Primary peritoneal ectopic pregnancy: A case report

Introduction: Primary peritoneal ectopic pregnancy is a rare condition that can be life-threatening. Herein, we report such a case which was managed by laparoscopy. Presentation of the case: A 31-year-old G1P0 woman, who had a history of pelvic infection and primary infertility, presented with lower abdominal pain and mild vaginal spotting. Abdominal and bimanual pelvic examination revealed mild left pelvic tenderness. Her serum β-human chorionic gonadotropin (β-HCG) was 7247 IU. Transvaginal ultrasound demonstrated a mass measuring around 1.5 cm in diameter with a well-defined yolk sac adherent to the left ovary. A left fallopian tube ectopic pregnancy was suspected. Laparoscopy revealed that both fallopian tubes were normal and freely moving. Peritoneal ectopic pregnancy was seen behind the uterus which was removed laparoscopically. Histopathology confirmed the diagnosis. The patient had a smooth postoperative recovery. Discussion: Primary peritoneal pregnancy can be life-threatening. A thorough laparoscopic examination of the entire pelvis and abdomen should be done by an experienced surgeon when the location of the suspected ectopic pregnancy could not be identified. Conclusion: Diagnostic laparoscopy for ectopic pregnancy should include the whole pelvis and the accessible part of the abdomen when the tubes and ovaries are normal.