|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Abdominal painFrom: Cathy Harsha MD (cgharsha@stvincent.org)Fri Dec 12 10:13:46 1997
At Thu, 11 Dec 1997, Ricardo Savaris wrote: > >Hi listers, > >Yesterday afternoon, a patient came into my office fro an emergency >consultation (I really dont like this emergencies, I am at my office and I >cannot provide much help there, and most of the times she ends up at the >E.R.), but here is the case: > >32 y-old, gesta 3 para 2 , 1 abortion, started yesterday morning with >intense colic pain starting on her back and goes to the front. The pain >moved, afterwords to the supra pubic region. The pain is like labour pain, >no relief position, last for few minutes and disapear. At the same time she >started with an abnormal uterine bleeding, not intense. No use of drugs or >fever. Her menses are regular 28 days cicles, 7 days of menses. >LMP: November, 20th no contraceptive method since quimioterapy >Medical past history: Breast cancer 6 years ago, sectorectomy + radioterapy >+ quimioterapy. >No history of urinary stones > >On the physical exam: > >No tenderness on her back. >Abdominal defense, and rebound tenderness. >Vaginal examination: pain in uterine mobilization, no adnexial pain, uterus >in normal size. After the exam she started with the pain. > >Ordered FBC, Urine analisis and Sedimentaion Rate (I sent her to E.R.) >FBC: Hb 13 Leucocytes: 4.800 >Urine analisys: all in normal range, 1-2 leuc/field, no bacteria, 1 blood >cell/field > >At the E.R. they asked for a pregnancy test and discharge to home. No >chance for nephrolithiasis. She is still with this ciclic pain. > >Any suggestion? > >-- >Ricardo Savaris, MD, TEGO, MSc >Porto Alegre, Brazil >55 51 3301354 > I've seen this a few times, and have thought it was the result of ovulation, and some heavier-than-average bleeding from the corpus luteum. One patient was a fellow physician, good historian, and had pain severe enough to warrant an appendicitis workup, but again, all labs cold normal, and the pain resolved over 48 hours. She agreed it felt like total peritoneal irritation, and was mid-cycle. Another patient got all the way to a scope, and had almost a liter of blood in her belly, and a tiny arterial pumper on the edge of the ovulaiton site.(Negative beta - wasn't an ovarian ectopic.) Your patient is a little past expected ovulation, and I have no clue as to what the breast cancer may have to do with this.
-- Catherine G. Harsha MD
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 05:22:31 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.