Tubal Ectopic Pregnancy 12 Weeks after Laparoscopic Supracervical Hysterectomy and Tubal Ligation

Abstract

Introduction: Since 1895, at least 67 ectopic pregnancies have been reported in patients previously subjected to hysterectomy.Most of them were abdominal or vaginal total hysterectomies. Only four cases of ectopic pregnancies in patients who hadundergone hysterectomies have been reported after a laparoscopic supracervical hysterectomy (LSH), with three of themhaving occurred years after surgery.Case Report: A 40-year-old white Caucasian woman was admitted to the emergency room with acute abdominal pain for 20min, 12 weeks after LSH and tubal ligation. Rapid examination using ultrasounds scan did not show free liquid in the abdomen,and initially, the cause of pain was not identified. However, the patient became unstable and 4 h after symptom presentation,a second ultrasound scan revealed a significant amount of free liquid in the abdomen. Quantification of β-HCG confirmed thesuspicion of a ruptured tubal ectopic pregnancy.Conclusions: Ectopic pregnancy is one of the conditions to be considered in differential diagnosis of abdominal pain in womenof child-bearing age. To the best of our knowledge, this is the first report of an ectopic pregnancy occurring as early as 3 monthsafter LSH and tubal ligation.