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左侧宫角妊娠破裂:一例报告

Ruptured Left Cornual Ectopic Pregnancy: A Case Report.

作者信息

Hoang Brittney T, Whitaker Donald W

机构信息

Department of Obstetrics and Gynecology, Edward Via College of Osteopathic Medicine Auburn Campus (VCOM-Auburn), Auburn, USA.

Department of Obstetrics and Gynecology, Hospital Corporation of America (HCA) Florida Fort Walton-Destin Hospital, Fort Walton Beach, USA.

出版信息

Cureus. 2023 Jul 6;15(7):e41449. doi: 10.7759/cureus.41449. eCollection 2023 Jul.

Abstract

Cornual ectopic pregnancies are rare with a mortality rate that is significantly higher than that of other ectopic pregnancy types. Due to the cornual region's location on the fallopian tube, rupture of a cornual gestation may lead to massive maternal hemorrhage resulting in hypovolemia and shock. Here, we report a 39-year-old female who presented to Hospital Corporation of America (HCA) Florida Healthcare's emergency department (ED) in a state of hypovolemic shock. She was six weeks pregnant based on an unknown and unsure last menstrual cycle. The diagnosis of a ruptured ectopic pregnancy was suspected based on a positive urine pregnancy test and a pelvic ultrasound that revealed an empty uterus and a copious amount of free fluid within the abdomen. Significant hematoperitoneum and hemodynamic instability required emergent exploratory laparotomy with findings of a ruptured left cornual ectopic pregnancy. A left cornual resection and repair was done with an uneventful postoperative period. With cornual ectopic pregnancies being a rare entity, our case emphasizes the importance of early detection and management to help prevent fatal complications.

摘要

宫角部异位妊娠较为罕见,其死亡率显著高于其他类型的异位妊娠。由于宫角部位于输卵管,宫角部妊娠破裂可能导致产妇大量出血,进而引起血容量减少和休克。在此,我们报告一名39岁女性,她因低血容量性休克状态被送往美国医院公司(HCA)佛罗里达医疗保健公司的急诊科。根据未知且不确定的末次月经周期,她已怀孕六周。基于尿妊娠试验阳性以及盆腔超声显示子宫空虚且腹腔内有大量游离液体,怀疑为异位妊娠破裂。大量腹腔积血和血流动力学不稳定需要紧急进行剖腹探查,结果发现左侧宫角部异位妊娠破裂。进行了左侧宫角部切除和修复,术后恢复顺利。鉴于宫角部异位妊娠是一种罕见情况,我们的病例强调了早期检测和管理以帮助预防致命并发症的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5059/10404111/a0986650f27c/cureus-0015-00000041449-i01.jpg

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