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Re: You've done enough surgery when...From: RModugno@aol.comSat Feb 24 12:17:19 2007
In a message dated 2/24/2007 1:07:12 P.M. Eastern Standard Time, el@lisse.NA writes: G4P2M0 2* previous C/S T/L separately Reversal of T/L Ectopic Right tube 2007-01-17 (Appendix also removed but nil of note) Complains about amenorrhea since ectopic. Seen by by colleague in a rural hospital (90km from the capital, where I work) 2007-02-19, b-HCG 500 Seen by me on 2007-02-22 in the same rural setting on my monthly visit, Clinically nil of note, a bit tender on the right side, perhaps. Ultrasound on the same day shows no intrauterine pregnancy, no free fluid. Vaginal Ultrasound shows no intruterine pregnancy, right adnexa nil of note, left adnexa, perhaps a hydrosalpingx. b-HCG 2800. You have a list of two total abdominal hysterectomies scheduled for the following day in that hospital. So, bogs, girls and witches, what's the plan and what happened next :-)-O? And, puleeze, we don't have Methrotrexate. greetings, el Well el, she seems stable. You could add her on to follow your hysterectomies - laparoscopy - if you don't have a laparoscope - then minilap? Sure seems like an ectopic - the tubal reversal seems to have "half-worked' for both tubes? Strange that y'all don't have methotrexate - one of the cheapest drugs around. Robert Modugno MD MBA FACOG Sylva, NC
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