1/11. An unusual cause of pelvic mass.BACKGROUND: pelvic pain with an associated pelvic mass is a common problem in the emergency room (ER) or physician's office. Concerns about ectopic pregnancy, infection, or malignancy usually dominate the diagnostic evaluation. At the same time, domestic violence as the cause of a pelvic mass is seldom suspected by physicians. CASE: A 38-year-old woman came to the ER with left lower quadrant pain and a left pelvic mass. After four hospital days and multiple diagnostic imaging studies, the diagnosis of hematoma caused by physical trauma to the abdomen was elucidated. CONCLUSION: Proper diagnosis of the cause of the pelvic mass could have been made earlier by careful attention to the social history and by recognizing the high incidence of domestic violence as opposed to the relative infrequency of some other diagnostic entities for which the patient was tested.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/11. Interstitial pregnancy: a potential for misdiagnosis of ectopic pregnancy with emergency department ultrasonography.Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy that can be mistaken for a normal intrauterine pregnancy on ultrasonography, leading to catastrophic results. Increasingly, emergency physicians are using ultrasonography to diagnose intrauterine pregnancy. Emergency physicians should be aware of the potential for mistaking an interstitial pregnancy for an intrauterine pregnancy. We present a case report of an interstitial pregnancy misdiagnosed as an intrauterine pregnancy and discuss ultrasonographic and physical examination findings to help differentiate interstitial pregnancy from an intrauterine pregnancy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/11. Ectopic pregnancy: symptoms, diagnosis and management.Ectopic pregnancy is the third biggest killer of pregnant women in the UK. Misdiagnosis and delay in treatment remain common problems, which feature in the Department of health's last two confidential inquiries into maternal death. This article outlines the symptoms and management of ectopic pregnancy as well as high-lighting its psychological and physical effects.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/11. The preoperative diagnosis of primary ovarian pregnancy.BACKGROUND: Ovarian pregnancies comprise 0.15% of all pregnancies and 0.15-3% of ectopic gestations, with an incidence of up to 1/7,000 deliveries. CASE: A single case of an ovarian gestation consistent with Spieglberg's four criteria in a primigravida without prior gynecological, medical, or surgical history is presented. Presumptive diagnosis was by thorough clinical examination with a single, palpable, adnexal mass in a patient with BMI of 19, supported with serial ultrasound and quantitative betaHCG-enabled preoperative diagnosis. CONCLUSION: Primary ovarian pregnancy may occur without any classical antecedent risk factors. ultrasonography can be a useful adjunct to clinical presentation and physical examination in allowing the preoperative diagnosis of ovarian gestation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/11. A young woman with abdominal pain.patients rarely present with solely a physical problem. While psychological overlay and social factors expand the differential diagnosis and modify management, physical dangers should not be forgotten. Disruption of the family unit isolates individuals and requires extra consideration from the caring practitioner, as in the case of Sarah Leigh.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
6/11. Complete abortion of early ectopic pregnancy.Abortion of an early ectopic pregnancy is a rarely diagnosed event. Coincidental serial hormonal studies performed on a patient suffering from idiopathic secondary infertility enabled the authors to record plasma estradiol, progesterone and beta-human chorionic gonadotropin concentrations, which, combined with the physical findings, ultrasonography and laparoscopy, led to the diagnosis of a complete abortion of an early ectopic pregnancy. Apart from slight vaginal bleeding on day 44 of a prolonged cycle, the patient was asymptomatic throughout and the importance of plasma beta-human chorionic gonadotropin determination in such a situation is discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/11. Ectopic pregnancy in the liver. Report of a case and angiographic findings.A 23-year-old woman underwent laparotomy due to physical signs of intra-abdominal bleeding. A 3 X 3 cm bleeding mass adherent to the liver surface was found. Microscopic examination of the removed encapsulated tumour demonstrated an ectopic pregnancy of the liver. angiography performed on the 10th postoperative day showed a hypervascular lesion in the right liver lobe. The angiographic findings are similar to those previously described in cases of tubal pregnancies.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/11. Intrauterine and ruptured tubal ectopic pregnancy: a diagnostic challenge.A case of combined pregnancy, an unusual condition, is presented. A 17-year-old woman came to the emergency department because of left-sided, low abdominal pain. An intrauterine pregnancy and a right-sided ovarian cyst were demonstrated by ultrasound. The presence of the intrauterine pregnancy caused the clinicians to disregard symptoms and physical findings suggesting the concomitant presence of a ruptured left tubal ectopic pregnancy. Forty-eight hours later, when the patient was in impending shock, laparotomy revealed the ruptured left tubal ectopic pregnancy. Surgical treatment was successful. Six weeks later, a blighted ovum was removed from the uterus, confirming that two pregnancies had coexisted. Undue reliance on ultrasonography is criticized, and culdocentesis is advocated.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/11. Treatment of ectopic pregnancy with single-dose methotrexate in a patient with an intrauterine device. A case report.BACKGROUND: Medical therapy for ectopic pregnancy is successful in 86-100% of selected patients. patients who conceive with an intrauterine device (IUD) in place have an increased risk of ectopic pregnancy (30% of conceptions); these patients have been treated routinely by surgery. CASE: A 33-year-old woman at 7 weeks' gestation with a copper-containing IUD in place presented with an ectopic pregnancy based on transvaginal ultrasound, quantitative beta-human chorionic gonadotropin and physical examination findings. Because she desired to keep her IUD and avoid surgery, she was treated with intramuscular single-dose methotrexate. CONCLUSION: This case was the first reported successful medical treatment of an ectopic pregnancy in a patient with an IUD. There appeared to be no adverse clinical interactions between the methotrexate and IUD.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/11. Ovarian pregnancy and operative laparoscopy: report of eight cases.We report a series of eight cases of ovarian pregnancy treated by operative laparoscopy during the last 12 years. This rare ectopic pregnancy (2.6% of all extra-uterine pregnancies in our experience) is difficult to diagnose prior to surgery. Earlier diagnosis is now possible, owing to the availability of highly specific radioimmunoassay for human chorionic gonadotrophin and the development of transvaginal ultrasonography. Primary ovarian pregnancy is distinguished by some authors from distal tubal pregnancy, in which a secondary ovarian implantation is possible. The therapy is surgical and currently more conservative than in the past, because of improvement in operative laparoscopy. laparoscopy allows a short hospital stay, less physical stress and a favourable cost-benefit ratio. Moreover, its low risk of adhesion formation is important with regard to reproductive prognosis: in the light of this, since the patients are generally young and desire future childbearing, laparoscopy may be the treatment of choice.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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