Endometriosis Case Summary

HISTORY OF PRESENT ILLNESS: This 46-year-old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis, presents to the emergency room after having had three days of abdominal pain. It initially started three days ago and was a generalized vague abdominal complaint. Earlier this morning, the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o. earlier around

HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

HISOTRY OF PRESENT ILLNESS: This 40-year-old Latin female presents with complaints of low back and right leg pain she said that she hurt her back in a motor vehicle accident three years ago and she has had a history of intermittent low back pain since that time. Last December she started a job where she had to lift boxes that weighed approximately 40 pounds. Around the first of January this year she began to complain of back pain that

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

In endometriosis, this endometrial tissue begins to grow in places outside the uterus. Typical sites include the fallopian tubes, intestines, vagina, and on scars that my form after abdominal surgery. The misplaced endometrial tissue thickens, engorges with blood and bleeds during the menstrual cycle, just like the normal tissue in the uterus. However, there is no place for the abnormally placed endometrial tissue outside the uterus to shed blood. This results in the formation of cysts, scars, and adhesions. This process can also block or affect the fallopian tubes so that conception and pregnancy are less likely to happen. It can also result in complete infertility. Other symptoms of endometriosis are often associated with heavy or painful periods. Risk factors for the development of endometriosis include having a mother or sister with the disorder, never having children, starting the menstrual period at an early age, and frequent or long periods. According to Dr. Camron Nezhat, Laparoscopic Surgeon at Stanford University, 5.5% of women in the U.S are infected with Endometriosis and 30% to 40% are infertile as a result of it.

Patient was in the ER room when first seen. PT was with her family members and family states that she speaks little English and that she has had abdominal pain for the past day along with bloody stools. Family states that she is on calcium supplements and no other medications. Last oral intake is 24 hours ago. Family states no known past medical history. Pt is in the hospital bed in the fetal position and towards the right side. Patient's airway is clear and breathing is normal. Skin is warm and dry. Patent is AAOx4. Assessment of head, neck, and chest show no signs of deformities. Abdominal area not assessed due to severe pain. Back is without deformity. The upper extremity shows no sign of deformities or trauma. The lower extremity shows

Upon inspection the contour of the patients abdomen was rounded, symmetric, color appropriate to genetic background, striae present, 6 to 8 round bruises from subcutaneous injections. No apparent pulsations, masses, lesions, rashes, wounds, ascites, scars, or hernias present. Auscultated bowel sounds in all four quadrants; hyperactive sounds heard in lower right quadrant, hyperactive sounds heard in upper right quadrant, normoactive bowel sounds in upper left quadrant, and hyperactive bowel sounds heard in lower left quadrant. Auscultated the aorta, renal arteries, and iliac arteries for vascular sounds, no bruits heard. Lightly palpated the abdomen in all four quadrants, patient felt tenderness on bruised areas, no masses present, abdomen distended. Percussed the abdomen in all four quadrants noting the predominately tympanic in all four quadrants and minimum dullness. The patient’s last bowel movement was around 0830, loose, with no pain. The patient stated having three to five loose bowel movements daily and that, “several bowel movements a day was common for her.” The patient describe the characteristics of her bowel movement as “watery, stinky, and not a large amount”. No prescription medication related to the abdomen. However, patient takes over the counter medication for frequent bowel movements at home. No surgeries related to the abdomen. No laboratory data related to the

Endometriosis is a common but often underdiagnosed disease in women during active reproductive years of 25 to 35 years. Endometriosis is an estrogen dependent chronic pelvic disorder that can cause severe pain and adversely affect fertility. Endometriosis is described as the occurrence of endometrial glands and connective tissue called stroma in the extra uterine mucosa located throughout the pelvis (Solnik, 2015). Therefore, as Family Nurse Practitioner (FNP) accurately diagnoses this disease, this patient population can increase the awareness become educated about endometriosis treatment options.

Patient CB is a 36 year old African American Female. She has a past medical history of hypertension, acid reflux, heartburn, and a hernia repair one year ago. She is a nonsmoker and reports never taking recreational drugs. Diagnostic tests related to her diagnosis include an abdominal ultrasound showing gallstones, an x-ray to verify stone presence, and tenderness with touch on the abdomin. CB was having a cholecystectomy because she was having pain in her abdomen related to gallstones. Her hernia was a result of a weakening of the abdominal wall.

Thus, laparoscopically detected endometriosis lesions not confirmed by biopsy may occur in those with minimal disease. However, the fact that those with minimal disease did not have biopsy-proven endometriosis raises the possibility that surgeons who only ablate lesions without biopsying them may overdiagnose and overtreat endometriosis. What then, is the role for MRI in the detection of endometriosis in a woman with pelvic pain? In women for whom endometriosis is likely after other causes of pelvic pain are excluded, MRI appears to be useful in confirming endometriomas, but not in defining peritoneal lesions or the extent of disease.

Infertility and ovarian cancer are very serious problems that can be developed in women with endometriosis. Infertility is the main problem associated with endometriosis. It can be a major setback for seemingly healthy couples that want to start a family. “Endometriosis is associated with infertility in 30-40% of sufferers (World Endometriosis, 2011)” “The presence of endometriosis may involve masses of tissue or scarring (adhesions) within the pelvis that may distort normal anatomical structures, such as Fallopian tubes, which transport the eggs from the ovaries. Alternatively, endometriosis may affect fertility through the production of hormones and other substances that have a negative effect on ovulation, fertilization of the egg, and/or implantation of the embryo” (MedicineNet, 2013). Although

My diagnosis for Eleanor is pelvic floor dysfunction. The symptoms of pelvic floor dysfunction are constipation, frequent urination, pain during urination, and lower back pain. Pelvic floor dysfunction is common in women. (Faubion et al., 2012). It may be caused by aging and childbirth. (Wang et al., 2012). Eleanor is an 88 year old woman. She is also a mother of two, which means that she has given birth at least once. These factors may have contributed to her condition. Eleanor has difficulties with constipation. She also has an increased urge to urinate and has minor problems in controlling her urinary process. She experiences pain when she urinates. Whenever she coughs, or carries anything, she cannot help but wet herself. She urinates as often as ten times in the day and five times at night. Lastly, Eleanor has chronic back pain that does not stop with over the counter pain medication. These symptoms show that Eleanor has pelvic floor dysfunction.

Uterine fibroids affect 3 out of 4 women (Mayo Clinic, 2014). They are non-cancerous but they can cause pain and discomfort. This paper will discuss who can be effected by Uterine fibroids and its effects on the female reproductive system. This paper will show the three types of fibroids that develop in or near the uterus. It will discuss the symptoms and when a diagnosis is needed. This paper will also look into the various forms of treatment including medications and surgery.