scholarly journals Torsion of a fallopian tube: a rare cause of lower abdominal pain in a female of reproductive age

2012 ◽  
Vol 33 (2) ◽  
pp. 63 ◽  
Author(s):  
Janitha R Costa ◽  
James Moohan
Keyword(s):  
Abdominal Pain ◽  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Reproductive Age

scholarly journals Management of hemoperitoneum due to rupture of the ovarian cyst

2021 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Oana Denisa Balalau ◽  
Ileana Maria Conea ◽  
Nicolae Bacalbasa ◽  
Anca Silvia Dumitriu ◽  
Stana Paunica ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ovarian Cyst ◽  
Lower Abdominal Pain ◽  
Physical Exertion ◽  
Sudden Onset ◽  
Reproductive Age ◽  
Adnexal Torsion ◽  
Ultrasound Monitoring ◽  
Chemical Peritonitis ◽  
Rule Out

Ovarian cyst is the most common female gynecological pathology and it is characteristic of reproductive age. Its rupture causes the sudden onset of pelvic-abdominal pain, often associated with physical exertion or sexual contact. The differential diagnosis is made with other causes of lower abdominal pain: ectopic pregnancy, adnexal torsion, pelvic inflammatory disease or acute appendicitis. The clinical picture may vary depending on the type of ruptured cyst. Dermoid cyst causes severe symptoms due to chemical peritonitis that occurs in response to extravasation of sebaceous contents in the peritoneal cavity. Surgical treatment is indicated for complicated forms of cystic rupture. Most cases have self-limiting, quantitatively reduced bleeding and spontaneous resorption within a few days. Patients diagnosed with ovarian cyst are recommended for regular ultrasound monitoring to prevent complications such as cystic rupture or adnexal torsion. The identification of any ovarian tumor mass in the woman at menopause requires further investigation to rule out the causes of malignancy.

scholarly journals Dysgerminoma: diagnostic impasse

2020 ◽  
Vol 7 (11) ◽  
pp. 3811
Author(s):  
Indrajit Anandakannan ◽  
Shanthi Ponnandai Swaminathan ◽  
Vikas Kawarat ◽  
Rajeshwari Mani ◽  
Kannan R.
Keyword(s):  
Abdominal Pain ◽  
Abdominal Mass ◽  
Germ Cell Tumour ◽  
Lower Abdominal Pain ◽  
Gastrointestinal Stromal Tumour ◽  
Reproductive Age ◽  
Ca 125 ◽  
Abdominal Radiograph ◽  
Bowel Loop ◽  
Plain Abdominal Radiograph

Dysgerminoma is a rare malignant ovarian tumour in women of reproductive age group, featuring lower abdominal pain and abdominal mass with elevated tumour markers. The tumour grows rapidly and diagnosed at an earlier stage. We present a short-statured 20 years girl with intermittent abdominal pain and distention for 4 months, on examination huge abdominal mass of size 20x15 cm, firm in consistency was palpable, lower limit not ascertained. Routine blood investigations normal, thyroid function test showed hypothyroidism. A plain abdominal radiograph shows a large homogenous mass fitting mid part of abdomen with displaced bowel loop. Contrast-enhanced computed tomography abdomen and pelvis show up 20x18.5x9.5 cm well defined heterogeneous mass, with areas of necrosis suggesting mesenchymal tumour or germ cell tumour. CA 125, alpha-fetoprotein, lactate dehydrogenase, beta human chorionic gonadotropin were raised. Magnetic resonance imaging abdomen and pelvis show 10x16x17cm hetero intense lesion, bilateral ovary normal. After tumour board discussion image-guided biopsy was done, suggestive of epithelioid gastrointestinal stromal tumour. Laparotomy displayed a large mass 22x16x10 cm arising from left ovary, no enlarged lymph node, completed with left salpingo-oophorectomy. Histopathology examination and immunohistochemistry definitive of dysgerminoma. In this clinical scenario, we narrate the importance of clinical examination and increased dependence on imaging modalities in diagnosing the patient. The treatment is based on the international federation of gynaecology and obstetrics staging with surgical treatment, adjuvant chemotherapy and radiotherapy.

scholarly journals Validation of the Diagnostic Score for Acute Lower Abdominal Pain in Women of Reproductive Age

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kijja Jearwattanakanok ◽  
Sirikan Yamada ◽  
Watcharin Suntornlimsiri ◽  
Waratsuda Smuthtai ◽  
Jayanton Patumanond
Keyword(s):  
Abdominal Pain ◽  
Likelihood Ratio ◽  
Lower Abdominal Pain ◽  
Positive Likelihood Ratio ◽  
Clinical Score ◽  
Reproductive Age ◽  
Differential Diagnoses ◽  
Validation Data ◽  
Diagnostic Score ◽  
Development Data

