34 year old F G4P1021, 14 weeks pregnant, presents with right lower quadrant pain x 1 day. She states that the pain began the night prior to presentation, feels like “pulling”, worse today and accompanied by difficulty walking. Has pain with movement as well as at rest. Radiates across the suprapubic area. Endorses dysuria. Denies vaginal bleeding or discharge, nausea, vomiting, or diarrhea. Last bowel movement was earlier today and was non-bloody. Denies abdominal surgeries in the past.
Ultrasound examination to confirm IUP and FHR, as well as identify other abdominal pathology like appendicitis, yielded the following:
Ultrasound visualization of a mass coming off of the right uterine body measuring approximately 5cm x 7cm, with mild peripheral edematous changes suggestive of a torsed pedunculated fibroid is visualized. A normal right ovary is seen posterior to the pedunculated fibroid. These findings were confirmed with MRI.
Torsed fibroids do not require acute surgical intervention, nor do they endanger the fetus by their presence. Management consists mainly of symptom control. The patient was given acetaminophen and oxycodone with improvement of symptoms. She will follow up with obstetrics within 48 hours for re-evaluation.
Lindsay Davis joins us from Hudson, OH. She graduated from Duke University undergrad. Afterward, she danced professionally with the Cincinnati Ballet Company, then worked in public health at the Cleveland Clinic. She completed her medical training and residency at Temple University School of Medicine/Temple University Hospital in Philadelphia, PA!
Di Coneybeare is one of our own! She just finished her residency here at NYU/Bellevue and is staying on for a two-year combined US fellowship and Masters in Health Education. She is originally from Portlandia, then transplanted to New York for medical school and residency. She enjoys exploring the city (especially the food scene), playing with her dogs and seeking out green spaces.