A case of retroperitoneal para‐aortic ectopic pregnancy detected by sonography

Zhang, Min; Qin, Ling-Ling

doi:10.1002/jcu.22554

Cited by 14 publications

(7 citation statements)

References 13 publications

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“…Es una emergencia común en obstetricia y representa 13% de todas las muertes relacionadas con el embarazo (7) . Su patogenia es desconocida, aunque se ha propuesto como la posible causa a cambios adhesivos en la pelvis, incluidas las trompas de Falopio (8) .…”

Section: Discussionunclassified

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Embarazo ectópico retroperitoneal primario

Torres-Cepeda¹,

Rondón-Tapía²

2023

Rev peru ginecol obstet.

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El embarazo ectópico representa 1,5% a 2% de todos los embarazos y es causa común de mortalidad relacionada con el embarazo durante el primer trimestre. La ubicación más común es la trompa de Falopio y menos del 2% son embarazos abdominales. El embarazo ectópico retroperitoneal es un tipo de extremadamente raro con una patogénesis bastante compleja. Esta ubicación inusual tiene un alto riesgo de complicaciones potencialmente mortales. El diagnóstico temprano es difícil por la incapacidad de diferenciar signos, síntomas, concentraciones de gonadotropina coriónica e imágenes con embarazos ectópicos de las ubicaciones inusuales, como el retroperitoneo. Además, es necesario tener cuidado con el diagnostico de estos casos cuando los sitios más comunes de aparición no presentan alteraciones. El tratamiento es la extracción de tejido trofoblástico por laparotomía o laparoscopia. Se presenta un caso de embarazo ectópico retroperitoneal primario.

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Section: Discussionunclassified

“…Los sitios más comunes del embarazo abdominal son el fondo de saco de Douglas, pared uterina posterior, ligamentos infundibulopélvicos, pared abdominal anterior, epiplón, hígado, bazo y diafragma. En casos excepcionales, la implantación del embrión se produce en el espacio retroperitoneal (8) .…”

Section: Discussionunclassified

Embarazo ectópico retroperitoneal primario

Torres-Cepeda¹,

Rondón-Tapía²

2023

Rev peru ginecol obstet.

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“…And those REPs in the mid or upper abdomen may be out of reach for TVS, which potentially increases the risk of misdiagnosis. Fortunately, the development of full abdominal ultrasonography, CT scan and magnetic resonance imaging (MRI) provide a strong support for early diagnosis of rare REP [ 29 , 30 , 35 ]. TAS is the most commonly used examination method (66.7%, 22/33), followed by CT (33.3%, 11/33) and MRI (18.2%, 6/33).…”

Section: Discussionmentioning

confidence: 99%

“…In our case, ultrasound-guided local injection of potassium chloride solution into gestation sac was combined with systemic MTX in order to reduce embryonic activity. Zhang et al [ 29 ] reported one patient treated with MTX and selective arterial embolization therapy. Unfortunately, all of the 6 cases were finally treated with retroperitoneal pregnancy resection due to treatment failure.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary treatment of retroperitoneal ectopic pregnancy: a case report and literature review

Cheng

Yang

et al. 2022

BMC Pregnancy Childbirth

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Background Retroperitoneal ectopic pregnancy (REP) is an extremely rare type of ectopic pregnancy, with a total of less than 32 cases reported in the English literature. Early diagnosis of REP is very difficult and all treatments entail a high risk of life-threatening complications. Case presentation A 29-year-old nulliparous woman presented a history of 50-day amenorrhea and 7-day upper abdominal pain without vaginal spotting. The serum beta-human chorionic gonadotropin (β-hCG) value was 65,004 m-international units per milliliter (mIU/mL), but no intrauterine gestational sac was found via transvaginal sonography (TVS). Then transabdominal ultrasonography (TAS) and abdominal contrast-enhanced computer tomography (CT) identified a retroperitoneal ectopic pregnancy (REP) tightly adjacent to the inferior vena cava and the abdominal aorta. After consultation from a multidisciplinary team, systemic methotrexate (MTX, intramuscular 20 mg daily for 5 consecutive days) combined with ultrasound-guided local potassium chloride solution injection into the gestational sac was scheduled firstly for the patient. However, serum β-hCG continued to increase and the patient experienced worsening abdominal pain. Laparotomy was performed jointly by a gynecologist and a vascular surgeon. During the operation, the gestational sac with fetal bud measuring about 4.5 × 4.0x3.0 cm, tightly adherent to the surface of inferior vena cava and the left side of abdominal aorta, was carefully dissociated out from the surrounding tissues and removed en bloc. Histopathology examination confirmed the diagnosis of REP. The patient recovered uneventfully and her serum β-hCG returned to normal range on the 23th postoperative day. Conclusions Considering the possibility of REP and combined radiological examinations, such as ultrasonography and CT, are crucial for the early diagnosis of this rare condition. A multidisciplinary team is necessary to treat REP.

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“…Huang et al calculated there are only 26 cases of retroperitoneal ectopic pregnancies during the past decades had been reported [2]. REP has a greater risk of rupture, surgery and methotrexate injection are the choises of treatment [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Abortive Retroperitoneal Ectopic Pregnancy Followed Up by Ultrasound: A Case Report

Ye¹,

Yu²,

Jiang³

et al. 2020

Preprint

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Background: Ectopic pregnancy can be life-threatening. Most of ectopic pregnancy located in the fallopian tube. But retroperitoneal ectopic pregnancies are extremely rare.Results: We report a 29-year-old Chinese woman with amenorrhea for 50 days presented to emergency department for abdominal pain. Her serum β-hCG level was 1675mIU/ml. Transvaginal sonography showed irregular anechoic area in uterine cavity without pregnancy sac echo. And nothing wrong was found in bilateral adnexa. Abdominal ultrasound showed a mixed echo region behind the pancreas. The clinical diagnosis was retroperitoneal ectopic pregnancy. The patient's vital signs remained stable with the mass size continue decreased . Because of the huge surgery risk, the mass was followed up by ultrasound closely.Conclusions: 5 months after bleeding, the fourth ultrasound follow-up examination showed the mass disappeared completely and serum β-hCG level was normal .

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A case of retroperitoneal para‐aortic ectopic pregnancy detected by sonography

Cited by 14 publications

References 13 publications

Embarazo ectópico retroperitoneal primario

Embarazo ectópico retroperitoneal primario

Multidisciplinary treatment of retroperitoneal ectopic pregnancy: a case report and literature review

Abortive Retroperitoneal Ectopic Pregnancy Followed Up by Ultrasound: A Case Report

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