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Think outside the box

While investigating a patient's dyspnea, physicians made an unusual discovery
Published:November 03, 2008DOI:https://doi.org/10.1016/j.ajog.2008.08.036
      A 73-year-old female presented with a 1-week history of progressive dyspnea. Six months earlier, she had been diagnosed with an International Federation of Gynecology and Obstetrics grade 3 uterine papillary serous carcinoma. Computed tomography (CT) of the thorax disclosed bilateral pulmonary emboli; a CT of the abdomen indicated retention of gastric contents, which suggested delayed gastric emptying (Figure 1). While anticoagulation was being initiated, the patient became hemodynamically unstable. In addition, evidence of melena was noted.
      Figure thumbnail gr1
      FIGUREComputed tomography (CT) demonstrated retained gastric contents with ascites in the left subphrenic space and 2 tiny, indeterminate, low-density lesions in the liver
      There were no enlarged lymph nodes in the paraaortic regions.
      Gleeson. Think outside the box. Am J Obstet Gynecol 2009.
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