Sato Fumikazu, Uramoto Satoshi, Amagai Teruyoshi
Department of Medicine, Kikai Tokushukai Hospital, Kagoshima, Japan.
Department of Emergency Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
Radiol Case Rep. 2023 May 23;18(8):2577-2580. doi: 10.1016/j.radcr.2023.04.053. eCollection 2023 Aug.
A 31-year-pld female patient, presented to the emergency room with vaginal bleedingand a three day history of left sided lower abdominal pain. he showed shock status and an'' as ``She came in with a hypovuoluminc shock and an enhanced 3-dimensional multidetector-computed tomography (3D-MDCT) images showed a specific teardropping owl's eye appearance consistent with an active bleeding around fetal sac and from ruptured tubal ectopic pregnancy (EP) spreading into peritoneum at the 9th gestational week. According to accurate radiological diagnosis, she has been able to receive a successful urgent transportation via helicopter to the consultee obstetricians and received an urgent salpingectomy with the diagnosis of tubal rupture in EP. Her post-surgical course was uneventful and discharged hospital on 8th day. From this case experience, an urgent diagnosis of a ruptured tubal EP in shocked female using not US but MDCT is accurately diagnosed because MDCT has radiological advantage to visualize active hemorrhage using contrast-medium.
一名31岁女性患者因阴道出血和左侧下腹部疼痛三天就诊于急诊室。她呈现出休克状态,增强三维多排螺旋计算机断层扫描(3D-MDCT)图像显示出一种特殊的泪滴状猫头鹰眼外观,这与妊娠9周时孕囊周围的活动性出血以及输卵管异位妊娠(EP)破裂并蔓延至腹膜一致。根据准确的放射学诊断,她得以通过直升机成功紧急转运至会诊产科医生处,并在诊断为输卵管妊娠破裂后接受了紧急输卵管切除术。她术后恢复顺利,于第8天出院。从这个病例经验来看,对于休克女性患者,使用MDCT而非超声能够准确诊断出输卵管妊娠破裂,因为MDCT在使用造影剂可视化活动性出血方面具有放射学优势。