• 36yo female patient, 13 days delayed period, was diagnosed left side ectopic pregnancy. HCG=2786mUI/mL. Patient were re-examination at Medic.
• Embryonic sac inside uterus d# 8mm, 2 normal ovaries and rules out EP.
• During Transvaginal Ultrasound exam, incidental mass was detected, sized # 35 x 40mm, rich echo. It located beside left ovary, hypervascular supplied was identical which reassemble a kidney. On abdominal view, 2 kidneys and other organs were normal. During consultation, 9/11 doctors thought a third pelvic kidney which is rare but possible.
• After reconsultation, patient wants abortion so we move on to CT exam. In arterial phase, the mass enhanced and shows connection with sigmoid colon and in late phase, rules out pelvic kidney diagnosis. CT Virtual Colonography was performed, air was pumped to inflate colon for better view. On 3D image, the mass reveals as polyp within sigmoid lumen.
• Next, the patient underwent endoscopic colon: demonstrated a bledding, 25cm away from anus, very mobile polyp with long stalk. Sample biopsy confirmed normal tubular polyp.
A studied case was represented around 11 doctors via email which was diagnosed exactly by MSCT and confirmed by colonoscopy.
Bài học 3: email hội chẩn.