Abramov Y, Nadjari M, Shushan A, Prus D, Anteby S O
Department of Obstetrics and Gynecology, Hebrew University Hadassah Medical Center, Jerusalem, Israel.
Ultrasound Obstet Gynecol. 1997 May;9(5):344-6. doi: 10.1046/j.1469-0705.1997.09050344.x.
Chronic ectopic pregnancy is an uncommon form of tubal pregnancy manifested as a pelvic mass with minimal symptoms and a low or absent titer of human chorionic gonadotropin. For this reason, most of the reported cases have been diagnosed only after explorative laparotomy. The value of Doppler ultrasonography for preoperative diagnosis of this entity has not yet been established. We report on a 36-year-old patient who was admitted for intermittent right lower quadrant abdominal pain of 3 months' duration, and a right adnexal mass found on pelvic examination. On Doppler ultrasonography, a right complex adnexal mass was demonstrated, characterized by extensive external vascularization, aberrant vessels and arteriovenous shunting, but with no internal blood flow. Explorative laparotomy revealed a right tubal mass adherent to the omentum, and covered by numerous enlarged and tortuous blood vessels originating in the omentum. Pathological examination of the mass revealed a chronic ectopic pregnancy. The possible contribution of Doppler-specific characteristics for the diagnosis of chronic ectopic pregnancy is described and discussed.
慢性异位妊娠是输卵管妊娠的一种罕见形式，表现为盆腔肿块，症状轻微，人绒毛膜促性腺激素水平低或无。因此，大多数报道的病例仅在剖腹探查术后才得以诊断。多普勒超声对该疾病术前诊断的价值尚未确立。我们报告一例36岁患者，因持续3个月的间歇性右下腹疼痛入院，盆腔检查发现右侧附件区肿块。多普勒超声显示右侧附件区有一复杂肿块，其特征为广泛的外部血管化、异常血管及动静脉分流，但无内部血流。剖腹探查发现右侧输卵管肿块与大网膜粘连，被源自大网膜的许多迂曲增粗血管覆盖。肿块病理检查显示为慢性异位妊娠。本文描述并讨论了多普勒特定特征对慢性异位妊娠诊断的可能作用。
