Infrahepatic Implantation of an Ectopic Pregnancy

2021 ◽  
pp. 1-3
Author(s):  
Peter Kern ◽  
Paula Ulrich ◽  
Rainer Kimmig ◽  
Peter Kern
Keyword(s):  
Ectopic Pregnancy ◽  
Close Contact ◽  
Blood Clot ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Greater Omentum ◽  
Free Fluid ◽  
Fallopian Tubes ◽  
Lower Abdomen ◽  
The Right

Background: Ectopic pregnancies occur predominantly in the fallopian tubes or ovaries. Very rarely, the distal part of the greater omentum may have close contact to the fallopian tubes and implantation of the embryo may occur in this part of the greater omentum. In the absence of signs of pregnancy in the uterus or the fallopian tubes, the greater omentum has to be closely examined for ectopic pregnancy. Case Presentation: A 22-year-old woman in her 4th week of pregnancy presents with spotting and severe pain in the right lower abdomen with a history of 2 cesarean sections. The sonographic examination showed a normal uterus with a thin endometrial line. The uterine cavity did not present with any signs of a gestational sac. A great amount of free fluid in the Douglas cavity suspicious of a hemoperitoneum. ßhCG-values in serum was highly elevated up to 16749 mU/ml and confirmed the suspicion of an ectopic pregnancy. A diagnostic laparoscopy was performed, during which a blood clot reaching from the right lower abdomen to the greater omentum was detected. After removing the blood clot, a normal-sized uterus with regular ovaries and no signs of a pregnancy in the fallopian tubes were seen. However, an abdominal adhesion in the right upper part of the omentum close to the liver with bleeding was seen. While examining the abdominal cavity for the cause of bleeding, a small cystic lesion adherent to the greater omentum – close the offspring from the colon – representing an ectopic pregnancy became apparent. A partial omentectomy of 9,5 cm x 5,5 cm x 2,5 cm was performed with the finding of trophoblast and embryoblast implantated in the infrahepatic part of the greater omentum. Conclusion: In cases of ectopic pregnancy with hemoperitoneum, special care has to be taken examining not only the fallopian tubes or ovaries but also the greater omentum, which may harbour an implanted trophoblast and embryoblast – even in the upper part directly beneath the liver – as presented in this case. In cases of ruptured ectopic pregnancy of the greater omentum, the cases may be dealt with laparoscopic partial omentectomy if the case is early detected.

scholarly journals A. A. Muratov. - To the question of sarcoma transplantation to the healthy part of the body in the same patient. (Yezhenedelnik, 1895, No. 15)

2020 ◽  
Vol 9 (7-8) ◽  
pp. 659
Author(s):  
N. Kakushkin
Keyword(s):  
Abdominal Cavity ◽  
Large Cell ◽  
The Body ◽  
Fallopian Tubes ◽  
Lower Abdomen ◽  
Cell Sarcoma ◽  
Constant Pain ◽  
Healthy Part ◽  
The Right

Cases of self-infection with cancer are described by Sippel. The author describes a case of self-infection with sarcoma. Dressmaker, 14 years old; complaints of severe constant pain in the lower abdomen. Recognized the neoplasm of common Fallopian tubes, or ovaries, probably of a sarcomatous nature. Gluttony showed that the tumor, extensively fused with the surrounding organs, belongs to the right appendage. When it was separated, part of its clumpy-purulent contents poured out into the abdominal cavity. The entire tumor was removed and, carefully examined, turned out to be a round-large-cell sarcoma, containing parts of fusiform cells in places.

scholarly journals Unsual Tubal Twin Ectopic Gestation Report of Three Different Cases

2018 ◽  
Vol 1 (3) ◽  
pp. 96-103
Author(s):  
S Gosavi Maheshgir ◽  
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Rare Condition ◽  
Fallopian Tubes ◽  
Tubal Ectopic Pregnancy ◽  
Ectopic Gestation ◽  
First Case ◽  
History Of ◽  
Twin Pregnancies

