In the State Clinical Hospital named after M.P. Konchalovsky saved a patient whose liver… was developing a child. A woman was admitted to the hospital emergency department with complaints of nagging pain in the lower abdomen. The doctors, as expected, performed an ultrasound on her and found free fluid in her abdominal cavity. Gynecologists immediately suspected an ectopic pregnancy.
“Additional laboratory testing confirmed our fears. It became clear that we were dealing with a pregnancy of unknown localization: the patient had a significantly elevated level of human chorionic gonadotropin. This hormone begins to be produced from the sixth to the eighth day after fertilization of the egg,” said aif.ru Deputy Chief Physician for Obstetrics and Gynecology of the M.P. City Clinical Hospital Konchalovsky Elen Vartanyan.
Doctors performed an emergency operation on the patient – diagnostic laparoscopy (puncture) and discovered intra-abdominal bleeding in the woman, the cause of which was a rare case of ectopic pregnancy. As experts clarified, the fertilized egg, measuring 3 by 3 centimeters, was located directly in the liver, which led to its rupture. As a result, the woman’s life was in danger.
“An ectopic pregnancy is a pathology in which the attachment of a fertilized egg occurs outside the uterine cavity. The most common type is tubal pregnancy, where the fertilized egg implants in the fallopian tube. But in some cases it can attach to the abdominal and pelvic organs. Pregnancy localized in the liver, like our patient’s, is an extremely rare pathology,” added Helen Vartanyan.
According to doctors, it was, of course, impossible to maintain the pregnancy. The fetal egg at this stage of pregnancy (5–7 weeks) is nourished by the chorion – the outer membrane of the fetus around the embryo, and has many very thin capillaries, which in this case are firmly embedded in the liver. Any damage to them would lead to severe bleeding and death of the patient. The doctors could not hesitate: surgeons, obstetricians-gynecologists, transfusiologists, anesthesiologists and resuscitators decided to perform a laparoscopic resection of the liver with a fertilized egg and removal of the gallbladder.
“We discovered that the fertilized egg grows not only into the liver itself, but also into the gallbladder. Therefore, it had to be completely removed along with the liver segment into which the embryo was implanted,” explained Chief Surgeon of the City Clinical Hospital named after M.P. Konchalovsky Alexander Voynovsky.
The patient is now fine and has been discharged. The surgeons wielded an ultrasonic scalpel with pinpoint precision. As a result of the operation, the fertilized egg, part of the liver and gall bladder were removed with minimal blood loss.
The postoperative period proceeded without complications. And according to doctors, after some time her liver will fully restore its volume and function.
“In the future, a woman will be able to conceive, carry and give birth to a healthy child. However, preparing for a second pregnancy will require a particularly thorough preliminary examination and consultation with specialists,” concluded the press service of the Moscow Department of Health.