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CASE 362: ACUTE FEMALE PELVIS PAIN, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER.
Women 21 yo, single, acute hypogastric pain, polykiuria, normal urine analysis.Ultrasound scanning in pelvis shows uterus normal in size with endometrium thickening, fluid arround uterus looks like blood (US 1) and on right site of uterus existing one round mass, size of 5 cm with multiple cystic (US 2), US 3= Color Doppler this mass is normal vascular , US 4= PW Doppler of right uterine artery with RI =0.82.Sonologist alerts bleeding intrapelvis and suspecting of rupture of right ovary cyst.
MSCT with CE : Non intrauterus pregnancy (CT1), this mass at right parameter is cystic in central part and thickening wall with blood arrounding. Radiologist diagnosis is hemoperitoneum due to rupture of corpus luteinic at the right ovary, blood volume arround 100ml.
Blood test makes sure negative beta HCG.Clinical finding is acute pelvis pain in single female patient, ultrasound quickly detected bleeding intrapelvis, and blood test rule out ectopic pregnancy.
Ultrasound is best diagnosis and follow up this case no need CT.This patient was admitted obgy hospital for survey in 3 days and discharged laterConclusion: in female patient, of acute pelvis pain ultrasound is first choice of imaging modalities for diagnosis about corpus luteinic rupture bleeding, and beta HCG confirms for diagnosis of MITTELSCHMERZT SYNDROME.