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Cao Y, Feng C, Li H. Spontaneous diaphragm rupture caused by abdominal pregnancy: A case report. Asian J Surg 2024:S1015-9584(24)00807-8. [PMID: 38714409 DOI: 10.1016/j.asjsur.2024.04.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/18/2024] [Indexed: 05/09/2024] Open
Affiliation(s)
- Yi Cao
- Department of General Surgery, Hangzhou Normal University Affiliated Hospital, Hangzhou, 310015, China.
| | - Chenglei Feng
- Department of General Surgery, Hangzhou Normal University Affiliated Hospital, Hangzhou, 310015, China
| | - Hang Li
- Department of General Surgery, Hangzhou Normal University Affiliated Hospital, Hangzhou, 310015, China
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Suryawan A, Rahardjo TM, Suparman E, Mahardhika JC. Right abdominal pregnancy with hemorrhagic shock after previous left tubal pregnancy: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231180757. [PMID: 37359286 PMCID: PMC10285589 DOI: 10.1177/2050313x231180757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Abdominal pregnancy is the rarest ectopic pregnancies, with an incidence of 1 per 10,000 live births, and life-threatening because the symptoms are not specific and diagnosis is made after abdominal pain, amenorrhea and vaginal bleeding occur. We present a rare case of abdominal pregnancy in a 31-year-old Indonesian woman with severe abdominal pain within 24 hours before hospital admission, accompanied by nausea, vomiting, dizziness and weakness. She felt the pain increasing since the last 2 weeks and limiting her movement. She has a history of a left tubal pregnancy 5 years ago. Ultrasonography examination revealed an ectopic pregnancy, and she was rushed to the operation room for emergency exploratory laparotomy. An abdominal pregnancy was found, located in the right adnexa with excessive fluid in cavum Douglass and a foetus in around 11-12 weeks of gestation accompanied by free fluid in the subdiaphragmatic, subhepatic and pelvic cavity. The surgery was a successful, four units of whole blood were transfused, and the patient was safely discharged from the hospital. The current concept on management of abdominal pregnancy supports immediate surgical intervention with pregnancy termination, as found in this case, because the patient's condition is hemodynamically unstable indicating hemorrhagic shock correlated with massive hemoperitoneum. A prompt diagnosis and good teamwork in treatment plays an important role for such a life-threatening condition to avoid maternal morbidity and mortality in a case of abdominal pregnancy.
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Affiliation(s)
- Aloysius Suryawan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia
| | - Theresia Monica Rahardjo
- Department of Anesthesia and Intensive Care, Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia
| | - Erna Suparman
- Department of Obstetrics and Gynecology, Prof. Dr. R. D. Kandou Hospital, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia
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Mulisya O, Barasima G, Lugobe HM, Matumo P, Vahwere BM, Mutuka H, Léocadie Z, Lumika W. Abdominal pregnancy with a live newborn in a low-resource setting: A case report. Case Rep Womens Health 2023; 37:e00480. [PMID: 36683781 PMCID: PMC9845762 DOI: 10.1016/j.crwh.2023.e00480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
Abstract
Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be frequently missed in low-resource settings because of poor antenatal healthcare provision, low socioeconomic patient status as well as lack of adequate medical resources. Clinical diagnosis can be difficult and ultrasound scan is helpful during the early stages of gestation but can be disappointing thereafter. A case of abdominal pregnancy in a 25-year-old woman, who presented at 26 weeks of gestation with severe abdominal pain not relieved by any medication, is reported. An emergency laparotomy was undertaken as her vital signs deteriorated. An abdominal pregnancy was found and a live neonate delivered. Ministries of health in developing countries should ensure routine access to ultrasound in early pregnancy. Obstetricians should bear in mind that abdominal pregnancy can present late in gestation.
