scholarly journals A case report on ruptured interstitial ectopic pregnancy: diagnostic dilemma

2019 ◽  
Vol 8 (6) ◽  
pp. 2567
Author(s):  
Suman S. Sharma ◽  
A. V. Gokhale ◽  
Shonali Agrawal
Keyword(s):  
Ectopic Pregnancy ◽  
Broad Ligament ◽  
Rare Event ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Radiological Features ◽  
Gestational Sac ◽  
Interstitial Ectopic Pregnancy

The ectopic pregnancy occurs when implantation of the blastocyst takes place in a site other than the endometrium of the uterine cavity. Interstitial ectopic pregnancies are gestations that implant within the proximal, intramural portion of the fallopian tubes with high vascularity. Ectopic pregnancy in the interstitial part of the fallopian tubes can be life-threatening considering the thin myometrial tissue surrounding the gestational sac and high vascularization which may result in catastrophic haemorrhage when interstitium is ruptured. Being a hazardous type of ectopic pregnancy, it becomes extremely important to diagnose and manage it. This condition presents a challenge for clinical as well as radiological diagnosis. Generally, a case of interstitial ectopic pregnancy has typical radiological features distinguishing it from other ectopic. The ultrasonographic finding of interstitial line has better sensitivity (80%) and specificity (98%) than eccentric gestational sac location (sensitivity, 40%; specificity, 88%) and myometrial thinning (sensitivity, 40%; specificity, 93%) for the diagnosis of interstitial ectopic pregnancy. Ultrasound is the mainstay of diagnosis, but magnetic resonance imaging can be helpful in unusual or complicated cases. Interstitial ectopic pregnancy rupturing into the leaves of broad ligament and creating a tamponade effect to alter the clinical presentation is a rare event which presents as a diagnostic challenge. Here authors present a case of ruptured interstitial ectopic pregnancy confined to the leaves of broad ligament, with atypical presentation and radiological features which led to difficulty in diagnosing the interstitial ectopic pregnancy. After laparoscopic confirmation of ruptured interstitial ectopic pregnancy, the patient was managed successfully by laparoscopic cornual resection.

scholarly journals Cornual pregnancy-an unusual site of pregnancy: a case report and literature review

2019 ◽  
Vol 10 (1) ◽  
pp. 64-67
Author(s):  
Tanzeem S Chowdhury ◽  
Homaira Hasan ◽  
TA Chowdhury
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Uterine Wall ◽  
Unusual Presentation ◽  
Cornual Pregnancy ◽  
Diagnostic Challenge ◽  
Unusual Site ◽  
Rare Type ◽  
Interstitial Pregnancy ◽  
Gestational Sac

Ectopic pregnancy is a condition where gestational sac is located outside the uterine cavity. Cornual pregnancy, also known as interstitial pregnancy, is a rare type of ectopic pregnancy that develops in the interstitial portion of the fallopian tube and invades through the uterine wall. It poses great diagnostic challenge because of its unusual presentation and late diagnosis. Cornual pregnancy, if not diagnosed early, may present with massive and uncontrollable bleeding even leading to maternal death. We hereby report an unusual presentation of cornual pregnancy which was diagnosed and subsequently managed successfully. Birdem Med J 2020; 10(1): 64-67

scholarly journals Lithopedion Causing Intestinal Obstruction in a 71-Year-Old Woman: A Case Report

2019 ◽  
Vol 41 (02) ◽  
pp. 129-132
Author(s):  
Francisco de Oliveira ◽  
Sandra Santos ◽  
Bruno Duarte ◽  
Alexandre Sisnando
Keyword(s):  
Intestinal Obstruction ◽  
Ectopic Pregnancy ◽  
Rare Event ◽  
Uterine Cavity ◽  
First Trimester ◽  
Abdominal Pregnancy ◽  
Fallopian Tubes ◽  
Rare Type ◽  
The World ◽  
Ectopic Pregnancies

AbstractEctopic pregnancy is the leading cause of pregnancy-related death during the first trimester, and it occurs in 1 to 2% of pregnancies. Over 90% of ectopic pregnancies are located in the fallopian tube. Abdominal pregnancy refers to an ectopic pregnancy that has implanted in the peritoneal cavity, external to the uterine cavity and fallopian tubes. The estimated incidence is 1 per 10,000 births and 1.4% of ectopic pregnancies. Lithopedion is a rare type of ectopic pregnancy, and it occurs when the fetus from an unrecognized abdominal pregnancy may die and calcify. The resulting “stone baby” may not be detected for decades and may cause a variety of complications. Lithopedion is a very rare event that occurs in 0.0054% of all gestations. About 1.5 to 1.8% of the abdominal babies develop into lithopedion. There are only ∼ 330 known cases of lithopedion in the world. We describe a lithopedion that complicated as intestinal obstruction in a 71-year-old woman.

