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 Huge Ovarian Cyst- A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 87-90
Author(s):  
Sunita Maharjan ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Ovarian Cyst ◽  
Ovarian Tissue ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Ultrasound Finding ◽  
Emergency Laparotomy ◽  
Diagnosis And Management ◽  
The Right

Ovarian cyst torsion (also termed as adnexal torsion) refers to partial or complete rotation of the ovary and a portion of fallopian tube along with its supply to vascular pedicle. It occurs commonly in females of all age group, more on the right side (60%) and often with acute lower abdominal pain lasting for few hours up to 24 hours. Ovarian cyst torsion is one of the devastating conditions hampering blood supply of ovary which may lead to total necrosis of ovarian tissue like in our case. Delayed diagnosis and management can lead to various complications. Here, we present a case of 46 years old perimenopausal female, para 2, living 2 who presented to our emergency department with complain of sudden onset severe pain abdomen since morning. Emergency exploratory laparotomy was done due to high clinical suspicion of torsion based on previous ultrasound finding of ovarian cyst done a day prior to the presentation. On intraoperative finding, the cyst was already necrosed. Due to timely diagnosis and management by emergency laparotomy, anticipated complications were reduced.    

scholarly journals Heterotopic Pregnancy: A Clinical Case Report

1970 ◽  
Vol 39 (3) ◽  
Author(s):  
S Chowdhury ◽  
T Chowdhury
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ectopic Pregnancy ◽  
Clinical Examination ◽  
Clinical Case ◽  
Lower Abdominal Pain ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Ectopic Pregnancies

Heterotopic pregnancy is coexistence of intrauterine and extrauterine pregnancies that is ectopic pregnancies. It is said to be rare. Here we report a case of 27 years old woman with heterotopic pregnancy. Patient had a typical presentation of severe lower abdominal pain following amenorrhoea for 2½ months. On clinical examination, there was suspicion of ectopic pregnancy but ultrasonography revealed early intrauterine pregnancy along with right tubal pregnancy with huge collection in abdomen . Immediate laparotomy was done and diagnosis was confirmed as a case of heterotopic pregnancy.DOI: http://dx.doi.org/10.3329/bmj.v39i3.9950 BMJ 2010; 39(3)

scholarly journals Laparoscopic Management of an Abdominal Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Aarthi Srinivasan ◽  
Suzanne Millican
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Lower Abdominal Pain ◽  
Pain Patient ◽  
Prior History ◽  
Intrauterine Pregnancy ◽  
Beta Hcg ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
The Right

Background. Ectopic pregnancy is one of the leading causes of significant maternal morbidity and mortality. Abdominal surgeries increase the risk of postoperative adhesions. We here present a case of omental ectopic pregnancy in a patient with a prior history of cesarean section.Case. A 20-year-old female presented with a two-day history of crampy lower abdominal pain. Patient was hemodynamically stable with a beta HCG of 1057 mI/mL. Transvaginal ultrasound did not show an intrauterine pregnancy but revealed an ill-defined mass in the midline pelvis extending to the right of the midline. Diagnostic laparoscopy revealed large clots in the pelvis with normal uterus and adnexa. Intra-abdominal survey revealed an omental adhesion close to the right adnexa with a hematoma. Partial omentectomy was completed and the portion of the omentum with the hematoma was sent to pathology for confirmation. Final pathology confirmed the presence of chorionic villi consistent with products of conception.Conclusion. Omental ectopic pregnancy is a rare diagnosis and often missed. We recommend careful intra-abdominal survey for an ectopic pregnancy in the presence of hemoperitoneum with normal uterus and adnexa. This can be safely achieved using laparoscopy in early gestational ages when the patient is hemodynamically stable.

scholarly journals Heterotopic pregnancy: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Tamer Ali ◽  
Mohamed A. Tawab ◽  
Mona Abdel Ghaffar ElHariri ◽  
Alaa A. Ayad
Keyword(s):  
Abdominal Pain ◽  
Adnexal Mass ◽  
Stable Condition ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Laboratory Findings ◽  
The Right

