宫内外同时妊娠3例误诊分析

宫内外同时妊娠（heterotopicpregnancy,HP）是指宫腔内妊娠和异位妊娠同时存在的一种病理情况,是一种罕见的疾病。临床诊断困难,常易误诊、漏诊。     

宫内外同时妊娠1例

患者，26岁，孕2产0,因停经50天，下腹痛14h于2005年11月19日入院。平素月经规律．末次月经2005年9月底。停经后有早孕反应，无阴道流血，入院14h前无诱因下腹持续坠痛，B超示子宫6．4cm×6．8cm×5．5cm．宫内孕囊2．8cm×2．2cm×1．9cm，囊内胚芽0．6cm，可见胎心搏动，双附件观察不满意，盆腔内见厚2．2cm液性暗区，WBC11．0×10^7L，Hb125g／L，GRN86．5％，查体生命体征平稳，宫颈举痛．子宫水平位，压痛明显，子宫大小因查体不合作触诊不满意，双附件区明显压痛，以右侧明显。     

彩超诊断宫内宫外同时妊娠1例

１患者，女，２６岁。停经６５d，伴恶心，阴道不规则流血３d就诊。查体：面色苍白，右下腹触痛，可扪及包块。实验室检查：WBC：７．８×１０９／L，RBC：６．３×１０９／L。尿HCG（＋）。彩超检查：采用百胜CARIS彩色超声诊断仪。探头频率在２．５－３．５MHz。超声所见：膀胱充盈良好，子宫前后径５．８cm，宫腔内见１．０cm×１．２cmr孕囊，囊内未见胚芽组织。右附件区查见一约４．５cm×５．２cm的孕囊，囊内见胚胎组织，胎心及胎图１宫腔内见１．０cm×１．２cm的孕囊。右附件区见一约４．５cm×５．２cm的孕囊，囊内见胚胎…     

超声诊断宫内外同时妊娠1例

1　临床资料　患者 ,女 ,38岁。因停经 6 5ｄ ,阴道不规则出血伴下腹痛 33ｄ加重 1ｄ ,于 2 0 0 1年 4月入院。入院前 1个月曾超声检查 :子宫增大 ,宫内探及孕囊。进而行人流术 ,术中刮出孕囊绒毛及血块。术后 4ｄ出现感冒症状 ,伴体温升高同时伴下腹痛、阴道不规则出血。曾用抗菌素等药物治疗2 0ｄ ,未见好转 ,血ＨＣＧ升高达 815 0 μ/ｍ ,因而入院。再次超声检查 :子宫前位 ,正常大小 ,宫内未见异常。但于右附件区探及混合性包块 ,其周边有低阻动脉血流 ,伴少量盆腔积液。超声诊断 :右附件包块 ,考虑宫外孕。当天手术证实为 :右输卵管妊…     

宫内外同时妊娠漏诊2例

例1，30岁。停经40d，人流术后17d，下腹剧痛8h于2005—09—19入院，17d前因停经40d，在外院诊断为宫内早孕，应其要求终止妊娠行人工流产术，吸出物见绒毛组织。1999年曾行剖腹产手术，2001年行右侧输卵管妊娠破裂切除术。入院前8h无诱因突然下腹剧痛来院急诊。查：血压60／40mmHg。急性痛苦面容，重度贫血貌，全腹压痛及反跳痛，移动性浊音阳性，查尿HCG阳性，腹穿抽出不凝血，考虑左侧输卵管妊娠、失血性休克，行急诊手术，术中见腹腔积血3800ml，诊断为左侧输卵管峡部妊娠破裂出血，行左侧输卵管切除术。术后病理诊断左侧输卵管峡部妊娠伴出血。     

自发性宫内外复合妊娠合并子宫肌瘤保胎成功1例

1病例报告患者,女,31岁,G3P。因停经12＋3周,下腹疼痛5h于2007年10月31日入院。末次月经为2007—08—05,停经35d查尿HCG阳性,孕早期出现恶心、呕吐、乏力等症状,至停经近3个月自然消失,于2007—10—31无诱因出现下腹疼痛,继之波及全腹,伴恶心呕吐2次,无肛门下坠感,无阴道流血,无发热。超声检查提示：     

宫内外同时妊娠9例临床分析

目的:分析宫内外同时妊娠9例。方法:收集本院2001～2005年宫内外同时妊娠病例行诊断分析。结果:术后足月顺产2例,妊娠中5例,流产1例,其他1例。结论:9例妊娠临床表现不典型,易误诊,应引起足够重视。     

Spontaneous rupture of a giant pyonephrosis: A case report

Pyonephrosis is a suppurative infection of the kidney caused by ureteral obstruction. It can lead to kidney failure, septic shock, and death. Thus, it requires prompt assessment and appropriate management. We report a case of a 63-year-old male with giant pyonephrosis contained 10 liters of pus and spontaneously ruptured in the adjacent muscles. This clinical case illustrates the value of computed tomography scan in the diagnosis and management of an uncommon upper urinary tract infection and its complications.     

超声诊断宫角早期妊娠1例

患者女,26岁。停经2个月,不规则阴道流血3天。平常月经规律,末次月经为2004年10月28日,无早孕反应,无其他妇科疾病。妇检:子宫前位,宫体略增大,如孕40天大小,质软,双侧附件未见明显触压痛及包块。B超检查:子宫前位,宫体略增大,内膜居中,厚8mm,宫腔内未见孕囊回声。于左侧宫角处可探及范围约65cm×48cm×47cm的混合包块。35cm×25cm的妊娠囊,内可见胎芽10mm及胎心搏动(图1)。双侧附件未见异常。诊断:左宫角早期妊娠。术后病理:左宫角妊娠(未破裂型),40cm×50cm大小。讨论:宫角妊娠是指妊娠囊种植在子宫角的妊娠,较为罕见,仅占所有异位妊娠的…     

Spontaneous resolution of syringomyelia in a child with Chiari I malformation: a case report

Cervicothoracic syringomyelia is a frequent feature in Chiari I malformation. It can be symptomatic or not, and is well demonstrated by magnetic resonance imaging (MRI). Its spontaneous resolution is uncommon. The authors report a case of spontaneous resolution of a thoracic syrinx in an 18-year-old patient with a Chiari I malformation. MRI study performed 6 years previously because of worsening headaches demonstrated a Chiari I malformation associated with a syrinx cavity. The cavity disappearance was noted after improvement of the symptoms.     

Spontaneous arterial recanalization--a case report

Spontaneous thrombolysis with recanalisation of peripheral arterial vessels is a well-known, albeit rare phenomenon. The probable mechanisms of this phenomenon is the activation of local fibrinolytic processes by local mediators of the vascular endothelial cells. Vascular stenoses of atherosclerotic origin are also subject to regression, depending on the plasma LDL level. Reangiography is indicated for determining further therapy planning if there is a change in clinical signs towards either improvement or deterioration. Reangiography is imperative if the previous angiography was performed before more than three months.