A Case of Ectopic Tubal Pregnancy Eight Years After a Hysterectomy Presenting as a Diagnostic Challenge

Abstract

Unusual clinical course Background: Ectopic pregnancy after hysterectomy is extremely rare, and the diagnosis can be challenging, even with modern imaging methods. A rare case is presented of ectopic tubal pregnancy in a 28-year-old woman that presented eight years following a hysterectomy. Case Report: A 28-year-old woman was admitted in our hospital with moderate hypogastric pain, mild vaginal bleeding, and bilateral mastalgia. She had undergone hysterectomy eight years previously for postpartum hemorrhage. Pelvic ultrasound showed a heterogeneous tissue mass in the pelvis with peripheral vascularity that was also seen on magnetic resonance imaging (MRI). Laboratory tests showed increased serum levels of human chorionic gonadotropin (hCG). Following hospital admission, she developed an acute abdomen and shock due to tubal rupture and an emergency salpingectomy was performed. Conclusions: A multidisciplinary approach to diagnosis and management facilitated an accurate and timely diagnosis in a rare case of ectopic pregnancy that presented eight years following hysterectomy, but could not prevent the development of potentially life-threatening complications.

Embarazo ectópico tubárico seis años después de una histerectomía

“…Este diagnóstico no suele ser considerado cuando la paciente tiene el antecedente de histerectomía, lo que aplaza el tratamiento, y da lugar a complicaciones que ponen en riesgo la vida de la paciente. Aunque es considerado un evento raro, hasta este momento existen aproximadamente 74 casos reportados en pacientes histerectomizadas (3,4) , y la mitad ha ocurrido años después de la histerectomía, como el caso que describimos a continuación.…”