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Re: abdominal pregancy and a myomatous uterusFrom: Dr. Carlos Chase (drchase@caribnet.net)Mon Oct 23 14:52:00 1995
On Sun, 22 Oct 1995, el@lisse.NA (Dr Eberhard W Lisse) wrote: >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 H If it was a pedunculated fibroid with a nice stalk yes. Otherwise LEAVE alone and return later. Dr. Carlos Chase Bridgetown Barbados "Sun, sea and sand in the Caribbean" E-mail: drchase@caribnet.net
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