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Re: Tubal Pregnancy--managementFrom: AllanHo@aol.comSat Jan 19 15:29:32 2008
In a message dated 1/19/2008 2:37:19 PM Eastern Standard Time, garrys@mindspring.com writes: At laparoscopy, had old PID and the left tube had a mid-ampullary 3 cm ectopic, with a huge reactive tubal cyst or hydatid (around 3 to 4 cm.) on the tube. I am surprised that the 3cm ampullary dilatation did not show up on ultrasound. I still feel that she had a tubal abortion when she first presented with the pain. The dilatation you saw could just be a blood clot that was left behind. Scoping someone with PID and adhesions could have caused you a real bad day. Furthermore, it's possible for the pathology to come back with no POC in the tube. The beta hCG could still go up or plateau afterwards. Then you are back to square one. I always tell my patients that they may still need methotrexate after laparoscopy. Allan Pennsylvania
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