Transverse vaginal septum25 Pathogenesis: Septae form during embryogenesis when the Müllerian ducts fuse improperly to the urogenital sinus. They may occur anywhere along the length of the vagina and are typically classified as upper, mid, and lower, with upper being the most common location. Diagnosis: Patients may only present with increasing cyclical abdominal pain, making diagnosis difficult and resulting in delay of treatment. However, clinical suspicion should be high when a patient presents with complaint of difficulty with sexual intercourse. Imaging can help to delineate the diagnosis and is usually necessary to determine location of the septae. Management: Surgical management involves excision of the septal defect. Dissection
The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Donnel documented a chief complaint, a brief history of present illness, and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Donnel also documented a complete examination of all body systems, which included all required elements. Medical decision making was of moderate complexity.
Abdomen: Soft, non-distended, non-tender throughout with palpation. No guarding or rebound. No masses. No hepatomegaly, spleen is non-tender with palpation. No aortic, renal, iliac, or femoral bruits auscultated, no friction rubs heard over the liver or spleen. Active bowel sounds in all 4 quadrants.
I was happy that I managed to rule out any distinct causes of the abdominal pain by performing the examination to collect data, analyse it, and use the results to make an appropriate decision (Schon, 1984). However, had I performed the examination without assistance I may not have gained all the information required to confirm diagnosis, as I did forget some aspects.
It is always challenging to accurately diagnose abdominal pain in the primary care settings. An extensive knowledge of the anatomy and physiology could help narrow down possible causes of abdominal pain.
The definitive diagnosis of endometriosis is made by histologic examination of a biopsied lesion collected during laparoscopy. However, the first line study for the diagnosis of endometriosis is pelvic ultrasound (US). The ultrasound can provide the FNP information that corroborates the suspicion of endometriosis, such as adnexal nodular mass, rectovaginal or bladder nodules (Solnik, 2015). Nonetheless, early stages of endometriosis may not be detected by transvaginal US. Rectal US may also be an appropriate test to visualize deep pelvic endometriosis or involvement of the colon or rectum (Solnik,
A 25-year-old female presents to your clinic for evaluation of a mass in the vulvar area. This has been present for the last 1 week and tender to touch, there is no fever and no chills. Upon exam, you noticed that there is a medially protruding mass in the introitus area around a radius of 1.5 cm and tender to touch with some induration around the area. You advised the patient that the most likely diagnoses in this case are:
Obtain CT of abdomen and pelvis with and without IV and P.O. contrast in four phases to look for masses in the liver and measure portal blood pressure.
Transvaginal is a term that is used the surgical technique that is used to implant the mesh via the vagina. The mesh itself is a type of surgical mesh that is usually made out of a type of plastic that goes by the name of polypropylene. This type of surgical mesh was created in an effort to fix POP or pelvic organ prolapse permanently as well as SUI or stress urinary incontinence. Many women experience this conditions after they have underwent childbirth, menopause or a hysterectomy.
Transvaginal mesh (TM) lawsuits are currently being filed by women across the country who have experienced side effects as a result of the implant of surgical mesh or slings. TM implants are used as a treatment for both stress urinary incontinence and pelvic organic prolapse, but unfortunately, it has become clear that there are significant complications associated with the use of this medical device. If you or a loved one has been affected, it is important to understand your legal rights in TM lawsuits.
During regular septum development in a fetus, the septum primum tissue between the left and right atria grows downward slowly creating two separate chambers and exposes a gap (ostium primum, “first opening”). The septum primum then fuses with the endocardial cushion and the gap closes completely while a hole appears in the upper area (ostium secundum, “second opening”). The septum secundum now starts to grow downward to the right of the septum primum, covering the ostium secundum but leaving an opening (foramen ovale).
Interventional Radiology referred him to call Ultrasound, CT Scan and Cath lab. He called ultrasound and they disclaimed that they have seen patient Tovar. CT scan duplicated the same
Are there any diagnostic studies that should be ordered on this patient and discuss why? A thorough history and physical examination in addition to lab tests and imaging are crucial in making tubo-ovarian abscess diagnosis. A transvaginal ultrasound (US) is commonly utilized imaging and shows a complex adnexal structure with thick walls and internal echoes likely pus with cellular debris, a CBC may indicate elevated leukocyte count (Velcani, Conklin, & Specht, 2010). Other test that may be done to rule out other conditions such as urinalysis for UTI, Genital swab for STIs (gonorrhea, chlamydia), and urine hCG for ectopic pregnancy.
Assessment of the entire abdominal wall, rib cage and breathing mechanics should therefore be a part of every pelvic floor/pelvic pain evaluation.38 Thompson
“The abdomen is a large, oval cavity extending from the diaphragm down to the brim of the pelvis” (Jarvis, 2016, p. 537). Amira is a 27-year old Syrian female who has been brought in to be seen due to abdominal pain and bleeding. I would first start to assess where the bleeding is coming from to stabilize and stop the bleeding from occurring cause excessive loss of blood could cause her to pass out and die. I want to know whether she might just be having a painful menstrual cycle which could include abdominal pain, upset stomach and appetite changes. I would start an IV to challenge possible fluid depletion, and then the doctor would order blood work which should include CBC, BMP, and of course a pregnancy test. An abdominal sonogram would
Acute and chronic are the two forms of salpingitis. “In acute salpingitis, the fallopian tubes become red and swollen, and secrete extra fluid so that the inner walls of the tubes often stick together. In rare cases fallopian tube ruptures and causes a dangerous infection of the abdominal cavity. Chronic salpingitis usually follows an acute attack” Women Health (2013). Salpingitis signs and symptoms are fever, abdominal pain, lower back pain, painful periods, and abnormal color and smell vaginal discharge. Both salpingitis and pelvic inflammatory disease are caused by sexually transmitted diseases. Also, the fallopian tubes are infected in both diseases. Antibiotic therapy is the treatment of choice for both diseases. Both disorders also have known differences. Only the fallopian tube is affected with salpingitis, however, a combination of organs can be affected with pelvic inflammatory disease. Salpingitis is diagnosed by pelvic examination, mucus swab, and blood test. Whereas, “ The diagnosis of pelvic inflammatory disease is based on history, abdominal tenderness, the presence of uterine and cervical movement tenderness on bimanual pelvic examination, mucopurulent discharge at the cervical os, and white blood cells on Gram stain or wet mount of cervical discharge” Huether & McCance