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伴有坏疽性卵巢和早期妊娠的输卵管扭转:一例罕见病例报告

Torsion of fallopian tube with gangrenous ovary and early pregnancy: A rare case report.

作者信息

Singh Komal, Mandal Sanchita

机构信息

Department of Obstretics and Gynaecology, Tata Central Hospital, Dhanbad, Jharkhand, India.

Department of Medicine, Tata Central Hospital, Dhanbad, Jharkhand, India.

出版信息

J Family Med Prim Care. 2022 Sep;11(9):5686-5688. doi: 10.4103/jfmpc.jfmpc_1225_21. Epub 2022 Oct 14.

Abstract

Torsion of the fallopian tube during early pregnancy is a very rare phenomenon. Most of them present with acute abdominal pain and are often misdiagnosed with a twisted ovarian cyst, ectopic pregnancy, appendicitis, etc. A 19-year-old female was referred to the medical department for pain abdomen, nausea, and vomiting. Her last menstrual period was 28 days back. The urine pregnancy test was negative. Ultrasonogram (USG) was suggestive of encapsulated exophytic hemorrhagic cyst in the right adnexa arising from the right ovary. A huge right-twisted fimbrial cyst with hemorrhagic contents (14 cm × 12 cm) along with a gangrenous right ovary was evident in emergency laparotomy. Right salpingo-oophorectomy was performed. She was discharged with an uneventful postoperative recovery. She presented again after 2 months with postoperative amenorrhea, nausea, and vomiting. USG suggested 12 weeks of pregnancy, which continued until term. Eventually, a lower segment cesarean section was done for fetal distress. A twisted fallopian tube during pregnancy is a rare phenomenon. A high index of suspicion necessitates prompt diagnosis and prevention of future fertility and obstetric morbidity.

摘要

妊娠早期输卵管扭转是一种非常罕见的现象。大多数患者表现为急性腹痛,常被误诊为卵巢囊肿蒂扭转、异位妊娠、阑尾炎等。一名19岁女性因腹痛、恶心和呕吐被转诊至内科。她的末次月经是28天前。尿妊娠试验为阴性。超声检查提示右附件区有一个来自右卵巢的包膜外生性出血性囊肿。急诊剖腹探查时可见一个巨大的右扭转伞端囊肿,内含血性内容物(14厘米×12厘米),同时右卵巢呈坏疽状。遂行右侧输卵管卵巢切除术。她术后恢复顺利出院。2个月后,她因术后闭经、恶心和呕吐再次就诊。超声检查提示妊娠12周,妊娠持续至足月。最终,因胎儿窘迫行下段剖宫产。妊娠期输卵管扭转是一种罕见现象。高度的怀疑指数需要及时诊断,以预防未来的生育和产科并发症。

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