Singap Med J
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Idiopathic thrombocytopenic purpura, an immune-mediated disease, usually has a relatively benign clinical course. Bleeding manifestations are mostly mucocutaneous and mild. Massive haemorrhages requiring transfusions or other interventions are rare, unless platelet counts are extremely low or other complicating conditions coexist. ⋯ We describe a 24-year-old Filipino woman presenting with severe abdominal pain and intra-abdominal haemorrhage requiring laparotomy, which revealed massive haemoperitoneum and a ruptured ovarian follicle. She had thrombocytopenia secondary to previously undiagnosed idiopathic thrombocytopenic purpura. This case illustrates how a combination of two otherwise common and benign clinical entities can result in a rare and potentially life-threatening event.
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Foreign body inhalation in children is not uncommon, and may escape notice by the parents as well as the physicians, because of the lack of knowledge of the exact history and inconclusive radiographical findings. ⋯ Rigid bronchoscopy usually gives good results in detecting airway foreign bodies. It should be performed at the earliest opportunity even when the definitive history is not forthcoming and the chest radiograph is inconclusive.