Just to share an experience while working in a resource-poor setting. A 26-year old woman was brought by her brother in law to the A&E department with history of lower abdominal pain for nearly 2 hours. She had her second child birth 5 months ago and reported her first menstrual bleed after the child birth 2 weeks ago although had only minimal bleeding just for 2 days with some abdominal pain. Her brother in law was my close friend and he caught hold of me to see her as I was in the A&E to see another patient.
She was already seen by the resident doctor who was waiting for the surgeon to see her after giving her intramuscular diclofenac for pain. She was in severe pain when I saw her and was pale. Abdominal examination showed diffuse hypogastric tenderness without any palpable organ enlargement. Her urine analysis, LFTs, renal functions, amylase, calcium levels and WBC count were…
