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患者26岁,孕3产0。停经7月余,下腹痛4h于1998年2月13日入院。患者既往月经正常,末次月经为1997年7月10日。孕期经过顺利。孕前2月查体发现右侧卵巢畸胎瘤。查体:T36.8℃,P108次/min,R24次/min,BP14/9kPa,一般情况好,心肺检查无异常,腹部膨隆,腹肌紧张,压痛、反跳痛均阳性。胎位不清,胎心音148次/min,宫颈管未展平,宫口闭。阴道后穹隆可及一囊性包块,张力大,边界不清,触痛明显。B超示:①单胎头位,存活;②右附件区混合性包块,右卵巢畸胎瘤。初步诊断:妊娠合并卵巢肿瘤蒂扭转。急诊行卵巢肿瘤切除术。术中可见右侧卵巢肿瘤呈葫芦状,上部直径5cm,部分实性,下部直径12cm,囊性。连同右输卵管扭转360℃,嵌顿于子宫直肠
The patient is 26 years old and has 3 pregnancies. Menopause in more than 7 months, abdominal pain 4h on February 13, 1998 admission. The patient had normal menstruation and the last menstruation was July 10, 1997. Pregnancy passed smoothly. Pre-pregnancy examination in February found the right ovarian teratoma. Physical examination: T36.8 ℃, P108 times / min, R24 times / min, BP14 / 9kPa, the general situation is good, no abnormal cardiopulmonary examination, abdominal bulging, abdominal muscle tension, tenderness, rebound tenderness were positive. Fetal ambiguity, fetal heart sound 148 times / min, cervical canal is not flat, cervix closed. Vaginal dome can reach a cystic mass, tension, unclear boundaries, tenderness significantly. B ultrasound showed: ① single fetal head, survival; ② right attachment area mixed mass, right ovarian teratoma. Preliminary diagnosis: pregnancy with ovarian tumor pedicle torsion. Emergency ovarian tumor resection. Intraoperative ovarian tumors showed a gourd-like shape, the upper diameter of 5cm, part of the real, the lower part of the diameter of 12cm, cystic. Together with the right fallopian tube torsion 360 ℃, incarcerated in the uterus and rectum