DOI: 10.36347/sjmcr.2021.v09i04.006

Pages: 332-335

Background: Ectopic pregnancy (EP) is a common and potentially life- and fertility-threatening condition in early pregnancy. The majority of EP are tubal. Interstitial EP is a rare site of implantation and usually associated with the highest risk of massive and uncontrollable bleeding. Despite the accurate and different diagnostic methods, the correct diagnosis of interstitial EP considered very difficult in early stages. Case Presentation: 20- year old fully lactating female gravida 2 para 1 with a history of normal vaginal delivery and amenorrhea for 5 months, presented with sudden acute abdominal pain 2 days prior to admission. On examination she had pallor tachycardic febrile and hypotensive. Her abdomen was distended and tender. She had a β-human chorionic gonadotropin level of 70 µIU/ml. The abdominal ultrasound showed only a moderate intra-abdominal collection. Emergency laparoscopic intervention revealed a large hemoperitoneum, and bleeding from a ruptured left interstitial ectopic pregnancy. The procedure was accomplished by hand-assisted suturing of the defect to control the bleeding. The patient was discharged after two days in good condition. Discussion: Early rupture of interstitial ectopic pregnancy is rare and seldom reported. Its diagnosis and management are challenging and requires prompt intervention. Although the diagnosis of ectopic pregnancy was valued in our evaluation, the exact diagnosis was unclear because the patient came in an acute abdomen, the fear of viscus perforation was existed, and the possibility of getting pregnancy in postpartum period was unexpected. Conclusion: Ruptured interstitial EP is a life threatened entity. The diagnosis of early ruptured interstitial EP is challenging in an emergency sitting. The final diagnosis usually confirmed during laparoscopic or surgical intervention.