{"created":"2023-05-25T05:25:38.799969+00:00","id":4086,"links":{},"metadata":{"_buckets":{"deposit":"e3dedfd7-aa6e-4f3c-9341-67059c5b80de"},"_deposit":{"created_by":17,"id":"4086","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"4086"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:00004086","sets":["29:31:106:107"]},"author_link":["12785","12792","12783","12784","12798","12793","12800","12796","12797","12790","12781","12799","12788","12795","12780","12787","12794","12789","12786","12791","12782"],"item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Unilateral twin tubal ectopic pregnancy diagnosed and treated with laparoscopic surgery: A case report"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"フククウキョウ ニテ シンダン チリョウ シエタ ヘンソク ランカン ノ イショセイ ソウタイ ニンシン ノ イチレイ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2016-08-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"125","bibliographicPageStart":"121","bibliographicVolumeNumber":"34","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal ","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"　腹腔鏡が奏効し診断・治療した自然妊娠による片側卵管の異所性双胎妊娠（以下、本症）を経験したので報告する。\n　症例は、34歳、未経妊の女性。尿妊娠反応陽性のため、近医を受診（最終月経から妊娠６週４日相当）。精査の結果、異所性妊娠の疑いで当科に紹介となった。来院時、腹痛や性器出血はなく、内診上子宮は鶏卵大で付属器は触知せず、圧痛も認めなかった。経腟超音波検査では子宮内に胎嚢を認めず、血中hCG値は 4789.1 mIU/mlであり、異所性妊娠疑いで入院となった。翌日（妊娠６週５日相当）の超音波再検でも子宮内に胎嚢を認めず、また、血中hCG値も上昇しないため、正常妊娠は否定的と判断した。流産と異所性妊娠の鑑別のために行った子宮内膜全面掻爬で採取した標本内に、絨毛組織は認められなかった。翌日（妊娠６週６日相当）の血中hCG値は低下しなかったが、超音波検査で右子宮付属器領域に胎嚢様構造を認め、右卵管妊娠の疑いで診断と治療を兼ね腹腔鏡手術を施行した。右卵管峡部に２つの腫瘤が視認され、それぞれを切開したところ、ともに絨毛様組織が摘出され、術後に血中hCG値は下降した。摘出標本の病理検査でいずれも絨毛組織が確認され、本症と診断した。\n　本症は全異所性妊娠の200例に１例の頻度で発生し、これまでに約100例の文献報告がある。本症例では術前の確定診断には至らなかったが、腹腔鏡により早期に本症を診断・治療しえた。異所性妊娠の腹腔鏡手術においては、稀ではあるが多胎の可能性も念頭に置き、注意深く腹腔内を観察することが重要である。","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"12787","nameIdentifierScheme":"WEKO"}],"names":[{"name":"アミタ, ミツヨシ"}]},{"nameIdentifiers":[{"nameIdentifier":"12788","nameIdentifierScheme":"WEKO"}],"names":[{"name":"イガラシ, ヒデキ"}]},{"nameIdentifiers":[{"nameIdentifier":"12789","nameIdentifierScheme":"WEKO"}],"names":[{"name":"マツカワ, ジュン"}]},{"nameIdentifiers":[{"nameIdentifier":"12790","nameIdentifierScheme":"WEKO"}],"names":[{"name":"スズキ, 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