Ji Jiaqi, Tan Li, Lv Ke
Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Ultrasound, Aerospace Center Hospital, Beijing, China.
AME Case Rep. 2024 Feb 7;8:34. doi: 10.21037/acr-23-164. eCollection 2024.
Rudimentary horn pregnancy (RHP) is a special type of ectopic pregnancy and its pathophysiological basis is an abnormal fusion of the bilateral accessory mesonephric duct during the embryonic period. If sonographers lack experience to this disease, it is easily to be misdiagnosed in the early period, which often leads to rupture of the pregnant horn and life-threatening bleeding. Therefore, a high index of vigilance is required.
We present a case of a 27-year-old female who went to the department of emergency due to menopause, pelvic pain and elevated human chorionic gonadotropin (hCG) (above 200,000 IU/L). Sonographic examination showed uterus only had the right horn and endometrium was thickened about 1.7 cm without gestational sac (GS) in the uterine cavity. Besides, a 3.5×3.0 cm GS was found between the left ovary and corpus uteri. RHP was suspected by sonographer, and the patient underwent laparoscopy. Obstetricians and gynecologists removed the rudimentary horn and the left fallopian tube. The patient made a good recovery and was soon discharged home after surgery.
This article analyzed one case and summarized ultrasonic characteristics of RHP which may help to improve the early diagnosis of RHP. If necessary, other imaging such as magnetic resonance imaging (MRI) can be combined to make a clear diagnosis and treatment as soon as possible.
残角子宫妊娠（RHP）是一种特殊类型的异位妊娠，其病理生理基础是胚胎期双侧副中肾管异常融合。如果超声检查医师对此病缺乏经验，在早期很容易误诊，这常导致妊娠残角破裂及危及生命的出血。因此，需要高度警惕。
我们报告一例27岁女性患者，因停经、盆腔疼痛及人绒毛膜促性腺激素（hCG）升高（超过200,000 IU/L）前往急诊科就诊。超声检查显示子宫仅有右角，子宫内膜增厚约1.7 cm，宫腔内未见妊娠囊（GS）。此外，在左卵巢与子宫体之间发现一个3.5×3.0 cm的妊娠囊。超声检查医师怀疑为残角子宫妊娠，患者接受了腹腔镜检查。妇产科医生切除了残角子宫及左侧输卵管。患者恢复良好，术后不久出院。
本文分析了一例病例并总结了残角子宫妊娠的超声特征，这可能有助于提高残角子宫妊娠的早期诊断。如有必要，可结合其他影像学检查如磁共振成像（MRI）以尽快明确诊断并进行治疗。
