Chapter 45 Flashcards
What is the differential diagnosis for acute unilateral abdominal pain and a female?
Adnexal torsion, ruptured or hemorrhagic cyst, ectopic pregnancy, PID, appendicitis, renal colic, UTI, degenerating leiomyoma, intestinal obstruction
What is leiomyoma degeneration presentation like?
History of fibroids, associated with heavy menses and pelvic pressure
What are the physical findings for adnexal torsion or ruptured cyst?
Cervical motion tenderness, right lower quadrant tenderness, right sided adnexal mass, no cervical discharge
What procedure is done to discern between adnexal torsion or ruptured cyst?
Pelvic ultrasound with Doppler
What is the part and findings in Doppler ultrasound pelvic for ovarian torsion?
Reduce or lack of blood flow in the ovarian vessels
What diagnostic test should be ran for Simple ovarian cyst with torsion?
CBC, BMP, pregnancy test, UA, pelvic ultrasound
Is this an emergency? What kind?
Surgical emergency
After the diagnosis is confirmed what should be done?
Analgesia, anti-emetics, gynecology consult, standard pre-op orders and admission to ICU/ward
Why is gynecology consulting? How is ovarian torsion diagnosed definitively and what is its therapeutic gold standard?
For emergent surgical intervention within the first 4 to 24 hours of torsion
In what cases can you untwist the adnexa as opposed to resecting the adnexa?
Depending on ovarian viability and likelihood of malignancy
Is laparotomy or laparoscopic detorsion preferred?
Laparoscopic detours in
Location for this patient?
ER, after confirm torsion ICU/ward, after Gyn recommendation OR
