MyMedR

Displaying all 3 publications

Abstract:

Sort:

Fulltext Unilateral live twin tubal ectopic pregnancy presenting at 12 weeks of gestation: A case report

Seak CJ, Goh ZNL, Wong AC, Seak JC, Seak CK

Medicine (Baltimore), 2019 Sep;98(38):e17229.
PMID: 31567985 DOI: 10.1097/MD.0000000000017229

RATIONALE: Abdominal pain in pregnancy represents a demanding diagnostic challenge in the emergency department (ED) due to the extensive list of differential diagnoses to be considered, coupled with the possibility of each disease having nonclassical, atypical signs and symptoms, resultant from the patient's pregnant state. Additionally, emergency physicians (EPs) face limitations on investigative imaging modalities because of the need to minimize fetal radiation exposure. EPs have to tackle this diagnostic challenge while performing a balancing act to maximize both maternal and fetal outcomes in a time-sensitive manner, becauser any delays in decision-making at the ED may threaten the safety of mother and child. Two common causes of abdominal pain in pregnancy presenting to the ED are acute appendicitis and ectopic pregnancy. The latter is almost always diagnosed by 10 weeks of gestation. Here, we report an extremely rare case of unilateral live spontaneous twin tubal ectopic pregnancy presenting past 12 weeks of gestation, diagnosed after magnetic resonance imaging (MRI) of the abdomen.
PATIENT CONCERNS: A 37-year-old gravida 2 para 1 at 12 weeks and 6 days of gestation presented to our ED with a 2-day history of right iliac fossa pain, not associated with vaginal bleeding, fever, diarrhea, and vomiting. On examination, she was tachycardic (pulse rate 124 beats/min) and hypertensive (blood pressure 142/88 mm Hg). There was marked tenderness and guarding at the lower abdomen.
DIAGNOSES: Blood investigations were unremarkable, while abdominal ultrasonography found a live twin gestation with foetal heartbeats of 185 and 180 beats/min. MRI of the abdomen revealed an empty uterine cavity; 2 amniotic sacs and fetuses of diameter 10 cm, and a single placenta were noted in the right uterine adnexa. The patient was diagnosed with right live monochorionic diamniotic twin tubal pregnancy.
INTERVENTION: Our patient underwent emergency laparoscopic right salpingectomy.
OUTCOMES: The operation was successful and her postoperative care remained uneventful up to discharge.
LESSONS: Ectopic pregnancy cannot be ruled out based on prior normal antenatal examinations and gestational age of >10 weeks. EPs should not hesitate to order MRI scans for further evaluation if ultrasonography and laboratory findings are equivocal.

Matched MeSH terms: Salpingectomy
Fulltext Large perineal and gluteal angiomyxoma: the role of diagnostic imaging and literature review

Alhabshi SM, Abd Rashid M

BMJ Case Rep, 2013;2013.
PMID: 23429032 DOI: 10.1136/bcr-2013-008680

Aggressive angiomyxoma is a benign soft tissue tumour usually affecting the pelvis and perineum predominantly in women. Because of its variable presentation, this tumour is often clinically misdiagnosed as liposarcoma. We describe a case of a 38-year-old woman who presented with a large perineal and gluteal mass which increased in size in one year. Ultrasound showed hypoechoic mixed solid and cystic mass. Contrasted CT and MRI examinations showed typical appearance of swirling and layering pattern. She had undergone TAHBSO as the mass was difficult to dissect intra-operatively. The post-operative specimen confirmed to be an aggressive angiomyxoma.

Matched MeSH terms: Salpingectomy
Fulltext Enterobius vermicularis salpingitis seen in the setting of ectopic pregnancy in a Malaysian patient

Ngui R, Ravindran S, Ong DB, Chow TK, Low KP, Nureena ZS, et al.

J Clin Microbiol, 2014 Sep;52(9):3468-70.
PMID: 24989613 DOI: 10.1128/JCM.01191-14

We report a rare and unusual case of invasive Enterobius vermicularis infection in a fallopian tube. The patient was a 23-year-old Malaysian woman who presented with suprapubic pain and vaginal bleeding. A clinical diagnosis of ruptured right ovarian ectopic pregnancy was made. She underwent a laparotomy with a right salpingo-oophorectomy. Histopathological examination of the right fallopian tube showed eggs and adult remnants of E. vermicularis, and the results were confirmed using PCR and DNA sequencing.

Matched MeSH terms: Salpingectomy

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links