This is a 39-year-old female patient, commercial occupation, nulliparous, primigravida, 12 weeks of amenorrhea, who consulted for desire of maternity after 15 years of infertility. The physical examination showed an a...This is a 39-year-old female patient, commercial occupation, nulliparous, primigravida, 12 weeks of amenorrhea, who consulted for desire of maternity after 15 years of infertility. The physical examination showed an abdomen of normal volume, soft and tender in the right iliac fossa. On vaginal touch, the uterus was of normal volume in an anteverted anteflexed position, regular surface with palpation at the right adnexa of a firm mass about 5 cm in diameter, irregular and tender. Free douglas. A diagnosis of infertility of 15 years was retained. Infertility workup showed a normal uterus. Right ovary normal volume, left ovary normal volume. Hysterosalpingography with and without opacification showed signs suggestive of bilateral hydrosalpinx predominating on the right. There was no obvious uterine anomaly. The blood biology did not show anything particular. An exploratory laparoscopy revealed multiple epiplo-tubero-intestinal adhesions. The right trumpet was dilated and adherent to an adnexal mass. A large adhesiolysis allowed the release of the right tube, thus opening the possibility to explore the adnexal mass. The opening of the mass allowed to individualize bony structures corresponding to the forearm with the calcified hand, and other less distinct structures. The latter finding led to the diagnosis of calcified ovarian pregnancy.展开更多
文摘This is a 39-year-old female patient, commercial occupation, nulliparous, primigravida, 12 weeks of amenorrhea, who consulted for desire of maternity after 15 years of infertility. The physical examination showed an abdomen of normal volume, soft and tender in the right iliac fossa. On vaginal touch, the uterus was of normal volume in an anteverted anteflexed position, regular surface with palpation at the right adnexa of a firm mass about 5 cm in diameter, irregular and tender. Free douglas. A diagnosis of infertility of 15 years was retained. Infertility workup showed a normal uterus. Right ovary normal volume, left ovary normal volume. Hysterosalpingography with and without opacification showed signs suggestive of bilateral hydrosalpinx predominating on the right. There was no obvious uterine anomaly. The blood biology did not show anything particular. An exploratory laparoscopy revealed multiple epiplo-tubero-intestinal adhesions. The right trumpet was dilated and adherent to an adnexal mass. A large adhesiolysis allowed the release of the right tube, thus opening the possibility to explore the adnexal mass. The opening of the mass allowed to individualize bony structures corresponding to the forearm with the calcified hand, and other less distinct structures. The latter finding led to the diagnosis of calcified ovarian pregnancy.
