[Rupture of two intact tubal pregnancies]. / Ruptur zweier intakter Tubargraviditäten.

We report on a 24 years old patient with an acute abdominal pain and an unknown intact tubal pregnancy in the 8th gestation week. The sonographic examination confirmed an intact tubal pregnancy. Shortly after the diagnosis, it ruptured with a massive intraabdominal bleeding. Thereafter, the patient collapsed. We carried out a laparoscopy and performed salpingotomy. Because of the persistent bleeding a salpingectomy was performed. We also report on a second patient 34 years old, who was referred to our Department on suspicion of a ruptured ectopic pregnancy with acute abdominal pains and a positive pregnancy test. The transvaginal sonography revealed massive intraabdominal fluid, adnexal tumor and endometriumhyperplasia without a sign of a gestational sac or an embryo.We carried out a laparoscopy, which revealed a ruptured tubal pregnancy with a life, fetus lying in the abdominal cavity. As a result of the massive and persistent intraabdominal bleeding, we carried out laparotomy and performed salpingectomy. Using these two case reports, the etiology, symptoms, clinical course, diagnosis, as well as surgical and drug therapy are discussed.

[Chronic abdominal pains caused by peritoneal tuberculosis - two case reports]. / Peritonealtuberkulosebedingte chronische unklare Unterbauchschmerzen - zwei Fallberichte und Literaturübersicht.

Chronic abdominal pains caused by peritoneal tuberculosis - two case reports. The diagnosis of a peritoneal tuberculosis could be a demanding task for even an experienced Physician, because of the unspecific symptoms. We report on two patients, who as a result of therapy refractory chronic abdominal pains, weight loss and ascites were admitted to our hospital. The excisional biopsy taken from the peritoneum and the omentum major during an exploratory laparotomy resulted in the histopathologic diagnosis of peritoneal tuberculosis being made. Both patients were given tuberculostatic therapy with isoniazid, rifampicin, pyracinamide and streptomycin and both have since recovered. The symptoms, the difficulties encountered in making the diagnosis and the therapy of the peritoneal tuberculosis are discussed using these two case reports.