Misdiagnosis of bilateral tubal pregnancy: a case report

Abstract

IntroductionThe incidence of bilateral tubal pregnancy is rising due to the increase of pelvic inflammatory disease and assisted reproductive techniques. Because the clinical manifestations of bilateral tubal pregnancy are not specific, we often ignore inspection of the other fallopian tube when focusing on the lesions, which may cause misdiagnosis.Case presentationA 33-year-old Chinese woman presented with vaginal bleeding after menopause and with an abnormality found by transvaginal ultrasound scan for which she underwent laparoscopy and salpingectomy. Unfortunately, she had to undergo a repetitive laparoscopic salpingotomy for the other tubal pregnancy due to misdiagnosis of her bilateral tubal pregnancy.ConclusionsThe incidence of unusual presentations of ectopic pregnancies has risen. Surgeons should always keep in mind the possibility of bilateral tubal pregnancy. An attentive examination of the pelvis, especially the two fallopian tubes, is necessary to avoid missing bilateral tubal pregnancy.

Misdiagnosis of spontaneous bilateral tubal pregnancy: a case report and review of literature

“…Surgical management of BTP include salpingectomy, linear salpingostomy, bilateral salpingostomy, and bilateral salpingectomy [3]. The procedure of laparoscopy is the best option for diagnosis and management of BTP [14]. However, there is a need to maintain a high index of suspicion for BTP as the diagnosis can also be missed on laparoscopy [14].…”

“…The procedure of laparoscopy is the best option for diagnosis and management of BTP [14]. However, there is a need to maintain a high index of suspicion for BTP as the diagnosis can also be missed on laparoscopy [14]. Laparotomy is equally effective for hemo-dynamically unstable patients.…”

An increasing trend of bilateral tubal ectopic gestation reported over the past two decades: a case report and review of literature

“…10,12,[19][20] Salpingectomy of one tube and salpingostomy of other tube was performed in the following cases reported. 4,11,13,19,[21][22][23][24][25][26] Salpingostomy without suturing carries higher rate of intrauterine pregnancy which may be due to rapid return of tubal function due to minimal injury to the tubal structures. 27 Viable pregnancy after conservative surgery for bilateral tubal ectopic was reported by Sreeja et al 24 Follow up of these patients is extremely important so as to assess the future fertility aspect with this mode of conservative surgery.…”

Bilateral ruptured tubal pregnancy: a case report

“…Pre-operational diagnosis is difficult due to unpredictable clinical presentation with no unique feature to distinguish unilateral from bilateral ruptured tubal pregnancy. 9 It is very difficult to pick up the diagnosis on USG and so is the case with serum ß-HCG estimation. 10 Our case was unusual case of ruptured tubal pregnancy in which patient presented with acute ruptured tubal pregnancy on one side and an old ruptured tubal pregnancy with omental mass organised around it on the other side.…”

“…Cases have been reported where the contra-lateral ruptured tubal conception was overlooked necessitating repetition of procedure after few days. 9 Intra-operatively once a gestational sac is found, the second sac is usually not expected and is likely to be missed. High index of suspicion and judicious look on the opposite tube in the operating room is the most effective method for diagnosing second pregnancy.…”