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abdominal pregancy and a myomatous uterusFrom: Dr Eberhard W Lisse (el@lisse.NA)Sun Oct 22 18:48:32 1995
Hi, I saw a patient on Thursday morning, complaining of abdomial pain and pv bleeding for two days getting worse. Pregnancy test had been positive a month earlier, now 12 weeks amenorrhea. On examination she was tender but not acute, some guarding, minimal bowel sounds. Os was closed, the fundus was enlarged (consistent with 12/40), the uterus felt somewhat hard though. I could not feel any adnexa. On Ultrasound the uterus was enlarged and looked myomatous with an endometrial line, there was free fluid in the Pouch of Douglas and a vital 12/40 pregnancy somewhere on the left adnexa high up. I was pretty sure it was an abdominal pregancy. I did an exploratory laparotomy, and found an abdominal pregnancy, 500 ml of blood in the abdomen, the trophoblast on the left adnexa and omentum, the vital fetus in the omentum. Uterus had a large myoma (8cm). I did a salpingectomy, preserving the ovary and took part of the omentum. Blood loss minimal. Recovery is excellent. I am wondering now, in retrospect should I have taken out the myoma at the same time? el
-- Dr. Eberhard W. Lisse \ / Swakopmund State Hospital <el@lisse.NA> * | Resident Medical Officer Private Bag 5004 \ / +264 641 61503 (pager) 61005 (home) 61004 (fax) Swakopmund, Namibia ;____/ Zone/Domain Contact for the NA-DOM Vice-Chairman, Board of Trustees, Namibian Internet Development Foundation, an Association not for Gain. NAMIDEF is the Namibian Internet Service Provider.
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