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首页> 美国卫生研究院文献>Case Reports in Surgery >Laparoscopic Excision of Coexisting Left Tubal and Right Pseudotubal Pregnancy after Conservative Management of Previous Ectopic Pregnancy with Methotrexate: An Unusual Clinical Entity
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Laparoscopic Excision of Coexisting Left Tubal and Right Pseudotubal Pregnancy after Conservative Management of Previous Ectopic Pregnancy with Methotrexate: An Unusual Clinical Entity

机译：保守治疗既往异位妊娠并加甲氨蝶呤后并发腹腔镜切除左右假性输卵管妊娠的临床研究

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摘要

Tubal pregnancy concerns 97% of all ectopic pregnancies. Treatment can be either surgical (salpingostomy or salpingectomy) or medical (methotrexate administration). We present a case of a pseudotubal pregnancy after methotrexate treatment of a previous ectopic pregnancy. A37-year-old woman was diagnosed with ectopic pregnancy in the left Fallopian tube. A year ago, she had an ectopic pregnancy in the right tube, which was successfully treated with intramuscular methotrexate. During laparoscopy, two tubal masses were revealed, one in each Fallopian tube, and bilateral salpingectomy was performed. Histological analysis confirmed tubal pregnancy in the left Fallopian tube and presence of endosalpingitis in the right tube with no signs of chorionic villi. The optimal management of such cases has not yet been clarified. However, evaluation of tubal patency after a medically treated ectopic pregnancy would permit proper counsel of the patient on her fertility options, in order to choose the appropriate method of conception to achieve and accomplish a future pregnancy.
机译：输卵管妊娠占所有异位妊娠的97％。治疗可以是外科手术（输卵管造口术或输卵管切除术）或药物治疗（甲氨蝶呤给药）。我们提出甲氨蝶呤治疗以前的异位妊娠后假管妊娠的情况。一名37岁的女性被诊断出左输卵管异位妊娠。一年前，她在右管异位妊娠，并通过肌肉内甲氨蝶呤成功治疗。在腹腔镜检查中，发现两个输卵管肿物，每个输卵管一个，然后进行双侧输卵管切除术。组织学分析证实左输卵管输卵管妊娠，右输卵管内膜炎，无绒毛膜绒毛征象。此类案件的最佳管理方式尚未阐明。但是，对经过药物治疗的异位妊娠后输卵管通畅性的评估将允许患者适当地咨询其生育能力，以便选择适当的受孕方法来实现并完成未来的妊娠。

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