Presentation

Employee reached out to PHM seeking support for their 21-year-old daughter that was hospitalized for severe acute abdominal pain while vacationing in Mexico.  

Initial testing suggested severe constipation with intestinal blockage, but review by a gynecologist had identified concurrent bilateral ovarian teratomas.  

The gynecologist was proposing stat surgery to remove the patient’s left ovary due to a concern for ovarian torsion (aka twisting), which is a medical emergency, though this was not evident on available imaging.  

The proposed procedure was an open abdominal surgery with removal of the entire left ovary, risking this young patient’s future fertility. 

PHM Actions

PHM quickly took action, connecting with the mother by phone for a clinical intake and offering initial guidance on surgical recommendations and further testing.

Medical records were translated and reviewed by PHM’s in-house gynecology specialist, who concurred with the concern for torsion and recommended an ultrasound to evaluate further.  

PHM suggested surgery with a gynecologic oncologist for superior surgical training and advised asking about ovarian-sparing techniques to preserve the patient’s fertility.  

After the PHM-recommended ultrasound confirmed ovarian torsion, PHM provided reassurance that immediate surgical intervention was necessary.  

PHM also provided post-operative support, advising on the risks of flying and coordinating a medical transport to ensure safe return to the US.   

PHM further arranged for local follow-up within three days of return home to ensure proper continuity of care and optimal post-operative outcome.