Answers to Clinical Scenarios 1 to 3
1. K- Ruptures ectopic pregnancy
Signs of hypovolaemic shock are described. The shoulder pain reflects diaphragmatic irritation from intra-peritoneal blood.
2. A- Acute appendicitis
3. M – Torsion of the ovary
This is characterised by sudden onset of pain. Signs of peritonism are usually evident.
· Pregnancy and its complication must be excluded in all women of childbearing age presenting with right iliac fossa pain.
· Ovarian cyst accidents (Torsion/rupture/haemorrhage) may result in lower abdominal pain, In the case of ovarian torsion, the women is characteristically unwell, often with tachycardia and signs of peritonism. It is more likely to occur in association with ovarian cysts (usually >5 cm in diameter). As with gonadal torsion in men, prompt diagnosis and emergency surgical intervention is required to save the gonad.
Signs of hypovolaemic shock are described. The shoulder pain reflects diaphragmatic irritation from intra-peritoneal blood.
2. A- Acute appendicitis
3. M – Torsion of the ovary
This is characterised by sudden onset of pain. Signs of peritonism are usually evident.
· Pregnancy and its complication must be excluded in all women of childbearing age presenting with right iliac fossa pain.
· Ovarian cyst accidents (Torsion/rupture/haemorrhage) may result in lower abdominal pain, In the case of ovarian torsion, the women is characteristically unwell, often with tachycardia and signs of peritonism. It is more likely to occur in association with ovarian cysts (usually >5 cm in diameter). As with gonadal torsion in men, prompt diagnosis and emergency surgical intervention is required to save the gonad.