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頁籤選單縮合
題名 | Delayed Diagnosis of Ectopic Pregnancy after Fallopian Tubal Ligation: A Case Report=延遲診斷輸卵管結紮後的子宮外孕病例報告 |
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作 者 | 郭華基; 邱俊傑; 邱守苕; 沈希哲; 王明正; 陳天啟; 李國平; | 書刊名 | 中華民國急救加護醫學會雜誌 |
卷期 | 18:3 2007.09[民96.09] |
頁次 | 頁131-135 |
分類號 | 417.347 |
關鍵詞 | 急症腹痛; 併發症; 絕育; 子宮外孕; Acute abdominal pain; Complications; Sterilization; Ectopic pregnancy; |
語文 | 英文(English) |
中文摘要 | 雖然接受輸卵管結紮,但仍可能會發生致子宮外孕。本文報告一位 31 歲已婚婦女,過去曾經受孕 3 次、妢娩 2 次和自然流產 1 次,急診說醫原因是晚餐後發生噁心嘔吐。據病人自述,其月經周期正常和五年前已接受輸卵管結紮手術,且兩週前亦有月經來潮。急診室初步診斷為急症胃炎,並予抗胃腸痙攣針劑藥物治療,但症狀未見緩解,在留院觀察治療2小時後出現低血容性休克;進一步檢查,其尿液孕姙反應呈現陽性,修訂診斷為子宮外孕合併急性出血,安排會診婦產科。緊急剖腹手術探查,從腹腔清出近2公升血塊,確認左側輸卵管子宮外孕合併破裂,經接受左側輸卵管切除,病情穩定,手術後5天出院。本例遲延診斷子宮外孕,歸納是受臨床病徵和病人結紮絕育病史的誤導。 |
英文摘要 | Prior tubal sterilization should be regarded as a possible etiological factor in the pathogenesis of ectopic pregnancy. The authors present the case of a 31-year-old female who presented to our Emergency Department (ED) with the principal complaints of nausea and vomiting. She had undergone postpartum tubal ligation 5 years previously. Initial impression was acute gastritis. However, the discomfort was not resolved with the antispasmodic Buscopan®. Hypovolemic shock developed 2 hours later. The diagnosis was revised to ruptured ectopic pregnancy as the urine pregnancy test was positive. Urgent laparotomy was performed and a rupture tubal pregnancy was found in the left fallopian tube. The patient recovered uneventfully after left salpingectomy and was subsequently discharged 5 days later. The pitfall of this case was the delayed diagnosis with mimicking clinical presentation and the patient having a history of tube sterilization. |
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