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Case Reports
. 2020 Apr 14:2020:5626783.
doi: 10.1155/2020/5626783. eCollection 2020.

Spontaneous Intraoperative Rupture of a Large Interstitial Pregnancy: Laparoscopic Management

Ourania Koukoura  1 , George Dragoumis  1 , Georgia Gorila  1 , Irontianta Gkorezi-Ntavela  1 , Konstantinos Dafopoulos  1 , George Pistofidis  2
Affiliations
Case Reports

Spontaneous Intraoperative Rupture of a Large Interstitial Pregnancy: Laparoscopic Management

Ourania Koukoura et al. Case Rep Obstet Gynecol. .

Abstract

We present a case of a large interstitial pregnancy which was intraoperatively ruptured, but was eventually laparoscopically treated. The patient experienced 9 weeks of amenorrhea, and a right cornual pregnancy measuring 6 cm was diagnosed. The patient consented on having a minimal surgical treatment, and a laparoscopic right cornuotomy was decided. During surgery, and prior to any manipulation to the uterus, there was a spontaneous rupture of the ectopic which resulted in excessive bleeding. Temporal pressure at the bleeding site and ligation of the superior branches of the right uterine artery allowed for a careful dissection of the right uterine cornua and achieved hemostasis. The surgery proceeded uneventfully thereafter. Although surgical intervention in such cases entails a high risk of hemorrhage, successful completion of the laparoscopy lies on the meticulous preoperative planning and the controlled precise surgical steps during the procedure.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
(a) The anatomical relation with other pelvic structures is shown in this panel. (b) Profuse bleeding caused by spontaneous rupture of the ectopic. (c) The superior branches of the right uterine artery were coagulated and transected. (d) Injection of diluted vasopressin in the myometrium, close to the border of the ectopic. (e) The uterine wall is incised with monopolar cautery. (f) The gestational sac is exposed and ruptured during dissection. (g) A portion of the uterine horn has been excised. (h) The uterine wound was closed with interrupted sutures.
See this image and copyright information in PMC

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