Conference abstract

Tubal caesarean section on endosalpingiosis: a case report

Pan African Medical Journal - Conference Proceedings. 2023:16(32).15 Mar 2023.
doi: 10.11604/pamj-cp.2023.16.32.2304
Archived on: 15 Mar 2023
Contact the corresponding author
Keywords: Tubal caesarean section, endosalpingiosis, ectopic pregnancy

Tubal caesarean section on endosalpingiosis: a case report

Nana Njamen Théophile1,2,&, Tchente Nguefack Charlotte2,3, Tchounzou R1, Watchung Marius2, Emaleu Josiane2, Mbi Fidelia2, Abega Cyrille2, Fulbert Mangala Nkwele3, Henri Essome3, Egbe Obinchemti1,2, Halle Ekane1,2

1Department of Obstetrics and Gynaecology. Faculty of Health Sciences, University of Buea, Buea, Cameroon, 2Douala General Hospital, Douala, Cameroon

&Corresponding author

Introduction: ectopic pregnancy is the leading cause of maternal mortality of the first trimester in our context. Regarding the accuracy of the diagnosis and the mastering of therapeutic modalities observed in recent years in sub-Saharan Africa's settings, conservative treatment with favorable fertility prognosis cases have been observed.

Patient and observation: a 26-year-old female patient, primigravid, consulted for pain in the left iliac fossa on amenorrhea of 6 weeks 03 days. Clinical examination and vital parameters were normal. The plasma beta HCG level was 8842 IU/ml, the hemoglobin level was 12.6 g/dl and the platelet count was 146. 103/ mm3. Transvaginal ultrason described a rupture of left tubal ectopic pregnancy because of a left heterogenic adnexal mass of 27mm, and collection of non-echogenic fluid of 150 ml in the Douglas pouch. Laparoscopy revealed bilateral endosalpingiosis, an unruptured gestational sac implanted at the isthmo-ampular junction of the left tube. We also observed a bilateral isthmic salpingopathy, a brownish blood collection of 200 ml, and some pelvic peritoneal endometriotic nodules of 8 to 12 mm. We proceeded to an uneventful tubal caesarean section. The postoperative course was good; the infectious tests (chlamydia research by PCR and Vaginal swab) were normal. The control hysterosalpingogram showed a bilateral tubal patency. Both tubes were concerned by the so-called “Boule de Guy” pathognomic of endosalpingiosis.

Conclusion: endosalpingiosis is indeed a risk factor for tubal ectopic pregnancy. Conservative treatment by laparoscopy is feasible in early diagnosis.