Can Surgery Be Avoided? Exclusive Antibiotic Treatment for P
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Case Presentation
A 42-year-old Caucasian female, gravida 3 para 1 (1 spontaneous vaginal delivery and 2 elective abortions), was admitted with a 2-month history of diffuse abdominal pain, decreased appetite, nausea, vomiting, abdominal distention, weakness, and a twenty-pound unintentional weight loss. Her history was significant for a twenty-eight-pack-year tobacco use and a copper IUD placed approximately fifteen years earlier.

On admission, the patient was found to be cachectic, tachycardic, and tachypneic but afebrile. Her abdomen was moderately distended, tender to palpation throughout but without acute peritoneal signs. It was diffusely tympanic but dull over bilateral lower quadrants, with hypoactive bowel sounds. External genitalia and vagina were normal. Cervix was parous in appearance with two strings visualized from the cervical os; IUD was removed and sent for microbiologic studies. Uterus was difficult to palpate secondary to pain and adnexal tenderness. Adnexa were diffusely tender with bilateral fullness. Rectal exam showed normal tone and normal rectovaginal septum with fullness palpated anteriorly....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337310/
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