PDF(Pubmed)
Abstract：
BACKGROUND: Interstitial ectopic pregnancy is an ectopic gestation developing in the uterine part of the fallopian tube. The condition is rare and presents challenges for clinical as well as radiological diagnosis. This case report presents a rare case of interstitial ectopic pregnancy diagnosed intraoperatively.
METHODS: A 36-year-old Black woman, referred from a peripheral health facility, presented at the emergency department with severe abdominal pains, vaginal spotting, nausea, and vomiting, with a 2-month history of irregular menstrual flow. Clinical and laboratory findings were suggestive of an acute abdomen likely due to a ruptured ectopic pregnancy (ultrasound was not available). An emergency exploratory laparotomy was done, which revealed a right adnexal ruptured interstitial pregnancy of a lifeless female fetus weighing 500 g (estimated mean gestational age of 22-23 weeks). The left fallopian tube looked normal. The site of rupture was repaired, followed by cleaning and closure of the abdomen. The post-operative period was uneventful, and the patient was discharged on postoperative day 7.
CONCLUSIONS: Interstitial pregnancies are uncommon and rarely attain advanced gestational ages, as in this case, compared with other tubal ectopic pregnancies. However, women presenting with signs of hypovolemic shock and acute abdomen, with a positive pregnancy test, warrant a high index of suspicion.
METHODS: A 36-year-old Black woman, referred from a peripheral health facility, presented at the emergency department with severe abdominal pains, vaginal spotting, nausea, and vomiting, with a 2-month history of irregular menstrual flow. Clinical and laboratory findings were suggestive of an acute abdomen likely due to a ruptured ectopic pregnancy (ultrasound was not available). An emergency exploratory laparotomy was done, which revealed a right adnexal ruptured interstitial pregnancy of a lifeless female fetus weighing 500 g (estimated mean gestational age of 22-23 weeks). The left fallopian tube looked normal. The site of rupture was repaired, followed by cleaning and closure of the abdomen. The post-operative period was uneventful, and the patient was discharged on postoperative day 7.
CONCLUSIONS: Interstitial pregnancies are uncommon and rarely attain advanced gestational ages, as in this case, compared with other tubal ectopic pregnancies. However, women presenting with signs of hypovolemic shock and acute abdomen, with a positive pregnancy test, warrant a high index of suspicion.
摘要：
背景：间质性异位妊娠是在输卵管子宫部分发生的异位妊娠。这种情况很少见，对临床和放射学诊断提出了挑战。此病例报告介绍了术中诊断为间质性异位妊娠的罕见病例。
方法：一位36岁的黑人妇女，从外围医疗机构转介，在急诊科出现严重的腹痛，阴道斑点，恶心,呕吐,有2个月月经不调的病史。临床和实验室检查结果提示可能是由于异位妊娠破裂引起的急腹症（超声检查不可用）。进行了紧急剖腹探查,这表明右附件破裂间质妊娠无生命的女性胎儿体重500g（估计平均胎龄22-23周）。左输卵管看起来正常。破裂部位修复了,然后清洁和关闭腹部。手术后的时期是平安无事的,患者在术后第7天出院。
结论：间质性妊娠并不常见，很少达到晚期胎龄，在这种情况下，与其他输卵管异位妊娠相比。然而,出现低血容量性休克和急腹症的女性，妊娠试验呈阳性,有很高的怀疑指数。
方法：一位36岁的黑人妇女，从外围医疗机构转介，在急诊科出现严重的腹痛，阴道斑点，恶心,呕吐,有2个月月经不调的病史。临床和实验室检查结果提示可能是由于异位妊娠破裂引起的急腹症（超声检查不可用）。进行了紧急剖腹探查,这表明右附件破裂间质妊娠无生命的女性胎儿体重500g（估计平均胎龄22-23周）。左输卵管看起来正常。破裂部位修复了,然后清洁和关闭腹部。手术后的时期是平安无事的,患者在术后第7天出院。
结论：间质性妊娠并不常见，很少达到晚期胎龄，在这种情况下，与其他输卵管异位妊娠相比。然而,出现低血容量性休克和急腹症的女性，妊娠试验呈阳性,有很高的怀疑指数。
