甲氨蝶呤治疗持续性宫外孕后，由于异位组织的被忽视的网膜植入导致严重的腹腔内出血。
Severe intra-abdominal bleeding from neglected omental implantation of ectopic tissue after methotrexate treatment for persistent ectopic pregnancy.
机构信息
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei City, Taiwan.
出版信息
Fertil Steril. 2011 Jun;95(7):2435.e1-3. doi: 10.1016/j.fertnstert.2011.01.165. Epub 2011 Feb 19.
OBJECTIVE
To describe a case of severe intra-abdominal bleeding from omental implants after laparoscopic linear salpingostomy for ectopic pregnancy (EP).
DESIGN
Case report.
SETTING
A medical center.
PATIENT(S): A 27-year-old woman, presenting 15 days after methotrexate (MTX) treatment for persistent EP (35 days after laparoscopic linear salpingostomy for EP).
INTERVENTION(S): Partial omentectomy.
MAIN OUTCOME MEASURE(S): Serial β-hCG levels after partial omentectomy.
RESULT(S): Histopathologic examination confirmed omental pregnancy. Her β-hCG levels decreased rapidly from 1,673 mIU/mL to 1.35 mIU/mL within 14 days after partial omentectomy.
CONCLUSION(S): Persistent EP after laparoscopic linear salpingostomy can occur in the omentum; meticulous clinical follow-up should be performed, especially when IM MTX injection was used as the salvage treatment for persistent EP.
目的
描述一例腹腔镜线性输卵管切开术治疗异位妊娠（EP）后网膜种植引起严重腹腔内出血的病例。
设计
病例报告。
地点
一家医疗中心。
患者
一名 27 岁女性，在接受甲氨蝶呤（MTX）治疗持续性 EP（腹腔镜线性输卵管切开术治疗 EP 后 35 天）后 15 天就诊。
干预措施
部分网膜切除术。
主要观察指标
部分网膜切除术后β-hCG 水平的变化。
结果
组织病理学检查证实为网膜妊娠。部分网膜切除术后 14 天内，她的β-hCG 水平从 1673mIU/mL 迅速降至 1.35mIU/mL。
结论
腹腔镜线性输卵管切开术治疗后持续性 EP 可发生在网膜上；应进行仔细的临床随访，尤其是当 IM MTX 注射作为持续性 EP 的挽救性治疗时。
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