PDF(Pubmed)
Abstract：
UNASSIGNED: Abdominal ectopic pregnancy (AEP) located at hepatic region and pelvic-wall ectopic pregnancy (EP) are rare entities, that provoking a potentially life-threatening condition. Due to insufficient data, a proper management of non-specific types remains a challenge for all gynecologists worldwide.
METHODS: Two child-bearing age women were hospitalized due to delayed menstruation and a urine pregnancy test was positive without a determination of intrauterine pregnancy. The first EP case was located at the pelvic wall which identified incidentally during laparoscopy for a presumed tubal ectopic pregnancy on ultrasonography throughout. The second EP case was found at the hepatic region due to intermittent pain rising from the right upper quadrant region and serial ultrasonic findings. In our management, both cases were successfully assessed by laparoscopy and laparotomy without requiring further intervention, respectively.
UNASSIGNED: An accurate diagnosis of EP location at liver and pelvic wall is totally difficult since its uncommon location. An initial assessment should be based on clinical symptoms and the treatment remains controversial. The surgical management including laparotomy and laparoscopy depends on clinical evaluation, experience of surgeon, and interdisciplinary team. Thus, these abnormal sites of ectopic pregnancy ought to take into consideration for all gynecologists in an emergency condition with a major hemorrhage.
CONCLUSIONS: In reproductive age women, primary EP at liver and pelvic wall should be considered with high index of suspicion if intrauterine pregnancy is totally excluded. Timely diagnosis, rational management by surgical excision, and a multidisciplinary team can reduce substantially adverse outcomes.
METHODS: Two child-bearing age women were hospitalized due to delayed menstruation and a urine pregnancy test was positive without a determination of intrauterine pregnancy. The first EP case was located at the pelvic wall which identified incidentally during laparoscopy for a presumed tubal ectopic pregnancy on ultrasonography throughout. The second EP case was found at the hepatic region due to intermittent pain rising from the right upper quadrant region and serial ultrasonic findings. In our management, both cases were successfully assessed by laparoscopy and laparotomy without requiring further intervention, respectively.
UNASSIGNED: An accurate diagnosis of EP location at liver and pelvic wall is totally difficult since its uncommon location. An initial assessment should be based on clinical symptoms and the treatment remains controversial. The surgical management including laparotomy and laparoscopy depends on clinical evaluation, experience of surgeon, and interdisciplinary team. Thus, these abnormal sites of ectopic pregnancy ought to take into consideration for all gynecologists in an emergency condition with a major hemorrhage.
CONCLUSIONS: In reproductive age women, primary EP at liver and pelvic wall should be considered with high index of suspicion if intrauterine pregnancy is totally excluded. Timely diagnosis, rational management by surgical excision, and a multidisciplinary team can reduce substantially adverse outcomes.
摘要：
■位于肝脏区域的腹部异位妊娠（AEP）和骨盆壁异位妊娠（EP）是罕见的实体，引发潜在威胁生命的疾病。由于数据不足,非特定类型的适当管理仍然是全球所有妇科医生面临的挑战.
方法：两名育龄妇女因月经推迟而住院，尿妊娠试验呈阳性，但未确定宫内妊娠。第一例EP病例位于骨盆壁，在腹腔镜检查期间偶然发现了整个超声检查中的输卵管异位妊娠。由于右上象限区域的间歇性疼痛和一系列超声检查结果，在肝脏区域发现了第二例EP。在我们的管理中,两例病例均通过腹腔镜和剖腹手术成功评估，无需进一步干预，分别。
■肝脏和骨盆壁的EP位置的准确诊断完全困难，因为其位置不常见。初步评估应基于临床症状，治疗仍存在争议。包括剖腹手术和腹腔镜检查在内的手术治疗取决于临床评估，外科医生的经验，跨学科团队因此，这些异位妊娠的异常部位应考虑到所有妇科医生在严重出血的紧急情况下。
结论：在育龄妇女中，如果完全排除宫内妊娠,应高度怀疑肝脏和盆壁原发性EP.及时诊断,手术切除的合理管理，多学科团队可以大幅减少不良后果。
方法：两名育龄妇女因月经推迟而住院，尿妊娠试验呈阳性，但未确定宫内妊娠。第一例EP病例位于骨盆壁，在腹腔镜检查期间偶然发现了整个超声检查中的输卵管异位妊娠。由于右上象限区域的间歇性疼痛和一系列超声检查结果，在肝脏区域发现了第二例EP。在我们的管理中,两例病例均通过腹腔镜和剖腹手术成功评估，无需进一步干预，分别。
■肝脏和骨盆壁的EP位置的准确诊断完全困难，因为其位置不常见。初步评估应基于临床症状，治疗仍存在争议。包括剖腹手术和腹腔镜检查在内的手术治疗取决于临床评估，外科医生的经验，跨学科团队因此，这些异位妊娠的异常部位应考虑到所有妇科医生在严重出血的紧急情况下。
结论：在育龄妇女中，如果完全排除宫内妊娠,应高度怀疑肝脏和盆壁原发性EP.及时诊断,手术切除的合理管理，多学科团队可以大幅减少不良后果。
