DOI: 10.36347/sjmcr.2018.v06i06.001

Pages: 368-371

Ectopic pregnancy in the interstitial part of the fallopian tubes is a rare event, associated with a high rate of complications due to delayed diagnosis. Rupture of such pregnancy often results in catastrophic hemorrhage. The differential diagnosis of acute abdominal pain in pregnancy is broad and can be complicated by atypical manifestations. Due to the lack of clinical understanding, angular or interstitial pregnancy does not appear to be recognized as a clinical entity and many cases are likely to go undiagnosed or incidentally diagnosed at laparotomy. This is a case report of an 18-year-old woman who was admitted in the obstetrics emergency department with 22 weeks pregnancy with severe lower abdominal pain. It was her first pregnancy and USG revealed intrauterine alive pregnancy of 22 weeks. At first she was managed conservatively but her condition was not improved. So, after consultation with general surgeon a decision for emergency exploratory laparotomy was done. Surprisingly it was a case of ruptured uterus and an about 22-weeks fetus with placenta and membranes lying freely in the peritoneal cavity. It was suggestive of a interstitial ectopic pregnancy which had grown upto 22 weeks, invaded the uterine cavity thus forming an angular ectopic, which ended up as the catastrophic event.