[38F] With severe abdominal pain and heavy bleeding with clots

Patient Description

A 38-year-old female reports experiencing sharp, stabbing pain in her right side, located above the hip and below the last rib, for the past 3 days. The pain is described as severe, with a rating of 10 out of 10, and it comes and goes. Additionally, the patient started experiencing heavy bleeding with blood clots yesterday, with the clots increasing in size to that of a golf ball. The clots are dark red and light red mixed, resembling cranberry sauce. The patient also reports having bad headaches. No relief measures have been identified for the abdominal pain. The last bowel movement was yesterday afternoon. No mention of nausea or vomiting.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few serious conditions that could be causing your symptoms:

  1. Severe Menstrual Bleeding (Menorrhagia): Heavy menstrual bleeding with large blood clots can be a sign of menorrhagia. This condition can lead to significant blood loss and anemia, which might explain your severe headaches and overall weakness.

  2. Ectopic Pregnancy: If you are of childbearing age and sexually active, an ectopic pregnancy (where a fertilized egg implants outside the uterus) could cause severe abdominal pain and heavy bleeding. This is a medical emergency.

  3. Pelvic Inflammatory Disease (PID): This infection of the female reproductive organs can cause severe pain, heavy bleeding, and clots. It requires prompt treatment to prevent complications.

  4. Uterine Fibroids: These noncancerous growths in the uterus can cause heavy menstrual bleeding, pain, and large blood clots.

  5. Ovarian Cyst Rupture: A ruptured ovarian cyst can cause sudden, severe pain and bleeding.

What you can do

Given the severity of your symptoms, it is crucial to seek immediate medical attention. Here are the steps you should take:

  1. Go to the Emergency Room: Given the heavy bleeding, large clots, and severe pain, you should go to the nearest emergency room immediately. If you are unable to get there yourself, call 911 or have someone drive you.

  2. Monitor Your Symptoms: While waiting for medical help, keep track of your symptoms. Note any changes in pain, bleeding, or other symptoms.

  3. Stay Hydrated: Drink water to stay hydrated, but avoid eating or drinking anything else until you have been evaluated by a healthcare professional.

  4. Rest: Try to stay as still and comfortable as possible to avoid worsening the pain or bleeding.

Remember, I am not a doctor, and it is essential to get a formal diagnosis and treatment from a healthcare professional. Your symptoms are serious and require immediate medical attention. Please seek care right away.

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5 mo ago

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People Also Ask

What are the common causes of severe menstrual bleeding with large blood clots?

Common causes of severe menstrual bleeding with large blood clots include uterine fibroids, hormonal imbalances, polyps, and conditions like menorrhagia. It is important to consult a healthcare provider for a proper diagnosis.

How can I differentiate between normal menstrual pain and pain that requires medical attention?

Normal menstrual pain is usually mild to moderate and can be managed with over-the-counter pain relief. Pain that is severe, sudden, or accompanied by heavy bleeding, large clots, or other symptoms like dizziness or fainting requires immediate medical attention.

What are the symptoms of an ectopic pregnancy?

Symptoms of an ectopic pregnancy can include sharp, stabbing abdominal pain, heavy vaginal bleeding, dizziness, and shoulder pain. It is a medical emergency and requires immediate attention.

What should I do if I suspect I have a ruptured ovarian cyst?

If you suspect a ruptured ovarian cyst, you should seek medical attention immediately. Symptoms can include sudden, severe abdominal pain, bloating, and sometimes bleeding. A healthcare provider can perform tests to confirm the diagnosis and recommend appropriate treatment.

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