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Placental Abruption
Gangrenous Cholecystitis
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Placental Abruption
- Suspect in blunt abdominal trauma
- Clinical diagnosis – suspect with vaginal bleeding (though 20% don’t have bleeding), abdominal/back pain, fetal distress. US is only 25-50% sensitive – 88% PPV.
- If signs of fetal distress or maternal hemodynamic instability, management is delivery
- Complication include Rh alloimmunization and DIC
Gangrenous Cholecystitis
- Increased pressure in gallbladder causes impaired gallbladder wall perfusion and progresses to gangrene
- Up to 2/3 will not have a Murphy’s sign due to denervation of the gallbladder
- Suspect in older patients, leukocytosis >17K, and comorbidities (CAD, DM)
- 22% mortality
- Surgical emergency