Background. The differential diagnoses of acute appendicitis obstetrics, and gynecological conditions (OB-GYNc) or nonspecific abdominal pain in young adult females with lower abdominal pain are clinically challenging. The present study aimed to validate the recently developed clinical score for the diagnosis of acute lower abdominal pain in female of reproductive age.Method. Medical records of reproductive age women (15–50 years) who were admitted for acute lower abdominal pain were collected. Validation data were obtained from patients admitted during a different period from the development data.Result. There were 302 patients in the validation cohort. For appendicitis, the score had a sensitivity of 91.9%, a specificity of 79.0%, and a positive likelihood ratio of 4.39. The sensitivity, specificity, and positive likelihood ratio in diagnosis of OB-GYNc were 73.0%, 91.6%, and 8.73, respectively. The areas under the receiver operating curves (ROC), the positive likelihood ratios, for appendicitis and OB-GYNc in the validation data were not significantly different from the development data, implying similar performances.Conclusion. The clinical score developed for the diagnosis of acute lower abdominal pain in female of reproductive age may be applied to guide differential diagnoses in these patients.

scholarly journals Epidemiology and Risk Factors of Pelvic Inflammatory Disease.

2015 ◽  
Vol 13 (1) ◽  
pp. 4-8
Author(s):  
Bandana Pandey
Keyword(s):  
Abdominal Pain ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Rural Areas ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Age Group ◽  
Increased Risk ◽  
Reproductive Age Group

Introduction: Knowledge of pelvic inflammatory disease and its epidemiology is essential to understand reproductive morbidity in women. This paper estimates the level of association between demographic factors and pelvic inflammatory disease in women in their reproductive age. Methods: A descriptive study done in Humla, Kritipur and Baudha by organizing a health camp. Women of reproductive age group and who have lower abdominal pain, pervaginal discharge, fever, and dysparunia were included in the study after taking informed verbal consent from the patient. Patients who have lower abdominal pain and pervaginal discharge were diagnosed as pelvic inflammatory disease. Results: Diagnoses of pelvic inflammatory disease were made in 30% of attendances amongst women aged between 16 to 48. Increased risk of pelvic inflammatory disease was associated with smoking (P<0.0001), age groups 31 – 40 yrs (44.6%),in rural areas(45%) and people who are illiterate (P<0.0001). Among 400, 383(95%) were reported ever using a modern contraceptive. Conclusion: The prevalence of pelvic inflammatory disease was 30% in reproductive age group and was significantly associated with smoking.doi: http://dx.doi.org/10.3126/mjsbh.v13i1.12992 

scholarly journals Herniation of Small Bowel Loop through a Broad Ligament Defect Masquerading as Torsion of Ovarian Cyst

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Babatola Bakare ◽  
Olumide Akadiri ◽  
Akinyemi Akinsoji Akintayo
Keyword(s):  
Abdominal Pain ◽  
Abdominal Surgery ◽  
Acute Abdomen ◽  
Ovarian Cyst ◽  
Broad Ligament ◽  
Previous History ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Essentially Normal ◽  
Broad Ligament Defect

Torsion of ovarian cyst is a common cause of acute abdomen especially in women of reproductive age-group. It commonly presents with colicky abdominal pain associated with nausea and vomiting. It could however mimic acute intestinal obstruction. The patient was a 32-year-old multipara with no previous history of pelvic or abdominal surgery. She was admitted with colicky lower abdominal pain associated with repeated episodes of vomiting and nausea. Laboratory investigations were essentially normal. Abdominopelvic USS showed a hypoechoic mass lesion in the left adnexium measuring 7.1 × 5.5 cm; surrounding bowel loops were hypoactive, dilated, and fluid filled. Diagnosis of acute abdomen secondary to suspected torsion of ovarian cyst was made. Management began for acute abdomen with intravenous hydration, prophylactic antibiotics, and analgesics. An emergency laparotomy revealed about 6 cm defect in the left broad ligament in which a 20 cm segment of terminal ileum was encased. Liberation of the ileal segment was done and the broad ligament defect closed. Bowel obstruction requires high index of suspicion in a patient with acute abdomen due to suspected torsion ovarian cyst most especially in the absence of previous pelvic or abdominal surgery.

scholarly journals Experience with Ectopic Pregnancy in a Tertiary Care Teaching Hospital

2018 ◽  
Vol 27 (2) ◽  
pp. 22-26
Author(s):  
NA Parveen ◽  
MM Sarker ◽  
MK Sarker
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Vaginal Bleeding ◽  
Tertiary Care ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Age Group ◽  
Treatment Morbidity ◽  
Incidence Risk ◽  
Abnormal Vaginal Bleeding

