| Atypical presentation of a large interstitial pregnancy. | |
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MedLine Citation:
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PMID: 23250569 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We report the case of a 20-year-old female who presented to the ER with a 1-week history of worsening abdominal pain and intermittent vaginal bleeding for the previous 5 days. Physical exam was notable for bilateral adnexal tenderness and a closed cervix without motion tenderness or discharge. Laboratory data demonstrated a beta HCG level of 7,787 IU/L, and pelvic ultrasound with transvaginal imaging was subsequently performed. Neither an adnexal mass nor a normal intrauterine pregnancy was demonstrable; however, a focal right fundal 7-cm area of heterogeneous echogenicity was observed. Initial findings were felt indeterminate with considerations including potential degenerating leiomyoma coexistent with a nonvisualized intrauterine pregnancy, ectopic pregnancy, or recent spontaneous abortion versus atypical interstitial ectopic pregnancy. The patient, initially declining further clinical intervention, returned within 24 h with continued pain. A repeat ultrasound demonstrated a relatively static and unchanged appearance with only a minimal concurrent interval increase in beta HCG levels. MRI was performed for further elucidation and demonstrated a heterogeneously hypervascular right fundal interstitial 6-cm mass, which, in the clinical context, was most suspicious for an ectopic pregnancy. Confirmatory laparoscopic cornual wedge resection and salpingectomy was subsequently performed. |
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Authors:
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Matthew Rheinboldt; Sherif Ibrahim |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-19 |
Journal Detail:
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Title: Emergency radiology Volume: - ISSN: 1438-1435 ISO Abbreviation: Emerg Radiol Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9431227 Medline TA: Emerg Radiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Emergency Radiology, Henry Ford Hospital, Detroit, MI, USA, mrheinbold@yahoo.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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