Kumbak Banu, Ozkan Zehra Sema, Simsek Mehmet
Department of Obstetrics and Gynaecology, Firat University, School of Medicine, Elazig, Turkey.
Eur J Contracept Reprod Health Care. 2011 Aug;16(4):319-21. doi: 10.3109/13625187.2011.577541. Epub 2011 May 4.
A 38-year-old woman presented, one year after bilateral tubal ligation, with vaginal bleeding, vomiting, and stupor. Ten days earlier, she had submitted to a dilatation and curettage for an unexpected intrauterine pregnancy. At the time of this presentation there was rebound tenderness and guarding on abdominal examination, and a 2.5 cm right adnexal mass was detected on transvaginal ultrasound together with free fluid in the pelvis. The serum level of beta-hCG was 8522 mIU/ml. At laparoscopy a right tubal pregnancy and a large haematocele in the pouch of Douglas were detected. A right salpingectomy and a bipolar electrocoagulation of the left tubo-cornual junction were performed laparoscopically.
Pregnancy after tubal sterilisation may be heterotopic and this possibility should be considered in the differential diagnosis.
一名38岁女性在双侧输卵管结扎术后一年出现阴道出血、呕吐和昏迷。十天前，她因意外的宫内妊娠接受了刮宫术。此次就诊时，腹部检查有反跳痛和肌紧张，经阴道超声检查发现右侧附件有一个2.5厘米的肿块，盆腔内有游离液体。血清β-hCG水平为8522 mIU/ml。腹腔镜检查发现右侧输卵管妊娠和Douglas窝有一个大血肿。腹腔镜下进行了右侧输卵管切除术和左侧输卵管子宫角交界处的双极电凝术。
输卵管绝育术后妊娠可能是异位妊娠，在鉴别诊断时应考虑到这种可能性。
