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An acute surgical abdomen revealing invasive mole Volume 31, issue 3-4, Mai-Août 2022

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Authors
Service de gynécologie obstétrique, Centre Hospitalier Universitaire Mohammed VI, Oujda, Maroc
* Tirés à part : H. Ennasser

Invasive mole is a gestational trophoblastic tumour characterised by myometrial invasion by molar vesicles which can lead to perforation of the uterine serosa. It is a serious but curable disease with a very good chemosensitivity, hence the need for early diagnosis as it could be fatal if not managed properly. We report the case of a 37 year old female patient, mother of a live child, with a history of spontaneous abortion at home dating back to one month, who presented to the emergency department with diffuse abdominal pain with cutaneous-mucosal pallor and haemodynamic instability. The diagnosis of gestational trophoblastic tumour was suspected in view of the intrauterine tissue process on ultrasound with the elevated level of beta gonadotropic hormone β which was 452 000 mIU/mL. The patient was referred to the OR for exploratory laparotomy finding a uterine rupture requiring haemostasis hysterectomy. This clinical case illustrates the possible and not exceptional haemorrhagic expression of invasive mole.