Gestation outside the uterine cavity in which the implantation occurs in any tissue other than the endometrium is referred as ectopic pregnancy. The most places for occurring ectopic pregnancy (97% of cases) are the fallopian tubes including ampulla (55%), isthmus (25%), and fimbria (17%), and in 3% of patient’s ectopic pregnancy occurs in the abdominal cavity, ovary, or cervix. The tubal twin ectopic pregnancy is a rare condition, and the first unilateral tubal twin was reported by De Ott in 1891, and the first live twin tubal ectopic pregnancy was reported in 1944. A live tubal twin ectopic pregnancy is a very rare condition and among >100 reports of tubal twin pregnancies, till now, only 8 cases were live. Early diagnosis and treatment of women with tubal twin ectopic pregnancy is very important and may decrease the risk of tubal rupture. I present three cases of tubal twin ectopic gestation. In the first case, spontaneous unilateral live tubal twin ectopic gestation. The second and third cases spontaneous ruptured twin ectopic gestation. All three cases were successfully managed and there was no history of assisted reproductive techninique fertilization or pelvic inflammatory disease.

ECTOPIC PREGNANCY WITH ACCEPTOR IMPLANT

2019 ◽  
Vol 3 (1) ◽  
pp. 48-55
Author(s):  
Putri Zelfitri Zen ◽  
Yusrawati Yusrawati
Keyword(s):  
Ectopic Pregnancy ◽  
Contraceptive Use ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Hormonal Contraceptive ◽  
Obstetrics And Gynecology

Objective: To report a case of Ectopic pregnancy with implant receptorsMaterials and Methods: This article describes the case of a 41-year-old woman, diagnosed with an Ectopic Pregnancy on the gravid G5P4A0H4 11-12 weeks. Patients are using implant contraception, which has been used since 2009-2018 (3 installations). The patient came to the obstetrics and gynecology clinic Dr. M. Djamil Padang. The ultrasound gives the impression of Ectopic pregnancy in the infindibule tube. Analysis Ectopic pregnancy can also occur due to the influence of hormonal contraceptive use (progesterone).Results: Patient gets intervention performed laparotomy After the peritoneum is opened it appears fresh red blood amounting to ± 500 cc filling the abdominal cavity. Blood evacuation and exploration are performed, it appears that the source of bleeding originates from the left tubal rupture (Infundibulum) Impression of the left tubal rupture (Infundibulum) ecectic ectopic pregnancy is impaired. Sinistal salpingectomy is performed.Conclusion: Ectopic pregnancy Ectopic pregnancy is all pregnancies where the ovum fertilized by spermatozoa implant and grows outside the uterine cavity endometrial.

HETEROTOPIC PREGNANCY WITH INEVITABLE ABORTION (RIGHT ADNEXAL LIVE ECTOPIC AND COEXISTING INTRAUTERINE TRIPLETS WITH ABSENT FETAL CARDIAC ACTIVITY)

2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Short Period ◽  
The Right

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.

scholarly journals Ectopic Pregnancy in Two Cats

2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Scar Tissue ◽  
Tubal Pregnancy ◽  
Abdominal Pregnancy ◽  
Fallopian Tubes ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.

scholarly journals Case of Ruptured Ectopic Pregnancy in the Uterosacral Ligament and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yasmin Abedin ◽  
Kanchi Chadha
Keyword(s):  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Uterosacral Ligament ◽  
Free Fluid ◽  
Fallopian Tubes ◽  
Review Of The Literature ◽  
Chorionic Villi ◽  
Beta Hcg ◽  
Beta Human Chorionic Gonadotropin ◽  
Potential Risk Factors

