Case report of ectopic pregnancy on transverse colon

Abstract

Abdominal ectopic pregnancy is a rare form of ectopic pregnancy, and there are a few cases of colonic implantation reported in the literature. In this report, we describe a unique instance of transverse colonic large hematocele associated with degressive ectopic pregnancy. Patient concerns: A 30–year–old female patient suffered abdominal pain and digestive disorders and did not report any gynecological diseases. The only indicator to diagnose gestative condition was beta-HCG, which increased slightly from 415IU/L to 435IU/L after 2 weeks. Transvaginal ultrasonography shows no evidence of a gestational mass inside the uterus or in the cul-de-sac, which is a frequent site of ectopic pregnancy. But abdominal CT with contrast injection revealed a hyperdense mass measuring 50´53´101mm along the edge of the right colon. A diagnosis of abdominal pregnancy was suspected. Thus, the patient underwent explanatory laparoscopy to confirm the diagnosis and for the treatment. Pathological examination confirms the diagnosis of transverse colonic ectopic pregnancy. After a few days of uncomplicated recovery, the patient was cleared to return home. On the first day following surgery, the beta-HCG results decreased to 112IU/L, and additional testing produced negative results. Conclusion: Ectopic pregnancy may be implanted anywhere in the abdominal cavity even on the transverse colon. When diagnosing a female patient of reproductive age with an inexplicable rise or even low blood BetaHCG level, clinicians must consider the potential of abdominal ectopic pregnancy.