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病例报告:异位妊娠——创伤情况下腹腔积血极罕见的原因。

Case report: Heterotopic pregnancy - A very unlikely cause of haemoperitoneum in trauma setting.

作者信息

Thant Phyu Cin, Isabel Luis

机构信息

Department of Surgery, Royal Darwin Hospital, Northern Territory, Australia.

Royal Darwin Hospital, Northern Territory, Australia.

出版信息

Int J Surg Case Rep. 2022 Apr;93:107025. doi: 10.1016/j.ijscr.2022.107025. Epub 2022 Apr 2.

Abstract

Heterotopic pregnancy is a rare occurrence whereby a concurrent intrauterine and extrauterine pregnancy exists. It is a difficult diagnosis to make early, and often associated with significant morbidity and mortality from complications if diagnosed late. In this report, we present a rare case of heterotopic pregnancy in a 25-year-old woman who presented with abdominal pain following blunt abdominal trauma, and ultrasound showing haemoperitoneum and a viable intrauterine 10-week gestation. CT scan was non diagnostic and significance of left parametrial contrast was not considered. She was admitted under the general surgical team and underwent laparoscopy showing a ruptured left tubal ectopic pregnancy and partial salpingectomy was performed. She recovered well post operatively and has continued to carry the intrauterine pregnancy without complications. Surgeons and emergency physicians should be aware of this condition and to consider it in female patients presenting with acute abdomen or trauma even in the presence of an intrauterine pregnancy.

摘要

异位妊娠是一种罕见的情况,即同时存在宫内妊娠和宫外妊娠。早期很难做出诊断,如果诊断延迟,往往会因并发症导致严重的发病率和死亡率。在本报告中,我们介绍了一例罕见的异位妊娠病例,一名25岁女性在腹部钝性创伤后出现腹痛,超声显示腹腔内有积血,宫内有一个存活的10周妊娠囊。CT扫描未明确诊断,未考虑左侧子宫旁造影剂的意义。她被普通外科团队收治,接受了腹腔镜检查,显示左侧输卵管异位妊娠破裂,进行了部分输卵管切除术。术后她恢复良好,继续妊娠,未出现并发症。外科医生和急诊医生应了解这种情况,并在出现急腹症或创伤的女性患者中考虑到这种情况,即使患者存在宫内妊娠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32b8/8991100/535d28684a0f/gr1.jpg

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