UNASSIGNED: A 40-year-old female, with 7 living children, who previously underwent an interval BTL, presented with acute abdominal pain for 2 days and amenorrhea for 6 weeks. She was stable but had generalized abdominal tenderness, guarding and rebound tenderness, and cervical motion tenderness. Her urine HCG was positive, and a trans-abdominal ultrasound scan revealed a tender echo-complex right adnexal mass, free fluid in the Cul-de-sac, and an empty uterine cavity, consistent with a ruptured right ectopic pregnancy. An emergency exploratory laparotomy was done with findings of a ruptured right distal tube containing products of conception, hemoperitoneum, and previous tubal ligation and left salpingectomy. A right total salpingectomy was done, and the excised right tube containing the mass was sent for histological examination, which revealed chorionic villi and hemorrhagic vascular decidual tissue in the fallopian tube, features suggestive of tubal ectopic pregnancy.
■一位40岁的女性,有7个活着的孩子,之前接受过间隔BTL的人,出现急性腹痛2天,闭经6周。她很稳定,但有全身腹部压痛,守卫和反弹的温柔,和颈椎运动压痛。她的尿HCG呈阳性,经腹超声扫描显示右侧附件有一个触痛的回声复合体肿块,Cul-de-sac中的自由流体,和一个空的子宫腔,与右侧异位妊娠破裂一致.进行了紧急剖腹探查,发现右远端管破裂,其中包含受孕产物,腹膜积血,先前的输卵管结扎术和左输卵管切除术。做了正确的全输卵管切除术,切除的右管包含肿块被送去进行组织学检查,这显示了绒毛膜绒毛和输卵管出血性血管蜕膜组织,特征提示输卵管异位妊娠。