Laohaburanakit P, Treevijitsilp P, Tantawichian T, Bunyavejchevin S
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Reprod Med. 1999 Jun;44(6):551-5.
Tuboovarian abscess is an unusual obstetric complication that causes maternal and fetal morbidity and mortality.
A woman, G1, P0, with a 32-week pregnancy presented with abdominal pain. Physical examination on admission revealed fever and unremarkable abdominal signs. Eleven hours after admission, signs of peritonitis became prominent, necessitating emergency laparotomy. Surgical findings included an 8-cm, right, ruptured tuboovarian abscess with massive purulent contamination of the abdominal cavity. Cesarean hysterectomy with bilateral salpingo-oophorectomy was performed. Neither the newborn nor the mother had postoperative complications.
Since there are discrepancies in the incidences of tuboovarian abscess in pregnant and nonpregnant groups, the pathogenesis of tuboovarian abscess may be different in the two populations. In pregnancy, diagnosis and management are also more difficult than in the nonpregnant state. Clinical data may not reveal the diagnosis until surgery is mandatory. Because most pregnant women with tuboovarian abscesses are young, conservative surgery should be attempted if the pathology is limited to only one side of the adnexa and further reproduction is desired.
输卵管卵巢脓肿是一种罕见的产科并发症,可导致母婴发病和死亡。
一名初产妇,孕32周,因腹痛就诊。入院时体格检查发现发热,腹部体征不明显。入院11小时后,腹膜炎体征变得明显,需行急诊剖腹手术。手术发现右侧有一个8厘米的破裂输卵管卵巢脓肿,腹腔有大量脓性污染。行剖宫产子宫切除术及双侧输卵管卵巢切除术。新生儿和母亲术后均无并发症。
由于妊娠组和非妊娠组输卵管卵巢脓肿的发病率存在差异,两组人群中输卵管卵巢脓肿的发病机制可能不同。在妊娠期间,诊断和治疗也比非妊娠状态更为困难。直到必须进行手术时,临床资料才可能揭示诊断结果。由于大多数患有输卵管卵巢脓肿的孕妇较为年轻,如果病变仅限于附件的一侧且希望进一步生育,应尝试进行保守手术。