Joshi Utsav, Upadhaya Sandesh Raj, Agrawal Vishakha, Rana Ashma
Department of Obstetrics and Gynecology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Int Med Case Rep J. 2020 Jul 8;13:255-259. doi: 10.2147/IMCRJ.S263298. eCollection 2020.
Hemoperitoneum resulting from the rupture of pancreatic tumors is a rare condition, especially during pregnancy.
We report a case of a 21-year-old gravida 2, para 1, at 25+5 weeks of gestation, who presented to the hospital with severe epigastric pain and decreased fetal movement. Ultrasonography showed intrauterine fetal death, a retroperitoneal mass in the epigastric region, and hemoperitoneum. Computed tomography scan revealed a heterogeneously enhancing pancreatic mass suggestive of pancreatic neoplasm. However, the late diagnosis and the delay in treatment resulted in a deterioration of maternal status with eventual mortality.
Diagnostic difficulties occur because of the rarity of the condition and vague clinical presentations. In case of a pregnancy complicated by hemoperitoneum, prompt effort to stop the intraperitoneal bleeding is imperative.
胰腺肿瘤破裂导致的腹腔积血是一种罕见情况，尤其是在孕期。
我们报告一例21岁孕妇，孕2产1，妊娠25⁺⁵周，因严重上腹部疼痛和胎动减少入院。超声检查显示宫内胎儿死亡、上腹部区域腹膜后肿块及腹腔积血。计算机断层扫描显示胰腺肿块不均匀强化，提示胰腺肿瘤。然而，诊断延迟及治疗延误导致产妇病情恶化，最终死亡。
由于该疾病罕见且临床表现模糊，诊断存在困难。对于合并腹腔积血的妊娠病例，必须迅速采取措施制止腹腔内出血。
