ABDOMINAL PAIN IN AN ADOLESCENT
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v25.i3.10084Keywords:
abdominal pain, adolescent, ectopic pregnancyAbstract
A 16-year-old adolescent presented to the Emergency Department with abdominal pain in the left lower quadrant with two weeks of duration and history of constipation. She denied onset of sexual activity and her last menses occurred three weeks before. On physical examination, she had a mild abdominal tenderness on the left lower quadrant. The initial blood workup and urine were normal. Abdominal and pelvic ultrasounds revealed a complex cyst on the left adnexal region and ascites. The serum hormone human chorionic gonadotropin was positive (2608 mUI/mL). Transvaginal ultrasound showed a simple adnexal cyst with a cobweb-like area contiguous to it. An intrauterine gestational sac was not seen. Exploratory laparotomy was performed showing an hemoperitoneum and a left ectopic tubal pregnancy. Salpingectomy was performed.
The authors intend to draw attention to a rare cause of abdominal pain in adolescence that should be considered in order to avoid a potentially fatal outcome.
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References
Jurkovic D, Wilkinson H. Diagnosis and management of ec- topic pregnancy. BMJ 2011; 342:d3397.
Kirk E, Bottomley C, Burne T. Diagnosing pregnancy and current concepts in the management of pregnancy of un- known location. Human Reproduction Update 2013; 20(2): 250-61.
Shaw JLV, Dey SK, Critchley HOD, Horne AW. Current knowledge of the aetiology of human tubal ectopy pregnan- cy. Human Reproduction Update 2010; 1-13.
Tulandi T. Ectopic pregnancy: Incidence, risk factors, and pathology. UpToDate; janeiro 2015. Consultado em outubro de 2015. Acessível em www.uptodate.com.
Panelli DM, Phillips CH, Brady PC. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review. Fertility Research and Practice 2015; 1-15.
Instituto Nacional de Estatística. Consultado em outubro de 2015. Acessível em www.ine.pt.
Relatório dos registos das interrupções da gravidez ao abri- go de lei 16/2007 de 17 de abril. Acessível em www.saud- ereprodutiva.dgs.pt.
Moura JP. Hemorragias da gravidez inicial. In Graça LM, edi- tors. Medicina Materno-Fetal. Lisboa: Lidel; 2010: 387-412.
Vichnin M. Ectopic pregnancy in adolescents. Current Opin- ion in Obstetrics & Gynecology 2008; 20(5): 475-8.
Melo C, Almeida F, Torres T, Oliveira F, Figueiredo M, Fon- seca P. Rastreio oportunístico de infeção genital por Chla- mydea Trachomatis em Adolescentes. Acta Pediatr Port 2014; 45: 266-9.
Neto S, Bombas T, Arriaga C, Almeida MC, Moleiro P. Contraceção na Adolescência: Recomendações para o aconselhamento contracetivo. Acta Pediatr Port 2014; 45: 51-63.
Tulandi T. Ectopic pregnancy: Clinical manifestations and diagnosis. UpToDate; setembro 2015. Consultado em outu- bro de 2015. Disponível em: www.uptodate.com.
Cunningham FG. Ectopic pregnancy; In: Cunningham FG, Leveno K, Blomm A, Spong CY, Dash J, editors. Williams Obstetrics. 23rd ed. New York: McGraw-Hill Companies; 2010: 238-56.
National Institute for Clinical Excellence, NICE. Ectopic preg- nancy and miscarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. NICE Clinical Guideline, 2012: 154. Acessível em http://guidance. nice.org.uk/cg154.
Royal College of Obstetricians and Gynaecologists, RCOG. The management of tubar preganancy. Clinical Guideline Reviewed 2010: 21. Acessível em https://rcog.org.uk/en/ guidelines-research-services/guidelines/gtg21.
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