• Title/Summary/Keyword: Acute Pelvic Pain

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Abdominal Cystic Lymphangioma (복부 임파관종)

  • Lee, Jin-Hyung;Choi, Soon-Ok;Park, Woo-Hyun
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.232-237
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    • 2006
  • Abdominal cystic lymphangiomas arising from the mesentery, omentum and retroperitoneum are rare and occasionally confused with other cause of acute abdomen. Sixteen children who underwent surgery for abdominal cystic lymphangioma between 1984 and 2005 at the Division of Pediatric Surgery, Keimyung University Dongsan Medical Center were evaluated retrospectively. There were 9 boys and 7 girls. Age ranged from 12 days to 13 years (mean age: 4.7years). The cysts were located in the omentum (4 cases),mesentery (9 cases: jejunum: 3, colon: 6). retroperitoneum (2 cases) and pelvic cavity (one case). The cyst content was hemorrhagic (8 cases), serous (5 cases), and inflammatory (2 cases), and chyle (one). Prenatal diagnosis was made in 3. The clinical features were variable, but abdominal pain, mass, and abdominal distention in order. There were 3 emergency operations in patients with complicated cyst, who were suspected of having panperitonitis and volvulus preoperatively. Complete excision was accomplished in all cases. There was one mortalityin a newborn with E.coli sepsis. Intestinal obstruction developed in 2 cases in long-term follow-up. No recurrence was observed. Although intraabdominal lymphangioma arising from mesentery, omentum and retroperitoneum are rare, it should be considered as a possible cause of acute abdomen.

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MRI Findings of Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA syndrome) with a Blind Megaureter: Case Report

  • Cho, Yun Hee;Sung, Deuk Jae;Han, Na Yeon;Park, Beom Jin;Kim, Min Ju;Sim, Ki Choon;Cho, Sung Bum
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.3
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    • pp.196-199
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    • 2015
  • Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is an uncommon congenital abnormality of the female urogenital tract characterized by the triad of uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. A 13-year-old female presented with acute lower abdominal pain. Magnetic resonance imaging (MRI) revealed uterine didelphys, hematometrocolpos, obstructed hemivagina, and right ipsilateral agenesis, consistent with OHVIRA syndrome. Also, a well-defined mass with fluid signal intensity, mimicking adnexal neoplasm was seen in the right lower pelvic cavity adjacent to the posterior wall of the bladder. Vaginal septotomy and drainage of hematometrocolpos were done initially, but unilateral hysterectomy was later performed to relieve the patient's symptoms. The cystic mass in the right lower pelvic cavity was also excised and confirmed as a blind megaureter.

Short-course palliative radiotherapy for uterine cervical cancer

  • Kim, Dong Hyun;Lee, Ju Hye;Ki, Yong Kan;Nam, Ji Ho;Kim, Won Taek;Jeon, Ho Sang;Park, Dahl;Kim, Dong Won
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.216-221
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    • 2013
  • Purpose: The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Materials and Methods: Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. Results: The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Conclusion: Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

The Experimental Study on Anti-thrombotic and Anti-inflammatory Effect of NeungaSoJeokTang(NSJT) (능아소적탕(稜莪消積湯)의 항혈전(抗血栓) 및 항염작용(抗炎作用)에 대한 실험적(實驗的) 연구(硏究))

  • Je, Jong-Min;Yoo, Dong-Youl
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.3
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    • pp.45-64
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    • 2007
  • Purpose: This study was performed to evaluate anti-thrombotic and anti-inflammatory effects of NeungaSoJeokTang water extract (NSJT). Methods: In the study of anti-inflammatory effects, NSJT was investigated using cultured cells and murine models. As for the parameters of inflammation, levels of several inflammatory cytokines and chemical mediators which are known to be related to inflammation were determined in mouse lung fibroblast cells(mLFC) and RAW 264.7 cells. Results: Prior to the experiment, we evaluated sGOT, sGPT, BUN and creatine after the treatment. As a result, NSJT was innoxious on liver and kidney. In experiment of anti-thrombotic effect, NSJT inhibited the platelet aggregation induced by ADP and epinephrine, and inhibited pulmonary embolism induced by collagen and epinephrine. NSJT did not affect significantly the blood flow rate both in vitro and in vivo. NSJT increased platelet number and fibrinogen amount, and NSJT shortened PT and APTT in thrombus model induced by dextran. In experiment of anti-inflammatory effect, NSJT inhibited $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, COX-2 and NOS-II mRNA expression in a concentration-dependent manner in RAW 264.7 cell line, and inhibited significantly NO production at 50, 100 ${\mu}g/ml$, and also inhibited ROS production in a concentration-dependent manner. NSJT inhibited $IL-1{\beta}$, IL-6 and $TNF-{\alpha}$ production significantly in serum of acute inflammation-induced Balb/c mice, and decreased $IL-1{\beta}$, IL-6 and $TNF-{\alpha}$ production in spleen tissue, but increased $IL-1{\beta}$, IL-6 and $TNF-{\alpha}$ production in liver tissue. NSJT increased survival rate at the 3th day in ICR mice with lethal endotoxemia induced by LPS. Conclusion: These results suggest that NSJT can be used for treating diverse female diseases caused by thrombosis and inflammation such as pelvic pain, pelvic inflammatory disease as well as vulvar pain due to vulvitis, vulvar vestibulitis and so on.

