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成功施行腹腔镜手术切除腹主动脉与下腔静脉之间的腹膜后异位妊娠:病例报告。

Successful laparoscopic resection of retroperitoneal ectopic pregnancy between the abdominal aorta and inferior vena cava: A case report.

机构信息

Department of Obstetrics and Gynecology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.

Department of Pathology, Showa University Hospital, Shinagawa-ku, Tokyo, Japan.

出版信息

J Obstet Gynaecol Res. 2024 Jul;50(7):1253-1257. doi: 10.1111/jog.15947. Epub 2024 Apr 17.

Abstract

Retroperitoneal ectopic pregnancies are extremely rare; only a few cases having been reported. Here, we report laparoscopic removal of an asymptomatic retroperitoneal ectopic pregnancy from a 29-year-old woman who was referred to our hospital for a suspected ectopic pregnancy. Transvaginal ultrasound did not reveal a gestational sac in the uterus or pelvic cavity. However, abdominal contrast-enhanced computer tomography showed a gestational sac between the abdominal aorta and inferior vena cava. On laparoscopy, the gestational sac was confirmed to be in this retroperitoneal location and successfully removed with minimal bleeding. Histopathologic examination revealed chorionic villi surrounded by lymphatic tissue, suggesting lymphatic spread of the retroperitoneal ectopic pregnancy. In summary, contrast-enhanced computer tomography is very useful for locating the site of pregnancy in women suspected of having a retroperitoneal ectopic pregnancy. Timely diagnosis of a retroperitoneal ectopic pregnancy before bleeding occurs can enable their safe laparoscopic removal.

摘要

腹膜后异位妊娠极为罕见,仅有少数病例报道。本文报道了 1 例 29 岁无症状腹膜后异位妊娠患者,因疑似异位妊娠转至我院。经阴道超声检查未在子宫或盆腔内发现妊娠囊。然而,腹部增强 CT 显示腹主动脉和下腔静脉之间有妊娠囊。腹腔镜检查证实妊娠囊位于此腹膜后位置,通过最小的出血成功切除。组织病理学检查显示绒毛膜组织被淋巴组织包围,提示腹膜后异位妊娠的淋巴播散。总之,增强 CT 对疑似腹膜后异位妊娠患者的妊娠部位定位非常有用。在出血前及时诊断腹膜后异位妊娠,可以安全地通过腹腔镜切除。

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