Early Primary Abdominal Ectopic Pregnancy

Background: Primary abdominal ectopic pregnancy is extremely rare. Abdominal ectopic pregnancy is often overlooked. This case is to report an early primary abdominal ectopic pregnancy managed successfully. Case report: A 32-year nulliparous woman presented with presented with sudden onset acute lower abdominal pain. Urine pregnancy test was positive. Ultrasonography of the pelvis showed a right adnexal mass with gestational sac. Emergency laparotomy was performed and noted an abdominal ectopic pregnancy on the right side of the adnexa adhered to large bowel. Adhesiolysis was done and the mass was removed. On postoperative day-4, inj methotrexate was administered and patient recovered. Conclusion: Every gynaecologist needs to have a high index of suspicion and a better understanding and interpretation of clinical and image findings and deal promptly to obviate grievous consequences. Teaching points: 1. Early primary abdominal ectopic pregnancy can be safely managed with surgical intervention without grievous consequences. 2. Inj. Methotrexate can be used in the management of abdominal ectopic pregnancy when there is doubt of residual trophoblastic tissues left behind.