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The Experimental Study on Anti-thrombotic and Anti-inflammatory Effect of BokbangHongdeungPaejangSan (BHPS) (복방홍등패장산(復方紅藤敗醬散)의 항혈전(抗血栓) 및 항염작용(抗炎作用)에 대한 실험적(實驗的) 연구(硏究))

  • Lim, Dong-Ug;Yoo, Dong-Youl
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.3
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    • pp.151-173
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    • 2006
  • Purpose : This study was performed to evaluate anti-thrombotic and anti-inflammatory effects of BokbangHongdeungPaejangSan water extract (BHPS). Methods : BHPS was investigated using cultured cells and a murine models. As for the parameters of inflammation, levels of several inflammatory cytokines and chemical mediators which are known to be related to inflammation were determined in mouse lung fibroblast cells (mLFC) and RAW 264.7 cells. Results : In experiment of anti-thrombotic effect, BHPS inhibited the platelet aggregation induced by ADP and epinephrine, and inhibited pulmonary embolism induced by collagen and epinephrine. BHPS increased Platelet number and fibrinogen amount, and shortened PT and APTT in thrombus model induced by dextran. In experiment of anti-inflammatory effect, BHPS inhibited IL-1${\beta}$, IL-6, TNF-${\alpha}$, COX-2 and NOS-II mRNA expression in a concentration-dependent manner in RAW 264.7 cell line, and inhibited significantly NO production at 50, 100 ${\mu}g/ml$, and also inhibited ROS production in a concentration-dependent manner. BHPS inhibited IL-1${\beta}$, IL-6 and TNF-${\alpha}$ production significantly in serum of acute inflammation-induced Balb/c mice, and decreased IL-1${\beta}$, IL-6 and TNF-${\alpha}$ production in spleen tissue, but increased IL-1${\beta}$, IL-6 and TNF-${\alpha}$ production in liver tissue. BHPS increased survival rate at the 3th day in ICR mice with lethal endotoxemia induced by LPS. Conclusion : These results suggest that BHPS can be used for treating diverse female diseases caused by thrombosis and inflammation such as endometriosis, pelvic pain, cervicitis, pelvic inflammatory disease and pelvic tuberculosis and so forth.

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Three-Phase Bone Scintigraphic Diagnosis of Acute Transient Synovitis (3상 골신티그램을 이용한 급성 일과성 활막염의 진단)

  • Chung, Soo-Kyo;Lee, Myung-Hee;Kim, Choon-Yul;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.1
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    • pp.73-75
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    • 1985
  • Acute transient synovitis of the hip presents clinically pain and limping. But in the majority of the cases, definite positive findings are not manifest in roentgenogram in its early phase. However radionuclide bone imaging combines with the assessment of vascularization and bone tracer uptake is of great value in solving this diagnostic problem. The materials for this study consisted of 29 children with acute transient synovitis of the hip, characterized by symptoms and physical signs of an arthritis, negative X-ray findings and disappearance of all symptoms and signs within a short period of time. They were twenty males and 9 females and age ranged from 1 to 12 years. We took pelvic reontgenogram in AP and frog-leg views. After intravenous bolus injection of 10 to 15 mCi of $^{99m}Tc-methylene$ diphosphonate, 24 sequential image of the pelvis was taken at 2-second interval for blood flow study. The scintigrams were made using a gamma camera with high resolution parallel hole collimator. Blood pool imaging was obtained at 2 minutes after tracer administration. After 3 hours, static images were taken and then closeup image of the hip using pin-hole collimator was followed. The results were as follows: 1) Bone scintigram was much more sensitive than conventional roentgenogram in diagnosis of acute transient synovitis of the hip. 2) Three-phase imagings showed increased vascular activities in blood pool scintigrams in 96%. 3) Pin-hole imaging showed increased tracer uptake in the regional bones of the hip, par ticularly in the medial aspect of femoral head and acetabulum. 4) We confirmed that three-phase imaging reinforced with pin-hole technique were very useful in diagnose of acute transient synovitis of the hip.

