Imaging diagnosis of rudimentary horn pregnancy: a case report.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL AME Case Reports Pub Date : 2024-02-07 eCollection Date: 2024-01-01 DOI:10.21037/acr-23-164
Jiaqi Ji, Li Tan, Ke Lv
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Abstract

Background: Rudimentary horn pregnancy (RHP) is a special type of ectopic pregnancy and its pathophysiological basis is an abnormal fusion of the bilateral accessory mesonephric duct during the embryonic period. If sonographers lack experience to this disease, it is easily to be misdiagnosed in the early period, which often leads to rupture of the pregnant horn and life-threatening bleeding. Therefore, a high index of vigilance is required.

Case description: We present a case of a 27-year-old female who went to the department of emergency due to menopause, pelvic pain and elevated human chorionic gonadotropin (hCG) (above 200,000 IU/L). Sonographic examination showed uterus only had the right horn and endometrium was thickened about 1.7 cm without gestational sac (GS) in the uterine cavity. Besides, a 3.5×3.0 cm GS was found between the left ovary and corpus uteri. RHP was suspected by sonographer, and the patient underwent laparoscopy. Obstetricians and gynecologists removed the rudimentary horn and the left fallopian tube. The patient made a good recovery and was soon discharged home after surgery.

Conclusions: This article analyzed one case and summarized ultrasonic characteristics of RHP which may help to improve the early diagnosis of RHP. If necessary, other imaging such as magnetic resonance imaging (MRI) can be combined to make a clear diagnosis and treatment as soon as possible.

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胚胎角妊娠的影像诊断:病例报告。
背景:胚角妊娠(Rudimentary horn pregnancy,RHP)是异位妊娠的一种特殊类型,其病理生理基础是胚胎时期双侧肾间质附属导管的异常融合。如果超声技师对这种疾病缺乏经验,很容易在早期被误诊,往往导致妊娠角破裂和大出血,危及生命。因此,需要高度警惕:本病例为一名 27 岁女性,因停经、盆腔疼痛和人绒毛膜促性腺激素(hCG)升高(超过 200,000 IU/L)而就诊于急诊科。超声检查显示子宫仅有右侧角,子宫内膜增厚约 1.7 厘米,宫腔内无孕囊(GS)。此外,在左侧卵巢和子宫体之间发现了一个 3.5×3.0 厘米的妊娠囊。超声波医生怀疑是 RHP,患者接受了腹腔镜检查。妇产科医生切除了胚角和左侧输卵管。患者术后恢复良好,很快就出院回家了:本文分析了一个病例并总结了 RHP 的超声波特征,这可能有助于提高 RHP 的早期诊断率。如有必要,可结合磁共振成像(MRI)等其他影像学检查,以尽快明确诊断和治疗。
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