scholarly journals A Case of Ovarian Pregnancy Diagnosed by MRI

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Shingo Io ◽  
Masaaki Hasegawa ◽  
Takashi Koyama
Keyword(s):  
Ectopic Pregnancy ◽  
High Intensity ◽  
Transvaginal Ultrasonography ◽  
Mr Images ◽  
Diagnostic Challenge ◽  
Rare Form ◽  
Low Intensity ◽  
Ovarian Pregnancy ◽  
Gestational Sac ◽  
The Right

Ovarian pregnancy is a rare form of ectopic pregnancy, causing a great diagnostic challenge. We report a case of ovarian pregnancy in a 42-year-old woman, in whom MRI successfully demonstrated the implantation in the ovary. Transvaginal ultrasonography showed an echogenic mass in the right ovary but failed to demonstrate tubal pregnancy. T2-weighted MR images disclosed a gestational sac structure in the right ovary, which exhibited heterogeneous high intensity intermingled with punctate foci of distinct low intensity. MRI may be a useful tool for diagnosing ovarian pregnancy, by demonstrating a gestational sac in the ovary.

scholarly journals Ectopic Pregnancy in Two Cats

2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Scar Tissue ◽  
Tubal Pregnancy ◽  
Abdominal Pregnancy ◽  
Fallopian Tubes ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.

Variance in clinical presentation of Ectopic pregnancy

2021 ◽  
Vol 15 (10) ◽  
pp. 2845-2847
Author(s):  
Areeba Aftab ◽  
Memoona Faiyaz ◽  
Uzma Fahim ◽  
Humaira Tabassum ◽  
Saima Rafique ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Key Words ◽  
Acute Abdomen ◽  
Vaginal Bleeding ◽  
Clinical Presentation ◽  
Uterine Cavity ◽  
Cross Sectional ◽  
Clinical Presentations ◽  
Gestational Sac ◽  
Labour Ward

Objective: To adjudge the prevalence of distinct presentations in ectopic pregnancy. Research Design: Descriptive cross-sectional. Place and Duration of Study: Emergency Labour Ward Department of Obstetrics & Gynecology, Nishtar Hospital Multan from 1.07.2017 to 31.12.2017. Methodology: Ninety five patients having positive pregnancy tests and uterine cavity with no intrauterine gestational sac on ultrasound were included. Clinical presentation like amenorrhea, vaginal bleeding, acute abdomen, shock or asymptomatic were assessed. Results: Amenorrhea observed in 73(76.8%) women, vaginal bleeding was seen in 32 (33.7%) women, 88 (92.6%) patients presented with acute abdomen and vitals instability was seen in 8 (8.4%) patients and 6(6.3%) patients were without symptoms. Conclusion: The two most common clinical presentations in patients included in study were amenorrhea and acute abdomen. Thorough evaluation of the patients with sub-acute or chronic presentation should be adopted to diagnose the cases of ectopic pregnancy. Key words: Ectopic pregnancy; Clinical presentation; Variations

scholarly journals A rare presentation of ruptured interstitial ectopic pregnancy with broad ligament hematoma: A case report

2017 ◽  
Vol 22 (1) ◽  
pp. 80-83 ◽  
Author(s):  
Ahmed M. Abbas ◽  
Amera M. Sheha ◽  
Shymaa S. Ali ◽  
Amr M. Maghraby ◽  
Esraa Talaat
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Broad Ligament ◽  
Rare Presentation ◽  
Interstitial Ectopic Pregnancy

scholarly journals Cervical Twin Heterotopic Pregnancy: Overview of Ectopic Pregnancies and Scanning Detection Algorithm

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 969
Author(s):  
Antonios Koutras ◽  
Zacharias Fasoulakis ◽  
Michail Diakosavvas ◽  
Athanasios Syllaios ◽  
Athanasios Pagkalos ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
First Trimester ◽  
Detection Algorithm ◽  
Heterotopic Pregnancy ◽  
Cervical Canal ◽  
Mortality And Morbidity ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is the leading cause of gestation-related deaths during the first trimester. Cervical twin heterotopic pregnancies, when ectopic, constitute a small and rare part of gynecological surgery. Case Presentation: A 30-year-old pregnant woman (gravida 3, para 2) presented with mild pain in the lower abdomen and traces of bleeding per vaginum for three days. Transvaginal ultrasonography revealed a balloon-shaped cervical canal with a visible gestational sac measuring 3.5 × 3.9 cm. A second gestational sac was seen in the uterine cavity. The measurements of the gestational sacs corresponded to 7 + 4 weeks’ pregnancy. A decision for medical abortion with mifepristone and misoprostol was made. However, due to an incomplete abortion and continuous bleeding, a curettage was performed. Conclusions: Spontaneous heterotopic pregnancy with the ectopic pregnancy located in the cervix is an extremely rare clinical condition requiring urgent treatment in order to reduce maternal mortality and morbidity and preserve fertility.

