Primary Abdominal Pregnancy- HEPATIC PREGNANCY

34 yr old female presented with abdominal pain and vomiting Chief Complaints 34 year old G6 P2 A1 MTP 2 Presented with history of amenorrhea for 2 months. History of abdominal pain and vomiting since 4 days. History History of generalised abdominal pain since 4 days. History of multiple episodes of vomiting. Previous 2 normal vaginal deliveries. Vitals Pulse 110/ min. BP 90/ 60 mmHg Physical Examination Pallor present. No icterus. Per abdomen. Generalised tenderness present . Per vaginal examination uterus normal size. Fornices free. CET negative Investigations UPT positive. Hb 7 gm% Ultrasound revealed Single live fetus attached to lobe 6 of liver. Uterus normal ..bilateral adnexa normal. Hemoperitoneum present. Diagnosis Pt was taken for laparotomy after starting iv fluids for resuscitation. OT findings. Uterus normal size. Bilateral fallopian tubes and ovaries normal. Clots seen extending from right hypochondriac region to pelvis. Ectopic pregnancy seen attached to lobe 6 of liver with a rent and active bleeding. Management Resection of ectopic gestation along with part of liver done with harmonic scalpel. Bilateral tubal ligation done as pt was willing for ligation. 3 pint packed cells transfused. Post op pt discharged on 11 th postop day

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Thanks Dr Viraj .R.Naik for this post of the rarest of rare cases of primary hepatic pregnancy. This case should have been reported on a National or international journal With persistently rising hCG levels and no pregnancy identified in the uterus or pelvis, there should be a thorough evaluation of the entire pelvis and abdomen. Magnetic resonance imaging is a useful tool for locating such an ectopic pregnancy. Now we should also have hepatic pregnancy in mind in such cases

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A case of multipara with ECTOPIC PREGNANCY Educational one sir Well done

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Rarest of rare case and competently handled by you and ur team a hepatic pregnancy is beyond my imagination but it is true . Congratulations and thanks for sharing this matter piece case with all of us.

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Rarest of Rae case Good surgey

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Extremely rare case wth higher mortality Well maneged Congratulation sir !

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rare case thanks for sharing sir

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Rarest case

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Thank you for sharing this case and explaining it so precisely and management ofcourse. The images are also clear

Excellent work Pure diagnosis

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