Atypical Presentation of Ectopic Pregnancy in an Obese Woman: A Case Report

子宮外孕在一名肥胖婦人的非典型表現：一個病例報告

楊德仁(Teck-Jin Yang) ； 蕭合莆(Ho-Fu Hsiao) ； 毛宏鑫(Hung-Hsin Mo)

《中華民國急救加護醫學會雜誌》 21卷4期 (2010/12) Pp. 216-220

https://doi.org/10.30018/JECCM.201012.0005

摘要

一名37歲的肥胖婦女因意識混亂，腹瀉以及呼吸過快送至急診，理學檢查發現呼吸音順暢，腹部柔軟。初步診斷為急性腸胃炎合併換氣過度後，隨即因D-dimer升高而懷疑是肺栓塞，但臨床表現及其它實驗室數據並不支持此診斷，一小時後病患卻出現休克現象及持續腹部不適，緊急安排腹部電腦斷層後，發現腹內出血的情形。之後病人接受了剖腹探查術，發現是子宮外孕破裂並予以清除。病患於五日後痊癒出院，術後於門診追綜復原良好。

關鍵字

子宮外孕 ； 肺栓塞 ； 肥胖

並列摘要

A 37-year-old obese woman (BMI=44.3) presented with disturbed consciousness, severe diarrhea and tachypnea. Physical examination revealed clear breathing sounds and a soft abdomen. She was initially treated as AGE and later a case of pulmonary embolism was suspected due to a high level of D-dimer. However the clinical presentation and the blood gas readings did not support a diagnosis of pulmonary embolism. Unstable hemodynamics developed within one hour. Emergency abdominal and pelvic computed tomography showed that this was a case of internal bleeding of unknown origin. Subsequently, the patient was subjected to laparotomy and a ruptured intratubal pregnancy was evacuated. She was discharged 5 days after admission as well and the recovery was still favorable at the 2 months follow-up.

並列關鍵字

ectopic pregnancy ； pulmonary embolism ； obesity