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Affiliation(s)
- Olivier Mulisya
- Department of Gynecology and Obstetrics, Fepsi hospital, Butembo, Democratic Republic of the Congo,Corresponding author at: Department of Gynecology and Obstetrics, FEPSI hospital, Butembo, Democratic Republic of the Congo.
| | - Guelord Barasima
- Department of Gynecology and Obstetrics, La Breche Medical Center, 00243 La Breche, BENI, Democratic Republic of the Congo
| | - Henry Mark Lugobe
- Department of Gynecology and Obstetrics, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara Uganda, Uganda
| | - Philémon Matumo
- Département de Gynécologie Obstétrique, Université Catholique du Graben, Butembo, Democratic Republic of the Congo
| | - Bienfait Mumbere Vahwere
- Surgery Department of Kampala International University, Box 20000, Gbaba Road, kansanga, kampala, Uganda
| | - Hilaire Mutuka
- Département de chirurgie, Institut de Technique Médical, Butembo, Democratic Republic of the Congo
| | - Zawadi Léocadie
- Department of Gynecology and Obstetrics, La Breche Medical Center, 00243 La Breche, BENI, Democratic Republic of the Congo
| | - Wesley Lumika
- Department of Gynecology and Obstetrics, La Breche Medical Center, 00243 La Breche, BENI, Democratic Republic of the Congo
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Pregnancy in a rudimentary horn: multicenter's MRI features of a rare condition. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:4195-4204. [PMID: 36094661 DOI: 10.1007/s00261-022-03658-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To describe the MRI features of rudimentary horn pregnancy (RHP) with surgical correlations. METHODS Nine women with a RHP underwent preoperative pelvic MRI. MRI protocol included T2- (n = 9), T1- (n = 7), and fat-suppressed contrast-enhanced T1-weighted sequences (n = 4). Two pelvic radiologists retrospectively analyzed MR images to assess the following MRI features: presence of a myometrium around the gestational sac (GS) and characteristics of its wall, GS surrounded by myometrium in contact with the round ligament, communication of the GS with the endometrial cavity of the main horn, continuity of the GS with the cervix, fibrous or muscular GS attachment to the main horn, lateral deviation, and endometrial thickness of the main horn. Ovaries and tubes were also assessed. MRI features were correlated with surgical findings. RESULTS Seven of the nine women [29 ± 6 SD years (range 16-37 years)] underwent surgical management. The first US diagnosed RHP in only 1/9 patients. All pregnancies were diagnosed using MRI. RHP was all located in the rudimentary horn of a unicornuate uterus. All the GS was surrounded by myometrium in contact with the round ligament. None of the RHP displayed communication with the endometrial cavity of the main horn nor with the cervix. An attachment between the RHP and the main horn was seen in 3/9 patients. All the main horns were lateralized and empty. CONCLUSION MRI diagnosed RHP in all patients by identifying the GS surrounded by myometrium in contact with the round ligament and the absence of continuity between the GS and the cervix. LEVEL OF EVIDENCE IV-retrospective study.
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5
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Suleiman R, Adwan D, Safadi MF. Ectopic abdominal pregnancy on the ascending colon. Clin Case Rep 2022; 10:e6581. [DOI: 10.1002/ccr3.6581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 09/01/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Riham Suleiman
- Department of Obstetrics and Gynaecology Maternity University Hospital Damascus Syria
| | - Dema Adwan
- Department of Obstetrics and Gynaecology Maternity University Hospital Damascus Syria
| | - Mhd Firas Safadi
- Department of General Surgery, Visceral Surgery, and Proctology Diakonie Hospital Hartmannsdorf Germany
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Gure T, Sultan S, Alishum R, Ali A, Dibaba B, Usmael I, Tsegaye S. Term Abdominal Pregnancy with Live Baby: Case Report from Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Int Med Case Rep J 2021; 14:689-695. [PMID: 34616185 PMCID: PMC8488043 DOI: 10.2147/imcrj.s331195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/18/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose To present a rare case of term abdominal pregnancy with live baby. Observation A 30-year-old gravida VI para V, all alive, woman who did not remember her last menstrual period but was stated amenorrheic for 9 months visited Hiwot Fana Specialized University Hospital (HFSUH) with abdominal pain of two weeks duration. The woman was diagnosed with a term abdominal pregnancy and underwent a laparotomy. The outcome of treatment was a 3200 gm healthy male baby and a total abdominal hysterectomy was done. Conclusion and Importance Term abdominal pregnancy is an extremely rare type of ectopic pregnancy that can cause diagnostic challenges and leads to life threatening conditions both before and after diagnosis because of the rupture of major blood vessels.
