Dorjey Y1* and Gyeltshen T2
1Department of Obstetrics & Gynecology, Phuentsholing Hospital, Bhutan
2Department of Interventional Radiology, Jigme Dorji Wangchuk National Referral Hospital, Bhutan
Background: An abdominal ectopic pregnancy is rare and often it is misdiagnosed as ovarian ectopic pregnancy. There is no standard treatment guideline for the diagnosis and management of abdominal ectopic pregnancy. This case write-up describes an abdominal ectopic pregnancy diagnosed per-operatively and managed with combined surgical and medical intervention.
Case Report: Initially the patient presented with lower abdominal pain with features of urinary tract infection. The urine pregnancy test was faintly positive, and the ultrasound scan of the pelvis was inconclusive. The patient was treated for a urinary tract infection. However, the pain aggravated in severity, and the repeat ultrasound scan of the pelvis showed suggestive of a right-sided ovarian ectopic pregnancy. Emergency laparotomy was performed and noted an abdominal ectopic pregnancy on the right side of the recto-uterine pouch adhered to the sigmoid colon. The right ovary was found separately from the mass and it was normal. The uterus and bilateral tubes and left ovary appeared normal. The mass was separated from the bowel and removed along with the blood clot. Patient recovery was uneventful. A single dose of methotrexate was administered on postoperative day-4, and the patient was discharged on postoperative day 7.
Conclusion: Initially abdominal ectopic pregnancy was misdiagnosed and treated as a urinary tract infection. Later misdiagnosed as an ovarian ectopic by the ultrasound scan for the abdominal pregnancy which was confirmed during the laparotomy.
Abdominal; Ectopic pregnancy; Laparotomy; Inj. Methotrexate
Dorjey Y, Gyeltshen T. Misdiagnosed Abdominal Ectopic Pregnancy. Ann Pregnancy Birth. 2023; 3(1): 1011..