1 case of intrauterine pregnancy at the same time.docVIP

 PAGE \* MERGEFORMAT 4 1 case of intrauterine pregnancy at the same time [Keywords:] intrauterine pregnancy A medical record Patients, female, 22 years old, married. Pregnant 0 2 production, an abortion a year ago. Were in at 0:00 on March 9, 2009 there was no incentive to lower abdominal bulge pain to the emergency clinic at 1:40 am and asked history, usually menstrual regularity, the last menstrual period December 15, 2008, postmenopausal not yet reached the hospital, no abdominal pain and vaginal bleeding situation. to diagnosis when abdominal pain in right lower abdomen is obvious, vomiting, stomach contents again, no coffee grounds-like material without syncope. checkup was lower abdominal tenderness, mild rebound tenderness, Gynecological Examining give pain cervical, uterine pregnancy as large as 3 months, tenderness with palpation of the annex are not satisfied because patients do not. to the emergency department ultrasound report “intrauterine pregnancy 12 + weeks, fetal heart rate 117 times / min, 0 placenta, the placenta over the cervix inside the mouth edge of 0.7 cm, amniotic fluid 3.4 cm “, blood WBC 16.9 × 109 / L RBC 3.15 × 1012 / L, HGB 93 g / L, HCT 26.4%, PLT 156 × 109 / L, diagnostic “abdominal pain of unknown origin: threatened abortion may be”, in the infusion and observing treatment. Patients with abdominal pain at about 7:00 am heavier than before, epigastric pain. Check the whole abdomen tenderness, turn surgical consultation. surgical check blood WBC 13.2 × 109 / L, RBC 2.15 × 1012 / L, HGB 73 g / L, HCT 21.1%, abdominal ultrasound report “liver, pancreas, spleen, and kidneys were normal, gallbladder wall rough, a lot of fluid within the abdominal cavity, “surgical abdominal puncture out of 4 ml blood was dark red, the patient again into obstetrics and gynecology. Diagnosis: (1 intra-abdominal bleeding, (2 intrauterine pregnancy may be at the same time, (3 moderate anemia . Immediate laparotomy, intraoperative intra-abdominal