症例報告
腹腔鏡下手術を施行した陳旧性卵管妊娠の2症例
2019 年 35 巻 2 号 p. 345-351
詳細
2019 年 35 巻 2 号 p. 345-351
Objective: To report our experience with the management of two cases of chronic tubal pregnancy by laparoscopic surgery.
Case 1: A 37-year-old woman presented to our hospital with a small amount of genital bleeding at 10 weeks and 3 days of gestation, calculated from the date of her last menstrual period. Serum human chorionic gonadotropin level was elevated to 108.5 mIU/mL and transvaginal sonography (TVS) revealed a 52-mm diameter of irregularly shaped left periovarian mass. Magnetic resonance imaging (MRI) also showed a periovarian cystic mass with suspicion of an old hemorrhage. We performed laparoscopic left salpingectomy after the diagnosis of chronic left tubal pregnancy.
Case 2: A 31-year-old woman was referred to our hospital with suspected left tubal abortion at 16 weeks and 1 day of gestation. Both TVS and MRI revealed a left periovarian mass with a diameter of 40 mm. After the mass was diagnosed as chronic left tubal pregnancy under laparoscopic vision, left fallopian tube was preserved by salpingotomy. She achieved twin pregnancy by ovulation induction with clomiphene 7 months after laparoscopic surgery.
Conclusion: Although preoperative diagnosis of chronic tubal pregnancy is difficult, laparoscopic approach would be feasible, especially when salpingotomy would be performed for future fertility preservation.
