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腹膜后异位妊娠的诊断与手术治疗:一例报告

Diagnosis and surgical therapy of the retroperitoneal ectopic pregnancy: A case report.

作者信息

Yang Yizhuo, Liu Zhongyu, Song Lei, Liu Hui, Li Lian, Meng Yuanguang

机构信息

Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China.

Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China.

出版信息

Int J Surg Case Rep. 2018;49:21-24. doi: 10.1016/j.ijscr.2018.05.027. Epub 2018 Jun 9.

Abstract

INTRODUCTION

Retroperitoneal ectopic pregnancy (REP) is a rare type of gestation that is difficult to diagnose and treat. To date, only several published cases are available and no specific guideline has been developed to manage this disease. As the lesions are located closely to the large retroperitoneal blood vessels, surgical resection of the gestational tissue might incur risks such as associated hemorrhage, injury of blood vessels or nerves. On the other hand, the therapeutic effect of conservative treatment using methotrexate is not satisfactory.

PRESENTATION OF CASE

A case of retroperitoneal ectopic pregnancy which was diagnosed in the PLA general hospital was reported here. A 34-year-old woman, gravida 2, parturition 0, was admitted via the emergency department on July 7, 2015 with the main complaint of missed period for 52 days and bellyache for 16 h.

DISCUSSION

The mechanisms of retroperitoneal embryo migration and related literatures are reviewed and discussed.

CONCLUSION

We have presented a scarce case of REP. As the ectopic pregnancy could not be readily detected by laparotomy, unusual locations such as the retroperitoneum should be carefully examined.

摘要

引言

腹膜后异位妊娠(REP)是一种罕见的妊娠类型,诊断和治疗都很困难。迄今为止,仅有几例已发表的病例,尚未制定出针对该病的具体治疗指南。由于病变部位紧邻腹膜后大血管,手术切除妊娠组织可能会引发相关出血、血管或神经损伤等风险。另一方面,使用甲氨蝶呤进行保守治疗的效果并不理想。

病例介绍

本文报道了一例在解放军总医院确诊的腹膜后异位妊娠病例。一名34岁女性,孕2产0,于2015年7月7日经急诊科入院,主要主诉为停经52天,腹痛16小时。

讨论

对腹膜后胚胎迁移的机制及相关文献进行了回顾和讨论。

结论

我们呈现了一例罕见的腹膜后异位妊娠病例。由于剖腹探查不易发现异位妊娠,对于诸如腹膜后等不寻常部位应仔细检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ae6/6010971/fc8c07b6f382/gr1.jpg

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