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妊娠晚期因良性肿瘤导致输卵管扭转的腹腔镜手术:一例报告及文献复习

Laparoscopic surgery for fallopian tube torsion due to benign tumour in the third trimester of pregnancy: a case report and literature review.

作者信息

Jo Jae Yoon, Cho In Ae, Shin Jeong Kyu, Lee Soon Ae, Choi Won Jun

机构信息

Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Republic of Korea.

Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.

出版信息

J Obstet Gynaecol. 2022 Oct;42(7):2566-2572. doi: 10.1080/01443615.2022.2107421. Epub 2022 Aug 5.

Abstract

Isolated fallopian tubal torsion is rare among women of reproductive age, and it is even rarer during pregnancy. Despite its rare incidence, it is important to consider this diagnosis to facilitate prompt and effective intervention. We present the case of a pregnant woman in her third trimester who presented with acute right abdominal pain. A 32-year-old primigravida woman at 29 weeks and four days of gestation visited the emergency department with acute right flank and abdominal pain. Sonography and MRI revealed the presence of a right adnexal cystic mass. Exploratory laparoscopy revealed isolated right tubal torsion and a normal ovary. To avoid torsion recurrence, we performed laparoscopic right salpingectomy. The remainder of her gestation was uneventful. Histopathological examination revealed serous cystadenoma with haemorrhagic infarction. We reviewed the literature for cases of isolated tubal torsion in the past 11 years. Twenty-three case reports were included in this study, and the average time from presentation to surgical intervention was 35.6 hours. In these cases, most of the patients underwent laparotomy and had good pregnancy outcomes. Although the approach may vary depending on the situation, the laparoscopic approach should be preferred to laparotomy in the third trimester of pregnancy.

摘要

孤立性输卵管扭转在育龄女性中较为罕见,在孕期更为罕见。尽管其发病率很低,但考虑到这一诊断对于促进及时有效的干预很重要。我们报告一例妊娠晚期孕妇出现急性右腹痛的病例。一名32岁初产妇,妊娠29周零4天,因急性右下腹和腹痛就诊于急诊科。超声和磁共振成像显示右侧附件有一个囊性肿块。腹腔镜探查发现孤立性右侧输卵管扭转,卵巢正常。为避免扭转复发,我们进行了腹腔镜右侧输卵管切除术。她妊娠的剩余时间顺利。组织病理学检查显示为伴有出血性梗死的浆液性囊腺瘤。我们回顾了过去11年中孤立性输卵管扭转病例的文献。本研究纳入了23例病例报告,从出现症状到手术干预的平均时间为35.6小时。在这些病例中,大多数患者接受了剖腹手术,妊娠结局良好。尽管方法可能因情况而异,但在妊娠晚期,腹腔镜手术应优先于剖腹手术。

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