Department of Gynecology and Obstetrics, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China (all authors).
Department of Gynecology and Obstetrics, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China (all authors)..
J Minim Invasive Gynecol. 2021 Sep;28(9):1662-1665. doi: 10.1016/j.jmig.2021.05.008. Epub 2021 May 19.
A retroperitoneal ectopic pregnancy is an extremely rare type of ectopic pregnancy and is difficult to diagnose and treat. Owing to its occult onset, it is life-threatening and often associated with high mortality. A 28-year-old woman was admitted to the emergency department of our hospital owing to soreness of the left lower quadrant of the abdomen and amenorrhea for 60 days. Dilatation and curettage were performed at a local hospital to induce abortion, but no gestational sac was found. Elevated plasma human chorionic gonadotropin levels suggested an ectopic pregnancy. An ultrasound showed an approximately 4.0 cm × 3.0 cm mass in front of the middle and upper poles of the left kidney. The plasma beta-human chorionic gonadotropin level was 99 286.00 mIU/mL. Under laparoscopy, an ovoid mass measuring approximately 4.0 cm × 5.0 cm below the left renal vessels and the abdominal aorta was successfully resected. Methotrexate (50 mg/m) was locally injected, and the retroperitoneum was sutured. Villi were observed in histopathologic sections. This case report highlights the importance of considering the possibility of a retroperitoneal ectopic pregnancy for patients with abdominal pain. Laparoscopic surgery by an experienced surgeon is the preferred method of treatment for this condition.
腹膜后宫外孕是一种极其罕见的宫外孕类型，难以诊断和治疗。由于其隐匿性发病，具有生命威胁性，常伴有高死亡率。一名 28 岁女性因左下腹疼痛和闭经 60 天就诊于我院急诊科。在当地医院行扩宫及刮宫术以进行流产，但未发现妊娠囊。血浆人绒毛膜促性腺激素水平升高提示宫外孕。超声显示左肾中上极前方有一约 4.0 cm×3.0 cm 的肿块。血浆β-人绒毛膜促性腺激素水平为 99 286.00 mIU/mL。腹腔镜下成功切除左肾血管和腹主动脉下方的卵圆形肿块，大小约 4.0 cm×5.0 cm。局部注射甲氨蝶呤（50 mg/m），缝合后腹膜。组织病理学切片可见绒毛。本病例报告强调了对于腹痛患者应考虑腹膜后宫外孕的可能性。有经验的外科医生进行腹腔镜手术是该疾病的首选治疗方法。
