Thinking through a diagnosis

After reviewing a patient's history, this clinician prevented a potentially fatal mistake.

Thinking through a diagnosis
Thinking through a diagnosis

I worked for an infertility specialist that shared an office with an oncologist. The oncologist referred a patient with a weird "intra-uterine" tumor found at time of a hysterosalpingogram. I was asked to see the patient before an exploratory laparotomy scheduled for the next day.

I realized the patient had not menstruated for six months, but because she had polycystic ovarian disease, that was not unusual for her. I told my boss I was ordering a pregnancy test. He looked aghast, because no one else had thought of that.

The weird tumor was a 6-month-old fetus. We immediately called the primary referring physician to instruct him to call his insurance company to warn them. The patient was so happy she was pregnant and did not need surgery. The radiation exposure did not harm the baby. I was just glad that I took time to think through the diagnosis.

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