体外受精-胚胎移植治疗过程中合并阑尾炎穿孔1例并文献复习

Perforative appendicitis during in vitro fertilization-embryo transfer: a case report and literature review

目的探讨体外受精-胚胎移植(IVF-ET)治疗过程中合并阑尾炎穿孔的诊断及治疗方案。方法回顾性分析和总结本中心收治的1例IVF-ET中合并阑尾炎穿孔病例的诊断及治疗方案。结果该患者入院诊断首先考虑为卵巢扭转而未诊断为阑尾炎,入院后进一步检查及会诊后诊断为阑尾炎,并行急诊手术治疗后病情恢复出院。结论 IVF-ET过程中合并阑尾炎的诊断易于卵巢扭转混淆,易于穿孔。必要的外科手术干预,可改善患者的预后。

Objective To investigate the diagnosis and treatment of perforative appendicitis during in vitro fertilization and embryo transfer（IVF-ET） to improve the understanding and reduce misdiagnosis of this disease.Methods The diagnosis and treatment of 1 case of IVF-ET with perforative appendicitis in our reproductive center were analyzed retrospectively.Results The patient was first diagnosed as ovarian torsion rather than appendicitis, but confirmed as appendicitis through further examinations and consultation after admission. The patient was discharged after emergency operation.Conclusion There is a trend of ovarian torsion in the process of IVF-ET because of the enlargement of ovary, especially at the right side, which increases the difficulty of diagnosis of appendicitis. And the ovarian hyperstimulation syndrome （OHSS） caused by IVF-ET will exacerbate the progress of appendicitis, making it easy to be perforative. The necessary surgical intervention can improve the prognosis of patients.