Presentation
Severe lower abdominal pain with vaginal bleeding, pregnancy test positive.
Patient Data
There is large heterogenous mass lesion seen within the right adnexa with internal hyper-echoic content suggestive of blood clots, it measures 13.0 x 5.2cm.
Rt Ovary : Couldn't be visualized separate from this lesion.
No intrauterine gestation sac could be visualized within the uterus .
Endometrial echo complex measures 8.5mm.
Moderate amount of free fluid in seen in pouch of Douglas that shows internal echoes.
IMPRESSION : -
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In the context of patient's history features highly suggestive of right tubal ruptured Ectopic pregnancy .
Case Discussion
Emergency laparotomy was performed, the right fallopian tube contained the ectopic pregnancy and omental tissue. Large blood clots were noted in the pelvis. Hemoperitoneum of up-to 400 ml was drained. Right salpingectomy was done .
This patient had previous history of left sided ruptured ectopic pregnancy 10 years ago with left salpingectomy.
In majority of cases, the ectopic implantation site is within a fallopian tube, with tubal ectopic pregnancy representing 93-97%.