Obstetrics and Gynaecology, Royal Derby Hospital, Derby, UK
Obstetrics and Gynaecology, Royal Derby Hospital, Derby, UK.
BMJ Case Rep. 2023 Jan 4;16(1):e253396. doi: 10.1136/bcr-2022-253396.
Though there is no definite agreement on diagnostic criteria or definition of chronic ectopic pregnancy (CEP), it could be deemed to be a variant of pregnancy of unknown location with non-specific clinical signs and symptoms. This was a case of a para 2+2 who presented with lower abdominal pain and bleeding per vaginum, and initial ultrasound was suggestive of a tubo-ovarian abscess/mass. With a further MRI scan and a diagnostic laparoscopy, she was found to have a CEP and had a laparoscopic salpingectomy for management. The diagnosis of CEP could be quite challenging as a result of the protracted symptoms, often negative/low serum B-HCG and ultrasound features mimicking a pelvic mass. A high index of suspicion is needed, and an MRI scan and diagnostic laparoscopy often aid in diagnosis and management.
尽管对于慢性宫外孕（CEP）的诊断标准或定义尚无明确共识，但它可以被视为不明位置妊娠的一种变体，具有非特异性的临床症状和体征。这是一位 2 次+2 次妊娠的患者，表现为下腹痛和阴道出血，最初的超声检查提示输卵管-卵巢脓肿/肿块。进一步的 MRI 扫描和诊断性腹腔镜检查发现她患有 CEP，并进行了腹腔镜输卵管切除术治疗。由于症状迁延、血清 B-HCG 通常为阴性/低值和超声特征类似于盆腔肿块，CEP 的诊断颇具挑战性。需要高度怀疑，MRI 扫描和诊断性腹腔镜检查通常有助于诊断和治疗。
