• 36yo female patient, 13 days delayed period, was
diagnosed left side ectopic pregnancy. HCG=2786mUI/mL. Patient were
re-examination at Medic.
• Embryonic sac inside uterus d# 8mm, 2 normal ovaries and
rules out EP.
• During Transvaginal Ultrasound exam, incidental mass was
detected, sized # 35 x 40mm, rich echo. It located beside left ovary,
hypervascular supplied was identical which reassemble a kidney. On abdominal
view, 2 kidneys and other
organs were normal. During consultation, 9/11 doctors thought a third pelvic
kidney which is rare but possible.
• After reconsultation, patient wants abortion so we move
on to CT exam. In arterial phase, the mass enhanced and shows connection with
sigmoid colon and in late phase, rules out pelvic kidney diagnosis. CT Virtual Colonography
was performed, air was pumped to inflate colon for better view. On 3D image, the
mass reveals as polyp within sigmoid lumen.
• Next, the patient underwent endoscopic colon: demonstrated
a bledding, 25cm away from anus, very mobile polyp with long stalk. Sample
biopsy confirmed normal tubular polyp.
A studied case was represented around 11 doctors via email which was diagnosed exactly by MSCT and confirmed by colonoscopy.
Bài học 3:
email hội chẩn.
