Manual compression management for internal bleeding of Cul-de-Sac ectopic pregnancy

Abstract

Abdominal ectopic pregnancy is rare among all ectopic pregnancies and only few cases were treated with laparoscopic surgery. The most challenging management is adequate hemostasis after the removal of gestational material. We present a case of abdominal ectopic pregnancy with massive hemoperitoneum who was treated with laparoscopy and manual hemostasis during the surgery. After the removal of gestational material, persistent bleeding from the rough surface of rectal serosa was observed. Thermal coagulation was dilemmatic due to proximity to the rectum. Then, we used manual compression with one index finger in the rectum combined with gauze compression by laparoscopic instrument. The hemostasis was achieved successfully.

Keywords

• Ectopic
• abdominal pregnancy
• hemoperitoneum
• surgery
• laparoscopy
• hemostasis