Zusammenfassung
Die cornuale Gravidität ist eine seltene und potenziell lebensbedrohliche Form der
extrauterinen Schwangerschaft, die den interstitiellen Anteil der Tuba uterina betrifft.
Das Hauptrisiko besteht in schweren intraabdominalen Blutungen. Allgemein gültige
Therapieempfehlungen zum Management dieser Sonderform existieren nicht. Im beschriebenen
Fall wurde durch eine spezielle laparoskopische Nahttechnik ein exzellenter Tourniquet-Effekt
durch lokale Ischämie ausgenutzt und eine suffiziente Hämostase gesichert. Das therapeutisch-operative
Vorgehen sowie weitere mögliche Therapiemodalitäten, beispielsweise die primäre Methotrexatapplikation,
werden erörtert.
Abstract
Interstitial or cornual pregnancies represent a small fraction of ectopic gestations.
They are especially feared due to their life-threatening intraabdominal hemorrhage.
General guide-lines for the medical management are missing. In this case report, a
special endoscopic conservative procedure using encircling suture and endoloop-technique
was performed. This method provided an excellent tourniquet effect and resulted in
effective hemostasis. In addition to our endoscopic treatment, other therapeutic procedures,
such as primary methotrexate application will be discussed.
Schlüsselwörter
Cornuale/interstitielle Schwangerschaft - Laparoskopie - Methotrexat
Key words
Interstitial/cornual pregnancy - endoscopic treatment - methotrexate
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Dr. med. Christoph Jäger
Universitätsfrauenklinik
Prittwitzstraße 43
89075 Ulm
eMail: christoph.jaeger@medizin.uni-ulm.de
