The difficult patient in gastroenterology: chronic pelvic pain, adhesions, and sub occlusive episodes

Peters, A. C. B.; Tillaart, S.A.H.M. Van den

doi:10.1016/j.bpg.2007.01.005

Cited by 17 publications

(10 citation statements)

References 45 publications

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“…[1] Many common organic and functional diseases can cause it. The most common organic conditions include intestinal adhesions,[78] biliary causes,[910] and appendicular causes,[11] while functional conditions include irritable bowel disease,[12] functional dyspepsia,[13] and various motility disorders. [14] Abdominal wall pain is also common and frequently mistaken for visceral pain.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain

Ellabban

Hokkam

2010

J Min Access Surg

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BACKGROUND:Chronic abdominal pain is a difficult complaint. It leads to evident suffering and disability, both physically and psychologically. Many diagnostic and therapeutic procedures have been described in literature, but with little proof or evidence of success. Laparoscopy is one of the modalities that could be of benefit in such cases. We aim to evaluate the diagnostic and therapeutic value of laparoscopy in cases with chronic abdominal pain.MATERIALS AND METHODS:Thirty patients with chronic abdominal pain were included in this prospective descriptive cross-sectional study. The pain in all patients was of unclear etiology despite all the investigative procedures. All patients were subjected to laparoscopic evaluation for their conditions. The findings and outcomes of the laparoscopy were recorded and analyzed.RESULTS:The most common site of pain was the periumbilical region (30%). A definitive diagnosis was made in 25 patients (83.3%), while five patients (16.7%) had no obvious pathology. Adhesions were the most common laparoscopic findings (63.3%) followed by appendiceal pathology (10%), hernia (3.3%), gall bladder pathology (3.3%), and mesenteric lymphadenopathy (3.3%). Postoperatively, pain relief was achieved in 24 patients (80%) after two months.CONCLUSION:Laparoscopy is an effective diagnostic and therapeutic modality in the management of patients with chronic abdominal pain.

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Section: Introductionmentioning

confidence: 99%

The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain

Ellabban

Hokkam

2010

J Min Access Surg

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“…89 Persistent lower back pain and pelvic pain have been associated with elective cesarean sections: the greater the number of cesarean sections the greater the likelihood of developing a pain phenomenon. 90,91 This behavior conflicts with the research conducted by Drew et al, who found no correlation of cesarean section and lower back pain/pelvic pain. 92 There are four stages of adbominopelvic adhesions that the clinician is to take into consideration 13…”

Section: Scarsmentioning

confidence: 63%

2 General Concepts

Philip¹

2016

Pelvic Pain and Dysfunction

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This chapter discusses components of differential diagnostics with which the clinician may or may not be familiar; however, they are important in the formation of a functional diagnosis that allows clinicians to better be able to treat their patients. Some of the information will be a review for the reader, whereas other information will be novel. To those for whom the information is novel: enjoy and learn. To those who "know" the information provided in this chapter, take the time to review and reflect on it and apply the concepts to your current practice. S5 Co1 Co2 SCJ X X Pancreas X X Liver X Gall bladder X X X X X Stomach/duodenum X X X X Small intestine X X Epididymis X Colon: ascending X X X X Kidney X X X X Appendix X X X X Ureter X X X Bladder fundus X X X Uterine fundus X X X Bladder neck X X X Vagina/penis X X X Suprarenal gland X X X Ovary/testes X X X Colon; flexure X X X Colon; sigmoid X X X Prostate X X X X Urethra X X X X Rectum X X X Muscle Upper trapezius X X Iliopsoas X X X X X Guteus: med/min X X X Gluteus maximus X X Piriformis X X Obturator internus X X Quadratus femoris X X X X Semitendinosus X X X X X Semimembranosus X X X X X Adductor magnus X X X X Peroneus: longus, brevis & tertius X X X X Tibialis anterior X X X X Ext. hall. Long/brevis X X X X X Triceps surae X X X X X Peroneus tertius X X X X X S5 Co1 Co2 Levator ani X X X X Superficial transverse perineal X X X X Deep transverse perineal X X X X Bulbospongiosus X X X X Ischiocavernosus X X X X External anal sphincter X X X X Urethral sphincter X X X X Coccygeus X X X Test Passive scap. Apprx T1-2 Abdominal reflex X X X X X X X X Beevor's Sign X X X X DTR: quadriceps X X Cremaster reflex Prone knee flexion X(?) X X X X X X Clitorolabial reflex X X X X Bulbocavernosus reflex X X X Straight leg raise X X X X DTR: achilles X X Q-tip X Pin-prick X Nerve branch: Superior glutea nerve X X X X Inferior gluteal nerve X X Lateral cutaneous branch of subcostal X Lateral cutaneous branch of femoral nerve X X Genitofemoral nerve X X Ilioinguinal nerve X Obturator nerve, cutaneous branch X X X Medial clunial nerve X X X Superior clunial nerve X X X

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“…These adhesions can be caused by a variety of factors, but it is estimated that 43%-85% of all cases are a result of prior surgery. 12,18 Intraabdominal adhesions can also be attributed to infections, appendicitis, pelvic inflammatory disease, or diverticulitis. 10,17,19 One of the patients who experienced a rectal perforation in the present study had a variety of potential risk factors for injury, including female sex, prior anterior surgery, pelvic inflammatory disease, and undisclosed diverticulitis.…”

Section: Discussionmentioning

confidence: 99%

Complications of axial lumbar interbody fusion

Lindley

McCullough

Burger

et al. 2011

SPI

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Object Axial lumbar interbody fusion (AxiaLIF) is a novel minimally invasive approach for fusion of L4–5 and L5–S1. This technique uses the presacral space for percutaneous access to the anterior sacrum. The AxiaLIF procedure has the potential to decrease patient recovery time, length of hospital stay, and overall occurrence of surgical complications. It can be used alone or in combination with minimally invasive or traditional open fusion procedures. The purpose of this study was to evaluate complications of the AxiaLIF procedure at the authors' institutions. Methods Patients who underwent AxiaLIF surgery between October 2005 and June 2009 at the authors' institutions were identified. The authors retrospectively reviewed these patients' charts, including operative reports and postoperative medical records, to determine what complications were encountered. Results A total of 68 patients underwent AxiaLIF surgery, with an average follow-up time of 34 months. Sixteen patients (23.5%) experienced a total of 18 complications (26.5%); this group included 8 men and 8 women (mean age 52.1 years). These complications included pseudarthrosis (8.8%), superficial infection (5.9%), sacral fracture (2.9%), pelvic hematoma (2.9%), failure of wound closure (1.5%), transient nerve root irritation (1.5%), and rectal perforation (2.9%). Conclusions The complication rate associated with AxiaLIF in the present study was relatively low (26.5%). The most common complications were superficial infection and pseudarthrosis. There were 2 cases of rectal perforation associated with AxiaLIF; one case was found intraoperatively and the other presented 4 days postoperatively. Both patients underwent emergency repair by a general surgeon and had no long-term sequelae as a result of the rectal injuries. It is important for surgeons to be aware of the potential for these complications. Many of these complications can probably be avoided with proper patient selection and operative planning. Preoperative MR imaging, a detailed patient physical examination and history, full bowel preparation, and the use of live fluoroscopy can all help to prevent complications with AxiaLIF surgery.

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The difficult patient in gastroenterology: chronic pelvic pain, adhesions, and sub occlusive episodes

Cited by 17 publications

References 45 publications

The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain

The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain

2 General Concepts

Complications of axial lumbar interbody fusion

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