卵管間質部妊娠に対し卵管子宮部楔状切除術後、同側卵管膨大部へ反復妊娠した1例：卵管間質部妊娠に対する術式の考察

抄録

  An interstitial pregnancy accounts for only 1-2.5% of tubal pregnancies; however, the incidence of interstitial pregnancies is increasing as a result of artificial reproductive technology and the spread of sexually transmitted diseases such as Chlamydia tracomatis. Because of the difficulty of early diagnosis, the mortality rate of interstitial pregnancies is higher than that of other sites. We report a rare case of repeat ectopic pregnancy in the ipsilateral fallopian tube after laparoscopic wedge resection for an interstitial pregnancy. The patient is a 32-year-old gravida 1, para 0 woman. She suffered a left-sided interstitial pregnancy and underwent a left cornual wedge resection via laparoscopic surgery two years earlier. She presented at our hospital with the chief complaint of lower abdominal pain at 7 weeks of gestation; an ectopic pregnancy was suspected. We performed laparoscopic surgery and discovered that her left fallopian tube was swollen, which was indicative of a tubal pregnancy; therefore, we performed a left salpingectomy. The patient's postoperative course was uneventful and she was discharged on postoperative day 5. Her serum hCG decreased, and pathology revealed products of conception in the fallopian tube. In view of this case, we recommend that a salpingectomy should be performed when interstitial pregnancy is found in order to avoid an ipsilateral tubal pregnancy.