急性腹症に対する腹腔鏡下腹腔内観察・洗浄が診断・治療に寄与したクラミジア性腹膜炎が疑われた1例Laparoscopic treatment of suspected chlamydial peritonitis: A case report
帝京大学ちば総合医療センターTeikyo University Chiba Medical Center
A 21-year-old woman, gravida 3, parity 0, presented with acute severe abdominal pain. Physical examination revealed muscle guarding and significant ascites beyond the pelvic line. Contrast-enhanced CT raised suspicion of ovarian bleeding as the cause of her abdominal pain. To confirm the diagnosis, diagnostic laparoscopy was performed. The surgical procedure included exploration of the peritoneal cavity, which revealed purulent ascites and swollen fallopian tubes. No evidence of ovarian bleeding, appendicitis, strangulated ileus, or violin string-like adhesion was found. Additionally, a lavage with 6 l of normal saline solution was performed. The patient has a smooth recovery without any complications. Diagnostic laparoscopy not only ruled out other causes of acute abdomen but also facilitated the recovery of the patient. She was discharged three days after the surgery. Therefore, laparoscopic diagnosis proves to be a valuable approach for diagnosing chlamydial peritonitis.
Key words: chlamydial peritonitis; laparoscopic drainage; laparoscopic diagnosis
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