RESUMO
Obstructive jaundice is one of the most common presentations of pancreatic cancer. Often the patients present when curative surgical resection is not possible due to late diagnosis. In these cases, palliation is the only option available. However in such cases, endoscopic retrograde cholangiopancreatography [ERCP] is not possible because of surrounding extensive inflammation. This study describes percutaneous transhepatic external biliary drain placement in patients with cancer of pancreatic head when surgical removal is not possible
RESUMO
Ectopic pregnancy [EP] is one of the leading causes of maternal mortality. Its frequency in Pakistan is 1:13 pregnancy.1 Tubal ectopic often becomes symptomatic in first trimester by eroding the tubal wall and causing hemorrhage and shock. It is very rare for an ectopic to progress into second trimester and remain asymptomatic2. We are reporting a rare case of tubal ectopic pregnancy which ruptured at 16 weeks of gestation with non-viable fetus. We report a case of 27-year-old female who presented to the emergency of Dr. Zia Uddin Hospital, North Nazimabad, Karachi, with bleeding per vagina and abdominal pain with history of 4 months of amenorrhea. Ultrasound showed 16 weeks fetus in abdomen without cardiac activity and severe hemoperitoneum. She was diagnosed as a case of non-viable, ruptured, tubal ectopic pregnancy of 16-week gestational age. Diagnosis of ectopic pregnancy in first trimester can avert rupture and potential mortality and morbidity. Very few cases of second trimester ectopic pregnancy are reported. The purpose of this case report is to draw the attention for the potential of such incidence in this region and prompt management of such situation.