Section of Reproductive Endocrinology, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20 Section 3 of South Renmin Road, Chengdu, Sichuan Province, 610041, China.
BMC Pregnancy Childbirth. 2017 Oct 16;17(1):358. doi: 10.1186/s12884-017-1542-y.
Retroperitoneal ectopic pregnancy (REP) is an extremely rare type of ectopic pregnancy, with a total of less than 20 cases reported in the English literature. However, failure to recognize REP may result in severe consequences.
We report a case of 32-year-old woman with REP. She had amenorrhea, left lower abdominal pain, but no vaginal bleeding. Her urine human chorionic gonadotropin (HCG) test was positive and blood HCG level was 1880 m-international units per milliliter (mIU/mL). Transvaginal ultrasound sonography showed a left adnexal mass. Laparoscopy found an enlarged uterus, normal right uterine tube and ovary, and normal left uterine tube. The left ovary was partly covered by a blood clot, but appeared normal after removing the clot. There was a 10-mm circular peritoneal defect located lateral to the left sacrocervical ligament, anterior to the left ovarian fossa, and next to the lower edge of the left broad ligament. The patient was diagnosed of having REP with the gestational tissues covered by the peritoneum. The REP was removed by laparoscopic surgery. Bleeding was stopped by bipolar coagulation and absorbable hemostatic cellulose. The patient recovered smoothly and was discharged on the next day after surgery. Her blood HCG returned to normal range 29 days after surgery.
REP is very rare, but in any suspected case of ectopic pregnancy, caution must be paid to find signs of REP when the common sites of ectopic pregnancy do not have any positive findings.
腹膜后宫外孕（REP）是一种极其罕见的宫外孕类型，英文文献中总共报道的病例不足 20 例。然而，未能识别 REP 可能会导致严重后果。
我们报告了一例 32 岁女性的 REP 病例。她出现闭经、左下腹疼痛，但无阴道出血。她的尿人绒毛膜促性腺激素（hCG）检测呈阳性，血 hCG 水平为 1880 毫国际单位/毫升（mIU/mL）。经阴道超声检查显示左侧附件区肿块。腹腔镜检查发现子宫增大，右侧输卵管和卵巢正常，左侧输卵管正常。左卵巢部分被血块覆盖，但在清除血块后外观正常。在左侧骶棘韧带外侧、左卵巢窝前、左阔韧带下缘附近有一个 10 毫米的圆形腹膜缺损。患者被诊断为腹膜覆盖的 REP，妊娠组织位于腹膜后。通过腹腔镜手术切除了 REP。通过双极电凝和可吸收止血纤维素止血。患者恢复顺利，术后第二天出院。她的血 hCG 在术后 29 天恢复正常范围。
REP 非常罕见，但在任何疑似宫外孕的情况下，当常见的宫外孕部位没有任何阳性发现时，必须谨慎寻找 REP 的迹象。
