腹腔鏡下手術で治療できた大網妊娠の１例

抄録

　A 26-year-old woman at 7 weeks and 4 days of gestation presented with atypical vaginal bleeding and mild abdominal pain. Transvaginal ultrasound revealed a free hypoechoic area of 10 mm in the pouch of Douglas and a 13-mm thick homogenous endometrium with no evidence of a gestational sac. A mass (46 × 38 mm) was detected outside of the uterine fundus. A T1-weighted MRI was performed, revealing a 4-cm mass between the left side of the fundus and the left ovary. Laboratory results indicated normal blood count values and a human chorionic gonadotropin (hCG) level of 4,393 mIU/ml. Because we suspected an ectopic pregnancy, we performed a laparoscopic exploration. An omental ectopic mass was detected 4 cm from the left fallopian tube. We performed a partial omentectomy using a laparoscopic approach to remove the omental mass. Pathological examination confirmed the diagnosis of an omental ectopic pregnancy with the presence of chorionic villi, blood clots, and adipose tissue. Post-operatively, the patient presented with decreased serum hCG levels and no surgery-related complications. We can use laparoscopy to successfully treat abdominal pregnancies, including rare cases of omental pregnancy.