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一例子宫切除术后八年发生的输卵管异位妊娠病例,诊断颇具挑战性。

A Case of Ectopic Tubal Pregnancy Eight Years After a Hysterectomy Presenting as a Diagnostic Challenge.

作者信息

Ilea Ciprian, Stoian Irina, Carauleanu Daniela, Socolov Demetra

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.

Department of Obstetrics and Gynecology, Cuza Vodă University Hospital, Iasi, Romania.

出版信息

Am J Case Rep. 2019 Oct 31;20:1596-1600. doi: 10.12659/AJCR.918894.

Abstract

BACKGROUND Ectopic pregnancy after hysterectomy is extremely rare, and the diagnosis can be challenging, even with modern imaging methods. A rare case is presented of ectopic tubal pregnancy in a 28-year-old woman that presented eight years following a hysterectomy. CASE REPORT A 28-year-old woman was admitted in our hospital with moderate hypogastric pain, mild vaginal bleeding, and bilateral mastalgia. She had undergone hysterectomy eight years previously for postpartum hemorrhage. Pelvic ultrasound showed a heterogeneous tissue mass in the pelvis with peripheral vascularity that was also seen on magnetic resonance imaging (MRI). Laboratory tests showed increased serum levels of human chorionic gonadotropin (hCG). Following hospital admission, she developed an acute abdomen and shock due to tubal rupture and an emergency salpingectomy was performed. CONCLUSIONS A multidisciplinary approach to diagnosis and management facilitated an accurate and timely diagnosis in a rare case of ectopic pregnancy that presented eight years following hysterectomy, but could not prevent the development of potentially life-threatening complications.

摘要

背景

子宫切除术后异位妊娠极为罕见,即使采用现代成像方法,诊断也颇具挑战性。本文报道一例罕见病例,一名28岁女性在子宫切除术后八年发生输卵管异位妊娠。病例报告:一名28岁女性因中度下腹疼痛、轻度阴道出血和双侧乳房疼痛入住我院。她八年前因产后出血接受了子宫切除术。盆腔超声显示盆腔内有一个不均匀的组织肿块,周边有血管,磁共振成像(MRI)也显示了这一情况。实验室检查显示血清人绒毛膜促性腺激素(hCG)水平升高。入院后,她因输卵管破裂出现急腹症和休克,随后进行了急诊输卵管切除术。结论:多学科的诊断和管理方法有助于对子宫切除术后八年发生的罕见异位妊娠病例进行准确及时的诊断,但无法预防可能危及生命的并发症的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcf9/6849500/0151f85c73ff/amjcaserep-20-1596-g001.jpg

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本文引用的文献

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Ectopic pregnancy after total abdominal hysterectomy.全腹子宫切除术后的异位妊娠。
J Obstet Gynaecol. 2014 Jan;34(1):90. doi: 10.3109/01443615.2013.830598.
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Ruptured ectopic pregnancy 11 years after supracervical hysterectomy: a case report.子宫颈上子宫切除术后11年发生的异位妊娠破裂:一例报告
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