妊娠13週に左卵管を温存し得た左傍卵管嚢胞茎捻転の一例

抄録

　There are a few reports of torsion of paratubal cysts during pregnancy. We encountered a case wherein it was possible to spare the fallopian tubes in a patient with parabutal cyst torsion during early pregnancy; herein, we report our findings. A 32-year-old nulliparous woman became pregnant naturally and was receiving prenatal care from her previous doctor. At 13 weeks and 1 day of gestation, the patient experienced sudden pain in the lower left abdomen. A 6-cm mass was found in the left ovary on transabdominal ultrasonography, which matched the site of the abdominal pain; so the same diagnosis was established in this hospital, and we implemented experimental laparoscopic surgery. Observation of the abdominal cavity revealed a cystic tumor in the left mesosalpinx, and the patient was diagnosed with torsion of the paratubal cyst. Each fallopian tube was twisted once and turned dark red in color. Once the torsion was removed, the color rapidly improved, and there was no adhesion to the surrounding tissue or necrosis; therefore, it was considered possible to spare the fallopian tubes. The ligament was opened, and only the cyst was excised. The pregnancy progressed well, and the patient had a spontaneous cephalic delivery at 39 weeks and 5 days of gestation. The baby was male, weighing 3500 g and with an Apgar score of 9/10. Prompt laparoscopic surgery without hesitation is an effective treatment when uterine appendage torsion is suspected with acute abdominal pain, even during early pregnancy.