Publication: Rare Presentation of Chorioadenoma Destruens as Acute Haemoperitoneum Mimicking Ruptured Ectopic Pregnancy
Date
2014
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Gestational trophoblastic neoplasms (GTN) are proliferative degenerative disorders
of placental elements and include complete or partial mole (90%), invasivemole
(5-8%), choriocarcinoma (1-2%) and placental site tumor (1-2%). Chorioadenoma
destruens is a trophoblastic tumor, characterized by myometrial invasion through
direct extension or via venous channels. We present a case of invasive mole eroding
uterus and uterine vasculature, causing sudden rupture of uterus with massive
haemoperitoneum mimicking ectopic pregnancy. A 20 year old G1P0 at 6 weeks
gestation presented in Casualty of Kasturba Hospital complaining of severe acute
onset lower abdominal pain for one hour. Clinical examination revealed shock.
Sonography suggested ectopic pregnancy and immediate exploratory laparotomy
was decided. On laparotomy, 2000cc of haemoperitoneum was noted. Grape like
vesicles protruding through fundal perforation with profuse active bleeding was
seen. Bleeding persisted despite evacuation. Step wise uterine devascularisation
failed to achieve haemostasis. Total abdominal hysterectomy was performed as a
life saving measure.
KEY WORDS
Ectopic pregnancy, haemoperitonem, invasive mole
Description
Sinha M,1 Kaur R,1 Gupta R,2 Rani R,1 Aggarwal A1
1Department of Obstetrics & Gynaecology
Kasturba Hospital, Delhi, India
2West Virginia University- Charleston Division
Charleston Area Medical Center
Charleston, West Virginia, USA
Keywords
Ectopic pregnancy, Haemoperitonem, Invasive mole