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以急腹症为表现的破裂型卵巢异位妊娠:一例病例报告。

A ruptured ovarian ectopic pregnancy presenting as acute abdomen: A case report.

作者信息

Wubalem Seblewengel Maru, Reta Birhanu Kassie, Woldemichael Mihret Adane, Wedaj Sara Alemnew, Hussien Shemsu Abraham

机构信息

Department of Pathology, Wachemo University, Hossana, Ethiopia.

Department of Pathology, Aksum University, Aksum, Ethiopia.

出版信息

Int J Surg Case Rep. 2025 Jun;131:111335. doi: 10.1016/j.ijscr.2025.111335. Epub 2025 Apr 21.

Abstract

INTRODUCTION

Ovarian ectopic pregnancy (OEP) is a well-known but rare type of ectopic pregnancy, accounting for approximately 0.5 %-3 % of all ectopic pregnancies. It is a potentially fatal type of ectopic pregnancy. Preoperatively diagnosis is difficult, as it can mimic tubal pregnancy or complicated ovarian cysts. The aim of this paper is to highlight the possibility of OEP in females presenting with acute abdomen and the necessity of prompt diagnosis and management of patients.

CASE PRESENTATION

A 28-year-old multiparous mother who had been amenorrheic for 4 weeks presents with a complaint of abdominal pain lasting 4 days. She had diffuse abdominal and cervical motion tenderness. The investigations revealed moderate anemia and right complex adnexal mass with hemoperitoneum. Right salphingoophrectomy was done for an assessment of ruptured ectopic pregnancy. Histopathologic examination confirmed ovarian ectopic pregnancy.

DISCUSSION

The incidence of ovarian pregnancy is estimated to be 1 in 7000 to 40,000 live births. It is among the causes of first-trimester maternal death. The use of intrauterine devices (IUDs) and assisted reproductive technologies (ART) are among the proposed mechanisms of OEP. The diagnosis is usually made postoperatively and confirmed by histopathological examination.

CONCLUSION

OEP is a rare potentially fatal condition. It is a diagnostic challenge since it is rare and mimics tubal ectopic pregnancy and complicated ovarian cysts. It should always be considered in patients presenting with amenorrhea, vaginal bleeding, and abdominal pain, particularly in those using an IUD. Surgery is the mainstay of management, and histopathologic examination is crucial for confirming the diagnosis.

摘要

引言

卵巢异位妊娠(OEP)是一种广为人知但罕见的异位妊娠类型,约占所有异位妊娠的0.5%-3%。它是一种潜在致命的异位妊娠类型。术前诊断困难,因为它可能类似于输卵管妊娠或复杂的卵巢囊肿。本文旨在强调急性腹痛女性发生卵巢异位妊娠的可能性以及对患者进行及时诊断和治疗的必要性。

病例介绍

一名28岁经产妇,停经4周,主诉腹痛持续4天。她有全腹压痛和宫颈举痛。检查发现中度贫血以及右侧附件区复杂包块伴腹腔积血。为评估破裂的异位妊娠而行右侧输卵管卵巢切除术。组织病理学检查确诊为卵巢异位妊娠。

讨论

卵巢妊娠的发生率估计为每7000至40000例活产中有1例。它是孕早期孕产妇死亡的原因之一。宫内节育器(IUD)的使用和辅助生殖技术(ART)是卵巢异位妊娠的可能发病机制。诊断通常在术后做出,并通过组织病理学检查确诊。

结论

卵巢异位妊娠是一种罕见的潜在致命疾病。由于其罕见且类似输卵管异位妊娠和复杂卵巢囊肿,因此是一项诊断挑战。对于出现闭经、阴道出血和腹痛的患者,尤其是使用宫内节育器的患者,应始终考虑到该病。手术是主要的治疗方法,组织病理学检查对于确诊至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d532/12060474/958eea90ff74/gr1.jpg

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