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Re: Gyn: persistent HCG From: Rafael Haciski (haciski@earthlink.net) Tue Nov 14 22:12:06 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Rafael Haciski: "Re: persistent HCG" Previous message: Dr Eberhard Lisse: "Re: ACOG statement" In reply to: Garry E. Siegel, M.D.: "Gyn: persistent HCG" Next in thread: Elrod, Darryl G Maj 48 MDOS/SGOBO: "Re: persistent HCG" These are tough cases. The low hCG would suggest laparoscopy not worthwhile as chances for finding something (surgically treatable ectopic) are nonexistent. On the other hand the acute abdomen suggests looking for other pathology (my last such case had a ruptured appendix). Is pregnancy desired? She could have concomitant intrauterine (very rare) - serial hCGs q 2 days, and sono at 1500 mIU should show something in utero. If pregnancy not desired, MTX. -- Rafael Haciski MD FACOG Palmetto, FL On Nov 14, 2006, at 7:22 PM, Garry E. Siegel, M.D. wrote: > 34 YO P2002 > ER 10/25 with acute abdominal pain, exam c/w acute abdomen, HCG 292, > scan showing empty uterus and free fluid. > > Lapscope--400 ml blood, normal tubes/pelvis save a clot from the left > tube in the fibriated end. My diagnosis was a tubal abortion, and > nothing done other than evacuation. > > HCG two days later 113. > Next week, 95, then 96 a couple of days later. > Now, 2.5 weeks postop, it is 224. The exam yesterday (when blood was > drawn) was normal. > > What's next? > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA Next message: Rafael Haciski: "Re: persistent HCG" Previous message: Dr Eberhard Lisse: "Re: ACOG statement" In reply to: Garry E. Siegel, M.D.: "Gyn: persistent HCG" Next in thread: Elrod, Darryl G Maj 48 MDOS/SGOBO: "Re: persistent HCG"

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