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  • Title: Ectopic pregnancy after tubal sterilization. Mechanism of recanalization. A case report.
    Author: Rimdusit P.
    Journal: J Med Assoc Thai; 1982 Feb; 65(2):101-5. PubMed ID: 7200507.
    Abstract:
    A case of tubal pregnancy occurring 8 years after a modified Pomeroy's tubal sterilization is reported. The gross and microscopic findings of the resected tubes and the possible mode of recanalization are discussed. A 36 year old Thai woman, para 3-0-0-2, with her last para 8 years previously had puerperal tubal sterilization by modified Pomeroy's technique. The patient was seen at Ramathibodi Hospital on March 28, 1975 because of unimproved left lower abdominal pain for 1 week and a few days of vaginal spotting. She had been treated with antibiotics and analgesic previously. Her last normal menstrual period was in early March, 1975. Pelvic examination revealed pus-like, foul smelling vaginal discharge. Cervical excitation pain was positive. The uterine size was normal, deviated to the right side and slightly tender. A tender, ill-defined, soft cystic mass was palpable at the left adnexa extending to the left side of cul-de-sac. The right adnexa was normal. Exploratory laparotomy revealed that the left adnexal mass consisted of blood clots and a ruptured enlarged ampullar portion of the left tube. The left ovary was normal. At the isthmic portion of the left tube which had previously been resected, there was a constriction. The stumps of both cut ends of the right tube were well healed and widely separated. Left salpingo-oophorectomy was performed. The microscopic finding of the left ampulla was ectopic pregnancy. From serial sections of the constriction site of the left tube, there were multiple small lumina lined by low columnar epithelium surrounded by a thin layer of fibromuscular tissue.
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