Re: Hospital admissions for obstetric patients

From: Meenan, Anna (annam@uic.edu)
Sat Oct 28 11:14:48 2006

Reminds me of the perforated peptic ulcer that the OB and i diagnosed in the ER during my residency. Culdocentesis for probably ruptured ectopic yielded gastric fluid (no availability of stat U/S back then) and 3-view abd showed free air. Back then, if anything female with pain between the zyphoid and the pubis came into the ER, they called the Ob-gyn resident.

Anna Meenan, MD

>
>When I was a resident (maybe even a student), there was a woman
>bouncing around the ER with abdominal pain and fever, as I recall,
>whom nobody "wanted." Medicine and surgery both declared that "it
>must be PID." Pretty typical.
>
>Well, the chief resident in OB-GYN, being the gentleman and
>physician that he was, admitted the lady under "r/o PID" or some
>such Dx, and she was treated with hydration, antibiotics, etc.
>However, when things started to "go south" that night, they decided
>she at the very least had a ruptured TOA. So we went to the OR with
>this "r/o PID -- poss. rupt. TOA" patient and opened her up. And
>found soap.
>
>We had to call the surgery resident and his staff, who were not in
>the hospital and had to come over from the VA, to handle this woman
>with hemorrhagic pancreatitis whom nobody wanted to admit but us.
>
>Joe P.

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