---------------------- Forwarded by Margaret Walker/HAY/KPNC on 03/24/2000 02:07 PM ---------------------------


Margaret Walker
03/22/2000 06:49 PM
To:     [log in to unmask]@Internet, [log in to unmask]@Internet, [log in to unmask]@Internet, [log in to unmask]@Internet, [log in to unmask]@Internet, [log in to unmask]@Internet, Caroline Magruder/CA/KAIPERM@KAIPERM
cc:
Subject:        Blood bilaterally from infant breasts: any ideas?

An experienced colleague practicing general pediatrics in a different city encountered an unusual patient yesterday and would love to receive suggestions from other MD's as we are puzzled. Her patient is age 3 1/2 months. He is status-post corrective surgery for transposition of the great vessels. He did well, and has been off all medications for 1-2 months. Yesterday his parents brought him to the doctor for the problem of blood spots noticed on the baby's shirt. The pediatrician examined the surgical scar and the chest tube scar very carefully and they were normal. When she touched one breast (not with any significant pressure) , fresh blood exited from the duct. When she gently touched the areola on the other side, a little bit of dark old blood exited from that duct. There is no palpable breast tissue, no milk production, no erythema or swelling, and nothing that looks like an infection. When she examined the ducts with a magnifying lens, she was unable to identify any fis!
sure at the opening of the duct.
Does this sound familiar to anyone? What possibilities should the pediatrician be considering? Thank you for any help you can give; I will forward it to the pediatrician. Margaret Walker MD, Hayward Kaiser Hospital, Hayward California USA.

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