-
Abdominal Radiology (New York) Aug 2022Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are... (Review)
Review
Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are most common in high-grade lymphomas, especially diffuse large B-cell lymphoma. Complications may occur as the initial manifestation of lymphoma, during treatment course, or late following complete disease remission. Most complications are associated with worse prognosis and increased mortality. Imaging is essential in evaluation of disease extent and diagnosis of complications. Therefore, radiologists should be familiar with the clinical context and imaging features of abdominal and pelvic lymphoma complications. We provide a comprehensive, organ system-based approach, and clinical and imaging review of complications of abdominal and pelvic lymphoma along with radiologic images of illustrated cases of the most commonly encountered complications.
Topics: Abdomen; Abdominal Neoplasms; Humans; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Pelvis; Prognosis
PubMed: 35690955
DOI: 10.1007/s00261-022-03567-5 -
International Braz J Urol : Official... 2022
Topics: Humans; Pelvis
PubMed: 35373953
DOI: 10.1590/S1677-5538.IBJU.2022.03.04 -
Journal of Medicine and Life 2015Pelvic exenteration remains one of the most destructive surgical procedures in gynecologic oncology, performed in patients with locally advanced malignancies who were... (Review)
Review
Pelvic exenteration remains one of the most destructive surgical procedures in gynecologic oncology, performed in patients with locally advanced malignancies who were considered for a long time as unresectable. However, for these patients, an aggressive surgical approach seems to be the only potential curative solution. This is a literature review of the most important studies, which analyzes the benefits and the secondary risks of this demanding procedure.
Topics: Female; Genital Neoplasms, Female; Humans; Pelvic Exenteration; Pelvis
PubMed: 25866569
DOI: No ID Found -
Pain Physician Sep 2023Endometriosis is a chronic common condition affecting 10% of reproductive-aged women globally. It is caused by the growth of endometrial-like tissue outside the uterine... (Review)
Review
BACKGROUND
Endometriosis is a chronic common condition affecting 10% of reproductive-aged women globally. It is caused by the growth of endometrial-like tissue outside the uterine cavity and leads to chronic pelvic pain, affecting various aspects of a woman's physical, mental, emotional, and social well-being. This highlights the importance of an understanding of the potential involvement of the nervous system and involved nerves as well as an effective multidisciplinary pain management.
OBJECTIVES
Our aim was to assess the current understanding of pain mechanisms in endometriosis and the effectiveness of different interventional pain management strategies.
STUDY DESIGN
Literature review.
METHODS
A search was conducted using multiple databases, including Google Scholar, MEDLINE (Ovid), PubMed, and Embase. We used keywords such as "endometriosis," "pain," pelvic pain, "management," and "anaesthesia" along with Boolean operators and MeSH terms. The search was limited to English language articles published in the last 15 years.
RESULTS
Nerve involvement is a well-established mechanism for pain generation in patients with endometriosis, through direct invasion, irritation, neuroangiogenesis, peripheral and central sensitization, and scar tissue formation. Endometriosis may also affect nerve fibers in the pelvic region, causing chronic pelvic pain, including sciatic neuropathy and compression of other pelvic nerves. Endometriosis can cause sciatica, often misdiagnosed due to atypical symptoms. Interventional pain management techniques such as superior hypogastric plexus block, impar ganglion block, S3 pulsed radiofrequency, myofascial pain trigger point release, peripheral nerve hydrodissection, and neuromodulation have been used to manage persistent and intractable pain with positive patient outcomes and improved quality of life.
LIMITATIONS
The complex and diverse clinical presentations of endometriosis make it challenging to compare the effectiveness of different pain management techniques.
CONCLUSION
Endometriosis is a complex condition causing various forms of pain including nerve involvement, scar tissue formation, and bowel/bladder symptoms. Interventional pain management techniques are effective for managing endometriosis-related pain.
KEY WORDS
Endometriosis, chronic pain, therapeutic interventions, interventional techniques, pain injections, visceral pain, peripheral pain.
