On Jan. 8, 2008, Nicole Yerkovich, who was 35 at the time, was taken by ambulance to the emergency department at LaGrange Memorial Hospital because of severe abdominal pain and nausea. The ER doctor at the hospital ordered a contrast CT scan of her abdomen and pelvis to see if she was suffering from an appendicitis attack. The CT scan was initially read by a teleradiologist who reported she could not visualize the appendix and therefore could not rule out appendicitis. The teleradiologist recommended the hospital’s doctors obtain the delayed images to get better visualizations of the appendix and noted a moderate amount of free fluid in the pelvis, which could have been due to a ruptured cyst.
The following morning, the in-house radiologist, Dr. Vladislav Gorengaut, reviewed the same CT scan and reported there were no definite findings to suggest appendicitis. He noted there were ascites, which may be caused by peritonitis, and there could be a gynecological issue such as a ruptured hemorrhagic ovarian cyst. Ascites refer to the accumulation of fluid in the peritoneal cavity in the abdominal area.
Based upon the first report of Dr. Gorengaut, the emergency department doctor canceled the delayed CT scan and instead admitted Yerkovich to gynecology and ordered a pelvic ultrasound. Dr. Gorengaut read the ultrasound and reported there was echogenic fluid most likely representing blood from a ruptured ovarian cyst.
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