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HemoperitoneumFrom: rchudacoff@mylinuxisp.comTue May 30 19:34:48 2000
16 yo hispanic G0 (10 previous partners, trying to get pregnant...another story all together) who was seen in the ER with pelvic pain for three days, abdominal pain and light headedness. She had a postive qualitative pregnancy and ultrasound showed bilateral adnexal masses and lots of free fluid, and a thickened endometrial stripe without an intrauterine pregnancy. Jeez......... if the case was that simple, I would not bother to list it. Please read on. At laparoscopy she had 350 cc clotted and non-clotted blood. Uterus and tubes were completely normal, left ovary was normal, and she was bleeding slowly from the right ovary. The surface epithelium looked as if it was pulled down and the expose corpus luteum was oozing. There was no evidence of peri-hepatic adhesions, TOAs, adhesions or PID, and I could not identify an ectopic pregnancy. I cauterized the HCL, and left the case. While in the PACU the lab called to say that while the qualitative hCG continued to be positive, the quantitative hCG was less than 2.0, essentially negative. They ran these tests three times each, using new packets/tests each time. So here is my question....why? My diagnosis is that of a hemorrhagic corpus luteal cyst, and no pregnancy. Any second opinions? Rick Richard Chudacoff, MD Chudacoff Obstetrics & Gynecology, PLLC 15200 Southwest Freeway # 270 Sugar Land, TX 77478 281-277-3900 281-277-3901 fax rchudacoff@mylinuxisp.com Richard.Chudacoff@obgyn.net
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