腹腔鏡下手術で診断治療した尿中hCG検査陰性の陳旧性異所性妊娠の1例
スポンサーリンク
概要
- 論文の詳細を見る
The early diagnosis and minimally invasive management of ectopic pregnancy are usually possible because of the development of highly sensitive urine pregnancy tests and ultrasonography. We herein report a rare case of chronic ectopic pregnancy which was difficult to diagnose before laparoscopic surgery due to a negative urine pregnancy test. A 21-year-old female (gravida 1, para 0) presented with right lower abdominal pain and irregular vaginal bleeding. A urine pregnancy test with a sensitivity of 25 IU/L was negative at triage. Since a 4 cm heterogeneous mass was identified on the right side of the uterus by transvaginal ultrasonography, a degenerative uterine myoma was diagnosed. Since the symptoms lasted another month without relief, MRI and CT were performed, but no definitive diagnosis was made. Thereafter, a laparoscopic examination revealed that the right fallopian tube was swollen to 4 cm in diameter, with extensive circumferential inflammatory adhesions. Another urine pregnancy test was performed during the operation because a tubal pregnancy was suspected, but it was negative. After laparoscopic right salpingectomy, the symptoms improved. Based on a histological examination of the surgical specimen showing degenerated villi and viable trophoblasts, chronic right tubal pregnancy was diagnosed. In conclusion, although a urine pregnancy test is useful and essential to rule out ectopic pregnancy in females of reproductive age presenting with abdominal symptoms, the possibility of chronic ectopic pregnancy should be considered even in cases with negative results. Laparoscopic surgery can be useful for diagnosis and treatment when a chronic ectopic pregnancy is suspected.
- 日本産科婦人科内視鏡学会の論文
日本産科婦人科内視鏡学会 | 論文
- ラテックスアレルギーのハイリスクグループと考えられた症例に対する腹腔鏡下手術の経験
- 不妊治療中に発見し腹腔鏡下手術後に生児を得た卵巣性索間質性腫瘍の2例
- 当教室における腹腔鏡下子宮筋腫核出術と妊娠および分娩予後に関する検討
- 腹腔鏡下に性腺を摘出した性染色体異常 (モザイク) の2例
- 妊娠初期の卵巣出血に対し、自己血回収装置を用いて腹腔鏡下止血術をしえた1症例