Melike GEYİK BAYMAN, Zeynep OZTURK INAL, Hasan Ali INAL

Aynı Adneksde Tuba-Ovaryan Abse ile Ektopik Tubal Gebeliğin Bir Arada Bulunması: Bir Olgu Sunumu

Tüm gebeliklerin yaklaşık % 1.3-2'sinde görülen ektopik gebelik (EG), fertilize yumurtanın uterin kavite dışına yerleşmesi olarak tanımlanır ve ilk trimesterdeki maternal morbidite ve mortalitenin en önemli nedenidir. Tubo-ovaryan abse (TOA), üreme döneminde pelvik inflamatuar hastalığı olan kadınların % 15'inde görülen yumurtalık, fallop tüpleri ve komşu organları tutabilen bir polimikrobiyal enfeksiyondur. Burada son bir yıl içinde daha önce üç düşük yapmış, tekrarlayan karın ağrısı ve vajinal kanama semptomları ile acil servise başvuran, muayene ve tetkiklerde ektopik gebelik ve tubo-ovaryan abse tanısı konulan bir hastayı sunmayı amaçladık. Olgu laparoskopik cerrahi sonrası iyileşmiştir. Hem EG hem de TOA'nın mümkün olduğu kadar kısa sürede teşhisi ve zamanında uygun tıbbi müdahale maternal morbidite ve mortaliteyi azaltmada önemlidir.

Anahtar Kelimeler:

Ektopik gebelik, laparoskopi, tubo-ovaryan abse

Coexistence Of Ectopic Tubal Pregnancy With A Tuba-Ovarian Abscess in The Same Adnexa: A Case Report

Ectopic pregnancy (EP), seen in approximately 1.3-2% of all pregnancies, is defined as the placement of the fertilized ovum outside of the uterine cavity and it is the most important cause of maternal morbidity and mortality in the first trimester. Tuba ovarian abscess (TOA) is a polymicrobial infection that can involve the ovary, fallopian tubes, and adherent organs, which is usually seen in 15% of women with pelvic inflammatory disease in the reproductive period. Here, we aimed to present a patient with three previous miscarriages in the last year, who was admitted to the emergency department with symptoms of recurrent abdominal pain and vaginal bleeding, and who was diagnosed as having ectopic pregnancy and tubal ovarian abscess in examinations and tests. She recovered well after laparoscopic surgery. Diagnosis of both EP and TOA as early as possible and timely medical intervention are important in reducing maternal morbidity and mortality.

Keywords:

Ectopic pregnancy, laparoscopy, tuba ovarian abscess.,

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1. Walker JJ. Ectopic pregnancy. Clin Obstet Gynecol. 2007 Mar;50(1):89-99.
2. Taran FA, Kagan KO, Hübner M, Hoopmann M, Wallwiener D, Brucker S. The Diagnosis and Treatment of Ectopic Pregnancy. Dtsch Arztebl Int. 2015 Oct 9;112(41):693-703; quiz 704-5.
3. Inal ZO, Inal HA. Comparison of Four Methods of Treating Ectopic Pregnancy: A Retrospective Cohort Study. Geburtshilfe Frauenheilkd. 2018 Jan;78(1):70-77.
4. Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005 Oct 11;173(8):905-12.
5. Inal ZO, Inal HA, Gorkem U. Experience of Tubo-Ovarian Abscess: A Retrospective Clinical Analysis of 318 Patients in a Single Tertiary Center in Middle Turkey. Surg Infect (Larchmt). 2018 Jan;19(1):54-60.
6. Inal HA, Ozturk Inal Z, Alkan E. Successful Conservative Management of a Dislocated IUD. Case Rep Obstet Gynecol. 2015;2015:130528.
7. Kinay T, Unlubilgin E, Cirik DA, et al. The value of ultrasonographic tubo-ovarian abscess morphology in predicting whether patients will require surgical treatment. Int J Gynaecol Obstet. 2016;135(1):77-81.
8. Inal ZO, Inal HA. Bilateral Dermoid Cysts of the Ovaries in a Term Pregnant Woman: A Case Report. Anatol JFM 2018;1(2):67-69.
9. Akkurt MÖ, Yalçın SE, Akkurt İ, et al. The evaluation of risk factors for failed response to conservative treatment in tubo-ovarian abscesses. J Turk Ger Gynecol Assoc. 2015;16(4):226-30.
10. Inal ZO, Inal HA. Comparison of abdominal, vaginal, and laparoscopic hysterectomies in a tertiary care hospital in Turkey. Ir J Med Sci. 2018;187(2):485-91.