Retroperitoneal ectopic pregnancy: a case report and review of the literature

Abstract

BackgroundRetroperitoneal ectopic pregnancy (REP) is an extremely rare type of ectopic pregnancy, with a total of less than 20 cases reported in the English literature. However, failure to recognize REP may result in severe consequences.Case presentationWe report a case of 32-year-old woman with REP. She had amenorrhea, left lower abdominal pain, but no vaginal bleeding. Her urine human chorionic gonadotropin (HCG) test was positive and blood HCG level was 1880 m-international units per milliliter (mIU/mL). Transvaginal ultrasound sonography showed a left adnexal mass. Laparoscopy found an enlarged uterus, normal right uterine tube and ovary, and normal left uterine tube. The left ovary was partly covered by a blood clot, but appeared normal after removing the clot. There was a 10-mm circular peritoneal defect located lateral to the left sacrocervical ligament, anterior to the left ovarian fossa, and next to the lower edge of the left broad ligament. The patient was diagnosed of having REP with the gestational tissues covered by the peritoneum. The REP was removed by laparoscopic surgery. Bleeding was stopped by bipolar coagulation and absorbable hemostatic cellulose. The patient recovered smoothly and was discharged on the next day after surgery. Her blood HCG returned to normal range 29 days after surgery.ConclusionsREP is very rare, but in any suspected case of ectopic pregnancy, caution must be paid to find signs of REP when the common sites of ectopic pregnancy do not have any positive findings.

Ruptured Right Broad Ligament Ectopic Pregnancy in a Patient With Prior Right Salpingo-Oophorectomy: A Case Report

“…Ectopic pregnancy is defined as the implantation of the fertilized egg outside the endometrial cavity of the uterus. It occurs in 2% of all pregnancies, with 95% of the cases occurring in the fallopian tube [1]. Abdominal pregnancy is a rare type of ectopic pregnancy, with a reported 1 , 2 3 3 3, 4 Open Access Case Report DOI: 10.7759/cureus.8276 incidence of 1:10,000 to 1:30,000 pregnancies [2].…”

“…It occurs in 2% of all pregnancies, with 95% of the cases occurring in the fallopian tube [1]. Abdominal pregnancy is a rare type of ectopic pregnancy, with a reported 1 , 2 3 3 3, 4 Open Access Case Report DOI: 10.7759/cureus.8276 incidence of 1:10,000 to 1:30,000 pregnancies [2]. It could be life-threatening with maternal mortality eight times greater than the usual tubal ectopic pregnancies [3][4].…”

Abortive Retroperitoneal Ectopic Pregnancy Followed Up by Ultrasound: A Case Report

“…The cause of retroperitoneal ectopic pregnancy is still unclear. Some scholars have shown that it may be caused by the following reasons 1) active embryonic villi may enter the retroperitoneum after fallopian tube injured or ruptured and invaded blood vessels and causing hematoma 2) the fertilized egg travels through the lymphatic system to the retroperitoneal space, similar to the lymphatic metastasis of malignant tumors 3) a fistula is formed between the end of the fallopian tube and the retroperitoneum after salpingectomy, so that the uterus is directly identical to the retroperitoneum [2,10,11]. The diagnosis of retroperitoneal ectopic pregnancy should be differentiated from diseases such as retroperitoneal mass and traumatic hematoma.…”

Ektopik Gebelik Rüptürü Nedeniyle Postoperatif Yoğun Bakım Ünitesine Alınan Hastalar Üzerine Bir Retrospektif İnceleme

“…Lokalizasyon bakımından, EG'lerin %95'inin tubal, %1,4'ünün abdominal ve %1' den daha azının da servikal ya da ovaryan yerleşimli olduğu belirtilmiştir (11). Bunlar dışında, daha az sıklıkta splenik bölgede ve sezaryen kesi bölgesinde de EG görülebilmektedir (5,12,13). Anatomik veya fonksiyonel tubal tıkanıklık, bozulmuş tubal hareketlilik, siliyer fonksiyonda bozulma ve tüp implantasyonunu uyaran veya destekleyen moleküler kemotaktik faktörler, EG gelişiminde öne sürülen mekanizmalardandır (5).…”