Subaqua Sternal Rubs

Tis better to be thought a fool, then to open your mouth and remove all doubt.

Unfortunately, I seemed to forget this wise old adage during today's radiology rotation. When called up to identify an unknown lesion on a plain abdominal x-ray, I examined the abnormal area closely with a magnifying glass. All of a sudden, without thinking, I blurted out, "blastocyst." I mean, it was in the area of the ovary/fallopian tube, and it really did look like a little embryo, so I was thinking possibly an undiagnosed ectopic pregnancy (where the embryo implants somewhere along the fallopian tube, rather than in the uterus, where it should go.) Turns out I was way off — evidently I was looking at a tooth, a molar to be precise (not to mention the fact that a blastocyst is nowhere near an embryo where you can start to recognize a shape). The fact that there were other lesions that looked like incisors should have clued me in that my first inclination was way off. (A multi-gestational, i.e. triplets, etc., ectopic pregnancy? Not very likely. Duh.) In case you were wondering, this patient had an ovarian teratoma — basically a growth of normal tissues from more than one germ cell layer in the wrong place. After looking at films to determine the difference between normal gas and obstruction, different stones, and various inflammatory diseases (i.e. Ulcerative Colitis, Chron's, etc.), it was back to campus for evening lectures. Oh, joy! Well, at least the lectures were on Emergency Medicine.

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