Adkins Kristin, Minardi Joseph, Setzer Erin, Williams Debra
West Virginia University School of Medicine, Morgantown, WV, USA.
Department of Emergency Medicine, West Virginia University, 7413B HSS, 1 Medical Center Drive, Morgantown, WV 26506, USA.
Case Rep Emerg Med. 2016;2016:9124967. doi: 10.1155/2016/9124967. Epub 2016 Feb 7.
Background. Retained products of conception is an important diagnosis to consider in patients presenting with postpartum complaints. Bedside ultrasound is a rapid, accurate, noninvasive modality to evaluate these patients. Objective. To report an atypical case of retained products of conception diagnosed with bedside ultrasound in the emergency department. Case Report. A 27-year-old female who was 1-month postpartum presented with vaginal bleeding, pelvic pain, and no fever. At the time of initial H&P, bedside ultrasound revealed echogenic material within the endometrial cavity with blood flow seen by color Doppler consistent with retained products of conception. The bedside ultrasound rapidly narrowed the differential and allowed a definitive diagnosis immediately. Ob/Gyn was consulted and dilation and curettage was performed in the operating room. Conclusions. Retained products of conception is an important diagnosis for the emergency physician to consider in at-risk patients. The sonographic findings are easily obtained and interpreted by emergency physicians. Earlier diagnosis of this disease process should lead to more focused patient evaluations and management.
背景。对于出现产后不适的患者，稽留流产是一个需要考虑的重要诊断。床边超声是评估这些患者的一种快速、准确、无创的检查方法。目的。报告1例在急诊科通过床边超声诊断为稽留流产的非典型病例。病例报告。一名产后1个月的27岁女性，出现阴道出血、盆腔疼痛，无发热。在初次进行病史采集和体格检查时，床边超声显示子宫内膜腔内有强回声物质，彩色多普勒显示有血流信号，符合稽留流产表现。床边超声迅速缩小了鉴别诊断范围，并立即做出了明确诊断。咨询妇产科医生后，在手术室进行了刮宫术。结论。对于处于风险中的患者，稽留流产是急诊医生需要考虑的重要诊断。超声检查结果易于急诊医生获取和解读。对该疾病过程的早期诊断应能使患者评估和管理更加有针对性。