Abstract Background Heterotopic pregnancy describes the occurrence of two pregnancies in different implantation sites simultaneously, which is rare, yet it is a challenge to diagnose such a problem due to complex clinical and laboratory findings. In the current study, we present a case of first trimester heterotopic pregnancy diagnosed by ultrasound (US) and magnetic resonance imaging (MRI) and was managed successfully. Case presentation A 22-year-old primigravida lady with spontaneous pregnancy was presented by increasing lower abdominal pain for 5 days with brownish vaginal discharge, nausea, and vomiting episodes. Trans-abdominal and endovaginal ultrasound was performed and revealed a viable intrauterine pregnancy of 8 weeks and 1 day, associated with a heterogeneous complex right adnexal mass. MR imaging revealed a right adnexal mass intimately anterior to the normal right ovary. Laparascopy was done; it revealed a distended right fallopian tube with pregnancy while the right ovary was not seen (impeded in the pouch of Douglas), and right salpingectomy was done. The specimen was sent for histopathology. The patient tolerated the procedure well and was then taken to the recovery room in stable condition. The histopathological report confirmed the diagnosis of ectopic pregnancy. Conclusion However, heterotopic is a rare condition, any pregnant woman presenting with alarming abdominal pain and adnexal abnormality; heterotopic pregnancy should be among the differential diagnosis possibilities. The patient should be thoroughly investigated using ultrasound and MRI if needed, to exclude this rare diagnosis and allow on-time proper management.

scholarly journals Heterotropic pregnancy: a common masquerade than ever thought?

2021 ◽  
Vol 10 (12) ◽  
pp. 1410
Author(s):  
Ayodele A. Olaleye ◽  
Boniface N. Ejikeme ◽  
Eziaha E. Okeke ◽  
Nwabunike E. S. Ede ◽  
Bartholomew I. Olinya ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Exploratory Laparotomy ◽  
Heterotopic Pregnancy ◽  
Multiple Gestation ◽  
Intrauterine Pregnancy ◽  
Vacuum Aspiration ◽  
Products Of Conception ◽  
History Of ◽  
One Year ◽  
Attending Physician

Heterotopic pregnancy, coexistence of living or dead intrauterine pregnancy, single or multiple, with extra-uterine pregnancy located in the oviduct, ovary, uterine cornua, cervix or rarely peritoneal cavity. Heterotropic pregnancy is relatively uncommon in spontaneous conception with 1 in 30,000 cases reported, the incidence of heterotopic pregnancy increases to 1 in 3900 when conception is enhanced with various assisted reproduction techniques (ART). It is an ectopic pregnancy coexisting with intrauterine pregnancy. But is the incidence of heterotropic pregnancy rising? A case was reported from our centre in 2018 by Ejikeme et al, and we have recorded another two cases in the period of one year. Ectopic pregnancy has been described as a great masquerader, which makes diagnosis and management of heterotropic pregnancy a dilemma to attending physician. We present a case of an unbooked 26 years old G4P3+0 who has no family history of multiple gestation and presented at gestational age of 8 weeks and 5 days with 2 days history of abdominal pain and vaginal bleeding and 2 hours history of loss of consciousness. She later had exploratory laparotomy with left salpingectomy and manual vacuum aspiration of Retained Products of Conception with good outcome. In conclusion, spontaneous heterotropic pregnancy is a rare occurrence, however with advent of artificial reproductive technology and increase incidence of pelvic inflammatory disease, the incidence could be higher than earlier suspected.

scholarly journals Vaginal Delivery at Term in a Woman with a Spontaneous Heterotopic Pregnancy Treated with Laparoscopic Salpingectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Michail Diakosavvas ◽  
Nikolaos Blontzos ◽  
Georgios Daskalakis ◽  
Athanasios Protopapas ◽  
Nikolaos Kathopoulis ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Vaginal Delivery ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Major Complication ◽  
Heterotopic Pregnancy ◽  
Clinical Image ◽  
Intrauterine Pregnancy ◽  
Beta Hcg ◽  
Laparoscopic Salpingectomy

