Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan.
J Minim Invasive Gynecol. 2012 Sep-Oct;19(5):647-50. doi: 10.1016/j.jmig.2012.03.024.
A 26-year-old primigravida patient was referred with suspicion of ectopic pregnancy 39 days after her last menstrual period. Her serum β-human chorionic gonadotropin value was 3812 mIU/mL. As we suspected the existence of ectopic pregnancy with bilateral dermoid cysts, laparoendoscopic single-site surgery was performed. After dissection of dense pelvic adhesion, cystectomy was performed for a left ovarian dermoid cyst. Although there was a right ovary at the correct position, a parasitic dermoid cyst firmly attached to the peritoneal surface of cul-de-sac was identified. After excision of the parasitic dermoid cyst, early abdominal pregnancy tissue implanted in the peritoneal hollow of right deep pararectal space was identified under the guidance of diffusion-weighted magnetic resonance imaging and was excised. With systemic administration of methotorexate, the postoperative course was uneventful.
一位 26 岁的初产妇，末次月经后 39 天，因疑似异位妊娠被转介。血清β-人绒毛膜促性腺激素值为 3812 mIU/mL。我们怀疑存在双侧卵巢皮样囊肿的异位妊娠，因此进行了腹腔镜单孔手术。在分离致密的盆腔粘连后，行左侧卵巢皮样囊肿切除术。虽然在正确的位置上有右侧卵巢，但识别出一个寄生性皮样囊肿，它牢固地附着在子宫直肠窝的腹膜表面上。切除寄生性皮样囊肿后，在弥散加权磁共振成像的引导下，发现右深部直肠旁间隙腹膜隐窝内有早期腹内妊娠组织，并将其切除。术后给予甲氨蝶呤全身治疗，过程顺利。
