Manejo conservador laparoscópico de un embarazo ectópico intersticial no roto: Reporte de caso, descripción de la técnica quirúrgica y revisión de la literatura / Conservative laparoscopic management of an unruptured interstitial ectopic pregnancy: A case report, surgical technique and review of literature

El embarazo ectópico es la implantación del embrión fuera de la cavidad endometrial. La localización más frecuente es en la trompa de Falopio en su porción ampular. La localización en la porción intersticial representa el sitio menos probable de implantación de un embarazo ectópico tubario. El diagnóstico y tratamiento oportuno previo a su ruptura son de importancia significativa, debido a que tiene una alta morbimortalidad materna en caso de presentarse la ruptura. El diagnóstico se realiza mediante sospecha clínica y la ayuda del ultrasonido, de preferencia endovaginal, y los niveles séricos de hCG. El tratamiento puede ser a base de metotrexate solamente, cirugía radical (cornuectomía e incluso histerectomía) y manejo conservador (cornuostomía) por laparotomía o laparoscopia. El objetivo del estudio es presentar el caso de una paciente con diagnóstico de embarazo ectópico intersticial no roto a la que se realizó cirugía laparoscópica conservadora, describir la técnica quirúrgica y revisión de la literatura.

Ectopic pregnancy is the embryo implantation outside the endometrial cavity. The most common location is the ampular region of Fallopian tube. The interstitial ectopic pregnancy represents the least probable site of implantation for a tubal ectopic pregnancy. The diagnosis and treatment, prior to rupture are important because its high morbidity and mortality when rupture occurs. Diagnosis is done by clinical suspicion, ultrasound and hCG blood levels. Treatment options are medical (metotrexate), radical surgery (cornuectomy or hysterectomy), and conservative management (cornuostomy) either by laparotomy or laparoscopy. The aim of this study is to report the case of a woman with an unruptured interstitial ectopic pregnancy who was managed by laparoscopic conservative management, describe the surgical technique and review of the literature.

Suction and Evacuation of Ectopic Conceptus by Laparoscopic Cornuostomy in Interstitial Pregnancy: 2 cases / 대한산부인과학회잡지

Interstitial pregnancy is a rare but very dangerous event if it would be ruptured and it occurs in about 1% of ectopic pregnancy. With recent advances in laparoscopic surgery many reports have been described laparoscopic cornual resection for interstitial pregnancy or laparoscopic cornuostomy as a safe alternative to laparotomy. We report two cases of unruptured interstitial pregnancy treated by laparoscopic cornuostomy with suction and evacuation of conceptus. This might be a safer and less destructive method by minimal incision of cornual lesion and suction/evacuation of the ectopic conceptus without myometrial reconstruction.