An unusual case of abdominal pregnancy after bilateral tubal block

Abstract

Here, we report a rare case of abdominal pregnancy after left-sided proximal tubal occlusion and right-sided salpingectomy. A 28-year-old patient came to us with a history of primary infertility. On investigations, left mid-tubal block and right hydrosalpinx were seen. Laparoscopic right salpingectomy with left proximal tubal occlusion was done. In vitro fertilization was done, but result was negative. One and a half months later, the patient presented with amenorrhea of 6 weeks and Transvaginal sonography showed gestation sac in the left adnexa. Emergency laparoscopy was done. The left tube was skeletonized after adhesiolysis, but no pregnancy was seen in the tube. Gestational sac was identified in the lateral pelvic wall. Severe bleeding was encountered during removal and sac was finally removed after laparotomy. Histopathological examination (HPE) of the tube showed endometriosis and HPE of the sac showed trophoblastic tissue without any ovarian tissue. The absence of ovarian tissue in HPE of sac confirms this case as abdominal pregnancy.