Background. The coexistence of an intrauterine pregnancy and an ectopic pregnancy (heterotopic pregnancy) is an extremely rare, yet major, complication during pregnancy. The early diagnosis of a heterotopic pregnancy is of great importance for fetal viability, maternal safety, and the progression of an uncomplicated intrauterine pregnancy. Case Presentation. We report a case of a naturally conceived heterotopic tubal pregnancy in a 37-year-old primigravida. The patient presented with continuous, dull, lower abdominal pain and a positive urine pregnancy test which was conducted a week prior to the start of the pain. The patient was hospitalized, and based on the clinical image and after strict monitoring, she was diagnosed with a heterotopic pregnancy. She was treated with laparoscopic salpingectomy after the rupture of the ectopic pregnancy while the desired intrauterine gestation continued without any complications. The pregnancy resulted in the birth of a healthy infant through vaginal delivery. Discussion. Strict monitoring with multiple sonographic evaluations should always be conducted in women with abnormal serum beta-hCG, adnexal abnormalities, or clinical symptoms, while heterotopic pregnancy should be in differential diagnosis and treatment should not be delayed since emerge management is important for the progression of the intrauterine pregnancy.

scholarly journals A unique case of diagnosis of a heterotopic pregnancy at 26 weeks – case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Kajdy ◽  
Katarzyna Muzyka-Placzyńska ◽  
Dagmara Filipecka-Tyczka ◽  
Jan Modzelewski ◽  
Marek Stańczyk ◽  
...  
Keyword(s):  
Gestational Age ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Free Fluid ◽  
Intrauterine Pregnancy ◽  
Unique Case

Abstract Background Heterotopic pregnancy (HP) is a rare condition when at least two pregnancies are present simultaneously at different implantation sites and only one located in the uterine cavity. The majority of cases are diagnosed in the first trimester. Case presentation We present a unique case of HP diagnosed at 26 weeks of spontaneous pregnancy in a patient without any relevant risk factors. We performed an extensive review of HP cases from MEDLINE (PUBMED) published in English between 2005-2019 to prove this case's uniqueness. A 24-year-old woman presented because of threatened preterm birth. Despite treatment, pain aggravated, without progression of labor. An emergency ultrasound exam revealed free fluid in the abdominal cavity. Suspicion of active bleeding prompted the medical team to perform an exploratory laparotomy. The surgery team found a ruptured heterotopic pregnancy. This was an unexpected cause of nontraumatic hemoperitoneum at such advanced gestational age. The postoperative period was uneventful, and the intrauterine pregnancy continued to term. The final review included 86 out of 124 records. A total number of 509 cases were identified, but not all of them had complete data. The maximum reported gestational age at the time of diagnosis was 16 weeks of pregnancy, while our case became symptomatic and was diagnosed at 26 weeks of pregnancy. Conclusions Regardless of pregnancy age, HP can be a cause of hemoperitoneum, and it should be included in the differential diagnosis of acute abdomen in the second trimester.

scholarly journals Occurrence of parasitism by Dioctophyma renale in ring-tailed coatis (Nasua nasua) of the Tiete Ecological Park, São Paulo, Brazil

2009 ◽  
Vol 29 (12) ◽  
pp. 959-962 ◽  
Author(s):  
Liliane Milanelo ◽  
Márcia Bento Moreira ◽  
Lílian S. Fitorra ◽  
Bruno S.S. Petri ◽  
Melissa Alves ◽  
...  
Keyword(s):  
Population Control ◽  
Abdominal Cavity ◽  
Exploratory Laparotomy ◽  
Renal Tissue ◽  
Intermediate Hosts ◽  
Wild Mammals ◽  
Rigid Structure ◽  
Nasua Nasua ◽  
Males And Females ◽  
The Right

Dioctophymosis is a worldwide renal parasitosis caused by the Dioctophyma renale nematode, which results in progressive destruction of renal tissue. Aquatics annelids are considered the main intermediate hosts and the literature refers as permanent hosts of dogs, wild mammals and even humans. During procedures for population control of coatis (Nasua nasua) in the Ecological Park of Tietê (PET), was noticed the presence of parasitosis by D. renale. From 68 animals, males and females, young and adults, submitted to exploratory laparotomy, 51 were positive for the presence of worms, 9 were found only in the right kidney. In 10 cases, in addition to right kidney parasitism, worms were also observed in the abdominal cavity. In 24 cases D. renale was found only in the abdominal cavity and in 8 animals the right kidney was reduced to a small rigid structure. The study showed that the preferred site for parasitism of the worm, considered erratic, was the abdominal cavity in 66.66% of the cases.

Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan
Keyword(s):  
Abdominal Pain ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Sudden Onset ◽  
Greater Omentum ◽  
Caribbean Woman ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right ◽  
Fat Stranding

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

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