卵管膨大部妊娠で卵管切除後に同側残存卵管峡部双胎妊娠を来し、２度の異所性妊娠手術を経て生児を得た１例

抄録

　Cases of ectopic pregnancies in the ipsilateral fallopian tube after salpingectomy are rare. This report presents a unique case of an ectopic twin pregnancy that occurred in the residual isthmus of the ipsilateral fallopian tube after a prior salpingectomy for an ampullary tubal pregnancy. This case led to a live birth following a second ectopic pregnancy surgery.

　A 39-year-old woman underwent laparoscopic salpingectomy due to a right ampullary tubal pregnancy at 36 years of age. She had previously undergone a frozen embryo transfer at the age of 38. At 5 weeks and 6 days of gestation, the absence of a gestational sac within the uterus and the detection of one gestational sac and two yolk sacs near the right adnexal area raised suspicions of an ectopic twin pregnancy. Initial imaging studies were inconclusive regarding the precise site of pregnancy, necessitating additional diagnostic examinations and hospitalization. On the third day of hospitalization, the suspected site had expanded, and further examinations confirmed the presence of an ectopic twin pregnancy in the residual tubal isthmus of the right fallopian tube. The ectopic pregnancy was successfully excised during a second laparoscopic surgery. Subsequently, the patient underwent a frozen embryo transfer. The pregnancy progressed without complications, resulting in the delivery of a 2,790 g infant by cesarean section. Careful patient management is crucial, given the potential for ectopic pregnancies in the ipsilateral fallopian tube following salpingectomy. Moreover, adding tubal interstitial sutures during salpingectomy may prevent ipsilateral residual tubal pregnancy.