■腹部妊娠是一种罕见且可能致命的异位妊娠变种,提出了独特的临床挑战。本报告讨论了与子宫和高直肠穿孔相关的腹部妊娠的不寻常病例,在临床实践中很少报道的并发症。
方法:我们报告了一个来自农村地区的31岁妇女的案例,有精神病史,出现严重的腹痛,呕吐,还有便秘.初步调查显示,CT显示骨盆区域有血气腹和胎儿骨骼,导致腹部妊娠的诊断。手术发现包括一个不能存活的胎儿,胎龄约5个月,直肠和子宫后壁穿孔。
■患者接受了广泛的手术,包括胎盘夹层,直肠前切除术,哈特曼结肠造口术,歇斯底里,和腹腔引流。管理腹部妊娠的复杂性,尤其是器官穿孔等其他并发症,带来了重大的手术挑战。该病例强调在女性腹痛的鉴别诊断中需要考虑腹部妊娠,由于存在误诊风险和复杂的手术要求。
结论:该病例强调了及时诊断和综合护理在处理罕见和危及生命的腹部妊娠时的重要性。它强调需要提高临床医生对及时干预的认识,并提供有关在器官穿孔增加的情况下手术管理复杂性的信息。
UNASSIGNED: Abdominal pregnancy is a rare and potentially fatal variant of ectopic pregnancy, presenting unique clinical challenges. This report discusses an unusual
case of abdominal pregnancy associated with uterine and high rectal perforations, complications that are rarely reported in clinical practice.
METHODS: We report a
case involving a 31-year-old woman from a rural area, with a psychiatric history, presenting severe abdominal pain, vomiting, and constipation. Initial investigations revealed a hemopneumoperitoneum and a fetal skeleton in the pelvic area by CT, leading to a diagnosis of abdominal pregnancy. Surgical findings included a nonviable fetus, approximately 5 months gestational age, and perforations in both the rectum and the posterior uterine wall.
UNASSIGNED: The patient underwent extensive surgery, including placental dissection, anterior rectal resection, Hartmann\'s colostomy, hysterorrhaphy, and drainage of the peritoneal cavity. The complexity of managing abdominal pregnancy, especially with additional complications such as organ perforations, poses significant surgical challenges. This
case emphasizes the need to consider abdominal pregnancy in differential diagnoses of abdominal pain in women, due to the risk of misdiagnosis and complex surgical requirements.
CONCLUSIONS: This
case highlights the critical importance of prompt diagnosis and comprehensive care in managing rare and life-threatening presentations of abdominal pregnancy. It underscores the need to increase awareness among clinicians for timely intervention and provides information on the complexities of surgical management in cases with additional organ perforations.