Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its incidence is rising mostly due to induction of ovulation or Assisted Reproductive Technique. Most ectopic in heterotopic pregnancies are l...Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its incidence is rising mostly due to induction of ovulation or Assisted Reproductive Technique. Most ectopic in heterotopic pregnancies are localized in the fallopian tubes. The occurrence of molar tubal ectopic pregnancy coexisting with intrauterine pregnancy is uncommon and consequently not often considered a diagnostic possibility. Case Report: We report the case of a 25-year-old woman, gravida 4 para 1, who complained of vaginal spotting and lower abdominal pain after 6 weeks of amenorrhea following clomiphene citrate ovarian stimulation. Transvaginal Ultrasonography revealed an intrauterine pregnancy and an unruptured left tubal ectopic pregnancy. She underwent successful laparoscopic salpingectomy while the intra-uterine pregnancy was allowed to continue. The ectopic pregnancy tissue histology reported an ectopic partial molar pregnancy. She subsequently had a normal vaginal delivery at 39 weeks and 3 days and her follow-up was uneventful. Conclusion: Heterotopic pregnancy is a rare but life-threatening condition. It should be suspected in a pregnant woman with a risk factor of multiple gestations who presents vaginal bleeding and lower abdominal pain in the context of early pregnancy. Laparoscopic surgery is effective for confirming the diagnosis and treating the ectopic component. Routine histological examination of tubal specimens must be taken very seriously because some findings like molar pregnancies may require specific management.展开更多
Abdominal cocoon （AC） is a rare condition, that leading to acute or chronic small bowel obstruction, characterized by a total or partial encapsulation of the small bowel by a fibrous membrane or sac-like cocoon, som...Abdominal cocoon （AC） is a rare condition, that leading to acute or chronic small bowel obstruction, characterized by a total or partial encapsulation of the small bowel by a fibrous membrane or sac-like cocoon, sometimes colon, uterus or accessories are encased in. The disease is characterized as either primary or secondary to other causes. The main reported clinical manifestations of AC are acute/subacute complete/partial intestinal obstruction and abdominal mass.H1 Here, we report a rare case of AC presenting as umbilical hernia, and to our knowledge, it is only a few cases of this entity have been reported previously. Even though preoperative diagnosis of AC is difficult and normally laparotomy is the main solution, in our case, we chose the method which combines laparoscopy with open surgery, it solved patient problem quickly and efficiently, and that further confirmed laparoscopic surgery has great significance in diagnosis and treatment of AC.展开更多
文摘Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its incidence is rising mostly due to induction of ovulation or Assisted Reproductive Technique. Most ectopic in heterotopic pregnancies are localized in the fallopian tubes. The occurrence of molar tubal ectopic pregnancy coexisting with intrauterine pregnancy is uncommon and consequently not often considered a diagnostic possibility. Case Report: We report the case of a 25-year-old woman, gravida 4 para 1, who complained of vaginal spotting and lower abdominal pain after 6 weeks of amenorrhea following clomiphene citrate ovarian stimulation. Transvaginal Ultrasonography revealed an intrauterine pregnancy and an unruptured left tubal ectopic pregnancy. She underwent successful laparoscopic salpingectomy while the intra-uterine pregnancy was allowed to continue. The ectopic pregnancy tissue histology reported an ectopic partial molar pregnancy. She subsequently had a normal vaginal delivery at 39 weeks and 3 days and her follow-up was uneventful. Conclusion: Heterotopic pregnancy is a rare but life-threatening condition. It should be suspected in a pregnant woman with a risk factor of multiple gestations who presents vaginal bleeding and lower abdominal pain in the context of early pregnancy. Laparoscopic surgery is effective for confirming the diagnosis and treating the ectopic component. Routine histological examination of tubal specimens must be taken very seriously because some findings like molar pregnancies may require specific management.
文摘Abdominal cocoon （AC） is a rare condition, that leading to acute or chronic small bowel obstruction, characterized by a total or partial encapsulation of the small bowel by a fibrous membrane or sac-like cocoon, sometimes colon, uterus or accessories are encased in. The disease is characterized as either primary or secondary to other causes. The main reported clinical manifestations of AC are acute/subacute complete/partial intestinal obstruction and abdominal mass.H1 Here, we report a rare case of AC presenting as umbilical hernia, and to our knowledge, it is only a few cases of this entity have been reported previously. Even though preoperative diagnosis of AC is difficult and normally laparotomy is the main solution, in our case, we chose the method which combines laparoscopy with open surgery, it solved patient problem quickly and efficiently, and that further confirmed laparoscopic surgery has great significance in diagnosis and treatment of AC.