Bilateral tubal incarceration into the broad ligaments caused by pelvic endometriosis: A case report

2021 ◽  
pp. 228402652110381
Author(s):  
Francesca Massimello ◽  
Andrea Giannini ◽  
Linda Tebache ◽  
Michelle Nisolle ◽  
Tommaso Simoncini
Keyword(s):  
Iliac Fossa ◽  
Broad Ligament ◽  
Rare Event ◽  
Reproductive Period ◽  
Infertile Woman ◽  
Fallopian Tubes ◽  
Assisted Reproductive Technique ◽  
Left Iliac Fossa ◽  
Common Location ◽  
Ablative Surgery

Introduction: Endometriosis is characterised by the presence of functional endometrial tissue outside the uterus. Salpinges are a common location of endometriotic implants. Endometriosis located into the broad ligament is a rare event. Case description: A 38-year-old infertile woman presented to our attention with moderate left iliac fossa pain after menses and intermenstrual bleeding. Transvaginal ultrasounds and pelvic magnetic resonance evidenced the presence of bilateral haematosalpinges. At the laparoscopic pelvic exploration, fallopian tubes were absent. Opening and dissecting the apical portion of the broad ligaments, we identified bilateral haematosalpinges incarcerated in the homolateral broad ligaments. We performed bilateral salpingectomy. Histological examination confirmed the presence of endometriosis. Conclusion: Care must be taken to the diagnostic assessment, counselling about the surgical programme before the intervention especially in patients during the reproductive period when the possibility of ablative surgery and subsequent need for an assisted reproductive technique exists.

Infrahepatic Implantation of an Ectopic Pregnancy

2021 ◽  
pp. 1-3
Author(s):  
Peter Kern ◽  
Paula Ulrich ◽  
Rainer Kimmig ◽  
Peter Kern
Keyword(s):  
Ectopic Pregnancy ◽  
Close Contact ◽  
Blood Clot ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Greater Omentum ◽  
Free Fluid ◽  
Fallopian Tubes ◽  
Lower Abdomen ◽  
The Right

Background: Ectopic pregnancies occur predominantly in the fallopian tubes or ovaries. Very rarely, the distal part of the greater omentum may have close contact to the fallopian tubes and implantation of the embryo may occur in this part of the greater omentum. In the absence of signs of pregnancy in the uterus or the fallopian tubes, the greater omentum has to be closely examined for ectopic pregnancy. Case Presentation: A 22-year-old woman in her 4th week of pregnancy presents with spotting and severe pain in the right lower abdomen with a history of 2 cesarean sections. The sonographic examination showed a normal uterus with a thin endometrial line. The uterine cavity did not present with any signs of a gestational sac. A great amount of free fluid in the Douglas cavity suspicious of a hemoperitoneum. ßhCG-values in serum was highly elevated up to 16749 mU/ml and confirmed the suspicion of an ectopic pregnancy. A diagnostic laparoscopy was performed, during which a blood clot reaching from the right lower abdomen to the greater omentum was detected. After removing the blood clot, a normal-sized uterus with regular ovaries and no signs of a pregnancy in the fallopian tubes were seen. However, an abdominal adhesion in the right upper part of the omentum close to the liver with bleeding was seen. While examining the abdominal cavity for the cause of bleeding, a small cystic lesion adherent to the greater omentum – close the offspring from the colon – representing an ectopic pregnancy became apparent. A partial omentectomy of 9,5 cm x 5,5 cm x 2,5 cm was performed with the finding of trophoblast and embryoblast implantated in the infrahepatic part of the greater omentum. Conclusion: In cases of ectopic pregnancy with hemoperitoneum, special care has to be taken examining not only the fallopian tubes or ovaries but also the greater omentum, which may harbour an implanted trophoblast and embryoblast – even in the upper part directly beneath the liver – as presented in this case. In cases of ruptured ectopic pregnancy of the greater omentum, the cases may be dealt with laparoscopic partial omentectomy if the case is early detected.

scholarly journals Angular Pregnancy Presenting as Cornual Ectopic Pregnancy

2014 ◽  
Vol 26 (1) ◽  
pp. 63-65
Author(s):  
Sankar Prosad Biswas ◽  
Suravi Halder ◽  
Feroja Banu Shirin
Keyword(s):  
Ectopic Pregnancy ◽  
Invasive Surgery ◽  
Uterine Cavity ◽  
Round Ligament ◽  
Obstetric Complication ◽  
Interstitial Pregnancy ◽  
Future Fertility ◽  
Life Threatening ◽  
Gestational Sac ◽  
Medicine Today

Angular pregnancy is a rare obstetric complication that can be life threatening. In this situation, gestational sac is implanted in the lateral angle of the uterine cavity, medial to the uterotubal junction and round ligament. Angular pregnancy is distinguished from interstitial pregnancy by anatomically, where embryo is implanted lateral to round ligament. The report presented here describes a case of angular pregnancy that was suspected by ultrasound and confirmed during surgery. Laparoscopy can be useful for guiding dilatation & curettage in angular pregnancy and may circumvent the need for invasive surgery or hysterectomy. It has an impact on future fertility. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21318 Medicine Today 2014 Vol.26(1): 63-65

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