Pregnancies that implant on the uterosacral ligament are rare. Here, we describe a case of ruptured ectopic pregnancy in the left uterosacral ligament in a patient with potential risk factors including possible endometriosis and recent hysteroscopic procedure. A 29-year-old female, para 0, presented to the emergency department with generalized abdominal pain. Pelvic examination was significant for fullness in the posterior cul-de-sac. Laboratory values were significant for beta-human chorionic gonadotropin (hCG) level of 6311 mIU/mL. Sonogram findings were significant for no intrauterine gestation, a 6.9×4.6×4.7 cm3 complex left adnexal mass, and moderate free fluid within the posterior cul-de-sac. The patient underwent laparoscopy, which revealed hemoperitoneum and unremarkable bilateral fallopian tubes and ovaries. An abnormal area was noted in the left uterosacral ligament. Tissue was bluntly removed and pathologically confirmed as chorionic villi within the left uterosacral ligament. After one week, her beta-hCG decreased to 784 mIU/mL. After two weeks, she was seen as an outpatient and was doing well without any symptoms. More information is required regarding these unique pregnancies to help understand the pathophysiology and determine the management.

scholarly journals A petevezeték-átjárhatóság vizsgálómódszereinek összehasonlító elemzése

2017 ◽  
Vol 158 (9) ◽  
pp. 324-330 ◽  
Author(s):  
Judit Lőrincz ◽  
Attila Jakab ◽  
Péter Török
Keyword(s):  
Direct Method ◽  
Standard Procedure ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Fallopian Tubes ◽  
Predictive Values ◽  
Tubal Patency ◽  
First Choice

Abstract: Most common organic cause of infertility is the blockage of the Fallopian tubes. Several methods were introduced to evaluate tubal patency. Hysterosalpingography is a conventional radiology procedure using contrast medium, which gives an accurate image of the uterine cavity and the Fallopian tubes, but radiation exposure is necessary. Hystero-contrast-sonography similarly examines the uterine cavity and tubal patency by ultrasonography, and it enables to detect pelvic pathology, too. Transvaginal hydrolaparoscopy is a minimal invasive direct method using endoscope introduced into the abdominal cavity through the posterior vaginal fornix, both ovaries and tubal patency can be observed. Laparoscopy is the “gold standard” procedure in the tubal testing, however it is a more invasive procedure. A cost-effective testing method is the selective tubal pertubation performed via office hysteroscopy. Recent outpatient methods to detect tubal patency have high negative predictive values and recommended to be the first choice in infertility work-up. Orv. Hetil., 2017, 158(9), 324–330.

Age Related Change of Inner Diameter of Ampulla of Fallopian Tube in Bangladeshi Female Cadaver

2018 ◽  
Vol 4 (2) ◽  
pp. 137-140
Author(s):  
Hasna Hena ◽  
Shamim Ara ◽  
Rubina Qasim ◽  
Dilruba Siddiqua ◽  
Fatema Johora ◽  
...  
Keyword(s):  
Fallopian Tube ◽  
Age Groups ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Cross Sectional ◽  
Age Related ◽  
Significant Difference ◽  
Inner Diameter ◽  
The Mean ◽  
The Right

Background: The fallopian tubes act as conduit for spermatozoa to reach the oocyte and to convey the fertilized (egg) to enter the uterine cavity following fertilization. Problems with the fallopian tubes can lead to infertility. Detailed morphological and histological knowledge is essential for the diagnosis and management of fallopian tube disease.Objective: The purpose of the present study was to identify the inner diameter of ampulla of the fallopian tube and its changes with advancing age.Methodology: This descriptive cross-sectional study was conducted in the Department of Anatomy at Dhaka Medical College, Dhaka, Bangladesh from July 2008 to June 2009 for a period of one (01) year. This present study was performed on post mortem fallopian tubes of Bangladeshi female. Among them lowest age was 12 years and highest age was 50 years. Samples were divided into three differential age groups named asgroup A (10 to 13 years), group B (14 to 45 years), and group C (46 to 50 years). All samples were studied morphologically and histologically.Results: The mean inner diameter of the ampulla of the right and left fallopian tubes ranged from 1.99±0.08 to 3.24±0.27 mm. The difference between all the groups were statistically significant (p < 0.001).Conclusion: The mean difference of the inner diameter of the ampulla of the right and left fallopian tubesbetween groupA and groupB and groupB and groupC were statistically significant; however, there was no significant difference between right and left fallopian tube.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 137-140

scholarly journals Cornual Heterotopic Pregnancy after Bilateral Salpingectomy and Uterine Septum Resection Resulting in Term Delivery of a Healthy Infant

