A Case of Rupture Ectopic Pregnancy Diagnosed 10 Days After Hospital Stay In A 22-Year-Old Girl Presented With Symptoms of Anemia Without Abdominal Pain and Amenorrhea: Lessons Learned

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Published: May 31, 2022
DOI: https://doi.org/10.47191/ijmscrs/v2-i5-20
Keywords:
refractory anemia, occult blood loss, ascites, rupture ectopic pregnancy, salpingectomy, clerking, delay diagnosis

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Khin Phyu Pyar
Professor and Head/Senior Consultant Physician, Department of Medicine/ Department of Nephrology, Defence Services Medical Academy/ No.(1) Defence Services General Hospital (1000-Bedded)
Sai Aik Hla
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Soe Min Aung
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Soe Win Hlaing
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Aung Aung
Consultant Hematologist, No.(1) Defence Services General Hospital (1000-Bedded)
Kyaw Zay Ya
Consultant Hematologist, No.(1) Defence Services General Hospital (1000-Bedded)
Kyaw Thet Aye
Consultant Hematologist, No.(1) Defence Services General Hospital (1000-Bedded)
Zar Ni Htet Aung
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Nyan Lin Maung
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Thurein Wynn
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Aung Phyoe Kyaw
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Han Lin Aung
Assistant Lecturer/ Consultant physician, Defence Services Medical Academy
Myo Thant Kyaw
Assistant Lecturer/ Consultant physician, Defence Services Medical Academy
Zay Phyo Aung
Assistant Lecturer/ Consultant physician, Defence Services Medical Academy
Thein Tun Myint
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Kyaw Thet Maung
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Saw Thar War
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Aung Thu
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Sitt Min
Consultant Physician, No.(1) Defence Services General Hospital (1000-Bedded)
Tin Tun Oo
Obstetrics and Gynaecologist, No. (1) Defence Services Obstetrics and Gynaecological Hospital (300-Bedded)
Aung Thura Soe
Obstetrics and Gynaecologist, No. (1) Defence Services Obstetrics and Gynaecological Hospital (300-Bedded)
Min Hein Myint Chein
Anaesthetist, No.(1) Defence Services General Hospital (1000-Bedded)

Abstract

A 22-year-old unmarried Myanmar girl presented with symptoms of anemia: fatigue, exertional dyspnea and fainting attack. There was no abdominal pain or amenorrhea. The hemodynamic status was stable except sinus tachycardia. Anemia was refractory to blood transfusion; thus, the differential diagnosis were autoimmune hemolytic anemia and occult blood loss. Blood film, bone marrow examination, Comb tests, Anti-nuclear antibody profile and PNH screen tests excluded autoimmune hemolytic anemia. Presence of fibrous strands in free fluids of abdominal cavity with normal uterus and ovary mislead the diagnosis of tuberculosis. Blood tap in ascitic fluid aspiration made all the answer- rupture ectopic pregnancy. The symptoms resolved after right salpingectomy and blood transfusion. The clerking on sexual exposure to Myanmar single is not acceptable in our culture; it is regarded as “social insult”. Atypical presentation and not asking sexual history caused delay in diagnosis; diagnosed 10 days after hospital stay. She recovered uneventfully.

Article Details

How to Cite
Pyar, K. P. ., Hla, S. A. ., Aung, S. M., Hlaing, S. W., Aung, A. ., Ya, K. Z., Aye, K. T., Aung, Z. N. H. ., Maung, N. L., Wynn, T. ., Kyaw, A. P. ., Aung, H. L. ., Kyaw, M. T. ., Aung, Z. P., Myint, T. T. ., Maung, K. T., War, S. T. ., Thu, A., Min, S. ., Oo, T. T. ., Soe, A. T. ., & Chein, M. H. M. . (2022). A Case of Rupture Ectopic Pregnancy Diagnosed 10 Days After Hospital Stay In A 22-Year-Old Girl Presented With Symptoms of Anemia Without Abdominal Pain and Amenorrhea: Lessons Learned. International Journal of Medical Science and Clinical Research Studies, 2(5), 422–428. https://doi.org/10.47191/ijmscrs/v2-i5-20
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Vol. 2 No. 5 (2022): Volume 02 Issue 05 May 2022
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Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

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