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A 28-year-old woman in her seventh month of pregnancy suddenly feels
faint and collapses. She wakes up within a few minutes, but over the ensuing
half hour she becomes extremely pale, diaphoretic, tachycardic, and progressively
weaker. When an ambulance is summoned, the emergency medical technicians find
her to have a blood pressure of 75/55 mm Hg, and to be developing abdominal
distention. They transport her rapidly to a nearby hospital, where she arrives moribund and expires on the operating table. Just before her death, a diagnostic
peritoneal lavage is grossly positive. The history provided by her relatives
indicates that this was her second pregnancy, that she had never taken birth
control pills but had relied on the rhythm method to control her fertility, that she had had prenatal care for the present pregnancy and had last been
seen 2 weeks before this event at which time everything checked out normal,
and that she had not experienced any labor pains before or during this lethal
complication. There was no history of trauma either. Which of the following is the most likely cause of this patient's
intraabdominal bleeding?

A. Ectopic

B. Ruptured
abdominal aortic aneurysm

C. Ruptured
hepatic adenoma

D. Ruptured

E. Ruptured
visceral aneurysm








could u give the reason for E and why not due to a ruptured uterus thanks Dr. illiac


i think its c-ruptured hepatic adenoma........more common in pregnancy..

what visceral aneurysm? i mean which viscera has aneurysm commonly which is predisposed to rupture during pregnancy ?

any discussions invited


I think it's C, too. A ruptured visceral aneurysm would cause pain, wouldn't it?


I thnk it could be C also but the thing is i thought that OCPs prone a female to hepatic adenomas and it seems it's either that or E (but she has no prior h/o urterine surgery so that makes it less likey).....anyone else please give some input into the thinking i have for this q


A. Ectopic

!!!!!!!why not? may because she denis pain
B. Ruptured
abdominal aortic aneurysm
!!!!!!!!!!!!not at this age & no pain

C. Ruptured
hepatic adenoma
no h/o o.c.p

D. Ruptured
no pain -not in labor -no h/o overdestension abdomen

E. Ruptured
visceral aneurysm
!!!!!!!!!!! what is visceral aneurysem!!!!!!!!!
why not a? is it because no pain?
what & why is e?
thanks for Qrolling eyes


i was looking through some old stuff and came across this post again.....yes the answer is E for this patient

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