Ectopic pregnancy is a common life-threating condition. Diagnosis is frequently missed and should be considered in any women in the reproductive age group presenting with abdominal pain or vaginal bleeding. This prospective observational study was conducted in RMCH to determine the incidence, risk factors, clinical presentation, treatment, morbidity and mortality associated with ectopic pregnancy. A total of 50 cases of ectopic pregnancy were operated during the study period giving the incidence of ectopic pregnancy of 8.02/1000 pregnancies. The age of the patient ranged from 18-37 years, with maximum (40%) between 26-30 years age group. 36% patients had delivered one child and 24% were nulliparous. 30% patients had pelvic inflammatory disease and 22% had history of previous abortion/ MR. All patients presented with lower abdominal pain, 68% presented with abnormal vaginal bleeding and 60% had amenorrhoea. Most of the patients were diagnosed by high clinical suspicion and confirmed by USG. 96% cases ectopic pregnancy occurred in the fallopian tube and ampullary part was mainly affected. Laparotomy followed by unilateral salphingectomy was performed in majority (60%) of cases. 22% cases ipsilateral salpingectomy with tubectomy other side and 12% cases salpingostomy were performed. The recovery of majority of patients was smooth and uneventful. There was no death in this study.TAJ 2014; 27(2): 22-26

scholarly journals Isolated twisted hematosalphinx misleading with ovarian cyst torsion

2019 ◽  
Vol 8 (3) ◽  
pp. 1219
Author(s):  
Vaibhav Khairnar ◽  
Shalini Mahana Valecha ◽  
Pandeeswari .
Keyword(s):  
Acute Abdomen ◽  
Fallopian Tube ◽  
Ovarian Cyst ◽  
Rare Case ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Clinical Findings ◽  
Reproductive Age ◽  
High Risk Factors ◽  
Acute Pelvic Pain

Normal or chronically inflamed fallopian tube can undergo torsion and present as acute abdomen, simulating clinically as ectopic gestation. Torsion of the fallopian tube is less frequent but significant cause of lower abdominal pain in reproductive age women that is difficult to recognize preoperatively. Authors present a rare case of hematosalpinx with torsion at its pedicle with hemoperitonium who presented as 28 years old female with acute abdomen that was successfully treated. In cases presenting with hemoperitoneum diagnosis of ruptured ectopic pregnancy should be made unless proved otherwise during reproductive age. Rarely ruptured ovarian cyst may also be a cause. Unfortunately, hematosalpinx sometimes can undergo torsion due to circulatory imbalance and can present as hemoperitoneum and circulatory collapse due to rupture. There have been no specific symptoms, clinical findings, imaging or laboratory characteristics identified for this condition. Imaging findings are non-specific in the preoperative diagnosis of torsed fallopian tubes. Therefore, most of cases with isolated fallopian tubal torsion had a delayed diagnosis and a subsequent delay of timely intervention that may result in failure to save tubal function. Torsion of tube can lead to hematosalpinx, hemoperitonium and necrosis of tube which necessitates urgent surgical management. This case report describes a twisted hematosalpinx presentation without any predisposing high-risk factors. A tubal torsion should be suspected in females with acute pelvic pain, of any age group. An early diagnosis and treatment are required to prevent complications. This rare case may highlight a new insight into pathogenesis of tubal torsion associated with hematosalpinx.

scholarly journals Isolated tubal torsion: A rare cause of acute abdomen in childhood

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Berat Dilek Demirel ◽  
Sertac Hancioglu ◽  
Unal Bicakci ◽  
Ender Ariturk ◽  
Ferit Bernay
Keyword(s):  
Blood Flow ◽  
Abdominal Pain ◽  
Acute Abdomen ◽  
Fallopian Tube ◽  
Reproductive Age ◽  
Radiological Evaluation ◽  
Women Of Reproductive Age

Isolated fallopian tube torsion is a rare cause of acute abdomen mostly seen in women of reproductive age. It is often diagnosed during surgery. In this study we aimed to present a case of isolated fallopian tube torsion in a child. An 11-year-old girl presented with abdominal pain. With the help of radiological evaluation we diagnosed. It should be kept in mind that even if ovarian blood flow is normal in girls with abdominal pain, it may be an isolated tubular torsion and requires immediate intervention.

Lipoleiomyoma Causing Adnexal Torsion

2016 ◽  
Vol 33 (1) ◽  
pp. 47-49 ◽  
Author(s):  
Christopher Kiefer ◽  
Joseph Minardi ◽  
Debra Williams ◽  
Shelley M. Layman
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Fibrous Tissue ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Emergency Physicians ◽  
Adnexal Torsion ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Patient At Risk

Abdominal pain in women of reproductive age is a frequently encountered chief complaint in the emergency department. Adnexal torsion is a time-sensitive diagnosis that is essential for emergency physicians to consider in the initial differential diagnosis. Bedside sonography can be used to assist the clinician in the detection of adnexal masses placing the patient at risk for torsion. Lipoleiomyomas are uncommon, benign neoplasms consisting of variable portions of mature lipocytes, smooth muscle, or fibrous tissue. Very few cases have been reported, with no cases previously reported by emergency physicians using bedside ultrasound. A case is presented of a middle-aged woman who presented to the emergency department with acute lower abdominal pain. At the time of the initial history and physical examination, bedside screening sonogram was performed, which allowed rapid diagnosis of a large, heterogeneous, relatively avascular adnexal mass that was later identified as a lipoleiomyoma, a rare adnexal neoplasm, that resulted in adnexal torsion.

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