About 6 years after tubal sterilization in 1 case.docVIP

 PAGE \* MERGEFORMAT 4 About 6 years after tubal sterilization in 1 case Keywords:] tubal pregnancy; after sterilization 1 Case information Patients, 33 years old, G2 P2, had in March 2003 (second child production of full term infants after 3 months) underwent bilateral tubal ligation, postoperative menstrual regularity, 3 / (29 ~ 31) days, no history of dysmenorrhea , sex life is normal. Last menstrual period May 8, 2010. On June 18, 2010 for “10 days of irregular bleeding, abdominal pain, fall 20h” admission. Checkup T 36 ℃, P 120 times / min, R 28 times / min, BP 105/60mmHg, anemic appearance, clear consciousness, heart rate 120 beats / min, law Qi, is not known and pathological murmur, lungs clear breath sounds, no tenderness on the abdomen, lower abdomen, slightly bulging, muscle tension, tenderness, rebound tenderness was positive to the left lower abdomen to the abdominal shifting dullness (+). gynecological examination: the vagina can be seen a small amount of dark red blood, cervical smooth, painted, give positive pain, vaginal dome after the full, anterior uterus, normal size, have a sense of floating, two attachment areas tenderness, rebound tenderness, untouched mass. vaginal blood was drawn after the dome puncture 5ml, urine pregnancy test was positive, immediate laparotomy epidural anesthesia, abdominal surgery, see old of blood in 2000ml, left fallopian tube congestion, swollen ampulla, umbrella-side active bleeding, surrounded by the accumulation of blood clot. normal uterus, right fallopian tube without congestion and thickening of the isthmus of old surgery scar visible, double the normal ovarian appearance, consider the left fallopian tube pregnancy, miscarriage, the line left salpingectomy, clean hemoperitoneum. Intraoperative Red Blood Cell Transfusion 400ml, pathological return a large number of left tubal decidual chorionic villi, postoperative antibiotics, symptomatic treatment for 5 days, the incision I / A healing hospital .