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多囊卵巢综合征患者的原发性肝异位妊娠:一例报告

Primary hepatic ectopic pregnancy in a patient with polycystic ovary syndrome: A case report.

作者信息

Zhang Ning, Yang Linqing, Wang Yunfei, Li Xiaoyu, Zhang Chao, Xu Jing

机构信息

School of Clinical Medicine, Jining Medical University.

Departments of Gynecology.

出版信息

Medicine (Baltimore). 2020 Mar;99(13):e19649. doi: 10.1097/MD.0000000000019649.

Abstract

RATIONALE

Hepatic ectopic pregnancy is an extremely rare ectopic pregnancy. This study aimed to report a case of primary hepatic pregnancy in a patient with polycystic syndrome.

PATIENT CONCERNS

A 30-year-old woman presented with vaginal bleeding after 63 days of amenorrhea.

DIAGNOSIS

The patient was initially diagnosed with liver ectopic pregnancy using abdominal ultrasound and abdominal computed tomography (CT).

INTERVENTIONS

The patient underwent laparoscopic exploration to reconfirm the gestational sac in the liver and abdominal surgery to remove liver gestation. The postoperative review of abdominal CT and the level of serum human chorionic gonadotropin (hCG) was performed.

OUTCOMES

The postoperative pathological examination revealed a fluffy tissue in the liver tissue and a blood clot. The patient's vital signs were normal, and she was advised regular follow-up after discharge from the hospital. One month later, the serum hCG level reduced to 0.32 mIU/mL (reference range 0-5 mIU/mL).

LESSONS

If the level of beta-human chorionic gonadotropin (β-HCG) is higher than normal in women of childbearing age and no gestational sac is found in the uterine cavity, the location of pregnancy and gestational sac should be positively confirmed. Also, the possibility of ectopic pregnancy in the abdominal cavity should be considered, and the relevant imaging and biochemical examinations should be improved to avoid delay in diagnosis and treatment.

摘要

原理

肝异位妊娠是一种极其罕见的异位妊娠。本研究旨在报告一例多囊综合征患者的原发性肝妊娠病例。

患者情况

一名30岁女性在闭经63天后出现阴道出血。

诊断

患者最初通过腹部超声和腹部计算机断层扫描(CT)被诊断为肝异位妊娠。

干预措施

患者接受了腹腔镜探查以再次确认肝脏中的妊娠囊,并进行了腹部手术以切除肝脏妊娠物。术后对腹部CT和血清人绒毛膜促性腺激素(hCG)水平进行了复查。

结果

术后病理检查显示肝脏组织中有绒毛状组织和血凝块。患者生命体征正常,出院后建议定期随访。一个月后,血清hCG水平降至0.32 mIU/mL(参考范围0 - 5 mIU/mL)。

经验教训

育龄期女性若β-人绒毛膜促性腺激素(β-HCG)水平高于正常且宫腔内未发现妊娠囊,应积极明确妊娠及妊娠囊位置。同时,应考虑腹腔异位妊娠的可能性,完善相关影像学及生化检查,避免延误诊治。

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