Edgar Allan Villagomez Mendoza, Pilar Alejandra Boix Escobar, Marco Antonio Cuellar Miranda, Hanzel Azael Espinosa Aguilar
Ectopic pregnancy develops when the blastocyst implants outside the endometrial cavity. Its most frequent location is fallopian tubes that account for 96% of all ectopic pregnancies, whereas 11% occur in the fimbrial end. Once the implantation of ectopic pregnancy has been attained, the villi rapidly invade the endosalpinx, and then it reaches the tubal wall and peritoneum. This penetration is accompanied by vascular proliferation and a peritubal hematoma or hematosalpinx that often affects the contralateral tubal portion. This is the clinical case report of 31 years old patient who reported to the emergency department with complaints of abdominal pain localized to the hypogastrium and mild vaginal bleeding. Her Beta HCG was 9462 miU/mL. The current gestation’s status was not known however, the patient gave a history of 7 weeks of amenorrhea. Endovaginal ultrasound was performed for high suspicion of ectopic pregnancy, findings of which were suggestive of left salpingitis. Exploratory laparotomy was performed which revealed a right ectopic pregnancy and left hematosalpinx. In this case report, hematosalpinx was observed to coexist with concurrent ectopic pregnancy. Unilateral salpingo-oophorectomy on the right side was performed as right ovarian parenchyma was compromised. However, in light of the patient’s wishes for future pregnancy, hematosalpinx on the left side was successfully managed through the technique of puncture and drainage. The approach to the management of such cases must always be individualized and the patient’s wish for future conception should be taken into consideration.
Ectopic pregnacy; hematosalpinx; fimbrial ectopic pregnancy.