Secondary abdominal pregnancy misdiagnosed on 1 case.docVIP

 PAGE \* MERGEFORMAT 3 Secondary abdominal pregnancy misdiagnosed on 1 case [Keywords:] secondary abdominal pregnancy; Misdiagnosis 1 Case information Patients, women aged 32 years old, due to postmenopausal sustained abdominal pain, patients last menstrual period June 22, 2009, stop by the January investigation of urine-HCG (+), 9 月 18 Nikkei transvaginal ultrasound: double uterus, the side of the 14 .10 of pregnancy increased abdominal pain admitted to hospital. Physical examination: general condition can be painful expression, no abnormal heart and lung, abdominal palpation, muscle tension (-), tenderness (+), Palace increase, such as duck eggs large, before the probe head and a large bag near newborn blocks, hard, double Annex tenderness (+) thick, blood was drawn after the dome 2ml. Laboratory examination: WBC 14 × 109 / L, RBC 3.1 × 1012 / L, urinary HCG (+). and ultrasound examination, probe scanning of pelvic and uterine size may be normal, muscle echo uniform, the other probe and a mixed mass, 16cm × 10cm, uneven echo, and no fetal structure, two iliac fossa fluid depth of about 2.9cm. Ultrasound diagnosis: pelvic masses (considering uterine rupture); abdominal effusion. Clinical diagnosis: double uterus; side of the pregnancy. Admission examination, preoperative diagnosis: bloody peritonitis; uterine malformation associated with pregnancy rupture. Intraoperative findings, extensive adhesions pelvic organs, we can see a lot of blood in the uterus were normal, the rear see 18cm × 12cm mass, bowel and bladder after extensive abdominal adhesions, see a 6cm mass surface rupture mouth and clear the blood clots 150ml , within which see the nearly 4-month-old placenta with stillbirth and most of the large volume of blood. Postoperative diagnosis: rupture of abdominal pregnancy 16W merger; bladder rupture; bilateral tubal broken. 2 Discussion Preoperative ultrasound and clinical examination shows repeatedly: double uterus, uterine rupture.