Yıl 2019, Cilt 3 , Sayı 6, Sayfalar 456 - 458 2019-06-28

Laparoscopic management of cornual pregnancy: A case report
Kornual gebelikte laparoskopik tedavi: Olgu sunumu

Görker SEL [1] , Dilara ÖZAYDIN [2] , Avni Ozan TEKİN [3] , Müge HARMA [4] , Mehmet İbrahim HARMA [5]


The incidence of cornual or interstitial pregnancy is approximately 2% of all pregnancies. Interstitial pregnancy is one of the rare form of ectopic pregnancies, with 1-6% of all ectopic pregnancies. In our case report, we present successful laparoscopic resection of a cornual pregnancy with positive fetal cardiac activity and laparoscopic suturing of cornu uteri. A 26-year-old pregnant; gravida 2, para 0, abortus 1; was admitted with a complaint of left lower quadrant abdominal pain. An ultrasound examination was performed. The ultrasound examination revealed a 4-cm ectopic gestational sac with positive cardiac activity in the left adnexa. Laparoscopy was planned. A left uterin approximately 3x4 cm cornual pregnancy was observed, under direct visualization, one 5-mm coagulating dissector was used to perform the resection and seal of the cornu uteri. After the sealing, two times laparoscopic suturing was applied. Detecting interstitial pregnancy is more difficult than revealing other ectopic pregnancy types. Severe hemorrhage could occur during the resection of the cornu uteri. Therefore, a laparoscopic approach should only be attempted if the surgeon is well skilled in laparoscopic technique, and has the capability to convert the operation quickly to a laparotomy.

Kornual veya interstisyel gebelik insidansı tüm gebeliklerin yaklaşık %2'sidir. İnterstisyel gebelik, tüm ektopik gebeliklerin %1-6'sı ile nadir görülen ektopik gebeliklerden biridir. Olgumuzda, pozitif fetal kardiyak aktivite gözlenen kornual ektopik olgusunun başarılı bir şekilde laparoskopik rezeksiyonu ve kornu uterinin laparoskopik sütüre edildiği olguyu sunuyoruz. 26 yaşında hamile; gravida 2, para 0, abort 1; sol alt kadran karın ağrısı şikayeti ile başvurdu. Ultrason muayenesi yapıldı. Ultrason muayenesinde sol adnekste pozitif kardiyak aktivite gösteren 4 cm'lik bir ektopik gebelik kesesi saptandı. Laparoskopi planlandı. Solda uterin kornuda, yaklaşık 3x4 cm kornual gebelik görüldü, 5 mm'lik bir koter disektör, cornu uteri'nin rezeksiyonu ve mühürlenmesi için kullanıldı. Sonrasında, iki kez laparoskopik dikiş atıldı. İnterstisyel gebeliği tespit etmek, diğer ektopik gebelik tiplerini ortaya koymaktan daha zordur. Cornu uteri'nin rezeksiyonu sırasında ciddi kanamalar görülebilir. Bu nedenle, laparoskopik bir yaklaşım, ancak cerrah laparoskopik teknikte uzmansa ve operasyonu hızlı bir şekilde laparotomiye dönüştürme yeteneğine sahipse denenmelidir.

  • 1. Soriano D, Vicus D, Mashiach R, Schiff E, Seidman D, Goldenberg M. Laparoscopic treatment of cornual pregnancy: a series of 20 consecutive cases. Fertility and sterility. 2008 Sep 1;90(3):839-43.
  • 2. Jermy K, Thomas J, Doo A, Bourne T. The conservative management of interstitial pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology. 2004 Nov 1;111(11):1283-8.
  • 3. Chan LY, Fok WY, Yuen PM. Pitfalls in diagnosis of interstitial pregnancy. Acta obstetricia et gynecologica Scandinavica. 2003 Sep;82(9):867-70.
  • 4. Saraswathi K, Prasad MS, Kumari BK. Tubal ectopic pregnancy: comparative study of laparoscopy vs laparotomy. JOURNAL OF EVOLUTION OF MEDICAL AND DENTAL SCIENCES-JEMDS. 2015 Nov 5;4(89):15447-9.
  • 5. Sel G, Harma Mİ, Harma M, Barut A, Arıkan İİ. Case report of a Successful Treatment of Interstitial Pregnancy with Systemic Methotrexate. Abant Med J. 2017;6(3):120-2.
  • 6. Goran A. Spontaneous uterine rupture. In: Acute Abdomen During Pregnancy. Springer, Cham, 2014. p. 495-527.
  • 7. Ong C, Su LL, Chia D, Choolani M, Biswas A. Sonographic diagnosis and successful medical management of an intramural ectopic pregnancy. Journal of Clinical Ultrasound. 2010 Jul;38(6):320-4.
  • 8. Grobman WA, Milad MP. Conservative laparoscopic management of a large cornual ectopic pregnancy. Human reproduction (Oxford, England). 1998 Jul 1;13(7):2002-4.
  • 9. Moawad NS, Mahajan ST, Moniz MH, Taylor SE, Hurd WW. Current diagnosis and treatment of interstitial pregnancy. American journal of obstetrics and gynecology. 2010 Jan 1;202(1):15-29.
  • 10. Ng S, Hamontri S, Chua I, Chern B, Siow A. Laparoscopic management of 53 cases of cornual ectopic pregnancy. Fertility and sterility. 2009 Aug 1;92(2):448-52.
  • 11. Weissman A, Fishman A. Uterine rupture after conservative surgery for interstitial pregnancy. Eur J Obstet Gynecol Reprod Biol 1992;13(44):237–9.
Birincil Dil en
Konular Cerrahi
Bölüm Olgu sunumu
Yazarlar

