Acute generalized peritonitis revealing an ovarian pregnancy: a case report.

Autor:	Boka Tounga Y; Department of Digestive Surgery, Abdou Moumouni University, National Hospital of Niamey., Soumana Diaouga H; Abdou Moumouni University in Niamey; Obstetrics and Gynecology Service; Maternity Issaka Gazobi in Niamey, Niamey, Niger., Moumouni S; Abdou Moumouni University in Niamey; Obstetrics and Gynecology Service; Maternity Issaka Gazobi in Niamey, Niamey, Niger., James Didier L; Department of Digestive Surgery, Abdou Moumouni University, National Hospital of Niamey., Rachid S; Department of Digestive Surgery, Abdou Moumouni University, National Hospital of Niamey.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2024 Jan 04; Vol. 86 (2), pp. 1234-1237. Date of Electronic Publication: 2024 Jan 04 (Print Publication: 2024).
DOI:	10.1097/MS9.0000000000001686
Abstrakt:	Introduction and Importance: Abdominal pregnancy is still seen in developing countries due to inadequate medical facilities. The clinical indicators manifest in various forms and are nonspecific, making it challenging to diagnose and often leading to delayed detection. The occurrence of an infectious complication that leads to the development of generalised acute peritonitis is rare. The author present a case of 34-year-old patient who presented with febril generalised acute peritonitis caused by an abdominal pregnancy. The result of the abdominal ultrasound and the serum β-human chorionic gonadotropin (β-HCG) level led to initial diagnostic confusion. Case Presentation: A 34-year-old primigravida with no medical or surgical history of comorbidity prior consulted in the authors' department for generalised abdominal pain in the context of fever and amenorrhoea for more than 4 months. Physical examination revealed a painful and contracted abdomen. The biological assessment showed white blood cells at 27 100/ul, the haemoglobin level at 11.8 g/dl. The serum β-HCG level was less than 5 UI/l. The abdominal ultrasound noted a peritonitis secondary to an abscess of the appendix. Exploratory laparotmy revealed 200 ml of pus in the peritoneum and a mass in the right iliac fossa at the expense of the ovary with agglutination of the intestines loops. After adesyolysis, a single-piece excision of the mass was performed, the break-in showing a macerated foetus, a right adnexectomy and an appendectomy. The maternal outcome was good. Clinical Discussion: Abdominal pregnancy remains an inadequately diagnosed condition in developing countries. This case reminds clinicians that abdominal pregnancy remains a differential diagnosis of all abdominal pain in a woman of childbearing age including when the serum β-HCG level was less than 5 UI/l. Conclusion: It is imperative to increase awareness among pregnant women about high-quality prenatal care, including early obstetric ultrasound, from conception. Meanwhile, healthcare professionals should receive continuous training and the technical platform modernised. Competing Interests: The authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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