Topics: Adult; Female; Humans; Chronic Disease; Cicatrix; Endometriosis; Pain Management; Pelvic Pain; Pelvis; Quality of Life
PubMed: 37774202
DOI: No ID Found -
Philosophical Transactions of the Royal... Mar 2015The pelvis performs two major functions for terrestrial mammals. It provides somewhat rigid support for muscles engaged in locomotion and, for females, it serves as the... (Comparative Study)
Comparative Study Review
The pelvis performs two major functions for terrestrial mammals. It provides somewhat rigid support for muscles engaged in locomotion and, for females, it serves as the birth canal. The result for many species, and especially for encephalized primates, is an 'obstetric dilemma' whereby the neonate often has to negotiate a tight squeeze in order to be born. On top of what was probably a baseline of challenging birth, locomotor changes in the evolution of bipedalism in the human lineage resulted in an even more complex birth process. Negotiation of the bipedal pelvis requires a series of rotations, the end of which has the infant emerging from the birth canal facing the opposite direction from the mother. This pattern, strikingly different from what is typically seen in monkeys and apes, places a premium on having assistance at delivery. Recently reported observations of births in monkeys and apes are used to compare the process in human and non-human primates, highlighting similarities and differences. These include presentation (face, occiput anterior or posterior), internal and external rotation, use of the hands by mothers and infants, reliance on assistance, and the developmental state of the neonate.
Topics: Adaptation, Biological; Animals; Biological Evolution; Female; History, Ancient; Humans; Labor Presentation; Midwifery; Parturition; Pelvis; Pregnancy; Primates; Species Specificity
PubMed: 25602069
DOI: 10.1098/rstb.2014.0065 -
Medical Physics Apr 2022Diffusion MRI has enormous potential and utility in the evaluation of various abdominal and pelvic disease processes including cancer and noncancer imaging of the liver,...
Diffusion MRI has enormous potential and utility in the evaluation of various abdominal and pelvic disease processes including cancer and noncancer imaging of the liver, prostate, and other organs. Quantitative diffusion MRI is based on acquisitions with multiple diffusion encodings followed by quantitative mapping of diffusion parameters that are sensitive to tissue microstructure. Compared to qualitative diffusion-weighted MRI, quantitative diffusion MRI can improve standardization of tissue characterization as needed for disease detection, staging, and treatment monitoring. However, similar to many other quantitative MRI methods, diffusion MRI faces multiple challenges including acquisition artifacts, signal modeling limitations, and biological variability. In abdominal and pelvic diffusion MRI, technical acquisition challenges include physiologic motion (respiratory, peristaltic, and pulsatile), image distortions, and low signal-to-noise ratio. If unaddressed, these challenges lead to poor technical performance (bias and precision) and clinical outcomes of quantitative diffusion MRI. Emerging and novel technical developments seek to address these challenges and may enable reliable quantitative diffusion MRI of the abdomen and pelvis. Through systematic validation in phantoms, volunteers, and patients, including multicenter studies to assess reproducibility, these emerging techniques may finally demonstrate the potential of quantitative diffusion MRI for abdominal and pelvic imaging applications.
Topics: Abdomen; Artifacts; Diffusion Magnetic Resonance Imaging; Humans; Male; Pelvis; Reproducibility of Results
PubMed: 34554579
DOI: 10.1002/mp.15246 -
JSLS : Journal of the Society of... 2001Chronic pelvic pain in women is a common and disabling illness caused by numerous organic pathologies usually accompanied by varying psychological dysfunctions. Many... (Review)
Review
Chronic pelvic pain in women is a common and disabling illness caused by numerous organic pathologies usually accompanied by varying psychological dysfunctions. Many patients may receive misdiagnosis, misdirected therapies, or do not seek help at all. Pelvic congestion may be responsible for pain in patients without more common diseases, such as endometriosis and pelvic adhesions, among others. Our view of this condition is evolving. In the United States, this medical condition remains controversial. More recent research from the United Kingdom has caused a fresh look at the diagnosis and treatment of chronic pelvic pain produced by pelvic congestion. Potentially, many patients may benefit from a reconsideration of this approach.
Topics: Chronic Disease; Female; Humans; Pelvic Pain; Pelvis
PubMed: 11394421
DOI: No ID Found -
Acta Obstetricia Et Gynecologica... Aug 2021Maternal pelvic capacity plays a major role during childbirth because the passage of the fetus through the bony birth canal enables vaginal birth. Maternal birthing...
