Korean J Obstet Gynecol.  2011 Apr;54(4):223-227. 10.5468/KJOG.2011.54.4.223.

A case of laparoscopic treatment of the retroperitoneal ectopic pregnancy

• Park BR
• Lee NH
• Ann CO
• Shim HJ
• Jo EK
• Kim YS
• Bae DH

• KMID: 2013248
• DOI: http://doi.org/10.5468/KJOG.2011.54.4.223

Abstract

Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Initial evaluation consists of beta-hCG and pelvic ultrasonography. The fallopian tube is the most common location for an ectopic pregnancy. Other types of ectopic pregnancy include cornual, ovarian, cervical, scar, and abdominal pregnancy. In very rare cases, the abdominal pregnancy may be retroperitoneal. The diagnosis is seldom established before surgery and therapy is surgical resection of the ectopic mass. A 26-year-old woman visited our emergency department with sudden massive vaginal bleeding. She had undergone curettage 3 weeks before. But the transvaginal sonogram of the cul-de-sac revealed no fluid collection. She failed variable-dose methotrexate therapy. On laparoscopic operation, we found a cystic, conception-like structure in the retroperitoneum. Histology of resected structure showed chorionic villi. We describe this case with a brief review of the literature.

Keyword

Laparoscopy; Retroperitoneum; Ectopic pregnancy

MeSH Terms

Adult
Chorionic Villi
Cicatrix
Curettage
Emergencies
Fallopian Tubes
Female
Humans
Laparoscopy
Methotrexate
Pregnancy
Pregnancy Trimester, First
Pregnancy, Abdominal
Pregnancy, Ectopic
Uterine Hemorrhage
Methotrexate

Figure

• 

  Fig. 1 Transvaginal sonogram showed the uterus, right ovary, and 26×17 mm sized right adnexal mass (arrow).

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  Fig. 2 (A) Laparoscopic operation findings showed both adnexas and no fluid collection of cul-de-sac. (B) About 25 mm sized dome like mass covered with retroperitoneum was shown between uterosacral ligament and right ovary at laparoscopy and diagram. (C) After resection of the retroperitoneal ectopic mass was seen.

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  Fig. 3 The pathologic findings showed trophoblastic villi adherent to the retroperitoneum (H&E, ×100).

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