Liu Cong, Huang Guangshuai, Zhu Cunzhi, Ji Meiling, Yang Xiaoxue, Peng Yigen
Department of Emergency Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
Department of Emergency Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.
J Med Case Rep. 2025 Jul 3;19(1):311. doi: 10.1186/s13256-025-05360-6.
Abdominal ectopic pregnancy is a rare form of ectopic pregnancy, and diaphragmatic ectopic pregnancy is even rarer. We described a case of an ectopic pregnancy implanted on the diaphragm's surface, diagnosed using multimodality imaging techniques, including ultrasonography, X-ray computed tomography, and magnetic resonance imaging.
A 39-year-old Han Chinese female presented with abdominal pain and was diagnosed with subcapsular hemorrhage of the liver on the basis of computed tomography imaging. The patient had experienced paroxysmal severe pain in the right abdomen, without any history of trauma, vomiting, or diarrhea. Her vital signs were stable, and she did not exhibit signs of hemorrhagic shock. She reported that her last menstrual period ended 13 days before the onset of symptoms and that she had a regular menstrual cycle. However, her blood human chorionic gonadotropin levels were significantly elevated. Based on multimodality imaging techniques, including ultrasonography, computed tomography, and magnetic resonance imaging, ectopic pregnancy was considered as a possible diagnosis. To further investigate, laparoscopic exploration was performed. During the procedure, minimal adherent tissue and a small clot were found on the diaphragm's surface. Histological examination confirmed the clot to be a mixture of chorion and blood. The patient remained stable postoperatively and was discharged 1 week after surgery.
Using multimodality imaging techniques for diagnosis prior to treatment is of great significance for patients with ectopic pregnancy with atypical clinical presentations. These techniques enable clear delineation of tissue planes, thereby facilitating accurate diagnosis and preoperative planning by the surgical team.
腹腔异位妊娠是异位妊娠的一种罕见形式，而膈异位妊娠更为罕见。我们描述了一例植入在膈肌表面的异位妊娠病例，该病例通过多种影像学技术诊断，包括超声、X线计算机断层扫描和磁共振成像。
一名39岁的汉族女性因腹痛就诊，基于计算机断层扫描成像被诊断为肝包膜下出血。患者右下腹阵发性剧痛，无任何外伤、呕吐或腹泻病史。其生命体征稳定，未表现出失血性休克迹象。她报告症状发作前13天末次月经结束，月经周期规律。然而，她的血人绒毛膜促性腺激素水平显著升高。基于包括超声、计算机断层扫描和磁共振成像在内的多种影像学技术，考虑可能诊断为异位妊娠。为进一步检查，进行了腹腔镜探查。术中，在膈肌表面发现少量粘连组织和一个小血块。组织学检查证实血块为绒毛膜和血液的混合物。患者术后情况稳定，术后1周出院。
对于临床表现不典型的异位妊娠患者，术前使用多种影像学技术进行诊断具有重要意义。这些技术能够清晰勾勒组织层面，从而便于手术团队进行准确诊断和术前规划。
