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资源匮乏地区残角子宫妊娠破裂的诊断与处理

Diagnosis and management of a ruptured rudimentary horn pregnancy in a low-resource setting.

作者信息

Nathan Hannah, Sornum Alvin

机构信息

Department of Obstetrics, Lower Umfolozi District War Memorial Hospital, Empangeni, KZN, South Africa.

出版信息

BMJ Case Rep. 2013 Jun 6;2013:bcr2013009957. doi: 10.1136/bcr-2013-009957.

Abstract

A 22-year-old woman presented with amenorrhoea, lower abdominal pain and brown vaginal discharge. She was noted to be in hypovolaemic shock with a distended and peritonitic abdomen. On bimanual examination, the uterus was not palpated, the posterior fornix was full and cervical excitation was present. A clinical diagnosis of a ruptured ectopic pregnancy was made. She was resuscitated and an emergency laparotomy was performed. Intraoperatively, a ruptured rudimentary horn with an ex utero pregnancy was discovered. The right horn and tube were removed, as was the non-viable fetus. There were no postoperative complications and the patient was discharged after 5 days of observation.

摘要

一名22岁女性出现闭经、下腹部疼痛及阴道褐色分泌物。她被发现处于低血容量性休克状态,腹部膨隆且有腹膜炎体征。双合诊检查时,未触及子宫,后穹窿饱满且有宫颈举痛。临床诊断为异位妊娠破裂。对她进行了复苏并实施了急诊剖腹手术。术中发现一个残角子宫破裂伴子宫外妊娠。切除了右侧角部及输卵管,同时取出了未存活的胎儿。术后无并发症,患者经5天观察后出院。

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