doiSerbia

Secondary abdominal appendicular pregnancy: Case report

Rosso Mićo (J.J. Strossmayer University, Department for Gynecology and Obstetrics, Osijek, Croatia + Clinical Hospital, Clinic for Gynecology and Obstetrics, Osijek, Croatia)
Šijanović Siniša (J.J. Strossmayer University, Department for Gynecology and Obstetrics, Osijek, Croatia + Clinical Hospital, Clinic for Gynecology and Obstetrics, Osijek, Croatia)
Topolovec Zlatko (J.J. Strossmayer University, Department for Gynecology and Obstetrics, Osijek, Croatia + Clinical Hospital, Clinic for Gynecology and Obstetrics, Osijek, Croatia)
Vidosavljević Domagoj (J.J. Strossmayer University, Department for Gynecology and Obstetrics, Osijek, Croatia + Vukovar General Hospital, Department for Gynecology and Obstetrics, Vukovar, Croatia)
Selthofer Robert (Clinical Hospital, Clinic for Gynecology and Obstetrics, Osijek, Croatia)
Blažičević Valerija (Clinical Hospital, Institute for Pathology and Forensic Medicine, Osijek, Croatia)

Introduction. The case report describes a 29-year-old nulliparous woman that was admitted at the Department of Gynecology and Obstetrics of the Clinical Hospital Osijek complaining of mild abdominal pain without vaginal discharge. Case Outline. The patient’s menstrual cycle was irregular, from 30-45 days. An ultrasound examination showed suspicion of an ectopic pregnancy with a βHCG level of 1358 IU/L. Due to the presence of liquid in the pouch of Douglas the patient underwent emergency laparoscopy, which showed the presence of tumor mass between the right Fallopian tube and the appendix. These two structures associated with adhesions corresponded to secondary implantation after spontaneous tubal abortion which was confirmed by histopathologic analysis. Conclusion. Laparoscopy has emerged as the “gold standard” in the diagnosis and treatment of ectopic pregnancy, in this case the secondary abdominal pregnancy. From the diagnostic point of view, all women of reproductive age should be considered pregnant until proven otherwise, also keeping in mind that ectopic pregnancies can have different locations and many clinical features.

Keywords: ectopic pregnancy, laparoscopy, appendix