita S Florova
Keyword(s):  
Quality Of Life ◽  
Mental Disorders ◽  
Pelvic Pain ◽  
Clinical Picture ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Working Capacity ◽  
Costs Of Treatment ◽  
Gynecological Disease

Endometriosis is a widespread gynecological disease which affects every tenth woman of reproductive age. The main symptoms of disease are chronic pelvic pain, sterility and miscarriage, that leads to a reliable decline in quality of life and working capacity, mental disorders. Timely and complete diagnostics of endometriosis allows choosing the best option of treatment and minimizes the costs of treatment. This article describes in detail the existing methods of diagnosis of endometriosis. Modern literature and the results of own studies are summarized in the text.

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