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Sigmoid Microinvasion by an Ectopic Pregnancy.

Joalee Paquette¹, Mathieu Leboeuf¹, Émilie Gorak-Savard¹

¹Department of Obstetrics, Gynecology and Reproduction, Université Laval, Québec QC.

Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC

|December 15, 2016

Summary

Ectopic pregnancies after in vitro fertilization (IVF) can rarely cause intestinal issues. This case highlights a presumed intestinal microperforation from an ectopic pregnancy attached to the sigmoid colon, emphasizing the need for vigilance.

Keywords:

Ectopic pregnancy intestinal microperforations in vitro fertilization methotrexate single-dose methotrexate

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Area of Science:

Reproductive Medicine
Gastroenterology
Surgical Oncology

Background:

Ectopic pregnancies following in vitro fertilization (IVF) with embryo transfer occur in 2.1%–8.6% of cases.
Intestinal involvement is a rare but serious complication of ectopic pregnancy.

Observation:

A 29-year-old woman presented with rectal bleeding.
Diagnostic imaging revealed an ectopic pregnancy adhered to the sigmoid colon.
The patient had a history of ectopic pregnancy treated with methotrexate.

Findings:

Surgical removal of the ectopic pregnancy was performed.
Intestinal microperforations were suspected, necessitating intravenous antibiotic therapy.
The ectopic pregnancy was directly attached to the sigmoid colon.

Implications:

Clinicians must consider ectopic pregnancy in patients with unexplained intestinal bleeding, even after appropriate treatment.
Early recognition and surgical intervention are crucial for managing ectopic pregnancies with gastrointestinal complications.
This case underscores the importance of a multidisciplinary approach in managing complex ectopic pregnancy cases.