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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of ruptured tubal pregnancy with massive life-threatening hemoperitoneum. The 38 year-old woman presented with gynaecologic haemorrhage, pelvic pain and hypovolemic shock. Without any ambiguity, the diagnosis was directly made during contrast enhanced Multidetector Computed Tomography (MDCT). Massive hemoperitoneum with fresh blood clots in the hypogastric area, active free peritoneal extravasation of intravascular contrast material and dramatic peripheral enhancement, - "ring of fire" sign - of an adnexal cystic structure were the key signs. These signs must be known by the emergency radiologist because of the more and more use of CT as the first imaging modality in emergency departments particularly for patients with abdominal pain and presenting life-threatening symptoms.
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PMID:MDCT diagnosis of ruptured tubal pregnancy with massive hemoperitoneum. 1785 2

Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Initial evaluation consists of hormonal assays and pelvic ultrasonography (US). A history of pelvic pain along with an abnormal beta human chorionic gonadotropin level should trigger an evaluation for an ectopic pregnancy. The fallopian tube is the most common location for an ectopic pregnancy. An adnexal mass that is separate from the ovary and the tubal ring sign are the most common findings of a tubal pregnancy. Other types of ectopic pregnancy include interstitial, cornual, ovarian, cervical, scar, intraabdominal, and heterotopic pregnancy. Interstitial pregnancy occurs when the gestational sac implants in the myometrial segment of the fallopian tube. Cornual pregnancy refers to the implantation of a blastocyst within the cornua of a bicornuate or septate uterus. An ovarian pregnancy occurs when an ovum is fertilized and is retained within the ovary. Cervical pregnancy results from an implantation within the endocervical canal. In a scar pregnancy, implantation takes place within the scar of a prior cesarean section. In an intraabdominal pregnancy, implantation occurs within the intraperitoneal cavity. Heterotopic pregnancy occurs when an intrauterine and an extrauterine pregnancy occur simultaneously. A spectrum of intra- and extrauterine findings may be seen on US images. Although many of the US findings are nonspecific by themselves, when several of them are seen, the specificity of US in depicting an ectopic pregnancy substantially improves.
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PMID:Diagnostic clues to ectopic pregnancy. 1893 28

This report describes the first case of superfetation after ovarian stimulation with gonadotrophins and intrauterine insemination (IUI) that were performed in the presence of an undiagnosed tubal pregnancy. A 32-year-old woman who underwent repeated attempts of ovarian stimulation and IUI was hospitalized for severe pelvic pain and submitted to laparoscopic salpingectomy because of ruptured salpynx containing a 6-week pregnancy. Transvaginal ultrasound examination showed a simultaneous intrauterine 2-week pregnancy that had been conceived by ovarian stimulation and IUI while the tubal pregnancy was already ongoing and still undiagnosed. The intrauterine pregnancy went on until term and ended with the spontaneous delivery of a healthy baby. This report demonstrates that human superfetation may occur after gonadotrophin treatment and IUI in the presence of an ongoing tubal pregnancy. It is recommended to perform a pregnancy test before starting ovulation induction even when an apparently normal blood discharge appeared.
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PMID:Superfetation after ovulation induction and intrauterine insemination performed during an unknown ectopic pregnancy. 2021 84

A 36-year-old woman was referred by general practitioner to the early pregnancy unit with pelvic pain in her seventh week of pregnancy. She had a transvaginal ultrasound. Unruptured live twin tubal ectopic pregnancy was diagnosed on. Diagnostic laparoscopy revealed an unruptured left interstitial ectopic pregnancy. The interstitial tubal pregnancy was removed by laparoscopic automatic stapler with minimal blood loss. The patient had an uneventful recovery to health.
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PMID:Laparoscopic management of interstitial pregnancy with automatic stapler. 2309 4

Heterotopic pregnancy is very rare under natural circumstances. We report the case of a 28 year old Gravida2 Para1001 woman at 9 weeks of pregnancy who consulted in emergency for acute pelvic pain following metrorrhagia. Physical exam revealed hemoperitoneum without shock. An emergency ultrasonography revealed two gestational sacs, one intra-uterine and the other extra-uterine. Laparotomy was done and the findings were: a ruptured right tubal pregnancy with 1,300 milliliters of hemoperitoneum, type B left utero-adnexal adhesions and an increased uterus consistent with a 9 weeks pregnancy. Right total salpingectomy was done and the patient did well postoperatively. That intrauterine pregnancy evolved normally under progesterone supply and the woman delivered a termed live female baby weighing 3.1 kilogrammes. In our context where ultrasound is not always available, practitioners carrying out salpingectomy for ruptured ectopic pregnancies should bear in mind the plausibleness of heterotopic pregnancy in order to properly handle the uterus.
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PMID:Ruptured heterotopic pregnancy in a natural conception cycle: a case report at the Yaounde central Hospital (Cameroon). 2487 95


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