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Serkan Oral ◽  
Yaşam Kemal Akpak ◽  
Nilay Karaca ◽  
Ali Babacan ◽  
Kadir Savan
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Heterotopic Pregnancy ◽  
Simultaneous Occurrence ◽  
Free Fluid ◽  
Uterine Septum ◽  
Bilateral Salpingectomy ◽  
Live Fetus

Heterotopic pregnancy is the simultaneous occurrence of two or more implantation sites. A 25-year-old infertile patient with a history of bilateral salpingectomy, uterine septum resection, and left cornual resection was diagnosed with heterotopic pregnancy in her secondin vitrofertilization trial. She attended our clinic when she was 7-week pregnant, complaining initially of severe abdominal pain. Findings associated with peritoneal irritation were positive during the physical examination. Transvaginal ultrasound revealed right cornual ectopic pregnancy with a live fetus in the middle of the uterine cavity. Also free fluid was noted in the pelvis. A diagnosis of heterotopic pregnancy with rupture of the cornual pregnancy was made. She underwent emergency laparoscopy with aspiration of the ruptured ectopic pregnancy, suturing to the entire visible cornual margins, and assurance of good haemostasis. Her recovery was uneventful and she continued receiving care in our obstetric unit. She delivered a healthy newborn by cesarean section at term.

scholarly journals Possibilities of CT in the diagnosis of complications of intestinal diverticulosis (clinical observation)

2019 ◽  
pp. 54-65
Author(s):  
E. P. Korneva ◽  
M. V. Rostovtsev ◽  
N. V. Nudnov ◽  
T. M. Rostovtseva ◽  
E. V. Pronkina
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
High Sensitivity ◽  
Intestinal Wall ◽  
Free Fluid ◽  
Abdominal Organs ◽  
Multiplanar Reformatting ◽  
Detection And Diagnosis ◽  
The Right

Purpose. To determine the possibility of MSCT in the detection and diagnosis of complications of diverticulosis.Materials and methods. MSCT was performed in the apparatus Aqullion Toshiba 64 with collimation of 0.5–1 mm with the multiphase contrast-enhanced and further multiplanar reformatting. The results of MSCT of abdominal organs in 2082 (100%) patients for 2016–2018 in GBUZ GKB im were analyzed. M.E. Zhadkevich, 841 (40%) – for emergency indications.Results. Intestinal diverticula was detected in 239 (11%) patients. CT-signs of diverticulitis were found in 36 (1.7%) subjects: 19 (0.9%) women aged 54 years to 91 years and 17 (0.8%) men aged 27 to 88 years. When admitted to the hospital, all patients (36 people – 100%) with CT signs of diverticulitis complained of severe abdominal pain: with localization in the left iliac and suprapubic areas of 22 (61%) patients, 2 (5.5%) – in the right iliac and suprapubic areas, the remaining 12 (33.5%) patients complained of abdominal pain without a clear localization. Localization of diverticulitis in the sigmoid colon occurred in 22 (61%) cases, in the descending part of the colon – in 13 (36%). In 1 (3%) observation diverticulitis was detected in the terminal part of the jejunum.The presence of perianth infiltrate took place – in 16 (44%) cases, with signs of abscedding – in 4 (11%), peritonitis was observed in 2 (5.5%) examined in combination with signs of intestinal obstruction. Perforation with the presence of a large amount of free gas was detected in 1 (3%) case, microperforation – in 12 (33.5%). A small amount of free fluid in the abdominal cavity was found in 18 (50%) patients. Conclusion. Timely diagnosis of complicated diverticular disease is crucial. MSCT has high sensitivity and specificity in the diagnosis of phlegmon and abscesses of the abdominal cavity, perforation of the intestinal wall, peritonitis, bleeding and intestinal obstruction.

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