Clinical case of ectopic pregnancy in the fallopian tube stump

Abstract

Here we describe a rare clinical case of female with a history of surgical sterilization coupled to ectopic pregnancy in the fallopian tube stump, comprising on average 1.19 % of total ectopic pregnancies. The patient E. was admitted to the gynecological department complaining of aching pain in the lower left abdominal quadrant, blood discharge from the genital tract, and delayed menstruation. Due to a previous operation for sterilization, no onset of pregnancy was expected. A positive urinary test for human chorionic gonadotropin was obtained, whereas ultrasound examination did not reliably confirm the onset of pregnancy. However, taking into account the ultrasound signs of the hematoperitoneum, a culdocentesis was performed that revealed dark liquid non-clotting blood. Laparoscopic surgery was performed on emergency indications. Intraoperatively: the stump of the left fallopian tube was dilated, cyanotic, and blood was leaking from the fimbria lend. Bilateral excision of fallopian tube stumps was performed. The primary clinical diagnosis was interrupted left-sided tubal pregnancy (in the fallopian tube stump) that was confirmed by pathomorphological examination. Thus, the clinical case described by us demonstrates properly conducted differential diagnostics as well as timely management and therapeutic interventions. Hence, previous surgical sterilization recorded in patient history should not rule out a diagnosis of ectopic pregnancy.

Keywords

• ectopic pregnancy
• fallopian tube stump
• clinical case