Ruptured Recurrent Interstitial Ectopic Pregnancy Successfully Managed by Laparoscopy

被引:0
作者
Ungureanu, Claudiu Octavian [1 ,2 ]
Stanculea, Floris Cristian [1 ,2 ]
Iordache, Niculae [1 ,2 ]
Georgescu, Teodor Florin [1 ,3 ]
Ginghina, Octav [1 ,4 ]
Mihailov, Raul [5 ]
Vacaroiu, Ileana Adela [1 ,6 ]
Georgescu, Dragos Eugen [1 ,7 ]
机构
[1] Carol Davila Univ Med & Pharm, Fac Dent Med, Dept Endodont, 37 Dionisie Lupu St, Bucharest 020021, Romania
[2] Sf Ioan Clin Emergency Hosp, Gen Surg Dept, 13 Vitan Barzesti Rd, Bucharest 042122, Romania
[3] Clin Emergency Hosp Bucharest, Gen Surg Dept, SplaiulIndependentei 168,Sect 5, Bucharest 050098, Romania
[4] Prof Dr Alexandru Trestioreanu Inst Oncol, General Surg Dept, Bucharest 022328, Romania
[5] Sf Andrei Clin Emergency Hosp, Dept Obstet & Gynecol, 177 Brailei St, Galati 800578, Romania
[6] Sf Ioan Emergency Clin Hosp, Nephrol & Dialysis Clin, Sos Vitan Barzesti 12, Bucharest 042122, Romania
[7] Dr I Cantacuzino Clin Hosp, Gen Surg Dept, 5-7 Ion Movila St, Bucharest 022904, Romania
关键词
ectopic pregnancy; hemorrhagic emergency; interstitial pregnancy; laparoscopic cornual resection; CORNUAL PREGNANCY; DIAGNOSIS; REMOVAL;
D O I
10.3390/diagnostics14050506
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Ectopic pregnancies are a frequently encountered cause of first-trimester metrorrhagia. They occur when an embryo is implanted and grows outside the normal uterine space. Uncommonly, the embryo can be implanted in the intramural portion of the uterine tube, a condition referred to as interstitial localization. This specific type of ectopic pregnancy may have an unpredictable course, potentially leading to severe uterine rupture and catastrophic bleeding if not promptly diagnosed and managed. We present a rare case of a multiparous 36-year-old female patient who underwent pelvic ultrasonography in the emergency department for intense pelvic pain associated with hypotension and moderate anemia. A history of right salpingectomy for a ruptured tubal ectopic pregnancy 10 years previously was noted. High beta-HCG levels were also detected. A pelvic ultrasound allowed us to suspect a ruptured ectopic interstitial pregnancy at 8 weeks of amenorrhea. An association with hemoperitoneum was suspected, and an emergency laparoscopy was performed. The condition was confirmed intraoperatively, and the patient underwent a right corneal wedge resection with suture of the uterine myometrium. The postoperative course was uneventful, and the patient was discharged on the fourth day postoperatively. Interstitial ectopic pregnancy is a rare yet extremely perilous situation. Timely ultrasound-based diagnosis is crucial as it can enable conservative management with Methotrexate. Delayed diagnosis can lead to uterine rupture with consecutive surgery based on a transection of the pregnancy and cornual uterine resection.
引用
收藏
页数:8
相关论文
共 37 条
  • [1] Fertility and reproductive outcome after tubal ectopic pregnancy: comparison among methotrexate, surgery and expectant management
    Baggio, Silvia
    Garzon, Simone
    Russo, Anna
    Ianniciello, Cesare Quintino
    Santi, Lorenza
    Lagana, Antonio Simone
    Raffaelli, Ricciarda
    Franchi, Massimo
    [J]. ARCHIVES OF GYNECOLOGY AND OBSTETRICS, 2021, 303 (01) : 259 - 268
  • [2] Interstitial ectopic pregnancy rupture at 17 weeks of gestation: A case report and literature review
    Bahall, Vishal
    Cozier, Wendel
    Latchman, Petal
    Elias, Sarah-Ann
    Sankar, Steven
    [J]. CASE REPORTS IN WOMENS HEALTH, 2022, 36
  • [3] The diagnosis and management of interstitial ectopic pregnancies: a review
    Brincat, Maximilian
    Bryant-Smith, Alison
    Holland, T. K.
    [J]. GYNECOLOGICAL SURGERY, 2019, 16
  • [4] Canis M, 2003, J Gynecol Obstet Biol Reprod (Paris), V32, pS54
  • [5] Pitfalls in diagnosis of interstitial pregnancy
    Chan, LYS
    Fok, WY
    Yuen, PM
    [J]. ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2003, 82 (09) : 867 - 870
  • [6] Corioni S, 2015, J RES MED SCI, V20, P312
  • [7] Interstitial and Cornual Ectopic Pregnancy: Conservative Surgical and Medical Management
    Dagar M.
    Srivastava M.
    Ganguli I.
    Bhardwaj P.
    Sharma N.
    Chawla D.
    [J]. The Journal of Obstetrics and Gynecology of India, 2018, 68 (6) : 471 - 476
  • [8] DECHERNEY AH, 1987, OBSTET GYNECOL, V70, P948
  • [9] Single-dose methotrexate for the treatment of unruptured ectopic pregnancy.
    Erdem M.
    Erdem A.
    Arslan M.
    Oç A.
    Biberoglu K.
    Gürsoy R.
    [J]. Archives of Gynecology and Obstetrics, 2004, 270 (4) : 201 - 204
  • [10] Faraj R., 2007, The Obstet Gynaecol, V9, P249, DOI [10.1576/toag.9.4.249.27355, DOI 10.1576/TOAG.9.4.249.27355]