Live ectopic pregnancy

Case contributed by Maulik S Patel
Diagnosis certain

Presentation

2nd gravida female with 6 weeks of amenorrhea. Complaining of lower abdominal mild pain for last one week.

Patient Data

Age: 30 years
Gender: Female
ultrasound

Uterine cavity shows a small amount of non-specific endometrial fluid. Both ovaries are normal. There is a thick-walled sac in the left adnexa along with the presence of a yolk sac and a fetal pole. Cardiac activity is present in the fetal pole. There is no collection in the pelvis.

Photo

There is left adnexal extra-ovarian lesion. Left salpingectomy was done. Left ovarian exophytic follicle was punctured. There is an exophytic lesion from the posterior aspect of the uterus.

Case Discussion

A female presented with 6 weeks of amenorrhea, a positive pregnancy test, and lower abdominal mild pain. Ultrasound shows a left adnexal live ectopic pregnancy corresponding to the period of amenorrhea.

Laparoscopy was done after a few hours; left salpingectomy was done. There is an exophytic lesion from the uterus in intraoperative photos which is a subserosal fibroid ( reported during 1st pregnancy ). However, this fibroid was missed during present ultrasound which makes this case an example of satisfaction of search error.

Intraoperative photos courtesy: Treating Dr. Drashti Patel.

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