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KMID : 0358419710140070011
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Korean Journal of Obstetrics and Gynecology
1971 Volume.14 No. 7 p.11 ~ p.15
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Reflux Hemaperitoneum Mistaken for Ectopic Pregnancy
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李承浩/Lee, Seung Ho
權寧鎭/鄭亨根/金容浩/Kwon, Young Jin/Keun, Hyoung/Kim, Yong Ho
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Abstract
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Physicians are so freguently encountered with diagnostic problems of ectopic pregnancy that the percentage-of error given by all authors is- quite large, varying from 15 to as much -as 35 percent.
There were 319 laparotomies performed under the diagnosis of ectopic pregnancy :at Cheil Hospital, Seoul, Korea from December 1963 to August 1969. Among these, 5 .cases revealed no other intraabdominal pathology than hemoperitoneum.
Preoperative diagnosis were based on the history of slight spotting beginning a few days after an expected period, relatively sudden onset of colicky lower abdominal pain, -tenderness over the lower abdomen and internal pelvic organs and were decisive with -positive culdocentesis in all of these cases.
Intrauterine exploration was performed on one of them,. who returned with exactly the same symptoms one month after having laparotomy, and presence of intrauterine ;adhesion was found.
This condition has been classically described by Asherman but no literature was found -that describing such development of the pathology occurring secondary to the intrauterine adhesion.
Criteria of differential diagnosis between reflux hemoperitoneum and ectopic pregnancy are made out with the retrospective study of these cases as followings. In case of reflux hemoperitoneum;
1. General conditions and vital signs are within normal limits. 2. Hemoglobin and hematocrit are within normal ranges. 3. No history of sterility.
4. History of artificial , abortion or intrauterine instrumentation one to - three monthsprior to the present illness. -
5. In some cases history of the same or similar experience one to three months priorto the present illness.
6. No palpable adnexal mass.
7. Negative pregnancy test.
8. Intrauterine probing prior to laparotomy.
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