The American journal of emergency medicine
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Case Reports
Pyometra: Atypical cause of pediatric abdominal pain following complicated appendicitis.
This case is significant to the practice of emergency medicine and describes a unique post-operative infection that to my knowledge has not been described in this age group or under this set of circumstances before. Pyometra is a rare disease that is classically seen in an older cohort, and not commonly on the differential for pediatric patients presenting to the ED with vaginal discharge and fever. While post operative complications such as abscesses may be common following a surgery, intrauterine infections in this context are rare and the treatment is unique. It is important for emergency physicians to have knowledge of pyometra to keep on their differential for abdominal pain and fever after surgery, as well as be familiar with its management and which consultants may need to get involved.
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First-trimester bleeding and pregnancy loss are common reasons for presentation to emergency departments. Women of childbearing age frequently receive urine and serum pregnancy tests, which are thought to be reliable markers of pregnancy. ⋯ Physicians should consider the use of ultrasonography to assess for pregnancy or retained fetal products in the appropriate patient, even with negative serum or urine markers of pregnancy.