January 2014 Case of the month- Courtesy of Rachel Wightman

34yo female presented with lower abdominal cramping and vaginal spotting.  She had an IUD placed three years ago (after her first child).  Her LMP was approximately 7 weeks ago.

On exam, she was uncomfortable with lower abdominal tenderness.  A transvaginal ultrasound was performed which demonstrated the following:

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ectopic4

Our patient had a tubal ectopic pregnancy.  She was admitted and went to the OR for laparoscopy with left salpingectomy.  Her IUD was malpositioned, located in the endocervix extending to the lower uterine segment.   Of note, she was also Rh negative and received Rhogam.

NYU/Bellevue Ultrasound heads to Ethiopia

Tsion Firew, one of our scholarly academy members, recently traveled to The Black Lion Hospital- a major referral hospital in the capital of Ethiopia, Addis Ababa.  They started the first EM residency in east Africa 3 years ago.  As it is a public hospital, CT/MRI are not readily available.  Most patients who require advanced imaging travel to private institutions then return back to the public hospital for additional care, so bedside/point-of-care ultrasound has been an integral part of their training and patient care.

She organized and taught Ultrasound to the EM residents!!

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