異所性妊娠による卵管切除後卵管断端に絨毛が存続し再度破裂した1症例

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<B>Case Report:</B> A persistent ectopic pregnancy (PEP) refers to the continuation of trophoplastic growth after a surgical intervention to remove an ectopic pregnancy. After a conservative procedure that attempts to avoid a salpingectomy of the affected fallopian tube, trophoblastic tissue may remain. In about 3-20% of these cases, the major portion of the ectopic growth is removed, but some trophoblastic tissue escapes removal and continues to grow, generating a new rise or prolongation of hCG levels. We report here a rare case of PEP after a salpingectomy. The patient was a 22-year-old woman who was referred to our hospital for a suspected ectopic pregnancy. We performed emergent laparoscopic salpingectomy, and followed up on hCG revels and ultrasonography as an outpatient. On the 38th postoperative day, she was transported to our hospital by ambulance; she was in shock and suffering severe abdominal pain from intra-abdominal bleeding. We performed the second emergent laparoscopic surgery, and bleeding from the severed end of the fallopian tube was present. We excised the residual fallopian tube. Trophoblastic tissue was identified in the specimen, and PEP was confirmed via pathological examination.
日本産科婦人科内視鏡学会の論文