J Korean Radiol Soc.
1982 Dec;18(4):859-864. 10.3348/jkrs.1982.18.4.859.
Plain abdominal and chest findings of ruptured ectopic pregnancies
- KMID: 2463257
- DOI: http://doi.org/10.3348/jkrs.1982.18.4.859
Abstract
- Intraperitoneal bleeding caused by ruptured ectopic pregnancy is a serious obstetrical emergency requiring accurate and prompt diagnosis and treatment to save the life. The plain X-ray of the abdomen is simple andnoninvasive method but a review of literature failed to disclose any previous systematic investigations andanalysis of plain x-ray findings of ruptured ectopic pregnancies except well known sign of free fluid ofperitoneal cavity which is obviously nonspecific, the present study has been undertaken to make a criticalanalysis of the plain abdonimal findings of ruptured ectopic pregnancies. In addition, plain chest film wereevaluated to aid the diagnosis of hemorrhagic nature of peritoneal fluid. The materials consisted of 64 cases ofsurgically proven ruptured ectopic pregnancies seen at St. Mary's Hospital and Holy Family Hospital, Catholic Medical college, during the period of Jan. 1979 through Dec. 1980. The results of the study are as follows; 1.Intraperitoeal fluid smaller in amount than 1 liter appeared as comb-like, new-moon, half-moon and full-moondensities in the minor pelvis. As the amount exceeds 1 liter, widening of paracolic gutter and obliteration of thehepatic angle occurred. 2. Indentation and displacement of the bladder and rectum were present in 29 cases (45%).3. Local ileus of considerable intensity occurred in LLQ and RUQ in 35%. Remakable gaseous distension of sigmoidcolon were noted in 30%. 4. Blurring of psoas muscle shadow took place in 33% and scoliosis in 11%. The curvature of lumbar scoliosis was directed away from the ruptured site of pregnance in the majority. 5. In the chest x-ray,the diameter of basal pulmonary artery appeared significantly reduced in acute group. On the other hand, thecardiothoracic ratio became slightly increased in non-acute group. These pulmonary arterial change and cardiomegaly seem to reflect acute and subacute blood loss, respectively.
