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Monday 7 January 2013

CASE 163: PELVIS PAIN, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM


Woman 20yo PARA 1001, pain at pelvis for 3 days.
US scan ( Image 01: cross-sectional scan at pelvis.):  Uterus in normal size, fluid around uterus.


Image 02 : longitudinal scan at pelvis, uterus with thickening endometrium, fluid and mass at posterior fornix.


Image 03 scan at liver shows fluid at space of Morrison.




Image 04 and 05 are pulse Doppler at left and right uterine arteries.




MDCT of  abdomen shows fluid collection in pelvis with high density and enlarged ovaries both sites in  suspecting intraabdominal bleeding.




This patiend was sent to OB-GY HOSPITAL for ECTOPIC PREGNANCY or  LUTEINIC CORPUSCULAR RUPTURE.



In Ob-Gy  hospital, TVS ultrasound suspected  ECTOPIC PREGNANCY, BLEEDING INTRAABDOMEN.
Blood test betaHCG is of 0,3 mUI/mL (n <25mUI/mL). It means  not ectopic pregnancy, and  she had been discharged Ob-gy hospital  with diagnosis of Rupture of luteinic corpus   or Mittelschmerz painful ovulation.
 
Discussion: Doppler uterine artey with typical waveform notching is not gestationa status
 

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