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Primary psoas abscess confused with hip pathology (고관절 이상으로 오인된 일차성 요근 농양 1례)

  • Kim, Young Ok;Woo, Young Jong
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.570-573
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    • 2006
  • A healthy, 14-year-old boy presented with right hip pain and consequent fever after falling out of bed while sleeping. The patient could not walk and complained of severe pain with active and passive motion, which consisted mainly in extension and internal rotation of the right hip. Laboratory analysis of the peripheral blood identified leukocytosis and increased levels of acute phase reactants. Magnetic resonance imaging of the hip, which was performed with the expectation of right hip pathology, revealed cellulitis and abscess in the right psoas muscle and associated inflammatory changes in the adjacent presacral fat plane but showed no abnormal lesions in the adjacent pelvic bone and spine. Staphylococcus hominis was cultured from the blood. With empirical antibiotic therapy, the patient recovered fully. We report a case of primary psoas abscess confused with hip pathology in an immunocompetent child without underlying disease.

The Experimental Study on Anti-inflammatory Effect of Cheongyeoljohyeoltangkamibang(CYJHT) (청열조혈탕가미방(淸熱調血湯加味方)의 항염작용(抗炎作用)에 대한 실험적(實驗的) 연구(硏究))

  • Lee, Jung-Hwa;Yoo, Dong-Youl
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.4
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    • pp.49-68
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    • 2008
  • Purpose: This study was performed to evaluate anti-inflammatory effects of Cheongyeoljohyeoltangkamibang water extract (CYJHT). Methods: In the study of anti-inflammatory effects. CYJHT was investigated using cultured cells and murine models. As for the parameters of inflammation. levels of several inflammatory cytokines and chemical mediators which are known to be related to inflammation were determined in mouse lung fibroblast cells(mLFCs). RAW 264.7 cells and acute inflammation-induced mice. Results: 1. CYJHT showed a safety in cytotoxicity and toxicity of liver. 2. CYJHT effected scavenging activity on 2.2-diphenyl-1-picrylhydrazyl(DPPH) free radical, superoxide dismutase(SOD) and superoxide anion radical(SAR). 3. CYJHT in RAW 264.7 cell decreased IL-l$\beta$ mRNA expression at 100, 50 ${\mu}g$/ml and also decreased TNF-$\alpha$ mRNA expression at 100 ${\mu}g/ml$ and decreased COX-2. NOS-II mRNA expression and decreased IL-6 mRNA expression in a concentration-dependent manner. 4. CYJHT in RAW 264.7 cell decreased IL-l$\beta$ significantly at 100, 50 ${\mu}g$/ml and decreased IL-6. TNF-$\alpha$ significantly at 100 ${\mu}g$/ml. 5. CYJHT inhibited IL-l1$\beta$, IL-6 and TNF-$\alpha$ production significantly in serum of acute inflammation-induced mice. 6. CYJHT decreased IL-1$\beta$, IL-6 and TNF-$\alpha$ mRNA production significantly in spleen tissue. and also decreased IL-l$\beta$. TNF-$\alpha$ mRNA production significantly in liver tissue of acute inflammation-induced mice. Conclusion: These results suggest that CYJHT can be useful in treating diverse female diseases caused by inflammation such as menstrual pain. menstrual disorder. leukorrhea. pelvic inflammatory disease and so on.

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Omental Torsion and Infarction Secondary to Omental Hernia in the Right Inguinal Canal (오른쪽 서혜부 탈장에 의해 이차적으로 발생한 대망의 염전 및 경색)

  • Yu Hyun Lee;Jae Hoon Lim;Heon-Kyun Ha
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.1003-1007
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    • 2020
  • Omental torsion secondary to inguinal hernia has rarely been reported as a cause of acute abdominal pain. However, in our case, omental infarction due to prolonged inguinal hernia-associated omental torsion led to the formation of a large omental mass with marginal fibrosis, and the patient presented with chronic abdominal pain. A 74-year-old man presented with complaints of lower abdominal pain for 1 month; subsequently, bilateral inguinal hernias were identified through inguinal ultrasonography. CT scans revealed that the greater omentum was trapped within the right inguinal canal, leading to omental torsion. The greater omentum, distal to the pedicle, appeared as a 30 cm-sized oblong fibrofatty mass in the right lower abdomen and pelvic cavity. Laparoscopic omentectomy with hernia repair was successfully performed.

A Case of Heterotopic Pregnancy in a Natural Cycle (자연 생리주기에서 발생된 병합임신 1예)

  • Bae, Sung Jun;Kim, Ju Sun;Kim, Jin Hak;Yun, Yeon Jung;lee, Shin Ae
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.1
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    • pp.69-69
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    • 2006
  • Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult due to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.