Author: Eva Račanská
Description:
28 year old II.gravida I.para referred from surgical emergency for an acute onset of pelvic pain which started after sexual intercourse. last menstrual period 6wks ago. Serum - hCG level 1046 IU/l. Pain was accompanied by nausea and vomiting. Patient delivered 6 years ago via Caesarean section (ophtalmologic indication). Right salpingectomy was performed 1 year ago due to an ectopic - right tubal pregnancy.
Bimanual pelvic examination showed enlarged uterus, tenderness during cervical movements and both adnexal regions tender to palpation as well. Ultrasound examination: no gestation sac in the uterine cavity, high endometrium 14 mm, moderate amount of the free fluid in the pouch of Douglas.
Diagnostic laparoscopy was performed because of suspicion of an ectopic pregnancy. Retroverted soft uterus, left uterine tube of normal size and shape, stub of the right uterine tube after previous salpingectomy was covered with the blood clot and devastated by ectopic pregnancy. Stub of the right uterine tube was removed using bipolar coagulation and scissors. Histology confirmed placental tissue in the resected uterine tube.
Categorization:
Tubal pregnancy
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