Leaking Ectopic Pregnancy Following In vitro Fertilization with Associated Acute Appendicitis

Ectopic pregnancy associated with appendicitis is rare, with very few cases reported in the literature. It is unclear if appendicitis is coincidentally associated with ectopic pregnancy or a possible risk factor for the development of ectopic pregnancy. Ruptured ectopic pregnancy has also been postulated as a possible risk factor leading to appendicitis because of the probable inflammatory reaction involving the adjacent appendix.

We present a 34-year-old female who presented with right lower abdominal pain and bleeding per vaginam, three weeks after in-vitro fertilization and embryo transfer.

A diagnosis of ectopic pregnancy was made following a positive β-HCG and empty uterine cavity on pelvic ultrasound scan. Intraoperatively, the appendix was noted to be inflammed and it was removed and confirmed on histology examination as acute appendicitis.

Ruptured ectopic pregnancy associated with acute appendicitis is rare, with few cases reported in the literature. We recommend an examination for other possible differentials of ruptured ectopic pregnancy like appendicitis during surgery for ectopic pregnancy on the right side.