緊急避妊薬内服後に発症し、腹腔鏡手術で診断および治療した大網妊娠の一例

抄録

　Omental pregnancy is a subtype of abdominal pregnancy, which accounts for <1% of all ectopic pregnancies. Definitive diagnosis is challenging due to its rarity and difficulty in localizing its implantation site. Here, we describe the case of a 20-year-old nulliparous woman with omental pregnancy, referred to our hospital due to acute abdominal pain and high serum human chorionic gonadotropin levels. The gestational sac was not detected on a pelvic ultrasound examination. Abdominal contrast enhanced computerized tomography (CT) revealed an intra-abdominal hemorrhage and a 3-cm mass in the omentum. Diagnostic laparoscopy confirmed the omentum as the implantation site, following which complete resection of the lesion was performed. Histopathological analysis confirmed the diagnosis of omental pregnancy. Her postoperative course was uneventful. Our findings suggest that CT and laparoscopy are useful when the implantation site could not be visualized via ultrasonography in ectopic pregnancy. In addition, we discuss the association between emergency contraception and ectopic pregnancies.