A ruptured ovarian ectopic pregnancy presenting as acute abdomen: A case report

Ovarian ectopic pregnancy (OEP) is a well-known but rare type of ectopic pregnancy, accounting for approximately 0.5 %-3 % of all ectopic pregnancies. It is a potentially fatal type of ectopic pregnancy. Preoperatively diagnosis is difficult, as it can mimic tubal pregnancy or complicated ovarian cysts. The aim of this paper is to highlight the possibility of OEP in females presenting with acute abdomen and the necessity of prompt diagnosis and management of patients.

A 28-year-old multiparous mother who had been amenorrheic for 4 weeks presents with a complaint of abdominal pain lasting 4 days. She had diffuse abdominal and cervical motion tenderness. The investigations revealed moderate anemia and right complex adnexal mass with hemoperitoneum. Right salphingoophrectomy was done for an assessment of ruptured ectopic pregnancy. Histopathologic examination confirmed ovarian ectopic pregnancy.

The incidence of ovarian pregnancy is estimated to be 1 in 7000 to 40,000 live births. It is among the causes of first-trimester maternal death. The use of intrauterine devices (IUDs) and assisted reproductive technologies (ART) are among the proposed mechanisms of OEP. The diagnosis is usually made postoperatively and confirmed by histopathological examination.

OEP is a rare potentially fatal condition. It is a diagnostic challenge since it is rare and mimics tubal ectopic pregnancy and complicated ovarian cysts. It should always be considered in patients presenting with amenorrhea, vaginal bleeding, and abdominal pain, particularly in those using an IUD. Surgery is the mainstay of management, and histopathologic examination is crucial for confirming the diagnosis.