Lydia had been admitted for 2 days in another private hospital because of weakness of the body and feeling to faint.
The other facility attributed the symptoms to malaria and they prescribed for her oral malarial treatment. The patient was also found to be anemic, and the condition was related to the hemolysis caused by malaria. Therefore she was also prescribed hematinics and she was discharged with the indication of doing an abdominal ultrasound as outpatient and of taking back the report to that hospital later.
In the discharge paper there was no reason given for the prescribed sonography and the only diagnosis written was “anaemia secondary to malaria”.
The patient was referred to a private doctor for the ultrasound and she was verbally told not to come to Chaaria for the same, “because our ultrasounds are substandard”.
I felt very bad when the patient told me like that because it was not the first time and I find very unprofessional when a colleague is sending such unjust and fake messages about our hospital: I have been doing ultrasounds for the last 20 years!
Nevertheless, I decided to forget the pain and to perform the requested examination.
Actually the ultrasound was extremely clear and useful: in spite of somebody calling our tests substandard, we were immediately able to diagnose a ruptured ectopic pregnancy with a lot of blood in the abdominal cavity.
We repeated an urgent full hemogram and we found that the patient had lost 2 grams of HB from the morning, when she had been discharged from the other hospital, up to 6.30 pm when we had received her in outpatients’ department.
Now she had an HB of 4 grams/dl, and we had to organize for urgent grouping and cross matching.
The staff of the theater has been wonderful as usual, and we were able to start the operation in 20 minutes’ time.
The procedure was successful, although we were literally flooded by the enormous amount of blood collected in the peritoneal cavity.
The blood in our bank was fortunately enough: we transfused the patient in theater first, and then overnight.
The following day Lydia was well and able to sit in bed. The malaria slide was absolutely negative.
It is my opinion that in the other facility there was a misdiagnosis and that the weakness of the body, the fainting and the anemia were not at all related to any malaria, but rather to an ectopic pregnancy which had been missed by the other clinicians.
On the other end, in spite of being a substandard hospital, as some colleagues are assuming, we were able to make the correct diagnosis on the spot, and to save the life of the patient with a timely operation.
Bro Beppe Gaido
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