Successful medical treatment of a hepatic pregnancy: a case report

A Sibetcheu Tchatou,L Mbuagbaw,E T Mboudou,R Tchounzou

doi:10.1186/s13256-017-1227-1

A Sibetcheu Tchatou, L Mbuagbaw + Show 2 more

Open Access

https://doi.org/10.1186/s13256-017-1227-1

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Abstract

BackgroundHepatic pregnancy is a rare form of abdominal pregnancy, often documented only as case reports.Case presentationWe report here the case of a 24-year-old African woman, gravida 4 para 3, presenting with right upper quadrant pains and metrorrhagia after amenorrhea of 8 weeks 5 days. Elements in favor of the diagnosis of hepatic pregnancy were her clinical presentation, the kinetics of β-human chorionic gonadotropin titers, and the presence of a sub-hepatic mass on ultrasound. We successfully treated this patient with intramuscular methotrexate only.ConclusionsThe interest of this case resides in the rarity of this condition and the therapeutic approach used. Clinicians should raise their index of suspicion for hepatic pregnancy when faced with females of reproductive age with such a clinical presentation.

Highlights

Hepatic pregnancy is a rare form of abdominal pregnancy, often documented only as case reports
Abdominal pregnancies constitute 1.4 % of ectopic pregnancies. This rare form of ectopic pregnancy is associated with high mortality due to diagnostic challenges and the massive intraperitoneal hemorrhage caused by the removal of the placenta [1]
We present this case of hepatic pregnancy diagnosed with noninvasive explorations and medical treatment

Summary

Background

Abdominal pregnancies constitute 1.4 % of ectopic pregnancies. This rare form of ectopic pregnancy is associated with high mortality due to diagnostic challenges and the massive intraperitoneal hemorrhage caused by the removal of the placenta [1]. A hepatic location is extremely rare and described only as case reports In these circumstances, treatment options are not as well defined as they are with tubal ectopic pregnancy. Case presentation A 24-year-old African woman, gravida 4 para 3, presented with a 2-week history of right upper quadrant pain and an 8 weeks and 5 days amenorrhea with spotting She first consulted in a secondary health facility where her clinical evaluation revealed a hepatomegaly on abdominopelvic ultrasound and positive urinary pregnancy test without intrauterine or tubal gestational sac. We suspected acute cholecystitis or acute viral hepatitis in pregnancy On another abdominopelvic ultrasound, a heterogeneous poorly vascularized mass was visible under the right lobe of her liver, of size 42 × 38 mm.

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