INTRODUCTION
Maternal pelvic capacity plays a major role during childbirth because the passage of the fetus through the bony birth canal enables vaginal birth. Maternal birthing position may influence pelvic capacity because upright positions optimize capacity, possibly due to free movement of the pelvic joints. Herein, pelvic capacity was assessed by comparing changes in pelvic dimensions across pregnancy and in three birthing positions.
MATERIAL AND METHODS
This diagnostic imaging study of 50 pregnant women was conducted at Aarhus University Hospital, Denmark. Pelvic measurements were obtained with 1.5 T magnetic resonance pelvimetry during gestational weeks 20 and 32, in three birthing positions: kneeling squat, semi-lithotomy and supine. Pelvic capacity was compared between gestational weeks and positions.
RESULTS
In all three positions there is an overall increase in pelvic capacity from gestational week 20-32 at both the pelvic inlet and outlet. Comparing pelvic capacity at gestational week 32 between the semi-lithotomy and supine positions revealed that the pelvic inlet was larger in the supine position, whereas the mean pelvic outlet was 0.2 cm (p < 0.001) larger in the semi-lithotomy position. Likewise, the pelvic inlet was larger in the supine than in the kneeling squat position. Shifting from supine to kneeling squat position increased the midplane and pelvic outlet dimensions by up to 1 cm (p < 0.001).
CONCLUSIONS
The finding herein of an increased pelvic capacity as the pregnancy progresses is novel. Further, the results indicate that the supine position is optimal for increasing pelvic inlet size, whereas the semi-lithotomy and kneeling squat positions are optimal for increasing mid- and outlet-pelvic capacities.
Topics: Adult; Delivery, Obstetric; Female; Humans; Magnetic Resonance Imaging; Patient Positioning; Pelvis; Pregnancy; Pregnant Women; Reference Values; Young Adult
PubMed: 33991336
DOI: 10.1111/aogs.14168 -
Diagnostic and Interventional Radiology... 2017This pictorial review aims to discuss and illustrate the up-to-date use of preprocedural magnetic resonance imaging (MRI) in selecting patients and planning uterine... (Review)
Review
This pictorial review aims to discuss and illustrate the up-to-date use of preprocedural magnetic resonance imaging (MRI) in selecting patients and planning uterine artery embolization (UAE). The merits of magnetic resonance angiography (MRA) in demonstrating the pelvic vasculature to guide UAE are highlighted. MRI features of fibroids and their main differential diagnoses are presented. Fibroid characteristics, such as location, size, and enhancement, which may impact patient selection and outcome, are presented based on recent literature. Pelvic arterial anatomy relevant to UAE, including vascular variants are illustrated, with conventional angiography and MRA imaging correlation. MRA preprocedural determination of the optimal projection angles for uterine artery catheterization is straightforward and constitutes an important strategy to minimize ionizing radiation exposure during UAE. A reporting template for MRI/MRA preassessement of UAE for fibroid treatment is provided.
Topics: Diagnosis, Differential; Female; Humans; Leiomyoma; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Pelvis; Treatment Outcome; Uterine Artery Embolization
PubMed: 28163256
DOI: 10.5152/dir.2016.16623 -
Fertility and Sterility Oct 2016The health care and the emotional cost of postoperative adhesions that frequently cause chronic pain, infertility, bowel obstruction, and repeat surgery are well known....
The health care and the emotional cost of postoperative adhesions that frequently cause chronic pain, infertility, bowel obstruction, and repeat surgery are well known. Our understanding of the pathophysiology of adhesion formation and of its prevention has evolved from good surgical practice based on microsurgical principles, barriers to keep denuded areas separated to the prevention of mesothelial cell damage and of acute inflammation in the entire peritoneal cavity. Oxidative stress, in the surgical lesions and in the peritoneal cavity has an important role in adhesion formation by slowing down repair. This has resulted in virtually adhesion-free surgery, in addition with less CO resorption, less postoperative pain, and a faster recovery. The clinical efficacy had been demonstrated by higher pregnancy rates (PRs) using microsurgical tenets.
Topics: Female; Gynecologic Surgical Procedures; Humans; Oxidative Stress; Pain, Postoperative; Pelvis; Postoperative Complications; Pregnancy; Pregnancy Rate; Quality Improvement; Quality Indicators, Health Care; Recovery of Function; Risk Factors; Tissue Adhesions; Treatment Outcome; Wound Healing
PubMed: 27567432
DOI: 10.1016/j.fertnstert.2016.07.1122