Orcid: 0000-0001-8653-5687
Yazar: Görker SEL (Sorumlu Yazar)
Kurum: ZONGULDAK BÜLENT ECEVİT ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0003-2973-6268
Yazar: Dilara ÖZAYDIN

Orcid: 0000-0003-0496-1055
Yazar: Avni Ozan TEKİN

Orcid: 0000-0002-4327-674X
Yazar: Müge HARMA
Ülke: Turkey


Orcid: 0000-0002-9734-5253
Yazar: Mehmet İbrahim HARMA
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 28 Haziran 2019

Bibtex @olgu sunumu { josam522344, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2019}, volume = {3}, pages = {456 - 458}, doi = {10.28982/josam.522344}, title = {Laparoscopic management of cornual pregnancy: A case report}, key = {cite}, author = {Sel, Görker and Özaydın, Dilara and Tekin, Avni Ozan and Harma, Müge and Harma, Mehmet İbrahim} }
APA Sel, G , Özaydın, D , Tekin, A , Harma, M , Harma, M . (2019). Laparoscopic management of cornual pregnancy: A case report . Journal of Surgery and Medicine , 3 (6) , 456-458 . DOI: 10.28982/josam.522344
MLA Sel, G , Özaydın, D , Tekin, A , Harma, M , Harma, M . "Laparoscopic management of cornual pregnancy: A case report" . Journal of Surgery and Medicine 3 (2019 ): 456-458 <http://jsurgmed.com/tr/pub/issue/45558/522344>
Chicago Sel, G , Özaydın, D , Tekin, A , Harma, M , Harma, M . "Laparoscopic management of cornual pregnancy: A case report". Journal of Surgery and Medicine 3 (2019 ): 456-458
RIS TY - JOUR T1 - Laparoscopic management of cornual pregnancy: A case report AU - Görker Sel , Dilara Özaydın , Avni Ozan Tekin , Müge Harma , Mehmet İbrahim Harma Y1 - 2019 PY - 2019 N1 - doi: 10.28982/josam.522344 DO - 10.28982/josam.522344 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 456 EP - 458 VL - 3 IS - 6 SN - -2602-2079 M3 - doi: 10.28982/josam.522344 UR - https://doi.org/10.28982/josam.522344 Y2 - 2019 ER -
EndNote %0 Journal of Surgery and Medicine Laparoscopic management of cornual pregnancy: A case report %A Görker Sel , Dilara Özaydın , Avni Ozan Tekin , Müge Harma , Mehmet İbrahim Harma %T Laparoscopic management of cornual pregnancy: A case report %D 2019 %J Journal of Surgery and Medicine %P -2602-2079 %V 3 %N 6 %R doi: 10.28982/josam.522344 %U 10.28982/josam.522344
ISNAD Sel, Görker , Özaydın, Dilara , Tekin, Avni Ozan , Harma, Müge , Harma, Mehmet İbrahim . "Laparoscopic management of cornual pregnancy: A case report". Journal of Surgery and Medicine 3 / 6 (Haziran 2019): 456-458 . https://doi.org/10.28982/josam.522344
AMA Sel G , Özaydın D , Tekin A , Harma M , Harma M . Laparoscopic management of cornual pregnancy: A case report. J Surg Med. 2019; 3(6): 456-458.
Vancouver Sel G , Özaydın D , Tekin A , Harma M , Harma M . Laparoscopic management of cornual pregnancy: A case report. Journal of Surgery and Medicine. 2019; 3(6): 456-458.
IEEE G. Sel , D. Özaydın , A. Tekin , M. Harma ve M. Harma , "Laparoscopic management of cornual pregnancy: A case report", Journal of Surgery and Medicine, c. 3, sayı. 6, ss. 456-458, Haz. 2019, doi:10.28982/josam.522344