자궁외임신으로 오진된 복강내 출혈 = Reflux Hemoperitoneum Mistaken for Ectopic Pregnancy

다국어 초록 (Multilingual Abstract)

Physicians are so freguently encountered with diagnostic problems of ectopic pregnancy that the percentage of error given by all authors is quite large, varying from 15 to as much as 35 percent. There were 319 laparotomies performed under the diagnosis of ectopic pregnancy at cheil Hospital, Seoul, Korea from December 1963 to August 1969. Among these, 5 case revealed no other intraabdominal pathology that hemoperitoneum. Preoperative diagnosis were based on the history of slight spotting beginning a few days after an expected period, relatively sudden noset of colicky lower abdominal pain, tenderness over the lower abdomen and internal pelvic organs and were decisive with positive culdocentesis in all of these cases. Intrauterine exploration was performed on one of them, who returned with exactly the same symptoms one month after having laparotomy, and presence of intrauterine adhesion was found. This condition has been classically described by Asherman but no literature was found that describing such development of the pathology occurring secondary to the intrauterine adhesion. criteria of differential diagnosis between reflux hemoperitoneum and ectopic pregnancy are made out with the retrospective study of there cases as following. In case of reflux hemoperitoneum; 1. General conditons and vital signs are within normal limits. 2. Hemoglobin and hematocrit are within normal ranges. 3. No history of sterility. 4. History of artificial abortion or intrauterine instrumentation one to three months prior to the present illness. 5. In some cases history of the same or similar experience one to three months prior to the present illness. 6. No palpable adnexal mass. 7. Negative pregnancy test. 8. Intrauterine probing prior to laparotomy.