Accidental abdominal ectopic pregnancy, clinical case presentation

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María Fernanda Calderón León
Vicente Patricio Molina Sabando
Narciso Gotairo Pincay Holguín
María Eugenia Ugarte Vega
Priscilla María Lugmania Sánchez
Pedro Roberto Rodríguez Díaz
Daniela Abigail Guzñay Muñoz
Gema Gabriela Guzñay Muñoz
Paula Elizabeth Pachucho Hernández
Flor Fernanda Lituma Vásquez

Abstract

Introduction: Abdominal ectopic pregnancy represents 1% of extrauterine pregnancies; its incidence ranges between 1:10,000 and 1:30,000 pregnancies, has the highest mortality rate, being this 7.7 times higher, than in other ectopic pregnancies. Objectives: To present a clinical case of an abdominal ectopic accident, its diagnosis and timely treatment. Materials and methods: a descriptive and retrospective study was performed, presenting a clinical case. Authorization was obtained from the teaching and research department for access to medical records and publication of images.


Clinical case:  21-year-old female patient, pregnancies 1, deliveries: 1, intergenetic period 5 years, presents symptomatology of 2 days of evolution, characterized by : moderate to high intensity pain in right iliac fossa, which is irradiated to hypogastrium. The physical examination draws attention to the depressive soft abdomen, painful in the right iliac fossa to the superficial and deep palpation, the vaginal exam closed cervix, painful to mobilization, does not present transvaginal losses. Ultrasound examination confirmed the presence of an ectopic miscarried pregnancy, so exploratory laparotomy was performed showing hemoperitoneum 1000 CC approximately, aspiration was performed, cavity was examined and uterus was observed, annexes within normal limits, unscathed , ectopic pregnancy is observed located in epiplón on the right side, in addition to satisfied maternity, partial bilateral salpinguectomy is performed.


Discussion: Abdominal ectopic pregnancy represents a diagnostic and therapeutic challenge and can be located at the bottom of the pelvic sac, wide ligament, intestine or lateral pelvic wall, is a rare type of pregnancy and is often misdiagnosed, passing a long time , evolving into hemoperitoneum, abortion, embolism or, rarely, in diagnosed cases, live birth by cesarean section. In the case presented, the pregnancy was located at the level of epiplón.


Conclusion: In our country, there is not yet a study that exposes the current reality of this condition at the national level, being abdominal ectopic pregnancy, a pathology with a mortality 7 times higher than other ectopic pregnancies, for its atypical clinical presentation and its difficult ultrasound location. It is concluded that in the presence of abdominal pain and positive serum HGC test in a young woman in reproductive stage with or without the use of contraceptive methods, the presence of an extrauterine pregnancy should be suspected and its treatment will depend on its hemodynamic state, whereas, if you arrive in hypovolemic shock your treatment will be imminent surgical, because it is a life-threatening accident ectopic pregnancy, as happened in the case presented, whose diagnosis was intraoperative at the time of the examination of the abdominal cavity; which can be performed , laparoscopically or by exploratory laparotomy, giving resolution and control of hemodynamics. In other cases conservative medical treatment with metrotexate may be given as long as it meets criteria.

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Article Details

How to Cite
Calderón León, M. F. ., Molina Sabando, V. P. ., Pincay Holguín, . N. G. ., Ugarte Vega, M. E. ., Lugmania Sánchez, P. M., Rodríguez Díaz, P. R. ., … Lituma Vásquez, F. F. . (2023). Accidental abdominal ectopic pregnancy, clinical case presentation. Mediciencias UTA, 7(2), 35–40. https://doi.org/10.31243/mdc.uta.v7i2.1992.2023
Section
Clinical case presentation article
Author Biographies

María Fernanda Calderón León, Universidad Católica de Santiago de Guayaquil

 

 

Vicente Patricio Molina Sabando, Universidad de Guayaquil

 

 

Narciso Gotairo Pincay Holguín, Universidad de Guayaquil

 

 

María Eugenia Ugarte Vega, Universidad Internacional de la Rioja

 

 

 

Priscilla María Lugmania Sánchez, Universidad Particular de Especialidades Espíritu Santo

 

 

Pedro Roberto Rodríguez Díaz, Universidad de Guayaquil

 

 

 

Daniela Abigail Guzñay Muñoz, Universidad de Guayaquil

 

 

 

Gema Gabriela Guzñay Muñoz, Universidad de Guayaquil

 

 

 

Paula Elizabeth Pachucho Hernández, Universidad de guayaquil

 

 

Flor Fernanda Lituma Vásquez, Universidad Católica de Santiago de Guayaquil

 

 

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