Ruptured Tubal Pregnancy in A Hemodynamically Stable Patient: A Case Report

Abstract

            An ectopic pregnancy is a pregnancy that is implanted outside of the uterine cavity. It is a life-threatening emergency condition in a first-trimester pregnancy.

            A 17-year-old primigravida woman came to our department with a sudden onset of lower abdominal pain and a history of amenorrhea for three months. The patient’s vital signs were stable. Physical examination showed mild tenderness on the lower abdomen with no signs of peritonitis. Pelvic examination revealed mild cervical motion tenderness, a slightly enlarged uterus, and a left adnexal mass. Ultrasonography showed a gestational sac with a viable fetus at 11 weeks of gestation, which was seen at the left adnexa with free fluid in the cul-de-sac and hepatorenal pouches. The patient was diagnosed with a ruptured ectopic pregnancy and consented to emergency exploratory laparotomy. Left salpingectomy was carried out. The patient improved gradually and was discharged without complication. However, this case was not an usual presentation of an ectopic pregnancy, and thus should be retained for differential diagnosis in pregnant women with uncertain clinical presentation and hemodynamic stability.