2007 Abdomen Case 2

“Lily”

Sg: 10 month “MiKi” (Pronounced Me-Key) Fe

Hx: straining, bred -- but unknown due date

Rads:    2 views abdomen


See images below. Click to enlarge. Click magnifying glass at the bottom of enlarged images for full-sized image.

 

Candidates received points for:


-- Abnormal Radiographic Findings: gas in a rounded shape, surrounding very large fetus with head wedged in pelvic canal; fetal skull measuring nearly same size as pelvic diameter; mottled gas in fetal abdomen; possible free air in maternal abdomen; collapse of fetal skull bones


-- Radiographic Diagnosis: fetal/maternal disproportion and dystocia; dead fetus; gas in the uterus and in the fetus and possibly free in the maternal abdomen suggesting uterine rupture


-- Points were deducted if abdominal ultrasound was recommended to evaluate for fetal vitality, since the fetus is surrounded by gas and there are multiple radiographic signs of fetal demise

 

Outcome: 


Surgery: Ruptured uterus with free air and fluid in abdomen; dead, mature single fetus; communication between colon and uterus with no regional adhesions – suspect congenital?

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