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Ectopic pregnancy after cesarean hysterectomy
Wendi D Brown1, Lara Burrows, Catherine S Todd
1Department of Obstetrics and Gynecology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
Background:
Ectopic pregnancy after a total abdominal hysterectomy is rare and, for this reason, delay in diagnosis may occur when such a patient presents with abdominal pain.
Case:
A multiparous patient with a history of cesarean hysterectomy 12 years before presented to the emergency department with abdominal pain and incidental positive urine beta-human chorionic gonadotrophin (hCG). A computed tomography scan revealed a loculated left cystic mass in the pelvis. Laparotomy findings revealed a left adnexal mass; pathology revealed chorionic villi consistent with pregnancy.
Conclusion:
Ectopic pregnancy may occur after hysterectomy, but typically presents near the time of surgery and is more commonly associated with vaginal hysterectomy. However, because ectopic pregnancy is possible after hysterectomy, it should be considered in the differential diagnosis of adnexal mass in such a patient.