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Affiliation(s)
- Tadesse Gure
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Semir Sultan
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Rehama Alishum
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Abdek Ali
- Department of Gynecology and Obstetrics, Jigjiga University, Jigjiga, Ethiopia
| | - Bayissa Dibaba
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Ibsa Usmael
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Setegn Tsegaye
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
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Van Antwerp E, Schick S, Cutlip H, Turner J, Hott J. Massive hemoperitoneum without peritoneal signs: An unusual presentation of omental ectopic rupture. A case report. Case Rep Womens Health 2021; 31:e00327. [PMID: 34094887 PMCID: PMC8167815 DOI: 10.1016/j.crwh.2021.e00327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/03/2021] [Accepted: 05/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background Extrauterine ectopic pregnancy is a rare form of ectopic pregnancy, accounting for roughly 1:10,000–30,000 of all pregnancies. Primary omental pregnancy is the least common form of abdominal ectopic pregnancies, making it extremely rare. Typical presentation includes pelvic pain, secondary amenorrhea, with or without vaginal bleeding. Atypical presentations range from nonspecific pain to asymptomatic. Case A 19-year-old woman presented to the emergency department after several syncopal episodes. She had a positive urine pregnancy test (serum hCG 446 IU/L). Her hemoglobin level was 10.6 g/dL. Due to lack of pain or bleeding, abdominal imaging was not indicated. A head CT scan rendered negative results. She was subsequently diagnosed with idiopathic headaches and anemia and was discharged. She returned to hospital 48 h later with vaginal bleeding and additional syncopal episodes. She was not experiencing any abdominal pain or discomfort. Her anemia worsened (hemoglobin 7.5 g/dL). For this reason, imaging was performed. It was significant for massive hemoperitoneum. Due to the imaging findings and worsening anemia, diagnostic exploratory laparoscopy was recommended to evaluate for ruptured ectopic pregnancy. Laparoscopic findings revealed large hemoperitoneum and a 10-week gestational sac attached to the greater omentum near the transverse colon. This exceedingly rare presentation of extrauterine ectopic pregnancy offered few clinical clues other than worsening anemia until imaging later revealed the abnormality. Ruptured ectopic pregnancy, a potentially fatal complication of pregnancy, should be included into the differential diagnosis of any gravid patient with syncope and anemia unexplained by extensive diagnostic workup. Primary omental ectopic pregnancy is exceedingly rare. Ectopic pregnancy with massive hemoperitoneum can present as painless, occult bleeding. Hemodynamic instability is often overlooked in early pregnancy due to expectation of low blood pressure.
