10-06-2008, 02:36 PM
A 24-year-old woman develops moderate, generalized abdominal pain of sudden onset and shortly thereafter faints. At the time of evaluation in the emergency department, she has regained consciousness, is pale, and has a blood pressure of 95/70 mm Hg and a faint pulse rate of 90/min. The abdomen is mildly distended and tender, with normal bowel sounds. Her hemoglobin is 7 g/dL. There is no history of trauma, but it is suspected that she might be bleeding into her abdomen, and a diagnostic peritoneal lavage is performed. The study shows that there is free blood in the peritoneal cavity. She denies the possibility of pregnancy because she has been on birth control pills since the age of 14 and has never missed taking them. Pelvic examination is normal, and a pregnancy test is negative. At laparotomy, the surgeons are likely to find which of the following?
A. Bleeding ovarian follicle
B. Ruptured abdominal aortic aneurysm
C. Ruptured ectopic pregnancy
D. Ruptured hepatic adenoma
E. Ruptured hepatic artery aneurysm
A. Bleeding ovarian follicle
B. Ruptured abdominal aortic aneurysm
C. Ruptured ectopic pregnancy
D. Ruptured hepatic adenoma
E. Ruptured hepatic artery aneurysm