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病例报告:阔韧带水平的异位妊娠:一例病例报告。

Case report: Ectopic pregnancy at the level of broad ligament: A case report.

作者信息

Belouad Moad, Benlghazi Abdelhamid, Messaoudi Hamza, Benali Saad, El Hassani Moulay Mehdi, Kouach Jaouad

机构信息

Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco.

Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110736. doi: 10.1016/j.ijscr.2024.110736. Epub 2024 Dec 12.

Abstract

INTRODUCTION

Ectopic pregnancies are a significant clinical concern, with 90 % occurring in the fallopian tubes. However, they can also manifest in other locations, including the cervix, ovary, and abdominal cavity. Abdominal pregnancies, which constitute less than 1 % of ectopic pregnancies, are associated with considerable morbidity and mortality. Among these, pregnancies located in the broad ligament are particularly rare and can sometimes be carried to term.

CASE PRESENTATION

This case report discusses a 27-year-old patient presenting with a 14-week pregnancy diagnosed in the broad ligament, highlighting the challenges in prenatal diagnosis and the potential complications associated with this condition. The report details the clinical management, including an exploratory laparotomy and subsequent treatment, and underscores the importance of awareness and timely intervention in cases of broad ligament ectopic pregnancies. This case contributes to the limited literature on this uncommon type of ectopic pregnancy and emphasizes the need for further research to improve diagnostic and therapeutic approaches.

CLINICAL DISCUSSION

Ectopic pregnancy of the broad ligament is a relatively rare pathology documented in the literature. Its diagnosis is clinical and paraclinical, especially if ultrasound is performed early. Management is similar to that of an abdominal pregnancy. Maternal prognosis can be difficult if management is less than optimal in terms of surgery, anesthesia, resuscitation and the absence of blood products. This is why first-trimester ultrasound is so important.

CONCLUSIONS

This case underscores the importance of awareness and timely intervention in managing broad ligament ectopic pregnancies, and highlighting the need for further research to improve diagnostic and therapeutic approaches.

摘要

引言

异位妊娠是一个重大的临床问题,其中90%发生在输卵管。然而,它们也可能出现在其他部位,包括宫颈、卵巢和腹腔。腹腔妊娠占异位妊娠的比例不到1%,与相当高的发病率和死亡率相关。其中,位于阔韧带的妊娠尤为罕见,有时可足月分娩。

病例报告

本病例报告讨论了一名27岁的患者,其妊娠14周,诊断为阔韧带妊娠,突出了产前诊断的挑战以及与该病症相关的潜在并发症。报告详细介绍了临床管理,包括剖腹探查术及后续治疗,并强调了对阔韧带异位妊娠病例提高认识和及时干预的重要性。本病例丰富了关于这种罕见类型异位妊娠的有限文献,并强调需要进一步研究以改进诊断和治疗方法。

临床讨论

阔韧带异位妊娠是文献中记载的一种相对罕见的病理情况。其诊断依靠临床和辅助检查,尤其是早期进行超声检查。治疗方法与腹腔妊娠相似。如果在手术、麻醉、复苏以及缺乏血制品方面管理欠佳,产妇预后可能不佳。这就是早期妊娠超声检查如此重要的原因。

结论

本病例强调了对阔韧带异位妊娠进行管理时提高认识和及时干预的重要性,并突出了进一步研究以改进诊断和治疗方法的必要性。

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