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Affiliation(s)
- Emily Van Antwerp
- West Virginia School of Osteopathic Medicine, United States of America
| | - Samuel Schick
- West Virginia University School of Medicine, United States of America
| | - Hunter Cutlip
- West Virginia University School of Medicine, United States of America
| | - Jason Turner
- West Virginia University School of Medicine, United States of America
| | - Jessica Hott
- West Virginia University School of Medicine, United States of America
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Son SY, Wu E, Gariwala V, O'Neill C. Mesenteric ectopic pregnancy with tubo-ovarian abscess. Radiol Case Rep 2021; 16:1165-1168. [PMID: 33777281 PMCID: PMC7985701 DOI: 10.1016/j.radcr.2021.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 12/03/2022] Open
Abstract
An ectopic pregnancy is the implantation of a fertilized ovum in a location other than the main cavity of the uterus. Ectopic pregnancies are reported in approximately 1%-2% of pregnancies, and while 95% of ectopic pregnancies are in fallopian tubes, only 3% are in ovarian, cervical, or abdominal sites. We present a case of a 38-year-old female with acute onset of severe lower abdominal pain, sepsis, chills, and diarrhea who was evaluated with a CT of the abdomen and pelvis with IV contrast only. The imaging revealed a likely second trimester age fetal skeleton with a partially collapsed calvarium within the peritoneal cavity and an abnormal complex cystic lesion in the right adnexal area. In this case, the patient successfully underwent exploratory laparotomy with removal of both the abdominal ectopic pregnancy and the tubo-ovarian mass.
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Affiliation(s)
- Sam Y Son
- EVMS Radiology, Eastern Virginia Medical School, 825 Fairfax Ave, Norfolk, VA 23507, USA
| | - Eunice Wu
- EVMS Radiology, Eastern Virginia Medical School, 825 Fairfax Ave, Norfolk, VA 23507, USA
| | - Veer Gariwala
- EVMS Radiology, Eastern Virginia Medical School, 825 Fairfax Ave, Norfolk, VA 23507, USA
| | - Christopher O'Neill
- EVMS Radiology, Eastern Virginia Medical School, 825 Fairfax Ave, Norfolk, VA 23507, USA
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Abstract
Abdominal pregnancy is a rare form of ectopic pregnancy with high morbidity and mortality. There are a limited number of case reports of abdominal ectopic pregnancies. We present a case of a 29-year-old woman who presented to her obstetrician at 17 weeks' gestation with abdominal pain. A sonogram and confirmatory magnetic resonance imaging demonstrated an abdominal ectopic pregnancy. The patient underwent exploratory laparotomy with removal of the ectopic pregnancy. Our case presents an opportunity to discuss a rare form of ectopic pregnancy and the importance of proper diagnosis and treatment to reduce morbidity and mortality.
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Affiliation(s)
- Reshma George
- College of Medicine, Texas A&M Health Science Center, Dallas, Texas
| | - Edward Powers
- Department of Obstetrics and Gynecology, Baylor University Medical Center, Dallas, Texas
| | - Robert Gunby
- Department of Obstetrics and Gynecology, Baylor University Medical Center, Dallas, Texas
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Soewondo W, Kusumaningrum S, Putro PS, Indriyani I, Maryetty IP, Rosati A, Yuliantara EE. The use of FIESTA sequence MRI in successful management of abdominal pregnancy. Clin Imaging 2021; 77:117-121. [PMID: 33667944 DOI: 10.1016/j.clinimag.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/30/2020] [Accepted: 01/06/2021] [Indexed: 11/19/2022]
Abstract
Identification of fetal location and its relations to abdominal organs is extremely important in reducing fetal and maternal morbidity in rare cases of abdominal pregnancy. Ultrasound examination is inadequate for helping to successfully manage such cases. In this case report, FIESTA sequence MRI is used to provide high-resolution, better contrast, and higher signal-to-noise ratio fetal and abdominal images. A case of advanced abdominal pregnancy with a live fetus is reported. The surgery was conducted successfully on 34 weeks of gestation.
