Delayed Diagnosis of Ectopic Pregnancy after Fallopian Tubal Ligation: A Case Report

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。

關鍵字

急症腹痛；併發症；絕育；子宮外孕

並列摘要

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.

並列關鍵字

acute abdominal pain ； complications ； sterilization ； ectopic pregnancy

國際替代計量

Delayed Diagnosis of Ectopic Pregnancy after Fallopian Tubal Ligation: A Case Report

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