Tanase Yasuhito, Yoshida Shozo, Furukawa Naoto, Kobayashi Hiroshi
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Asian J Endosc Surg. 2013 Nov;6(4):327-9. doi: 10.1111/ases.12056.
A 32-year-old gravid 1, parity 0 woman was referred to our hospital with suspicion of ectopic pregnancy 31 days after her previous menstrual period. She had a 5-month history of secondary infertility reported increasing lower abdominal pain. Her serum human chronic gonadotropin level was 8160 mIU/mL. Her medical history was significant for a myomectomy and an enucleation of left ovarian cyst. On suspicion of an ectopic pregnancy, laparoscopic exploration was performed. Dense pelvic adhesion was seen. After dissection of the adhesion, we could not find the blastocyst in her pelvis. Early pregnancy tissue implanted in the omentum was identified and was excised laparoscopically. The postoperative course was uneventful. When no ectopia is found in the fallopian tubes during laparoscopy or laparotomy for ectopic pregnancy, all peritoneal surfaces and the omentum must be carefully inspected during surgery.
一名32岁初孕0产的女性，在末次月经后31天因疑似异位妊娠被转诊至我院。她有5个月的继发性不孕病史，自述下腹部疼痛加重。她的血清人绒毛膜促性腺激素水平为8160 mIU/mL。她的病史中有子宫肌瘤切除术和左卵巢囊肿摘除术。因怀疑异位妊娠，进行了腹腔镜探查。可见盆腔粘连致密。粘连松解后，未在盆腔内发现胚囊。发现早期妊娠组织植入大网膜，并通过腹腔镜切除。术后过程顺利。在因异位妊娠进行腹腔镜检查或剖腹手术时，若在输卵管中未发现异位妊娠，手术过程中必须仔细检查所有腹膜表面和大网膜。