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Affiliation(s)
- Widiastuti Soewondo
- Department of Radiology, Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.
| | - Sulistyani Kusumaningrum
- Department of Radiology, Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Prasetyo Sarwono Putro
- Department of Radiology, Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Ifada Indriyani
- Department of Radiology, Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Ida Prista Maryetty
- Department of Radiology, Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Ari Rosati
- Department of Radiology, Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Eric Edwin Yuliantara
- Department of Obstetrics, Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
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Stabile G, Zinicola G, Romano F, Buonomo F, Mangino FP, Ricci G. Management of Non-Tubal Ectopic Pregnancies: A Single Center Experience. Diagnostics (Basel) 2020; 10:E652. [PMID: 32878097 PMCID: PMC7555978 DOI: 10.3390/diagnostics10090652] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 01/13/2023] Open
Abstract
Non-tubal ectopic pregnancies (NT-EPs) are rare but potentially life-threatening conditions. The incidence ranges are between 5-8.3% of all ectopic pregnancies. For this retrospective observational study, 16 patients with NT-EP and treated from January 2014 to May 2020 were recruited. Demographic details, symptoms, Beta human chorionic gonadotrophin (β-hCG) levels, ultrasound findings, management and treatment outcomes were presented. In hemodynamically stable patients, diagnosis was made using ultrasounds and β-hCG levels. Laparoscopy was essential to identify and remove the ectopic pregnancy in clinical unstable patients. A radical laparoscopic approach was chosen in one case of cervical pregnancy diagnosed late in the first trimester. Medical treatment and minimally invasive procedure, alone or combined, resulted in effective strategies in asymptomatic women with an early diagnosis of NT-EP. We report cases of cervical pregnancies successfully treated by hysteroscopy alone or combined with medical treatment, the first case of scar pregnancy treated by mini-reseptoscope and curettage and the fifth case of interstitial pregnancy treated with Methotrexate and Mifepristone. In this manuscript we report a single center experience in the management of NT-EPs with the aim of outlining the importance of the early diagnosis for a minimally invasive treatment in order to reduce maternal morbidity and mortality and preserve future fertility.
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Affiliation(s)
- Guglielmo Stabile
- Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (F.R.); (F.B.); (F.P.M.); (G.R.)
| | - Giulia Zinicola
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy;
| | - Federico Romano
- Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (F.R.); (F.B.); (F.P.M.); (G.R.)
| | - Francesca Buonomo
- Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (F.R.); (F.B.); (F.P.M.); (G.R.)
| | - Francesco Paolo Mangino
- Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (F.R.); (F.B.); (F.P.M.); (G.R.)
| | - Giuseppe Ricci
- Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, 34137 Trieste, Italy; (F.R.); (F.B.); (F.P.M.); (G.R.)
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy;
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Qian H, Tian G, Zheng H, Liang W, Jiang T. Successful management of diaphragmatic ectopic pregnancy using ultrasound-guided percutaneous microwave ablation. J Obstet Gynaecol Res 2019; 46:181-185. [PMID: 31642129 DOI: 10.1111/jog.14131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 09/06/2019] [Indexed: 12/22/2022]
Abstract
Diaphragmatic ectopic pregnancy is a rare status during the perinatal period. We reported that a 24-year-old woman with diaphragmatic ectopic pregnancy successfully received ultrasound-guided percutaneous microwave ablation. It found that beta-human chorionic gonadotropin level decreased showing 1067, 311.3 and 118.4 mIU/mL within five postoperative days, and P level reduced from 3.64 to 1.59 nmol/L. Contrast-enhanced ultrasonography image on the third day after ablation indicated that there was no enhancement in the lesion. This case indicated that ultrasound-guided percutaneous microwave ablation could be critical for a good outcome in diaphragmatic ectopic pregnancy.
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Affiliation(s)
- Hongrong Qian
- Department of Ultrasound, Shengzhou Branch of the First Affiliated Hospital of Zhejiang University, Shengzhou, China
| | - Guo Tian
- Department of Ultrasound, Zhejiang University, Hangzhou, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China
| | - Haizhen Zheng
- Department of Gynecology, Shengzhou Branch of the First Affiliated Hospital of Zhejiang University, Shengzhou, China
| | - Weifeng Liang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Shengzhou People's Hospital, Shengzhou Branch of the First Affiliated Hospital of Zhejiang University, Shengzhou, China
| | - Tian'an Jiang
- Department of Ultrasound, Zhejiang University, Hangzhou, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China
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