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罕见病例:卵巢宫外孕破裂出血,并发黄体囊肿出血,导致血腹。

Rare case of haemoperitoneum secondary to a ruptured ovarian ectopic pregnancy superimposed by a bleeding corpus luteum cyst.

机构信息

Obstetrics & Gynecology, KK Women's and Children's Hospital, Singapore

Obstetrics & Gynecology, KK Women's and Children's Hospital, Singapore.

出版信息

BMJ Case Rep. 2024 Jan 29;17(1):e256872. doi: 10.1136/bcr-2023-256872.

Abstract

An adolescent female presented with an acute abdomen and elevated beta-human chorionic gonadotropin levels and underwent a laparoscopy for a suspected ruptured ectopic pregnancy. Intraoperatively, a ruptured haemorrhagic corpus luteal cyst and tissues suggestive of products of conception were noted in the same ovary. Histology confirmed an ovarian ectopic pregnancy. Haemorrhagic ovarian cysts, and ectopic pregnancies, can cause acute pelvic pain in women of childbearing age. Their similar clinical signs and symptoms pose a diagnostic dilemma for any gynaecologist. Ruptured corpus luteal cysts, as well as ruptured ovarian ectopic pregnancies, should be considered rare but differential diagnoses in women presenting with acute abdominal pain, an adnexal mass and ultrasound features of haemoperitoneum. The mainstay of treatment is a diagnostic laparoscopy, which is a safe and feasible management strategy without compromising patient safety or ovarian function in the long run.

摘要

一位青春期女性因急性腹痛和β-人绒毛膜促性腺激素水平升高就诊,并接受腹腔镜检查以排除疑似宫外孕破裂。术中发现同一侧卵巢有破裂出血性黄体囊肿和疑似妊娠产物的组织。组织学检查证实为卵巢宫外孕。出血性卵巢囊肿和宫外孕均可导致育龄妇女急性盆腔痛。它们相似的临床症状和体征给任何妇科医生都带来了诊断上的困境。破裂的黄体囊肿以及破裂的卵巢宫外孕应被视为罕见但需鉴别的诊断,对于以急性腹痛、附件包块和超声提示血腹为表现的女性。治疗的主要方法是诊断性腹腔镜检查,这是一种安全可行的管理策略,从长远来看不会危及患者安全或卵巢功能。

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